Dear Colleagues,

This morning, unions representing employees at UCSF Benioff Children’s Hospital (BCH) Oakland began striking. Some unions have committed to a five-day strike ending Monday, June 23, while others have announced open-ended strikes or ongoing picketing activity.

UCSF Benioff Children’s Hospital Oakland is a vital part of our mission. Our top priority remains maintaining safe, high-quality care for the patients and families who rely on us. With the strike underway, teams at BCH Oakland and across UCSF Health are actively managing operations to reduce disruption and ensure continuity of care. We respect the rights of represented employees to participate in labor actions and the decision of others to continue supporting patient care during this time.

This labor action is centered on a planned integration of BCH Oakland into UCSF Health’s broader system — bringing the Oakland hospital into alignment with UCSF’s infrastructure, clinical systems, and employment model. We are confident that this transition will strengthen our entire pediatric health system — expanding access for patients, creating long-term value for employees, and better connecting care across the Bay Area.

To maintain safety and manage capacity, BCH Oakland has temporarily adjusted operations across ambulatory, surgical, and inpatient services. Elective visits and surgeries are being rescheduled, in-person care is prioritized for urgent needs, and inpatient census is reduced. The Emergency Department remains open for ambulance-based trauma care, and interfacility transfers are being reviewed based on capacity. UCSF physicians remain accessible through the Access Center to support referring providers.

This transition isn’t just about systems — it’s about people. Integration will make it easier for patients and families to access coordinated, high-quality care, no matter where they enter the UCSF Benioff Children’s network. For UCSF Health, it represents a crucial step toward building a more connected, resilient system of care — bringing teams, tools, and protocols together to better serve communities across the Bay Area.

‌For employees, integration brings meaningful long-term benefits. It includes a more valuable retirement plan — with an accrual rate at least 56% higher than current plans — earlier retirement eligibility, and lifetime retiree health coverage for eligible employees. It also opens access to performance-based bonuses through UCSF Health’s Incentive Award Program, which rewards staff for contributing to organizational success.

It’s true that many employees will see a change in their monthly paycheck as they begin contributing to retirement and health benefits — just like their peers across UCSF and most public institutions in California. Most union-represented employees will continue to have access to a $0 monthly premium plan. For NUHW members who currently pay $0, the new plan under UCSF Health will cost around $40 per month for individuals earning $68,000 or less. These contributions come with significantly more generous long-term benefits, including UC-subsidized health coverage that pays up to 91% of premium costs for lower-wage employees.

‌Every employee has been mapped to a role at UCSF based on their current position. While some job titles are changing to align with UC standards and union agreements, all roles have a place in the new structure. Importantly, wages will now be aligned with colleagues across the Bay, supporting equity by ensuring employees are paid the same for the same work.

Strikes are always disruptive — and especially so for a safety-net hospital like BCH Oakland. But this moment also underscores why integration matters and what’s at stake: a stronger, more unified pediatric care system that delivers on our mission across San Francisco and Oakland.

We’re grateful to the teams at BCH Oakland for their resilience, and to all UCSF Health colleagues who continue to support patients and each other during this time.‌

Thank you for your continued commitment.

‌Suresh Gunasekaran
President & CEO, UCSF Health‌

‌Nicholas Holmes, MD, MBA
President, UCSF Benioff Children’s Hospitals
Senior Vice President, Children’s Services, UCSF Health