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A brief roundup of recent direct-care worker state news:

Court Rules That Missouri Home Care Workers Can Unionize

A state appeals court ruled May 1 that Missouri home care workers can unionize, ending their three-year battle to gain legal recognition as a union in the eyes of the state.

In 2009 and 2010, Missouri’s 13,000 home-care workers voted — by overwhelming margins — in favor of unionization. Both times, however, the votes were thrown out in court after anti-union activists challenged the results, alleging procedural flaws in the voting process.

Last week, however, a Missouri appeals court ruled that the state had to validate the 2010 election, thus clearing a path to the creation of a union for home-care workers.

The newly formed union, Missouri Home Care Union, is a partnership between SEIU and AFSCME.

Minnesota PCAs Temporarily Spared Wage Cuts

Proposed wage cuts to thousands of personal care aides (PCAs) in Minnesota were left out of the state’s latest Health and Human Services (HHS) budget, which Governor Mark Dayton (D) signed into law April 30.

The original HHS budget bill would have reduced state spending on PCAs by nearly $6 million. The cuts would have affected as many as 7,000 family caregivers who serve as PCAs to low-income relatives and receive payment through Medicaid.

The controversial cuts were deemed legal by a district judge in March after being challenged in court by eight Minnesota home care agencies. Despite the judge’s ruling, however, the legislature removed the cuts from the final budget sent to the governor.

Additionally, the budget bill postpones a $20.6 million rate cut to long-term care facilities. The postponement could give Minnesota enough time to negotiate a deal with the federal government, rendering the cut unnecessary.

Alabama Gov. Pushes for More Medicaid Funding

Alabama Governor Robert Bentley (R) vowed on May 2 that he would veto any General Fund budget bill that allots less than $602 million for Medicaid.

The governor’s announcement was a response to an early FY 13 budget proposal from state lawmakers that would have set aside just $400 million in Medicaid spending, 30 percent less than the FY 12 Medicaid allotment.

On May 8, a State Senate committee approved a budget bill that would devote $418 million of the General Fund to Medicaid, with the remaining $184 million to come from a line of credit from a state trust fund.

The credit line can only be created through a constitutional amendment, however. The state legislature is currently considering the amendment; if it passes, it will have to be approved by Alabama voters.

– by Matthew Ozga

Home health aides in New Jersey held a rally on April 25 to voice their opposition to wage cuts proposed by their employer.

The aides, who provide in-home care for elders and people with disabilities, work for Personal-Touch Home Health Services, a large, for-profit home care company with locations in 13 states.

Personal-Touch is currently in contract negotiations with its 350 home health aides, who are represented by 1199 SEIU. During negotiations, Personal-Touch proposed instituting a sliding scale of rate-based cuts that would reduce many workers’ wages by as much as 30 cents an hour.

Dozens of Personal-Touch aides attended the rally, which was held outside the company’s Roselle Park branch, one of four Personal-Touch locations in New Jersey.

Lawmakers Join Rally

At the rally, the workers were joined by several members of the New Jersey General Assembly, who spoke in support of the aides.

Assemblyman Gary Schaer (D) told the gathered workers that his mother has received care from a home health aide for the last four years.

“That home health aide has been the difference to her between life and death,” he said. “Although you might think you are few in numbers, there are a whole lot of us standing right beside you.”

Assemblyman Joseph Cryan said that Personal-Touch must demonstrate that it values its workers by paying them fairly.

“For the lives you touch, you deserve a whole lot more than a pay cut,” Cryan said. “You deserve a pay raise, because what you do matters to people each and every day. When corporations make millions, they can spare 30 cents a head every hour.”

Additionally, 38 New Jersey lawmakers — including U.S. Senators Frank Lautenberg (D) and Robert Menendez (D) — signed a letter to Personal-Touch urging the company not to cut its workers’ wages.

– by Matthew Ozga

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

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

In a reversal of a 20-year-old decision, the National Labor Relations Board (NLRB) issued a rule on August 26 regarding what constitutes a bargaining unit in nursing homes, rehabilitation centers, and other non-acute health care facilities.

The NLRB decision (pdf) in the Specialty Healthcare and Rehabilitation Center of Mobile and United Steelworkers, District 9 case concluded that the 53 certified nursing assistants (CNAs) employed by this facility had the right to form a bargaining unit that does not include other “nonprofessional” staff such as maintenance workers, cooks, dietary aides, and clerical workers.

New “Community of Interest” Standard Applied

The ruling makes it possible for employees that share a “community of interest,” such as employees with the same job title, to form collective bargaining units, regardless of the size of the unit.

The “community of interest” standard that will now be applied to employees of non-acute health care facilities is the standard used in other workplaces, according to a NLRB press release.

Under the traditional “community of interest standard,” factors such as common supervision, interchange of employees, geography, job classifications, departments, functions, and skills are considered.

Under the new rule, should an employer make the case that “the proposed unit inappropriately excludes certain employees, the employer will be required to prove that the excluded employees share an ‘overwhelming community of interest’ with employees in the proposed unit,” the NLRB release explains.

According to a New York Times article, the lone dissenter on the NLRB “asserted that the new approach would encourage the unionization of units as small as possible, which he said conflicted with the labor act’s aims.”

Majority Calls Precedent “Obsolete”

Referencing the 1991 case that the NLRB reversed, the 3-1 majority opined that “we have concluded that the Park Manor approach to determining if a proposed bargaining unit in a nursing home is an appropriate unit has become obsolete.”

– by Deane Beebe