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Connecticut State Capitol building in Hartford

The Connecticut House approved a bill on April 20 that would give collective bargaining rights to a newly formed union of personal care attendants (PCAs).

The union, which formed last month, is comprised of PCAs who provide Medicaid-funded services and supports to elders and people with disabilities. The PCAs are employed by individual consumers but are paid by the state.

The bargaining-rights legislation passed the House by a vote of 84 to 57 as an amendment to a broader labor bill. If passed by the State Senate, it is expected to be signed by Governor Dannel Malloy (D), a vocal supporter of collective bargaining rights for PCAs.

Currently, the PCA union only has “meet and confer” status, meaning its members can meet with a newly formed Workforce Council to discuss ways to improve working conditions in Connecticut’s home care programs.

Bargaining Would Give Common Voice to PCAs

Collective bargaining would be a huge step forward for PCAs, supporters of the House bill say.

Marjorie Davis, a PCA from Hartford, told the Connecticut Mirror that PCAs are “a very discounted group of workers,” and that the ability to collectively bargain would represent “cohesion [through] a common voice.”

Supporters also said that collective bargaining rights are essential to help PCAs fight for better wages and adequate benefits — which, in turn, will result in better care for elders and people with disabilities in Connecticut.

“Granting workers a voice will, in the long run, improve their lives and the lives of the people they serve,” said State Representative Zeke Zalaski (D), the co-sponsor of the bargaining-rights bill, shortly before the House voted on it.

– by Matthew Ozga

Connecticut Gov. Dannel Malloy (D)

Connecticut Governor Dannel Malloy (D) has proposed that home health aides and agency-based personal care attendants (PCAs) in the state should be trained to administer medication to consumers.

Currently, only nurses are permitted to administer medication to consumers receiving care in the home. Nurse visits cost an average of $54 each last fiscal year, for a total cost to the state of nearly $130 million.

The Malloy administration says that the plan would save the state more than $28 million a year, once fully implemented.

It would also help thousands of elders and people with disabilities to remain in their homes — rather than enter nursing homes or other long-term care facilities — by ensuring that the cost of home care is as low as possible, administration officials say.

Nurses and many home care agencies say they oppose the idea, arguing that medication is more safely administered by highly trained nurses.

Malloy’s plan comes as part of a set of proposed adjustments to the state budget, which will go to the legislature for approval.

Details of Plan

Malloy’s plan would allow home health aides to administer oral medicine, topical medications, and eye drops, so long as they are trained and certified to do so.

The plan would also permit agency-based PCAs to administer medication. Currently, only independent PCAs who have been trained by their clients can legally give out medicine.

“Allowing home health aides and agency-based PCAs to administer medication is a positive step for Connecticut’s home care industry,” said PHI National Director of Curriculum and Workforce Development Peggy Powell.

“However, it is extremely important that these direct-care workers are properly trained in handling and administering medication in order to keep their clients as safe as possible,” Powell added.

Additionally, the Malloy administration’s proposal would reduce by 10 percent the rates paid to nurses administering medication. It would also allow certain medicine-related assisted technologies — such as medication reminders and automatic pill dispensers — to be covered under Medicaid.

– by Matthew Ozga

A five-member working group met in Connecticut on Jan. 10 to determine whether personal care attendants (PCAs) employed through the state’s Medicaid waiver program should be given the opportunity to join a union.

Gov. Dannel Malloy (D) opened the door to PCA unionization through an executive order issued in September. Prior to the executive order, PCAs were not legally allowed to organize because they do not share the same employer.

In Connecticut, people with Medicaid hire PCAs through a registry maintained by the state Department of Social Services. Although all PCAs receive their wages through the state, they are individually employed by the Medicaid recipients who hire them.

The five-member Personal Care Attendant Working Group met twice in December to discuss the viability of unionization for PCAs.

It plans to meet two more times in January before submitting its report to the state. That report is due February 1.

If the group finds providing PCAs with the opportunity to join a union to be appropriate, Connecticut’s PCAs will hold a vote. The Service Employees International Union (SEIU) is seeking to represent the Connecticut PCAs for collective-bargaining purposes.

Julie Popper, an SEIU communications coordinator, told the Hartford Courant in December that her organization wants to “make home care a viable, stable, professional option, and it’s not going to be if qualified, skilled workers are attracted to working in nursing homes instead.”

The September executive order also established a 13-member Personal Care Attendant Workforce Council, responsible for studying issues related to PCA recruitment, retention, and training.

– by Matthew Ozga

Connecticut Gov. Dannel Malloy (D)

Personal care attendants (PCAs) who are employed through Connecticut’s Medicaid waiver program now have the option of joining a union, following an executive order issued by Gov. Dannel Malloy (D) in September.

Through the PCA Waiver program, elders and adults with disabilities can direct their own care, hiring and training PCAs as they see fit. The PCAs’ wages, however, are paid by the state.

The executive order says that worker representatives elected by PCAs can engage in non-binding discussions with state officials over issues such as wages, benefits, and collective bargaining rights. The governor can then address those and other workplace issues based on the discussions.

“No one should be surprised that I believe people who care for others need to earn decent wages and earn respectable benefits,” said Malloy, whose mother worked for years as a public health nurse.

A related executive order, signed by Malloy on the same day, grants unionization rights to day care workers employed by the state-run Care 4 Kids program.

Reliance on Public Assistance to Supplement Low Wages

PCAs in Connecticut earned an average of just $10.37 an hour in 2010, and the current pay ceiling for the state’s PCA Waiver program is a little more than $13 an hour.

Earlier this year — during public testimony offered in support for a bill that would have given them collective bargaining rights — several PCAs told the Connecticut legislature that they had to use food stamps and other public-assistance programs to make ends meet. (The bill was ultimately never brought to the floor for a vote.)

A PHI analysis found that two out of five direct-care workers in New England relied on public assistance programs, such as food stamps and Medicaid, during the period 2007 to 2009.

– by Matthew Ozga

Connecticut State Capitol building in Hartford

Connecticut will become the first state to require service-sector employers to provide paid sick leave to their workers, following an early-morning vote by the state House on June 4.

Governor Dannel Malloy (D) is expected to sign the bill into law before the end of the year.

The bill will require employers in the service sector with more than 50 employees to award one hour of earned sick leave per worker for every 40 hours worked. Only employees who earn an hourly wage are covered by the requirement.

Employees can receive a maximum of five days of earned sick leave per year under the terms of the bill.

Implications for Nursing Home and Home Care Workers

An estimated 200,000 to 400,000 workers in Connecticut will be covered by the legislation, including restaurant servers, cashiers, security guards, and nursing home assistants and home care aides.

Many nursing home and home care workers who get sick are faced with a difficult decision: Stay home and lose a day’s pay, or go to work and risk spreading their illness to the vulnerable people they provide care for.

Beginning in 2012, when the law takes effect, “hundreds of thousands of working families in Connecticut will no longer have to choose between their health and their economic security when illness strikes,” said Debra Ness, the president of the National Partnership for Women and Families, in a statement.

Other Paid Sick Leave Laws

In 2006, San Francisco became the first city to pass a law mandating paid sick leave for certain employees.

Two years later, Milwaukee and Washington, D.C., passed similar laws. California and Massachusetts are considering their own mandatory paid sick leave laws, as are Philadelphia, Denver, and Seattle.

On a national level, the Healthy Families Act, re-introduced to the Senate and House last month, would mandate paid sick days for tens of millions of workers across the country.

An estimated 40 million American workers — including more than 80 percent of low-income workers — do not get paid sick leave.

– by Matthew Ozga

The Senior Resources Agency on Aging has released a report titled “When No One Cares: Why We Need to Save Connecticut’s Direct Care Workforce” (pdf) that argues for increased investment in the state’s direct-care workforce in order to ensure access to quality care.

“Folks, we’re brewing the perfect storm,” said Lisa Reynolds, one of the report’s authors. “If you don’t have the staff, you can’t serve the clients. And if you can’t serve the clients, then you don’t have a business” (“Aging population, health worker shortage creating ‘perfect storm,’ advocates say,” Norwich Bulletin, May 22). Read the full story