San Francisco In-Home Supportive Services (IHSS) Public Authority held an information meeting to discuss IHSS program changes. As a result of IHSS workers’ successful fight
against Governor Brown’s proposal to cap IHSS worker hours to 40 hours per week
to avoid paying overtime, the State Budget included pay for IHSS overtime,
travel time and wait time starting January 1, 2015. In addition, Governor Brown’s proposed budget includes restoration of the 7% cut to IHSS hours effective July 1, 2015. However, at this January 21 meeting, it was
announced that California IHSS Program will not pay overtime, travel, or wait
time due to recent U.S. District Court decisions. . . and after it printed six million new timesheets!
On
September 17, 2013, the U.S. Department of Labor (DOL) announced a final rule
extending the Fair Labor Standards Act (FLSA)'s minimum wage and overtime
protections to most workers who provide home care assistance to elderly people and people with illnesses, injuries or disabilities. Set to take effect January 1, 2015, DOL’s proposed
changes would have extended FLSA protections to more than two million home care
workers by 1) eliminating the companionship exemption for home care workers employed by third-party agencies,
and 2) limiting the definition of “companionship” to providing fellowship and protection, with “care” services limited to no more
than 20% of hours worked per week.
With a Little Help From My Friends: On
a sunny Saturday morning, joined Beatles Choir led by Christie Chew of City Church San Francisco for the past five years to provide monthly musical companionship to residents at Laguna Honda Hospital and Rehabilitation
Center. We met in the lobby to introduce ourselves,
receive Beatles Choir Lyrics booklets and rehearse for our tour of three
“neighborhoods” (home to maximum 60 residents each who live in four 15-person
“households”).
We practice
choreography for Here Comes the Sun: raise hands for “sun, sun, sun,
here it comes“ and then lower bodies for “I see the ice is slowly
melting.”
However,
two U.S. District Court rulings on December 22, 2014 and January 14, 2015
vacated DOL’s
Home Care Rule, finding DOL was “trying to do through regulation what must be done
through legislation.” While home care
agencies challenged DOL’s rule to maintain the affordability of home care
services, DOL disagreed with the Court’s orders,
stating:
“We believe the Rule is legally sound and is the right policy—both for those
employees, whose demanding work merits these fundamental wage guarantees, and
for recipients of services, who deserve a stable and professional workforce
allowing them to remain in their homes and communities.” DOL is considering “legal options” including
appeal.
With this recent setback for IHSS workers, I decided
to re-visit a gerontology class paper I wrote two years ago about the campaign for Domestic
Worker Bill of Rights, which California Governor Brown signed into law (though it does not cover IHSS workers) just
nine days after DOL announced its Home Care Rule.
Ob-la-di, Ob-la-da got a bird sing-ing-a-long “life goes on,
brah!”
Domestic Worker Rights and Implications for Aging in Place
Most people wish to remain
in their own homes (“age in place”), and view nursing home placement as a last
resort option. In the absence of
informal care by family and friends, domestic workers provide formal in-home
care to seniors who need assistance with activities of daily living so they can
age in place.
I Wanna Hold Your Hand (with permission): “And when I touch you, I feel happy inside”
Government Policies Relating to Formal In-home Care
As supplements or
substitutes for informal caregivers, domestic workers make possible
middle-class women’s “liberation” from unpaid housework and caregiving, which
are often outsourced to racial minority and immigrant women in mostly
low-paying in-home care jobs. Due to its
historical roots in slavery and association with women’s unpaid labor, domestic
work is undervalued and underpaid. Further, domestic workers are marginalized by
deliberate government policies, often criticized as rooted in gender and race
discrimination, which exclude them from labor protections that apply to other
occupations and workplaces.
Yellow Submarine: “As
we live a life of ease, Every one of us has all we need,
Sky of blue, and sea
of green, in our yellow submarine”
Since colonial times in
the United States
The Occupational Safety
and Health Act specifically excludes domestic workers. Other federal laws exclude most domestic
workers on a de facto basis, because they
only apply to employers with multiple employees:
- Title VII of Civil Rights Act of 1964 and Americans
with Disabilities Act: at least 15 employees
- Age Discrimination in Employment Act: at least
20 employees
- Family and Medical Leave Act: at least 50
employees
Policymakers have been
reluctant to extend labor protections to domestic workers for performing care work, based on the presumption that
women would always be willing to provide care and companionship for loved ones. Caregivers may develop emotional attachment
to those they care for, which reduces their bargaining power,
as the lack of boundaries leads to working around the clock beyond paid hours.
Hey Jude: “Take a sad song and make
it better!”
“Care Crisis”:
Growing Demand for yet Shortage of Domestic Workers
Demand for home care is expected to rise faster than institution-based care. The unprecedented increase in our older
population, as the baby boom generation ages with chronic conditions and
prefers to age in place, has translated into an increased demand for domestic
workers. Long-term care policies focused primarily on
protecting the consumer, but paying little attention on protecting domestic
workers, have not helped the recruitment and retention of these workers.
All You Need is Love is affirming: “There's nothing you can do that can't be done”
Instead, the low pay, poor
working conditions and challenges of caring for clients, who are increasingly
more sick and disabled, have contributed to a “care crisis” due to high turnover and vacancy rates among domestic workers. Men, in particular, are not attracted to
domestic work because of the low wages paid and cultural stereotypes of women’s
work. About 25% of home aides make less than the
federal minimum wage, and about 40% rely on public assistance, such as Medicaid
and food stamps.
A survey of domestic workers in the San Francisco Bay Area
revealed the following
work conditions: the majority work to provide support for their families, yet
their wages are not sufficient to meet family living expenses; 90% of workers
did not receive overtime pay when they worked overtime; over 80% did not
receive paid rest and meal breaks; and the majority are exposed to health and
safety hazards (exposure to toxic cleaning chemicals, risk of injury).
As the demand for in-home
care rises in response to our growing older population that wishes to age in
place, policy change is needed to improve the recruitment and retention of
domestic workers. The wages and working
conditions of domestic workers are directly related to the quality and availability
of care. Problems with attracting and
retaining domestic workers may translate to disruptions in continuity of care,
and overworked and frustrated workers may be more likely to physically or
emotionally abuse home care clients or become victims of abuse from underserved
clients.
Art with Elders, a
program of Elder Givers Connecting the Generations:
Do you hear me, me, me, me painting
Proposed Solutions
Advocates propose
interventions to address power imbalances and discriminatory policies. One model is California
Yet, working conditions
for domestic workers cannot be improved by merely shifting their location from
the private market to the public sector, but we need to challenge policies that
sustain low wages and poor working conditions.
Assemblyman Tom Ammiano advocated for a California Domestic Worker Bill
of Rights to address discriminatory policies that have sustained low wages and
poor working conditions for domestic workers.
Visited Laguna
Honda’s farm animals after completing Free Memory Screening based on Brief Alzheimer Screen Test,
which included naming as many animals in 30 seconds time: pig, turkey, duck, goat, sheep, goat, rabbit,
etc.
In 2012, California
Governor Jerry Brown vetoed California Domestic Worker Bill of Rights (Assembly Bill 889), based on
paternalistic concerns that requiring overtime and rest/meal breaks to domestic
workers might result in 1) increased costs beyond the financial capacity of the
elderly and disabled to the point of “forcing people out of their homes and
into licensed institutions,” and 2) fewer jobs, less hours and flexibility for
domestic workers.
In 2013, Assemblyman Tom
Ammiano introduced a revised California Domestic Worker Bill of Rights
(Assembly Bill 241), with the following six provisions for improving work conditions to
promote the welfare of both domestic workers (except IHSS workers) and those under their care: 1) overtime pay, 2) meal and rest breaks, 3)
workers compensation, 4) uninterrupted sleep provisions (live-in), 5) use of
kitchen facilities, and 6) paid days of rest.
On September 26, 2013, Governor Brown signed this Bill into law, which became effective January 1, 2014.
Gerald Heffernon’s sculpture, Rabbinoid
on Cell Phone, at Laguna Honda
Ethical Principles
which has the most significant collection of magnolias outside of China
The ethical principles
driving Domestic Worker Bill of Rights are beneficence, nonmaleficence and
justice. Beneficence comes into play
because the bill attempts to do what is good for domestic workers and care
recipients. San Francisco Department of
Public Health conducted a Health Impact Assessment of AB 889, finding that both domestic workers and care recipients would benefit from
giving 24-hour or live-in caregivers the right to protected time to rest and
recover. Sufficient sleep would reduce
risk of premature death, chronic disease and depression for caregivers, and
ensure that caregivers are more alert and attentive to their client’s
needs.
Without this protection,
sleep-deprived workers may be more prone to mistakes and accidents, potentially
jeopardizing themselves and those under their care as well. In addition, overtime pay provides a
disincentive to employers scheduling workers for more than 8 hours a day or 40
hours a week, because long work hours are associated with increased stress, depression, high blood pressure and
cardiovascular disease. Thus, a related
principle is nonmaleficence. Justice
also comes into play because it seems only fair to extend labor law protections
already enjoyed by other California workers to cover over 200,000 domestic workers in California,
who are 93% female, majority are women of color, 40% are immigrants and 22% are
undocumented, earning just over the minimum wage and averaging less than $20,000
per year.
Quality of care is affected when domestic workers do not reflect most of their older clients who are white. One study noted that beneficial close relationships, akin to nurturing familial relationships, between domestic workers and older adults in their care are possible when they are the same gender and race, and relationships have continued for at least one year. As status and power differentials are reduced, clients are satisfied with work performed, and workers feel valued as persons.
Power dynamics in domestic
worker-older client relationships that resemble master-servant roles make
workers less able to negotiate work conditions in private homes, where they are
often isolated and invisible to the public, and thus vulnerable to exploitation in an unregulated
industry. When underpaid and overworked,
they suffer burnout and lose commitment to remain in their jobs to the
detriment of their older clients who need continuity of quality care.
To attract and retain a
more stable and diverse group of domestic workers to provide continuity of care
and gender/race preferences for our growing older population, we need policy
change to recognize domestic workers worthy of labor protections enjoyed by
other workers. To date, only three
states have adopted Domestic Worker Bill of Rights: New
York (2010), Hawaii (2013) and California
Domestic workers are the
front-line caregivers who ensure that our growing elderly population with
chronic conditions can continue to age in place at home. Thus, there is an
urgent need to address how we value both our elderly population and domestic
workers.
Ai-Jen Poo, lead organizer
in New York’s Domestic Worker Bill of Rights campaign, co-director of Caring Across Generations and author of The Age of Dignity: Preparing for the Elder Boom in a Changing America,
said, “It’s about respect and dignity, not for one group or another but for all
of us as humans.”
Who Will Care for America's Seniors?
ReplyDeleteALANA SEMUELS
APR 27, 2015
...Nearly 90 percent of seniors want to stay in their own homes as they age, according to AARP. Sometimes, it’s not a choice: Government programs such as Medicaid, in an effort to save money, are shifting spending away from institutional settings toward home and community-based care.
…But the resources to help seniors stay at home are shrinking. Many seniors are finding that their boomer children are staying in the workforce longer than they did, and are unable to care for them. Demand for direct-care workers is expected to grow 37 percent between 2012 and 2022. Demand for personal care aides alone—the entry-level workers in the field—will grow 49 percent. There are currently 3.5 million direct-care workers in the country, according to the Bureau of Labor Statistics.
... to find someone to take care of them when they stay at home. About 20 percent of the elderly live in non-metropolitan designated areas, according to the National Rural Health Association, which makes it harder for them to find helpers nearby.
…Medicaid reimbursement rates govern wages in the industry, but states have kept reimbursements flat as they struggle with budget issues...It's part of the Catch-22 of the home-care aide field—policymakers want to help people age at home because it's cheaper than a nursing home, but agencies argue that it won't be cheaper anymore if they raise wages and pay for overtime.
…On average, home care aides work 34 hours a week, and make an average of $17,000 a year. One in four live in households below the federal poverty line, and one in three doesn’t have health care because their employer doesn't offer it or because they can't afford it. Perhaps unsurprisingly, the field has a high rate of turnover—some estimates put it as high as 60 percent.
… home care aides aren’t covered included under the Fair Labor Standards Act, which means they’re not subject to overtime pay or minimum wage requirements. The Obama Administration extended the FLSA in 2013 to cover home-care workers, but a federal judge struck down that rule in January of this year. The Department of Labor is appealing the ruling, which applies to home care aides and personal care assistants, but not nursing assistants.
At the core of the debate is whether America’s 1.7 million home-care aides are “elder sitters,” and are thus, like babysitters, excluded from labor rules. Congress expanded FLSA coverage to domestic service workers in 1974, but exempted babysitters and companions for the aged and infirm. In his decision, the federal judge wrote that Congress would have to change the law in order to include home care aides under the labor standards—it currently likens aides to babysitters, he wrote.
…If home-care workers were treated as professionals, rather than “elder sitters,” some advocates argue, receiving better pay and benefits and stable hours, it would be easier to attract workers to the field and to retain them. In addition, a nationwide training system could also help prepare workers for the challenges of helping the sick and infirm, which would also reduce turnover.
… unlikely that they’re going to stay on the job unless they can afford to do so. For this to change, states need to put more money into Medicaid, ,,,But the opposite is currently happening. States including Connecticut, California and Illinois are planning to cut back on eligibility of Medicaid recipients and are requiring low-income seniors to pay more for their care as a way to close budget gaps.
…Some workers have unionized in an effort to force change in the field. This often begins with states recognizing independent home-care workers funded by Medicaid as public employees, which allows them to organize, as happened in Oregon, California and Washington.
http://www.theatlantic.com/business/archive/2015/04/who-will-care-for-americas-seniors/391415/
U.S. Court Reinstates Home Care Pay Rules
ReplyDeleteBy NOAM SCHEIBER
AUG. 21, 2015
WASHINGTON — A federal appeals court on Friday reinstated regulations drawn up by the Obama administration to extend minimum wage and overtime protections to almost two million workers who provide home care for the elderly and disabled.
The regulations, struck down by a lower court about nine months ago, were intended to remove an exemption in federal minimum wage and overtime laws for home care workers employed by third-party staffing agencies. A three-judge appellate panel in Washington ruled Friday that the Labor Department has the authority to eliminate the exemption.
Labor law specialists, noting that Democratic administrations have been trying to eliminate the exemption since the early 1990s, called the ruling momentous. “It’s not that surprising, since it’s absolutely correct as a legal matter,” said Kate Andrias, a professor at the University of Michigan Law School. “But it has an extremely important effect on the home care industry, home care workers, which is a lot of people.”
Professor Andrias added that the ruling represented a major victory in the administration’s effort to revise labor regulations to reflect the economy today.
Union leaders and advocates were also quick to embrace the decision. “This is an enormous step forward for home workers and for our country,” said Mary Kay Henry, the president of the Service Employees International Union, which has pushed for the change for decades.
The Labor Department created the exemption in 1975, while carrying out a law that Congress passed the year before. But the Obama administration argued that much had changed in the industry since the mid-1970s, when most patients received professional care in institutional settings, or received less-demanding care at home, known as “companionship” services, from workers they hired directly. Today, professional home care is widespread and is typically provided by employees of staffing agencies.
Advocates and labor lawyers have long argued that Congress meant for all full-time care providers to be covered by the minimum wage and overtime provisions of federal labor law when it revised the law in 1974. The Labor Department made this argument when it issued the regulation in 2013, and on Friday the appellate panel, in the District of Columbia Circuit, agreed.
“What the court recognized is that Congress intended this exemption to apply to people who do casual work, not people doing home care work as a full-time vocation or job,” said Peter Romer-Friedman, deputy director of litigation at the Washington Lawyers’ Committee for Civil Rights and Urban Affairs.
A lawyer for the National Association for Home Care and Hospice, one of the industry groups that challenged the new regulations, indicated that the plaintiff did not consider the fight over. “We’re reviewing the decision and considering all our options, including Supreme Court review,” said the lawyer, William A. Dombi of the Center for Health Care Law, which is backed by the home care and hospice industry.
But the circuit court decision may be difficult to reverse. In its opinion, the court relied on a Supreme Court case from 2007 explicitly ruling that the 1974 law gives the Labor Department discretion over how to define the exemption, as long as the department’s interpretation is reasonable.
The Supreme Court held that “Congress had granted authority to the department to resolve the issue,” the circuit court wrote in its opinion Friday. It also said that the Labor Department interpretation in question was reasonable…
http://www.nytimes.com/2015/08/22/business/us-court-reinstates-home-care-pay-rules.html
No training for in-home caregivers
ReplyDeleteBy BEN TREFNY & NEWS PRODUCER & ANNA GORMAN & KAISER
AUG 26, 2015
Born just a year apart, Oliver Massengale and his brother Charles grew up together. Now, in a two-story home in Compton, California, they are growing old together. But Charles Massengale, 71, can do little on his own.
The former tree trimmer has severe brain damage from a 30-foot fall, as well as dementia, diabetes and high blood pressure. Six years ago, Oliver took over as his brother’s full-time caregiver, paid about $10 an hour by the state.
It was not a job he was trained to do.
“I didn’t have a clue,” said Oliver, a retired grounds manager at a college. “I was just so afraid of what I was doing.”
He constantly worried – about giving Charles the wrong medication, about him getting bedsores, about his blood pressure. And he had no idea how easily his brother could fall over. One day, he was cooking and Charles was on a stool at the kitchen counter.
“I heard BAM,” he said. “I turned around and he was on the kitchen floor.”
No overall training is required for the more than 400,000 caregivers in California’s $7.3 billion In-Home Supportive Services Program (IHSS) for low-income elderly and disabled residents. Without instruction even in CPR or first aid, these caregivers can quickly become overwhelmed and their sick or disabled clients can get hurt, according to interviews with caregivers, advocates and elder abuse experts.
The lack of training is “of enormous concern,” said Gary Passmore, a vice president of the Congress of California Seniors, an advocacy organization. “We are dealing with a lot of frail, elderly people.”
The need for in-home caregivers is rising as the elderly and disabled population grows. The demand for personal aides – most of whom work in the home — is expected to increase by 37% over the next decade, requiring about 1.3 million new positions, according to research published last year by the New-York based Paraprofessional Healthcare Institute, an advocacy group that also provides training.
http://kalw.org/post/no-training-home-caregivers
U.S. Court of Appeals Unanimously Upheld DOL Rule, Opinion Effective as of Oct. 13, 2015
ReplyDeleteThe Department of Labor issued the Home Care Final Rule to extend minimum wage and overtime protections to almost 2 million home care workers. The rule was challenged in federal court, but on August 21, 2015, a federal Court of Appeals issued a unanimous opinion affirming the validity of the Final Rule. This opinion upholding the Home Care Final Rule became effective on October 13, 2015, when the Court of Appeals issued its mandate. As previously announced, the Department will not begin enforcement of the Final Rule until November 12, 2015. From November 12 through December 31, 2015, the Department will be in the second phase of its previously announced time-limited non-enforcement policy.
Please see below for more details about the litigation and the Department’s non-enforcement policies.
U.S. Court of Appeals Unanimously Upheld DOL Rule, Opinion Effective as of Oct. 13, 2015
The Department of Labor issued the Home Care Final Rule to extend minimum wage and overtime protections to almost 2 million home care workers. We believe the Rule is the right policy—both for those employees, whose demanding work merits these fundamental wage guarantees, and for recipients of services, who deserve a stable and professional workforce allowing them to remain in their homes and communities. The Home Care Final Rule, issued on October 1, 2013, had an effective date of January 1, 2015.
In June 2014, associations of home care companies filed a lawsuit in federal court challenging the Final Rule. In December 2014 and January 2015, U.S. District Court Judge Richard Leon issued opinions and orders vacating the Final Rule’s revised third party regulation and revised definition of companionship services, respectively.
The Department of Labor filed an appeal of the district court’s orders to the U.S. Court of Appeals for the District of Columbia Circuit. The case is Home Care Association of America v. Weil, No. 15-5018 (D.C. Cir.).On August 21, 2015, the Court of Appeals issued a unanimous opinion affirming the validity of the Final Rule and reversing the district court’s orders.
Because of the district court orders, the Department could not begin enforcement of the Final Rule on January 1, 2015, and because the Court of Appeals opinion did not take effect immediately, it could not begin enforcement on August 21, 2015, either. The home care associations asked the Court of Appeals and the Chief Justice of the U.S. Supreme Court to delay the date the Court of Appeals opinion would become effective, but both requests were denied. The Court of Appeals opinion reversing the district court’s orders became effective on October 13, 2015, when the Court of Appeals issued its mandate. The Department will not begin enforcement of the Final Rule before 30 days after that date, which is November 12, 2015. From November 12 through December 31, 2015, the Department will be in the second phase of the time-limited non-enforcement policy it announced in October 2014, during which it will exercise prosecutorial discretion in determining whether to bring enforcement actions, with particular consideration given to the extent to which States and other entities have made good faith efforts to bring their home care programs into compliance with the FLSA since the promulgation of the Final Rule.
The Department has led an unprecedented implementation program to help employers of home care workers prepare for FLSA compliance, including offering an extensive and individualized technical assistance program, providing a 15-month period before the effective date, and adopting a time-limited non-enforcement policy. We have repeatedly encouraged States and other employers to take the necessary steps toward implementation. We continue to stand ready to provide technical assistance to States and other entities as they implement the Final Rule.
http://www.dol.gov/whd/homecare/litigation.htm
Workers At Bay Area Assisted-Living Facilities Awarded More Than $1 Million In Back Wages
ReplyDeleteInvestigators found employees were made to work around the clock without pay.
By California Patch (Patch Staff) - July 6, 2016 12:13 pm ET
BAY AREA, CA -- Dozens of caregivers at several Bay Area assisted living facilities have been awarded more than $1 million in back wages and damages in suits brought by the U.S. Department of Labor in recent months, labor department officials announced Tuesday.
Wage and overtime violations are common for residential caregivers. Investigations concluded by the Department of Labor's San Francisco office in 2015 have led to the payment of more than $3 million to 475 employees, labor department officials said. Between 2011 and 2014, $6.8 million in wages was awarded to more than 1,300 Bay Area caregivers.
--By Bay City News Service/
http://patch.com/california/unioncity/workers-bay-area-assisted-living-facilities-awarded-more-1-million-back-wages
US Labor Department conducts compliance and enforcement initiative in Bay Area nursing homes, residential care facilities
SAN JOSE, Calif. -- A multiyear compliance assistance and enforcement initiative conducted by the U.S. Department of Labor’s Wage and Hour Division has found that Bay Area residential care facilities and nursing homes have underpaid more than 1,300 workers by millions of dollars.
The agency’s investigations concluded that between 2011-2014 minimum wage and overtime violations resulted in more than $6.8 million dollars in back wages and damages for the workers, money desperately needed to cover basic life expenses, such as rent, food, transportation and child care. Additionally, the initiative has served to level the playing field among the businesses by ensuring compliance with the federal Fair Labor Standards Act.
At the same time, the Wage and Hour Division has worked with business owners, worker advocacy groups and employees to educate the industry on basic federal labor law requirements. However, investigators continued to see widespread abuses where many employers took advantage of workers vulnerable to exploitation because they often don’t know their rights. As a result, they were subject to wage violations and retaliation.
“The hardworking men and women who take care of our relatives and friends need to be compensated fully for their time,” said Ruben Rosalez, regional administrator for the department’s Wage and Hour Division in San Francisco. “We know that rewarding hard work with fair and full pay leads to happier and more productive workers. The trend of violations is therefore not only harming workers, but patients alike who might suffer with less quality care. We will continue to investigate and penalize employers who cheat their employees and gain an unfair competitive advantage over their law-abiding competitors at the expense of their workers.”
Working conditions in some residential care facilities can be difficult for many caregivers. Many of the facilities require employees to stay overnight on the premises to ensure round-the-clock care for patients. Despite the fact that they are on call assisting residents overnight, investigators found that some workers were not paid for such time, and some were denied adequate sleeping facilities and were forced to sleep on the floor. Such conditions can erode the quality of care patients receive.
Additionally, investigators found that employees who are paid hourly often worked 10 to 14 hours per day, six days per week, but were only paid for eight hours per day. Some workers were paid a flat weekly salary regardless of the hours they worked and were therefore denied time and one-half pay for hours worked beyond 40 per workweek. Employees were also threatened and harassed if they questioned their working conditions. Some employees were intimidated or retaliated against by their employers and were instructed not to cooperate with Wage and Hour investigators.
https://www.dol.gov/whd/media/press/whdpressVB3.asp?pressdoc=Western/20150407_1.xml
The Impact of Women’s Work on Gendered Health Inequities
ReplyDeleteTam Lynne Kelley
Page 333-346 | Published online: 26 Aug 2016
Lack of recognition of the value of caring work
Cultural norms in the United States devalue caring work; it is not adequately recognized, financially rewarded, tracked, or counted. Work in the caring economy is not considered in pension accounts or unemployment insurance systems….Structural social determinants of health, such as cultural norms and the unequal distribution of power, are part of the causal pathway that leads to the “invisible work” of raising children and caring for families being excluded from economic data (Commission on Social Determinants of Health, 2008Commission on Social Determinants of Health. (2008).Closing the gap in a generation: Health equity though action on the social determinants of health. Final report to the Commission on Social Determinants of Health.Geneva, Switzerland: World Health Organization. Retrieved from http://www.who.int/social_determinants/final_report/csdh_finalreport_2008.pdf, p. 150).
The lack of recognition of the value of caring work is also reflected in the health care system. Although women perform the majority of all health care services, this contribution is not adequately supported by or recognized within the health care system …Providing this care without adequate training, support, or supplies, women are at an increased risk for stress, illness, and injuries …. This increased risk is part of the causal pathway that leads to poor health for women. In conclusion, the unequal responsibilities of caring work and the lack of recognition and value placed on this work, negatively affects the health of women.
Higher level of stress
Stress is one of the most important components of the causal pathways that link gender and health inequities. Lower levels of participation in the formal economy, feminization of work in the formal economy, the gendered pay gap, unequal caring responsibilities, and inadequate family leave policies often result in considerable levels of stress for women. Additional “gendered processes” that cause stress for women include discrimination, harassment, and poverty… In fact, the Centers for Disease Control (2004) found that women experience approximately twice the stress-related illnesses as compared to men. The negative health consequences of high stress levels include an increased risk of cardiovascular disease, migraines, musculoskeletal disorders, and mental health problems… Responsibilities in the caring economy and the feminization of work in the formal economy are significant sources of psychosocial stress for women.
The unequal distribution of caring responsibilities results in more time pressures and, therefore, more stress for women. Studies have shown that their “greater hours of unpaid work contribute to women experiencing more stress than men” …One causal pathway that includes time pressures and stress is that to fulfil all of their daily tasks, women “may forgo healthy behavior such as regular exercise or sleep, compounding health problems” …Another pathway that includes time pressure, stress, and poor health outcomes involves nutrition. The preparation of healthy meals requires time, whereas fast food is quick and easy, albeit often less healthy…In these ways, stress results from unequal caring responsibilities and can lead to poor health outcomes for women.
Stress can also result from attempts to complete both caring responsibilities and work in the formal economy. American sociologist Arlie Hochschild described the struggles of working mothers in her book entitled The Second Shift…
http://www.tandfonline.com/eprint/wXXZ4kJ6RI4utVPFTZST/full
California Governor Signs Bill Granting Overtime to Domestic Workers into Law
ReplyDeleteBY AGNES CONSTANTE
SEP 13 2016
California Gov. Jerry Brown signed into law a bill that grants permanent overtime protections to privately hired domestic workers in the state on Monday, in a victory for Filipino-American advocates who had pushed for the legislation.
"I am very thankful that SB 1015 was signed into law by Gov. Brown," Emily, 57, a Filipino caregiver who declined to give her last name, told NBC News. "With SB 1015 making AB 241's overtime provisions permanent, I don't have to work as much to get so little pay. I get more of a choice on which shifts I want to take and I now have some breathing room between bills as well as more time to also care for my own health."
The bill, SB 1015, was introduced in February by Sen. Connie Leyva (D-Chino Hills). It built upon existing legislation approved in 2013 known as the known as the Domestic Worker Bill of Rights, which mandated overtime pay for domestic employees who work more than nine hours a day or more than 45 hours per week. The measure, however, included a sunset clause that would have led overtime protection to expire in January 2017. SB 1015 eliminates this clause.
"I thank Governor Brown for signing SB 1015, since this critically important legislation will allow domestic workers to continue receiving overtime now and into the future," Leyva said in a statement. "By eliminating the original sunset date on AB 241, SB 1015 will make sure that domestic workers in California continue to receive a fair wage with overtime for their daily hard work."
In the Asian American community, SB 1015 is particularly meaningful to the Filipino community, as a large number of the group are employed in the homecare industry, according to activists.
"[The passing of SB 1015] is really significant because it really validates the dignity of the work that [Filipinos] are doing, the proud leadership that's brought by the community that has really helped to build this movement, and build the power that we have to be able to make changes," Aquilina Soriano-Versoza, executive director of the Pilipino Workers Center, a non-profit organization in Southern California serving Filipino workers that actively advocated for the measure, told NBC News. "This will very directly affect a lot of our community members in terms of the level of compensation that they will get as caregivers by [having over time protections] permanently."
After the passing of AB 241, the Pilipino Workers Center was involved in studying how the bill affected families and workers, and contributed to one of the first reports on domestic employers. It also worked with members of its organization to file wage claims and the Division of Labor Standards Enforcement to enforce the 2013 measure, according to Soriano-Versoza.
Also contributing to the passage of SB 1015 was the Filipino Community Center, a Bay Area non-profit and associate member of the National Domestic Workers Alliance.
"With the domestic workers and caregivers we work with, the new law is very important, especially because for some of them, it's their only source of income," Marienne Cuison, the center's program manager, told NBC News. "Because of the lack of overtime protection, many have to take on multiple jobs to just make ends meet."
SB 1015 is set to take effect on Jan. 1, 2017.
http://www.nbcnews.com/news/asian-america/california-governor-signs-bill-granting-overtime-domestic-workers-law-n647816
The Invisible Revolution: How Aging Is Quietly Changing America
ReplyDeleteDEREK THOMPSON
OCT 6, 2016
…What if presidential candidates took a CEO approach to future-planning? Perhaps they'd spend …more time talking about America’s old people.
…In the 1950s, at the height of the U.S. manufacturing supremacy, less than 10 percent of the country was older than 65. That share will double to 20 percent by 2050. The greying of America will touch every station of economic and political life: the size of the labor force, the jobs the economy will require, the ethnic makeup of the country, and the productivity of the workforce. In short, aging affects everything.
Start with the economy. First, as a workforce ages, it becomes less productive…a recent study found that a 10 percent increase in the fraction of the population ages 60+ "decreases the growth rate of GDP per capita by 5.5 percent.” Slowing productivity growth will be particularly challenging because as the country gets older, a larger share of the native born population will be retired. Medicare, Social Security, and other programs for the elderly require lots of tax income from a large and vibrant working force.
… without changes to taxes, spending, growth, or health care inflation, deficits will grow in the near future due to the increased health-insurance demands of the elderly.
But the future is more than the sum of its federal budget deficits. The aging of the population will also change the kinds of jobs Americans will do.
…The fastest growing occupations of the next decade are all in health—personal care aides, registered nurses, and home health aides…Underpaid and without a strong union, home health aides make an average wage of about $23,000, according to the New York Times’ Binyamin Appelbaum. "…increasingly made up of minority women who serve people,” he writes. Indeed, immigrants account for almost a third of the in-home health-care workforce, and one in five of them are undocumented, by one estimate.
This speaks directly to a second-order effect of an aging country, which is the diversification of the workforce. In 2015, the majority of children born in the U.S. were non-white….Today the rich and mostly white upper- and upper-middle class pay the majority of federal income taxes, which often support programs to help lower-income minorities. This contributes to a “makers" vs “takers" narrative that often skirts dangerously close to dividing the country on racial lines. But within a generation or two, …the minority-white labor force will be supporting the majority-white retirees.
…The need for home health aides should factor into the conversation about immigration …the fastest growing occupations in the U.S. currently relies on a steady supply of immigrants. The rise in health-care spending for the elderly will force debates about the most humane and affordable way to care for those who need it. The next presidents may not serve as grand architects of public health policy, as Obama did. Rather they may have to serve as tinkerers and handymen, making targeted fixes to keep the house from falling apart. As Americans live longer, poor and middle class retirees will need more savings. The U.S. government could discuss an expansion of Social Security for the poorest, or new ways to force—or “nudge”—even low-income Americans to save enough money to last their extended lifetimes.
…The greying of a generation is slow and ordinary. For that reason, it can go unnoticed. But perhaps political leaders could afford to do the boring thing and talk about the country as it is, and as it will soon be …
http://www.theatlantic.com/business/archive/2016/10/aging-america/503177/
Workers Who Give Care To The Homebound Often Can’t Afford To Get Their Own
ReplyDeleteBy Shefali Luthra March 31, 2017
…Like many others who work in the lower rungs of the health care system, she has worked hard to keep her clients healthy by feeding them, dressing them and helping them navigate chronic conditions.
But because of the low wages and the hourly structure of this industry — which analysts estimate is worth nearly $100 billion annually and projected to grow rapidly — workers like Thompson often don’t have health insurance. Many home health agencies, 80 percent of which are for-profit, don’t offer coverage, or their employees don’t consistently clock enough hours to be eligible. They generally earn too much to qualify for public aid but too little to afford the cost of premiums.
“It’s a social justice issue. We have a workforce that is the backbone of long-term [care] services, and they themselves don’t have coverage,” said Caitlin Connolly, who runs a campaign to increase home care wages at the National Employment Law Project, an advocacy organization.
In 2015, Montana opted in to the 2010 health law’s expansion of Medicaid, the state-federal low-income health insurance program. Thompson, who was making about $10 an hour, immediately signed up.
Her vision care was among the first things she focused on…because her job includes keeping track of patients’ pill bottles and making sure they take the right medications. “I had to use a magnifying glass to see small print,” said Thompson, who now wears bifocals. Her doctor has since warned her she may need a stronger correction soon.
The Trump administration’s attempt at replacing the Affordable Care Act would have reined in Medicaid spending…But the bill failed to get enough support in Congress and was withdrawn March 24. Many Republicans say repeal is still a priority, and Health and Human Services Secretary Tom Price could change key regulations affecting the current law right now, without Congress.
Thompson is part of a large population of home-based caregivers who might be affected by such changes. From 2010 to 2014, about half a million of these workers gained new health insurance through Obamacare, estimates PHI, a New York-based nonprofit that researches this slice of the labor force and advocates for improved working conditions, in a March issue brief.
Most home care workers’ gains came from living in states that …expanded Medicaid. But even with Obamacare in place, many home health workers — perhaps 1 in 5 — remain uninsured. By contrast, about 8.6 percent of all Americans lack coverage…
Many Republicans have long favored proposals to reduce federal costs associated with this state-federal low-income insurance program, saying that shifting funding from a per-capita basis to block grants to states would make the system more efficient.
But many advocates for these workers take a different view …Under the 2010 law, “at least we were on a path” to addressing coverage and access concerns, said Elly Kugler, the federal policy director at the National Domestic Workers Alliance, a coalition that represents home care providers. If it goes away, she said, it’s not so clear how these workers will access health care.
Currently, home care workers on average earn less than $20,000 per year. The federal government only recently ruled they qualify for overtime pay and minimum wage protections. And there’s another rub: Most of the money paying for long-term home care comes from Medicaid and Medicare, PHI estimates. If either of those sources is squeezed, “that will translate to hours cut,” Connolly said — because people who need home care will also have fewer resources to pay for these services.
http://khn.org/news/workers-who-give-care-to-the-homebound-often-cant-afford-to-get-their-own/
Everything You Need To Know About Ai-jen Poo — Meryl Streep's Red Carpet "Date"
ReplyDeleteRACHEL SELVIN
JANUARY 8, 2018, 12:50 PM
Refinery29 caught up with MacArthur “Genius” Award winner, Ai-jen Poo …director of the National Domestic Workers Alliance — to learn more about her courageous advocacy for the caregivers still fighting for the basic protections most of us take for granted…
What is the National Domestic Workers Alliance?
…advocates for the women who labor in our homes every day as nannies, personal attendants, caregivers to the elderly, and housecleaners. Above all, they are the people who make all other labor possible by supporting millions of working families and allowing them to go out in the world and do what they do…undervalued and invisible labor in our economy…very little in the way of guidelines or standards about how to fairly compensate…vulnerable to modern day slavery situations, rape, or sexual assault.
Our work…to elevate the level of respect we assign to this work, to raise awareness for the ways we have to invest in these jobs, and to act as a resource and support system for theses laborers. Ultimately, we want to change the politics and policy around how we value caregiving.
There's a personal story behind how you began advocating for the importance of intergenerational care. Can you tell me about that?
I grew up in an immigrant household, and my grandparents moved in with my family when I was pretty young. They played a really strong role in raising me and my sister, which taught us so much about valuing family and respecting our elders. Embedded in both of those values is the importance of care and care giving — knowing how to recognize the people who support you. When I was a young adult, my grandfather started to lose his sight and became much frailer as he grew older,…unable to care for him at home, so we ended up having to place him in a nursing home against his wishes. Visiting him there always broke my heart, and I lived with that sense of regret that someone who provided such good care for so many others wasn't able to receive the same thing in his final days…
Immigration has become one of the most visible socio-economic issues since the 2016 election. How do immigration and domestic labor issues intersect?
...the largest concentration of undocumented laborers are found in the domestic work industry. So it's really the women in our homes — the ones caring for our children or grandparents and cleaning our houses — who are the ones being demonized in this political climate...
In 2010, you successfully advocated for the passage of the Domestic Workers Bill of Rights. How has your ability to work with the government to create real change shifted since the Trump administration came to power?
…we were successful in winning wage protection for these laborers, and it was a big victory of the Obama administration.
The Trump administration...focused on ejecting a large portion of the workforce that so many of us are connected to or dependent upon…polarizing the country by trying to turn people against each other. We believe in a nation that is based on an acknowledgement of how we're interconnected — one that understands that the only way we solve problems is by working together...
…women have been a real source of hope and power for us. It's not surprising that women were the first to call for a march and have been organizing ever since…Women are really disproportionately impacted by any policies that get created around care and care giving — women are providing 72% of family care giving and 90% of the professional care workforce is female. Domestic care is a sector where women are leading, developing solutions, and pushing the conversation forward. It's also profoundly intersectional, touching every generation, every race. Above all, women are leading the energy that will save our democracy. That's what's keeping us hopeful.
http://www.refinery29.com/2018/01/184108/caregiving-domestic-workers-alliance-founder-ai-jen-poo
The Shortage of Home Care Workers: Worse Than You Think
ReplyDeleteBy Chris Farrell
April 18, 2018
Among society’s most pressing questions with the aging of the population is who will help growing numbers of frail elderly with routine tasks at home, such as bathing and dressing and cooking. Families often take on these caregiving responsibilities, but the job isn’t practical for many working boomers and Gen Xers, families with far-flung children, widows and widowers and the childless elderly. That’s why the need is so great for professional home care workers.
The demand for home care workers — also known as the “direct care” workforce — is expected to increase dramatically in coming years. Government statisticians rank home care as one of the nation’s fastest growing occupations, with an additional million workers needed by 2026; that’s an increase of 50 percent from 2014. And the number of Americans age 85 and older is projected to more than double in the next few decades, soaring from 1.8 percent of the population in 2010 to 4.5 percent in 2050.
Sadly, the dismal combination of low wages, inconsistent work schedules and poor advancement prospects will make it extremely hard to fill the projected home care positions…
…home-care experiments at the state level could eventually inform federal blueprints for change.
“We don’t think there is a path forward without a political solution,” says David Hammer, executive director of the ICA Group, a consulting firm that helps grow worker cooperatives…
…home care industry is losing workers to big box retailers, fast food restaurants and similar businesses paying higher wages. The median hourly rate for home care workers is a measly $10.66 according to the U.S. Bureau of Labor Statistics. That’s about what a short-order cook makes and it’s two-thirds of the hourly earnings of veterinarian technicians, notes Howard Gleckman, senior fellow at the Urban Institute think-tank and an authority on long-term care.
…Only a third of home care workers are employed full-time and, as with most businesses, part-timers often don’t qualify for benefits…about 40 percent of home care workers rely on public health care coverage (mostly Medicaid).
Worse, the industry has high rates of on-the-job injuries (higher than mining and oil and gas extraction) and there is a high risk of sexual harassment and assault for its primarily female workforce. Little surprise that The National Domestic Workers Alliance has called for a #MeToo Day of Action for domestic workers including home care workers; it will be April 24.
It’s easy to see why annual turnover rates at home care agencies are around 60 percent…
And yet the job market for home care workers may well deteriorate even more.
One reason: The Trump administration’s plans to restrict legal immigration to the United States. About one-in-four workers at nursing homes, assisted living facilities and home care agencies are immigrants, according to PHI, the Bronx-based advocate for the direct care workforce.
Another: local independent home care agencies are closing up as their owners retire…
…The ICA Group is working to expand thome care cooperatives beyond the current 10 nationwide. Co-ops are owned and controlled by home-care workers; members get more training opportunities, steadier work schedules and better benefits than normal. ICA is also reaching out to retiring home care agency owners to see if they’re interested in selling the businesses to their employees.
Similarly, several states are taken small steps to improve the home-care worker job, most importantly by creating opportunities for advancement.
For example, New York has a program that lets trained home health aides administer routine medications, a step closer into the health care system. “People still think of them as baby sitters,” says Gurgone. “They have to be seen as part of the health-care team.”…
https://www.nextavenue.org/home-care-workers-shortage-worse-think/
When Family Members Care for Aging Parents
ReplyDeleteBy Sandeep Jauhar
Sept. 19, 2018
…We wanted our parents to live independently in their own home, which meant that my siblings and I were going to have to chip in to help. It was a small price to pay, we thought. When my sister visited from Minneapolis, she bathed and dressed my mother. I administered their medications and helped with groceries. My brother took care of household issues. Still, my parents’ home, like my parents themselves, was in a constant state of disrepair.
That summer, my siblings and I joined the ranks of the 15 million or so unpaid and untrained family caregivers for older adults in this country. A recent study found that almost half of this largely invisible work force spends, on average, nearly 30 hours a week providing care to relatives, many of whom have dementia, an estimated more than $400 billion worthof annual unpaid time.
The work takes its toll. These sons, daughters, husbands and wives are at increased risk of developing depression, as well as physical and financial difficulties, including loss of job productivity. Being sick and elderly in this country can be terrifying. Having a sick and elderly loved one is often a full-time job.
As the workload increased, we hired help, as much for ourselves as for our parents. But after some items were stolen, we realized we had to be more careful about whom we allowed into our parents’ home. Older adults in this country lose almost $3 billion a year to theft and financial fraud. Nearly every week my father instructed us to donate money to someone who had sent him a generic email appeal. It fell on us to keep our parents from being exploited.
With millions of elderly adults requiring assistance with daily living, physicians should make it routine practice to ask family members whether they can provide the requisite care. Many of these potential caregivers, ill or stressed themselves, simply cannot.
Insurers should also set aside funds to support these caregivers. Family members are often the people most invested in the care of their loved ones. Supporting them will only benefit our most vulnerable citizens. It won’t be cheap, of course. Because of the size of this unpaid family work force, even providing minimum wage to the most taxed caregivers could cost up to $100 billion annually.
In 2015, Andrew Cuomo, governor of New York, announced a $67.5 million grant to help ease the burden of informal caregivers of dementia patients in the state. The money pays for counseling, support groups and a 24-hour hotline. It also subsidizes the hiring of friends and neighbors at $15 an hour so that family members can enjoy occasional respite from the strain of caregiving. Several other states, including North Carolina, North Dakota, Minnesota and Vermont, have similar programs but on a much smaller scale. Much more needs to be done nationally.
Though our parents’ independent living required a steadily increasing commitment, there was no dearth of moments to remind us that it was worth it. I once called my father to tell him I was going to stop by the house later to talk about a change in one of her medications that her doctor had suggested.
When we ended the conversation, he forgot to hang up the phone. I heard him turn on the TV, which was playing a popular Hindi film song.
“Will you listen to some music with me?” he asked my mother. She did not reply. “Come on, hold my hand,” he said.
“No one has any use for me,” I heard my mother say.
“I do,” my father said. “The kids do. Here, hold my hand and dance with me.”
Sandeep Jauhar (@sjauhar), a cardiologist, is the author of “Intern,” “Doctored” and the newly released “Heart: A History.”
https://www.nytimes.com/2018/09/19/well/live/when-family-members-care-for-aging-parents.html
Expanding in-home care as San Francisco’s population ages
ReplyDelete‘There’s a huge need and a huge gap. It’s a really tough job’
SYDNEY JOHNSON
Oct. 15, 2021
…The program, which is funded by the San Francisco Office of Economic and Workforce Development and the Metta Fund, provides free on-the-job training to in-home supportive service workers at Homebridge and clinical training with UCSF, culminating in a certified nursing assistant certification through City College of San Francisco.
The 15-week fully accredited course started in September. It includes 10 hours of weekly instruction through CCSF plus a clinical practice requirement of 100 hours at UCSF Health.
In-home health services are a vital cog in San Francisco’s health care network that helps keep extremely low-income residents in their own homes, providing both a sense of independence and keeping the hospital and emergency room beds open for patients with other immediate needs.
But the training initiative comes at a time when San Francisco is facing a serious shortage of in-home service providers coupled with an aging population, creating the perfect storm for unmet hospital bed demands and rising homelessness.
“If you can’t survive well at home, you could lose your housing,” said Mark Burns, executive director of Homebridge. “You can’t keep the place clean and can get evicted. You could have too many emergency health experiences, end up in the ER more, and can’t help yourself at home. So you could end up in a nursing home, but there are not even enough beds.”
Older adults make up the fastest-growing age group in San Francisco. By 2030, The City’s Human Services Agency estimates 30% of the population will be 60 and older.
There are currently about 25,000 people who receive in-home care and 23,000 caregivers, according to the San Francisco Human Services Agency. Demand for in-home care recipients has grown by about 5% annually over the last two years, a trend that’s expected to continue unless workforce patterns shift.
“There’s a huge need and a huge gap. As you can imagine, it’s a really tough job,” said Kelly Dearman, executive director, of disability and aging services for SF Human Services Agency. “It’s not just about recruiting anyone, but we need people who speak various languages and can meet a variety of needs.”
In-home care is a cottage industry relative to other medical practices. In many cases, these caregivers are family members who are paid to take care of a relative full-time.
Clients who can’t afford to manage their own services, or don’t have a family member who can support them, can find in-home caregivers through San Francisco’s in-home supportive services caregiver registry or through Homebridge. (To ask questions or to apply for in-home supportive care services, San Francisco residents can call (415) 355-6700 or find out more here.)
But in-home support services typically pay minimum wage salaries, making it harder for caregivers to live in San Francisco and work a physically and emotionally demanding job.
Across The City, 65% of in-home service providers are women and 34% are men, according to the Human Services Agency. Black and Latinx women make up a large majority of in-home caregivers in San Francisco and beyond.
“People who work in that industry are predominantly immigrants and women of color, people who are often taken advantage of for working long hours with low pay,” said Burns. “Our goal is to move them to a place like Laguna Honda where starting (salary) is closer to $25-$26, and (they can) experience more growth in pay scale there.”…
https://www.sfexaminer.com/news/expanding-in-home-care-as-san-franciscos-population-ages/
Why I fought for paid sick leave for San Francisco’s domestic workers
ReplyDeleteI wish my mother, who cared for families across The City, could be here now
By Kimberly Alvarenga
December 16, 2021
As a child, I have vivid memories of my mom working as a domestic worker in San Francisco to make a better life for us. Every day, she would leave the house early in the morning while it was still dark…because she had to get to work before her employers left for their own jobs. She was a single mother and, like many women who immigrate here, she cared for elders or other people’s children.
She never took a day off because she had to provide for me. She worked even when she was sick and when her bones ached because, if she did not work, she was not paid and could not put food on our table.
Thousands of workers still experience similar conditions today in The City. Many labor laws do not address the specific needs of this industry, which is why making change often takes a long and consistent effort from domestic workers to win new rights and to make those rights real in their lives.
The journey to win the Access to Paid Sick Leave Ordinance in San Francisco, which was recently passed by the Board of Supervisors, is no exception.
…domestic work industry continues to be mostly unregulated and excluded from the protections other workers enjoy.
The impacts of these exclusions can still be seen in how this workforce remains invisible when legislators write laws. The uniqueness of the domestic work industry, such as working for multiple individual employers and behind closed doors, can further marginalize workers and make it harder to address violations and needs in comparison to other workplaces.
The COVID-19 pandemic has made clear that domestic workers’ health needed to be prioritized. They were among the essential workers who continued their jobs at the frontlines of the pandemic. Domestic workers kept going into work, caring for those most vulnerable to the virus without any health and safety protections, without access to paid sick leave and without an economic safety net if they became ill. Many could not take time off to support sick and dying family members, as their communities were among the most impacted in The City. Others, without options, stayed home, but at the expense of losing critical income.
It was in the midst of this crisis that domestic workers decided access to paid sick leave had to be made a priority…
The Access to Paid Sick Leave Ordinance makes San Francisco one of the first cities in the country to create a portable benefits system for domestic workers to finally access paid sick leave…support domestic employers to contribute their share of what is owed. Domestic workers will be able to accrue paid sick leave hours from multiple employers through a centralized account, which they may access directly through an app or web-based platform…
Making safety net benefits accessible is not only a matter of equity and correcting an historic injustice, it is also part of our vision for the future of the domestic work industry.
My mom worked as a domestic worker most of her life. She passed away earlier this year, and I wonder what she would say if I could tell her now, after a lifetime of hard work taking care of families across The City, that she could take the day off to take care of herself…
Kimberly Alvarenga is director of the California Domestic Workers Coalition.
https://www.sfexaminer.com/opinion/why-i-fought-for-paid-sick-leave-for-san-franciscos-domestic-workers/