When Will We Recognize Direct Care Worker Crises

Financial Justice Health Care Ideas and Issues

New Orleans  Most people – and politicians – don’t recognize the real contributions of direct care health workers until their lives or the lives of loved ones depend on them.  And, when I say, depends on them, I mean for everything from mobility, to feeding, to bathing, to the most basic and private needs that constitute basic human dignity.  These workers in home health, community homes for the mentally challenged, nursing homes, and even in private homes as sitters, are critical and essential workers.  There are millions of such workers now and the numbers are expected to double over the next 20 years, yet despite their important contributions many are working in semi-feudal conditions.

            Not surprisingly there is high turnover in these jobs.  Pay is low.  National averages indicate pay is around $11.75 per hour, but in nursing home and community home chains, wages hardly over the federal minimum are more common and cash strapped states continue to whack away at reimbursement rates forcing virtual freezes and impenetrable ceilings.  On-the-job injury rates caused by excessive lifting by predominantly female workers are frighteningly high and according to the Bureau of Labor Statistics are as high as the rates achieved at slaughtering houses where knives are the basic work tools and just below the rates of injuries for professional sports teams.  Add to all of this the fact that some of the tasks involved in this work are unpleasant to put it mildly, and it is amazing that so many are so devoted to this labor and the compensation is so embarrassing and degrading.

            These are problems everyone recognizes, yet no one moves to solve.  Unionization rates remain abysmally low, especially in nursing homes where turnover is rampant and reimbursement rates are typically ridiculous.  Thousands of workplaces averaging 50 workers or less make organizing under existing legal restraints exorbitantly expensive and inefficient and in right-to-work states economically prohibitive for many unions under current recruitment models, despite a plethora of issues and worker complaints.  Experts agree that high turnover is a problem leading to worse care for patients and higher costs given an estimated new hire recruitment and training cost of about $4000 per worker, yet nothing seems to change except the workload.

            A new unit organized by Local 100 recently at a work facility for the mentally challenged in Louisiana contacted the union when daily ratio hit one staff member to 20 clients throughout the day, simply overwhelming the workers.   In a rarity the company directly recognized our union knowing that 100% of the workers were signed up, but probably hoping that workers in the union were more likely not to call the state to come investigate the working and staffing conditions.

            Average costs to care for the elderly are now being projected to hit $50,000 per year with the numbers expected to soar over the next 10 to 20 years as the baby boom generation wears out.   Full time in-home care even when informal and off the books can reach $70 to $80,000 annually now, which financially pushes loved ones into the cheaper, most affordable arrangements regardless of how untenable situations might be.

            Workers and families are at their breaking points with no sign of relief in sight.  There is a political crisis and a worker revolution ticking quietly, but quickly, towards either revolution or chaos without anyone but the workers themselves lifting much of a hand towards the problems.

Direct Care Workers Audio Blog.