September 12, 2002
The Invisible Women
By BOB HERBERT
hey have names like Peggy Turner and Angela Muniz and Elena Susana. They are the invisible women who fan out across the city each day, mostly traveling by subway, to go into people's homes and do the grunt work of caring for those who are sick or infirm.
There are thousands of home health aides in New York City and they work hard, taking on the tasks that most people, even close relatives, shun. "We bathe the clients, and feed them and dress them and give them their medication," said Mary Toni, an aide who lives in the South Bronx. "We run errands and take them to their doctors' appointments. Whatever is necessary, that's what we do."
"Some of the patients are bed-bound and you're using your back a lot," said Peggy Turner. "It can be tough, especially when they are bed-bound and obese. We had a woman who was nearly 500 pounds and she couldn't even turn herself over."
This is important work. Home health care is much cheaper and, for patients, generally preferable to lengthy hospital stays or other forms of institutionalization. And as the baby boomers continue to age, home care will become more and more common-not just in New York, but across the nation.
So now would be a good time to stop the utter exploitation of these workers, who are among the most poorly paid and poorly treated that you can find. There are more than 20,000 home health aides in New York City. Most are paid a pathetic $6 or $7 an hour. Some are paid less. Nearly all of the workers are women, and most of them receive no health care, no sick pay, and get no vacations.
Elena Susana, a home health aide who lives in the Bronx with her two young daughters, has to rent out one room of her two-bedroom apartment and cook meals for her boarder in order to make ends meet.
This is the face of 21st-century poverty-a hard-working woman with children caught in a system that refuses to pay what her services are worth.
Virtually all of the money for these workers comes from taxpayers. But the money-inadequate to begin with-makes a long and debilitating trip from Medicare and Medicaid, the dominant providers, to the pay envelopes of the workers. In between are the certified home health agencies, which take their cut for a variety of services and administrative costs, and then the subcontractors of the certified agencies, known as licensed home care service agencies, which siphon off a lot more for operating expenses and profits. The workers are last and least.
"These are among the lowest paid workers in New York State," said Dennis Rivera, president of 1199/S.E.I.U., the health-care workers' union. "They take care of the people who are dying, or are too infirm to bathe themselves or feed themselves. But they're so impoverished they can't provide for their own families."
Mr. Rivera's union is the largest in the state. His most recent mission has been to bring thousands of non-unionized home health workers into the fold. More than 15,000 home health aides in the city have voted to join the union, but negotiating contracts with the various licensed home care service agencies has proved extremely difficult.
Mr. Rivera is pushing the matter aggressively on two fronts. In the court of public opinion, his union has posed the issue as a moral or ethical one: "Should we allow those on whom we rely to provide assistance to our loved ones to live in poverty and deprivation?"
And in the arena of hardball labor negotiations, 1199 is threatening to call the nation's first strike ever by home health aides. If no contract is reached by Sept. 18-next Wednesday-union members will begin a strike against Premier Home Health Care Services, which employs about 3,500 home health aides.
The president of Premier, Arthur Schwabe, agrees that the workers are underpaid and deserve health coverage and other benefits. "I want wage and benefit increases for my people," he said.
But for that to happen, according to Mr. Schwabe, the government would have to come up with more money, or the union would have to take the money that is already available and divide it among many more workers.
Neither of those options is likely.
Sep 12, '02
I definitely agree that home health aides and homemaker/companions are some of the most overworked and underpaid people around. Occasionally when we are understaffed due to illness or vacations, I have to go out to cover for one of the aides, and boy, I really appreciate all they do after that! I'm not sure I could do all the things they do every day and still have a smile on my face. They really don't get all the credit or benefits to go along with it for what they deserve!
Sep 14, '02
Been in home health for 11 years and I know exactly what you mean........in the last place I worked the aides made 9. per hour but they had to pay for a family insurance plan over 500 per month.........................
Sep 15, '02
I actually was a HHA during school and didn't feel underpaid. I say this because I only had to look after one person or two people at a time. I felt underpaid when I took a job in LTC looking after 9 at a time and barely making more. I do think the low wages will not attract good workers to this field though, so a pay raise is in order. ESPECIALLY FOR NYC!
Sep 23, '02
I worked as a nurses aide while I went to nursing school so I understand how hard the work is. At the time I didn't feel I was underpaid, I was happy to be getting the experience at the time. I've been an rn now for greater than 12 years and once was asked to do the job of a nursing assistant when I was on call as an RN for a home health agency that I left, you can guess why. I didn't have the faintest idea how to do the job. I was away from this type of patient care for too long to do the job the way it deserved to be done. I will not go into detail but when I was leaving I'm sure the patient was glad to get rid of me. After the experience I refused to do any such job again on only a registered nurse pay, at the time 30 dollars hour.
Sep 24, '02
Good article, tells the brutal truth.