Robert Kuttner
Economics writer Robert Kuttner has some advice for President-Elect Barack Obama in his new book Obama’s Challenge: America’s Economic Crisis and the Power of a Transformative Presidency.
Kuttner makes a strong case for professionalizing the human services sector – jobs which are harder to outsource – to boost the U.S. economy.
Last week, he told NPR’s Fresh Air, “All jobs taking care of America’s children and taking care of America’s old people and taking care of America’s sick people, by definition, these are jobs that have to be close to home.”
He told Fresh Air interviewer Terry Gross that CNAs are doing 95 percent of the hands on care in nursing homes, making much less than $10 an hour with very little training, and a turn over rate above 200 percent.
“They could get better training. They could make more like $15 an hour,” he said. “They could join the middle class. They could treat our parents and grandparents with better professional skill and that would be both an act of macroeconomic stimulus—it would also be an act of mercy. These are the things we should be doing as a country. These are the things we need to do to get out of an economic crisis…”
A longtime columnist for Business Week, Kuttner is also co-founder of The American Prospect Magazine, in which he wrote last May about home-care workers’ lack of bargaining power and the resulting “vicious circle of burnout and high turnover, even though the vast majority of these workers are conscientious and eager to perform well.”
Home-care workers have begun collective bargaining, he pointed out, thanks to the work of the Service Employees International Union. He also outlined a plan for professionalizing human service jobs, calling for a starting annual salary of $12 an hour for nurse’s aides and home-care workers, opportunities for advancement with pay increases, and on the job training.
I agree with Mr. Kuttner I’ve worked in the LTC for 3 years and I see what goes on the Nursing Homes the workers are under tremendous stress as well as being underpaid for the work that they do, I decided to remain in LTC but work as a Private Duty
Caregiver for an agency I also think they need pay raises in this sector also. I believe if you give people the respect, and the tools to work with it would be a better outcome for both the workers and the patients.
I also want to support Mr. Kuttner’s thoughts on professionalizing the human service workforce. We would do well to take his choice of words seriously…that is, the entire human service community must advocate for these issues AS ONE! It makes no sense for the senior care industry to act like the mental health, child welfare and developmental disability communities do not exist. They do exist and in significant numbers. And if my experience in all four areas of service is at all valid, the experience of the direct care workforce is practically identical regardless of whether they are working with seniors, children or adults. Besides, from a political perspective, most of the public does not differentiate.
Larry Wenger, MSW
Workforce Performance Group
As someone who has worked in the nonprofit disability field for more than 20 years, I could not agree more about the need to increase the training, support and mosdt of all, the salaries of my colleagues who provide essential services through direct care. howeve, it needs to be pointed out that many direct care workers are employed by nonprofits (like mine) whose reimbursement/salary rates are set by the state – not the nonprofit employer (we continually advocate for higher salaries for our staff). Unions like SEIU cannot effectively secure higher salaries from the employer through negotiation/pressure – because we can only pay the rates established in the state contracts.
Robert Kuttner’s article makes an important point that is often overlooked by progressive policy leaders seeking to expand consumer choice. Kuttner rightly describes the problems associated with the “trend toward casualization of labor”, which can be a problem with consumer-directed care if programs are not carefully constructed.
No doubt, consumer-directed care is an important means of improving the quality of life for people who need home care and similar services; it is also an important way to expand the workforce. But an orthodox version of consumer-direction ends up leaving workers without the supports that a traditional employer relationship provides. No way to raise wages without cutting back services; no way health insurance or worker’s comp.
One option is giving independent providers an entity that can bargain with the state on their behalf over wages and other traditional components of a regular employment relationship. After all, it is really the state that controls the resources available to the program or to the individual beneficiary. There are probably other options but in most cases, it is clear that “casaulizing” home care makes the workers may worse off than if they worked for an agency. The last thing most of us want to do is create a long-term care system that advances the well-being of one group of low income individuals at the expense of another.