At $3,000 per replacement worker, Saint Louise forked over a hefty sum to bring in about 20 temporary replacements from all over the country, said Lin Velasquez, vice president of human resources at Saint Louise. To save costs, the hospital closed its MRI services, breast care center, human resources department and lab in Morgan Hill for the day.

The hospital also paid about $12,000 in catering as the food service workers, who would normally keep the cafeteria up and running, picketed as part of the Service Employees International Union-United Healthcare Workers, which includes nursing assistants, lab technicians, housekeepers and hospital clerks in its 190 members at Saint Louise.

About 25 percent of workers crossed the picket line and came back to work, Velasquez said.

The union workers' contract expired April 30 and union representatives don't expect to ratify a new contract until the spring, said Susan Reddell, chief union steward at Saint Louise, while pushing her infant granddaughter in a stroller along the picket line.

"There's certain things that we're not willing to negotiate on, and taking away things we've already won is non-negotiable," Reddell said of the hospital's proposal to increase health insurance premiums and introduce a management rights clause. The clause would allow administrators to make unilateral changes to any hospital procedure not specified in the contract without negotiating with union workers.

"If our operating margin is shrinking, the management rights clause give us the ability to reduce hours and lay people off," Velasquez said. "We're not trying to lay off people, but these are very tumultuous times."

The clause was a sticking point until recently, when administrators took the proposal off the table at Saint Louise. However, the Daughters of Charity system is still proposing the clause for the union workers at St. Francis Medical Center near Los Angeles.

The union workers are determined to hammer out a single contract for all of its members employed by the Daughters of Charity, which also owns O'Connor Hospital in San Jose, Seton Medical Center in Daly City and Seton Coastside in Moss Beach.

"They wanted to see the management rights clause expunged from St. Francis," Velasquez said. "We want to see some more compromise."

She said taking the proposal off the table for the Saint Louise workers was an effort to show that the administration was bargaining in good faith.

But union workers weren't impressed with the hospitals' concessions and want one contract for all five hospitals, employees said.

"That's the point of having a union," said Ernest Gonzales, union steward at Saint Louise. "The whole point of having these negotiations is for everyone to have a fair contract."

"CHW did it and their system has 34 hospitals," Reddell said of the contract union workers recently won with Catholic Healthcare West. "We want to unite only five."

Although Saint Louise union members said they were fighting for the rights of their fellow members in Southern California, they are also fighting for greater job security and against wage increases that lag behind competitors and insurance premiums that would more than double some workers' monthly bills, Reddell said.

"It's not affordable healthcare," she added.

However, Velasquez said administrators planned to restore health benefits to the status quo.

Disappointed that a fair compromise hasn't been reached, she hopes to have a contract in place by the end of the year.