I found last month’s article “Is Unionization
of PCAs the Answer?” very interesting and thought provoking.
However, unlike the author, I would celebrate PCAs being unionized.
I encourage Service Employees International Union (SEIU) to begin
organizing personal care assistants (PCAs) employed in the home
health care service industry now. But I have not seen any evidence
that this organizing is happening.
Since the author states, “I’m unsure how historical union
activities and models, plus union visions and goals, will be able to
ensure quality and stability for workers and consumers,” I thought
I’d provide some responses. These observations are not from
a union organizer, but from a social justice worker who also has
personal experience with PCAs.
First,
a little history of PCAs. When I first started receiving
assistance from Ramsey County in the late ‘60s and early ‘70s,
the county provided me with a monthly check to hire and pay someone
to provide me with the services I needed. In the late‘70s privatization
began and as a result pay dropped for PCAs to between $5 and $6 dollars
an hour, as did the control I had over the hiring process. However,
before (and during the transition to) total privati-zation, there
were PCAs with full benefits, health insurance, paid vacations, good
wages and overtime pay. Why? Because they were hired by the county
and served on a public health nursing team and belonged to a union.
Not long into the 80s the full privati-zation of PCAs took place,
and those county jobs disappeared; wages dropped, the benefits disappeared
and the unionized PCAs also disappeared. Most of the women that worked
for me were very well trained through the county system and supervised
regularly by a Public Heath Nurse. In my experience, unionization
created a much more efficient and happier worker with fewer worries
about their quality of life. Thus, better service for me.
Oh, and did I mention that this profession was 99% women in the union
days? Today, the PCAs in a typical agency in the metro area are probably
85% women, and 50% African-American. These are populations that historically
make up low-paying jobs and could greatly benefit from union bargaining
power.
Now,
on to my responses. How
does a union model work in a consumer-directed residential environment? When a union carpenter gets hired by a company, the boss on the
job directs the carpenter to do carpentry. Likewise, when a company
hires a union PCA, the consumer OKs them to work in their home and
asks the PCA to do what they are supposed to do.
Will
union practices jeopardize consumer freedom, direction, choice,
privacy, quality, and safety? Will a
union model make it difficult to avoid inappropriate workers who
may pose risk to consumers’ physical
and emotional health and safety? These two questions incorrectly assume
that a company that hires a PCA is no longer involved and has given
up its responsibility to the consumer and that somehow federal HIPA
and state vulnerability laws are no longer applicable. Oh, and speaking
of inappropriate workers, with the current consumer-directed system,
there is extreme chance of consumer abuse due not only to lack of supervision
by the hiring agency but also to the consumer’s inability to
physically be in charge.
Who will
be responsible for documenting behaviors that negatively impact
quality-of-life? Once again the hiring agency (whether under
the current system or a unionized system) would be mandated to make
reports. Hopefully advocacy organizations would not disappear.
Will
poor-performing workers shirk their responsibilities citing union
protection? Shirking
happens under the current, consumer-directed model—the
PCA and the consumer cite nothing. With union workers, there would
be another layer of consumer protection and empowerment.
Who will
be responsible for providing individual consumer advocacy and management
training? As always, the consumer must be a self-advocate.
However, I do not see any advocacy organization disappearing simply
because PCAs are unionized. Management training would probably be jointly
performed by the hiring agency and the union.
Who will
be responsible for collectively bargaining with unions: consumers,
personal care provider agencies (PCPOs), or the Department of Human
Services (DHS), which controls resources available for compensation
and benefits? PCPOs will be the bargaining agent with the union. If
company X gets a government contract to build a bridge, and their
workers go on strike, the bargaining is between the union and Company
X, not between the union and the Department of Transportation.
Similarly, the PCPO gets the authority from the state to provide
PCA services (and receive reimbursement). So, if PCAs don’t
like their working conditions, they would negotiate with their
employer, the PCPO.
Will
consumers and PCPOs become strategic negotiation pawns? Yes!
As will the governor, legislature and DHS.
Will
strikes, walkouts, and picketing be used? Yes!
Where
will picket lines be drawn? At DHS, PCPO offices, or consumers homes? Probably at
PCPO offices, and for public awareness at DHS offices and the governor’s
office.
Who will
be responsible for funding these additional administrative tasks? This issue is a contract concern.
Will
gains in PCA wages be consumed by mandatory union dues? I’m
not sure why this is a consumer concern, but …. Workers in
many industries which pay $30.00 an hour have union dues of $90.00
a month. If the worker is receiving $15.00 an hour with benefits,
union dues are at most $35.00 a month. Does that rate seem unfair?
I think an efficient answer is NOT unionization, but rather a unified
public awareness and advocacy campaign by consumers, families,
PCAs, and provider agencies targeting elected state and federal
officials plus mainstream media. I strongly encourage the Minnesota
Consortium for Citizens with Disabilities, Minnesota Association
of Centers for Independent Living, Direct Support Professional
Association of Minnesota, Minnesota HomeCare Association, and their
national counterparts to begin examining these issues and working
toward alternative solutions to rebuild and maintain community-based
support systems protecting consumer-direction as well as providing
competitive and livable wages and benefits. This is a great idea,
but the Consortium for Citizens with Disabilities is not the vehicle,
because the CCD has a make-up of individual representatives of
organizations that represent mostly professional advocacy groups,
private for-profit and not-for-profit companies with very little
input from those that are directly affected—direct
support professionals and consumers.
As for the writer’s
last sentence …. However,
if these stakeholders do not act, then I would support unionization
for the advantages it may provide.
LET’S GET ON WITH IT! ![]()
Rick Cardenas is executive
director of Advocating Change Together.
