Putting the DC in the DCA: Advocating for the FLSA Fix and Our Health Care Reform Principles

Students and instructors of the first Voices Institute National Training in town for the DCA legislative visits. Thirty constituents of the Direct Care Alliance - half of them direct care workers - visited Capitol Hill last week, asking Members of Congress to sign a Dear Colleague letter to U.S. Secretary of Labor Hilda Solis. They also asked legislators and staff of key committees to support the DCA's health care reform principles, which call for improvements to direct care jobs.

"We will not achieve health care reform until America's elders and people with disabilities are sure of receiving the direct care services they need when they need them, delivered by a qualified worker," the principles state. "And that will happen only when direct care workers receive family-sustaining wages, adequate training, health insurance, and other elements of a good job, making direct care a viable career option."

Our Dear Colleague Letter

Renee Pietrangelo (L) and Anne Fiala of ANCOR with DCA board member Jeni Gipson (R)
The Dear Colleague letter (PDF), which was drafted by the DCA and is now circulating in Congress, asks Secretary Solis to overturn the ruling that excludes home care aides from the Fair Labor Standards Act (FLSA). The ruling makes home care workers ineligible for federal minimum wage and overtime protection.

The letter's sponsors, co-chairs Linda Sánchez, Michael Michaud and Stephen Lynch of the Congressional Labor and Working Families caucus, are urging their fellow Members of Congress to sign on. Once they have collected all the signatures at the end of this month, they will send the signed letter to Secretary Solis.

Our Legislative Teams
The DCA representatives included board members, staff, and direct care worker specialists, as well as seven other direct care workers, most of whom are graduates of the Voices Institute. Teams of two to five people, each of which included at least one direct care worker, visited nearly 50 offices of U.S. Senators, Members of Congress, and staff of key committees. Most of the legislators and aides expressed interest in or agreement with at least some of the DCA's messages.

Board member Jim Locke and Executive Director Leonila Vega
"It is extremely rewarding to know that the Direct Care Alliance successfully carried out a historic event on behalf of the direct care workforce," says Leonila Vega, executive director of the DCA. "To see elected officials respond so positively to our message gives me great hope that the Direct Care Alliance, in collaboration with all our key constituents, will indeed achieve important reforms for the direct care workers we represent. Workers, employers, and people with disabilities all spoke up for better pay, wages, training and benefits. And this is only the beginning."

Our Health Care Reform Principles
The DCA's Health Care Reform Principles (PDF) ask legislators and policymakers to do three things for direct care workers:

Assure living wage and overtime protections. The median hourly wage for direct care workers in 2007 was $10.48, and 40 percent lived in households that received public benefits such as food stamps, Medicaid, or housing subsidies. "It defies all logic that someone who sits behind a computer all day with no human contact can make a million dollars a year, while a direct care worker who makes a impact on someone's life every day cannot make enough money to feed her children or pay her bills," says Jenn Craigue, a former direct care worker and the secretary of the DCA board.
DCWs Vicki and Ray Erickson and Julie Bell (second from L) with Tom Price (R-GA)
The DCA teams asked legislators to find ways to improve direct care wages, which are primarily funded by public programs such as Medicaid and Medicare. They also asked for support for the FLSA fix. "We told them these rights are granted to many other classes of workers, and we home care workers should be granted them too," says home care aide and DCA board member Tracy Dudzinski. "We asked that they contact Secretary Solis immediately to correct this injustice."

The FLSA exemption puts home care workers in the same category as babysitters, considered to be providing merely "companionship" and therefore to be exempt. "But we are so much more than babysitters," says Dudzinski. "Maybe years ago, when that category was first set up, it made sense, but in this day and age we are taking care of people at home who are eligible to be in nursing homes. The cares we have to provide are much more involved."

Enhance education and training. The only direct care workers required by federal law to have any training at all are those who work in Medicaid- or Medicare-certified nursing facilities and home health agencies. Even that training is a mere 75 hours - far less than is required of dog groomers or hairdressers. And there are no federal requirements at all for other direct care jobs, although states often require some minimal training.

DCWs Ray Erickson, Julie Moulton, and board Vice Chair John Booker "Our member organizations are strong supporters of training, as the needs of today's seniors continue to evolve," says DCA board member Kim Stoneking, the executive director of the National Private Duty Association. "Proper caregiver training results in a quality care experience for all involved, allowing more aging disabled Americans to remain in their homes for longer periods of time."

Expand access to quality, affordable health insurance. According to PHI's Health Care for Health Care Workers campaign, approximately a quarter of all nursing assistants in nursing homes and a third of all personal and home care aides lack health insurance.
"As someone who looks at the health and safety of this workforce, I pointed out that if they can't get health insurance for preventive care, they're going to keep work while they get sicker and sicker," says DCA board member Jane Lipscomb, the Director of the University of Maryland School of Nursing Center for Work and Health Research. "Eventually they're going to cost the system much more because they'll need much more complex and expensive health care - and they'll get to the point where they won't be able to care for their clients. That's damaging to the continuity of care that is so important for clients. In some cases it will even cause workers to leave the profession.

Board member Tracy Dudzinski captures the action on video
"We also asked: 'How, from an ethical standpoint, can we expect these individuals to provide care for others when they can't get care themselves?'"
What's more, DCA constituents pointed out, direct care workers have a very high rate of on-the-job injuries, making their lack of adequate health coverage all the more unjust. "Being a direct care worker is physically challenging," says Craigue. "Over the years I have done a lot of damage to my body because my client always came first, even over me. Now I am disabled, and I don't understand how the workers are expected to provide care but not be entitled to receive it."

A Chorus of Voices
This is high season for legislative visits, and many other groups were in town to advocate for their agendas - including ADAPT, whose members were telling legislators they need to include long-term care in health care reform, so people with disabilities can get the services they need in their homes and communities.

L to R: Direct care workers Peg Ankney, Brenda Nachtway and Jenn Craigue with Mark Johnson of ADAPT
"I got to speak with several of the members of the ADAPT community," says Peg Ankney of the Pennsylvania Direct Care Workers Association, who was part of the DCA group. "They're fighting for the same things we are, just from a different angle. We as direct care workers are just the ticket these people need to be able to stay out of the facilities. I loved their signs saying LABEL JARS NOT PEOPLE."

Home care worker Helen Hanson, who was also in town with the DCA group, met with legislators and staff from her home state of Maine, among others. "I never would have thought a couple of years ago that I'd be on Capitol Hill, talking with my congressional delegation about my job and the tough work issues I and my fellow workers face every day," she says. "The DCA has made that possible for me."