It'll come down to a vote within the next 42 days thanks to a ruling from the National Labor Relations Board. Union members will decide whether or not to stay with SEIU or join the breakaway National Union of Healthcare Workers.
SEIU, which is seeking a review of the ruling, says employees could lose raises and protections if they defect.
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"This decision puts all of that at risk and holds out the real threat that we will lose what we've fought so hard to achieve," said Jeanette Cryer, a licensed clinical social worker at Kaiser Corona/Riverside Psychiatry.
Jim Clifford, a therapist at Kaiser San Diego, says the switch to NUHW will bring democracy and integrity back to their union.
"SEIU has made deals behind our backs to cut our pension and lay off 1,800 of our co-workers. We've been waiting months for the chance to join NUHW and put members in charge of our union again," he said.