Nearly 1 million poor Americans who are disabled or too old to manage for themselves are able to keep out of costly institutions with help from home-care workers.
The government-financed home-care program is far from ideal. It is estimated that another million people who need the help and are poor enough to qualify for it are not getting it. But at least the needs of some are considered.
Ignored, however, are the serious problems facing most of the estimated 600,000 home-care workers themselves. The vast majority of these workers are women, most of whom are blacks or members of other minority groups, and they are usually about as poor as the people they help, just not as old or disabled.
To be sure, some home-care workers are fortunate because they are on the payrolls of private firms under government contract to provide services. And a few others are employees of government agencies.
These relatively few home-care workers are usually union members, such as those employed by one of the largest of the private firms, Remedy Home & Health Care Co., based in San Juan Capistrano. They generally earn around $5 an hour and get fringe benefits such as health insurance and paid vacations, and usually are offered 30 hours or more of work each week.
But the overwhelming majority of home-care workers don't earn even that small wage, and they get no fringe benefits. In relatively prosperous California, for example, the average home-care worker earns $3.72 an hour.
The unlucky majority get only 20 hours of work a week or less. But they do get the impressive title of "independent providers." That title seems to allow them to work for below poverty-line wages. When they get sick, most are eligible for medical help through welfare programs just like the disabled and elderly they assist.
At least three unions are mounting major organizing drives in such metropolitan areas as Los Angeles, San Diego, Boston, Chicago and New York. Most of the workers are receptive to unionization, according to officials of the three unions: Service Employees International Union, the American Federation of State, County and Municipal Employees and the United Domestic Workers of America.
However, forming unions for home-care workers is more difficult than recruiting members because organizers face unusual obstacles. Perhaps most incomprehensible is the contention of many government officials that the elderly and the disabled are really the employers of the "independent providers."
By that reasoning, neither the government nor private firms that offer government-paid home-care service can negotiate union contracts for independent providers because they aren't the employers.
More than 80% of home-care workers in California are independent providers, and a similar pattern exists in most other parts of the nation. There is validity to the argument that many home-care recipients want to feel more in charge of their lives and that the government helps them get that feeling by letting them hire and supervise the workers.
But this ignores the fact that government social workers determine whether people are eligible for home care and how much help they should get. Also, it is the government, not the recipients, that determines the amount of wages and benefits paid to the independent providers.
And it is the government, not the recipient, that writes and sends out paychecks to the providers.
Consequently, the government should not be able to avoid responsibility as the primary employer. Making recipients of in-home help the official employers has the earmarks of a clever plan by government officials who want to avoid unionization of home-care workers.
The system puts the union in the hopeless position of first having to recruit the workers as members and then, in California, for instance, having the impossible task of trying to negotiate contracts with each of the more than 200,000 "employers" who use the services of the workers.
Unions have filed test court cases in an attempt to upset the strange concept that poor elderly and disabled people are actually the primary employers.
A formal opinion issued by California's Deputy Atty. Gen. Rodney O. Lilyquist says they are not because, among other reasons, the state, not the recipient, pays the workers' wages and unemployment and disability insurance.
Since the counties run most day-to-day aspects of the in-home aid program, however, Lilyquist found that the workers are really county employees when it comes to union and collective bargaining issues.
The Service Employees' campaign in Los Angeles is typical of the union-organizing drives. Kirk Adams, the union's senior organizer, said nearly 10,000 of the 40,000 independent providers in this area have already been contacted by organizers in recent weeks, and the response has been excellent.