California Home Care Workers facing Wage Cuts

In California, cheers from SEIU and other homecare supporters over the state’s abandonment of a plan to slash wages for home health workers (”Wage Cuts Avoided for CA Home Care Workers“) gave way to renewed protests last week as the state revisited the plan after being told that it does not, in fact, violate the terms of the American Recovery and Reinvestment Act (ARRA) (”U.S. backs off threat to withhold California stimulus money,” Los Angeles Times, May 20).

The new ruling came a day after California voters rejected a series of fiscal ballot initiatives intended by Gov. Arnold Schwarzenegger to help fix the budget.

In response, Schwarzenegger brought back the plan to cut wages for home care workers and began announcing a series of draconian cuts to state programs that would include, among other things, the complete elimination of welfare and medical insurance for low-income families. “I understand that these cuts are very painful and they affect real lives,” he said. “This is the harsh reality and the reality that we face. Sacramento is not Washington — we cannot print our own money. We can only spend what we have” (”California faces its day of fiscal reckoning,” Yahoo! News, May 23).

SEIU and others react

SEIU and other homecare advocates have been swift to respond. On May 22 more than 5,000 homecare providers, care recipients, and disability and senior advocates rallied in front of the California State building in downtown Los Angeles to protest the proposed cuts to the state’s home care program.

On Tuesday — the very day that Schwarzenegger outlined a plan to cut funding for even more state programs– SEIU launched a planned month of protests, began a 48-hour vigil on the grounds of the state capitol, and filed a class action lawsuit seeking a preliminary injunction to stop the State of California and Fresno County from cutting home care worker wages and reducing care hours for seniors and people with disabilities. The suit charges that the cuts will put these people at risk and violate the ADA and federal Medicaid law.

On Wednesday the Los Angeles Times ran a letter from Pauline Beck, the California home care worker with whom Obama prominently spent a day during his presidential campaign in 2007, in which Beck pleads with the President not to let Schwarzenegger cut home care workers’ wages and hours. SEIU also began airing a television ad (see video at top of post) this week in the Los Angeles, Sacramento, and Fresno media markets, which shows presidential candidate Obama with Beck at her client’s home. The ad praises Obama for appreciating the commitment of home care workers to their clients and then challenges Gov. Schwarzenegger as someone who “doesn’t see [elders and people with disabilities] at all.”

Dr. Susan Chapman, associate professor at the University of California—San Francisco Department of Social and Behavioral Sciences, warns that California’s health care workers may be overlooked. “Some of the importance of the home care issue gets lost in the overall picture of California’s giant fiscal crisis,” she told PHI.

She described the plan to take money away from California’s In-Home Supportive Services program as “short-sighted,” since “it may create a situation where more people have to resort to institutional care, which is far more expensive.”

She also said the negative impact on homecare workers themselves may hurt the state’s economy. “These people have to survive, and their wages are already so low that cutting them further will only make these workers more reliant on the state’s support services,” she said. “So for various reasons, it’s not clear at all that the governor’s plan will result in budgetary savings. In fact, it may end up losing money for the state in the long run.”

Hurting the powerless

Bernadette Lynch, president of California Association of Public Authorities for IHSS and executive director for Sacramento County IHSS Public Authority, told PHI the timing of the planned cuts could not be worse.

“IHSS provides services to hundreds of thousands of clients, and the economy is already devastating California’s families, so this isn’t a time to be cutting necessary support systems or reducing those already-small wages,” she said. “The current pay for homecare workers doesn’t even amount to a living wage at this point, except in one or two counties. Reducing it will end up causing a dearth of providers, which will hurt consumers. It’s devastating.”

She continued, “As always, it’s the people who tend to be less heard, who don’t have a voice, who are basically powerless, that will be hurt by this.”

Help Fellow Home Care Workers in California

Governor Schwarzenegger proposes to balance his state's budget by cutting wages to California's home care workers. He wants to cut their pay by $4.10 per hour; from $12.10 down to $8.00. Tell Governor Schwarzenegger to balance California's budget some other way. Home care workers already make low wages. Tell him to find a different way to balance the budget. See President Obama walking a day in the shoes of Pauline Beck, a SEIU Home Care Worker in California.

MSEA-SEIU Action Alert

Come to the State House (3rd Floor) at Noon Tuesday, May 26, to Show State Legislators Whose Pay and Benefits They are Cutting On Tuesday, May 26, the Maine Legislature starts voting on the proposed two-year state budget cutting state workers' pay and benefits. Please bring your families to the State House (3rd Floor) at Noon Tuesday, May 26, so state legislators can look you and your family in the eyes before cutting your pay and benefits. Wear purple. We are looking at further actions at a later date to protect jobs, but it's important that you come to the State House (3rd Floor) at Noon Tuesday, May 26.

Andy Stern Delivers SEIU Message at Senate Finance Roundtable Hearing on Health Care Reform

On May 5 2009, SEIU President Andy Stern spoke to the Senate Finance Committee on Health Care Reform. President Stern reminded them that all Americans should have the choice to get needed medical care at home. Out of 89 per cent of Americans, 50 percent want to remain at home as long as possible. Health Care needs to be improved for the chronically ill. Chronic care should be included in reform to promote more home and community based options under Medicare and Medicaid. Reform should include more coordinated care, especially for the most chronically ill, especially those who are both Medicaid and Medicare patients. Reforming America's broken health care system requires training and upgrading the health care system. Our new health care system must expand its reach and capacity in order to deliver cost effective, preventive and primary care to our rapidly aging population, uninsured, and under insured Americans who currently go without adequate health care. There are more then 116,000 unfilled nursing jobs in Americas hospitals and more the 25,00 unfilled nursing jobs in our nations nursing homes. To keep pace with projected demand , our health care system will grow by nearly three million workers by 2016. Overall the number of Americans who need long term care and services will increase from approximately 10 million today to 15 million in 2020 to 27 million in 2050. A significant federal investment in appropriate training and education of the non physician work force is also needed, along with training in new technologies, teams, and systems must be provided to both incumbent health care workers and new recruits. Support should be provided to recruit and train a workforce that reflects the diversity of the community it serves.

Direct Care Workers in Iowa achieve Health Care Coverage

This year the Iowa CareGivers Association (ICA) helped lead a coalition of advocates for expansion of adult coverage as well as the funding of a premium assistance demonstration project for direct-care workers. While the priority of the legislature for this year was expanding coverage for children, we were able to get specific language included in the health reform bill (SF 389) that new coverage options for adults would be available for purchase by July 1, 2010. Affordable, quality coverage for adults will enable many direct-care workers in Iowa to have health insurance which they currently cannot afford. In addition, the 2009 General Assembly agreed to fund a demonstration project that will allow a minimum of 250 direct care workers in Iowa to participate in a premium assistance project. The project will assist those workers in paying for coverage that is currently available to them through their employer, but that they do not access due to its cost. The outline for the demonstration project was developed in 2008 by an advisory council that included the Iowa Caregivers Association, agencies of state government, and long term care employers. The advocates were also able to secure a number of seats on a reconstituted Legislative Health Care Coverage Commission. Details about the adult plan will be decided by the members of this Commission. The ability to serve on and provide technical support to this Commission will enable us to hold the legislature accountable for meeting the July 2010 goal. John Hale Policy Director Iowa Caregivers Association

Examining Medicaid as an Option for Health Care Reform

The Kaiser Commission on Medicaid and the Uninsured has released new related research papers examining the policy opportunities for expanding Medicaid to cover more low-income and high-need people in ways that would enable the program to serve as a platform for larger national health reform efforts.

A briefing held at the Kaiser Foundation yesterday discussed the issues that must be addressed as congressional leaders work on proposals for universal coverage that might include the expansion of Medicaid. Some of those issues included:

• Cost at the state and federal level
• Variance in federal match rate for states
• Eligibility in terms of income and health status
• Provider payment rates
• Balance between public programs and private insurance

The briefing is available via webcast.

Allison Lee

National Campaign Manager

HCHCW

alee@phinational.org

State Budget moves from Appropriations to Full Legislature

Appropriations Committee Replaces Across-the-Board 5 Percent Pay Cut with 20 Shutdown Days for Executive and Legislative Branch Workers, Freezes Merit Increases and Longevity Increases for Workers in All Three Branches of State Government, and Cuts Individual Health Insurance Benefits In one of its final votes on the proposed two-year state budget, the Appropriations Committee at 10:20 PM Monday, May 18, eliminated the across-the-board 5 percent pay cut on all state workers. In its place, the Committee imposed 20 shutdown days (10 per fiscal year) on Executive Branch and Legislative Branch workers, exempting so-called "Tier 1" workers such as those in institutions, law enforcement and public safety. For workers in all three branches of state government, the Committee voted to freeze merit increases and longevity increases for two years. The Committee allowed for comparable savings to be identified through contract negotiations. On health insurance, the Committee imposed tiered individual premiums as follows: Beginning October 1, 2009, those earning $30,000 or less will pay no premium, those earning $30,001 to $79,999 will pay 5 percent premiums; and those earning $80,000 and up will pay 10 percent premiums. Beginning July 1, 2010, those earning $30,000 or less will pay 5 percent premiums, those earning $30,001 to $79,999 will pay 10 percent premiums; and those earning $80,000 and up will pay 15 percent premiums. The Committee voted to establish a health credit premium program for implementation on July 1, 2010, where workers could earn back some or all of their individual premiums through healthy behavior. Under this program, to be developed by the State Employee Health Commission, workers earning $30,000 or less could earn their way back to fully paid premiums, those earning $30,001 to $79,999 could earn their way back to up to 95 percent paid premiums, and those earning $80,000 and up could earn their way back to up to 92.5 percent paid premiums. These cuts affecting state workers are now part of the overall two-year state budget that will go to the House and Senate for voting. We'll post more detailed information on Tuesday, May 19. from MSEA-SEIU's website At this point, I do not know what programs have been cut, nor how or if elders and disabled have been affected.

State Budget Update as of Saturday, May 16

Appropriations Deadlock Continues, Triggers Likely Delays in Payments to Home Care and Personal Care Members The Appropriations Committee spent Friday in closed-door negotiations over remaining issues, adjourning for the weekend without an agreement. State employee health insurance is one of the last issues in contention, with Republicans insisting that any wellness incentive require some payment of the individual premium. The continuing deadlock is already triggering delays in payments to providers, and will likely delay payments to MSEA-SEIU members working in home care or personal care, as the State runs out of funds for the current budget year. We do not expect any further developments until late on Monday, perhaps Monday night. As usual, it will be important to have members in the Appropriations Committee hearing room Monday evening.

Congresswoman Chellie Pingree in Augusta Tomorrow

Congresswoman Chellie Pingree will in Augusta tomorrow. Her first stop is at Shaw's on Western Avenue from 10:30 am until noon. She will then be at Longfellow's Greenhouses in Manchester from 1 pm to 2:30 pm. If there are 771 workers shopping at Shaw's or at Longfellow's tomorrow, stop and talk to her about the work you do. Long-term care is being overlooked in the current health care reform. Tell Chellie that it needs to be included in any health care reform that Congress is working on. With the Direct Care Alliance in Washington, DC a couple of weeks ago, I got to talk to Chellie about this. Please see previous post on it. I urge anyone in the Augusta area tomorrow, shopping at either location, to plan your shopping around the times she'll be at either store. Talk to Chellie. She is very personable and will listen to what you have to say. Take the chance. This is a lot easier than trying to talk to her while she's in DC! Trust me on that one!

Reminder - LOCAL 771 Bargaining Forum Tomorrow

Local 771 is having its first of two bargaining forums tomorrow in Bangor. The meeting starts at 10 am. It is located at the blue Maine DOT building on the Hogan Road. Both bargaining units of 771, Alpha One and Home Care for Maine, will be negotiating contracts in the upcoming months. Home Care for Maine's contract is due to expire on June 30th. Alpha One's expired last year. For our union to be strong, and have a powerful voice at the bargaining table, we need members to come to both meetings. We need members with ideas and proposals that will make working conditions better. We need members to put forth these ideas to get them into the contracts. I urge members in the Bangor area to come out to this very important meeting tomorrow. Here's an example of how our union is working for us. Recently there was a problem with Home Care for Maine workers not getting their February stipend in the last stipend payment. This was brought to my attention. Apparently the agency had under 1515 billable hours for the month of February, and thought it was not bound to pay its workers the $0.30 stipend per hour worked for that month. I passed this information on to our field representative, CJ Betit. CJ looked at the contract. His stand was that the additional $0.15 per hour was paid only when the agency reached that 1515 billable hours. If the agency was under the 1515 billable hours in any given month, the agency was still to pay the $0.30 per hour for that month. CJ got in touch with Mollie Baldwin, Home Care for Maine's CEO. She took another look at the contract and saw Article 12, the article pertaining to wages and how the stipends are paid, and realized that a mistake had been made. She is going to make good on the error and workers should receive their February stipend in the payroll run today, payment available on Monday, May 18th. Please see the May 12th post on the stipend issue. Without our union working for us, we wouldn't have the stipend much less the means to resolve this issue. The stipend doesn't seem like much, but to many workers it is. They count on that extra money they receive every quarter for their hard work with the people they serve.

MaineCare Programs that may be Affected by Budget Cuts

Thursday, May 14, 2009 Council members: The Appropriations Committee is considering a proposal for another major cut in the budget for the next two years that could cause serious harm to people with disabilities in Maine - legislators need to hear how their constituents feel about this proposal today. Please send an email or call and leave a voice message for your legislators to let them know this proposal would hurt people with disabilities and may result in greater cost to taxpayers if services are not provided when they are needed. (One example of this is early intervention services.) Here is a little more information about this proposal: Late last night during the discussions about the biennial budget, the Republicans proposed a five percent cut to "optional services" under MaineCare. It would be up to DHHS to decide how to limit services to stay within the lower budget amount, but it would be over and above cuts that have already been approved for several items within the "optional services" category. Large cuts have already been made in Children's Mental Health Services, the Home- and Community-Based waiver program, Children's residential services (private non-medical institutions), targeted case management, pharmacy services, and others. Here is a listing of the categories under the "Optional Services" of MaineCare - persons with disabilities are receiving services in every one of these categories, and would likely face limits on the services or not be able to get the services at all, if these cuts are included in the budget for the next two years. I have listed all of the services, so you can see how many of the services people depend on are considered "optional services". Adult Family Care Services Ambulatory Care Clinics Ambulatory Surgical Center Services Ambulance Services Consumer Directed Attendant Services Targeted Case Management Chiropractic Services Community Support Services Home and Community Based Servcies for Elderly and People with Disabilities Home and Community Based Services for Persons with Mental Retardation or Autistic Disorders Home and Community Based Services for those with Physical Disabilities Developmental and Behavioral Evaluation Clinics Day Habilitation Services Dental Services Day Health Services Early Intervention Services Hearing Aid Dealers Audiology Services Home Based Mental Health Services Home Health Services Day Treatment Services Hospice Services Psychiatric Facility Services (Spring Harbor, Acadia) Durable Medical Supplies Prosthetics & Orthotics Screening/Genetic Testing Mental Health Services Social Work Substance Abuse Treatment Psychological Services Nursing Facility (for anyone under 21 years old) Occupational Therapy Vision Services Pharmacy Physical Therapy Podiatrist Services Private Duty Nursing Personal Care Services Private Non-medical Institutions Rehabilitative Services (Brain Injury) School-based Rehabilitative Services Speech and Hearing Services Speech Pathology Services Transportation Services Boarding Home and Related VD Screening If you have any questions about this, feel free to send me an email, Julia.J.Bell@maine.gov or you can call Kathleen or Rachel at the Council office. I am sitting in the Appropriations Committee hearing room, so it is hard for me to take phone calls. (Note- this would be a good time to ask your friends and family members to make a call or send an email as well - this next week is going to be very challenging as the Legislature tries to finalize and pass the budget for the next two years, and any of the Senators and/or Representatives may make a suggestion that could be very harmful to people with disabilities. They need to be reminded how important these services are.) Julia Julia Bell Executive Director Maine Developmental Disabilities Council

Home Care for Maine's response to Quarterly Stipend Issue

This clearly was an error on our part. We neglected to read the second paragraph and only looked at paying the $.45 per hour and providing at least 1515 hours on average per day. We will send out the $.30 per hour for February on the May 15,2009 in a dedicated payroll to active employees. This means we will mail out direct deposits and checks this Friday and the pay date will Monday, May 18,2009. Any employee who has a stipend calculated to be less than $5.00 will receive that amount in the next payroll sent out May 25, 2009 to limit on the banking transaction fee for this small check amount. We truly apologize for this oversight.

Direct Care Worker Wages Bill, LD 1364, Carried Over

The work session on LD 1364, the wages bill for direct care workers, was last Thursday, April 30th. I am very happy to report that the bill was carried over to next session. This means that it is not dead, right in committee. I take this as a small victory. Again, a little bump in that uphill climb to gain better wages for workers. Health and Human Services Co-Chair Senator Brannigan mentioned LD 1059 in his comments. That was pleasing in that the HHS Committee is aware of the insurance bill. Senator Brannigan said that maybe the two bills could be combined, providing better pay and health insurance to workers. I had that same thought when I was in Washington D.C. with the Direct Care Alliance earlier in the week. It is kind of scary when a committee chair-person thinks the same way I do! It appears to me that both bills may compete for the same Medicaid enhanced reimbursement. I would hate for one bill to get shot down because the other won the funding. They should go hand-in-hand. This is an idea I have not mentioned further to those on the Direct Care Worker Coalition yet. I figure with both bills carried over, I can buy a little time and work on follow-up with Maine's congressional delegation on the issues that the Direct Care Alliance raised with our legislative visits. Again, good news on the wages bill. It is carried over to next session. It is not dead! Thanks to my co-workers and colleagues for being at 1364's hearing! We could not have won the small victory without you!

My Trip to DC with the Driect Care Alliance: A Home Care Worker’s Report

I just got back from a trip to DC with the Direct Care Alliance. It was a great start to achieving the FLSA rule change and to achieving health care reform that keeps direct care workers in the conversation. I think we started something that will just get bigger and keep raising awareness. What is unique is that the Direct Care Alliance is having us workers talk to members of Congress. They need to hear from us - not the policy experts or service providers, but the hands on, day-to-day workers. I never would have thought a couple of years ago that I’d be on Capitol Hill, talking with my congressional delegation about my job and the tough work issues I and my fellow workers face every day. The DCA has made that possible for me. I got the opportunity to personally thank Congresswoman Linda Sanchez and Congressman Mike Michaud for sponsoring our “Dear Colleague” letter to Secretary of Labor Solis. I am so honored that I got the chance to do that.

Seated, DCA Board Member, Dennis Fitzgibbons; L to R, Helen Hanson, Congresswoman Chellie Pingree, Julie Moulton

But the highlight of the visit for me was getting to talk with Congresswoman Chellie Pingree herself. Congresswoman Pingree was very supportive of the workforce and agreed direct care workers need to be included in health care reform. She also wanted to know more about the FLSA. She sounded as if she’ll probably sign the letter. We encouraged her to talk to her congressional colleagues about the FLSA, and we’ll do some follow-up with her. We were also scheduled to visit Senator Susan Collins, but that visit got cancelled because her health care staffer, Priscilla Hanley, was in a hearing on the swine flu problem. But after talking with Jackie Merkel, another of the direct care workers in town for the visits, Julie Moulton and I decided to go to Senator Collins’ office anyway. Jackie said we should go so the senator would know that we were in DC and see the packet from her Maine constituents and the Direct Care Alliance. So we did just that. We also told the staffer that we would follow up with Patricia Hanley from home, which we plan to start doing next week. The next visit for us was with Senator Olympia Snowe’s health care staffer, Bill Pewen. We were concerned about our flight so we stopped by Senator Snowe’s office early. The staffer we talked to was great. She got Bill Pewen’s assistant, Scott Nolan, who talked with us for about half an hour. The meeting went well, despite the fact that Scott did not know much about direct care workers. Julie kept hammering the FSLA and I kept hammering that the direct care workforce must be part of health care reform, as we are a vital part of the health care system. Julie told Scott that workers in home care are not guaranteed minimum wage and paid overtime. She said that it is a shame because this workforce is vital to keeping elders and disabled healthy and home, where they want to be. He was surprised when she told him that someone working as a cashier at Wal Mart is guaranteed at least minimum wage, but home care workers aren’t. She was fantastic! At first when we talked about health care reform, Scott talked about how reform will focus on the health insurance industry, possibly drawing some nationwide standards as to what is covered. He said long term care is under the radar in the current plans for health care reform, meaning that it is not included at all. He gave us a brief overview of what health care reform might look like, saying that it might require all employers to purchase health insurance for their employees and give employees a subsidy to help pay for the coverage if they can’t afford what their employers offer. To me, it sounded a lot like what the state of Massachusetts has done. Maine’s Dirigo Health came into the conversation, much to my surprise. I told Scott that whenever I’m involved with trying to gain health insurance for direct care workers back home, someone always brings up Dirigo and says it was designed for workers like me. I tell them yes it is, but it simply is not working. Agencies like the one I used to work for cannot get on Dirigo because they have too many employees. And individuals who wish to get on to Dirigo and who need a subsidy to help pay for it also have a hard time getting on it. I told him that every year, the savings offset payment is figured, and then it is challenged in court by organizations like the Maine State Chamber of Commerce and Anthem, and that drags out the process even further. I also told him that I was a bit miffed when the stimulus provided help to laid off workers by helping them with COBRA payments. I told him that I am working, still employed, and cannot get health insurance through my job. It is such an injustice. Helen Hanson Home care worker