How Care Worker Unions Could Transform Our Economy

Organizing care workers and improving pay and working conditions is the foundation on which all other care movement goals are built.

How Care Worker Unions Could Transform Our Economy
United Domestic Workers showing their union pride at the Care Workers Can't Wait Summit in April 2023

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Before I jump into my regularly scheduled programming, I want to say a quick word about the situation in the Middle East from my perspective as an American Jewish mother. Every Jewish person I am in community with, especially those with friends and family in Israel, is feeling tremendous anguish about the attack 12 days ago and the many horrors that have unfolded since. We are struggling with how to talk to our kids about a situation that is far from simple. We are navigating increased fears about anti-Semitism in our own lives. I can't think about the brutal violence inflicted on Palestinian civilians and the humanitarian crisis underway in Gaza without crying.

Nothing about this war can be summed up well in an Instagram caption. Many people using their public platforms to "take a stand" know very little about the region and its geopolitical tinderbox. I am learning a lot, too. I encourage you to educate yourself with researched and fact-checked news sources. Know that more important than liking something on social media is checking on and showing up for the Jewish, Palestinian, Muslim, and Middle Eastern people in your life. So in the spirit of talking about things I actually know about, onto the newsletter about care unions.

-xo Katherine ❤️ ☮️ 🕊️

Thanks for the birthday wishes, y'all. I’m starting the new decade off with a fireworks display of professional activity mixed with some fun trips. And I’m super amped that my report for Better Life Lab will be out in less than a week! I hope you will join our virtual launch event for it, Let’s Transform How America Cares, on October 24th at 2pm EST. RSVP for the link.

In a newsletter earlier this month, I outlined ways unions in the first part of the 20th century didn’t want to represent care workers for a range of racist and sexist reasons. But times have seriously changed. Today, unions are all in on the importance of care professions such as child care, long-term care, or in-home health and personal care aides. Liz Shuler, the President of the AFL-CIO, explained in an interview that care worker unionization today looks different than the typical worker versus employer sitting across from each other at the bargaining table, and called care worker bargaining “the ultimate example of creativity and innovation.” 

So, here’s how care unions work: 

Commonly, the goal of care workers isn’t to negotiate with an individual employer. Care workers at one facility, for instance, typically wouldn’t get far trying to bargain with their individual employers. Unless that facility is part of a larger chain with deeper pockets, most childcare facilities are run by single operators or as small businesses operating on razor-thin margins. So childcare workers, long-term care workers, direct care workers, and even childcare center owners have learned to instead come together to bargain collectively with state or local governments as their “employer of record.” This is possible because state or local government agencies set rules and rates around Medicaid reimbursements or child care and Pre-K subsidies. This has a direct impact on care workers’ pay and benefits. This approach, called sectoral bargaining, has the power to make sweeping changes for large numbers of care workers and providers, rather than, as is standard practice in the labor movement, being forced to make incremental changes employer by employer or worksite by worksite. 

Here’s the potential of care worker unions: 

Ai-jen Poo, the President of The National Domestic Workers Alliance, explains that efforts to organize care workers today are similar to organizing manufacturing workers in the first part of the 20th century—people who were often immigrants working for poverty wages in dangerous conditions. “Through a rising labor movement and changing legal frameworks and our social contract, we were able [in the 20th century] to create the biggest on-ramp into the middle class in the history of the world,” says Poo. “Now we want to make care jobs this generation's version of that on-ramp.” It’s a compelling and logical vision, especially given that the demand for care workers will continue to increase since Baby Boomers are aging and care workers’ core skills and services simply can’t be replaced by automation. Employment rates for home health and personal care aides, for instance, are expected to increase by 22 percent between 2022 and 2032, which is anticipated to translate to 684,600 job opportunities, according to projections from The Bureau of Labor Statistics—a leap forward in demand that transcends the average for all other occupations. Improving wages, benefits, and conditions will be crucial to getting people into the sector to fill the huge growth.

“Through a rising labor movement and changing legal frameworks and our social contract, we were able in the 20th century to create the biggest on-ramp into the middle class in the history of the world. Now we want to make care jobs this generation's version of that on-ramp.” - Ai-jen Poo

Part of their rising political power comes from what unions have helped deliver to care workers since the start of the pandemic. These examples are all built upon previous, pre-pandemic efforts but are signs of recent forward progress.

  • In Washington State, the Service Employees International Union (SEIU) 775 and others organized its care workers to successfully advocate for over $1 billion to be included in the state’s 2023-2025 budget for long-term care. This will result in funding to give homecare workers a starting wage of $21 per hour with benefits.
  • In California, Childcare Providers United, organized center owners and workers. In 2021 they won their first contract with the state. The agreement raised the subsidy rate that the government pays to family child care providers who care for low-income children for the first time since 2016.
  • In 2023, unions representing over 560,000 In-Home Supportive Services (IHHS) workers, who are often also the family members of elderly and disabled people who need their care, successfully lobbied the California legislature to pass AB 1672 to begin fleshing out details for statewide collective bargaining.

Here’s what consumers of care should take away:

Organizing care workers and improving pay and working conditions is the foundation on which all other care movement goals are built. Care worker unionization is also already a tangibly successful tactic. But because organized labor’s influence is geographically dispersed, advocates in many parts of the country may not be attuned to how transformational care worker organizing can be. I know this was the case for me. I live in North Carolina with strong anti-union laws, and I wasn’t tuned into the powerful care worker union efforts in other parts of the country.  

For those facing immediate care crises like a year-long childcare waitlist or losing a string of home care aides because of low pay, know that your personal struggles are not the result of personal failures. Improving our care infrastructure is a long process that won’t likely address immediate needs. Here’s how you can support care workers in your community:

Those who are committed to the care movement but are not involved directly in worker rights should consider learning more about these efforts, shout them from the rooftops, and support them however possible. Care consumers committed to systemic change will ultimately benefit from staying focused on the big picture: supporting worker pay is a crucial step towards broad solutions for everyone. If cost increases for families are a downstream effect of improved worker pay, be vocal about it and push for the next step of progress, including major new public investments to help make care affordable for all families while at the same time ensuring all care jobs are good jobs. Staying united with workers will strengthen the overall care movement efforts to get much-needed government funding and subsidies to address the care crisis broadly. 

If this is interesting to you, stay tuned for a bunch more on this in my report, A Playbook to Transform How America Cares, out October 24th. Thanks as always to the Better Life Lab for their support in this research! 

For this week’s members-only thread I definitely need a break from serious topics, so I'll be asking you all, what are your fall book, TV and podcast recs? I LOVE hearing what media you all are consuming and getting recs from you!

If you want in on this discussion, become a member of The Double Shift. You get great conversation on our members-only threads, virtual hangouts, and audio newsletters.

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Let's Transform How America Cares! Join me virtually on Oct 24th from 2-3pm EST to celebrate the launch of Better Life Lab’s newest, groundbreaking report, A Playbook to Transform How America Cares: The Care Movement’s Winning Tactics, Lessons, and Case Studies from the Pandemic-era and Beyondwritten by yours truly! I would LOVE to have some Double Shifters in the audience! For more info and to RSVP for the link, go here.

See you in NYC? I will be moderating a discussion at MH WorkLife's upcoming Care At Work Summit NYC on October 26th, 2023. Join me for a thought-provoking discussion on The Cost Of Care: The Financial, Health, And Wellbeing Implications. I think there are still a few tix left, so hope to see you there, IRL!


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