Acerca de Know Your Contract Current Collective Bargaining Agreement The Housestaff Association Collective Bargaining Agreement is the contract between HSA and Cook County Health. It establishes many of the rights, benefits, protections, and working conditions that apply to interns, residents, and fellows in the bargaining unit. Below you can view or download the current full Collective Bargaining Agreement and the current contract extension agreement. Full Collective Bargaining Agreement Review the complete HSA Collective Bargaining Agreement, including provisions related to compensation, benefits, scheduling, leave, educational support, grievances, discipline, and more. Quick Contract Highlights The current agreement includes important protections and benefits for HSA-represented residents and fellows, including: Commonly Used Sections: Salary & Stipends — pp. 3, 6, 8–11 Hours & Scheduling — pp. 28–31 Educational Stipend — p. 42 Leave — pp. 31–36 Discipline & Remediation — pp. 43–45 Grievance Procedure — pp. 45–48 Disability Insurance — p. 40 Wage increases through the current extension period. A $2,500 lump-sum payment for eligible housestaff working in December 2025 A $240 per-paycheck meal stipend Health, dental, vision, and disability benefits Educational stipend and reimbursement protections Limits and protections related to work hours and scheduling Due process and representation in disciplinary or remediation-related matters A formal grievance process to enforce the contract Paid leave and holiday protections Not Sure What Applies to Your Situation? The contract can be lengthy, and not every workplace issue is straightforward. Reach out to HSA if you have questions about scheduling, compensation, leave, reimbursements, benefits, discipline, patient care, safety, or another workplace concern. Email HSA: admin@hsacc.org Grievance Support: grievances@hsacc.org Need Help With a Workplace Issue? If you believe the contract may have been violated, or you are unsure where to start, contact HSA before responding to management or signing documents related to a workplace concern. Contact HSA / Request Support

Join your union Your union at Cook County Health The HSA represents interns, residents, and fellows at Cook County Health. When you become a dues-paying member, you enhance our ability to negotiate, enforce contracts, support our members, and advocate for improved working conditions, better training, and superior patient care. SIGN UP NOW Eligibility: If you are an intern, resident, or fellow at Stroger Hospital, you can join the HSA. Membership offers benefits such as training on your rights and access to exclusive member savings. How to Join: Fill out the form below, email us at admin@hsacc.org , or contact your representative. Monthly Meetings: All members are welcome to our monthly council meeting on the first Thursday of each month from 5:30 PM to 7:00 PM, held in person with a virtual option. Non-members may attend with council approval. For details, email admin@hsacc.org or reach out to your representative. Why Join HSA? Stronger Contract Enforcement Your dues support the resources HSA needs to enforce the contract and protect members’ rights. More Bargaining Power Membership gives HSA the strength to fight for better pay, benefits, scheduling protections, leave, educational support, and safer working conditions. Support When Issues Come Up HSA helps members navigate workplace concerns, grievances, remediation, discipline, pay issues, reimbursement problems, scheduling concerns, and more. Member Benefits HSA members can access union benefits, discounts, and resources through HSA, NUHHCE, AFSCME, and Union Plus. We Are Physicians and Trainees HSA members are both physicians and trainees. Our contract helps protect the conditions that make strong training possible — including fair schedules, educational support, due process, and a voice in decisions that affect patient care and residency education. Through HSA, residents and fellows can organize around issues like remediation, advancement, supervision, educational time, reimbursements, patient care standards, and safe working conditions. While the ACGME standards set important minimum requirements, but a union contract gives housestaff a legally binding way to enforce workplace rights and negotiate protections that reflect the reality of training at Cook County. Training protections Advancement, supervision, remediation, and non-renewal should be fair and transparent. Educational support Stipends, reimbursements, board prep, and required materials matter. Due process Career-impacting decisions should not happen without a clear process. Patient care voice Residents and fellows need a say in the systems where they provide care. When housestaff organize together, we strengthen both our workplace and our training. Unions Make Work Better Unions protect benefits Union contracts help secure leave, health insurance, disability benefits, and paid holidays. Union contracts help raise standards for everyone — and they are especially important for workers who are too often underpaid, undervalued, or excluded from workplace power. Unions narrow pay gaps Collective bargaining helps reduce racial and gender wage gaps. Unions raise wages Union workers earn more on average than nonunion workers. Unions give workers a voice A union gives workers a collective way to address safety, scheduling, discrimination, and workplace concerns. Stronger together. Better for everyone. Did you know unions help close pay gaps? +9.8% Women represented by a union are paid more than nonunion women on average. +12.6% Black workers represented by a union are paid more than nonunion Black workers on average. +16.4% Hispanic workers represented by a union are paid more than nonunion Hispanic workers on average. Source: Economic Policy Institute analysis of union representation and wages.

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HSA Statement and Solidarity Actions for Friday, January 23 Dear HSA Members, As healthcare workers and union members, we share a core commitment: hospitals must be places of safety, dignity, and care for all people. When policies or enforcement actions create fear in our communities or interfere with access to care, they directly undermine our work as clinicians, learners, and advocates for public health. In recent weeks, federal Immigration and Customs Enforcement (ICE) activity has intensified across the Midwest, with significant impacts in Minneapolis–St. Paul and here in Chicago. Community members, workers, and healthcare professionals have raised serious concerns about the effects of these actions on immigrant communities, public trust, and safety. In Minnesota, medical staff at public hospitals have publicly expressed alarm about ICE presence in and around healthcare settings, warning that enforcement activity may deter patients from seeking care and disrupt the delivery of safe, effective medical services. These concerns resonate deeply with us at Cook County Health. Many of the patients we serve — and many of our coworkers — are part of immigrant communities that already face structural barriers to accessing care. Actions that increase fear or uncertainty around hospitals risk worsening health outcomes, delaying treatment, and eroding the trust that is essential to patient care and medical education. Healthcare settings should be places of healing and learning — not sites of intimidation or enforcement. In response to the escalation of ICE activity, labor unions and community coalitions in the Minneapolis–St. Paul area have called for a Day of Truth and Freedom on Friday, January 23. This action asks people to withhold labor and economic participation and to engage in protests or solidarity actions as a collective statement in support of immigrant communities and accountability in federal enforcement practices. While Minnesota is the focal point, solidarity actions and conversations are unfolding in cities across the country, including Chicago, reflecting a broader labor and immigrant justice movement. It is important to understand that this call for action is not a traditional, contract-ratified strike under collective-bargaining protocols. Rather, it is a community- and labor-led mobilization grounded in shared values: dignity, safety, and care for working-class and immigrant communities. As healthcare workers and union members, we hold dual responsibilities — the right to engage in protected collective activity and the obligation to safeguard patient care and continuity of services. For this reason, the most responsible ways for healthcare workers to engage are those that honor both our solidarity and our professional commitments. Participating off-duty or in non-work-related ways — such as community events, advocacy, education, or mutual aid — allows members to show support while ensuring that patient care and training responsibilities are not compromised. Actions that interfere with clinical duties or continuity of care may carry professional or contractual consequences, and members should remain mindful of workplace policies. For those who are unable to attend protests or public actions, there are still powerful ways to support communities affected by ICE enforcement. This includes participating in Know-Your-Rights education, supporting mutual aid and legal defense efforts, and contributing to rapid-response funds that provide food, housing assistance, healthcare access, and legal support to impacted families. Collective care takes many forms — and all of them matter. There are also concrete, everyday ways to demonstrate solidarity that are visible, values-aligned, and compatible with our roles as healthcare workers. Solidarity does not have to look the same for everyone. For members who want to participate in visible, values-aligned ways while remaining attentive to patient care and workplace responsibilities, here are a few meaningful options: ·       Wear HSA or union apparel on Friday as a visible sign of solidarity with immigrant communities and the broader labor movement. ·       Participate in the economic blackout where possible by avoiding purchases at the hospital café or nearby businesses across the street during the day. ·       Contribute to mutual aid by bringing: o   Canned or boxed, shelf-stable food, or o   Clean, gently used coats Donation boxes will be available in the main lobby downstairs. If you have questions about appropriate items or distribution, social workers on your floor or in the Emergency Department can help guide you, or you can check in with a Family Medicine resident on the 8th floor. For members who want to take an additional step beyond visible solidarity or mutual aid, contacting elected representatives can also be a quick and effective form of advocacy — and you do not need to be an expert to do it well. Many tools provide short scripts and automatically connect you to the correct offices: ·       5 Calls ( 5calls.org ) — helps you find your federal and state representatives and provides brief call scripts on current issues. ·       USA.gov – Find Your Elected Officials ( usa.gov/elected-officials ) — a direct way to identify your representatives and their contact information. ·       ACLU Action ( aclu.org/action ) — offers advocacy resources and action alerts related to immigrant rights and civil liberties. If helpful, here is a short guiding script: “As a constituent and healthcare worker, I am calling to urge my representative to oppose ICE operations in our cities, particularly in and around healthcare settings. I also urge support for policies that ensure access to care and patient safety for immigrant communities.” These actions may feel small on their own, but taken together, they demonstrate collective care, shared values, and solidarity with communities directly impacted by immigration enforcement — all while honoring our responsibilities as healthcare workers. HSA stands in solidarity with immigrant communities, healthcare workers, and labor organizations calling for systems rooted in care rather than punishment. We remain committed to advocating for hospitals that are safe spaces for healing and learning, to protecting our members, and to supporting the communities we serve. If you have questions or want to talk through how to engage thoughtfully, your HSA representatives are here to support you. In solidarity, Housestaff Association Leadership

Residents united in support of patient safety and optimal learning conditions: Dear Leadership,  We are writing to express our outrage and deep disappointment regarding the sudden and unilateral curricular changes to the Neuro ICU and MICU rotation, changes being implemented in less than one month without adequate notice. Today, we join together in collective action alongside our IM, FM, and EM colleagues because it is clear our voices are not being heard through traditional channels.  These changes were crafted behind closed doors, with little transparency and even less regard for the concerns raised by the Curriculum Committee, our peer-selected representatives who are simply advocating for the best interests of the residents. This is not collaboration. It is dismissal.  With the academic year just over 2 weeks away, there is still no clear or finalized schedule for either ICU rotation. Why are we forcing residents into a mandatory Neuro ICU rotation when there are already issues getting elective time in their specialty of choice, not to mention critical staffing needs in Firm C Blue that would benefit from these same residents? Why not focus efforts on strengthening the general neurology curriculum first, rather than patchworking an ill-conceived plan at our expense?  As for the MICU, in an era when programs nationwide are abandoning 24-hour call structures, this administration is inexplicably reinstating a 24+4 q4 call model. This regressive move worsens the schedule, removes essential supervision for interns on post-call days, and eliminates a valuable learning role for day float seniors—undermining both education and patient safety.  To date, leadership has not even had the courtesy to formally announce these sweeping changes to the IM residents outside of the Curriculum Committee or hold a single Town Hall to hear resident concerns. Since we’ve been denied the opportunity to speak, we are presenting you with the results of our resident survey, which overwhelmingly reflect how deeply unpopular and unsafe these changes are.  We are left with no choice but to take action. This collective action is not symbolic—it is necessary. Our learning, safety, and dignity demand better.  The IM Residents  Click here to review the polling data from the Internal Medicine Residents.