On the day Gov. Jerry Brown gathered last week in Los Angeles with legislators and union members to sign a bill raising California’s minimum wage to $15 an hour by 2022, Dave Regan was calculating the payoff for workers at his health care union’s office in Oakland.

His organization, representing 85,000 hospital employees, spent about $1.6 million to qualify a minimum wage initiative for the fall ballot.

For the relatively small sum the union spent, he said, millions of low-wage workers will get $20 billion in increased wages once their pay rises to $15 an hour.

Regan, president of the Service Employees International Union-United Healthcare Workers West, said the rough estimate demonstrates what he’s been saying for years – that ballot measures are “the best bargain in American politics.”

Brown credited Regan’s measure, along with a separate wage-hike proposal by SEIU California, for pushing political leaders to agree on the historic accord.

“This is the work of many hands and many minds and many hearts,” Brown said at the signing ceremony. But he added, without the looming ballot initiatives, “we probably wouldn’t be here today.”

The deal validates a divisive strategy embraced by Regan, who over his career has made frequent use of the initiative process to advance an aggressive political agenda and secure partnerships from reluctant employers. Twice he’s used the prospect of stringent proposals to forge pacts between his union and hospitals – a dynamic that’s earned the outspoken labor leader such uncharitable labels as “ballot measure extortionist.”

Regan said doubters should look to the momentous wage deal. It allows governors to postpone increases in tough financial times and provides three annual sick days for in-home health aides. Regan’s initiative did not include the delays or the sick days, but would have raised the base wage to $15 an hour by 2021.

“Most people today are very cynical about the political process. This is something for us where what you do has a direct effect on the bottom lines of millions of people,” Regan said. “It proves the point that this (ballot) mechanism has all kinds of political possibilities that we intend to follow up with.”

Regan’s leadership style and internal criticism of labor failings pique civic players and unions alike, however, and many in the labor community downplay his significance in the political sphere.

Leveraging the Legislature and governor with ballot measures is “over-rated now (because) so many people do it,” said veteran Democratic strategist Gale Kaufman, who works extensively with labor on initiative campaigns.

“Unless you have the full backing of your own organization and others, it rarely works,” she said. “You can get people’s attention for 20 minutes, but you can’t get issues resolved … All you do is make a lot of noise.”

Steve Maviglio, another Democratic consultant with labor clients, said while the UHW minimum wage initiative was first to qualify this year, it’s unclear whether Regan’s coalition could have translated that success into a winning campaign in November.

“It would have required all hands on deck, and they simply don’t have the alliances within labor to lead that, nor to even be at the table with the governor to forge the successful agreement that has resulted in the biggest success for organized labor in a generation,” Maviglio said.

Regan said he’s convinced UHW would have had the partners to pass minimum wage. “We don’t go out of our way to ruffle anyone’s feathers,” he said.

Still, he acknowledged sharp differences of opinions within SEIU, contending that the union’s national leadership rebuffed his proposal to place minimum wage measures on the ballot in as many of the 24 states that allow it as possible. Here, only after he acted did SEIU California commit to introducing its measure, Regan said, an assertion other labor leaders privately dispute.

Last year, SEIU President Mary Kay Henry effectively cut UHW in half by shifting about 65,000 home care workers to the new Local 2015. Regan called the move a disservice to home care workers and said Henry acted due to “insecurity.” Officials with SEIU California and SEIU in Washington declined to comment.

Regan’s foray into labor happened by chance when he moved to Columbus, Ohio, after spending a year teaching high school math in Buffalo, N.Y. Then 24 years old, he came upon a newspaper ad that caught his attention: “Union Organizer. Long hours. Low pay. Must be committed to social and economic justice.” It paid him $17,000 a year.

Known for his tough command, Regan spent 12 years as the head of SEIU District 1199, with members in Ohio, Kentucky and West Virginia. Before advancing to the international as an executive vice president, he turned the local into a political force in races across Cleveland, Cincinnati, Youngstown and Toledo. Reports critical of the hospital industry were deployed to spur changes – and grow union membership.

Regan’s first taste of the ballot’s potential came in 2003, when Cuyahoga County considered a health and human services tax for children, seniors and the developmentally disabled. He and another labor leader told county officials they would back the tax measure if they went neutral in union elections rather than devote taxpayer money to oppose organizing efforts. When officials refused, Regan set out to tank the levy, but failed.

In 2008, Regan helped qualify for the Ohio ballot a proposal providing paid sick leave for workers, though it was ultimately pulled by his successor.

Former Ohio Gov. Ted Strickland said he talked with Regan about how labor is too often forced to play defense on issues that affect its self-interest, like collective bargaining. In California, labor spent upward of $150 million to defeat three measures between 1998 and 2012 that threatened to limit union political spending.

Regan told him they needed to turn the tables and go on offense.

“It’s a way that advocates for working folks can take the ballot and try to achieve something that’s positive for working people rather than simply trying to hold onto what we already have,” Strickland said. “That made a lot of sense to me. I think (that’s) what he has been doing in California.”

Regan came to California, which he calls “the most interesting laboratory in the country,” after SEIU took trusteeship of UHW in 2009. His objective was lofty: to redefine what the union is about.

“Most Americans think unions are a narrow special interest that don’t care about the common good or common welfare. And I think that’s fair criticism,” he said. “So much of what the labor movement does today is act at the margins,” not in the public interest.

Ballot initiatives, he said, can help unions meet that goal.

Still new on the scene in 2011, Regan seized the attention of the California hospital industry with a pair of proposed 2012 initiatives to halt excessive hospital billing and expand charity care. Three-quarters of the hospital industry pays no taxes, Regan argued. Tax-free companies shouldn’t be permitted to overcharge patients. It got him a seat at the table.

After two months of meetings, UHW and the California Hospital Association said the measures were being dropped, and that the traditionally adversarial organizations were on a new course to address the challenges facing the health care system, including rising costs. The hospital association was to help set up meetings with its CEOs that could allow UHW to grow its ranks by 100,000 nonunion workers.

UHW’s strategic marriage soon dissolved. Regan said hospitals weren’t prepared to agree on specifics for bringing down costs. The hospital association argued it wasn’t an “agent” for hospitals in labor matters.

The next year, Regan came to Sacramento to file 2014 initiatives to ban hospitals from overcharging and decrease executive compensation at nonprofit facilities. Hospital officials, including the association’s chief executive, Duane Dauner, this time said UHW was making an obvious play for leverage.

Just a few months after the filing, there was another deal between them, the centerpiece of which was a $100 million joint campaign to find a way to increase funding for Medi-Cal, the state’s health insurance program for the poor. The partners were not to criticize each other in public, and some 60,000 workers would be able to join the union with minimal interference.

They developed a 2016 initiative to raise income taxes on the wealthy, but conflict ensued, prompting a court battle between the on-again, off-again partners.

Regan was accused of assaulting a process server at his home in Kensington. He called it an outrageous claim, and his attorney characterized the allegation as attempted intimidation by the hospital association.

A spokeswoman for the association, which has joined another tax initiative, said the group would not comment on Regan, citing the legal fight as the reason.

Now, UHW’s newest version of the proposal on hospital executives’ pay is back on the streets gathering signatures for the fall ballot. UHW is turning to the courts for Medi-Cal money via a federal civil rights complaint.

Regan has clashed with others. Sal Rosselli, his predecessor until being replaced by their parent union in 2009, said UHW takes a top-down approach focusing on employers and politicians, not workers. “It’s the opposite ideology of what we have,” said Rosselli, of the rival National Union of Healthcare Workers.

The alliance with hospitals is clear evidence that UHW was too cozy with the industry, said Jamie Court, president of Consumer Watchdog. Court said UHW crossed a line by agreeing not to pursue, sponsor or support legislation considered adverse to hospitals.

“He’s the Vichy France of the labor movement,” Court said of Regan, comparing him to World War II collaborators with occupying Nazi forces. “He’ll sleep with the Nazis if it will get him what he wants. But you know what? Labor unions (should) fight corporations.”

Others see the partnerships as innovative, even visionary.

Lenny Mendonca, director emeritus of McKinsey & Co., and co-chairman of California Forward, said he appreciated Regan’s willingness to ally with employers in an effort to redefine the way care is delivered and financed. He conceded it’s not universally popular.

“When you are breaking orthodoxy, those who adhere to the orthodoxies sometimes find you a heathen,” Mendonca said. “I find it refreshing. (He’s) prepared to do things others haven’t thought of beyond a traditional labor approach.”

Regan is not finished with raising the minimum wage, which he originally proposed in California three years ago, or the statewide ballot. His union contributed $5 million to The Fairness Project to advocate for wage hikes in other states. He wants to build toward qualifying initiatives entirely through volunteers. The union may focus on housing, student loans, preserving retirement benefits and what it calls a fair work week.

“Using direct democracy expands the range of possibilities,” he said. “I don’t think you could look to elected officials as your saviors.

“That’s not their jobs.”