A review of Caring for America: Home Health Workers in the Shadow of the Welfare State by Eileen Boris and Jennifer Klein (New York: Oxford University Press, 2012) 295 pp.
America’s growing workforce of home-based care-givers has provided the labor movement with its main source of recent membership growth, in a period of overall union decline. Some of these gains were rolled back last year in states like Wisconsin, Ohio, and Michigan. There, Republican governors have un-done the union organizing deals, made by their Democratic predecessors, that created new bargaining units composed of state-funded home health aides or child care providers. As a result, tens of thousands of newly organized workers have lost their precarious toehold at the bottom rung of public employment. In other states, where funding has been reduced and direct-care jobs curtailed or eliminated, low-income Americans have suffered both as workers and clients. The predominantly female, largely non-white labor force that cares for young, old, and disabled people continues to get organized where political conditions permit. In Connecticut, for example, 11,000 Medicaid- paid personal care attendants and state-funded day care workers won union recognition earlier this year from labor-friendly legislators and new Democratic Governor Dan Malloy.
However, as part of the nationwide conservative counter-attack against public sector unionism, multiple lawsuits were quickly filed against this expansion of collective bargaining in Connecticut, a delaying tactic used in other states. In Missouri, for example, the Service Employees International Union (SEIU) and the American Federation of State, County, and Municipal Employees (AFSCME) engineered a statewide referendum authorizing homecare unionism in 2008. But even after the two unions later won representation votes among 13,000 workers, right-wing opponents succeeded in delaying first contract negotiations for nearly four years-- until the state supreme court finally upheld union certification.
In California, Jerry Brown—a governor elected, like Malloy, with strong labor support—vetoed a bill passed by state legislators that would have allowed child care providers to unionize, more speedily, through a card check process. Home health aides in California—many of whom care for a member of their own family--are already heavily unionized. But, citing fiscal constraints, Brown balked at extending bargaining rights to their thousands of under-paid counterparts in home-based child-care.
Home Care, Before and After
Eileen Boris, chair of the Feminist Studies Department at UC-Santa Barbara, and Jennifer Klein, a history professor at Yale, have written a comprehensive guide to the contested terrain of home-based labor. The authors provide valuable historical background on the emergence of this still largely invisible and undervalued workforce. They also offer a balanced of assessment of the strengths and weaknesses of recent union growth in this sector, which has been accompanied by considerable inter-union competition and conflict in California, Illinois, and other states.
Caring for America includes detailed case studies of successful home care organizing, often aided by experienced organizers from ACORN (before that well-known community organization was weakened by internal dysfunction, demonized by the right, defunded by its friends, and effectively dismantled as a national entity).
Prior to winning union representation in about twenty states, home healthcare aides and childcare providers were classified as "independent contractors.” This left them with little or no organizational voice in their "non-traditional" workplaces.
Even with union contracts, which sometimes took many years of struggle to win, their jobs often pay too little and lack full benefit coverage. Two-thirds of the 2.5 million workers who provide direct care in clients’ homes are still awaiting action by the Obama Administration to extend minimum wage and overtime law protections unfairly denied to them under the federal Fair Labor Standards Act (FLSA).
Waiting For Obama
As Boris and Klein noted last month in Labor Notes, Obama’s foot-dragging on this U.S. Department of Labor rule-making initiative increases the possibility it may become a casualty of Democratic defeat next month. “If Mitt Romney wins the White House,” they write, “not only will this initiative be dead in the water but the Republicans in Congress have already introduced bills to permanently classify aides and attendants as ‘companions’ rather than as workers” entitled to full FLSA coverage. (For more details on this controversy, see http://labornotes.org/2012/08/home-care-workers-still-waiting-obama
As Boris and Klein document, the deepest economic crisis since the Great Depression, public sector budget crises everywhere, and right-wing ascendancy in some state capitals has exposed an “Achilles heel of the organizing model established by SEIU and copied by other unions." Top-down union organizing victories, achieved through political deals with labor-friendly politicians, are now vulnerable in a sector where the work was "already insecure and unstable, with constant turnover." Home-based worker unionism will not survive, they fear, unless “workers themselves have been able to build the union” through “member-to-member organizing,” rank-and-file leadership development, the creation of “social bonds,” and a continuing reliance on “mobilized political action.” The authors argue that:
“Unions must have social depth and a culture that enables them to live on when workers (or leaders or staff) move in and out and that sustain political activism at the state house where the budget and wages take shape. Those who do the work have to be at the table and part of the process. And when political deals fall through, there has to be power on the ground.”
While appreciative of the economic gains made for home care workers in New York, California, and Illinois, the authors warn about the tendency toward a "bureaucratic unionism that reinforces the old racialized gender distinctions of care work and stymies the advancement of rank-and-file women." Building real grassroots organization among home-based workers isolated from other union members and lacking traditional union structures (like a shop steward network) has never been easy. But, according to the authors, it is now more necessary than ever before to help thwart the attempted dismantling of remaining “welfare state” programs.
The dramatic and unusual display of grassroots activism in Wisconsin last year has shown the potential for a different kind of public sector unionism. During the winter of 2011, rank-and-file union members there broke with business as usual, by using direct action on the job in the form of teacher sick-outs and occupying the state capitol to protest budget cuts and anti-union legislation.
For thousands of direct-care providers, the fight to defend recently acquired bargaining rights, modest first contact gains, or adequate program funding was an important, if little noticed, part of labor's larger struggle against Governor Scott Walker and his GOP clones elsewhere in the mid-west.
Too often this campaign was couched, misleadingly, as a defense of “the middle class.” In reality, as Caring for America confirms, the working poor who care for other poor people -- and many of us in other classes -- haven't made it that far up the ladder yet. Their paltry pay, lack of benefit coverage, limited training and promotional opportunities all belie the importance of the work they do every day, in difficult non-institutional settings.
Organized labor would do well to put their continuing plight front and center because there are no union "fat cats” anywhere to be found in the fields of home care and childcare in 21st century America.
(Steve Early is labor journalist who worked for 27 years as an organizer for the Communications Workers of America. He is the author most recently of The Civil Wars in U.S. Labor which reports on home-based worker organizing in New Jersey, California, Illinois, and other states. A different version of this review originally appeared in Dollars & Sense. Early can be reached at <firstname.lastname@example.org.