Man in mask giving home care

Brace yourselves, home care agency owners: President Biden’s $2 trillion American Jobs Plan could set the stage for an expansion of union organization in the home care industry — one of the nation’s fastest-growing  employment sectors.

The president’s plan supports the care economy by funneling $400 billion into the industry by creating jobs and raising benefits. It also ensures that “workers have a free and fair choice to organize, join a union and bargain collectively with their employers.”

The Service Employees International Union (SEIU), which represents 740,000 home care workers nationwide, called the plan a game-changer. In a statement released shortly after the plan was unveiled, SEIU International President Mary Kay Henry said “encouraging the ability of home care workers in every state to join together in a union will turn poverty into living wage jobs with secure benefits.” 

While union membership has been declining in the U.S. for decades, the care economy offers organized labor tremendous potential. The sector employs roughly 3.4 million low-wage workers and is expected to grow 34% over the next decade. According to the Bureau of Labor Statistics, only about 5.7% of personal care workers and 7.4% of healthcare workers are currently represented by unions.

Organizing challenges

But University of Illinois labor professor Robert Bruno told McNight’s Home Care Daily there are significant challenges to organizing these workers because they mostly work by themselves off-site.

“You don’t have an employment setting where you’re also interacting with other colleagues, where you could be sharing a set of grievances that you might have. You also don’t know one another in a sense that builds a collective identity,” Bruno said.

In recent years, the courts and policy makers have not been especially kind to the organizing efforts of home care workers. In 2014, The Supreme Court ruled in favor of an Illinois home care worker who wasn’t a union member and refused to pay union fees, even though she benefited from a collective bargaining agreement with the state.

A turning tide?

Two years ago, President Donald Trump tried to stop union dues from being deducted from Medicaid payments to home care workers. A federal judge blocked the rule last fall.

There are other signs the tide could be turning in favor of unionizing home care workers. Recently, a California judge denied a motion by the Home Care Association of America and California Association for Health Service at Home to challenge a bill that allows the state to turn over the names of Medicaid-paid home care workers to unions.

LeadingAge California, a nonprofit representing the long-term care sector, is lobbying for better wages for home care workers but is neutral on the issue of union representation.

“Organizing is one way to do that, but we also think there are other avenues to getting fair pay, and as an organization we support fair pay for workers in general,” Alexandria Smith-Davis, LeadingAge California public policy director, told McKnight’s Home Care Daily.

Smith-Davis says at the moment her organization is still looking over the details of what President Biden is proposing and how that might impact home care workers, as well as providers.