After more than three months of waiting for approval, 91 medical providers at Peak Vista Community Health Centers in six southern Colorado communities have received the legal go-ahead from the National Board of Labor Relations to vote on whether to unionize.

Ballots will be mailed Thursday to eligible employees and must be returned before Jan. 2, when votes will be counted and a “yes” or “no” decision will be announced, according to a letter the Union of American Physicians and Dentists received last week from the federal labor board.

“It’s a direct way to have a form of democracy in your workplace if a majority of providers vote in favor of unionization, which we expect them to do,” said Andrew Guttman, a union representative.

“It provides legally protected rights for representation, which makes sure providers have a voice and not be disciplined for speaking out,” he said. “There’s some teeth with that.”

Dr. Emily Ptaszek, president and CEO of Peak Vista Community Health Centers, disagrees that a union is the best route for workers.

“While we are committed to respecting the rights of our providers to choose whether or not to be represented by a union, our preference is to continue working together directly, providing primary healthcare services to people in our community who face access barriers,” she said in a statement.

“We hope our providers will vote ‘no’ for union representation in the upcoming election so that we can continue working directly together on concerns and issues we face in our industry and to strengthen engagement with our provider team,” Ptaszek said.

All full-time and regular part-time physicians, physician assistants, pediatricians, nurse practitioners, obstetrics and gynecology physicians, certified nurse midwives, physician-level psychiatrists and psychiatric nurse practitioners who work at Peak Vista’s 21 clinics in the Pikes Peak region and who were employed through the payroll period that ended Nov. 16 qualify to cast a vote, the letter states.

Some Peak Vista medical providers contacted the California-based Union of American Physicians and Dentists after the beginning of this year when new protocols regarding work hours and quotas on patient counts increased, Guttman said.

Workplace conditions deteriorated over this year, he said, with multiple terminations for what employees called unfair reasons, including suspected backlash for those involved with trying to organize under union representation and as an act of retribution.

That resulted in a complaint of unfair labor practices to the federal agency.

Other employees quit voluntarily, citing intolerable policies and procedures.

“Management is trying to say they have mechanisms whereby employees can give feedback and attain collaboration, but history has proven that not to be true,” Guttman said.

The delay in the labor board issuing a decision that an election could proceed was partially due to leaders of the private nonprofit Peak Vista, which provides medical, dental and behavioral health care to low-income and indigent clients who have Medicaid or are uninsured, objecting to the filing.

Peak Vista submitted four challenges to the union’s request to the National Labor Relations Board to hold an election regarding union affiliation.

Following a hearing in early September with the National Labor Relations Board, Peak Vista’s challenges were denied.

The board cited “insufficient evidence” for Peak Vista’s argument to include dentists and registered hygienists in the same bargaining unit, Guttman said, and the federal agency also struck down holding an election on a single day, which would have excluded per diem providers from participating. Other conditions Peak Vista wanted also were not approved.

Ptaszek said the organization disagrees with the labor board’s decision.

“Unfortunately, the National Labor Relations Board ordered an election among only a portion of our providers; physicians are included, but dentists have been excluded,” Ptaszek said.

“Peak Vista’s position is that all providers should be allowed to vote.”

Peak Vista had 1,063 employees last year, according to its 2023 tax filing. Of the organization’s 140 current contracted providers, 91 are eligible to vote, Guttman said.

Should those employees agree with unionization, Peak Vista — although largely funded by federal dollars is classified as a private nonprofit — would have to recognize the union and agree to collective bargaining to negotiate a master agreement because it is governed by federal labor laws, he said.

“The official declaration of election is proof positive that National Labor Relations Board understands this to be under their jurisdiction, and Peak Vista would be legally required to recognize bargaining,” Guttman said.

The Union of American Physicians and Dentists currently works with 35 bargaining units across the nation and has nearly a dozen new campaigns at various stages of organizing, including Peak Vista.