Health Advice



Unionization could help home health care workers, experts say

Eric D. Lawrence, Detroit Free Press on

Published in Health & Fitness

For Susie Young, the days before she was a unionized caregiver weren't ones to cheer about.

"Before the union came in, we had nothing," she said. "No training. Forget about a paid holiday or vacation. ... There's many workers in this country today that's where they are."

Young, 73, lives and works in Spokane, Washington, where she has been a home care worker for about 35 years. She helps a developmentally delayed man who's high-functioning enough to work outside the home and ride the bus but still needs reminders and other assistance to keep him on track.

Her workload, a couple of days a week, is less than it once was. Decades ago, Young, who's a founding member of the executive board of the Service Employees International Union Local 775, was caring for people suffering from HIV and was a union skeptic. Having to press her employers for basic protective gear, a situation that's since improved, was what, she said, changed her mind about the union.

"I had asked my office for a box of gloves. I wanted a box of gloves and I saw they're just going to give me a few gloves in a bag, and I said, 'What?' and I was very vocal about it and I said, 'I tell you what, if I get HIV, I'll be coming and making sure that my husband sues this agency because all I want is a box of gloves. And I was like, 'Oh my God, I have to fight for a box of gloves?' " Young recalled.

Washington is among a handful of states, including New York, California and Illinois, where unions play a role in direct home care. In many states, paid caregivers who work in home care are not represented, a state of affairs influenced, in part, by the way home care is funded and managed in the United States as well as the isolated nature of the workplace.


What's under consideration

President Joe Biden has said he wants it to be easier for home care workers to unionize, but there are barriers to making that happen. Anti-union forces that fight "compulsory unionism" and court rulings in recent years that prevent unions from collecting agency fees from nonmembers highlight the broader ideological challenge to union expansion in this arena.

Conservative groups that oppose unionization of home care workers, such as the Heritage Foundation, have asserted that union membership numbers and coffers benefit more than the workers themselves. A 2014 article in the foundation's "The Daily Signal" publication said unions "negotiated union contracts on their behalf that include mandatory dues payments — and sometimes little else," a view rejected by union supporters.

Caregivers in home care generally work for low wages, a point reinforced when California's state auditor this year wrote to the governor and other officials that many full-time caregivers there would qualify for public assistance. One of the key areas where unions are expected to deliver for their members, however, is in better pay.


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