Bring Back Unions for PCAs

Addressing concerns raised in last month’s article I found last month’s article “Is Unionization of PCAs the Answer?” very interesting […]

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Addressing concerns raised in last month’s article

I found last month’s article “Is Unionization of PCAs the Answer?” very interesting and thought provoking. However, unlike the author, I would celebrate PCAs being unionized. I encourage Service Employees International Union (SEIU) to begin organizing personal care assistants (PCAs) employed in the home health care service industry now. But I have not seen any evidence that this organizing is happening.

Since the author states, “I’m unsure how historical union activities and models, plus union visions and goals, will be able to ensure quality and stability for workers and consumers,” I thought I’d provide some responses. These observations are not from a union organizer, but from a social justice worker who also has personal experience with PCAs.

First, a little history of PCAs. When I first started receiving assistance from Ramsey County in the late ‘60s and early ‘70s, the county provided me with a monthly check to hire and pay someone to provide me with the services I needed. In the late‘70s privatization began and as a result pay dropped for PCAs to between $5 and $6 dollars an hour, as did the control I had over the hiring process. However, before (and during the transition to) total privati-zation, there were PCAs with full benefits, health insurance, paid vacations, good wages and overtime pay. Why? Because they were hired by the county and served on a public health nursing team and belonged to a union. Not long into the 80s the full privati-zation of PCAs took place, and those county jobs disappeared; wages dropped, the benefits disappeared and the unionized PCAs also disappeared. Most of the women that worked for me were very well trained through the county system and supervised regularly by a Public Heath Nurse. In my experience, unionization created a much more efficient and happier worker with fewer worries about their quality of life. Thus, better service for me.

Oh, and did I mention that this profession was 99% women in the union days? Today, the PCAs in a typical agency in the metro area are probably 85% women, and 50% African-American. These are populations that historically make up low-paying jobs and could greatly benefit from union bargaining power.

Now, on to my responses. How does a union model work in a consumer-directed residential environment? When a union carpenter gets hired by a company, the boss on the job directs the carpenter to do carpentry. Likewise, when a company hires a union PCA, the consumer OKs them to work in their home and asks the PCA to do what they are supposed to do.

Will union practices jeopardize consumer freedom, direction, choice, privacy, quality, and safety? Will a union model make it difficult to avoid inappropriate workers who may pose risk to consumers’ physical and emotional health and safety? These two questions incorrectly assume that a company that hires a PCA is no longer involved and has given up its responsibility to the consumer and that somehow federal HIPA and state vulnerability laws are no longer applicable. Oh, and speaking of inappropriate workers, with the current consumer-directed system, there is extreme chance of consumer abuse due not only to lack of supervision by the hiring agency but also to the consumer’s inability to physically be in charge.

Who will be responsible for documenting behaviors that negatively impact quality-of-life? Once again the hiring agency (whether under the current system or a unionized system) would be mandated to make reports. Hopefully advocacy organizations would not disappear.

Will poor-performing workers shirk their responsibilities citing union protection? Shirking happens under the current, consumer-directed model—the PCA and the consumer cite nothing. With union workers, there would be another layer of consumer protection and empowerment.

Who will be responsible for providing individual consumer advocacy and management training? As always, the consumer must be a self-advocate. However, I do not see any advocacy organization disappearing simply because PCAs are unionized. Management training would probably be jointly performed by the hiring agency and the union.

Who will be responsible for collectively bargaining with unions: consumers, personal care provider agencies (PCPOs), or the Department of Human Services (DHS), which controls resources available for compensation and benefits? PCPOs will be the bargaining agent with the union. If company X gets a government contract to build a bridge, and their workers go on strike, the bargaining is between the union and Company X, not between the union and the Department of Transportation. Similarly, the PCPO gets the authority from the state to provide PCA services (and receive reimbursement). So, if PCAs don’t like their working conditions, they would negotiate with their employer, the PCPO.

Will consumers and PCPOs become strategic negotiation pawns? Yes! As will the governor, legislature and DHS.

Will strikes, walkouts, and picketing be used? Yes!

Where will picket lines be drawn? At DHS, PCPO offices, or consumers homes? Probably at PCPO offices, and for public awareness at DHS offices and the governor’s office.

Who will be responsible for funding these additional administrative tasks? This issue is a contract concern.

Will gains in PCA wages be consumed by mandatory union dues? I’m not sure why this is a consumer concern, but …. Workers in many industries which pay $30.00 an hour have union dues of $90.00 a month. If the worker is receiving $15.00 an hour with benefits, union dues are at most $35.00 a month. Does that rate seem unfair?

I think an efficient answer is NOT unionization, but rather a unified public awareness and advocacy campaign by consumers, families, PCAs, and provider agencies targeting elected state and federal officials plus mainstream media. I strongly encourage the Minnesota Consortium for Citizens with Disabilities, Minnesota Association of Centers for Independent Living, Direct Support Professional Association of Minnesota, Minnesota HomeCare Association, and their national counterparts to begin examining these issues and working toward alternative solutions to rebuild and maintain community-based support systems protecting consumer-direction as well as providing competitive and livable wages and benefits. This is a great idea, but the Consortium for Citizens with Disabilities is not the vehicle, because the CCD has a make-up of individual representatives of organizations that represent mostly professional advocacy groups, private for-profit and not-for-profit companies with very little input from those that are directly affected—direct support professionals and consumers.

As for the writer’s last sentence …. However, if these stakeholders do not act, then I would support unionization for the advantages it may provide.


Rick Cardenas is executive director of Advocating Change Together.

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