American Medical Response

National Labor Relations Board - Board Decisions

Sep 20, 2001

335 N.L.R.B. 1176 (N.L.R.B. 2001)

DECISIONS OF THE NATIONAL LABOR RELATIONS BOARD 1176
American Medical Response, Inc. and Allen Bryer,
and Charles Williams, and George A. Gardiner
Jr.

International Association of EMTS & Paramedics,
NAGE, AFL–CIO and International Association
of EMTS & Paramedics, Local 1, NAGE, AFL–
CIO and Allen Bryer and Charles Williams and
George A. Gardiner Jr. Cases 1–CA–35553, 1–
CA–35578, 1–CA–35600, 1–CB–9098, 1–CB–
9101, and 1–CB–9106
September 20, 2001
DECISION AND ORDER
BY MEMBERS LIEBMAN, TRUESDALE, AND
WALSH
On October 30, 1998, Administrative Law Judge
Bruce D. Rosenstein issued the attached decision. The
General Counsel filed exceptions and a supporting brief,
and the Respondents filed briefs answering the General
Counsel’s exceptions. Subsequently, the General Coun-
sel filed a brief in reply to the Respondents’ answering
briefs, including a motion to strike portions of Respon-
dent American Medical Response’s answering brief. Re-
spondent American Medical Response filed an opposi-
tion to the motion to strike.
The National Labor Relations Board has delegated its
authority in this proceeding to a three-member panel.
The Board has considered the decision and the record
in light of the exceptions and briefs,1 and has decided to
affirm the judge’s rulings, findings,2 and conclusions as
clarified below, and to adopt the recommended Order as
modified.3
This is essentially an accretion case. The judge found
that, following a merger of two companies into Respon-
dent American Medical Response (AMR), some of the
employees from the other companies were properly ac-
creted into the bargaining unit of AMR employees repre-
sented by Respondent International Association of EMTs
& Paramedics (IAEP), but that other employees were not
properly accreted into the unit. With respect to the latter
group, the judge found that Respondents AMR and IAEP
violated the Act to the extent that they entered into a rec-
ognition agreement and applied their existing collective-
bargaining agreement to those new employees. How-
ever, the judge found that, unlike Respondent IAEP, Re-
spondent IAEP Local 1 (Local 1) did not obtain recogni-
tion from AMR or apply the contract to those employees
who were not properly accreted to the unit. He therefore
concluded that Local 1 did not violate the Act.

1 We grant the General Counsel’s motion to strike from Respondent
American Medical Response’s answering brief all references disputing
the judge’s finding that American Medical Response is not a “health
care institution” within the meaning of Sec. 2(14) of the Act. No excep-
tions pursuant to Sec. 102.46 of the Board’s Rules and Regulations
were filed to this finding. Accordingly, the matter is not before us and
American Medical Response’s contentions in this respect are inappro-
priate.
2 The General Counsel has excepted to some of the judge’s credibil-
ity findings. The Board’s established policy is not to overrule an admin-
istrative law judge’s credibility resolutions unless the clear preponder-
ance of all the relevant evidence convinces us that they are incorrect.
Standard Dry Wall Products, 91 NLRB 544 (1950), enfd. 188 F.2d 362
(3d Cir. 1951). We have carefully examined the record and find no
basis for reversing the findings.
3 We will modify the recommended Order to reflect the addition of
International Association of EMTs & Paramedics, Local 1 as a liable
party, as explained below, and also more generally to reflect current
Board remedial practice and precedent.
The General Counsel excepts to the judge’s finding
that some of the employees of the merged companies
legitimately were accreted into the bargaining unit. The
General Counsel also excepts to the judge’s failure to
find that Local 1, as a joint collective-bargaining repre-
sentative with IAEP, was equally liable and violated the
Act as alleged. For the reasons set forth below, we affirm
the judge’s finding that certain employees were properly
accreted. However, contrary to the judge, we find that
Local 1 violated the Act in the same manner as IAEP
with respect to those employees who were not properly
accreted.4
I. BACKGROUND
AMR operates emergency medical service (EMS)
trucks. It is a nation-wide business. Its operation in New
England, and especially in eastern Massachusetts, is at
issue in this case. In February 1997,5 a series of mergers
dating back to 1995 culminated in AMR’s absorption of
two Massachusetts EMS companies, Med-Trans Ambu-
lance Company and Brewster Ambulance Company.
Med-Trans and Brewster were nonunion companies.
AMR had a preexisting collective-bargaining relation-
ship with the Union.6 The term of their most recent col-
lective-bargaining agreement was from July 6, 1996, to
July 5, 2000. This contract included a union-security
provision. The contractual bargaining unit primarily cov-
ered paramedics, emergency medical technicians, and
wheelchair car drivers who were employed by AMR in
Maine, New Hampshire, Rhode Island, and eastern Mas-
sachusetts, including the Worcester area. At the time of
4 No exceptions were filed by AMR and IAEP to the violations
found by the judge.
5 All dates hereafter are in 1997.
6 For ease of reference, “the Union” refers here to both Respondent
IAEP and Respondent Local 1. As discussed more fully in the next
section, we find that the collective-bargaining agreement was with both
IAEP and Local 1 and that they are joint collective-bargaining repre-
sentatives.
335 NLRB No. 90
AMERICAN MEDICAL RESPONSE 1177
the absorption of Med-Trans and Brewster, the contract
covered about 1300 AMR employees in multiple EMS
station locations. At the same time there were about 400
Brewster employees and 360 Med-Trans employees, also
at multiple EMS stations, who worked in job classifica-
tions of the type covered by the contract.
After February, AMR proceeded to integrate the Med-
Trans and Brewster operations with its own. Two new,
managerially autonomous divisions of AMR’s national
operation were formed. Newly constituted division 12
was coextensive with the geographic scope of the con-
tractual bargaining unit, except for the exclusion of the
Worcester area. For business reasons, Worcester was
placed in a new division 13, which also included western
Massachusetts, Connecticut, and New York. By summer,
the integration was well under way. On July 29, AMR
and the Union signed an agreement providing for recog-
nition of the Union as the collective-bargaining represen-
tative of the former Med-Trans and Brewster employees
who worked within the scope of the contractual bargain-
ing unit, regardless of whether they were assigned to
division 12 or division 13. Pursuant to the agreement’s
terms, the Respondents subsequently applied the collec-
tive-bargaining agreement to the new employees in the
contractual unit. Three of these employees filed unfair
labor practice charges. The General Counsel issued a
complaint alleging that these and the other previously
unrepresented former employees of Med-Trans and
Brewster were improperly accreted into the bargaining
unit and that, as a consequence, AMR violated Section
8(a)(1), (2), and (3) and the Union violated Section
8(b)(1)(A) and (2).
Preliminary to addressing the accretion question, the
judge found that a new bargaining unit limited to the
scope of division 12 was appropriate. In light of this
finding, and the level of common interests among the
employees in that division, he found that former Med-
Trans and Brewster employees working within division
12 had been appropriately accreted into this new unit.
However, to the extent that AMR’s July 29 recognition
of the IAEP had reached into division 13 (i.e., to Med-
Trans employees in the Worcester area, which was cov-
ered by the contractual unit),7 he found that accretion
was improper, and that AMR and IAEP had, to this ex-
tent, violated the Act as alleged. As noted above, no
exceptions have been filed to these violations found by
the judge. However, the General Counsel does except to
the judge’s finding that the Med-Trans and Brewster em-
ployees assigned to Division 12 were properly accreted

7 Of the employees whose companies were merged into AMR, only
former Med-Trans employees, not those formerly employed by Brew-
ster, were working in the Worcester area at the time of recognition.
to the contractual unit, and to his finding that Local 1 did
not violate the Act in the same manner as IAEP.
II. THE JUDGE’S ACCRETION FINDINGS
After careful consideration, we affirm the judge’s find-
ing that the Med-Trans and Brewster employees in divi-
sion 12 were properly accreted into the contractual unit.
Contrary to the General Counsel, we find that the judge’s
overall analysis applies the appropriate accretion factors,
and is consistent with the goal of balancing two compet-
ing statutory interests: the right of employees to choose
their collective-bargaining representative, and the main-
tenance of stable collective-bargaining relationships. See,
e.g., Safety Carrier, 306 NLRB 960, 969 (1992).
However, there are two aspects of his analysis that we
believe require clarification. First, we find that the judge
erred by effectively creating a new bargaining unit rather
than relying on the existing unit defined by the parties’
collective-bargaining agreement. “‘An accretion is sim-
ply the addition of a relatively small group of employees
to an existing unit where these additional employees
share a sufficient community of interest with the unit
employees and have no separate identity.’” Judge &
Dolph, Ltd., 333 NLRB 175, 181 (2001), quoting Lam-
mart Industries v. NLRB, 578 F.2d 1223, 1225 fn. 3 (7th
Cir. 1978) (emphasis added). See also Archer Daniels
Midland Co., 333 NLRB 673, 676 (2001). There is no
dispute in this case that the contractual unit was a previ-
ously existing, appropriate bargaining unit. Thus, in af-
firming the judge, we clarify that we are doing so be-
cause the former Med-Trans and Brewster employees
who now work within division 12 were legitimately ac-
creted into the existing contractual unit based on the
level of their community of interest with the unit em-
ployees. In contrast, those former employees of Med-
Trans working in the Worcester area of division 13 were
improperly accreted to the contractual unit because they
lacked a sufficient community of interest with the em-
ployees in the contractual unit, the vast majority of
whom worked in division 12.8
8 A number of AMR employees historically represented by the Un-
ion in the contractual unit were, like the Med-Trans employees above,
working in the Worcester area and therefore within Division 13. Their
continued representation by the Union is unaffected by our findings
here. Thus, no unfair labor practice or representation issues concerning
these employees, in light of AMR’s postmerger changes, have been
raised in this proceeding. Compare Crown Zellerbach Corp., 246
NLRB 202, 203–204 (1979).
In these circumstances, one significant problem with the new unit
found by the judge—i.e., a unit exactly coextensive with Division 12—
lies with these AMR employees stationed in the Worcester area. The
judge’s unit would have excluded these employees, thereby depriving
them of the union representation they historically enjoyed.
DECISIONS OF THE NATIONAL LABOR RELATIONS BOARD 1178
Second, the judge’s accretion analysis did not distin-
guish between events before and events after AMR’s
July 29 recognition of the Union. We agree with the
General Counsel’s contention that the question whether
the Med-Trans and Brewster employees constituted an
appropriate accretion to the AMR bargaining unit must
be determined on the facts that existed on the date of the
recognition of the Union. See, e.g., Brooklyn Hospital
Center, 309 NLRB 1163, 1182 (1992), enfd. sub nom.
Service Employees Local 144 v. NLRB, 9 F.3d 218 (2d
Cir. 1993).
In this case, the unfair labor practice allegations center
on the status quo as of July 29; factors favoring accretion
that arose after the recognition of the Union are not sig-
nificant for determining violations of the Act. Accord-
ingly, we do not rely on the following community-of-
interest facts which contributed to the judge’s conclusion
that there was a proper accretion: health benefits, holi-
days, wages and bonuses, and a retirement plan all
shared in common among the AMR, Med-Trans, and
Brewster employees working in division 12. These were
all controlled by the collective-bargaining agreement and
not applied to the Med-Trans and Brewster employees
until after AMR recognized the Union. Common uni-
forms as well were not available until after the recogni-
tion.
Nevertheless, the facts which were in place as of July
29 are sufficient for us to affirm the judge’s finding of a
legitimate accretion. For example, accretion is supported
by AMR’s implementation of its “system status man-
agement” program prior to recognition, which signifi-
cantly affected dispatching of assignments, employee
contacts, and field supervision within division 12. Under
this program, posting of trucks within division 12 to par-
ticular areas in the field was based on anticipated client-
call volume. Such postings could, consistent with call
volume, change from day to day and from time to time
during the day. Thus, employees spent most of their
work time on the road within the division, rather than at
their designated stations. The identity of their field su-
pervisors and their interaction with unit employees as-
signed to other trucks depended on their location at any
particular time. Accordingly, the institution of this pro-
gram created common field supervision, a common dis-
patching system, and a significant breadth of contact
between unit employees in division 12.
In addition, as of July 29 the employees of division 12
shared the same skills and job functions; standardized
hiring and disciplinary policies; common work schedul-
ing; common training and orientation; a common system
of employee identification numbers; and common servic-
ing of health care facilities under contract with AMR.
Further, employees were permanently transferred be-
cause of the closure and consolidation of stations follow-
ing AMR’s absorption of Med-Trans and Brewster. This
was done regardless of union affiliation. And temporary
transfers occurred on a daily basis due to illness, vaca-
tion, and other absences. Finally, labor relations and op-
erations were controlled at the division level, and divi-
sion 12 management consisted of former Med-Trans and
Brewster managers as well as those previously with
AMR.
In light of the circumstances in place on July 29, we
agree with the judge that neither the Med-Trans nor the
Brewster employees working in division 12 retained any
significant group identity separate from the AMR em-
ployees, and that their community of interest with the
AMR employees was more than sufficient to establish an
appropriate basis for accretion. Accordingly, we find that
they were properly accreted into the contractual bargain-
ing unit at that time, and that Respondents did not violate
the Act with regard to them.
III. THE LIABILITY OF RESPONDENT LOCAL 1
As discussed, the judge found that on July 29 AMR
agreed to recognize IAEP and to extend coverage of their
current collective-bargaining agreement to employees of
the merged companies. In the July 29 agreement, and in
the collective-bargaining contract itself, AMR explicitly
recognized IAEP as the bargaining representative of
AMR’s employees in the defined bargaining unit. The
judge therefore concluded that it was not proper to hold
Local 1 liable for any alleged violations involving the
July 29 recognition and subsequent application of the
contract. The General Counsel argues that because IAEP
and Local 1 were joint collective-bargaining representa-
tives, Local 1 is equally liable for unlawfully obtaining
recognition and applying the contract to the division 13
employees who were improperly accreted.
The record supports the General Counsel’s contention.
It is true that only IAEP is named in the July 29 recogni-
tion agreement and in the recognition clause of the col-
lective-bargaining agreement. However, the cover page
of the collective-bargaining contract states that the con-
tract is between AMR and Local 1, and three Local 1
officials signed the collective-bargaining agreement as
representatives of the Local.9 In addition, Local 1 admit-
ted at the hearing that it maintained and enforced the
collective-bargaining agreement subsequent to July 29.
Further, a letter dated October 10 from IAEP to AMR
concerning upcoming negotiations states that “the Union

9 The attorney for both IAEP and Local 1 in this proceeding also
signed the collective-bargaining agreement, presumably as the sole
representative of IAEP.
AMERICAN MEDICAL RESPONSE 1179
shall be represented by an agent from [IAEP] and Local
1’s bargaining committee.” Finally, a sample union dues
check-off authorization card in the record identifies
“IAEP Local 1” as the employees’ collective-bargaining
representative.
In these circumstances, we find that IAEP and Local 1
were joint collective-bargaining representatives. See
Tree-Free Fiber Co., 328 NLRB 389 fn. 4, 398–399
(1999); BASF-Wyandotte Corp., 276 NLRB 498, 504–
505 (1985). Accordingly, Local 1, like IAEP, violated
Section 8(b)(1)(A) when it obtained recognition from
AMR on July 29, and violated Section 8(b)(2) when it
subsequently extended, maintained and enforced the par-
ties’ collective-bargaining agreement, which contained
union-security provisions, with respect to those employ-
ees who were improperly accreted into the bargaining
unit.10
ORDER
The National Labor Relations Board adopts the rec-
ommended Order of the administrative law judge as
modified and set out in full below and orders that
A. The Respondent, American Medical Response, Inc.
(AMR), Natick, Massachusetts, its officers, agents, suc-
cessors, and assigns, shall
1. Cease and desist from
(a) Recognizing International Association of EMTs &
Paramedics (IAEP) and IAEP Local 1 (Local 1) as the
collective-bargaining representatives for former employ-
ees of Med-Trans Ambulance Company (Med-Trans)
working in AMR’s division 13 and within the scope of
the bargaining unit set forth in the parties’ collective-
bargaining agreement, unless and until these Unions have
been certified by the Board as the representatives of these
employees in an appropriate unit.
(b) Extending, maintaining, and enforcing its collec-
tive-bargaining agreement with IAEP and Local 1, in-
cluding its union-security provisions, with respect to
former Med-Trans employees working in AMR’s divi-
sion 13 and within the scope of the bargaining unit set
forth in the agreement, unless and until these Unions
have been certified by the Board as the representatives of
these employees in an appropriate unit; provided how-
ever, that nothing in this Order shall require the with-
drawal or elimination of any wage increases or other
benefits, terms, or conditions of employment that may
have been established pursuant to the collective-
bargaining agreement with respect to these employees.

e-bargaining agreement.

10 In his decision, the judge found that no dues had been collected
and he refrained from providing the normal dues reimbursement rem-
edy. No party has taken issue with this limitation of the remedy.
(c) In any like or related manner interfering with, re-
straining, or coercing employees in the exercise of the
rights guaranteed them by Section 7 of the Act.
2. Take the following affirmative action necessary to
effectuate the policies of the Act.
(a) Withdraw and withhold recognition from IAEP and
Local 1 as the collective-bargaining representatives for
former Med-Trans employees working in AMR’s Divi-
sion 13 and within the scope of the bargaining unit set
forth in the collective-bargaining agreement, unless and
until the Unions have been certified by the Board as the
representatives of these employees in an appropriate unit.
(b) Within 14 days after service by the Region, post at
its facility in Natick, Massachusetts, copies of the at-
tached notice marked “Appendix A.”11 Copies of the
notice, on forms provided by the Regional Director for
Region 1, after being signed by the Respondent’s author-
ized representative, shall be posted by the Respondent
immediately upon receipt and maintained for 60
consecutive days in conspicuous places including all
places where notices to employees are customarily
posted. Reasonable steps shall be taken by the Respon-
dent to ensure that the notices are not altered, defaced, or
covered by any other material. In the event that, during
the pendency of these proceedings, the Respondent has
gone out of business or closed the facilities involved in
these proceedings, the Respondent shall duplicate and
mail, at its own expense, a copy of the notice to all
former Med-Trans employees employed by the
Respondent at any time since July 29, 1997, in its
division 13 and within the scope of the bargaining unit
set forth in the collectiv
(c) Post at the same places and under the same condi-
tions set forth in (b) above, as they are forwarded by the
Regional Director, copies of Respondent IAEP’s and
Respondent Local 1’s notices, marked “Appendix B” and
“Appendix C” respectively.
(d) Within 14 days after service by the Region, mail
signed copies of the attached notice marked “Appendix
A” to the Regional Director for posting at the offices and
meeting halls of Respondents IAEP and Local 1.
(e) Within 21 days after service by the Region, file
with the Regional Director a sworn certification of a re-
sponsible official on a form provided by the Region at-
testing to the steps that the Respondent has taken to
comply.
11 If this Order is enforced by a United States Court of Appeals, the
words in the attached notices reading “Posted by Order of the National
Labor Relations Board” shall read “Posted Pursuant to a Judgment of
the United States Court of Appeals Enforcing an Order of the National
Labor Relations Board.”
DECISIONS OF THE NATIONAL LABOR RELATIONS BOARD 1180
B. The Respondent, International Association of EMTs
& Paramedics, NAGE, Quincy, Massachusetts, its offi-
cers, agents, and representatives, shall
1. Cease and desist from
(a) Obtaining recognition from Respondent AMR and
acting as the collective-bargaining representative for
former Med-Trans employees working in AMR’s Divi-
sion 13 and within the scope of the bargaining unit of the
parties’ collective-bargaining agreement, unless and until
it has been certified by the Board as the representative of
these employees in an appropriate unit.
(b) Extending, maintaining, and enforcing its collec-
tive-bargaining agreement with AMR, including its un-
ion-security provisions, with respect to former Med-
Trans employees working in AMR’s division 13 and
within the scope of the bargaining unit of the agreement,
unless and until it has been certified by the Board as the
representative of these employees in an appropriate unit.
(c) In any like or related manner restraining or coerc-
ing employees in the exercise of the rights guaranteed
them by Section 7 of the Act.
2. Take the following affirmative action necessary to
effectuate the policies of the Act.
(a) Within 14 days after service by the Region, post at
its office and meeting halls copies of the attached notice
marked “Appendix B.”12 Copies of the notice, on forms
provided by the Regional Director for Region 1, after
being signed by the Respondent’s authorized representa-
tive, shall be posted by the Respondent immediately
upon receipt and maintained for 60 consecutive days in
conspicuous places including all places where notices to
members are customarily posted. Reasonable steps shall
be taken by the Respondent to ensure that the notices are
not altered, defaced, or covered by any other material.
(b) Post at the same places and under the same condi-
tions set forth in (a) above, as they are forwarded by the
Regional Director, copies of Respondent AMR’s and
Respondent Local 1’s notices, marked “Appendix A” and
“Appendix C” respectively.
(c) Within 14 days after service by the Region, mail
signed copies of the attached notice marked “Appendix
B” to the Regional Director for posting at Respondent
AMR’s facilities and the office and meeting halls of Re-
spondent Local 1.
(d) Within 21 days after service by the Region, file
with the Regional Director a sworn certification of a re-
sponsible official on a form provided by the Region at-
testing to the steps that the Respondent has taken to
comply.
12 See fn. 11, supra.
C. The Respondent, International Association of EMTs
& Paramedics, Local 1, NAGE, Quincy, Massachusetts,
its officers, agents, and representatives, shall
1. Cease and desist from
(a) Obtaining recognition from Respondent AMR and
acting as the collective-bargaining representative for
former Med-Trans employees working in AMR’s divi-
sion 13 and within the scope of the bargaining unit of the
parties’ collective-bargaining agreement, unless and until
it has been certified by the Board as the representative of
these employees in an appropriate unit.
(b) Extending, maintaining, and enforcing its collec-
tive-bargaining agreement with AMR, including its un-
ion-security provisions, with respect to former Med-
Trans employees working in AMR’s division 13 and
within the scope of the bargaining unit of the agreement,
unless and until it has been certified by the Board as the
representative of these employees in an appropriate unit.
(c) In any like or related manner restraining or coerc-
ing employees in the exercise of the rights guaranteed
them by Section 7 of the Act.
2. Take the following affirmative action necessary to
effectuate the policies of the Act.
(a) Within 14 days after service by the Region, post at
its office and meeting halls copies of the attached notice
marked “Appendix C.”13 Copies of the notice, on forms
provided by the Regional Director for Region 1, after
being signed by the Respondent’s authorized representa-
tive, shall be posted by the Respondent immediately
upon receipt and maintained for 60 consecutive days in
conspicuous places including all places where notices to
members are customarily posted. Reasonable steps shall
be taken by the Respondent to ensure that the notices are
not altered, defaced, or covered by any other material.
(b) Post at the same places and under the same condi-
tions set forth in (a) above, as they are forwarded by the
Regional Director, copies of Respondent AMR’s and
Respondent IAEP’s notices, marked “Appendix A” and
“Appendix B” respectively.
(c) Within 14 days after service by the Region, mail
signed copies of the attached notice marked “Appendix
C” to the Regional Director for posting at Respondent
AMR’s facilities and the office and meeting halls of Re-
spondent IAEP.
(d) Within 21 days after service by the Region, file
with the Regional Director a sworn certification of a re-
sponsible official on a form provided by the Region at-
testing to the steps that the Respondent has taken to
comply.

13 See fn. 11, supra.
AMERICAN MEDICAL RESPONSE 1181
APPENDIX A
NOTICE TO EMPLOYEES
POSTED BY ORDER OF THE
NATIONAL LABOR RELATIONS BOARD
An Agency of the United States Government

The National Labor Relations Board has found that we vio-
lated the National Labor Relations Act and has ordered us to
post and abide by this notice.

WE WILL NOT recognize International Association
of EMTs & Paramedics (IAEP), and International Asso-
ciation of EMTs & Paramedics, Local 1 (Local 1), as the
collective-bargaining representatives for former employ-
ees of Med-Trans Ambulance Company (Med-Trans),
working in our division 13 and within the scope of the
bargaining unit set forth in our collective-bargaining
agreement with these Unions, unless and until these Un-
ions have been certified by the Board as the representa-
tives of these employees in an appropriate unit.
WE WILL NOT extend, maintain, and enforce our col-
lective-bargaining agreement with IAEP and Local 1,
including its union-security provisions, with respect to
former Med-Trans employees working in our division 13
and within the scope of the bargaining unit set forth in
the agreement, unless and until these Unions have been
certified by the Board as the representatives of these em-
ployees in an appropriate unit.
WE WILL NOT in any like or related manner interfere
with, restrain or coerce you in the exercise of the rights
guaranteed you by Section 7 of the Act.
WE WILL withdraw and withhold recognition from
IAEP and Local 1 as the collective-bargaining represen-
tatives for former Med-Trans employees working in our
division 13 and within the scope of the bargaining unit
set forth in our collective-bargaining agreement with
these Unions, unless and until these Unions have been
certified by the Board as the representatives of these em-
ployees in an appropriate unit.
AMERICAN MEDICAL RESPONSE, INC.
APPENDIX B
NOTICE TO MEMBERS
POSTED BY ORDER OF THE
NATIONAL LABOR RELATIONS BOARD
An Agency of the United States Government

The National Labor Relations Board has found that we vio-
lated the National Labor Relations Act and has ordered us to
post and abide by this notice.

WE WILL NOT obtain recognition from American
Medical Response, Inc. (AMR), or act as the collective-
bargaining representative for former Med-Trans employ-
ees working in AMR’s division 13 and within the scope
of the bargaining unit of our collective-bargaining
agreement with AMR, unless and until we have been
certified by the Board as the representative of these em-
ployees in an appropriate unit.
WE WILL NOT extend, maintain, or enforce our col-
lective-bargaining agreement with AMR, including its
union-security provisions, with respect to former Med-
Trans employees working in AMR’s division 13 and
within the scope of the bargaining unit of the agreement,
unless and until we have been certified by the Board as
the representative of these employees in an appropriate
unit.
WE WILL NOT in any like or related manner restrain
or coerce you in the exercise of the rights guaranteed you
by Section 7 of the Act.

INTERNATIONAL ASSOCIATION OF
EMTS & PARAMEDICS

APPENDIX C
NOTICE TO MEMBERS
POSTED BY ORDER OF THE
NATIONAL LABOR RELATIONS BOARD
An Agency of the United States Government

The National Labor Relations Board has found that we vio-
lated the National Labor Relations Act and has ordered us to
post and abide by this notice.

WE WILL NOT obtain recognition from American
Medical Response, Inc. (AMR), or act as the collective-
bargaining representative for former Med-Trans employ-
ees working in AMR’s division 13 and within the scope
of the bargaining unit of our collective-bargaining
agreement with AMR, unless and until we have been
certified by the Board as the representative of these em-
ployees in an appropriate unit.
WE WILL NOT extend, maintain, or enforce our col-
lective-bargaining agreement with AMR, including its
union-security provisions, with respect to former Med-
Trans employees working in AMR’s division 13 and
within the scope of the bargaining unit of the agreement,
unless and until we have been certified by the Board as
the representative of these employees in an appropriate
unit.
WE WILL NOT in any like or related manner restrain
or coerce you in the exercise of the rights guaranteed you
by Section 7 of the Act.

INTERNATIONAL ASSOCIATION OF
EMTS & PARAMEDICS, LOCAL 1

Laura A. Sacks, Esq. and Sara R. Lewenberg, Esq., for the General Counsel.
DECISIONS OF THE NATIONAL LABOR RELATIONS BOARD 1182
Arthur P. Menard, Esq. and Terence P. McCourt, Esq., of Washington, D.C. and Boston,
Massachusetts, for Respondent Employer.
Wendy M. Bittner, Esq. and Joseph G. Donnellan, Esq., of Boston, Massachusetts, for the
Respondent Union.
DECISION
STATEMENT OF THE CASE
BRUCE D. ROSENSTEIN, Administrative Law Judge. This case was tried before me in
Boston, Massachusetts, on May 18, 19, 20, 21, and June 24, 1998, pursuant to a consolidated
complaint and notice of hearing (the complaint) issued by the Regional Director for Region 1 of
the National Labor Relations Board (the Board) on February 25, 1998. The complaint, based
on original charges filed on various dates in 1997,1 and certain amendments thereto filed on
various dates in 1998, by individual employees Allen Bryer, Charles Williams, Sheila
O’Malley,2 and George A. Gardiner Jr., alleges that American Medical Response, Inc. (Re-
spondent AMR or AMR), and International Association of EMT’s & Paramedics, NAGE,
AFL–CIO (Respondent IAEP or Union), and International Association of EMT’s & Paramed-
ics, Local 1, NAGE, AFL–CIO (Local 1), has engaged in certain violations of Section 8(a)(1),
(2), and (3) and Section 8(b)(1)(A) and (2) of the National Labor Relations Act (the Act).
Issues
The complaint alleges that Respondent AMR granted recognition on July 29, to Respondent
IAEP for former unrepresented employees and extended, maintained, and enforced its current
collective-bargaining agreement that contains a union-security clause to these unrepresented
employees even though Respondent IAEP did not represent an uncoerced majority of employ-
ees in an appropriate unit.
On the entire record, including my observation of the demeanor of the witnesses, and after
considering the briefs filed by the General Counsel, Respondent AMR and Respondent IAEP, I
make the following
FINDINGS OF FACT
I. JURISDICTION
Respondent AMR, a corporation, is engaged in the operation of an ambulance service, with
offices and places of business throughout the United States, including an office and place of
business in Natick, Massachusetts, where it annually purchased and received goods and materi-
als at its facility in excess of $50,000 directly from points outside the Commonwealth of
Massachusetts. Respondent AMR admits and I find that it is an employer engaged in com-
merce within the meaning of Section 2(2), (6), and (7) of the Act and that the Union and Local
1 are labor organizations within the meaning of Section 2(5) of the Act.
II. ALLEGED UNFAIR LABOR PRACTICES
A. Background
In July 1995, a company known as Chaulk Services, Inc. and Ambulance Systems of Amer-
ica, Inc. (ASA) merged.3 In October 1995, Respondent AMR acquired these merged compa-
nies. On January 4, a company known as Laidlaw, Inc. (Laidlaw), put forth a tender offer to
acquire Respondent AMR, and on February 19, Respondent AMR became a wholly owned
subsidiary of Laidlaw.
In January 1997, Med-Trans Ambulance Co. (Med-Trans) acquired Brewster Ambulance
Co. (Brewster) and later in January 1997, Laidlaw acquired Med-Trans. Accordingly, when
Laidlaw acquired Respondent AMR, it now owned Respondent AMR, Med-Trans, and Brew-
ster.

1 All dates are in 1997 unless otherwise indicated.
2 The charges in Cases 1–CA–35599 and 1–CB–9105, filed by
Sheila O’Malley, were withdrawn prior to the opening of the subject
hearing and are not part of this decision.
3 Respondent IAEP, based on Board certifications, is the exclusive
collective-bargaining representative for the Chaulk and ASA employ-
ees (Jt. Exhs. 9 and 22).
In 1996, Respondent IAEP and Respondent AMR entered into a 4–year (July 6, 1996–July
5, 2000) collective-bargaining agreement for AMR employees employed in Maine, New
Hampshire, Rhode Island, and eastern Massachusetts, including the metropolitan Worcester
area for the following unit:

The Employer recognizes the Union as the exclusive bargaining representative for the
purpose of collective bargaining for all full-time and part-time emergency medical tech-
nicians (EMT’s) and paramedics (including field trainers and lead technicians), cardiac
technicians, intermediates, telecommunications operators, dispatchers, and wheel chair
car drivers, including employees, who regularly average 4 or more hours of work per
week, employed by American Medical Response of Massachusetts, Inc.

Excluded from this Agreement are all other employees, including but not limited to,
buildings and ground employees, maintenance employees, office clerical employees,
professional employees, guards, managerial employees, all supervisors as defined in the
Act, and all employees of Commonwealth Ambulance Service, Inc. which ambulance
service has a collective-bargaining Agreement with OPEIU, Local #6.

Before February 19, the parties’ collective-bargaining agreement covered approximately
1300 AMR employees. At the time of the acquisition, Med-Trans employed approximately 360
unrepresented employees while Brewster’s unrepresented employees numbered around 400.
On March 17, Respondent IAEP filed a unit clarification petition with the Board in Case 1–
UC–713, but subsequently withdrew it. On May 16, Respondent IAEP filed a second unit
clarification petition in Case 1–UC–716, and a hearing was conducted before a Board hearing
officer on June 10. On June 12, Teamsters Local Union 653 filed a representation petition in
Case 1–RC–20638, seeking to represent EMT’s and paramedics in AMR’s South Division
station locations. On June 25, Teamsters Local 25 filed a representation petition in Case 1–
RC–20642, seeking to represent EMT’s and paramedics in AMR’s South Boston, Hyde Park,
Readville, Dedham, Weymouth, and Quincy station locations.
On July 1, the merger became official and the articles of merger were filed with the Massa-
chusetts Secretary of State (R. AMR Exh. 1). As a result of the merger, Respondent AMR
added 30 new station locations throughout Massachusetts to the approximate 30 station loca-
tions it already maintained throughout Massachusetts, Rhode Island, Maine, and New Hamp-
shire.
On July 21, the Board consolidated the UC and RC petitions and conducted a representation
hearing. During the course of the hearing, Teamsters Local Union 653 and 25 withdrew their
respective representation petitions.
On July 29, Respondent AMR granted recognition to the Union as the exclusive bargaining
representative of all former Med-Trans and Brewster employees employed in Massachusetts
and extended all of the benefits, privileges, and obligations of the collective-bargaining agree-
ment, in effect between the parties, to these employees. As part of the parties’ agreement
extending recognition, the Union withdrew the petition in Case 1–UC–716 (Jt. Exh. 20).
B. AMR’s Organizational Structure
After the acquisition, AMR’s central headquarters located in Aurora, Colorado, began the
process of reorganizing its nationwide operation. For this purpose, the United States was
broken down into four specific groups consisting of the western group, which includes divi-
sions 1, 2, 3, and 4; the central group which is made up of divisions 5, 6, 7, 8, 9, and 10; the
eastern group includes divisions 11, 12, 13, and 14; and the southern group contains divisions
15, 16, 17, 18, 19, 20, and 21.
The subject case concerns employees located in division 12 and 13. The Commonwealth of
Massachusetts falls within division 12 and 13 and was split in half primarily because of call
volume and revenues among divisional lines. Division 12 covers eastern Massachusetts,
Maine, Vermont, New Hampshire, and Rhode Island. It is further divided by regions including
the north, central, and south regions. Division 13 covers western Massachusetts including the
Worcester area, Connecticut, and New York.
Division 12 headquarters is located in Natick, Massachusetts, while division 13 headquar-
ters is in New Haven, Connecticut. Effective May 5, division 12 is identified as AMR North-
east and division 13 is known as AMR New York/Southern New England. Division 12 has
approximately 2500 employees while division 13 has around 3000 employees. There are
AMERICAN MEDICAL RESPONSE 1183
around 300–350 employees in the Worcester area that is part of division 13. Within division
13 there are eight current collective-bargaining agreements, in effect, between Respondent
AMR and various labor organizations.4 Additionally, in division 13, Respondent maintains
and operates several nonunion stations, including North Hampton, Massachusetts, Bridgeport,
Waterbury, and Southington, Connecticut, and Farmington and Ronkonamha, Long Island,
New York.
Both divisions 12 and 13 are headed by a separate divisional CEO, who supervise directors
or vice presidents in charge of human resources, logistics, support services, operations, finan-
cial services, corporate development, education services, continuous quality improvement, and
patient account information.
C. Emergency Medical Services
The Office of Emergency Medical Services (EMS) is the agency in the Commonwealth of
Massachusetts designated by statute to oversee, coordinate, and regulate emergency medical
services. For this purpose, five regional EMS councils are designated for coordinating the
delivery of EMS within its geographic boundaries. Within each of the regions are local regions
referred to as consortiums. Each advanced life support (ALS) ambulance service is required by
regulation to have an affiliation agreement with a hospital and that affiliation agreement
identifies a medical director who is responsible for the medical direction of the paramedics
within the system. Paramedics are required to credential with a specific medical director.
Respondent AMR employs approximately 1500 EMTs and 300 paramedics within division
12, who provide emergency medical services to patients located within the geographic bounda-
ries of the division. All EMS employees must operate under the license of a physician since
they are certified and do not hold a license. After the merger the medical director for Respon-
dent AMR, Dr. Assaad J. Sayah, assumed responsibility for the training and education of
former Med-Trans and Brewster employees as they were now operating under his license.
Training to achieve EMT status requires 500 hours while paramedics receive approximately
2000 hours of training before being certified in Massachusetts. After reaching basic EMT
status, employees can advance to EMT intermediate and then progress to the paramedic classi-
fication. In order to perform medical services within each of the regions or local consortiums,
paramedics must be individually credentialed within those locations and are not permitted to
perform emergency medical services in regions or consortiums that they are not credentialed.
In an EMS system, response time is the single most critical issue in the provision of emer-
gency medical care. The system of parking emergency vehicles at fire stations or at fixed EMS
locations that predominated through the 1970s has been replaced by the concept of system
status management. Under that concept, an analysis of call volume is used to apply staffing
patterns and vehicles are posted at various locations to increase response time to handle de-
mand. Each ambulance crew is assigned and reports to a station location to pick up their
vehicle and are then posted to different locations.
D. Events After the Acquisition
Respondent AMR made a number of changes to its organization and commenced a struc-
tured program of consolidation after the February 19 acquisition. For example, a number of
station locations were closed or downsized when original AMR station locations were geo-
graphically proximate to former Med-Trans or Brewster station locations. Employees at these
locations were either temporarily transferred or permanently assigned to new station locations,
so that in a number of circumstances original AMR employees work at the same station loca-
tion along side former Med-Trans or Brewster employees (GC Exh. 20). For example, the
Hyde Park station location contains approximately 189 original AMR employees and approxi-
mately 88 former Brewster employees. Likewise, in certain station locations, former Med-

4 They include the subject agreement covering EMTs and paramed-
ics in the Worcester area, the agreement with the Office and Profes-
sional Employees International, Local 6, covering EMTs and paramed-
ics in the Springfield area (Jt. Exh. 21), the negotiation of an agreement
with the Service Employees International Union, Local 285, covering
EMTs and paramedics in the Pittsfield area pursuant to its December 2
certification, and the remaining five agreements are for EMTs and
paramedics located in Connecticut and New York.
Trans and Brewster employees now partner with original AMR employees. Thus, in a number
of station locations, there is daily contact among original AMR and former Med-Trans and
Brewster employees. Such contact also occurs when ambulance crews respond to the same
call, when an ALS/BLS intercept occurs,5 and when emergency situations require multiple
vehicles to respond to the same call. Additionally, based on operational necessity, employees
are temporarily transferred between 1 and 30 days from their permanently assigned location to
another station location either physically reporting into that station location to receive work
assignments or receiving radio dispatched calls while in their vehicle from the new station
location. At the end of each work shift, employees that are temporarily transferred into another
station location return to their home base and are given instructions for their next work assign-
ment that might include reporting back to that same temporarily assigned station location,
reporting to another nearby station location or remaining within the boundaries of their perma-
nently assigned station location.
Effective with the February 19 acquisition, Respondent AMR began the task of restructur-
ing its operation both on a national and divisional basis. On a national basis, common stan-
dardization of payroll functions, fleet purchase and maintenance of vehicles, procurement of
medical supplies, standardization of a common uniform, and centralization of human resource
functions were undertaken. Some of these changes were slowed because they had to be ap-
proved by the Federal Government including employee 401(k) plans and medicare and medi-
caid approval for billing purposes. The payroll operation for 26,000 employees needed to be
centralized and this is the reason that former Med-Trans and Brewster employees continued to
receive paychecks throughout 1997 under the logo of their former employer with all employees
receiving their W-2 tax forms for that year from Respondent AMR’s headquarters in Colorado.
As it relates to division 12, former managerial and supervisory personnel of original AMR
and former Med-Trans and Brewster entities are unified into one management structure. Thus,
in a number of station locations, original AMR supervisors supervise former Med-Trans and
Brewster employees while former Med-Trans and Brewster supervisors supervise original
AMR employees.
Hiring is centralized in Natick, new employee interviewing and orientation takes place in
Hyde Park, and disciplinary standards are uniform for all employees. While all employees
continued to wear their former uniforms until they were fitted and wore a standardized uniform
after August 1997, they received an AMR patch in early spring 1997, to be affixed on their
uniforms. On a staggered basis, all vehicles were repainted to reflect the AMR logo and new
station location signs were completed. All billing and accounts payable are consolidated in the
Natick office and all vendors were notified of the change. The dispatch function for vehicles
and chair cars, fleet maintenance, procurement of materials and the marketing function all
became centralized within the division. Training for refresher courses is centralized in Hyde
Park and mandatory training and monthly station meetings take place at various station loca-
tions for original AMR employees along side of former Med-Trans and Brewster employees.
III. ANALYSIS AND CONCLUSIONS
A. The Arguments of the Parties
The General Counsel alleges in paragraphs 7(a) and (b) of the complaint that Respondent
AMR violated Section 8(a)(1), (2), and (3) of the Act by extending recognition to Respondent
IAEP and Local 1 as the exclusive bargaining representative in an inappropriate unit consisting
of original represented AMR employees and formerly unrepresented Med-Trans and Brewster
employees, and by applying the terms of the existing collective-bargaining agreement to the
unit employees. It further alleges in paragraphs 9(a) and (b) of the complaint that Respondent
IAEP and Local 1, by obtaining recognition from Respondent AMR and applying the terms of
the existing collective-bargaining agreement to the unit employees, independently violated
Section 8(b)(1)(A) and (2) of the Act. The General Counsel further argues that the overall unit
is not presumptively appropriate under any Board standard. In this regard, the General Counsel
relies on the fact that the unit is not employerwide nor is it an administratively divided unit as
recognition was extended to include areas both in AMR’s divisions 12 and 13, with the later
5 In an EMS model system, a paramedic equipped vehicle responds
to assist an ambulance with EMTs who are qualified only to give basic
life support (BLS) assistance.
DECISIONS OF THE NATIONAL LABOR RELATIONS BOARD 1184
division including both represented and unrepresented employees at certain station locations.
In addition, under the accretion principles established by the Board, the employees have
retained their own identity such that they could appropriately be included in another unit.
Moreover, there is not a substantial community of interest to properly include the formerly
unrepresented Med-Trans and Brewster employees in the existing unit. Thus, it is inappropriate
to disenfranchise the approximate 760 former unrepresented employees from there right to
select or not select a representative of their own choosing.
Respondent AMR opines that it extended recognition consistent with the terms of the par-
ties’ preexisting collective-bargaining agreement, and the original AMR employees still consti-
tute a majority of the employees in the appropriate bargaining unit. It further argues that the
purpose of the acquisition was to provide efficient and cost effective service in a very competi-
tive environment and in order to accomplish this purpose, all of the traditional community-of-
interest factors were met. In this regard, Respondent AMR integrated its operations, centralized
labor relations and the prior identity of former Med-Trans and Brewster employees has been,
essentially, obliterated. Further, wages have been raised to bring the previously unrepresented
employees to parity with other employees under the collective-bargaining agreement and other
terms and conditions of employment have been standardized.
Respondent AMR and Respondent IAEP in denying that the Act has been violated assert
that this is a paradigmatic case in that the Board has not addressed the principles of accretion in
the context of emergency medical services. They point to a line of cases in the package deliv-
ery and public utilities industries as instructive in determining the appropriateness of the unit
and the extension of recognition in the subject case.
B. Board Case Law
In Baltimore Gas & Electric Co., 206 NLRB 199 (1973), the Board described the rationale
for its view that, in general, systemwide units are optimal in the public utility industry:

As the parties are aware, the line of Board precedents developed for the public utility
industry contains frequent expression of the Board’s view that a systemwide unit is the
optimal appropriate unit in the public utility industry and of the strong considerations of
policy which underlie that view. That judgement has plainly been impelled by the eco-
nomic reality that the public utility industry is characterized by a high degree of interde-
pendence of its various segments and that the public has an immediate and direct inter-
est in the uninterrupted maintenance of the essential services that this industry alone can
adequately provide. The Board has therefore been reluctant to fragmentize a utility’s
operations. It has done so only when there was compelling evidence that collective bar-
gaining in a unit less than systemwide in scope was a “feasible undertaking” and there
was no opposing bargaining history. As an examination of the cases in which narrower
units have been found appropriate indicates, it was clear in each case that the boundaries
of the requested unit conformed to a well-defined administrative segment of the utility
company’s organization and could be established without undue disturbance to the
company’s ability to perform its necessary functions. 6

The Board follows a restrictive policy in finding accretion because it forecloses the em-
ployees’ basic rights to select their own bargaining representative. Towne Ford Sales, 270
NLRB 311 (1984); Melbet Jewelry Co., 180 NLRB 107 (1970).
Accretion is not applicable to situations in which the group sought to be accreted would
constitute a separate appropriate bargaining unit. Passavant Health Center, 313 NLRB 1216
(1994). The Board will find a valid accretion when the extended recognition involves employ-
ees who have little or no separate group identity and when the additional employees share an

6 In Purolator Courier Corp., 265 NLRB 659 (1982), the Board
concluded that the courier-guards in the Employer’s south-central re-
gion rather than a single location unit at one location was appropriate
for collective-bargaining purposes. In this regard, all of the Employer’s
courier-guards wear identical uniforms, drive the same type of vehicle,
perform the same work duties, and are subject to the same work rules
and enjoy common wage scales, increases, vacation benefits, and paid
holidays all of which are determined by the national headquarters.
overwhelming community of interest with the pre-existing unit. Super Valu Stores, 283 NLRB
134, 136, (1987); and Safeway Stores, 256 NLRB 918 (1981).
The Board when considering the appropriateness of accreting employees into an established
bargaining unit, evaluates the following factors: “the integration of operations, centralization of
managerial and administrative control, geographic proximity, similarity of working conditions,
skills and functions, common control over labor relations, collective bargaining history and
interchange of employees.” TRT Telecommunications Corp., 230 NLRB 139, 141 (1977).
Lastly, the Board has held that unit clarification and accretion principles are applicable to
merged operations involving represented and unrepresented employees. Armco Steel, 312
NLRB 257, 259 (1993); and Central Soya Co., 281 NLRB 1308 (1986).
C. Conclusions
1. The appropriate unit
The subject case presents an opportunity to determine whether Respondent AMR extended
recognition in an inappropriate unit, whether a systemwide unit is the optimal appropriate unit
as found in the public utility industry or as the Board has held a narrower unit is appropriate
when it is clear that the unit conforms to a well-defined administrative segment of the organiza-
tion and could be established without undue disturbance to the Company’s ability to perform its
necessary functions.
The facts in this matter establish that all original AMR and former Med-Trans and Brewster
employees are subject to the same companywide policies, practices, and procedures. In the
main, all terms and conditions of employment, specifically including hours, wage rates, wage
progressions, fringe benefits, work rules, job classifications, and duties within those classifica-
tions are instituted and determined on a divisionwide basis. It is undisputed that each AMR
division maintains strict control over virtually all aspects of operations and labor relations
throughout its geographic boundaries, and maintains uniform control over scheduling and
routes assigned to its employees. Division personnel spend a substantial amount of time
visiting the station locations where they review routes and monitor compliance with all of
AMR’s policies and procedures. All of AMR’s employees including former Med-Trans and
Brewster personnel wear identical patches and, after August 1, the same uniforms, drive the
same type of vehicle, perform the same work duties, are subject to the same work rules and
receive the same benefits. Likewise, all employees receive the same annual and sick leave, the
same number of holidays, and the national headquarters in Colorado handles their payroll.
Each division plays an important role in hiring, firing, and transferring employees, and cen-
tralizes the format and language to be used in advertisements for new hires. New employee
orientation and interviewing is centralized within each AMR division. Training and staff
meetings are centralized by division and involve contact among original AMR and former
Med-Trans and Brewster employees. Contact among employees also occurs when the crews
respond to the same call and in a situation requiring multiple vehicles to respond to the same
emergency call. Transfers also require the approval of division personnel. In this regard,
temporary transfers from one station location to another from 1 to 30 days in duration occur on
a regular basis. Thus, EMTs and paramedics are transferred from their permanent station
location to other nearby station locations either physically reporting into that station to receive
work assignments or they receive radio dispatched assignments while in their vehicles from the
new station location. At the completion of the daily work shift, employees return to their
permanently assigned station location and receive their work assignments for the next shift
which might include returning to the same temporarily assigned station location, being sent to
another nearby station location or remaining within the boundaries of their permanently as-
signed station location.
In view of the factors discussed above, I conclude that a bargaining unit limited to AMR’s
division 12 employees rather than an employerwide unit is appropriate in the subject case. I
reach this decision based on the high degree to which AMR’s operations are integrated as a
result of demands for time-sensitive response time, the overlapping and common supervision
under which EMTs and paramedics routinely work, the contact among original AMR and
former Med-Trans and Brewster employees in individual station locations throughout division
12, the uniformity of EMT’s and paramedics’ working conditions and duties, and the broad
authority over daily operations and labor relations exercised by division 12 personnel.
AMERICAN MEDICAL RESPONSE 1185
Based on this finding, it follows that when Respondent AMR extended recognition to Re-
spondent IAEP for the employees located in division 12, it was a legitimate and lawful exercise
and did not contravene the Act. Indeed, the original AMR employees still constitute a numeri-
cal majority when the former Med-Trans and Brewster employees are included in the division
12 unit. Central Soya Co., supra. On the other hand, the facts establish that the extension of
recognition reaches across divisional boundaries and includes former Med-Trans employees
located in the Worcester area that is part of division 13.
The record establishes that AMR has eight separate collective-bargaining agreements with
various labor organizations including the subject Union in division 13. Additionally, it is
undisputed that division 13 contains unrepresented employees in stations including North
Hampton, Massachusetts; Bridgeport, Waterbury, and Southington; Connecticut; and Farming-
ton and Ronkonamha, Long Island, New York. I find that the former Med-Trans employees in
division 13 have retained their own identity such that they could appropriately be in another
bargaining unit and do not share a community of interest with employees in the division 12
unit. Under these circumstances, and particularly noting my finding that AMR divisions are
appropriate administrative segments, the extension of recognition to those former Med-Trans
employees located in division 13 contravenes the Act.
Therefore, I find that when Respondent AMR extended recognition to Respondent IAEP for
the former division 13 Med-Trans unrepresented employees and Respondent IAEP acquiesced,
Respondent AMR violated Section 8(a)(1) and (2) of the Act and Respondent IAEP violated
Section 8(b)(1)(A) of the Act. Contrary to the General Counsel, I do not find that Respondent
AMR extended recognition to Local I as the exclusive collective-bargaining representative. In
this regard, both the July 29 extension of recognition (Jt. Exh. 20), and the parties’ collective-
bargaining agreement (Jt. Exh. 1), conclusively establish that only Respondent IAEP obtained
recognition for the employees in the unit. Thus, Local 1 did not violate Section 8(b)(1)(A) of
the Act, and I recommend that those allegations be dismissed.
2. The collective-bargaining agreement
The General Counsel alleges in paragraph 7(b) of the complaint that Respondent AMR has
extended, maintained, and enforced a collective-bargaining agreement, containing a union-
security clause, with Respondent IAEP and/or Local 1 covering the employees in the unit in
violation of Section 8(a)(1) and (3) of the Act. Additionally, the General Counsel alleges in
paragraph 9(b) of the complaint that Respondent IAEP and/or Local 1 has maintained and
enforced a collective-bargaining agreement with Respondent AMR covering the employees in
the unit in violation of Section 8(b)(2) of the Act.
There is no dispute that the July 29 recognition agreement provides that AMR voluntarily
agrees to recognize the Union as the exclusive bargaining representative for all its employees,
including the former Med-Trans and Brewster employees, and to extend all of the benefits,
privileges, and obligations of the collective-bargaining agreement, in effect between the parties,
to its employees. Likewise, record testimony indicates that wages of former Med-Trans and
Brewster employees were raised to the minimum level required in the parties’ agreement to
conform with those wage rates paid to original AMR employees, and certain former unrepre-
sented employees after July 29, used the services of the Union for representational purposes
under the parties’ agreement.
Under these circumstances, I find that Respondent AMR and Respondent IAEP violated
Section 8(a)(1) and (3) and 8(b)(2) of the Act when the parties’ collective-bargaining agreement
was extended to cover the wrongly accreted employees in division 13. Mego Corp., 254 NLRB
300 (1981). Consistent with my above finding, I do not find that Local 1 maintained and
enforced the parties’ collective-bargaining agreement and recommend that those allegations in
the complaint be dismissed.
In regard to the union-security provisions contained in the parties’ agreement, credible tes-
timony establishes that the provisions of the union-security clause are not being enforced.
Thus, no dues have been paid to the Union, no employee has been required to become a mem-
ber of the Union, and the Union has not requested AMR to terminate any employee for the
refusal to tender periodic dues and initiation fees. According to the Board, however, this is not
dispositive. Thus, in Combustion Engineering, 195 NLRB 909 (1972), the Board held that the
fact that an employer expressed its intention to wrongfully accreted employees that the union-
security provisions applied to them, violates the Act. In the subject case, the evidence shows
that Olson told employees that Respondent would terminate employees for failing to pay union
dues and Respondent IAEP sent correspondence stating that each employee must be a dues
paying member to maintain employment. Accordingly, I find that Respondent AMR and IAEP
violated Section 8(a)(1) and (3) and 8(b)(2) of the Act when they expressed their intention to
extend the union-security provisions contained in the parties’ agreement to the wrongly ac-
creted employees in division 13. Consistent with my above finding, I do not find that Local 1
maintained and enforced the parties’ collective-bargaining agreement including the union-
security provisions and recommend that those allegations in the complaint be dismissed.
3. The status of Respondent AMR as a health care institution
During the course of the hearing, counsel for Respondent AMR and IAEP asserted that
AMR might be a health care institution as defined in Section 2(14) of the Act, and therefore,
should benefit from the congressional admonishment against the undue proliferation of bargain-
ing units in the health care field.
While not dispositive to the underlying issues in this case, I find that the definition of a
health care institution in Section 2(14) of the Act does not specifically include ambulance
companies.7 Thus as the Board held in Albuquerque Ambulance Service, 263 NLRB 1 (1982),
ambulance services are merely engaged in the business of transporting patients to health care
institutions, and are not themselves health care institutions as defined in the Act. This specific
finding was not disturbed by the United States Court of Appeals for the 10th Circuit in Albu-
querque Ambulance Service v. NLRB, 736 F.2d 1332 (10th Cir. 1984).
CONCLUSIONS OF LAW
1. Respondent AMR is an employer engaged in commerce within the meaning of Section
2(2), (6), and (7) of the Act.
2. Respondent IAEP and Local 1 are labor organizations within the meaning of Section
2(5) of the Act.
3. Respondent AMR engaged in violations of Section 8(a)(1) and (2) of the Act by granting
recognition to Respondent IAEP as the exclusive collective-bargaining representative for
certain former unrepresented Med-Trans employees in AMR’s division 13.
4. Respondent IAEP engaged in violations of Section 8(b)(1)(A) of the Act when it ob-
tained recognition from Respondent AMR as the exclusive collective-bargaining representative
for certain former unrepresented Med-Trans employees in AMR’s division 13.
5. Respondent AMR engaged in violations of Section 8(a)(1) and (3) of the Act when it
extended, maintained, and enforced a collective-bargaining agreement containing union-
security provisions with Respondent IAEP covering certain former unrepresented Med-Trans
employees in AMR’s division 13.
6. Respondent IAEP engaged in violations of Section 8(b)(2) of the Act when it extended,
maintained, and enforced a collective-bargaining agreement containing union-security provi-
sions with Respondent AMR covering certain former unrepresented Med-Trans employees in
AMR’s division 13.
7. Local 1 did not engage in violations of Section 8(b)(1)(A) or (2) of the Act. It did not
obtain recognition from Respondent AMR as the exclusive collective-bargaining representative
for certain former unrepresented Med-Trans employees in AMR’s division 13 nor did it extend,
maintain, or enforce a collective-bargaining agreement containing union-security provisions
with Respondent AMR covering certain former unrepresented Med-Trans employees in AMR’s
division 13.
8. The unfair labor practices described above affect commerce within the meaning of Sec-
tion 2(6) and (7) of the Act.
REMEDY
Having found that Respondent AMR and Respondent IAEP have engaged in certain unfair
labor practices, I find that they must be ordered to cease and desist and to take certain affirma-
tive action designed to effectuate the policies of the Act.

7 In Lifeline Mobile Medics, Inc., 308 NLRB 1068 (1992), although
the Regional Director found that the employer, an ambulance service, is
a health care institution under Sec. 2(14) of the Act, the Board did not
address that issue as no party requested review of that finding.
DECISIONS OF THE NATIONAL LABOR RELATIONS BOARD 1186
[Recommended Order omitted from publication.]