To: Board of Supervisors
From: Monica Nino, County Administrator
Report Title: Resolution approving the Memorandum of Understanding between Contra Costa County and the California Nurses Association
Recommendation: Recommendation of the County Administrator
RECOMMENDATIONS:
ADOPT a Resolution approving the Memorandum of Understanding between Contra Costa County and the California Nurses Association, implementing negotiated wage agreements and other economic terms and conditions of employment for the period of September 1, 2026, through November 30, 2029.
FISCAL IMPACT:
The general wage adjustments are anticipated to increase costs by approximately $9.08M in FY 26/27, $8.9M in FY 27/28, $8.67M in FY 28/29, and $1.45M in FY 29/30. The Nurse Practitioner salary increases and evening differential will have an annual cost of approximately $645,000 annually beginning on September 1, 2027. Costs for the telehealth incentive will be based on productivity and are anticipated to be offset by increased telehealth visits.
Changes to professional development are anticipated to increase costs by up to $118k annually, depending on usage. The bilingual stipend will increase costs by $138k annually and the modification of call-back language amounts to an annual cost of $145k. The increased cost for Public Health Nurse longevity pay is expected to amount to approximately $140k in FY 26/27, and will have an ongoing cost based on length of tenure by individual nurses.
BACKGROUND:
The California Nurses Association (CNA) began bargaining with Contra Costa County for a successor Memorandum of Understanding beginning July 21, 2025. The parties reached a tentative agreement on August 13, 2026. The CNA ratified the tentative agreement on August 19, 2026. The resulting Memorandum of Understanding between the County and the CNA, attached, includes modifications to wages, working conditions, and other economic items.
In summary, those changes are:
Section 64 (Ambulatory Care Nurses)
• Delete obsolete MOU section.
Section 53.3 (Expanded Roles) and Section 53.4 (Filling Expanded Roles)
• Delete obsolete MOU subsections.
Section 5 (Salaries)
• Section 5.1 (General Wages):
o Effective September 1, 2026, base salary for all classifications represented by the CNA will be increased by four percent (4%).
o Effective September 1, 2027, base salary for all classifications represented by the CNA will be increased by three percent (3%).
o Effective September 1, 2028, base salary for all classifications represented by the CNA will be increased by three percent (3%).
o Immediately before applying the September 1, 2026, across the board salary increase, the first step of the annual salary range for the Health Services Education and Training Specialist classification will be increased to $180,790.181, and the top salary step for that classification will be increased to $225,782.162.
o Immediately before applying the September 1, 2027, across the board salary increase, the base rate of pay for the Nurse Practitioner classification will be increased by five percent (5%).
• Section 5.2 (Longevity Pay)
o Effective January 1, 2028, employees in the Public Health Nurse Unit who have completed fifteen (15) years of employment shall receive additional pay in the amount of two and one-half percent (2.5%) for a total of seven and one-half percent (7.5%).
o Effective January 1, 2028, employees in the Public Health Nurse Unit who have completed twenty (20) years of employment shall receive additional pay in the amount of two and one-half percent (2.5%) for a total of ten percent (10%).
• Section 5.3 (Charge Nurse Relief)
o Effective January 1, 2028, the Charge Nurse Relief benefit will be increased to sixty dollars ($60.00) per shift.
• Section 5.4 (Entrance Salary or Wage)
o Causes per diem nurses who are appointed to permanent positions to be appointed at the same permanent salary step they reached as a per diem.
• Section 5.6 (Increments Within Range)
o Cleaned up outdated language.
Section 13 (Vacation Leave)
• Modified language to permit management, at its sole discretion, to pre-approve vacation for more than one employee per classification from each worksite and shift.
Section 6 (Days and Hours of Work)
• Codified and clarified the process by which employees are assigned “extra shifts.”
• Established the requirement that per diem employees must provide availability for at least six (6) shifts each monthly schedule.
• Codified that per diem employees are employed to work as-need on a limited-term, hourly basis.
Section 65 (Duration of Agreement)
• The term of the agreement is from September 1, 2026, to and including November 30, 2029.
Section 52 (Nurse Practitioners)
• Effective September 1, 2027, all evening and weekend assignments for Nurse Practitioners in the Hospital and Clinics Division will be paid an additional 10% of base pay for all hours actually worked.
• Effective September 1, 2027, Nurse Practitioners will receive sixty dollars ($60.00) for each completed billable telehealth visit provided during non-clinical or unscheduled time.
Section 51 (Lunch Period / Rest Break)
• Incorporate the SB 1334 Side Letter adopted by Board Resolution No. 2024-353 into Section 51 (Lunch Period / Rest Break) of the MOU.
Section 24 (Grievance Procedure)
• Modified the Section 24 Grievance Procedure.
Section 12 (Holidays)
• Added June 19th (“Juneteenth”) to list of holidays observed.
Section 7 (Overtime and Compensatory Time)
• Added the West County Re-Entry Treatment and Housing Facility to list of worksites where an employee may opt for compensatory time off in lieu of overtime.
Section 4 (Nurse Representatives)
• Establishes a bank of twenty-four (24) hours per month of paid release time for designated nurse representatives to attend grievance meetings scheduled outside of their regular shift.
• Increases the number of designated nurse representatives from six (6) to eight (8).
• Increases the number of release time hours for training from two hundred forty (240) to three hundred (300).
Section 40 (Workplace Violence Prevention and Safety)
• Establishes a procedure by which the CNA Professional Performance Committees may review the Health Services Department’s Workplace Violence Prevention Plan.
Section 33 (Safety)
• Establishes a rotation by which nurses are given transport assignments.
Section 30 (Training Reimbursement)
• Effective September 1, 2027, costs for career development training will be reimbursed up to $800.00 per calendar year for employees who regularly work twenty-four (24) hours or more per week.
• The year-end carry-over amount of training reimbursement dollars is increased from seven hundred dollars ($700.00) to eight hundred dollars ($800.00).
• The Health Services Department will provide ACLS certification and re-certification classes to those employees who are required to be certified at no cost to the employee.
• All employees will receive training on reimbursement submissions as part of the Health Services Department’s New Employee Orientation (“NEO”).
Section 14 (Sick Leave)
• Added to the definition of “Immediate Family” a registered domestic partner’s child, parent, grandparent, grandchild or sibling.
• Clarified that sick leave may be used for the diagnosis, care, or treatment of an immediate family member’s existing health condition, or preventative care for an immediate family member.
• Expanded the use of sick leave for the death of a family member to five working days, regardless of an employee’s need for travel.
• Modified Section 14.4B (Department Responsibilities) to establish a “reasonable cause” standard for management to require medical verification of absences of less than 3 or more working days.
Section 8 (Call-Back Time)
• Clarifies that only permanent employees are entitled to call-back pay.
• Added the Post-Anesthesia Care Unit to Section 8.2 (Operating Room Call-Back).
Section 9 (On-Call Duty)
• Establishes an on-call scheduling procedure and rotation for the Operating Room and Post Anesthesia Care Units.
Section 25 (Compensation Complaints)
• Eliminated obsolete reference to the Adjustment Board.
Section 3 (No Discrimination)
• Clarified that complaints of unlawful discrimination, harassment, or retaliation will be filed pursuant to the complaint procedures outlined in Contra Costa County Administrative Bulletin No. 429.
• Provides that an employee who files a complaint of unlawful discrimination, harassment, or retaliation may have a nurse representative of their choice accompany them as an observer during any investigation interview regarding the complaint.
Section 2 (Association Security)
• Permits employees to elect to make contributions to the CNA’s Political Action Fund (“PAC”) with voluntary payroll deductions.
• Provides that the County will furnish on a monthly basis a list of information on all new hires into bargaining units represented by the CNA.
Section 28 (Bilingual Pay)
• Effective October 1, 2026, increases the bilingual pay benefit from eighty dollars ($80.00) per month to two hundred dollars ($200.00) per month.
CONSEQUENCE OF NEGATIVE ACTION:
The County will not have a contract with the CNA.
THE BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA
and for Special Districts, Agencies and Authorities Governed by the Board
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IN THE MATTER OF: Memorandum of Understanding with the California Nurses Association for the period of September 1, 2026, through November 30, 2029.
The Contra Costa County Board of Supervisors acting in its capacity as the Governing Board of the County of Contra Costa RESOLVES that:
The Memorandum of Understanding (MOU) between Contra Costa County and the California Nurses Association providing for wages, benefits and other terms and conditions of employment for the period beginning September 1, 2026, through November 30, 2029, for those classifications represented by the California Nurses Association is ADOPTED. A copy of the MOU is attached.
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