Archive for the ‘caregivers’ Category
Monday, August 19th, 2013
For many seniors, growing older means facing new kinds of stress—such as fragile health, a tight budget on a fixed income, or the travails of living alone.
And for the people who care for the aging, the stress can be just as severe. When her client is going through a rough time, one domestic worker says she lives through every minute of it, too: “Sometimes we stay there for five days…and we don’t know what’s outside…You cannot leave the job.”
Stories like this one, recorded as part of a survey of New York’s care workers, form the invisible pillar of an evolving industry that is making the private home the center of public health, and in the process, reshaping our relationships of family, work, community and social service. Yet the home care workforce, which is driven largely by poor women of color, mirrors inequities embedded in the low-wage economy. At work, caregivers manage the lives of our loved ones while often facing exploitation and abuse, and after a long day of delivering comfort to vulnerable clients, many struggle themselves to cope with ingrained poverty their communities.
To open a conversation about the economics and ethics of caregiving, ALIGN (Alliance for a Greater New York) has partered with the national advocacy campaign Caring Across Generations, along with various community and labor groups, to study New York City’s more than 150,000 home care workers. The surveys and investigations published by ALIGN reveal structural problems in the industry and identify potential for reforms that work for those who give and those who receive care.
In New York, the home care industry is booming as more seniors opt to live at home rather than in institutions. Thousands across the city earn their living by taking care of seniors and people with disabilities. Overall, according to the study, the sector “will be the single biggest driver of employment in the city in the coming years.”
On a typical day in New York, these workers, mostly women of color and immigrants, act as both therapists and companions, managing medications, bathing and feeding, and helping seniors feel dignified even on the days they can’t get out of bed. On top of this, the workers have to negotiate with stressed families about hours and pay–and typically take home low wages that keep them and their families mired in poverty.
And yet it turns out that consumers and providers of care want the same things. ALIGN’ssurveys of New Yorkers, including both caregivers and care “consumers,” show strong concern about decent pay for workers, along with retirement and healthcare benefits. These labor conditions are many cases dictated by insurance companies and Medicaid, not by the families receiving care.
The fact that consumers and caregivers both recognize that labor should be fairly valued “really does challenge this zero-sum notion that good jobs and affordable care can’t coexist,” says ALIGN policy analyst Maya Pinto. “And it suggests that people understand the connection between the quality of care and the quality of jobs.”
The converse is also true: When workers are miserable, it shows up in their work. Nearly 40 percent of people receiving care complained that the quality of services was “fair” to “very poor.”
But from a workers’ standpoint, this is the consequence of a job that treats them poorly. One worker described her situation bluntly: “It is a very difficult job at times because there are patients who think the home care workers are slaves.” Workers reported being subject to verbal and physical abuse, sometimes racial slurs, on the job.
Nonetheless, many care workers feel deep devotion to their job—they just want to their labor to be appreciated and duly compensated. “I do my work well…and the person I care for is very satisfied with my work,” said one worker. “It is very dignified work but it needs to be paid better.”
A priority across all respondent groups was providing appropriate training and monitoring–indicating that workers, contrary to stereotypes, are not instinctively resistant to greater accountability and oversight, and that all stakeholder groups realize the depth and complexity of responsibilities involved in caring for vulnerable seniors.
One area of divergence between consumers and workers was the importance placed on career advancement. The issue was a higher priority for caregivers, especially domestic workers who serve seniors but lack the official credentials of “formal sector” workers—a category that includes certified “home health aides” and “home attendants,” and who are generally employed through an agency. Lacking the formal qualifications associated with specialized, better-paying positions, domestic worker-caregivers (who are disproportionately low-income immigrant women, both documented and undocumented) often remain stuck in the most grueling, precarious jobs.
Some of New York’s privately employed home care workers benefit from a recently enacted domestic workers’ “Bill of Rights” that provides stronger workplace protections and wage standards than does federal labor law. However, domestic workers overall, who include nannies and housekeepers as well as direct caregivers in private households, still suffer from poverty, discrimination and exploitation. According to ALIGN’s survey of caregivers’ household incomes, about nine in 10 domestic workers earn less than $25,000 annually, compared to six in 10 formal sector workers. That is, despite the strides that domestic workers made with the Bill of Rights, in material terms, they still lag behind those employed through agencies or with more formal credentials.
ALIGN recommends several reforms to ensure dignity for both caregivers and people receiving care. More training and certification options–such as programs equipping domestic workers with emergency medical skills–would expand workers’ access to more formal and higher-paying positions and lift up standards for the workforce overall. On a policy-making level, the report calls for a expansion of publicly funded insurance programs so care workers, many of whom cannot afford medical coverage, can safeguard their own health as they care for others.
Since so many families struggle to pay the cost of community-based elder care, especially if they fall outside the income-eligibility bracket for Medicaid, the report recommends a more comprehensive publicly supported insurance program as an alternative to private long-term care plans. Noting that the current rollout of the Affordable Care Act and Medicaid overhaul present an opportunity for fudamental reforms in home care funding, ALIGN suggests creating a broadly accessible long-term care benefit that would be funded through payroll contributions, like Social Security.
The report also highlights why workers need not just laws but organization and collective bargaining power. In recent years, SEIU and the National Domestic Workers Alliance have organized tens of thousands of workers to win fairer contracts for workers and to press for reforms to extend labor protections for care workers. Meanwhile, some workers are changing how care is delivered in their communities by forming their own cooperatives.
ALIGN cites the worker-owned cooperative model as a system that can empower caregivers, by enabling them not only to share in the ownership and profits of the enterprise but also to access training, negotiate better working conditions, and “improve compensation for workers while keeping the cost of care relatively low.” One impressive case study is New York’s Cooperative Home Care Associates, one of the country’s leading cooperatives with about 2,000 workers, half of whom own a part of the business.
Despite the sometimes harsh conditions, Vilma Rozen, a 52 year-old home care worker, remains unshakably devoted to her job and embraces the challenges. “If you want to take care of elderly people, you have to keep your feelings very in touch [with] the person, because the elderly people in some cases are very alone and very depend[ent],” she says. At the same time, she adds, many seniors “suffer so much, because the home-carers, they have a very sad life, very underpaid… They don’t have happiness.” Rozen, a native of Costa Rica, says that if Americans want to place their elders in the care of attentive, dedicated people, “they need to change the system.”
Whether they give or receive care, everyone wants dignity–both seniors and their aides want to look forward to seeing each other every day in a relationship of mutual respect. The labor issues in senior care show the consequences of neglecting shared needs, but also open space for creating a fairer system of care, by making the home a more welcoming workplace.
This article originally appeared on Working in These Times on August 17, 2013. Re-posted with permission.
About the Authory: Michelle Chen is a contributing editor at In These Times, a contributor to Working In These Times, and an editor at CultureStrike. She is also a co-producer of Asia Pacific Forum on Pacifica’s WBAI.
Friday, April 1st, 2011
New report documents how low-wage workers are discriminated against at work based on their caregiving responsibilities at home
A new report by U.C. Hastings’ Center for WorkLife Law details the extreme measures to which low-wage workers must go to keep a job and care for their children or elderly family members—and the sometimes shocking discrimination they face at work despite these efforts.
The first of its kind to analyze caregiver discrimination lawsuits filed by low-wage workers, the report—Poor, Pregnant, and Fired: Caregiver Discrimination Against Low-Wage Workers—exposes mistreatment at work around caregiving responsibilities. The powerful cases profiled in the report, which attracted the attention of the National Law Journal, include:
- employees encouraged to get abortions or asked about their birth control usage, or sexually harassed because of their roles as caregivers;
- pregnant workers fired on the spot or immediately after announcing their pregnancies, or banned from certain positions no matter what their individual capabilities;
- workers routinely denied access to their legal rights, especially to family and medical leave;
- employees being set up to fail, with unreasonable goals or tasks assigned to them, after caregiving responsibilities are discovered;
- low-wage men who care for children or elderly parents subjected to extreme gender stereotyping at work; and
- pregnant women of color denied access to accommodations regularly granted to their pregnant co-workers of a different race.
Even in family emergencies, the report shows, low-wage workers are refused the small kinds of workplace flexibility that are commonplace for middle-wage and professional workers. One retail worker whose case is profiled in the report was fired for insubordination for carrying a water bottle at work—despite a doctor’s note recommending she do so to treat recurring urinary and bladder infections due to her pregnancy.
Ironically, small changes by employers can make a significant difference in keeping experienced employees in their jobs. They can also prevent costly liability: several lawsuits profiled resulted in large verdicts, including four with recoveries of between $2.3 and $11.65 million, despite the plaintiffs’ (a housekeeper, a shipping dispatcher, a bakery delivery driver, and a hospital maintenance worker) low wages.
“Caregiver discrimination lawsuits brought by low-wage workers document clearly that work-family conflict is not just a professional women’s problem. In fact, it’s most acute and extreme for low-income families,” said study author Stephanie Bornstein, Deputy Director of the Center for WorkLife Law. “To help families move out of poverty, we can’t just focus on ‘fixing’ the worker. We also need to look at how caregiver discrimination in low-wage jobs undercuts economic stability. Discrimination not only hurts workers and their families; it leads to high turnover and legal liability for employers.”
Another case profiled in the report is that of a pregnant woman who was forced out of her retail sector job onto unpaid leave despite her desire to work as long as possible while pregnant. Her supervisor had allowed her perform all of her job tasks while avoiding heavy lifting, and she was working successfully. Yet several weeks later, when her doctor sent a letter to the company’s HR office to cement this arrangement, she was immediately sent home and told that she could not be accommodated—in violation of California law.
A soon-to-be single mother, the woman was “trying to do the best she could for her baby,” and was confused as to why she was being sent home when she wanted to work, said Jamie Dolkas, Staff Attorney at Equal Rights Advocates in San Francisco, who represents the woman. “As a low-wage worker, she was really disenfranchised….[T]hey didn’t take the time to explain to her what her rights or options were—they just gave her something in writing that essentially said we can’t accommodate you, go home,” explained Dolkas.
The report profiles 50 cases—selected from among hundreds identified by Center for WorkLife Law research—of low-wage workers who experienced discrimination at work based on their efforts to be both a good worker and a good parent or family member.
The Center for WorkLife Law is a nonprofit research and advocacy organization that works with employees, employers, attorneys, unions, and policymakers to fuel social and organizational change around work-life issues. The Center is part of the University of California, Hastings College of the Law in San Francisco.
About the Author: Stephanie Bornstein is an employment attorney and Deputy Director of WLL. Prior to joining WLL, she worked as a staff attorney at Equal Rights Advocates (ERA), a public interest law center focused on gender discrimination in employment and education. At ERA, Bornstein represented plaintiffs in individual and class action employment matters, specializing in pregnancy discrimination and family and medical leave. She was also among a small group of advocates to help author and enact California’s Paid Family Leave insurance program, the nation’s first comprehensive paid leave law. In addition, Bornstein worked as a legal editor of employment law products at Nolo Press, a leading publisher of legal books for non-lawyers.
Friday, August 20th, 2010
For the last few months I’ve been thinking about and writing about home care workers. In my work, I find that if folks haven’t had to hire a homecare worker for themselves or their family, it appears that most of these workers fall off the radar.
The problem here is somewhat circular. The demand for homecare services is exploding as the baby boomer generation ages and more seniors and people with disabilities choose to live at home rather than in a nursing home. Low wages, no federal minimum wage or overtime protections, and no benefits contribute to homecare workers leaving their profession (turnover is estimated to be as high as 60% per year). Consumers and patients have difficulty finding and keeping homecare services as a result. Which leads to – yes – increasing demand for homecare workers.
How did this happen?
Well, it goes all the way back to 1938 when the Fair Labor Standards Act (FLSA) was enacted to ensure a minimum standard of living for workers through the provision of minimum wage, overtime pay, and other protections – but domestic workers, for some reason, were excluded.
Then 36 years later, in 1974, the FLSA was amended to include domestic employees, such as housekeepers, full-time nannies, chauffeurs, and cleaners. However, people who were described as “companions to the elderly or infirm” were for some reason excluded from the law. They were compared to “babysitters.” Weird, huh?
The following year, in 1975, the Department of Labor (DOL) goes on to interpret this “companionship exemption” as including all direct-care workers in the home, even homecare workers employed by third parties, such as home care agencies.
So, in 2001, the Clinton DOL finds that “significant changes in the home care industry” have occurred and issues a “notice of proposed rulemaking” that would have made important changes to this weird exemption. They agreed that it made no sense to exclude this whole industry, as if they were just like “babysitters.”
Clinton’s findings were unfortunately short-lived because the incoming Bush Administration terminated the revision process. Thank you, Mr. Bush.
In 2007 something else happened worth noting: The US Supreme Court, in a case brought by New York home care attendant Evelyn Coke, upheld the DOL’s authority to define this exception to the FLSA. This means, this crazy archaic law can easily be reversed by the DOL.
Meanwhile more than 1.5 million homecare workers are currently living at near poverty level earning a median income of $17,000 a year. Most of these workers, who both love their work and are good at their work, must have two and three jobs to just make ends meet. Many of these workers need food stamps to put food on their tables. All this ultimately comes back to the consumer who often finds it difficult to find and retain high quality homecare services.
The injustice here is, as was said in a June 6 NY Times Op-Ed, ” …while nannies and caregivers make it possible for professional couples to balance the demands of family and work, they often cannot take time to be with their own families when sickness or injury strikes.”
Though I inherently know that we can fix this problem together, I am keen to know what you think is the best way to make this happen.
This article originally appeared on the SEIU Blog.
About the Author: Richard Negri is the founder of UnionReview.com and is the Online Manager for the International Brotherhood of Teamsters.
Tuesday, December 22nd, 2009
Finding a manageable work/life balance is something many of us struggle with a great deal–and the stakes only get higher for Americans who work full-time and have caregiving responsibilities at home. Whether that means taking care of children, a sick partner, or an elderly loved one, holding down an ambitious career while still taking good care of those that depend on you at home can be a daunting challenge.
While I’d like to be able to tell you that employers are universally understanding of their employees that struggle with juggling a full-time job while being a caregiver, we all know this simply isn’t true. As if layoffs due to our ailing economy weren’t bad enough, employers discriminating against employees based on their caregiving responsibilities is on the rise–and it has a name: Family Responsibilities Discrimination (FRD).
Before you stop reading this post because you’re thinking “such a wonky-sounding term can’t possibly affect me,” I beg you to take another few moments and keep on reading. Family Responsibilities Discrimination can occur in any number of unfortunate–but very real–workplace circumstances. Such as….
- when a new mother is denied a promotion NOT based on her job performance, but because it is assumed she will no longer be as committed to work once baby enters the picture.
- when a man’s employer refuses him paternity leave because “his wife should do it”
- when a worker is fired for not meeting work goals while he is on legally protected family and medical leave to take care of a sick parent.
A new report by the Center for WorkLife Law’s Stephanie Bornstein & Robert J. Rathmell provides us with information about additional worker protections under local laws about which most people are not aware–like the ones described above. Take this true situation cited in the report, for example:
In Chicago, a single mother of two who filed a complaint for parental status discrimination under the city’s local ordinance was recently awarded over $300,000 in damages. The woman had been fired from her job as a medical services salesperson after rescheduling a meeting because her daughter was ill.
The report finds that while no federal law and only a few state laws expressly prohibit discrimination against working caregivers, at least 63 local governments in 22 states do. The findings also demonstrate that while the scope of local laws may seem limited, their impact can be pretty significant.
Working caregivers shouldn’t end up unemployed because of their responsibilities at home–but the fact is that they sometimes do. While we may not be able to legislate employer attitudes, we can take responsibility for knowing our rights. Read the report here: “Entitled Caregivers as a Protected Class?: The Growth of State and Local Laws Prohibiting Family Responsibilities Discrimination.”
For more information about each local law collected in the survey, visit www.worklifelaw.org/pubs/LocalFRDLawsDetail.html.
Additional findings of the report can be found after the break.
- The sizes and types of employers (whether public or private) covered by local FRD laws vary, but most apply to private employers, with some covering businesses as small as those with only one employee.
- While the vast majority of states have no explicit protections against FRD, laws or regulations in Alaska, Connecticut, New Jersey, and the District of Columbia are the exceptions to the rule.
- States including Florida, Maryland, Michigan, Oregon, and Pennsylvania have the most protections under local FRD laws, increasing the likelihood that a business or an employee in that state may be covered.
Local governments that have explicitly banned Family Responsibilities Discrimination also include:
• Tucson, Arizona • Atlanta, Georgia • Cook County, Chicago & Champaign, Illinois • Boston, Cambridge & Medford, Massachusetts • St. Paul, Minnesota • Kansas City, Missouri • Tacoma, Washington • Milwaukee, Wisconsin
*This post originally appeared in the SEIU Blog on December 17, 2009. Reprinted with permission from the author.
About the Author: Kate Thomas is a blogger, web producer and new media coordinator at the Service Employees International Union (SEIU), a labor union with 2.1 million members in the healthcare, public and property service sectors. Kate’s passions include the progressive movement, the many wonders of the Internet and her job working for an organization that is helping to improve the lives of workers and fight for meaningful health care and labor law reform. Prior to working at SEIU, Katie worked for the American Medical Student Association (AMSA) as a communications/public relations coordinator and editor of AMSA’s newsletter appearing in The New Physician magazine.