Oregon State strives to improve home care
ERIN HOOVER BARNETT
Older adults, people with disabilities and caregivers plan to gather at the Capitol today to watch Gov. John Kitzhaber initiate what they hope will be a new, improved era in home care.
The governor will sign into law House Bill 3816, which implements Ballot Measure 99, which was passed by voters last fall to create an independent Quality Home Care Commission. The commission will help coordinate in-home care for elderly and disabled Oregonians who receive Medicaid, the federal insurance program for the poor.
The commission will be the employer of record for the more than 10,000 home-care workers in the state, enabling them to unionize and shore up the kind of in-home care that keeps people out of expensive nursing homes.
It is the latest attempt to stabilize this work force, a loose-knit group with high turnover that ranges from former homemakers to former servicemen. With little or no formal training, they are paid on average $8.12 an hour and receive no health coverage, no paid time off or no worker's compensation insurance.
Advocacy groups have made only minor gains for home-care workers in the Legislature, so the commission effort, lead by Service Employees International Union, hopes to create more leverage. The group has made modest gains for California's 100,000 unionized home-care workers, and is making the same attempt -- qualifying a ballot initiative -- for Washington's 23,000 in-home caregivers.
"It is preparing for the future with a growing population of people who are aging," said Karla Spence, home care campaign coordinator for SEIU Local 503. "This could be anyone's mother, father, sister, brother. To allow them to live in their own homes, not in a nursing home, is a benefit not only to that person but to their families and to taxpayers."
The home care commission faces hurdles, not the least of which is winning money from the Legislature to give caregivers benefits or higher pay.
The Legislature's Emergency Board is expected to allocate the commission $300,000 at its September meeting. The money will be used to staff and organize the commission, to begin building a caregiver training program and a registry to better track and match caregivers with clients. Boosts in benefits and pay would cost much more.
The nine-member commission includes five people who use home-care services, a state Senior and Disabled Services Division representative and three advocacy group leaders.
Although most advocacy groups and the state support the commission as the will of the voters, some wonder if it is the best approach.
"I can't say how long it's going to take them (the commissioners) even to decide what they're going to negotiate on," said Jacqueline Zimmer, director of the Oregon Association of Area Agencies on Aging and Disabilities, which has a seat on the commission. "Meanwhile, (home-care workers) still aren't paid well and training still isn't standardized."
Martin Carkhuff, 43, and a home-care worker for nearly 16 years in Portland, is hopeful yet skeptical. Carkhuff drives his red Mitzubishi Mirage between the homes of two to five clients each day, getting them out of bed and dressed in the morning and then back into bed at night. He carries a pager day and night so he can help a client with a plugged catheter or another emergency. He makes $8.38 an hour and works seven days a week.
"I've got the feeling that the Legislature is going to do what they want to do. If they don't have the money, they don't have the money" to improve caregivers wages and benefits, Carkhuff said. "But let's wait and see what happens."
Michael Goldhammer, among the newly appointed home-care commissioners, said the commission is his best chance to improve the system. Goldhammer, born with limited use of his arms and legs, uses home-care workers to get him out the door to his job as an adaptive technology specialist at Mt. Hood Community College.
"What we're trying to do is move (home-care workers) from the 16th century, where we viewed people as indentured servants and slaves . . . to where we realize if we don't treat these people with respect, they're not going to come back," Goldhammer said.
You can reach Erin Hoover Barnett at 503-294-5011 or by e-mail at firstname.lastname@example.org