American Medical Response, Inc.

National Labor Relations Board - Board Decisions

Aug 17, 2005

344 N.L.R.B. 1406 (N.L.R.B. 2005)

DECISIONS OF THE NATIONAL LABOR RELATIONS BOARD
344 NLRB No. 161
1406
American Medical Response, Incorporated and Na-
tional Emergency Medical Services Association
Union, Petitioner
American Medical Response, Incorporated and Eric
Stephens, Employee Petitioner and SEIU United
Healthcare Workers West, Service Employees
International Union,1 Union. Cases 32–RC–5234
and 32–RD–1450
August 17, 2005
DECISION AND DIRECTION OF THIRD ELECTION
BY CHAIRMAN BATTISTA AND MEMBERS LIEBMAN
AND SCHAUMBER
The National Labor Relations Board has considered an
objection (Objection 3) to a mail ballot election held
from February 23–March 16, 2005, and the attached ad-
ministrative law judge’s supplemental report recom-
mending disposition of it.2 The election was conducted
pursuant to a Stipulation on Objections and Challenges
dated December 27, 2004.3 The tally of ballots shows
848 for National Emergency Medical Services Associa-
tion (NEMSA); 580 for SEIU United Healthcare Work-
ers West, Service Employees International Union
(SEIU); 19 against the participating labor organizations;
and 90 challenged ballots, an insufficient number to af-
fect the results of the election.
The Board has reviewed the record in light of the ex-
ceptions and brief, has adopted the administrative law
judge’s findings and recommendations only to the extent
consistent with this Decision and Direction of Third
Election, and finds that the election must be set aside and
a new election held.
Objection 3 alleges that the failure to provide the Em-
ployer’s critical care transport registered nurses (RNs),
who are professional employees under the Act, with a
Sonotone4 ballot warrants setting aside the election. The

1 We have amended the caption to reflect the disaffiliation of the
Service Employees International Union from the AFL–CIO effective
July 25, 2005.
2 SEIU filed 6 objections to the election. The Regional Director di-
rected a hearing on Objection 3 and overruled each of the other objec-
tions. SEIU filed a request for review of the Regional Director’s over-
ruling of Objections 1 and 2. In light of our disposition of Objection 3,
we find it unnecessary to rule on SEIU’s request for review.
3 An initial election was held on August 30 and 31, and September 1
and 2, 2004. All parties stipulated, with the approval of the Regional
Director, that the 2004 election should be considered a nullity and the
results set aside.
4 Sonotone Corp., 90 NLRB 1236 (1950). In Sonotone, the Board
adopted a two-step voting procedure for professional employees in
elections involving both professional and nonprofessional employees.
The ballot includes two questions. The first question asks the profes-
sional employees if they want to be included in a unit of professional
and nonprofessional employees. The second question asks the profes-
judge recommended that this objection be overruled. For
the reasons set forth below, we find, contrary to the
judge, that the election failed to comport with the re-
quirements of Section 9(b)(1) of the Act and accordingly
must be set aside.
I. BACKGROUND
A. The Facts
The facts are undisputed. The SEIU has been the col-
lective-bargaining representative of employees of the
Employer since 1995. Initially, the bargaining unit only
included nonprofessional employees. A collective-
bargaining agreement covering those nonprofessional
employees was entered into and was effective from Oc-
tober 12, 1996 through June 30, 2001. The SEIU and the
Employer subsequently entered into a successor agree-
ment effective from July 1, 2001 to June 30, 2006. In
2002, the Employer’s RNs, who were not at that time
represented by any union, began to express interest in
being represented by the SEIU.5 The parties stipulated
that the RNs are professional employees.
The current collective-bargaining agreement contains a
recognition clause that includes a provision entitled “Fast
and Fair Recognition Procedure.” That provision estab-
lishes a procedure governing “the representation of em-
ployees not currently represented by the Union.” Section
1.4, A.2 states:
If the Union notifies the Employer that it has the major-
ity support in a facility, operation, or class of workers
that is currently unrepresent[ed] as demonstrated by
signed membership cards or a signed recognition peti-
tion, which is verified by the California State Concilia-
tion Service, the parties will jointly request the State
Conciliation Service to conduct a representation elec-
tion within 30 days of the notice.
Section 1.4, A.3 states:
Within a week of the verification of the Union’s major-
ity support, the Employer and the Union will jointly
meet with affected workers to announce the election,
outline the election process, and to jointly commit to
the employees[’] right to choose.
Section 1.4, A.5 states:

sional employees if they wish to be represented by the union or unions
involved.
5 Two geographically separate groups of the Employer’s RNs con-
tacted the SEIU. One was located in the Valley Region of the Em-
ployer’s Northern Pacific Region and the other was located in the
Bay/Coastal Region of the Employer’s Northern Pacific Region.
AMERICAN MEDICAL RESPONSE, INC. 1407
If the Union receives a majority of the votes cast in the
representation election, the Employer shall recognize
the Union as the representative of the affected employ-
ees, cover the affected employees under the terms of
this agreement and bargain over appropriate wage
scales and any other condition of employment, which
may not be covered by this agreement.
Upon learning of the RNs’ interest in being repre-
sented, the SEIU formed an organizing committee to
explain to the RNs the fast and fair recognition process
set forth in the contract. SEIU organizing committee
members communicated with each RN and told each that
a result of voting for the SEIU under the fast and fair
recognition procedure would be the addition of the RNs
to the existing bargaining unit. The SEIU solicited and
received RN signatures on representation petitions.
The petitions were submitted to the California State
Mediation and Conciliation Service (CSMCS), and the
CSMCS agreed to conduct an election. Joint meetings to
announce the election and outline the election process
were then held by the Employer and the SEIU with the
RNs as required by the contract. During those meetings,
the RNs who attended were told and understood that they
would be voting on whether to be represented by the
SEIU as part of the overall bargaining unit.
The CSMCS conducted separate elections among the
two RN groups. The Bay/Coastal Region RNs voted on
June 24, 2002, and the Valley Region RNs voted on Oc-
tober 7, 2002. In each election the ballot question was:
“I choose to be represented by Healthcare Workers Local
250 (SEIU) or No Organization.” The SEIU won both
elections, and there were no objections filed or other unit
or self-determination disputes in either election.
After each election, the Employer recognized the SEIU
as the RNs’ representative as part of the overall bargain-
ing unit, and the Employer and the SEIU negotiated and
executed “side letter” supplements to the contract cover-
ing the RNs.
On March 12, 2004, NEMSA filed a representation pe-
tition seeking to represent employees of the Employer in
a mixed professional and nonprofessional unit, and the
same day an employee filed a decertification petition
seeking to decertify the SEIU in the same unit. A hear-
ing was held, and on July 23, 2004, the Acting Regional
Director for Region 32 issued a Decision and Direction
of Election directing an election in a unit consisting of
both professional employees (RNs), and nonprofessional
employees such as EMTs, drivers, wheelchair van driv-
ers, dispatchers, system status controllers, call takers,
prebillers, and billers. An initial election was held in
August and September 2004, and the question on the
ballot was whether employees wished to be represented
by SEIU, by NEMSA, or by neither. There was no sepa-
rate ballot for professional employees, and the profes-
sional employees (RNs) were not asked if they wanted to
be included in a unit with nonprofessionals. The initial
election was set aside pursuant to a stipulation of the
parties, and a new mail ballot election (the election at
issue here) was held in February and March 2005. The
ballot was the same as in the 2004 election. NEMSA
won the mail ballot election, and the SEIU filed objec-
tions. The RD directed a hearing on Objection 3, the
Sonotone objection, and overruled all the other objec-
tions.
B. The Judge’s Supplemental Report
A hearing on Objection 3 was held before an adminis-
trative law judge. In his supplemental report, the judge
initially found that the SEIU’s failure to raise the
Sonotone ballot issue at an earlier stage in this proceed-
ing did not preclude it from raising this issue now.6
The judge next rejected the contention that Sonotone
voting procedures were necessary in this election. The
judge stated that “the provisions of Section 9(b)(1) of the
Act have been held to require only a single, one time,
self-determination election by professionals . . . .”7 The
judge also stated that the “one time” self-determination
election need not have been a Board-conducted Sonotone
election, and that the Board will accept elections con-
ducted by other agencies, including state agencies, pro-
vided that the state agency’s election procedure was “free
of irregularities and reflected the true desires of the em-
ployees.” Corporacion de Servicios Legales de Puerto
Rico, 289 NLRB 612 fn. 2 (1988).
The judge found that the RNs’ elections in 2002 met
the standard of Corporacion de Servicios Legales, in that
they were free of irregularities, and they tested the true
desires of the professional employees as to whether or
not they wished to be included in the larger bargaining
unit with nonprofessional employees. Because the SEIU
was not seeking to represent the RNs in a free-standing
unit in those elections, by voting for the SEIU the em-
ployees were effectively voting to be represented in a
unit with nonprofessionals. The RNs were well aware of
the purpose and consequences of the 2002 balloting. The
RNs were told both individually by the SEIU agents and
by the Employer and the SEIU agents at employee meet-

6 The judge relied on Pontiac Osteopathic Hospital, 327 NLRB 1172
(1999), in which the Board found that the self-determination require-
ments of Sec. 9(b)(1) of the Act are mandatory and are to be enforced
by the Board where appropriate, irrespective of the position taken by
the parties at any stage of the proceeding. There were no exceptions to
the judge’s finding.
7 The judge did not cite any authority for this proposition.
DECISIONS OF THE NATIONAL LABOR RELATIONS BOARD1408
ings that the question to be presented in the election was
whether or not the nurses wished to join the existing
SEIU-represented unit. The judge concluded, therefore,
that the elections among the RNs in 2002 fulfilled the
9(b)(1) requirement that professional self-determination
elections be held, and that it was not necessary that the
instant Board election include self-determination ballot-
ing of professional employees. Accordingly, he recom-
mended that Objection 3 be overruled.
C. The SEIU’s Exceptions
The SEIU contends in its exceptions that the failure to
provide the RNs with a Sonotone ballot is a violation of
Section 9(b)(1) of the Act. The Act specifically prohibits
the Board from finding appropriate a unit that joins pro-
fessional employees with nonprofessional employees
unless a majority of the professional employees vote to
be so included. It is undisputed that the mandatory
Sonotone procedure was not utilized in this election, nor
was it used in the CSMCS elections in 2002. Thus, those
elections did not conform to the requirements of Section
9(b)(1). Moreover, even if the RNs had acquiesced in
their inclusion in a mixed unit represented by SEIU in
2002, they did not agree to representation by NEMSA in
a mixed unit. The SEIU argues that the election must be
set aside because the absence of a Sonotone ballot in this
election deprived the RNs of the opportunity to vote on
such inclusion, in violation of Section 9(b)(1) of the Act.
II. DISCUSSION
Section 9(b)(1) of the Act provides:
[T]he Board shall not (1) decide that any unit is appro-
priate . . . if such unit includes both professional em-
ployees and employees who are not professional em-
ployees unless a majority of such professional employ-
ees vote for inclusion in such unit[.]
Thus, the Act effectively grants professional employees
the right to decide by majority vote whether they wish to
be included in a unit with nonprofessional employees. In
Leedom v. Kyne, 358 U.S. 184, 191 (1958), the Supreme
Court held that Congress “intended that right to be en-
forced” by the Board. To safeguard that right, the Board
has adopted a special type of self-determination proce-
dure known as a Sonotone election, so named after the
lead case. Sonotone Corp., 90 NLRB 1236 (1950). In a
Sonotone election, the ballots for the professionals in-
cludes two questions. The first question asks the profes-
sional employees if they want to be included in a unit of
professional and nonprofessional employees. The sec-
ond question asks the professional employees if they
wish to be represented by the union or unions involved.
In the instant case, it is undisputed that the RNs are
professional employees and that they were not provided
with a Sonotone ballot. In other words, the election was
held in a unit that, contrary to Section 9(b)(1) of the Act,
combined professional employees with nonprofessional
employees without affording the professionals an oppor-
tunity to vote whether they wished to be included in such
a unit. Therefore, we find that the election must be set
aside.8
The judge’s conclusion that a Sonotone ballot was not
necessary in this election was based on the assumption
that professional employees need only have one opportu-
nity to vote on inclusion in a mixed profes-
sional/nonprofessional unit. However, that assumption is
inconsistent with the Board’s decision in Westinghouse
Electric Corp., 116 NLRB 1545, 1547 (1956). In that
case, the Board rejected the argument that separate
Sonotone balloting was unnecessary because the profes-
sionals had, 6 years earlier, “already enjoyed the statu-
tory privilege” of separately expressing their desire to be
included in a mixed professional/nonprofessional unit.
The Board stated that “[t]here is nothing in the statute
limiting the privilege thus accorded to professional em-
ployees to a single opportunity in the course of their em-
ployment for a particular employer. Nor do we perceive
anything in the statutory language which frees the Board,
in its unit determinations, from the limitation imposed by
Section 9(b)(1) after it has once conformed to it with
respect to any particular group of professional employ-
ees.” This principle was reaffirmed in Westinghouse
Electric Corp., 129 NLRB 846, 848 (1960) (“Section
9(b)(1) of the Act precludes the Board from joining in a
single bargaining unit professional and nonprofessional
employees, without first affording to the professional
employees [an] opportunity to separately express their
desires respecting such inclusion. This is so whether or
not the professional employees have, on a prior occasion,
been afforded such opportunity.”)9

8 A Sonotone ballot is particularly necessary here, where the RNs
have never expressed any view as to whether they wished to be repre-
sented by NEMSA in a mixed professional/nonprofessional unit. The
2002 CSMCS elections involved only the SEIU.
9 We therefore find it unnecessary to pass on the judge’s finding that
the 2002 CSMS elections were equivalent to Board Sonotone elections
and provided the professional employees with an adequate opportunity
to vote on whether to be included in the same unit with the nonprofes-
sionals.
Corporacion de Servicios Legales de Puerto Rico, supra, 289 NLRB
612 fn. 2, cited by the judge, does not require a different result. Indeed,
that case cites the first Westinghouse Electric decision, quoted above,
with approval. Corporacion de Servicios Legales is distinguishable, as
it did not involve the issue presented here of whether a Sonotone ballot
is required in a Board-conducted election involving both professional
and nonprofessional employees held subsequent to a state election.
AMERICAN MEDICAL RESPONSE, INC. 1409
For these reasons, we sustain Objection 3, set aside the
election, and direct a new election providing for a
Sonotone ballot for the RNs. See Sunrise, Inc., 282
NLRB 252 (1986) (setting aside the election is the ap-
propriate action following a failure to provide required
Sonotone ballots).
We shall therefore direct elections in the following
separate voting groups, one consisting of all RNs and the
other consisting of all other nonprofessional unit em-
ployees.
The RNs will be asked the following two questions on
their ballots:
(1) Do you wish to be included with nonprofessional
employees in a unit for the purposes of collective bar-
gaining?
(2) Do you wish to be represented for purposes of col-
lective bargaining by National Emergency Medical Ser-
vices Association; by SEIU United Healthcare Workers
West, Service Employees International Union; or by nei-
ther?
If a majority of the professional employees vote “yes”
to the first question, indicating a desire to be included in
a unit with nonprofessional employees, they shall be so
included. Their vote on the second question will be
counted with the votes of the nonprofessional employees
to decide which union, if any, shall be the representative
for the entire combined bargaining unit. If, on the other
hand, the RNs do not vote for inclusion, their votes on
the second question will be separately counted to decide
whether they want either of the Unions on the ballot to
represent them in a separate professional unit. Similarly,
the votes of the nonprofessionals would be separately
counted to decide whether they want either of the Unions
on the ballot to represent them in a separate nonprofes-
sional unit.
[Direction of Third Election omitted from publication.]
Timothy K. Talbot, Esq. (Carroll, Burdick & McDonough), of
Sacramento, California for NEMSA.
William A. Sokol, Esq. (Weinberg, Roger & Rosenfeld), of Ala-
meda, California for the SEIU.
Julian B. Bellenghi, Esq. (Collins & Bellenghi), of Irvine, Cali-
fornia for the Employer.
Mr. Eric Stephens, pro se, of Santa Rosa, California.

Instead, that case dealt with the applicability of the contract-bar doc-
trine, and the Board decided that it was “not unreasonable to defer the
exercise of the professional employees’ right of self-determination until
the end of the then-current contract.” 289 NLRB at 613.
SUPPLEMENTAL REPORT AND RECOMMENDATIONS
ON OBJECTIONS
STATEMENT OF THE CASE
CLIFFORD H. ANDERSON, Administrative Law Judge. I heard
the above captioned case in Oakland, California on April 27,
2005. The matter arose as follows.
On March 12, 2004, the National Emergency Medical Ser-
vices Association (NEMSA) filed a representation petition with
Region 32 of the National Labor Relations Board (NLRB)
docketed as Case 32–RC–5234 seeking to represent certain
employees of American Medical Response, Incorporated (the
Employer). On the same day, Mr. Eric Stephens, an individual,
filed a representation petition with Region 32 of the NLRB
docketed as Case 32–RD–450 seeking an election to decertify a
bargaining unit of certain employees of the Employer repre-
sented by the SEIU United Healthcare Workers West, Service
Employees International Union, AFL–CIO (the SEIU).
On July 23, 2004, following a consolidated hearing, the Act-
ing Regional Director for Region 32 issued a Decision and
Direction of Election directing an election be held in the con-
solidated cases in the following unit of the Employers Califor-
nia employees (the unit):
Including: all full-time and regularly scheduled part-time reg-
istered nurses, EMT-1s, EMT-2s, EMT-Ps, Drivers, Wheel-
chair Van Drivers, Dispatchers, System Status Controllers,
Call takers, Pre-Billers, and Billers (except for Pre-Billers and
Billers in Stanislaus, San Francisco, Sacramento, Shasta, and
San Joaquin Counties) including bargaining unit personnel
serving as acting supervisors in the following counties: Mon-
terey, Tulare, Santa Cruz, Santa Clara, San Mateo, (except
EMT-Ps covered in a separate Agreement) Stanislaus (ex-
cluding Turlock Operations), Alameda, San Francisco, Contra
Costa, San Mateo, Stanislaus (Vehicle Service Technician
only) and Tulare(Clerk 1s and Clerk 2s only). Also including:
all full-time and regularly scheduled part-time CCTs and
EMT/CCTs in Alameda, Contra Costa, San Mateo and Yolo
Counties, Paramedic/CCTs in Contra Costa, Monterey,
Placer, Sacramento, San Joaquin-Calaveras, and Santa Clara
Counties, CCT/RNs in Alameda, Contra Costa, Monterey,
Sacramento, Santa Clara, and Sonoma Counties; Mail Room
Clerks in Alameda County; Dispatchers and Call Takers in
Modesto and Sacramento Dispatch Centers, EMT-1s and
Paramedics in San Benito County; Vehicle Service Techni-
cians (VST) in Contra Costa, San Joaquin-Calaveras, San
Mateo and Santa Clara Counties; Gurney Van Drivers in Sac-
ramento County, Pre-Billing Representative and Technicians
in San Mateo County; and Service Receipt Processor/Pre-
Billers in Santa Clara County.
Excluding: Advanced Life Support (ALS) paramedics in
Turlock, Tracy and San Mateo County, all other personnel
including guards and supervisors as defined by the National
Labor Relations Act, as amended.
The direction of election provided that all eligible voters in
the Unit would vote whether or not they no longer wished to be
represented by the SEIU, and whether or not they wished to be
represented by NEMSA without discussion or distinction be-
DECISIONS OF THE NATIONAL LABOR RELATIONS BOARD1410
tween professional or nonprofessional employees and without
provision for a separate ballot for professional Unit voters.
An initial election was held on August 30 and 31, 2004 and
September 1 and 2, 2004. The challenged ballots in the vote
were determinative. Timely objections were filed. Thereafter
all parties stipulated, with the approval of the Regional Director
on December 27, 2004, that the election should be considered a
nullity and the results set aside. The issue of professional em-
ployee self determination ballots was not raised.
A new election was conducted by mail ballot from February
23, 2005 through March 16, 2005. The same voter choices were
presented as in the first election. The tally of ballots served on
the parties on March 21, 2005 showed the challenged ballots
were not determinative and that NEMSA had obtained a major-
ity of valid votes cast.
Thereafter the SEIU filed timely objections to the election
which were served on all parties. On April 14, 2005, the Re-
gional Director issued a Report and Recommendations on Ob-
jections and Notice of Hearing. The report overruled all the
SEUI’s objections save its objection number 3. The report
quoted the objection in full and made the following assertions
respecting that objection:
Objection No. 3.
Approximately forty (40) Registered Nurses[1], who
are professionals within the meaning of the Act, were
permitted to vote in the election with ballots exactly
like all other nonprofessional members of the unit,
and were thus denied their right to vote separately as to
whether they wished to be separately represented in a
professional unit of their own, or whether they wished
to be represented as part of the larger nonprofessional
unit.
Section 9(b)(1) of the Act provides that professional em-
ployees may not be included in a bargaining unit with nonpro-
fessionals unless they vote in favor of such inclusion. While
the investigation disclosed that, pursuant to Article 1.4 of the
latest collective bargaining agreement between the Employer
and the SEIU, elections were conducted by the California
State Conciliation Service in 2002 amongst the Employer’s
previously unrepresented critical care transport registered
nurses, hereinafter RNs, which resulted thereafter in the RNs
being included in the recognized unit and covered by the col-
lective bargaining agreement, I have determined that the cir-
cumstances surrounding this election raise material issues of
fact and law that may best be resolved by a hearing.
The Director’s report on objections then directed that a hear-
ing on the SEIU’s objection no. 3 be held and, further directed
that the hearing officer prepare and cause to be served upon the
parties a report containing resolutions of the credibility of wit-
nesses, findings of fact, and recommendations to the Board as
to the disposition of the objection. The matter was assigned to
me in due course prior to the hearing.

1 The instant record establishes that 73 nurses were eligible to vote.
FINDINGS OF FACT
Upon the entire record,2 including helpful briefs3 from the
Employer and NEMSA, I make the following findings of fact.4
1. Bargaining unit history and events
The Employer employs both professional and nonprofes-
sional employees.5 As set forth in the Regional Director’s re-
port quoted above, the bargaining unit as presently composed,
save that no Registered Nurses were included, was represented
by the SEIU and a collective-bargaining agreement was in
place as early as 1996. The initial bargaining unit was therefore
composed entirely of nonprofessional employees under Board
definitions.
The collective-bargaining agreement, effective by its terms
from July 1, 2001 to June 30, 2006, contains a recognition
clause which includes Article 1, Section 4 entitled: “Fast and
Fair Recognition Procedure,” which establishes an elaborate
procedure for adding employees to the collective-bargaining
unit. Section 1.42 of Article 1.4 states:
2. If the Union notifies the Employer that it has the majority
support in a facility, operation, or class of workers that is cur-
rently unrepresented[ed] as demonstrated by signed member-

2 The transcript of proceedings commences its pagination at 263,
presumably following on the pagination of the original preelection
representation hearing. The record includes the original 2-volume
transcript as an exhibit.
3 Briefs were due on May 11, 2005.
4 The findings are based primarily on the written and oral stipula-
tions of counsel at trial, documents of record, and the findings con-
tained in the Regional Director’s Report. In certain cases where noted,
reliable, unchallenged testimony in the instant proceeding and at the
original representation hearings herein was also considered. The record
is essentially free of contested facts beyond arguments of relevancy.
5 The term “professional employee” is a statutorily defined term of
art.
Sec. 2(12) of the Act states:
The term “professional employee’’ means—
(a) any employee engaged in work (i) predominantly intellec-
tual and varied in character as opposed to routine mental, manual, me-
chanical, or physical work; (ii) involving the consistent exercise of
discretion and judgment in its performance; (iii) of such a character
that the output produced or the result accomplished cannot be stan-
dardized in relation to a given period of time; (iv) requiring knowl-
edge of an advanced type in a field of science or learning customarily
acquired by a prolonged course of specialized intellectual instruction
and study in an institution of higher learning or a hospital, as distin-
guished from a general academic education or from an apprenticeship
or from training in the performance of routine mental, manual, or
physical processes; or
(b) any employee, who (i) has completed the courses of special-
ized intellectual instruction and study described in clause (iv) of para-
graph (a), and (ii) is performing related work under the supervision of
a professional person to qualify himself to become a professional em-
ployee as defined in paragraph (a).
In this proceeding, the “Registered Nurses” in the unit, sometimes re-
ferred to as the nurses, were stipulated to be professional within the
meaning of the Act. There was no contention by any party that any
other Unit employees were professionals as defined in the Act. All
non-nurse Unit employees are therefore considered nonprofessional in
the legal noted for purposes of the analysis herein.
AMERICAN MEDICAL RESPONSE, INC. 1411
ship cards or a signed recognition petition, which is verified
by the California State Conciliation Service, the parties will
jointly request the State Conciliation Service to conduct a rep-
resentation election with 30 days of the notice.
Section 1.43 of Article 1.4 states:
3. Within a week of the verification of the Union’s majority
support, the Employer and the Union will jointly meet with
affected workers to announce the election, outline the elec-
tion process, and to jointly commit to the employees right to
choose.
Section 1.45 of Article 1.4 states:
5. If the Union receives a majority of the votes cast in the rep-
resentation election, the Employer shall recognize the Union
as the representative of the affected employees, cover the af-
fected under the terms of this agreement and bargain over ap-
propriate wage scales and any other conditions of employ-
ment which may not be covered by this agreement.
In 2002, two geographically separate groups of the Em-
ployer’s critical care transport registered nurses (sometimes
referred to as CCT-RNs or nurses) utilized these procedures.
The first was located in the Valley Region of the Employer’s
Northern Pacific Region (Alameda, Contra Costa, Santa Clara,
Monterey and San Mateo Counties) and the second was located
in the Bay/Coastal Region of the Employer’s Northern Pacific
Region (Alameda, Contra Costa, Santa Clara, Monterey and
San Mateo Counties). Each of the two nurses groups contacted
the SEIU and expressed the desire to become represented as
part of the existing unit.
The parties stipulated to the following facts. Upon learning
of the nurses, interest in being represented, the SEIU formed an
organizing committee to explain the fast and fair recognition
process set forth in Section 1.4 of the contract to the nurses.
The nurses had earlier met among themselves on multiple occa-
sions to discuss union representation and considered three pos-
sible options. The first option was to seek to be added to the
SEIU collective-bargaining unit under the fast and fair recogni-
tion process and thus to be represented by the SEIU. The sec-
ond option was to join an existing nurses only organization
such as the California Nurses Association and request that body
represent a CCT-RN only professional bargaining unit. The
third option was to form a new employer/nurses only associa-
tion and request representation by that organization in a sepa-
rate CCT-RN professional bargaining unit. The Employer’s
nurses decided to seek representation by the SEIU in the exist-
ing unit.
At that point, each of the two nurses groups contacted the
SEIU and expressed the desire to become represented as part of
the existing unit. Upon learning of the nurses interest in being
represented, the SEIU formed an organizing committee to ex-
plain the fast and fair recognition process set forth in Section
1.4 of the contract to the nurses. The parties stipulated that
Messrs. Scott Lemmon and Roland Guy, at the time the SEIU
organizing committee members, would have testified that the
two communicated with each CCT-RN and told each that vot-
ing for the SEIU under the fast and fair recognition procedure
would result in the nurses being added to the existing bargain-
ing unit.
The SEIU solicited and received nurse employee signatures
on representation petitions. The language on the petition forms
stated in part:
To: California State Conciliation Service
We are dedicated American Medical Response (AMR) regis-
tered nurses who seek to improve the lives of our patients and
ourselves. We believe that joining a union is the best way to
have a real voice at work and develop solutions to issues we
face. AMR registered nurses are uniting in order to most ef-
fectively contribute our knowledge and experience to the task
of improving health care. We, the undersigned, therefore au-
thorize Health Care Workers Union, the SEIU Local 250 as
our union for purposes of negotiation ages, benefits and other
terms and conditions of employment.
The petitions were submitted to the California State Concilia-
tion Service under the provisions of contract Section 1.42. The
California State Conciliation Service verified majority support
in each case and in each case the parties jointly requested the
State Conciliation Service to conduct a representation election.
After the representation petitions were submitted, the State
was asked to conduct an election and agreed to do so; joint
meetings were held by the Employer and the SEIU with the
nurses as required under Section 1.43 of the contract, inter alia,
to announce the election and outline the election process. Dur-
ing those meetings, the CCT-RNs who attended were told and
understood they would be voting on whether to be represented
by the SEIU as part of the overall bargaining unit.
The SEIU independently publicized the elections seeking
nurse support. The SEIU document, “The Voice of AMR CCT
RN Employees,” dated, June 2, 2002, was placed in evidence.
The document under a headline announcing a union election
among Bay/Coastal Region nurses began:
On Monday June 3rd] [2002], neutral mediator Paul Roose of
the California State Mediation and Conciliation Service veri-
fied that a majority of CCT RNs in the five counties signed
petitions to be represented by the health Care Workers Union,
the SEIU Local 250 and directed that a secret ballot election
be held whether to join with the rest of our AMR coworkers
as members of the SEIU Local 250.
The document contained prounion nurse commentary, includ-
ing: “Alameda County CCT RN Scott Lemon agrees; ‘CCT
RNs need to be part of the same bargaining unit as other AMR
union employees. . . .’”
The California State Conciliation Service conducted separate
election among the two nurse groups. The Bay/Coastal Region
nurses voted on June 24, 2002. The Valley Region nurses voted
on October 7, 2002. In each case the ballot question was: “I
chose to be represented by Healthcare Workers Local 250
(THE SEIU) or No organization.” The tally of ballots respect-
ing the Bay/Coastal Region nurses recited that out of 52 eligi-
ble voters, 34 cast valid ballots with the SEIU receiving 28
votes and no organization 6. The tally of ballots respecting the
Valley Region nurses recited that out of 36 eligible voters, 31
cast valid ballots with the SEIU receiving 18 votes and no or-
DECISIONS OF THE NATIONAL LABOR RELATIONS BOARD1412
ganization 11 and two challenged. In each election, there were
no objections filed or other unit or self determination disputes
of any kind.
After each election, the Employer recognized the SEIU as
the relevant nurses representative as part of the overall bargain-
ing unit. After each election and recognition, the Employer and
the SEIU negotiated “side letter” supplements to the contract
covering the nurses involved. In each case the side letter pro-
vided that the main contract would govern terms and conditions
of employment of the nurses involved with additional particu-
lars contained in the side agreement. The Bay/Coastal Region
nurses side letter was signed and dated by the SEIU and the
Employer on February 18 and 25, 2003, respectively. The Val-
ley Region nurses’ side letter was signed and dated by the SEIU
and the Employer on October 9 and 15, 2002, respectively. The
side letter agreements became addendums to the collective-
bargaining agreement.
There is no contention that any represented nurse or other
member of the bargaining unit objected to the nurses’ inclusion
in the larger overall unit or suggested that such unit placement
had not been fairly decided by the nurses in the State balloting
described above. Neither the Employer nor the SEIU ever ob-
jected to the initial or continued inclusion of the nurses in the
overall unit. No objection to the continued inclusion of the
nurses in the overall unit was raised in the initial preelection
representation case hearing. No party proposed self-
determination balloting language for the nurses in the initial
hearing or in the stipulation for a second election in the instant
case.
2. Board election standards for mixed professional/ nonprofes-
sional employee unit elections
The Act addresses appropriate bargaining units in which
elections may be held and provides at Section 9(b)(1):
[T]he Board shall not (1) decide that any unit is appropriate
for such purposes if such unit includes both professional em-
ployees and employees who are not professional employees
unless a majority of such professional employees vote for in-
clusion in such unit;
Over time the Board has evolved election procedures to ac-
commodate self-determination elections of which a profes-
sional/nonprofessional unit self-determination election is one
type. Thus the Board’s Case Handling Manual, Part Two,
Representation Proceedings, Section 11091.1, Self-
Determination Elections, Elections Involving Professional Em-
ployees provides:
. . . In elections to ascertain the desires of professional em-
ployees as to their inclusion in a unit with nonprofessional
employees, pursuant to Section 9(b)(1) of the Act, para-
graph 9 of the election agreement, which describes the word-
ing of choices on the ballot, should be altered to conform to
the following:
Two questions shall appear on the ballot:

1. Do you wish to be included with nonprofessional
employees in a unit for the purposes of collective bargain-
ing?
To which the choice of answers shall be “Yes’’ or
“No.”

2. Do you wish to represented for purposes of collec-
tive bargaining by [union]?
. . . .
This type of election is referred to as a Sonotone election after
the Board’s fountainhead case: Sonotone Corp., 90 NLRB 1236
(1950), in which the procedures were established.
Professional self-determination elections under Sonotone and
its progeny have many variations. Some elections provide the
professionals with the choice of being represented in a single
unit with nonprofessional employees or in an all professional
employee unit. There may be more than one labor organization
involved; one union may be willing to represent the profession-
als only as part of an overall unit and another may be willing to
represent them in either or only as a separate group. There are
therefore many permutations and ballot options.
In the instant case, respecting the nurse elections in 2002,
there was but the single labor organization, the SEIU, seeking
to represent the nurses and the SEIU was seeking to represent
them only as part of the overall unit and not as a free-standing
professional or nurse only unit. In such a situation, the nurses
were in fact answering both the Board’s Sonotone questions by
voting to be represented by the SEIU as part of the larger bar-
gaining unit or in choosing no representation. Since there was
only one union seeking to represent the nurses in one overall
unit, the more complicated alternative choices the Sonotone
scheme was created to handle are not relevant to the instant
case.
The Board’s Representation Case Handling Manual at para-
graph 11091.2) describes a different type of self-determination
election in which a group of unrepresented employees decides
whether or not to join an existing represented bargaining unit.
(a) One voting group—one union: This is an election in
which the incumbent representative of employees in a partially
organized plant seeks to add a group of unrepresented employ-
ees to its existing unit, commonly referred to as an Armour-
Globe[6] election. In such event, the following language should
be added to the agreement:
If a majority of valid ballots are cast for [the incumbent un-
ion], they will be taken to have indicated the employees’ de-
sire to be included in the existing [fill in description] unit cur-
rently represented by [the incumbent union]. If a majority of
valid ballots are not cast for representation, they will be taken
to have indicated the employees’ desire to remain unrepre-
sented.
The ballot choice presented voters in a single union Armour-
Globe election is in essence that which the nurses were pre-
sented on their 2002 ballots. Do you wish to be represented by
the union? Yes or no?
The Board also conducts elections among employees in cur-
rently represented bargaining units based on representation
petitions seeking to remove or change the labor organization

6 Armour & Co., 40 NLRB 1333 (1942); Globe Machine & Stamp-
ing Co., 3 NLRB 294 (1937).
AMERICAN MEDICAL RESPONSE, INC. 1413
representing the unit involved. Those bargaining units some-
times contain both professional and nonprofessional employees.
The Board early on had to deal with the complications and
implications to its representation law framework of such peti-
tions and how to conduct elections in such a setting.
The Board has taken the position that, if professional em-
ployees in an existing professional/nonprofessional mixed bar-
gaining unit had earlier had the opportunity to vote to choose
inclusion in a single unit with nonprofessional employees in a
fair election, they need not do so a second time. Thus, for ex-
ample, if the Board had conducted a professional employee
self-determination election in the past which resulted in the
professional employees electing to be included in a mixed pro-
fessional/nonprofessional bargaining unit, and had that mixed
represented unit been subject to a later Board election, the
Board does not find it necessary to hold a second self-
determination election for the professionals. Rather the profes-
sional employees in that second vote cast their single question,
representation or not, ballots in the same manner as all other
unit employees and the ballots are tallied without distinction as
between professionals and nonprofessionals. In effect, the
provisions of Section 9(b)(1) of the Act have been held to re-
quire only a single, one time, self-determination election by
professionals and does not require them to repeatedly decide if
they desired to be included in a mixed profes-
sional/nonprofessional employee unit. In such a setting, once is
enough.
Bargaining relationships within the jurisdiction of the Act re-
sult not only from Board certifications of labor organizations as
representative of employees, but also result from voluntary
recognition and from elections conducted by public agencies at
the state and local level. State certifications of state election
results in effect, certifying a union as the representative of em-
ployees in particular bargaining units, come before the Board
both from elections conducted under contractually established
election agreements, as here, and in cases where employees
initially were under state jurisdiction and subsequently came
under the jurisdiction of the Act. Such bargaining units which
subsequently come before the Board often involve mixed pro-
fessional/nonprofessional units, because the Board in more
recent times expanded its jurisdiction to include certain types of
health care institutions which often had earlier state certified
unions representing mixed professional/nonprofessional units.
In examining a state certification of a mixed profes-
sional/nonprofessional unit for purposes of determining if a
Board election now requires self-determination balloting on the
part of the unit professionals, the Board does not take a reflex-
ive approach accepting or rejecting certifications automatically,
but rather looks to the original process. The Board noted in
Corporacion de Servicios Legales de Puerto Rico, 289 NLRB
612 fn. 2 (1988):
The Board will recognize the validity of a state certification
where the election procedure was free of irregularities and re-
flected the true desires of the employees. See St. Luke’s Hos-
pital Center, 221 NLRB 1314, 1315–1316 (1976), enfd. 551
F.2d 476 (2d Cir. 1976).
Thus the Board in appropriate cases will scrutinize prior state
balloting of professionals to determine if that state balloting
provided a proper professional employees’ self-determination
election and thus allows the Board to forgo conducting a sec-
ond self-determination election process among the profession-
als in the unit. And, in considering the state action, the Board
will look to the substance of the initial state self determination
process to determine if the true desires of the professional em-
ployees were fairly tested by the election procedures used.
Substance, not form is the relevant consideration in determining
the sufficiency of the state’s earlier election. Surely an element
of comity lies in holding the state to the test of Corporacion de
Servicios Legales de Puerto Rico, supra, rather than the Board’s
self-imposed Sonotone standard.
3. Analysis and conclusions
a. Preliminary matters
Two arguments respecting the objection here under consid-
eration should be dealt with initially. First, is the objection here
improper and invalid because it is a post election challenge to
voter ballots? Second, is the SEIU in some manner or to some
degree estopped or limited in pressing this objection before the
Board because it had represented the mixed profes-
sional/nonprofessional unit and/or because it had entered into
stipulations following the initial election that the second elec-
tion be held in the same fashion as the first, i.e. agreed it would
be conducted without special self-determination balloting of
nurses?
These arguments are definitively resolved by Pontiac Osteo-
pathic Hospital, 327 NLRB 1172 (1999). There the Board
made clear that a hearing officer who found that an objection
dealing with the failure to address self-determination issues was
“in the nature of a post election challenge” was in error. The
Board ruled that the self-determination requirements of Section
9(b)(1) of the Act, quoted above, are a mandate to the Board
and apply and will be enforced where appropriate irrespective
of the position taken by the parties at any stage of the proceed-
ing. See also Sunrise, Inc., 282 NLRB 252 (1986). Thus, I find
it is appropriate and necessary to consider whether or not the
2002 nurses balloting in the instant case meets the requirements
of Section 9(b)(1) of the Act as that section is applied by the
Board to the election under objection herein.
b. The issue narrowed
The cases cited above make clear that a Board decertification
election or a Board representation petition election in the situa-
tion where a petitioning union seeks to replace the current rep-
resenting labor organization in a mixed profes-
sional/nonprofessional bargaining unit requires Sonotone pro-
fessional employees self-determination balloting unless the
professional employees in the existing mixed profes-
sional/nonprofessional unit have previously voted in an election
in which a majority of the voting professionals chose to join the
current mixed unit. The Board does not require that the earlier
election have been a Board-conducted Sonotone election. The
Board will accept elections conducted by other agencies, in-
cluding state agencies. It does require however that the state
agency’s “election procedure was free of irregularities and
DECISIONS OF THE NATIONAL LABOR RELATIONS BOARD1414
reflected the true desires of the employees.” Corporacion de
Servicios Legales de Puerto Rico, supra. In other words, the
Board requires that the statutory requirements of Section
9(b)(1) of the Act, quoted supra, be fairly met, but does not
require that the Board have conducted the self-determination
election involved or that the procedures involved be precisely
those of Sonotone so long as the election process was free of
irregularity and reflected the true desires of the professional
employees as to whether or not they wished to be included in a
bargaining unit with nonprofessional employees.
Applying those doctrines to the instant case, the issue nar-
rows significantly. The parties agree the bargaining unit in-
volved included professional employees, i.e. registered nurses,
and nonprofessional unit employees, i.e. all others. There is no
doubt that the Board in conducting the election under objection
did not provide self determination balloting for the professional
nurses. As noted above, such self determination provisions are
necessary under Section 9(b)(1) of the Act, the SEIU’s objec-
tion has merit, and a new Board election will be necessary,
unless the nurses had earlier fairly elected to be included in the
mixed unit in the 2002 elections.
There is no doubt that the sufficiency of the State’s 2002
election to meet the self determination requirements of Section
9(b)(1) of the Act and thus make such balloting unnecessary in
the Board election, is the issue the Regional Director has di-
rected me to resolve. Thus the Director held in his report:
Section 9(b)(1) of the Act provides that professional employ-
ees may not be included in a bargaining unit with nonprofes-
sionals unless they vote in favor of such inclusion. While the
investigation disclosed that, pursuant to Article 1.4 of the lat-
est collective-bargaining agreement between the Employer
and the SEIU, elections were conducted by the California
State Conciliation Service in 2002 amongst the Employer’s
previously unrepresented critical care transport registered
nurses, hereinafter RNs, which resulted thereafter in the RNs
being included in the recognized unit and covered by the col-
lective-bargaining agreement, I have determined that the cir-
cumstances surrounding this election raise material issues of
fact and law that may best be resolved by a hearing.
The employees in the job description of critical care trans-
port registered nurses are the Registered Nurses who are the
professional employees at issue here. Thus, all the professional
employees involved were eligible to vote in the State election
in 2002, and no other employees were eligible to so vote. The
majority of voting professional employees chose representation
and the professional employees, i.e. the Registered Nurses,
were included in the larger represented bargaining unit which,
from that point forward, continued in unchanged form and was
the unit involved in the election under objection.
Thus, there is no dispute and I find that the professional em-
ployees held a vote among themselves and by majority elected
union representation as part of the up to that point nonprofes-
sional unit. The record contains neither a contention by any
party nor evidence which even suggests let alone establishes
that the California State Conciliation Service’s election proce-
dures in the 2002 elections were in any way irregular. Thus,
there is no dispute and I find that there were professional em-
ployee only elections conducted by a state agency and that the
election procedures were free of irregularities. Further, there is
no dispute and I find that a majority of the professional em-
ployees voting in that 2002 chose union representation.
The sole remaining element of the Board elements necessary
to satisfy the self-determination requirements of Section 9(b)(1)
of the Act and the Board’s application of that as relevant in
Corporacion de Servicios Legales de Puerto Rico, 289 NLRB
612 (1988), is the single question of whether or not the 2002
elections tested the true desires of the professional employees
as to whether or not they wished to be included in the larger
bargaining unit with nonprofessional employees. Here we ar-
rive at the heart of the SEIU’s objection to the validity of the
Board election conducted on February 23, 2005, the SEIU ar-
gues that Section 9(b)(1) of the Act required the Board provide
the Registered Nurses with a self determination, Sonotone type,
election and failed to do so.
Counsel for the SEIU at trial and counsel for the Employer
on brief argue that Sonotone voting procedures were necessary
in the election under objection because the 2002 state election
failed to test the true desires of the Registered Nurses as to
whether or not they wished to be included in a unit with non-
professional employees. NEMSA disagrees. It is appropriate to
turn to that narrow issue.
c. Did the 2002 California State Conciliation Service elections
among the Employer’s unrepresented critical care transport
registered nurses fairly test the voters desires to be represented
in a unit with nonprofessional employees?
1. May Any Non-Sonotone Election Test the True Desires of
Professional Employees as to Whether they Wished to Be In-
cluded in A Bargaining Unit with Nonprofessional Employ-
ees?
The SEIU and the Employer argue that Section 9(b)(1) of the
Act requires a two-part Sonotone election among professional
employees. The Employer on brief argues that this requirement
applies not only to Board elections, where Sonotone procedures
are always invoked, but also to any state or other election
which is offered as a sufficient earlier testing of professional
employee sentiments. Thus, the Employer on brief and the
SEIU by the language of its objection itself are arguing that the
California State elections held in 2002 were not Sonotone elec-
tions and therefore, ipso facto, the bargaining unit’s profes-
sional employees have not been provided with a required self-
determination election. The only cure, they argue, is to set
aside the current election under objection and hold a new elec-
tion with Sonotone procedures in place for the nurses.
Counsel for NEMSA argues on brief at 11–12:
Congress intended Section 9(b)(1) to be applicable to situa-
tions where the Board itself establishes bargaining units in the
first instance.” Retail Clerks Local 324 (Vincent Drugs), 144
NLRB 1247, 1251 (1963) (emphasis added). The Board
found “nothing in Section 9(b)(1) or its legislative history to
suggest that Congress intended that section to invalidate as in-
appropriate a historically established contract unit simply be-
cause of a joinder of professional and nonprofessional em-
ployees. Id. At 1252.
AMERICAN MEDICAL RESPONSE, INC. 1415
NEMSA argues further that Section 9(b)(1) of the Act does
not require the professionals always be asked two separate
questions on the ballot. Rather, counsel argues, as Sonotone
itself states, the Board need only “ascertain the desires of the
professional employees as to inclusion in a unit with nonprofes-
sional employees.” Sonotone Corp., 90 NLRB 1236, at 1241
(1950). Thus, counsel for NEMSA argues on brief, in the in-
stant case because in the State elections the only choice to be
presented to the nurses was whether or not they wished to join
the larger nonprofessional unit, the single question asked the
nurses on the ballot presented the only question before them
and that single decision differed in no possible way from the
same question presented in a two-part Sonotone ballot.
To exemplify NEMSA’s argument, the two ballot forms or
styles are set forth below. The only question presented the
nurses in 2002, as discussed in greater detail above, was
whether or not they wished to be represented as part of the
nonprofessional unit.
The California ballots provided each voting nurse a single
choice: “I choose to be represented by Healthcare Workers
Local 250 (The SEIU) or No organization.” A two part
Sonotone election ballot on the same issue would break the
choice into two questions: Question one: Do you desire to be
included with nonprofessional employees in a single unit for
purposes of collective bargaining? Question two: Do you de-
sire to be represented by the SEIU?
There is no dispute and I find that the California State Con-
ciliation Service nurse self-determination elections in 2002
were not Sonotone elections with Sonotone’s characteristic two
ballot questions discussed above. Rather, in Board parlance, the
ballot choices presented to the nurses in the two 2002 Califor-
nia State Conciliation Service elections were those of an Ar-
mour-Globe7 self-determination election, as described supra.
Having found that the California State elections in the ballot
choice presented were equivalent to Board Armour-Globe elec-
tions, does such an election satisfy the self-determination re-
quirements for professional employees joining a nonprofes-
sional unit or on the facts of this case, was a Sonotone style two
part balloting necessary?
Based on all the above and the record as a whole, I find and
conclude that the 2002 California State Conciliation Service
elections for nurses were fully equivalent to Board Armour-
Globe elections and that in the instant case the Armour-Globe
balloting format met the requirements of Section 9(b)(1) of the
Act. I reach this latter conclusion for several reasons.
First, the Armour-Globe procedures are as venerable as those
of Sonotone and have been held by the Board and the courts in

7 The Board adds to the notice of election in Armour-Globe elections
additional explanatory language making clear to voters the conse-
quences to the voters of a vote for the union. The Board notice pro-
vides the following:
If a majority of valid ballots are cast for the incumbent union, they will
be taken to have indicated the employees’ desire to be included in the
existing [fill in description] unit currently represented by [the incum-
bent union]. If a majority of valid ballots are not cast for representa-
tion, they will be taken to have indicated the employees’ desire to re-
main unrepresented.
countless cases to provide valid self-determination elections for
residual groups of employees. Thus in Belroit Corp., 310
NLRB 637, 637 (1993), described the intent of the Armour-
Globe election as follows:
[W]e find that the logical and unambiguous intent of the en-
tire self-determination election process was to allow the plant
clerical employees to become part of the existing represented
group of production and maintenance employees. Southern
Indiana Gas Co., 284 NLRB 895, 898 (1987), enfd. 853 F.2d
580 (7th Cir. 1988); see also NLRB v. Raytheon Co., 918 F.2d
249 (1st Cir. 1990). Since a majority of the clerks who voted
in the self-determination election cast ballots indicating a
‘‘desire to be included in the existing unit of production and
maintenance employees currently represented by’’ the Union,
they joined that unit on certification.
The nurses in 2002 were, in effect, a residual group of em-
ployees being given an opportunity to join an existing unit.
They were clearly not given an option to be represented sepa-
rately in a second all professional unit. No union save the SEIU
was involved. Therefore polling the nurses in 2002 in an Ar-
mour-Globe self-determination election provided them with the
only two, single self-determination choices: did the nurses
chose representation in the existing nonprofessional unit repre-
sented by the SEIU or did they desire no representation, that a
Sonotone two question ballot in that limited choice situation
would provide. In the unusual case presented in 2002, where
the residual nurses could only chose joining the represented
unit or chose not being represented, any argued distinction
between Sonotone and Armour-Globe balloting is a distinction
without a difference. And to deny the California State elec-
tions’ effectiveness on such grounds would be a needless af-
front to comity.
Second, even were the Board to exalt form over substance
and find an Armour-Globe balloting did not meet Board stan-
dards in this narrow fact situation, I find as NEMSA argues,
the standard to be applied is not that which the Board directs its
own agents to undertake, but rather the standard of Corpora-
cion de Servicios Legales, 289 NLRB 612 fn. 2 (1988):
The Board will recognize the validity of a state certification
where the election procedure was free of irregularities and re-
flected the true desires of the employees. See St. Luke’s Hos-
pital Center, 221 NLRB 1314, 1315–1316 (1976), enfd. 551
F.2d 476 (2d Cir. 1976).
I find without any doubt that the ballot questions presented
the nurses in the 2002 California State Conciliation Service
elections were procedurally able to ascertain the true desires of
the employees. I find therefore that the California State Con-
ciliation Service election procedures were proper and polling
employees under them could reflect the true desires of employ-
ees and therefore meet the Board’s requirements that profes-
sional employees have been provided a self-determination elec-
tion in joining a nonprofessional unit.
DECISIONS OF THE NATIONAL LABOR RELATIONS BOARD1416
2. Did the California State Conciliation Service 2002 Nurse
Self-Determination elections reflect the true desires of
the employees?
It is one thing to hold that an election procedure has the po-
tential to fairly poll professional employees desires respecting
joining a nonprofessional employees bargaining unit. It is an-
other to find that the election, in fact, did produce such a result.
It is therefore appropriate to turn to the actual 2002 elections
themselves.
There was no contention that the 2002 California State Con-
ciliation Service elections were in any way irregular. No party
raised such a challenge in the instant case either before me or in
the preelection portion of the instant case. The record is clear
that no challenges or protests to the elections were made fol-
lowing their conclusions or after the nurses were included in
the bargaining unit.
While the record has no evidence of the language on the
2002 California State Conciliation Service notices of election,
the record contains substantial evidence, discussed in greater
detail above, that the nurses were well aware of the purpose and
consequences of the 2002 balloting. Thus the record estab-
lished that the nurses considered seeking separate representa-
tion in an all professional unit by a professional employees
labor organization, but chose rather to seek to join the existing
SEIU represented bargaining unit. The record further estab-
lishes that the nurses were told both individually by the SEIU
agents and by the Employer and the SEIU agents at employee
meetings, that the question to be presented in the election was
whether or not the nurses wished to join the existing SEIU rep-
resented unit. The SEIU election literature also made it clear
the nurses were voting to join the existing unit.
Finally, of course the election mechanism itself, the Fast and
Fair Recognition Procedure of the collective-bargaining agree-
ment, by the contract’s terms, made it explicitly clear that such
an election only applied to employees not currently represented
who sought to join the represented unit covered by the contract.
I find therefore that the nurses in 2002 were fully appraised of
the self determination choices the election presented and were
also aware that a majority vote for representation would place
the nurses in the existing nonprofessional employee unit repre-
sented by the SEIU.
d. Summary and conclusion
In summary, based on all the above and the record as a
whole, I found that the election under objection in the instant
case did not include Sonotone polling of the professional em-
ployees in the unit. I further found that the Board requires self-
determination elections among professional employees in join-
ing bargaining units of nonprofessional employees.
I considered evidence of the circumstances of the 2002 Cali-
fornia State Conciliation Service elections for nurses which led
to their inclusion in the bargaining unit to determine if the elec-
tions met the requirements of the Board as set forth in Corpo-
racion de Servicios Legales, supra: “The Board will recognize
the validity of a state certification where the election procedure
was free of irregularities and reflected the true desires of the
employees.” I determined that the elections in 2002 were free
of irregularities and reflected the true desires of the employees.
Based on this determination, I further find and conclude that
the elections among the nurses in 2002 fulfilled that Board
requirement that professional self-determination elections be
held. Based on that conclusion, I further conclude that it was
not necessary that the Board election, currently under objection,
include professional self-determination election balloting of
professional employees. That being so, the election at issue was
proper, the SEIU’s Objection number 3 is without merit and
should be overruled.
Recommendation to the Board8
The Director in his Report on Objections directed that I
make recommendations to the Board as to the disposition of the
objection contained in the SEIU’s objection number 3. Based
on the record as a whole, as set forth above, I have found and
concluded that the SEIU’s Objection No. 3 is without merit. I
therefore make the following recommendation to the Board.
I recommend the Board overrule the SEIU United Healthcare
Workers West, Service Employees International Union,
AFL–CIO’s Objection No. 3 and certify the election results
that the National Emergency Medical Services Association
received a majority of ballots cast and is therefore the exclu-
sive representative of employees in the following unit:
The Northern California employees of American Medical
Response: Including: all full-time and regularly scheduled part-
time registered nurses, EMT-1s, EMT-2s, EMT-Ps, Drivers,
Wheelchair Van Drivers, Dispatchers, System Status Control-
lers, Call takers, Prebillers, and Billers (except for Pre-Billers
and Billers in Stanislaus, San Francisco, Sacramento, Shasta,
and San Joaquin Counties) including bargaining unit personnel
serving as acting supervisors in the following counties: Mon-
terey, Tulare, Santa Cruz, Santa Clara, San Mateo, (except
EMT-Ps covered in a separate Agreement) Stanislaus (exclud-
ing Turlock Operations), Alameda, San Francisco, Contra
Costa, San Mateo, Stanislaus (Vehicle Service Technician only)
and Tulare(Clerk 1s and Clerk 2s only). Also including: all
full-time and regularly scheduled part-time CCTs and
EMT/CCTs in Alameda, Contra Costa, San Mateo and Yolo
Counties, Paramedic/CCTs in Contra Costa, Monterey, Placer,
Sacramento, San Joaquin-Calaveras, and Santa Clara Counties,
CCT/RNs in Alameda, Contra Costa, Monterey, Sacramento,
Santa Clara, and Sonoma Counties; Mail Room Clerks in Ala-
meda County; Dispatchers and Call Takers in Modesto and

8 The Board’s Rules and Regulations Section 102.69(e) provides in
part concerning a hearing officer’s report resolving questions of credi-
bility and containing findings of fact and recommendations as to the
disposition of the issues:
[A]ny party may within 14 days from the date of issuance of the re-
port on challenged ballots or on objections, or on both, file with the
Board in Washington, D.C., exceptions to such report, with supporting
brief if desired. Within 7 days from the last date on which exceptions
and any supporting brief may be filed, or such further period as the
Board may allow, a party opposing the exceptions may file an answer-
ing brief with the Board in Washington, D.C. If no exceptions are filed
to such report, the Board, upon the expiration of the period for filing
such exceptions, may decide the matter forthwith upon the record or
may make other disposition of the case.
AMERICAN MEDICAL RESPONSE, INC. 1417
Sacramento Dispatch Centers, EMT-1s and Paramedics in San
Benito County; Vehicle Service Technicians (VST) in Contra
Costa, San Joaquin-Calaveras, San Mateo and Santa Clara
Counties; Gurney Van Drivers in Sacramento County, Pre-
Billing Representative and Technicians in San Mateo County;
and Service Receipt Processor/Pre-Billers in Santa Clara
County. Excluding: Advanced Life Support (ALS) paramedics
in Turlock, Tracy and San Mateo County, all other personnel
including guards and supervisors as defined by the National
Labor Relations Act, as amended.