
Students and instructors of the first Voices Institute National Training were among the advocates at the DCA legislative visits.
The co-chairs of the Congressional Labor and Working Families Caucus have endorsed the Direct Care Alliance’s position that home care workers are entitled to minimum wage and overtime protection.
The DCA is spearheading an effort by Linda Sánchez, Michael Michaud and Stephen Lynch, who are urging their colleagues in Congress to sign onto a letter asking U.S. Secretary of Labor Hilda Solis to end the exclusion of home care workers from the federal Fair Labor Standards Act (FLSA).
Teams of Direct Care Alliance constituents from around the nation — half of them direct care workers and the rest elders, people with disabilities, employers, and other advocates — visited Capitol Hill last week, asking Members of Congress to sign the Dear Colleague letter. The DCA teams also asked legislators and key committee staff members to support the Direct Care Alliance’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, adequated training, health insurance, and other elements of a good job, making direct care a viable career option.”
Our Dear Colleague Letter
The Dear Colleague letter (PDF) asks Secretary Solis to overturn the DOL ruling that was upheld by the U.S. Supreme Court in Long Island Care at Home, Ltd. v. Evelyn Coke.
Once the letter’s sponsors have collected signatures from their fellow Members of Congress, 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 several other direct care workers, most of whom are graduates of the Voices Institute National Leadership Program. 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.
“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.
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.
“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.
“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
“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.”
Read Helen Hanson’s posts about the DCA legislative visits on our blog and on the blog she writes for her union
Read John Booker’s blog post on his visits
Read the DCA board’s resolution about the need to FLSA exemption










I’ve just returned from Washington D.C., what an amazing outcome. I’d first like to thank Leonila Vega, Roy G., Bridget S. and Vicki E. you all did a amazing job with the DC trip. Over 45 on the Hill telling our stories. We did in the last two and half days use our VOICE…
It is my dream that in one year we again will use our stories and voices with 4,500!
We can do it. We need you, the direct care workers. I’d like to send a special thank you as well to Connie K, and Peg A. for taking time from you busy days to make the trip, I know you did a great job. I was there to witness it.
Never can we do it alone. We are a team, and the best team wins, WE WILL WIN….
Thanks to all.
Hi, DCA family,
We did it! This is just the beginning.
I am so proud of the accomplishment we made in honor of direct care workers in the nation. I am proud to be a health care worker.
I have done this job for over 30 years. Saying we get no respect is an understatement. The lack of attention they play to the key of education is appalling, and the way we continue to let our employers think it is O.K. to not have benefits that we can live with is unacceptable. What puzzles me is we still let this happen today.
No more! We will speak and do everything in our power to change this wrongdoing. I made a difference in my journey in Washington, and those of you who were with me did as well. Our campaign has just begun.
Great job, you guys! I am proud to have been a part of such a historical day for healthcare workers in the nation.
Renee J. Tillman CNA/CHPNA
President and Founder, Texas Association of Nurse Assistants
Watching all this come together was inspiring. We have it in our hands to effect a change, and make sure we are not forgotten.
Change is definitely coming, that much is certain. I’m very glad to be part of this effort to help set the agenda, pushing for basic protections and dignity.
Thank you all for the opportunity to work with you! Our perseverance is the key to success in this. We need for people to know who we are, and what we stand for. Each Direct Care Alliance member who shared their personal stories on the Hill is one vital piece of the solution. This is important work we’ve started. It’s up to all of us now to keep it going!
Jim Locke — Direct Care Worker
Direct Care Alliance Board Member
Jim, it was an honor to work beside you. It is individuals like yourself , Dr. Laurie Powers, Mr. Dennis Fitzgibbons and others who are living the experience, and who are best qualified to educate others , including congress, so thank you all for your inspiration. John
It was great to be a part of this historical event. I shared a quote with some of you that I would like to share with everyone:
Each time someone stands up for an ideal, or acts to improve the lot of others, or strikes out against injustice, he sends forth a tiny ripple of hope.
– Robert F. Kennedy
I think this sums up our work, and things will start to change. Hopefully our ripples turns into waves.
Tracy Dudzinski
Direct Care Worker
DCA Board Member
It is indeed encouraging to see all the hard work focused on improving the pay and conditions of the direct care workers. As a long-term care ombudsman, it is very evident that we cannot improve the care being delivered to loved ones in long-term care until we improve the conditions of the caregivers. We at Ombudsman Services of San Mateo County, California, are fully supportive of your efforts
I certainly support improving the pay and benefits for caregivers. They most often are amazing individuals, providing excellent, loving care. The challenge is that one size does not fit all in caregiving. There are friends and family in many cases, as well as those who make caregiving their profession. Some friends and family simply need to have a small amount to allow them to provide care, while others need a living wage.
I want to be sure that you are considering one of the likely unintended consequences of your proposals. I believe that these recommendations will result in many individuals with disabilities finding that they can no longer live independently, in the community, because of the prohibitive cost of a live in caregiver.
In our market, a live in caregiver making $75 per day will earn up to $27,000 per year, with a total cost of about $32,000 when payroll taxes are included. This payment structure works rather well for family members to be able to remain full-time caregivers. There are also non-family members paid in this range.
Paying for hourly 24-hour care at the minimum rate of $9 per hour would cost over $93,000 per year, with payroll taxes but without any overtime. This assumes three eight-hour shifts daily. The group homes in our market are in the $3,000 to $5,000 range per month, well under this cost of nearly $8,000 per month. Most individuals who receive long-term care assistance are likely to find that the group home alternative is the only affordable one for their managed care organization. For any individual who is private pay, this is completely out of reach.
The unintended consequence of trying to treat all situations the same, is that many existing situations that are very satisfactory will no longer be possible.
With the increasing demand for caregivers, rates are rising on their own. This is likely to continue with the aging of baby boomers. If you prevail, you may find that you have achieved a victory for some at the expense of others.
Thank you to share with us this information. I really appreciated it.
I would like to take this opportunity to thank all members who sacrificed and offered their time to make this important trip to DC.
I will share also this important information with my co-workers and friends who are direct care workers.
Timothy Doe
Catholic Community Services