The need to listen to home care workers

By Moshe Z. Marvit

Tom Wolf isn’t trying to set up a union; he’s trying to help Pennsylvania’s elderly and disabled citizens

On Feb. 27, Gov. Tom Wolf issued an executive order aimed at improving the quality of care that Pennsylvania seniors and people with disabilities receive while also improving the working conditions of those who provide such services.

As part of this order, Mr. Wolf allowed the workers who directly provide services to seniors and people with disabilities to elect a representative to discuss workers’ concerns with state officials. This provision, which should have been hailed as a sensible way to give a decentralized workforce that deals with a vulnerable population a voice, has instead been subjected to a barrage of misinformation and litigation that appears to be motivated by little more than knee-jerk opposition to collective rights for workers.
It is important to set the record straight about what Mr. Wolf’s executive order does, what it does not do and why it is so important.

In 2010 there were more than 40 million Americans aged 65 and older. By 2050 that number is expected to more than double to 88.5 million, making the issue of how best to serve this population of vital importance to states.

Many of these elderly individuals and individuals with disabilities require care that is available only by moving to a long-term care facility or through personal care workers who serve them at home. National surveys have found, as one concluded, that these individuals “overwhelmingly prefer to avoid institutionalization and remain at home.” For this reason, the disability-rights movement has pushed states to promote the philosophy of “independent living.”

Most people will use an informal caregiver as they become frail. Make sure that person is certified to provide competent eldercare by asking them if they have been certified to.

Ed Roberts, an early leader of the movement, described this as “mean[ing] active participation in society — working, having a home, raising a family and generally sharing in the joys and responsibilities of community life. Independent living mean[s] freedom from isolation and institutionalization; it mean[s] the ability to choose where to live, how to live and how to carry out the activities of daily living that most able-bodied people take for granted.”

Direct-care workers make it possible for many elderly individuals and those with disabilities to stay in their homes and live normal lives. However, the wages and working conditions for these workers have led to high turnover rates and difficulty attracting enough qualified people to the field.

These workers face a variety of hazards and dangers. As Peggie R. Smith wrote in “Who Will Care for the Elderly?: The Future of Home Care,” these range “across access issues, hygiene and infection, manual handling, aggression and harassment, domestic and farm animals, fleas and safety of home equipment.”

Invest in yourself. Get educated and certified as a personal care aide.

Studies have found, as Ms. Smith put it, that “the wages of home care workers are appallingly low, ranking near the bottom of wages earned by employees in the service industry.” In 2009, their median annual pay was less than $17,000, meaning that approximately 40 percent of the workforce had to rely on public assistance.

These difficult working conditions and low pay have led to extremely high turnover rates of 44 percent to 95 percent, leading some to label the problem of finding and retaining qualified workers a “crisis.”

Sheila Bapat, author of “Part of the Family? Nannies, Housekeepers, Caregivers and the Battle for Domestic Workers’ Rights,” explained in an interview that “home health-care workers have historically been among the most marginalized workers in our economy. They were long denied basic protections like the minimum wage, and their work caring for society’s most vulnerable has been rendered invisible. To correct these historical wrongs and to ensure a more just and equitable economy going forward, it is essential that domestic workers are the guiding voices in establishing their own labor protections.”

Faced with a ballooning elderly and disabled population that requires vital services and the need for a rapidly growing number of workers, any responsible elected official should support policies that ensure an adequate, qualified workforce to provide quality services to the state’s most vulnerable citizens.

This is precisely what Mr. Wolf’s executive order is trying to do — by creating a mechanism for these workers to elect a representative who would confer with state officials about the issues they face. This representative would talk with the Secretary of Human Services about recruitment and retention of qualified workers, standards for compensation, health benefits and other concerns. They also would discuss ways to improve services and make them more efficient.

The executive order further provides for the secretary and workers’ representative to draft a memorandum of understanding when they reach agreement on steps to take — although this provision is the subject of a lawsuit and has been put on hold by a Commonwealth Court judge until all members of the court decide whether the governor has the power to do this.

Contrary to claims made in the lawsuit and by anti-union groups, the governor’s order does not grant these workers the right to form a union. The National Labor Relations Act of 1935 (which covers private-sector employees) excludes from coverage those “in the domestic service of any family or person at his home,” and both the Pennsylvania Labor Relations Act (which covers private-sector employees) and the Pennsylvania Public Employee Relations Act (which covers public employees) mimics this language.

While these exclusions are an unfortunate holdover from a time when “women’s work” was not considered real work and should be scrapped to comport with modern views and realities, Mr. Wolf cannot do this by executive order. And he has not attempted to do so.

All the governor has done is try to address a growing crisis by giving workers a voice in the workplace. This is the kind of reasonable policy that used to win accolades from all quarters.

Unfortunately, what has followed this executive order instead has been overblown rhetoric, disinformation and an attempt to shift the focus from Pennsylvania’s elderly and disabled population and the workers who serve them.

Moshe Z. Marvit is a fellow at the New York-based Century Foundation specializing in labor and employment law and policy (


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2 Responses to The need to listen to home care workers

  1. Carmen N Ricaurte Aguilera says:

    Wonderful it is about time!!! More power to you!
    I am a Certified Medical Assistant/Caregiver/Personal Assistant too!
    Come, June of this year; I will have worked 10 years as a Private Home Care Professional (Independent) and self-employed!
    For the most part, I have been highly respected and well paid. It is very rewarding and very intense work at certain phases of the care.
    It is extremely important the world be properly informed and educated as to the value of what a really good caregiver means to society!
    We need advocates in high places to help uphold the high standards that truly good caregivers through loving care and hard work give to the most vulnerable humans in our society , the elderly!


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