Unions Set Sights on Home Health Care Industry

The government is paying more and more people to care for the elderly in their homes as the U.S. population ages. The Wall Street Journal reported that it’s triggered unions to attempt to organize these workers, who usually get low wages and few or no benefits. However, some question whether home health workers qualify to join a union, stating that many are caring for family members and relatives and could be conceived as being self-employed. A 2011 study authorized by the state of Michigan found that 75% of home-care providers in the state went into the field to care for a family member or friend. This has spurred debate in legislative branches over whether to allow or forbid these workers from unionizing.

Many home health care aides are employed directly by people with disabilities or their families, as opposed to working for a private agency. The workers are by and large paid with Medicaid or Medicare funds managed by the state.

The Labor Department expects the number of home health-care workers to reach 3.2 million by 2020, a 68% increase from 1.9 million in 2010.
Home health-care workers are also known as personal-care aides, and their daily duties usually include bathing, dressing and feeding the elderly and those with disabilities, and they did this for a median wage of $9.70 per hour in 2010, according to the Labor Department’s reports. Many of these workers don’t have health-care coverage themselves.

Democratic lawmakers and unions agree that workers receiving public funds are state employees and therefore can be unionized. However, many Republican lawmakers and those anti-unionization argue that personal-care aides are independent contracts and therefore don’t qualify to join unions.

An estimated 25 percent of home care workers in America belong to unions. Perks vary for unionized home-care workers. The article noted that in northern California, personal-care aides who are members of SEIU make more than $12 per hour and a small number of them have health care through union contracts. However, in Michigan, SEIU organized 41,000 home-care workers in 2005, and today, many earn only $8 an hour, just slightly more than the federal minimum wage of $7.25 per hour. During the eight years of being a union member, those workers didn’t attain health benefits, sick leave, or vacation time.

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Home Health Care Reform

Changes in healthcare are taking place all throughout the country, including the home. According to Healthcare Finance News, The Alliance for Quality Home Care (AQHC) recently outlined its new policy on post-acute healthcare reform. Post-acute healthcare refers to home care that people receive when they are not sick enough to be in the hospital, but need medical attention and help with daily activities. The AQHC outlined three main objectives of their plan:

Patient Needs First: The needs of patients must be the driver of reform. The reform is intended to integrate systems and put all people involved in home care on the same page with aligned incentives, rather than mixed incentives, in order to match each patient individually with their needs.

Payment Tied to Quality: Performance metrics must be developed that better apply across all care sectors, and also keep the “big picture” of total care in mind to see how each caregiver is performing in context. High performers get compensated for their work, which will encourage only the best care.

Adequate Payment: While not easy to accomplish in times of budget cuts, with the proper structure in place adequate compensation can be given. This requires looking at situations that providers face and making cuts accordingly, not across the board.

For the full article, see Nursing Home Alliance Offers Post-Acute System Reform