Dear SEIU 775 Family,

I am writing to update you on our Union’s actions to respond to the COVID-19 crisis that is impacting our State, and particularly King County.

First, I want to recognize that nursing home workers have been among the hardest hit – we’re taking a number of steps in response:

  1. Making sure the legislature increases Nursing Home funding that many of you have been supporting at Purple Presences in Olympia
  2. Working with various state agencies to seek emergency funding to help alleviate the additional staffing and supply burdens on nursing homes in the short term
  3. Preparing a public campaign to highlight the need for better staffing, better wages, healthcare, and unions for nursing home workers. Some of those stories have already run, including:

In addition, to protect home care workers and our clients we are:

  • Coordinating with the SEIU 775 Benefits Group on education webinars, you can view the latest one here
  • Communicating with employers and the State to ensure that caregivers showing symptoms can stay home and be paid for the time in quarantine
  • Working to ensure that caregivers can get quicker access to gloves and other protective equipment when possible

We also want to make sure that our union staff is protected, which is why we are following King County’s guidelines to allow employees to work from home. This has been a particular challenge for our Member Resource Center, but I’m proud to report the MRC is now up and running with reps answering calls remotely! If you get an error message between our modified hours of operation 8-4:30, please send us an email at or try calling again! We appreciate your patience as we work to get back up to normal operations.

Out of an abundance of caution we are also cancelling in-person Union meetings for the month of March.

We’re also getting questions about the ongoing availability of training classes especially from those nearing deadlines – we are working with the State to try to extend training and testing deadlines. Please stay tuned for more information and keep an eye out on updates about training from SEIU 775 or the SEIU 775 Benefits Group.

And while all this was happening, the legislature passed SB6205 – landmark legislation that addresses the harassment, abuse and discrimination of caregivers, an important part of the HADit campaign we launched during Leadership Conference last year! This was only possible because of the leadership that came from you all and other member leaders.

While we’re taking the time we need to respond to caregivers at the center of this crisis, our Union is not slowing down one bit!

Sterling Harders
  Sterling Harders
  SEIU 775 President


Montana Governor Steve Bullovk with Members


SEIU 775 Endorses Montana Governor Steve Bullock for United States Senate

 Montana caregivers union endorses Bullock: He has been a champion for caregivers, our families, and working people across our state

HELENA, MT – With today’s news of Governor Steve Bullock running for United States Senate, the caregivers union SEIU 775 announces their endorsement of him. Caregivers from across the state endorse Bullock because he understands and values the role caregivers play across every community in our state.

“Governor Bullock has been a great partner of caregivers and low wage workers across the state,” said SEIU 775 President Sterling Harders. “When Bullock announced his plan to run for US Senate, our caregivers here spoke up and shared their support. It was an easy decision to endorse him since he’s done so much for healthcare and put working people first.”

During his tenure as governor, Bullock has worked with SEIU 775 to improve conditions for caregivers and those we care for. In 2013, he included raises for direct care workers in his budget in recognition of the important work caregivers do in our communities. He also led the effort to pass Medicaid Expansion in 2015 covering 70,000 Montanans, and in 2019, he championed Medicaid Expansion reauthorization leading to healthcare coverage for 100,000 individuals in our state.

“Governor Bullock has walked a day in my shoes, and I know he will take that experience with him to the US Senate. He knows firsthand what we face every day and will take into consideration caregivers and working people from across the state,” said Anna Volkersz, a caregiver from Bozeman.




SEIU 775

SEIU 775, the caregivers union, represents more than 45,000 long-term care workers providing quality home care, nursing home care, and residential services in Washington and Montana.


Companion bill to Senate Bill 6205 hears testimonies from caregivers in the House Labor & Workplace Standards Committee


OLYMPIA, WA – Today, caregivers, agency employers, and allies testified in front of the Washington state House Labor & Workplace Standards Committee in support of House Bill 2681 – a bill that addresses the harassment, abuse, and discrimination of caregivers.

“Every single time workers demand rights and protections, the response is that this isn’t the right time, or that we need to slow down, or that we need to study the problem more,” said SEIU 775 President Sterling Harders. “But caregivers in this state are at risk. People deserve to be safe while giving and receiving care.”

HB 2681 was created with significant input from caregivers and the aging and disability rights community, including self-advocates. Caregivers from across the state urge the legislature to pass this powerful and comprehensive policy that ensures everyone can feel safe while giving and receiving care. 

Caregiver Danielle Green said: “While my client’s mother behaved in ways that made the overall care environment dangerous, they did not appear to put her son – my client – in immediate danger. When my client’s mother came after me with a butcher knife, there was no one for me to report it to who would have my back and ensure I was safe at work.”

For caregivers, incidents of harassment, abuse and discrimination can come from anyone in the care environment – including other people residing in or visiting their client’s home, friends, family, or neighbors. And the impacts can linger. It affects caregivers’ health, wellbeing, and quality of care. Additionally, it leads to increased turnover among direct care workers, which can lower quality of care for clients.

SEIU 775 testified in support of HB 2681 because:

  • Everyone deserves to feel safe at work and while giving & receiving care.
  • Everyone deserves to feel respected when giving & receiving care.
  • Everyone wants to strengthen long-term care workforce and system in our state.
  • And above all, caregivers want to provide the best quality care they can.

The bill is sponsored in the Washington state House of Representatives by Mike Chapman, 24th District; Eileen Cody, 34th District; Lauren Davis, 32nd District; Carolyn Eslick, 39th District; Noel Frame, 36th District; Roger Goodman, 45th District; Mia Gregerson, 33rd District; Paul Harris, 17th District; Christine Kilduff, 28th District; John Lovick, 44th District; Nicole Macri, 43rd District; Timm Ormsby, 3rd District; Lillian Ortiz-Self, 21st District; Tina Orwall, 33rd District; Gerry Pollet, 46th District; Marcus Riccelli, 3rd District; June Robinson, 38th District; Mike Sells, 38th District; Sharon Shewmake, 42nd District; Monica Jurado Stonier, 49th District; Gael Tarleton, 36th District; My-Linh Thai, 41st District; Steve Tharinger, 24th District; Javier Valdez, 46th District; and Amy Walen, 48th District.

HB 2681 is the companion bill to Senate Bill 6205, which caregivers testified in support of in front of the Senate Health and Long Term Care Committee on January 15.

More information on SEIU 775’s campaign to address harassment, abuse and discrimination (HADit) is available at:




SEIU 775

SEIU 775, the caregivers union, represents more than 45,000 long-term care workers providing quality home care, nursing home care, and residential services in Washington and Montana.

This year, the Washington state Legislative Session is only a couple months long. That means we have a lot of work to do in a shorter amount of time!

Our caregivers from across the state will be heading to Olympia over the next two months to ask for lawmakers’ support on important legislation and budget items that impact not just us, but our communities and the people we care for.


Here are our legislative priorities that we’re asking lawmakers in Olympia to support this year:

Addressing the Harassment, Abuse, and Discrimination of caregivers: At SEIU 775, we believe everyone should feel safe at work and while giving and receiving care. Yesterday, caregivers went to Olympia and testified in front of the Senate Health and Long Term Care Committee in support of Senate Bill 6205 – a bill that will address the harassment, abuse, and discrimination of caregivers.

We first introduced our campaign to address Harassment, Abuse, and Discrimination – or as we call it, HADit – at our Leadership Conference in September, and since then, we have worked with caregivers, lawmakers, and the aging and disability rights community, including self-advocates, to draft legislation, testify in front of lawmakers before the legislative session had even begun, and continue conversations with stakeholders.

We also know that there is a history of harassment, abuse and discrimination of people with disabilities. While this legislation focuses on the treatment of caregivers, we’re working closely with members of the disability rights community to make the care environment safer for everyone.

We look forward to working with advocates throughout this process to make the care environment safer for everyone.

Improving Funding for Home Care Agencies: We are asking legislators to clarify the Parity law, so agency caregivers are paid equivalent wages and benefits for doing the same work that State-paid Individual Providers do.  We are also pushing for a 10-cent increase to the in-home care agency administrative rate, which will help stabilize funding for agencies and help ensure access to home care for Washingtonians who need it.

Improve the Nursing Homes reimbursement system: Additional funding for the Nursing Home system in our state will help ensure quality care to our most vulnerable residents.

Investing in the newly established Consumer-Directed Employer: The Individual Provider system is transitioning to this model and needs carefully targeted investments to ensure strong administration of the program.

Passing the Domestic Workers Bill of Rights:  The Domestic Workers Bill of Rights will extend critical worker protection laws to domestic workers, including minimum wage requirements, overtime pay requirements, rest and meal breaks, and protections against sexual harassment and discrimination, and create a pathway for workers to have an ongoing voice in their compensation and working conditions.

Balancing our upside-down tax code: We support proposals to rebalance our tax code and make it work for working people, which includes passing a capital gains tax and a Working Families Tax Credit.

Supporting justice, access to healthcare, and safe communities for all Washingtonians, regardless of if we’re white, Black, or brown, our gender, our abilities, or how much money we earn: We support investments and policy changes to make Washington thrive for all people through the Worker Protection Act, secure scheduling, affordable housing and tenant rights, access to dental therapists, affordable prescriptions including insulin, criminal justice reform, immigrant rights, gender equality, language access, and climate justice.

Together, we can build a better future for all of us.


SEIU 775 President Sterling Harders: “This bill will make the care environment safer for both caregivers and the people they care for by creating safety, prevention, and reporting standards. Caregivers in this state are at risk every single day, and we need real protections now.”


OLYMPIA, WA – Today, SEIU 775 President Sterling Harders, caregivers, agency employers, Parent Providers, and allies testified in front of the Washington state Senate Health and Long Term Care Committee in support of Senate Bill 6205 – a bill that addresses the harassment, abuse, and discrimination of caregivers.

“This bill will make the care environment safer for both caregivers and the people they care for by creating safety, prevention, and reporting standards,” said SEIU 775 President Sterling Harders. “Caregivers in this state are at risk every single day, and we need real protections now.”

SB 6205 was created with significant input from caregivers and the aging and disability rights community, including self-advocates. Caregivers from across the state urge the legislature to pass this powerful and comprehensive policy that ensures everyone can feel safe while giving and receiving care.

“I’m a Parent Provider, and I support Senate Bill 6205 addressing harassment, abuse, and discrimination of caregivers as a caregiver and as an advocate for my son,” said caregiver Melissah Watts, who cares for her son, Max, who has developmental disabilities. Max joined her at the hearing.

Caregivers typically work in isolated environments. A survey of Washington caregivers found:

  • 47 percent reported experiencing verbal abuse while working
  • 24 percent reported physical violence
  • 12 percent reported sexual harassment (Parent Providers were not asked this question)

For caregivers, incidents of harassment, abuse and discrimination can come from anyone in the care environment – including other people residing in or visiting their client’s home, friends, family, or neighbors. But the impact is more than an immediate reaction. It affects caregivers’ health, wellbeing, and quality of care. Additionally, it leads to increased turnover among direct care workers, which can lower quality of care for clients.

Caregiver Darryl Johnson said, “A couple years ago, I was working with an elderly white woman. A couple weeks into working with her, she started to make inappropriate comments toward me. As a Black male caregiver, I was scared. I thought I was going to go to jail because of what she was saying, and no one would believe me. I stopped working with this client – but it meant I gave up a paycheck to feel safe.”

SEIU 775 testified in support of SB 6205 because:

  • Everyone deserves to feel safe at work and while giving & receiving care.
  • Everyone deserves to feel respected when giving & receiving care.
  • Everyone wants to strengthen long-term care workforce and system in our state.
  • And above all, caregivers want to provide the best quality care they can.

The bill is sponsored in the Washington state Senate by Andy Billig, 3rd District, Spokane; Annette Cleveland, 49th District, Vancouver; Steve Conway, 29th District, Tacoma; Manka Dhingra, 45th District, Redmond; David Frockt, 46th District, Seattle, Kenmore, Lake Forest Park; Karen Keiser, 33rd District, Des Moines; Mark Mullet, 5th District, Issaquah; Emily Randall, 26th District, Bremerton; Rebecca Saldaña, 37th District, Seattle; Kevin Van De Wege, 24th District, Sequim.

More information on SEIU 775’s campaign to address harassment, abuse and discrimination (HADit) is available at:




SEIU 775

SEIU 775, the caregivers union, represents more than 45,000 long-term care workers providing quality home care, nursing home care, and residential services in Washington and Montana.

State Tax Credit Could Help WA Working Families ‘Pay the Bills’

Public News Service
November 27, 2019

11.25.19 WFTC Jayapal Roundtable - reduced(Please click through here to listen to the radio version of this story.)

SEATTLE – Ahead of the 2020 legislative session, a diverse coalition is calling on state lawmakers to fund a working-class tax break.

The Working Families Tax Credit, the Evergreen State’s version of the federal Earned Income Tax Credit, would provide an average income boost of $350, mainly for people making less than $51,000 a year.

Brittany Williams, an executive board member for the Service Industry Employees Union 775, a home-care providers’ union, said most families would use the extra income to pay bills. In her case, that means medical expenses.

«I need dental work done and, even though I do have dental insurance, because of the work that I need done, it just doesn’t cover it,» she said. «And so, I work through the pain, and I live with that pain with my mouth issue every day and I just don’t complain about it to anybody. I make sure my children are taken care of.»

The Working Families Tax Credit already has passed in Washington state but has yet to be funded. It’s estimated the measure would affect about 967,000 households. Supporters include Moms Rising, United Way of King County and the Washington State Coalition Against Domestic Violence.

At a roundtable this week in support of the state tax credit, U.S. Rep. Pramila Jayapal, D-Wash., said she also is working on federal legislation. Jayapal is co-sponsoring the «Working Families Tax Relief Act» and the «Building Our Opportunities to Survive and Thrive Act,» which would provide up to $3,000 in tax credits for individuals and $6,000 for married couples. She said the 2017 Republican tax cut isn’t helping working families, and contended that wealthy Americans can afford to pay more.

«When three people in the United States of America – two of whom live in our state – have the same combined wealth as 160 million Americans across the country,» she said, «we know that that does not provide the opportunity for everyone to have a fair and decent life, and just to make ends meet.»

The 60-day state legislative session begins Jan. 13. state Sen. Joe Nguyen, D-West Seattle, and Rep. Debra Entenman, D-Kent, are the primary sponsors of the Working Families Tax Credit bill. Its text is online at

April 13, 2020 Update

IMG_2523_reducedThe HADit law officially goes into effect in 90 days with some aspects going into effect immediately and others having longer timelines.  Passing this law was a HUGE first step, but there is still work to be done. Below are some of what we’ll be working toward next:

Prior information for in-home caregivers to feel more prepared – All covered employers, DSHS and their agents are now required to inform workers of instances of abusive conduct or challenging behaviors.

Recording and reporting – Employers are now required to keep a record of any reported incidents of abusive conduct or discrimination. Incidents of challenging behaviors are not required to be recorded or reported.

Enforcement – Labor and Industries will investigate to ensure compliance with the policy, prevention plan, informing workers, and reporting requirements.

Prevention plans – By July 1, 2021 all home care agencies and the Consumer Direct Employer must implement a prevention plan to reduce workplace violence including clear processes for emergency responses and leaving unsafe situations.

Training and future policy workgroup – A multi-stakeholder workgroup, including caregivers, will be convened to recommend by December 1, 2021 additional policy recommendations and training for workers, clients and agency supervisors.

Comprehensive written policy – By July 1, 2021 all employers must have written policies about how they will address instances of discrimination, abusive conduct and challenging behaviors. Policies must be delivered to caregivers at least annually, in a way that everyone can understand.

In addition to the work we did in Olympia, all our agencies have also implemented some version of our HADit asks into each of our contracts, including some or all of the following:

Advanced notice of known client behavior – When a client’s behaviors have been reported to the agency, new workers assigned to the client will be advised if those behaviors have made care challenging.

Clear rules for reporting – Known policies and procedures for reporting health and safety issues – a specific chain of communication, documentation of issues and employer follow-up.

Safety equipment provided – Safety equipment that is needed for job performance will be provided per the client’s care plans.

Client-Specific Training – Some clients require special training (e.g. operation of Hoyer lifts in the home), and this puts the onus on the employer to provide training.

Paid shifts for leaving due to health or safety concerns – If an employee feels that their health or safety is compromised in the home, employees may leave their shift, contact their supervisor and still be compensated for their shift (assuming that their concern is validated). In any case, employees will not be retaliated against for leaving a shift.

You can find your contract here.


March 4, 2020 Update

Both the Washington State Senate and House of Representatives voted in support of SB 6205 – landmark legislation that addresses the harassment, abuse, and discrimination of caregivers! The final step is Governor Inslee signing the bill, which he plans to do!

Together, we’ve done so much in Olympia throughout this legislative session to get this bill passed, including multiple testimonies, handing out care packages, sharing our stories, and calling and emailing lawmakers. It is the first of many steps we’re taking to make the care environment safer for everyone. This is how we can use our power together to make change.

It’s your stories that made a difference for lawmakers, and they heard you.

Some of the legislators we’ve been talking to about supporting these bills are the same lawmakers we interviewed, endorsed, and worked hard together to elect. Our power in Olympia comes from us working together to fight to improve our lives, the lives of the people we care for, and for our communities.

Together, we can build a better future for all of us.


About HADit

Low-wage workers – especially women, immigrants, and people of color – are particularly vulnerable to harassment, abuse, and discrimination in the workplace. For home care workers, the isolated and often intimate nature of our work can put us even more at risk.

For caregivers who have experienced harassment, abuse, and discrimination, the impact is more than an immediate reaction. It also effects their health, wellbeing, and quality of care. Negative health outcomes include depression, flashbacks, sleeplessness, traumatic stress disorder, and poorer physical health – which can last for years after the incident. Additionally, it also leads to increased turnover among direct care workers and lower quality of care for clients.

Prevalence of Harassment, Abuse, and Discrimination of Washington SEIU 775 Caregivers  

47% reported Verbal Abuse 

24% reported Physical Violence 

12% reported Sexual Harassment (Parent Providers were not asked about this)


In 2018, an SEIU 775 caregiver reported to our Union a harrowing story of the harassment and discrimination they faced while working as a caregiver. At the time, their livelihood, housing, safety, and dignity were at risk, and there was little we as a union could to do to help them because of the lack of structures in place to address harassment, abuse, and discrimination of caregivers.

Unfortunately, the experience they went through was only one of many reported to us in the past year alone.

That’s why SEIU 775 launched our HADit campaign – the campaign to address Harassment, Abuse, and Discrimination of caregivers and make the care environment safer for everyone.

SEIU 775 is working with caregivers and the aging and disability rights community including self-advocates to craft a powerful and comprehensive policy to address these issues that include:

  • Model employer policies and practices: Employers should be required to have written, comprehensive policies that are delivered to caregivers at least annually, in a way that everyone can understand.
  • Violence prevention plans, including a plan to leave unsafe situations: Employers must have violence prevention plans,  developed in conjunction with workers or their representatives. This is required in most other healthcare settings and should be required for caregiving.
  • Advance warning for caregivers: Employers must give caregivers advance warning and updates on patterns of conduct or dangers in or around the household. This needs to be done in a way that is respectful of individual privacy, while also communicating to caregivers the information we need to safely do our job.
  • Transparency: Employers of in-home based direct care workers should be required to record incidents, retain those records for at least 5 years, make those records available for inspection upon request, and report certain metrics to the State.
  • Training: The legislature should convene a multi-stakeholder work group to create recommendations around
    training for caregivers, clients, and agency supervisors.

Harassment, abuse, and discrimination of caregivers is something that can and should be addressed. We’re asking for your support to make sure:

  • Everyone feels safe at work and while giving and receiving care.
  • Everyone feels respected when giving and receiving care.
  • Everyone can continue to strengthen the long-term care workforce and system in our state.
  • And, caregivers are empowered to provide the best quality care possible.

We launched our HADit campaign at our Leadership Conference in September 2019.

Watch the Nov. 20, 2019 work session with the Washington state Senate Health and Long Term Care Committee here. Watch SEIU 775 President Sterling Harders, caregivers, agency employers, Parent Providers, and allies testify in front of the Committee in the the Jan. 15, 2020 hearing in support of Senate Bill 6205 here.

If you have a harassment, abuse, or discrimination story from your workplace that you would like to share with the Union, please contact

Logo that says "HADit"

SEIU 775 caregivers across Washington state came together and are proud to endorse the following candidates for elected office and initiatives.

You should get your ballot for the General Election by Oct. 22. Mail it back or put it in a drop box as soon as you can. The last day to vote is Nov. 5.

No ballot? Contact your county auditor for a replacement.

Washington state

  • Approve R-88 to approve I-1000. Fairness and opportunity for ALL Washingtonians!
  • Reject I-976. Protect funding for repairing local roads, ADA transit services, and traffic improvements!
  • Maintain Advisory Votes 20-30. In Washington, we have the most upside-down tax system in the country, where low- and middle-income families pay a much larger share of their salary than those at the top. Tim Eyman fought to put these advisory votes on the ballot to erode public trust in our government. By voting to maintain all of them we can make sure everyone, especially the wealthy, pay their fair share for public schools, affordable health care, and investments that help grow our economy.

City of Seattle 

  • City Council District 1 – Lisa Herbold
  • City Council District 2 – Tammy Morales
  • City Council District 5 – Debora Juarez
  • City Council District 6 – Dan Strauss
  • City Council District 7 – Andrew Lewis

City of SeaTac 

  • City Council Pos. 1 – Senayet Negusse
  • City Council Pos. 3 – Damiana Merryweather
  • City Council Pos. 5 – Takele Gobena 
  • City Council Pos. 7 – Mohamed Egal

City of Spokane 

  • Mayor – Ben Stuckart
  • City Council President – Breean Beggs
  • City Council District 2 – Lori Kinnear
  • City Council District 3 – Karen Stratton

City of Tacoma 

  • City Council District 1 – Nathaniel Lawver 
  • City Council District 3 – Keith Blocker 
  • City Council Position 7 – Conor McCarthy 
  • City Council Position 8 – Kristina Walker  

City of Kent 

  • City Council Pos. 1 – Marli Larimer 
  • City Council Pos. 3 – Hira Singh Bhullar
  • City Council Pos. 5 – Mizan Rahman 
  • City Council Pos. 7 – Awale Farah 

City of Auburn

  • City Council Pos. 1 – Chris Stearns

City of Bellevue

  • City Council Pos. 7  — James Bible
  • City Council Pos. 3  — Jeremy Barksdale

City of Burien

  • City Council Pos. 6 – Sofia Aragon

City of Edmonds

  • Mayor – Mike Nelson

City of Federal Way

  • City Council Pos. 5 – Jamila Taylor
  • City Council Pos. 3 – Sharry Edwards

City of Fife

  • City Council Pos. 1 – Bryan Yambe

City of Issaquah

  • City Council Pos. 2  — Michele Kemper
  • City Council Pos. 3  — Barbara de Michele

City of Kirkland

  • City Council Pos. 6  —  Amy Falcone

City of Olympia

  • City Council Position 2 – Jessica Bateman

City of Tukwila

  • City Council Pos. 2 – Nancy Manos
  • City Council Pos. 4 – Cynthia Delostrinos Johnson

King County

  • King County Council District 6 — Claudia Balducci
  • King County Council District 4 — Jeanne Kohl-Welles
  • King County Council District 2 — Larry Gossett
  • King County Council District 8 – Joe McDermott
  • Assessor – John Wilson

Snohomish County

  • Executive – Dave Somers

Legislative District 40

  • State Senator – Liz Lovelett

Guardianship Process to Be Streamlined in WA

Washington News Service
May 16, 2019

(Please click through here to listen to the radio version of this story.)

SEATTLE – Washington state lawmakers passed bills this session to make the guardianship application process easier for parents.

Sterling Harders, president of SEIU 775, says her union represents thousands of parents who take care of children with intellectual and developmental disabilities.

She says she’s heard from members that when their children turned 18 the path to guardianship was complex and expensive, often requiring a lawyer to understand the process. It also differs from county to county.

Harders says two pieces of legislation are addressing these issues, easing some of the burden for parents.

«Life is difficult enough for these folks having to take care of special needs kids,” she states. “They don’t need one more thing to worry about, and so we are really hopeful that these two bills will make life just a little easier for parent providers.»

The Uniform Guardianship Act, Senate Bill 5604, will standardize the guardianship process across the state’s 39 counties and create a monitoring system and model training program.

The bill currently is on Gov. Jay Inslee’s desk.

The other measure, House Bill 1329, creates alternatives to full legal guardianship. The bill was signed in April and goes into effect at the end of July.

«In today’s world, you’re either an incapacitated person or you’re a person that is not incapacitated with full legal rights, and creating an opportunity for there to be some different options within that continuum, I think, is very important,» [Beigert] states.

Shannon Beigert, the mother of two children with very different needs, is the legal guardian for her daughter, who has an intellectual disability. Her son has autism, which manifests in challenging and oppositional behavior to her and her husband and has led to third-party guardianship of him.

Beigert says one-size-fits-all laws around guardianship don’t work well for people as different as her two children.

«In today’s world, you’re either an incapacitated person or you’re a person that is not incapacitated with full legal rights, and creating an opportunity for there to be some different options within that continuum, I think, is very important,» she states.

Beigert says she appreciates Washington state lawmakers’ capacity to help the state’s most vulnerable.

Washington State Has Created the Nation’s First Social-Insurance Program for Long-Term Care

The Nation
May 13, 2019

When Americans age or need help with the basic tasks of living, they often have no one to turn to but their family members. A groundbreaking program in Washington will change that for residents of the state.

About three years ago, Ruth Egger’s father got up to go to the bathroom in the night. When he tried to get back into bed, he fell, breaking his hip. The painful recovery, during which he used a walker, sent him into a depression. “Since then, he’s gone downhill,” Egger said. He suffers from memory loss, had gallbladder surgery, and now needs help dressing, showering, and even taking medication.

Egger’s parents, both in their early 90s, are fortunate enough to be able to afford to live in an assisted-living facility in Issaquah, Washington. But their rent is climbing while their income stays fixed, forcing them to draw from their savings. That has made them unwilling to pay for the extra services available at their facility that could really make a difference for them, including help with chores and assistance for Egger’s father with his daily tasks. Without another adult present, Egger’s mother is afraid to leave her husband to go to the pool or exercise classes in case he falls again. “My mother suffers because she has to do everything,” Egger said. “I would feel so much happier if they had somebody at least once a week come in so [she] would feel like she could leave and go to the doctor or do what she needs to do and not worry about him…. It would give her some relief.” But, she adds, “They are just so frightened of not having enough money.”

Without professional assistance, Egger picks up the slack; she drives a half hour each way once a week from where she lives in Seattle to spend time with her father so her mother can leave their apartment for a bit. She’s taken over doing their bills and goes with them to doctor appointments. She feels the strain. “Emotionally, it’s extremely difficult,” she said. Egger now suffers from her own depression. “I worry about them a great deal.”

A policy about to become law in Washington State, the first of its kind, would offer relief to people in Egger’s parents’ position—and to her as well. The Long Term Care Trust Act, which passed the state legislature at the end of April and will be signed into law by Governor Jay Inslee on Monday, establishes the country’s first social-insurance program to pay for long-term care. All residents will pay 58 cents on every $100 of income into the state’s trust. After state residents have paid into the fund for ten years—three if they experience a catastrophic disabling event—they’ll be able to tap $100 a day up to a lifetime cap of $36,500 when they need help with daily activities such as eating, bathing, or dressing.

The money can be spent in a variety of ways. It could cover a home health aide to provide periodic support and care. But it could also be used to install an accessible shower in someone’s home or a ramp so they can get in and out of their front door more easily. It could cover transportation costs to and from medical appointments or to have food delivered to someone who is homebound.

The Long Term Care Trust Act will “help ensure that the caregivers who are providing this care are skilled, that they are trained, that they are certified, that they are paid fairly for the work that they’re doing,” said Harders.

If her parents had access to a fund like that, “they wouldn’t have to worry” about paying for extra help, Egger said. And Egger herself could relax just a bit. “I would know that [my mother] has someone else to help her instead of just me.”

A recently retired gerontologist, Egger has seen the need for such a policy among the clients she used to work with. One client’s husband had ALS and eventually needed a tracheostomy, which meant his trachea and airway needed to be regularly suctioned. The burden fell on his wife to be at his side constantly in case he needed care. “They didn’t have the resources to hire a nurse…so she could get a break for four hours a week,” Egger recalled. Another of her clients who used a wheelchair after a stroke couldn’t afford to add a ramp to get in and out of his house. The new fund could have enabled him to pay to build a ramp and grant him access to the outside world.

But the long-term-care fund won’t bring relief only to the elderly. A younger person who suffers an unexpected injury or illness could similarly hire someone to help him in his home. Those with disabilities, and the family members who support them, can help cover some of their more episodic needs, particularly for individuals whose needs aren’t severe enough to require living in a facility. “It expands options for people who are in need of care, aging adults, or people with disabilities,” said Sarita Gupta, co-director of Caring Across Generations, which advocated for the legislation.

The payroll premium will collect about $1 billion each year for the dedicated trust fund. “This structure will only help support the work that we’ve done here in Washington to help professionalize caregivers,” noted Sterling Harders, president of SEIU 775, which represents home health workers. While her members had already secured a $15 minimum wage, affordable health insurance, and a retirement benefit in Washington, across the country their peers mostly earn less than that and have little access to benefits. The Long Term Care Trust Act will “help ensure that the caregivers who are providing this care are skilled, that they are trained, that they are certified, that they are paid fairly for the work that they’re doing,” said Harders.

Building a constituency to demand long-term-care insurance requires educating Americans about how neglected this need currently is. Some Americans may erroneously believe that, when they reach old age, Medicare will cover the cost of any long-term care they may need. In fact, Medicare only covers medical needs, not living supports like home health aides or nursing homes. Elders with low enough incomes—depending on the state, anywhere from $6,825 to $47,139 a year—qualify for Medicaid, which does cover nursing-home costs. Those with greater resources must first spend down their savings and assets in order to qualify. They also must demonstrate they have a need for nursing-home care. And some state Medicaid programs don’t cover in-home care, while some of those that do cap the number of people who can get it.

“The system right now is quite narrow, and it requires individuals to basically impoverish themselves to be able to access any coverage,” said Elaine Ryan, vice president of state advocacy and strategy integration at the AARP. There is private long-term-care insurance, but few people have it. The cost of the premiums has become very expensive over the past decade, and people with pre-existing conditions, including dementia and Alzheimer’s, are unable to purchase a policy. So, Ryan explained, “tens of millions of Americans live their lives outside of all of those systems.”

Instead, most people rely on family members or, in some cases, friends to provide them with that care. Among adults with an aging parent who needs care, 31 percent provide it themselves, while 39 percent say another family member does. That places a tremendous burden on the caregivers. Even if someone can take paid time off from work to care for a family member—Washington State guarantees residents 12 weeks of paid family leave—some medical needs may be better handled by a professional. Not to mention it’s hard to do it alone. In one 2015 report, nearly 40 percent of caregivers said it was emotionally stressful, while about 20 percent said they experienced physical or financial strains.

“To date, elected officials have really failed to come up with a plan,” Gupta said. “In the absence of that we see families really struggling to meet their caregiving needs.”

Washington State’s policy, which Ryan calls a “breakthrough piece of legislation,” took years of dedicated, unglamorous work. “We worked with a really broad coalition,” Harders noted, which included organizations like hers representing home health workers, disability-rights advocates, and advocates for the elderly like the AARP. The mix of all those voices united behind a single request helped sway lawmakers. “It made a huge difference that they were standing together,” Gupta noted.

“What really was effective at helping unite us all is that everyone can look down the road and see that we are headed towards a crisis,” Harders explained. As the American population ages, more and more will need help. By allowing people to spend smaller amounts on the kinds of things they might need to safely and comfortably keep living at home, more people should avoid tapping Medicaid to pay for long-term care—which would not just save government funds, but give people what most of them say they want. “It will allow people to take care of those episodic periods where they need that support,” Ryan said. “Most people need something, but not all people need everything…. The idea that everyone’s going to end up in a nursing home can’t be the future that we imagine.”

The amount state residents are eligible for isn’t huge, given that it’s capped at $36,500. If a person needs a few hours of in-home care each week, that means a year or two of coverage. The sum won’t cover a full-time nursing home, which can cost $10,000 a month; a person who needs that will still need to turn to Medicaid for financial help.

“What really was effective at helping unite us all is that everyone can look down the road and see that we are headed towards a crisis,” Harders explained.

But the cap will rise automatically every year as inflation rises. The architects of the legislation were trying to find “a number adequate enough to meet people’s needs and at the same time not be catastrophic if everybody [made claims] at the same time,” Ryan explained. “To make it actuarially sound so people could be guaranteed a benefit.”

The policy’s universal structure and funding is also significant. All working people will pay into the fund through a payroll tax and then be able to claim a benefit when they need it. The same structure has “stood the test of time” with Social Security and Medicare, Ryan noted. Politically speaking, “it mattered a lot that it was set up as a social-insurance program,” Caring Across Generations’ Gupta said. And it ensures everyone will have some cushion when they need it—important given how few people are saving or planning for long-term care. “We have to shift [from] perceiving care as an individual burden to a shared responsibility we all have a stake in,” Gupta said. “This legislation in Washington is a big step toward that end.”

That differs from a failed ballot measure in Maine, which would have guaranteed universal home health care for all disabled and elderly people in the state by levying a new 3.8-percent tax on the wealthy. It’s also different than the Kupuna Care program in Hawaii, which was launched in 2017. That program similarly gives people a daily fund to cover these kinds of needs, but the money comes from the state’s general budget. That means every few years legislators have to decide how much funding to devote to it and that its capacity is limited.

Washington’s social-insurance model could spread if it’s successful after it’s enacted. Similar legislation is being considered in California, Illinois, and Michigan, Ryan said, and advocates in Maine are now looking at legislative options.

“It’s a good model that we’re going to explore in other states,” Gupta said, “and build towards a bigger picture of universal family care being a broader social-insurance program.”

Long-term care is also a facet of the Medicare for All bill put forward in Congress by Representative Pramila Jayapal in February—something the current system doesn’t cover, nor is included in Senator Bernie Sanders’s version. Jayapal’s bill would provide coverage for long-term nursing-home and care services.

Without new programs like Washington’s, families will keep shouldering huge financial and emotional burdens as they care for their loved ones, while many people will struggle to afford the kind of care they want and need. “We don’t think that in a wealthy nation like we live in that’s the way it has to be,” Gupta said. “Having more creative and bold solutions like this [is] going to be really critical.”

Washington Becomes First State to Approve Publicly Funded Long-Term Care

The Intercept
April 26, 2019

Washington State Lawmakers on Tuesday passed the nation’s first long-term care benefit program, which would provide residents with up to $36,500 to pay for costs like caregiving, wheelchair ramps, meal deliveries, and nursing home fees. Jay Inslee, Democratic governor and 2020 presidential candidate, has said he intends to sign the Long-Term Care Trust Act into law.

The measure is hailed as a monumental achievement not only for Washingtonians, but also for advocates working nationally to tackle the rising and formidable costs of care work and old age, something that’s become only more pressing as the baby boomer generation heads into retirement. The Long-Term Care Trust Act comes on the heels of a novel cash benefit program Hawaii launched in 2017 that distributes $70 a day for up to 365 days to family caregivers. A growing number of states have passed paid sick leave policies over the last five years, and more presidential candidates are elevating the issue of child care and how to afford it. Washington Rep. Pramila Jayapal’s new Medicare for All bill even includes coverage of long-term care, something not currently provided by the federal insurance program.

The ultimate goal, advocates say, is some kind of universal family care, a comprehensive social infrastructure to support all the varied costs of care work from birth to death. “That’s our North Star,” said Sarita Gupta, co-director of Caring Across Generations, a national campaign that launched in 2011. “We have really been trying to help people go from seeing care work as an individual burden to a shared responsibility that we’re all going to face.”

With the Long-Term Care Trust Act, taxpayers expect to save $3.9 billion in state Medicaid costs by 2052. The bill had bipartisan support early on, including three Republican co-sponsors, but it was approved largely along party lines in the Democratic-controlled legislature. Advocates for the bill said that Republicans voted against it for political reasons amid heated budget negotiations, and not because they disagreed with it in substance.

“We first started talking about long-term care about 10 years ago, because the funding system is really broken and because we’re focused on lifting caregivers out of poverty,” said Sterling Harders, president of SEIU 775.

Republican Reps. Drew MacEwen and Paul Harris, both original co-sponsors, told The Intercept that they support the intent of the bill but could not get behind its final provisions. “Although we had concerns about the original draft, we signed onto the bill in an effort to support the dialogue. With more people living longer, the cost of long-term care has to be addressed,” they wrote in a statement. “However, being first in the nation to create such a program, it’s important we get it right. In the end, we felt that the cost to taxpayers outweighed the long-term benefit.”

IN SOME WAYS, it makes sense that the groundbreaking long-term care legislation would originate in Washington, which has been leading the country in progressive policies. In 2013, the small town of SeaTac, which surrounds the Seattle-Tacoma International Airport, voted to increase its minimum wage to $15 an hour. This marked the first real policy win for the nascent Fight for $15 movement. Seattle would become the first major U.S. city to approve a $15 minimum wage a year later. In 2016, voters approved a state ballot measure to raise Washington’s minimum wage and establish a paid sick leave program. The same year, SEIU 775, which represents 45,000 long-term care workers in Washington and Montana, negotiated a home care worker retirement benefit, the first of its kind in the nation.

“We first started talking about long-term care about 10 years ago, because the funding system is really broken and because we’re focused on lifting caregivers out of poverty,” said Sterling Harders, president of SEIU 775, which helped push for the bill. Harders said the union’s work began with commissioning studies, followed by many years of slow coalition-building. “I think it’s easy to forget on days like this when I’m jumping up and down celebrating our victory that we’ve essentially been working on this for the past decade, and intensely for the past three years,” she said. “This is really the end of a long road.”

The bill works like this: Beginning in 2022, workers will pay a modest monthly payroll tax, 58 cents for every $100 they earn in income. The per capita average income in Washington is about $37,000, meaning that the average monthly contribution would be about $18. Those who pay into the program for three years, or for a total of 10 years including five consecutive years, will be able to access the benefit, which, at present, maxes out at $36,500. In 30 years, as it’s indexed for inflation, the benefit will be more than $88,000.

The $36,500 could pay for respite care, in-home caregiving, time in a nursing home or assisted living facility, home modifications like constructing a wheelchair ramp, and other elderly care expenses.

The legislation was first considered by lawmakers in 2018, but at the last minute, the state’s chapter of the American Association of Retired Persons, or AARP, withdrew its support, citing disputes over details like eligibility for qualifying as a caregiver. Members of civil rights, disability, senior, and health care groups who organized under the banner of Washingtonians for a Responsible Future reconvened this year to hash out compromises.

“I think what changed this year is that coalition members just met more and worked more closely to hear each other’s concerns,” said Janet Kim, a spokesperson for Caring Across Generations. “The resulting policy is more comprehensive and flexible than what was considered in 2018.”

Legislators worked on the bill with a few key facts in mind: Caregiving is an increasingly stressful burden for not only seniors, but also for their family members. Nationally, relatives spend an average of 20 percent of their own money on caregiving costs, according to the AARP, and often have to leave their jobs, sacrificing hundreds of thousands of dollars in income and benefits. A 2018 Associated Press-NORC Center for Public Affairs Research poll found that approximately two-thirds of adults support a long-term care program like Medicare, including 76 percent of Democrats and 56 percent of Republicans.

In addition, legislators grappled with the mounting strain on the state’s budget. Seventy percent of Americans end up needing long-term care after turning 65, and more than 90 percent of people do not have private long-term care insurance. While Medicare does not cover the cost of most long-term care services, many individuals don’t realize this until it’s too late. Medicaid, however, does cover long-term care services, but to access it, individuals have to deplete their assets until they have less than $2,000 in savings, a system that literally incentivizes going into poverty. As Washington’s population gets older, actuaries have projected that the state’s Medicaid-funded long-term care program would almost double to $4.01 billion annually by 2030.

RUTH EGGER, A 65-year-old retiree in Seattle and a part-time caregiver for her parents, has advocated for the bill since it was first introduced. Though she and her parents, who are in their 90s, are unlikely to directly benefit from the Long-Term Care Trust Act, she said her personal experience as a caregiver and her professional experience as a social worker motivated her to fight for the legislation. She personally testified in support of the bill last year and this year before the Washington State Legislature.

Egger’s father fell and broke his hip a few years ago, which brought on debilitating depression. “My father temporarily lost the ability to dress himself, and if he had had access to this benefit, he would have been able to pay for an aide to come help him,” she said. “It was exhausting watching him trying to figure out how to get his clothes on, and at that point, it would have been really beneficial if he had access to this extra money.”

“Caregivers are really members of a larger health care team; they spend hours and hours with the person they’re taking care of, they know when that person has changes in their health condition, when someone is losing weight, when someone gets dizzy, but it’s really a struggle for caregivers to be taken seriously as health care professionals,” Harders said. “That’s part of why this bill is so important for our union because we feel this is a step down the path of making sure caregivers are given the respect they deserve.”

Egger also stresses that so-called orphan elders — single seniors, or seniors who never had children or have children who live across the country or abroad — are also in particular need for long-term care assistance. “They get old and they have no support to help them, and they may need someone to come in twice a week and help them bathe or set up their medication,” she explained.

Washington’s benefit could also prove beneficial to the long-term care insurance industry. “Those companies didn’t expect people to live so long and to pay out so much, so fewer companies are writing those [long-term care] plans,” said Egger. Some experts think that the Long-Term Care Trust Act will make the economics of supplemental long-term care insurance plans more feasible, similar to the supplemental private Medicare insurance that 13 million Americans currently pay for. A recent article in Forbes reported that insurance industry officials expressed interest “in developing products” to supplement what Washington state is proposing.

Ultimately, Harders sees the Long-Term Care Trust Act as not just providing a needed economic benefit, but also as one more step toward elevating the field of caregiving, which is largely dominated by unpaid or low-wage women and people of color.

“Caregivers are really members of a larger health care team; they spend hours and hours with the person they’re taking care of, they know when that person has changes in their health condition, when someone is losing weight, when someone gets dizzy, but it’s really a struggle for caregivers to be taken seriously as health care professionals,” Harders said. “That’s part of why this bill is so important for our union because we feel this is a step down the path of making sure caregivers are given the respect they deserve.”