Why Washington State Invests in Home Care Workers — and Your State Should, Too

A groundbreaking partnership of labor, government, business, and nonprofits in Washington State is reinventing the home care industry to improve wages and opportunities for workers, meet employer demands for new skills, and provide high-quality services to consumers.

Sponsored by a labor-management partnership including SEIU, the State of Washington and private industry, the SEIU Healthcare NW Training Partnership has created the nation's first large-scale career pathway program for home care aides — one of the fastest-growing, lowest-paid occupations in America and a field vital to job creation and economic growth, especially in immigrant communities and communities of color. The program trains 40,000 aides a year in 200 classrooms across the state and online, offering instruction in 13 languages.

The partnership also runs the nation's first registered apprenticeship for more advanced training. It has won praise from the White House for committing to serve 3,000 apprentices annually in five years, up from 300 now.

By earning certification while strengthening their capacity to handle the increasingly complex needs of clients, graduates of the SEIU Healthcare NW Training Partnership can command higher pay, opportunities to advance, and greater respect for their work.

After completing the program, Home Care Aide Glenda Faatoafe received a $4-an-hour raise, to $15.03, and was invited to apply for a job at a local hospital. Although she loves working one-on-one with clients in their homes and intends to keep doing it — at age 52, she has done this work for 20 years — she is thrilled to realize she has career options.

"I didn't realize how employable I would become," she said. "We're overcoming what's always been one of the biggest challenges in our industry — having people realize this is not just a job but a career that can go somewhere."

A new direction in policy

Nationally, about 900,000 people — overwhelmingly women, many of them immigrants and women of color — care for ailing or frail elders, people with disabilities, and others who need assistance at home. The care workforce is projected to grow by nearly 50 percent in the coming decade, as the population ages and as more complex health problems are handled at home instead of in health care settings.

At $10 an hour, the median pay for a home care aide is considerably lower than the $16 average for all U.S. workers. About 45 percent of the nation's home care workers live in households with incomes below 200 percent of the federal poverty line.

Job training is generally minimal. Turnover is high, with estimates ranging from 25 percent to more than 200 percent a year. This is expensive for employers and disruptive for families, which means we all have a stake in developing a stable, valued workforce in this sector

Why has the arduous job of caring for our ill and disabled loved ones been marginalized and underpaid? A major reason is federal policy. Until this year, home care aides along with other direct care workers like personal attendants were exempt from federal wage and overtime guarantees. It was a throwback to New Deal legislation, which viewed the work as companionship, as opposed to real work.

The Department of Labor has at last taken a step forward in recognizing the value of direct care. As of January 1, many direct care workers are entitled to receive at least the federal minimum wage, $7.25 an hour, and overtime pay.

A market-based case for raising the floor

States have always been able to extend their labor standards to home care aides. Washington has led the way in doing so, thanks in large part to advocacy and organizing by SEIU 775. In 2011, voters overwhelmingly approved a union-sponsored ballot initiative to strengthen training requirements for aides and require certification. The union campaigned on a potent economic message: Home care aides add value to the health care chain by helping to keep people healthy and out of emergency rooms and hospital beds; they should receive the training to contribute even more and they should reap a fair share of the financial benefits that accrue to the system.

"It's a market-based view of raising the floor," said Charissa Raynor, executive director of the training partnership. "We're not talking about winning a 50-cent differential for aides. We're talking about widespread adoption of the view of home care workers as trusted, influential members of the health care team. They're not just compassionate individuals who help older people and people with disabilities stay at home, but professionals who are skilled and competent at helping people stay out of the emergency room, which saves the system a lot of money."

The partnership's basic program provides the 75 hours of training that the state requires all home care aides to complete. The apprenticeship program offers more advanced training, continuing education, and peer mentorship. Glenda Faatoafe has graduated from both programs and hopes to become a mentor for a new generation of home care professionals.

"My quest for us to get better training has become the focus of my life," she said.