After months of pressure from UAPD, in January 2021 the LA County Chief Executive Officer (CEO) issued a memo authorizing a “Critical Shortage Recruitment Rate” for obstetric, pediatric and cardiothoracic anesthesiologists which moved them to the top step of the pay scale resulting in pay increase of about $5,000 per month. This victory capped a process initiated in contract negotiations in 2018 where the County failed to adequately address inequities in anesthesiologist pay. On July 1, 2019, the CEO issued a memo authorizing the Critical Shortage Rate, but it was only implemented for some anesthesiologists. Those who had been left out approached UAPD Representative/Organizer Rob Leonard in August 2020 asking that something be done to address this inequity. After informal efforts to address this with DHS leadership failed, Mr. Leonard issued a demand letter which initiated a process that ultimately resulted in the new Rate being given to anesthesiologists across DHS.