Martindale Center- Policy Briefs on the Future of Work

Essential, Undervalued, and Underpaid: Home Health Care Workers in the United States during the COVID-19 Pandemic 43 workers in the coming decade is predicted to grow by 34%. It is also important to note that wages of home health care workers increased during that time period. Because monthly 2020 wage data specific to home health care workers are unavailable, an estimate is extrapolated using 2019 monthly earnings. Looking at September, the sector saw a 3.65% rise in wages. It is relevant that the overall consumer price index in the US rose 1.4% from 2019 to 2020; thus, the industry’s wages still had net growth above inflation. Given the 3.5% industry wage increase from 2019 to 2020, the 2020 median hourly wage of home health care workers is estimated at $12.55. While these wages did grow over the rate of inflation, the changes seem minimal in comparison to the outspoken support for workers deemed essential during the COVID-19 pandemic. Hazard pay is tied to the relationship between the risk involved in performing a job and the worker’s salary by providing additional wages to workers for jobs involving hazardous duty or physical danger. Unsafe jobs with hazardous characteristics or unpleasant working conditions often pay higher wages to maintain a balance between positive and negative job conditions (Hecker). Traditionally, hazard pay has compensated workers performing dangerous jobs, such as military service and construction, but today, COVID-19 poses a deadly threat to any frontline worker. The COVID-19 pandemic has highlighted frontline workers, such as doctors, nurses, home caregivers, transporters, cleaners, waste disposal personnel, etc., who put their lives at risk by facing the pandemic head-on to control the spread of the virus, and it is critical that their work be appropriately valued and compensated. The pandemic has forced home health care workers into increasingly risky working conditions as well. At the beginning of the pandemic, home health care workers faced difficulty in attaining proper personal protective equipment (PPE) (Kinderet al.), butevenwithadequatePPE, homehealth care workers risk being exposed to COVID-19 every time they enter a client’s home. Unsafe working conditions should be met with increased compensation in the formof hazard pay to account for the risk. Hazard pay for home health care workers is an immediate, temporary solution until the vaccine has been properly distributed and COVID-19 is no longer a serious threat. Beyond COVID-19, some consideration should be given to creating a permanent framework for possible future health care–related emergencies requiring additional immediate consideration and short-term compensation. One of the more effective ways of changing policy is through unionization. According to a study conducted by associate professor and labor economist Aaron Sojourner, “Unionized workers are more likely than their non-union peers to speak up about health and safety problems in the workplace” (Sojourner). The idea is that unions help home health care workers learn about their rights and file complaints, thereby producing tangible results. Research has shown that health facilities with unions have more inspections, better patient outcomes, more access to PPE, and even lower COVID-19 mortality rates compared to nonunion facilities (Pattani). While home health care workers have always been undervalued and underpaid, the challenges they face have been only amplified by COVID-19, which has encouraged more workers to join unions, particularly in traditionally antiunion states. For instance, in Colorado, Service Employees International UnionLocal 105 has seen an increase in interest fromnonunion frontline workers in rural areas where union representation is usually low (Pattani). Unfortunately, interest does not always lead to membership. “Health care employers, in particular, are known to launch aggressiveandwell-fundedanti-unioncampaigns,” explained Rebecca Givan, a labor studies expert (Pattani). Unions and advocacy groups play a key role in the struggle to achievelivingwagesforhomehealthcareworkersbecausethey have the political clout to push for statewide policy changes. Several unions and advocacy organizations have taken the lead in urging states to pass laws that protect home health care workers and guarantee higher wages. Service Employees International Union Local 775, representing long-term care workers in Washington and Montana, signed a contract in September 2020 with the Washington State Department of Social and Health Services extending Caregiver Hazard Pay and allocating funds for PPE. As a result of this contract, home health care workers in the union received an additional $2.56 per hour for the remainder of 2020, and will receive an additional $2.54 per hour for the first three months of 2021. Moreover, the contract states a further 3% increase in wages for the next two years (SEIU 775). SIEU Local 512, representing Virginia, also has achieved a major accomplishment for their members. On October 15, 2020, Virginia Governor Ralph Northam announced the allocation of $73 million in federal Coronavirus Aid, Recovery and Economic Security funds to be used as hazard pay for home health care workers affected by COVID-19 (De La Rosa). A one-time $1,500 payment was sent to 43,500