US carers join fight for higher wages

A movement launched last week to raise wages and improve workplace protections for home health-care aides in the US. Photo / AP

Working a string of low-wage jobs, Lynette Reece has always had trouble paying the rent. A home health-care aide for the past 21 years, too often she has had to skip work to go to landlord-tenant court to try to hold on to her apartment.

"How can I go to work if I have to go to court?" said Reece, 46, a single mother of two in Washington who pays $985 for a two-bedroom place. "That's stressful when you're trying to concentrate at work, and you can't because you got so much on your mind."

Her predicament eased when the District of Columbia's 2006 living-wage law for government contractors - including home health-care aides paid by Medicaid - took effect. She now receives $13.60 an hour, up from $10.50 a few years ago. "I can pay my rent with one check. One check," she said.

Knowing what a difference higher pay can make, Reece joined a movement that launched last week to raise wages and improve workplace protections for home health-care aides nationwide. Backed by the Service Employees International Union, the effort seeks to replicate the "Fight for 15," a push early this year to raise the income of fast-food workers through high-profile strikes.

Last Wednesday, Reece rallied on DC's Freedom Plaza to demand the same for home health-care aides. It's part of actions in nine states aimed at putting the concerns of the nation's fastest-growing workforce - one that's 91 per cent female, 56 per cent non-white and highly dependent on public aid - on the political agenda. About 600,000 of the country's 2.1 million home health-care aides are members of the SEIU.

Home health aides can't entirely replicate the fast-food workers' tactics. Unlike someone flipping burgers, they can't just walk off the job. That would leave those they care for - the nation's parents and grandparents - in danger. Although most low-wage workers battle big corporations, home health-care workers usually deal with a different beast: the state, which ultimately pays their wages.

The SEIU, along with other unions and advocates, has had some success. Washington state recently signed a contract to raise wages over $14 an hour, while the Illinois contract raised the average to $13. Montana and North Dakota also have earmarked money to raise wages over the past few years. Others, including Missouri, are considering it.

But it's a long way to $15 in most states, and that remains the rallying cry. For Reece, the higher wage would help her get a three-bedroom apartment with a washer and dryer. "With the $15, I'll be able to pay my rent and have some change left over, be able to pay my bills," she said.

Reece is being paid substantially more than the median wage for home health aides, which is $10.01. But she and others describe a wide range of problems in the field: Agencies don't always pay their employees promptly, they don't always keep wages on track with local laws, and local governments don't always enforce the laws. Reece's agency, ASAP Services, doesn't offer paid time off or retirement benefits, and she says the health insurance option it offers is unaffordable.

"That's something we're reviewing," said Denetria Ngati, ASAP's director of nursing, referring to the prospect of offering more benefits.

According to the Paraprofessional Healthcare Institute, a nonprofit consultancy affiliated with a worker-owned home-care co-op, 58 per cent of home-care aides are either uninsured or are covered through the safety net.

Organised labour officials say it's important that these workers get a raise, and also that they join a union to give them more leverage. But there are myriad challenges. In the District, for instance, none of the 27 home-care agencies is unionised. Reece has been working with the local SEIU to try to sign people up. But many of her fellow aides are from West Africa and speak only French. "Some of these workers don't know they're supposed to be making $13.60," Reece said.

Nationally, unions have faced similar problems. Unlike factory workers, home health-care aides rarely work in the same place, requiring unions to track them down at home. They also work for thousands of small agencies, which means that unions must negotiate contracts with each one to build membership.

And it may become harder still. Earlier this year, the Supreme Court threw up a big roadblock. In Harris v. Quinn, it ruled that "fair share fees" - which many contracts allowed the SEIU to collect from all workers, whether they joined the union or not - infringed on free-speech rights.

The ruling represents a substantial financial hit for unions, and made organising that much more difficult.

"Now they have to go out there and get every single home-care worker to be a member of the union," said Janice Fine, a professor of labour relations at Rutgers University who focuses on immigrant and low-wage work.

Another obstacle in the Fight for 15 is dealing with the public sector. About three-quarters of home health aides are paid through Medicaid, which means that higher wages are a blow to public budgets, not shareholders.

By and large, states haven't been increasing budgets to keep pace. New York state, for example, cut its home health-care budget by hundreds of millions of dollars in 2011 and 2012. In 2013, it imposed a wage mandate for the New York metropolitan area that reached $14.09 in pay and benefits in March.

That has squeezed providers. According to Joanne Cunningham of the Home Care Association of New York State, which represents the private providers that employ health aides, agencies have been cutting other priorities such as training and administrative staff to comply.

"No one, least of all the agencies, wants to pay their workers anything less than a living wage," Cunningham said. "The issue is, the health-care system now is going through such change and challenge that home health-agency providers are feeling a lot of fiscal pressure, and they're having a very hard time coping with the wage mandate."

That became glaringly apparent last week, when the Obama administration announced a six-month delay in enforcement of a new federal requirement that home-care workers be paid the minimum wage and overtime. States complained that overtime protections in particular could cost hundreds of millions more per year, so the effective date was moved back to July 1.

But even in California, which has long applied its minimum wage to home health aides, an old notion remains that they aren't due full protections because it's just "companionship" - a job a young woman might do to help an aging relative. Last month, California Governor Jerry Brown signed a bill requiring employers to pay for sick leave, but home health aides were excluded.

Lifting the elderly in and out of beds, keeping track of their medicine, doing their shopping and generally keeping them healthy is just as challenging as the factory jobs of days past, Reece said.

"It's not right," she said. "We have to be their mother that died, their son that died, their daughter that doesn't come around, their niece that doesn't come around. We're like their whole family. So why can't we get paid?"