Keeping the Promise: Aging with Dignity

by Wilma Chan

5/25/00

Like many of you, I was heartened to see Governor Gray Davis announce the 'Aging with Dignity Initiative' during his State of the State speech in January.

Access to good quality, affordable home-based support services is important to millions of Californians. Statewide, more than 220,000 frail elderly and people with disabilities are able to remain in their own homes thanks to the daily assistance they receive from 200,000 home health care workers. For families who want to keep loved ones at home and for all of us who will one day come to rely on the state's long-term care programs, home-based services are critical to keeping families together. We depend on home health care workers as the 'front line' in keeping the elderly independent, yet most earn little more than minimum wage and work without health insurance. The work they do helping elderly and disabled residents live lives of dignity and independence, rather than being forced into institutions, is essential. Unfortunately, low wages and lack of benefits has resulted in high staff turnover and the disruption of vital services. More than 7000 seniors and people with disabilities in Alameda County alone depend on these workers for help with cooking, dressing and other daily tasks. It is imperative that we insure stability by paying a decent wage and providing benefits.

Earlier this month, Governor Gray Davis kept his promise to "keep families together by providing services older Californians need to remain in their own homes, instead of nursing homes" by proposing an increase in the wages of home care workers' to $7.50 this year and to $11.50 over the following four years. He has also recommended investing $30 million towards health care benefits.

Governor Gray Davis and the Legislature have earned our strong endorsement for responding to the needs of the elderly and people with disabilities. If these proposals are adopted in the final budget, Governor Davis will have done more for home health care than any Governor in memory. This is a tremendous step towards ensuring stability, continuity and quality services for the elderly.

Now we need to follow up on the local level by paying our share of wage and benefit costs. We also need to look towards the future. I believe that in the next five years, we must work to further professionalize the homecare workforce by strengthening and stabilizing health insurance benefits, adding retirement benefits and providing additional hours of service to consumers. Further, we must expand access to affordable, home-based health care services to all California families on a sliding fee basis.

As Governor Gray Davis and the Legislature begin to finalize the budget, they deserve a great deal of credit for giving a fair shake to the elderly, people with disabilities, and their caregivers.

WILMA CHAN is President of the Alameda County Board of Supervisors and Chair of the Health Committee.

Home-Care Workers Press Pay Demands

Labor: Hundreds employed by government march in L.A. for raises and health insurance.

By Nancy Cleeland, Times Staff Writer

Los Angeles Times, Wednesday, May 10, 2000

Hundreds of government-paid home-care workers and their clients--including some in wheelchairs--marched through downtown Los Angeles Tuesday afternoon to underscore their demands for a substantial raise and health insurance.

Wearing purple T-shirts and chanting "No justice, no peace," the demonstrators were clearly borrowing tactics from the successful janitors' strike of last month, which featured boisterous daily marches.

Both sets of workers are represented by the fast-growing Service Employees International Union. The home-care workers, who marched from the governor's office to the county building, vowed to escalate their actions unless the state offers a substantial wage hike.

About 72,000 unionized workers in Los Angeles care for the disabled and elderly in the patients' homes under a program funded by federal, state and county governments. They earn $6.25 per hour with no health benefits. Gov. Gray Davis has proposed a 35-cent raise for each of the next five years, and county officials have refused to budget any wage increases. Workers are seeking an immediate jump to $7.50 per hour plus health insurance.

"I'm a nurse, a mother, a cook and more for these people," said Theresa Edwards, who cares for two women in their 90's and a younger client left partly paralyzed by a stroke. She said she is paid for 291 hours a month, which does not include the bus commute between her clients, who live in South-Central Los Angeles and Santa Monica.

"I do it because I like working with people, and they need someone to help them," Edwards said as she marched, holding a picket sign. "But I have to live too."

Davis is due to release a revised budget early next week, and union officials said they were optimistic that it would include funding for a higher wage. A spokeswoman for the governor said she could not comment on the home-care issue until the revised budget is released.

Union leaders said part of the state's projected multibillion-dollar surplus should be used to help home-care workers, particularly because those workers allow patients to stay home rather than move to more costly state facilities.

"This is a question of political will," said Tyrone Freeman, general manager of SEIU Local 43B, which organized the workers a year ago. "The surplus is there. If we can't do it now, we'll never get there."   

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L.A. County Home-Care Aides Still Seek 'Fair Share'

Labor: State and local officials blame each other for failing to help improve workers' wages, benefits.

Los Angeles Times, Tuesday, March 14, 2000

By: NANCY CLEELAND and NICHOLAS RICCARDI, TIMES STAFF WRITERS

A year after celebrating the largest union victory in recent U.S. history, 74,000 Los Angeles home-care workers are only marginally better off, with wages up a mere 50 cents an hour and health insurance still nowhere in sight.

The landmark vote by Los Angeles care providers in February 1999 boosted union membership in the county by 10%, and was hailed by national labor leaders as proof that organizing low-wage, immigrant and minority workers can pay off in big numbers.

But as events of the last year have demonstrated, even when organized, such workers face great obstacles in improving wages and benefits. For workers who were active in the union drive and who supported political candidates who promised to help them, the experience has been sobering.

"Thank God for the 50 cents, but it's still a poverty wage," said Mary Simmons, who cares for a partially paralyzed stroke victim. "Everything is such a fight. Sometimes it seems like no one's listening to us."

State and county political leaders who once championed the home-care cause have blamed each other for failing to contribute a "fair share" to the workers. But the complicated mechanics of the program--which is funded by three levels of government while an L.A. County-appointed board serves as the employer of record--also has hampered progress.

Care providers now earn $6.25 per hour, up from the state minimum wage of $5.75. In contrast, home-care workers in San Francisco earn $9 per hour with medical and dental insurance.

County home-care workers feed, clothe, bathe and provide other assistance to elderly and disabled clients in their homes. They are paid out of a mix of county, state and federal funds. Advocates say the program saves the state millions of dollars a year by keeping indigent people at home rather than in more costly facilities.

Advocates for higher pay note the irony that many of those who care for the county's sick and infirm cannot afford health care themselves. A recent survey by researchers with USC and the Service Employees International Union found that 45% of the home-care providers in Los Angeles have no health insurance.

Debate Over Who Should Bear Costs

State and county officials have said they favor higher pay and benefits for home-care workers, but have not produced proposals that would make the increases possible.

L.A. County supervisors have said the state should bear much of the cost of any raise because the program saves the state government so much money. In fact, when supervisors created the public board that allowed home-care workers to unionize, they did it with the understanding that no additional county funds would be spent.

"The linchpin to all this is state funding," said L.A. County Supervisor Zev Yaroslavsky, who was among a half a dozen political leaders on hand to celebrate the union victory last year. "The county has done a lot here," he said. "The county created the vehicle through which the in-home care workers could be unionized."

But Gov. Gray Davis and several state legislators said L.A. County should help fund an increase. "The county has obligations and there's an expectation they fulfill them," said Assemblyman Gil Cedillo (D-Los Angeles). "The state would be willing to work with them."

After federal grants, the Los Angeles County-state split has been 35-65 to pay for in-home health-care workers, officials said. Last year, the county paid 20% of the cost for the new 50-cent raise, with the state picking up the remainder. Gov. Davis has irked the county this year by proposing it resume its 35-65 ratio to fund future raises.

Jeanine Meyer Rodriguez, a legislative strategist with the SEIU state council, said such arguments have been typical of negotiations for the last year. "One of the problems has been that no level of government takes full responsibility," she said. "When it comes to making improvements, they all point to the other. Our challenge is to work at each level. That's why things are so slow."

The campaign to unionize home-care workers in Los Angeles dates back to 1990. At that time, home-care workers, who found clients through classified ads or word-of-mouth, were considered independent contractors and so could not form a union. The state eventually passed legislation that allowed counties to appoint boards that would act as the employer of record, so that the workers would be considered employees.

Five other counties--San Francisco, San Mateo, Contra Costa, Alameda and Santa Clara--also established boards, and workers eventually voted in unions. Wages in those counties range from $6.05 in San Mateo to $9 in San Francisco, where the county is picking up the entire increase.

But when Los Angeles County supervisors established the Personal Assistance Services Council in 1997, they made it clear the county would not contribute to any increase in wages or benefits. They were willing to assume the 20% cost for last year's raises, county officials said, because a change in the formula for their federal funding covered the county's share of the raises.

Davis, who courted home-care workers during his 1998 campaign, has proposed a 50-cent annual raise for home-care workers over the next five years on the condition that counties pay 35% of it.

"Right now what the governor is saying is, 'I'm going to put in a higher rate [of funds for raises] than I ever have before.' What's in the governor's budget is what the governor feels he can commit to this program," said a Davis spokeswoman, who would not speak on the record.

At Least Another Year to See Change

Art Pulaski, secretary-treasurer of the California Federation of Labor, said labor--a strong ally of Davis during the campaign--was "vigorously supporting a significant increase" in pay and benefits for home-care workers. On the other hand, Pulaski didn't expect any news soon.

"It always takes a few years once you get organized for things to really take shape," he said. "But in this case, it's complicated further by the quasi public/private nature of these workers. It's not like you're sitting down at a negotiating session with an employer who's got money in his pockets.

"On top of that, you've got an extremely deliberative governor, who really studies an issue before he makes a decision. I'd say it may be another year at least before you see a significant change."

In the meantime, home-care workers in Los Angeles have a union hall that offers groceries at warehouse prices five nights a week and free English and Spanish classes two nights a week.

"Sometimes in this job, you feel like you're all alone," said Simmons. "You might be with your client eight hours a day, even longer. You lift them out of bed, put them on the potty, put on their clothes. You pray with them, and you try to keep them from getting too depressed. I don't think most people understand what that's like. At least here at the union, you get to meet other people who are going through the same thing."

Wage Disparity

Hourly wages vary considerably for in-home health-care workers who have voted to unionize in six California counties:

San Francisco: $9*

Contra Costa: 7.01

Santa Clara: 6.25

Alameda: 6.25

Los Angeles: 6.25

San Mateo: 6.05

*Health benefits included

Source: SEIU Local 434 IG Wage Disparity, Los Angeles Times

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Mean and Cheap
The State Drops the Ball on Health Care for Health Workers

LA Weekly - February 11-17, 2000

When last we wrote of local home health-care workers, there was hope in the air. As you may recall, the Los Angeles County Board of Supervisors asked the state for some health-care benefits for primary health-care givers. Those workers — 73,000 of whom have registered with the county — come into your home when you can’t take care of yourself and take care of you. They help many thousands of seniors, people with disabilities, and people of all ages who simply need care during recovery from severe accidents and illness. They do difficult work; they get paid around $6 an hour to feed, clean, medicate and otherwise assist people in their homes. "The work they do is unremunerative and burdensome," said Supervisor Zev Yaroslavsky last week. And in its difficulty and quiet importance, there’s something saintly about their task.

So why is the state suddenly trying to off load its share of the health-care burden on the counties? Late last year, this column reported that the county was requesting — via a motion by all the supervisors — that the state cover some or all of the costs of a health-care benefits program for registered county health-care workers. Many observed that it was not a little ironic that the people who provide basic care for so many of us had no health plans of their own. Assemblyman Gil Cedillo initiated legislation toward that purpose. Supervisor Gloria Molina, who introduced the December Board of Supervisors initiative, observed that what the care workers needed most was their own medical program — even more than they needed a raise in their minimum $6.25-an-hour pay.

She’s a Democrat. So is the governor. So is most of the Legislature, for what that’s worth. You usually write about things like this, and goon to other business, because there doesn’t seem to be much standing in the way of their accomplishment. But I should have known better.

The first tip-off that things weren’t on course was in Governor Gray Davis’ initial budget message, which didn’t mention health care for care providers, but instead mentioned higher wages for health-care providers. While not a bad thing, this indicated that the governor and the county supervisors were not on the same page as to what the care workers needed.

Then came more detail: The state also wants the perpetually strapped county to pay for the promised care workers’ pay increase. And you had to stop and think: Just how generous can our governor get? "This is in the face of a $3 billion state-budget surplus," objected Miguel Santana, Molina’s deputy.

"This was supposed to be a partnership," noted Yaroslavsky, "with the state picking up costs." Currently, the state picks up 80 percent of those health-care-worker costs, while the individual counties pay 20 percent.

But the crucial datum, said Yaroslavsky, is that the state saves money even under the current system whereby it pays the lion’s share of care costs. That’s because when disabled people can’t get home care, they have to be moved to nursing homes. And for this care upgrade the state pays more.

All of which makes one wonder just what priority health care has in the Gray Davis administration. Certainly, it stood in the shadow of education in Davis’ State of the State message. It took the governor many months to appoint his current state health director, and when he did so, he ended up eschewing several nationally prominent choices in favor of Diana Bontá, whose previous career apex had been as health chief for the city of Long Beach.

Insiders suggest that the state’s health division badly needs both new goals and new, strong leadership. There are many reasons for this, including the growing number of people dependent on public health care in urban and poor rural California communities. But we also ought not to forget that, for 16 years, the state health department was a Republican satrapy, dominated by small town–conservative AMA types. If it’s going to express the higher ideals of Gray Davis’s party, this bureaucracy needs lots of winnowing out.

Otherwise, we’re going to see lots more brilliant ideas. Like the one about picking the counties’ pockets to boost the wages of the home-care workers who save money for the state.

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