A meeting in New York in February kicked off with stories. "Share a personal care story," coaxed Ai-jen Poo, co-director of Caring Across Generations (CAG) and director of the National Domestic Workers Alliance,
Funny how storytelling works. Within minutes I'm thinking of the live-in assistants who helped my father, Michael Flanders, perform on Broadway. A star, but also a polio survivor, Dad rolled onto the stage in his wheelchair every evening thanks in part to the help of an assistant in the morning. My grandmother Hope was said to be "independent" because she lived past 100 in her own apartment teaching writing to the end, but her students' classes and her sense of self got a whole lot of help from Geen Crooks, her live-in aide.
Ask anyone. We all have our "care stories." What we don't tend to have is a plan for what we'll do when someone we love needs care, or when we ourselves turn out not to be invincible. We don't have a plan, and neither does our government, and yet a crisis looms. The immigrant population grows as the baby boomers age. As of 2010, every eight seconds another American turned 65. The "age wave" is upon us—except it's not a wave; it's a tsunami. Just as more families are economically stretched, the number of Americans in long-term care is projected to mushroom, from 13 million in 2000 to 27 million in 2050. More of us want to stay in our homes, where care also happens to be cheaper. (The National Association for Home Care & Hospice reports that one day in a nursing home is four times as expensive as twelve hours of homecare.) But the current homecare workforce—at approximately 2 million workers—is nowhere near large enough to meet the need.
High-quality long-term caregivers are already in short supply, and it's no big mystery why. Homecare is a female-dominated world, open to young and first-time workers and immigrants. It's also unprotected, uncovered by basic wage and overtime laws that apply in nursing homes. At the time the Fair Labor Standards Act (FLSA) was passed in 1938, caregivers were thought of as relatives or friends—or as a way to get the unemployed off welfare. Which leads us to now: in 2010 the national median wage for homecare workers stood at $9.40 per hour. According to a 2011 survey by the Paraprofessional Healthcare Institute (PHI), the mean annual income for these workers in 2009 was $15,611. More than half of all personal care aides live in households that depend on one or more public benefits. Although homecare has become an $84 billion, largely for-profit industry, the typical care provider can still be hired and fired at will.
You might say: Organize! And that is what Caring Across Generations is doing. "Frankly," says Ai-jen Poo, who started working on this issue at the height of the economic crash, "we thought, There's a jobs crisis, there's a care crisis. We should create millions of quality jobs in homecare. Caregivers will benefit. Care receivers will benefit. Everyone is touched by it. Let's do it!"
There's just one problem. Although a few states have extended some wage and hours protections to homecare workers, these workers enjoy no federal right to form a union or bargain collectively. There's not even a real collective; the workforce is isolated in homes—a private worksite where, as Friedrich Engels put it, women are either openly or covertly "enslaved" in the name of "caring." Poo and her comrades are undaunted: indeed, they are taking aim at the very isolation that makes their tasks as organizers of this fragmented workforce so difficult—seeking above all else to build the connections that may make a breakthrough possible.
* * *
Last July, with Sarita Gupta, executive director of Jobs With Justice, Poo co-hosted a national town hall meeting at the Washington Hilton to launch the Caring Across Generations campaign. Spilling off the stage was a cavalcade of workers, seniors and people with disabilities—mostly women—representing virtually every constituency touched by the care crisis.
Exuding more can-do spirit than the capital was accustomed to, the campaign's collaborators spanned the community/labor spectrum, from AFSCME and the SEIU to 9 to 5, the Alliance of Retired Americans, the National Day Laborer Organizing Network and the YWCA. Labor Secretary Hilda Solis, the daughter of a domestic worker, addressed the 700-strong crowd: "America must be a nation where dignity and respect are afforded equally and rightfully to caregivers and to loved ones alike."
The White House's Valerie Jarrett made an appearance. Liz Shuler, secretary-treasurer of the AFL-CIO, spoke too, but the stars of the day were caregivers and -receivers, people like the Direct Care Alliance's Tracy Dudzinski, who has been working in this field for fifteen years in Wisconsin. "The public thinks we are companions or bedpan changers. We are the eyes, ears and backbone of the care system," declared Dudzinski to cheers.
Rabbi Felicia Sol, of Bend the Arc: A Jewish Partnership for Justice, described the funerals she attends where the deceased's doctors rarely appear, "but almost always there's an immigrant woman of color who has provided dignity and care."
Jessica Lehman, of Hand in Hand: The Domestic Employers Association, spoke about her ability to work full time despite her physical handicaps, because of her home health aide. "Without attendants, I would have no control over my life. I couldn't work. I wouldn't be paying taxes. I'd be living in an institution," said Lehman. Her group, mostly employers, goes to rallies, signs petitions and gives testimony in defense of caregivers because, as she says, "My quality of life depends on their quality of life."
After lunch, what seemed like the entire Caring Across Generations conference headed to Capitol Hill to lobby against cuts to Medicaid and Medicare—with the artwork of the children who'd spent the morning in conference-provided childcare.
Caring Across Generations, like the National Domestic Workers Alliance, aims to build relationships between those doing the work and those they're working for. (That's why it is rigorous about workers' leadership, multi-language translation and creating activities where participants can bring their kids.) Its agenda is "interdependent" too. At last count, more than 200 groups were signed on as campaign partners—and member groups can't sign up for just their "piece" of the plan. The federal policy solution CAG proposes would create 2 million new jobs in homecare, with new safety, hours and wage protections, as well as organizing rights for workers. Those jobs would come with training and certification to improve the quality of care and create a path to citizenship for those who participate in the training programs. Poo argues that because homecare is cheaper than care in institutions, the extra costs should be manageable. "Besides, it's not manageable or acceptable to be balancing our books on the backs of our caregivers or shortchanging people in need." She also argues for cuts to the defense budget, imposing financial transaction taxes and increasing corporate taxation to open up new revenue streams. CAG is fighting to expand Medicaid and Medicare, and to protect Social Security and healthcare spending too.
Over and over again, Poo returns to basics: the basics of the labor movement, the civil rights movement, the movement for women's rights, LGBT rights and abolition: "It's about respect and dignity, not for one group or another but for all of us as human," she says. Reconnect the issues, and you reconnect the movements in a way that has the potential to build real power, she believes.
Already there's a feather in the campaign's cap. Many members have been working for years to change those federal labor laws. In meetings with Solis, backed by a letter-writing campaign, CAG amped up the pressure. In December members of the group, plus Dudzinski, joined President Obama when he announced a rule change to extend overtime and minimum wage protections to tens of thousands more home health aides. Despite industry complaints that paying minimum wages will drive up the cost of care, CAG and its allies flooded the Labor Department website with positive comments. Since the public comment period closed on March 12, the group has been waiting with bated breath. The department has sixty days to review, after which the Office of Management and Budget has ninety days, and then the rules should go into effect—ideally in good time to be safe from a rollback in the advent of a new administration.
"It's a visionary agenda when we've been playing so much defense," says Deepak Bhargava of the Center for Community Change. "It's also a fascinating theory of the case: can you bring together constituencies that have never worked so closely before—and have all those groups hold up the whole of the vision of the organization?"
"They're taking very diverse populations who are intentionally pitted against each other and saying, We start from the principle that we rise together," says Ellen Bravo, of Family Values @ Work, a multistate coalition working for family leave insurance and sick days. Bravo, who, like Bhargava, has already done enough organizing to last a lifetime, has signed up for the CAG Leadership Team.
Since summer, local Care Councils have formed across the country, bringing people on all sides of the care equation together to fight budget cuts and attacks on union rights, and for increased funding for homecare. The councils have planned public Care Congresses in key cities, such as Los Angeles, San Francisco, Dayton, Seattle and San Antonio. New York's is coming up in June.
Asked why the SEIU, the service employees' union, which represents more than 500,000 home health aides nationally, is working with CAG, even helping to underwrite CAG's Care Congress in Seattle in February, Abigail Solomon, director of the SEIU Home Care Council, explained, "We've worked on efforts around immigration, healthcare and homecare before, but separately…this coalition is attempting to bridge a lot of those pieces and look at the whole in an integrated way. Also, the coalition has reach in states—like Texas—where we know homecare workers need a voice on the job. It's strengthening organizing locally and nationally at the same time."
Suffice it to say, traditional labor gets it. If it is to scratch back from the brink of irrelevance in a postindustrial economy, it must organize these workers. Homecare, after retail and nursing, is the third-fastest-growing workforce in the United States. But organizing has been slow and sometimes cutthroat, not breaking the unions' isolation but reinforcing it.
"It's a Wild West of rules out there for homecare workers," reports Jennifer Klein, who with Eileen Boris has written a book on organizing homecare. Caught in a jumble of welfare, healthcare and social work bureaucracies, the workers are variously defined as public workers (employed by the state and paid through Medicaid) or independent contractors (working for private agencies) or they may be hired directly by the client. There are no clear boundaries, no rules, no list of names, no standard schedule, no "labor hall." The mess lends itself to interunion conflict. After 74,000 mostly Latina homecare workers in Los Angeles voted to join the SEIU in 1999, the labor movement celebrated—and then fell into a bitter turf war between the SEIU and the state, city and municipal employees' union, AFSCME, over how California's remaining homecare workers should be contracted and represented.
* * *
The women leading Caring Across Generations have built exactly the relationships traditional labor unions will need if they are to gain the trust and the tools they'll need to work in this community.
Sarita Gupta comes to this work from many years of overseeing national field operations for Jobs With Justice, where she built connections among independent workers' groups and traditional labor unions to defend collective bargaining, immigrant workers and accessible healthcare.
Poo rose to organizing stardom when the Domestic Workers United mobilized so many nannies and their allies in Albany in 2010 that New York legislators were ashamed not to pass a Domestic Workers Bill of Rights, the first in the nation to recognize these workers' rights to overtime pay, three days' paid leave, and legal protections from harassment and discrimination. A similar bill is in the works in California, and with the help of the AFL-CIO, domestic workers persuaded the UN's International Labour Organization to sign an international version.
"From that experience I learned that there is no such thing as an unlikely ally," says Poo.
* * *
Like Gupta, Poo has spent her whole career in inter-sectional politics, which is to say, where the "nontraditional" workers are, and where the rest of the workforce is headed. In contrast with traditional unions and movement leaders who have prioritized short-term legislative, ballot-measure or electoral campaigns, intersectional organizers emphasize building power over the long term and strategies funders haven't always believed can produce demonstrable here-and-now "victories." Gupta served on the National Planning Committee of the US Social Forum, the equivalent of the AFL-CIO convention for independent community organizers. The National Domestic Workers Alliance emerged from the first US Social Forum, in 2007 in Atlanta. In Detroit in 2010, the Forum convened a landmark three-day meeting of 400 "excluded workers" (those denied FLSA protections); among them were day laborers, domestic workers, taxi workers, formerly incarcerated workers and workers in what they called the "right to work-for-less states."
Saket Soni, executive director of the New Orleans Workers' Center for Racial Justice, emerged from the Detroit meetings beaming. In an interview for GRITtv at the time, he called the discussions "historic," adding that "we realized our own capacity." It seemed as if workers who'd been on the margins of the old economy realized that they, in effect, had become the first responders in the new economy. Divided from their fellow workers with no "shop floor," erratic schedules and no obvious way to assert collective power, they had nonetheless pioneered creative coalitions to have impact. They were old-timers in the new postindustrial, post-union world in which white public sector workers found themselves in Wisconsin and Ohio six months later.
CAG is a test of the Social Forum theory that you put at the center the people most affected by a given situation and they will know best how to operate within it. Asked how she imagines achieving any, let alone all, of the group's grand goals, Poo says in her disarmingly strong, quiet voice that she believes in the irrepressible power of love. She saw love in action when East Side doormen got on buses to support the domestic workers in their buildings, and when workers' kids and employers' kids rallied side by side carrying signs that said, Respect My Mommy and Respect My Nanny.
For better or worse, caregivers are family members, and love is part of the conversation. That makes it very different from your average fight between worker and boss. Care stories also reveal our vulnerability, exploding in a useful way the man- as-an-island myth that runs so deep in American iconography. As Marxist feminists have argued till they're hoarse, behind every rugged individual hero tends to be an unpaid wife or enslaved person. Yet individual rights—like the right to vote—have always been easier to win in the United States than collective rights, like the right to organize; and globalization, mechanization and a three-decade corporate assault on unions have only exacerbated that problem. More Americans than ever are finding themselves on their own in the workplace—and barred from access to a union.
CAG Steering Committee member Heidi Hartmann, of the Institute for Women's Policy Research, notes, "Women are always the pioneers, going into new things that no one wants to do. Those are the jobs they can get. That's also where the economy is going." But there's no reason service jobs, like caring, can't become good jobs, believes Hartmann. The first assembly-line jobs were women's jobs because men didn't want them. Excess farm labor went to textile factories, and over time organizing made these good jobs. At the end of the day, making today's bad jobs "good" will take two things: a cultural shift and a whole lot of pressure.
In a visit to a Connecticut home in February, I meet Erika (not her real name), a 56-year-old woman suffering from arthritis, muscle loss and bone pain. Erika is a large woman in a small apartment, and there's not a cry she makes that isn't heard by Mel (not her real name, either), her live-in caregiver from Liberia. "I can't hear her cry and not come—that's not my nature," Mel tells me. Cooped up and frustrated, Erika is not the silent suffering kind, to be honest. It all adds up to a 24/7 job for Mel, although she is paid for only twenty-one hours per week. Erika, who is on public assistance, says she "loves" her "angel" Mel but can't afford a full-time employee. Ostensibly, Mel could take on other clients, but on $12.30 per hour for twenty-one hours, plus the food and home expenses she must pay for, she can't afford to travel to other clients. (There's no travel allowance for homecare workers.) Besides, she has no idea how she'd find more clients. Now she's facing days without pay altogether when Erika goes into the hospital for surgery. (Erika's benefits won't cover homecare if the client's not at home, even if the worker is still working.)
Mel and Erika went together to the State Capitol to lobby for collective bargaining rights. This past March, Connecticut homecare aides who are paid through government programs such as Medicaid voted 1,228 to 365 to join a division of District 1199, SEIU and form Connecticut Home Care United, the first-ever union for the state's in-home care providers. Governor Dannel Malloy paved the way for the vote when he signed an executive order last year, but the legislature has yet to approve a bill that would grant a right to collective bargaining.
When I ask her about her prospects, Mel, exhausted and exasperated, weeps. "I support the union," she says, "but I don't really see how it can help me. I'm trapped."
* * *
As Engels and the feminists knew, the "private" sphere is a tough place to regulate. The Marxist plan was to de-privatize and collectivize care. That's rarely mentioned these days, but Karen Higgins, co-president of National Nurses United, does worry about simply going along with the trend toward homecare. "Obviously, we want people to have choices, but it can't be driven by budgets," she says. "As nurses, we're still seeing the blowback from the deinstitutionalization of mental care."
The SEIU's Solomon says the shift toward homecare must come with extra regulation and oversight. In terms of what the union can offer Mel, in several states where they represent caregivers, unions have created a registry of potential clients for their members—but people like Mel (and Erika) need more. They need everything from free, high-quality healthcare to affordable healthy housing to reliable public transportation—and how about cheap, durable smartphones to connect workers to lawyers and one another?
As union rights are won, will workers like Mel be more than dues-paying members with PR-friendly faces for their union? Mel has a voice and a story to tell, but she needs the power to change the conditions she's living in.
It comes back to power. In an era of state-level budget cuts, rights rollbacks and belligerence in Washington, will the campaign be able not just to win symbolic and incremental victories, like the Domestic Workers Bill of Rights and Obama's proposed extension of FLSA protections, but to build enough power to force broader change? Clinton introduced the same FLSA rule change right before leaving office, but in 2000 homecare agencies and clients pressured the Bush administration to reverse it.
What next? "There are definitely life cycles in unions and movements," says Poo, "and this is very much in its infancy. But I believe the possibilities are unlimited because we really do represent the ninety-nine percent, perhaps even the 100 percent."
About the Author
Laura Flanders
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