The Washington state legislature is finally starting to support the work we home care workers and our allies have been doing to establish a professional career path for direct care workers in long-term care. On Saturday, a bill to allow home care workers to more easily become nursing assistants was passed out of committee. It will soon be voted on by the state Senate.
The House bill, HB 2766, and the Senate’s, SB 6582, are nearly identical. A third bill, SB 6662, is slightly different and more inclusive of other types of workers. None of the three have funding attached, so they will only be effective if my union, SEIU 775, can negotiate money for our joint Training Trust.
The cynical part of me says it’s about time the legislature recognized the work we home care aides have been doing to improve the quality of care we provide, but the optimistic part is happy for this good news.
Nursing home operators support this endeavor because it would provide them with a new source of experienced caregivers. It would also be good for long term care providers (my state’s name for home care workers like me) and other home- and community-based caregivers because it would give us a first step on a much needed career ladder.
I know this is needed because I have talked to many caregivers who want to continue on into the nursing profession – or who want to stay in direct care but can’t afford to stay at the same pay rate forever.
Acknowledging our growing expertise
This bill is also good because it recognizes the generally unacknowledged expertise that we home care workers develop, both on the job and through the training that is now provided to us all statewide. As more people are electing to stay in their own homes and neighborhoods instead of going into an institution to get long-term care services, we are being called on to do more all the time. Our clients’ needs have become much more complex since I first started doing this work many years ago. Our care practices have evolved too.
My favorite clients are the children with developmental disabilities. Their will to survive inspires me to fight on their behalf, making sure they get to have quality experiences. We have come a long way from the time when I discovered that a case manager for the state had authorized the money for a metal cage for a young girl who had seizures and fell out of her bed at night.
The fight for better training
But our training hasn’t caught up yet. That’s why we took up the fight a while back for training that was appropriate and standard throughout our state. Some areas took training seriously, but others took the cheapest easiest way possible. In one rural county, training consisted of checking a book out of the library and writing a report on it, while caregivers in larger cities could attend classes at a local community college. And the training to care for active disabled children was the same as we got to care for the elderly.
Our requests were largely ignored at first, but we kept working at it, appealing to all the people in the system who were supposed to care. I remember how frustrated I got as I spoke to one representative at a legislative reception. Finally I showed him the purple high-tops I was wearing under my skirt and told him I was ready to walk the streets to demand the training we needed.
Caregivers from all over the state gathered signatures for a petition to put statewide, standardized training on the ballot for the public to approve. We went wherever there was a crowd, talking to people at the beach, standing in line at the grocery store, on the ferries between islands, at a parade in Seattle celebrating the summer solstice, at powwows and fairs, in parking lots, and wherever else we could find a willing ear.
We had some opposition – my hometown newspaper was very negative – but it only made people curious, so it was easier to get them to talk to us about it. In the end, 74 percent of the voters approved our training initiative. That felt great – proof that the public knew what we did and cared enough to show their support and appreciation.
Initiative 1029 increased the training for us home care workers from 28 hours to 75 hours and made sure it was equally available throughout the state, in rural and urban areas. Caregivers were included in the development of the training modules, and a professional statewide certification was established, which will be a step toward career development, wage increases and respect. As a result of that initiative, we will no longer be considered “casual labor,” and we can learn specialized skills to respond to the individual needs of our clients.
The additional 24 hours of training that is called for in the three pending bills is aimed at bridging the gap between the expertise developed in home care and what nursing assistants in an institutional setting need to know.
Another step forward
Making it easier for us home care workers to get CNA status is just the next step in a long journey. We long term care providers need to be recognized as the health care specialists that we are. Direct patient care should be required by all health care providers as a step in their training. And since home care workers are generally isolated, we need to give them more support as well as better training. My union is working on establishing a mentorship program and 75 additional hours of training, for what we hope will become a federally recognized apprenticeship program attached to a wage progression scale.
Our history with passing the training bill gives me confidence that our representatives will join us in passing the current bill – and in doing more to create a better and more seamless system of quality home-based, community, and institutional long-term care, provided by a direct care workforce that is valuable and valued.
Long Term Care Provider