Homecare is Healthcare Report

Read the full report here.

Washington’s home care workers are a vital part of our State’s pandemic response. COVID-19 has sickened and led to the deaths of thousands of older adults and essential workers, and has disproportionately impacted low-wage workers, people whose primary language is not English, and Black, Indigenous and people of color. Home care workers are highly trained healthcare professionals who have helped protect their clients from exposure to COVID-19. 

Home care workers support medically fragile elders and people with disabilities in their homes, where people are safest during a pandemic. They are essential, low-wage workers who risk their own health and economic stability to protect their clients. Both caregivers and their clients are disproportionately immigrants, people whose primary language is not English, and Black, Indigenous and people of color. Even before the pandemic and its economic fallout, these communities already experienced higher rates of poverty and economic hardship, and, during the pandemic, have faced more severe health consequences. 

The following report examines the role of the Medicaid Home Care Program in promoting the health of Washington residents, equity among communities, and sustainability of state systems and safety nets. The analysis is based on academic and scientific literature, data from state agencies like the Department of Health, and interviews we conducted in 2020 with home care workers and clients across the state. We conclude: 

1. Home care workers reduce the spread of COVID-19. 

Staying home is the most powerful action any of us can do to reduce the spread of the virus. Home care workers help clients do this. 

  • Quality, skilled home care allows elders and people with disabilities to stay out of residential care facilities where more than 40% of the deaths due to COVID-19 in the U.S. have taken place. 
  • Caregivers are also coming up with creative ways to ensure their clients can leave their residence as little as possible, to decrease their exposure to the disease. They acquire clients’ basic needs, such as prescriptions, groceries from the store or food bank, and, during the pandemic, supplies like hand sanitizer and masks. 
  • Caregivers’ training includes knowledge of infection control protocol and caregivers’ practices with their clients demonstrate the seriousness with which they take their responsibility to protect their clients. 

2. Caregivers provide care at great risk to themselves. 

Compared to the general population, caregivers in Washington are more likely to experience COVID-19 and are more likely to live on the brink of crises, like food insecurity or homelessness. 

  • More than twice as many caregivers in Washington tested for COVID-19 were found to be positive, compared to people tested in the general population. 
  • Medicaid home care employment keeps caregivers afloat economically. However, low wages mean that many caregivers still depend on state and community safety nets and cope with precarious household finances. 

3. Investing in home care is an investment in Black, Indigenous and communities of color, communities most impacted by economic hardship and COVID-19. 

  • Black, Indigenous and people of color are at higher risk of exposure to and serious health consequences from COVID-19. Underlying health conditions, caused by factors like inequity in access to healthcare, are compounded by inequities in access to timely COVID-19 testing and care. 
  • People whose primary language is not English have also been more likely to contract COVID-19 and need hospitalization. Caregivers who speak the same language as the client become essential messengers of public health information and mitigate the risks of exposure. 
  • Black, Indigenous and communities of color in Washington experience poverty at higher rates than White communities. 
  • Medicaid home care is a financial lifeline for caregivers and clients. This is especially true for Parent Providers and other family caregivers who are limited in their ability to secure other employment because they are responsible for the well-being of their clients. 

4. A quality home care program reduces strain on hospitals, mental health care systems, criminal justice systems, emergency services, and state social safety nets. 

  • Caregivers have extensive training in client health and support. Through daily tasks like reducing client falls and reminding clients to take medications and eat healthy meals, caregivers maintain clients’ health and well-being. These efforts slow the decline of clients’ conditions and reduce their need for expensive emergency services and hospitalization. 
  • When people with mental or behavioral health needs have an in-home caregiver, they are less likely to experience relapses that could prompt more expensive medical responses, such as hospitalization. It also prevents increased criminalization and the costs, to the state and the individual, of courts, incarceration and re-entry. 
  • Medicaid home care is essential for the well-being and health of caregivers and their families. Health insurance allows caregivers to access care when they need it, before their health needs become an expensive emergency. Paid caregiving also reduces caregivers’ reliance on safety nets like unemployment, food assistance, housing assistance, and public health insurance. 

When the Medicaid Home Care Program is strong, providing quality care and livable jobs, it protects some of the communities hardest hit by COVID-19: elders, people with disabilities, Black, Indigenous and people of color, immigrants and people whose primary language is not English. 

Investing in home care saves the State money, by reducing institutionalization, hospitalization, and reliance on other systems and safety nets. Moreover, it saves and improves lives, keeping people most at risk of dying from COVID-19 away from possible exposure, reducing declines or relapses in clients’ conditions, and providing wages and benefits that increase caregivers’ access to basic needs for themselves and their families. 

As we work to keep our state’s most vulnerable residents safe and reduce inequities in health and well-being, Washington must continue to invest in this highly qualified workforce through wages and benefits that ensure clients receive the care they need and caregivers are able to sustain themselves in their essential work. 

Read the full report here.

We have exciting news for Washington caregivers. We have finished bargaining with the state and all home care agencies over the impact of the COVID-19 pandemic – and thanks to workers raising their voices, we have won some real improvements! Details in the links below.

IP Impact Bargaining Wins

Agencies

Many of us are feeling hope on the horizon, as more and more people get the COVID-19 vaccines. Vaccine priorities continue to be updated regularly and now all of our clients ages 16 or older are eligible. Updated vaccine information, including how and where to get it for you or your client, can be found here.

The COVID-19 crisis is nearing its end. But the nurses and home health aides who saw us through it may never recover.

People come to Shelly Hughes to get better. Most patients at the Washington State long-term-care facility she works at are there for the express purpose of getting well enough to go home. In a typical year, she would rarely see cases of “failure to thrive,” the technical term for a sharp and sudden decline in health. But last year, multiple people who were expected to make a full recovery went into rapid decline: They refused to eat, drink, or move, and then died.

She blames isolation, in part. Her facility has dramatically limited inside visitors since the start of the coronavirus pandemic, and employees wear full personal protective equipment, which makes communication difficult, especially with patients who are hard of hearing or have dementia. “Everyone that you see is basically a spaceman with no face,” she told me. She used to be able to comfort scared and lonely patients not just with her words, but with body language and facial expressions. Now she’s resorted to exaggerated gestures and writing questions down on a pad of paper.

Hughes and her co-workers are also trying to provide care while significantly understaffed, tending to far more patients than they should. Every shift has open slots, putting a greater burden on those who come in to work. “You physically do not have the caregivers and the nurses and social workers in the building to be able to sit and talk with people in a way that makes them feel like they’re not alone,” she said. “You feel really helpless.”

Read more in The Atlantic.

With more federal money coming from the American Rescue Plan Act passed last month, caregivers want Washington lawmakers to extend hazard pay and increase to at least $4, which is comparable to other essential workers.

Adam Glickman is secretary- treasurer for Service Employees International Union 775, which represents home caregivers in Washington. He said it’s a low-wage workforce and hazard pay will help retain and recruit workers at a crucial time.

“These workers are continuing to make a choice to risk their own health and their families’ health to go out and help seniors and people with disabilities be safe and healthy in their own homes,” said Glickman.

Wilson said caregivers brought to people’s attention how essential they’ve been during the pandemic.

“It wasn’t just the crisis,” said Wilson. “It was the crisis and us also pushing, saying we need to be able to get to our clients. We need to be able to feed our families. We need the money, and the money’s there so why not help us?”

SEIU 775 wants lawmakers to extend hazard pay before the Legislature is scheduled to adjourn on April 25.

Read more at Public News Service.

OLYMPIA, Wash. — Washington state caregivers are boosting a bill that closes some loopholes in the Long-Term Care Trust Act as it nears the governor’s desk.

Passed in 2019, the program created a trust fund for Washingtonians through a payroll premium that collects 58 cents for every $100 earned.

It was the first of its kind in the nation, but lawmakers want to tweak the program before it goes live.

Victoria Kahn, a family care provider and member of Service Employees International Union 775, said the program helps support her and her colleagues, such as helping to fund accessibility features like ramps.

“It’s something that us as caregivers have been working really hard for because we know long-term care is very vital for our nation, for everyone,” Kahn asserted.

Read more at Public News Service.

July 27, 2021 Update: Amicable APs will get a $2.71 per hour increase to our base wages for all hours worked between July-December 2021.  

You can read the latest MOU here.   


April 7, 2021 Update: Amicable APs will get a $2.71 per hour increase to our base wages for all hours worked in April, May, and June 2021.  

You can read the latest MOU here.   


January 15, 2021 Update: Amicable APs will continue to get a $2.71 increase to our base wages for all hours worked in January, February, and March 2021. We’ll also continue to receive an additional $2 of targeted Hazard Pay per hour if taking care of a COVID-19 test-positive client.

You can read the latest MOU here.

Amicable APs are also in the 1A priority group for getting the COVID-19 vaccine because of our advocacy as a Union. Learn how to get the vaccine here.


August 21, 2020 Update: We have exciting news for Amicable caregivers. Our bargaining team has been working to reach an agreement with Amicable about extending Hazard Pay – and thanks to workers raising their voices, we have made it happen!

Hazard pay: Amicable APs will now get a $2.71 increase to your base wages for all hours worked in July, August, and September. You’ll also receive an additional $2 an hour of targeted hazard pay if taking care of a COVID-19 test-positive client.  You’ll see your hazard pay for hours you already worked in your August 20 paycheck.

PPE: You will continue to be provided with all the necessary PPE for caring for all your clients.

You can read the latest MOU here. 


Through impact bargaining, Amicable caregivers have won:  

  1. Hazard Pay: Amicable APs will receive an additional $3 an hour for every hour worked in May and June. We are all on the front lines, so all Amicable APs will receive this pay, regardless if you are caring for a client with COVID-19. And you’ll get aadditional $25 targeted-hazard pay per shift for taking care of COVID-19 test-positive clients. 
  2. More PPE: Amicable has committed to spending additional funds to provide PPE and supplies intended to protect workers, including one-timeuse N-95 masks, gowns, and gloves for caring for test-positive clients. 
  3. Healthcare and Training: Amicable is increasing their hourly contribution rate to the Training Partnership and Health Benefits Trust for all hours worked in May and June, so no one loses healthcare coverage. 

Read the full MOU here.

Despite the State facing a growing budget deficit as a result of the pandemic, Governor Inslee agreed to increase funding for home care agencies like Amicable in order to provide this immediate support to caregivers. This was all made possible because of caregivers like you sending letters, signing petitions, sharing your stories, and so much more to demand the Legislature prioritize caregivers to receive Federal stimulus money.  

Standing together got us to this point – we need to keep this up to make sure that caregivers are treated as the essential professionals they are. 

August 10, 2021 Update: First Choice APs will get a $2.54 per hour increase to our base wages for all hours worked between July 1 and December 31, 2021. 

You can read the latest MOU here.   


April 5, 2021 Update: First Choice APs will get a $2.54 per hour increase to our base wages for all hours worked in April, May, and June 2021.  

You can read the latest MOU here.   


January 25, 2021 Update: First Choice APs will get a $2.54 per hour increase to our base wages for all hours worked in January, February, and March 2021.  

You can read the latest MOU here.  

First Choice APs are also in the 1A priority group for getting the COVID-19 vaccine because of our advocacy as a Union. Learn how to get the vaccine here


August 13, 2020 Update: We have exciting news for First Choice caregivers. Our bargaining team has been working to reach an agreement with First Choice about extending Hazard Pay – and thanks to workers raising their voices, we have made it happen!

Hazard pay: First Choice APs will now get a $2.75 increase to your base wages for all hours worked in July, August, and September. You’ll see your hazard pay for hours you already worked in your September 1 paycheck.

PPE: You will continue to be provided with all the necessary PPE for caring for all your clients.

You can read the latest MOU here. 


Through impact bargaining, First Choice caregivers have won:  

  • Hazard Pay: First Choice APs will receive an additional $3.50 an hour for every hour worked in May and June. We are all on the front lines, so all First Choice APs will receive this pay regardless if you are caring for a client with COVID-19.  
  • More PPE: First Choice has committed to spending $166,000 to provide PPE and supplies intended to protect workers, including one-time use N-95 masks,  gowns, and gloves for caring for test-positive clients. 
  • Healthcare and Training: First Choice is increasing their hourly contribution rate to the Training Partnership and Health Benefits Trust for all hours worked in May and June, so no one loses healthcare coverage. 

See the full MOU here.

Despite the State facing a growing budget deficit as a result of the pandemic, Governor Inslee agreed to increase funding for home care agencies like First Choice in order to provide this immediate support to caregivers. This was all made possible because of caregivers like you sending letters, signing petitions, sharing your stories, and so much more to demand the Legislature prioritize caregivers to receive Federal stimulus money.  

Standing together got us to this point, we need to keep this up to make sure that caregivers are treated as the essential professionals they are. 

Amirah Harris, a caregiver in Tacoma and member of SEIU 775, received the vaccine and said it’s important for caregivers like her to get it.

“We are in contact with people who are not in the best health,” Harris noted. “We are in contact with people who cannot make the best decisions for themselves, so we have to make a good decision for ourselves in a way that impacts others in a good way.”

Harris added she’s spoken to colleagues who are skeptical about the vaccine and encourages them to do research into its safety.

Nearly 30% of Washingtonians have received at least one shot of the vaccine, according to the most recent data tracked by The New York Times.

Read more at Public News Service.