Proposition B on the Nov. 4 Missouri ballot may be titled the Quality Home Care Act, but it's drawing a lot of opposition from health care groups and business owners because of its potential to unionize home-care workers.
That was the message during an Oct. 20 presentation to the Springfield Area Chamber of Commerce's Governmental Relations Committee.
The bill would create an 11-member Missouri Quality Homecare Council charged with maintaining a statewide database of eligible in-home health care workers and encouraging people to join the field.
The official ballot language summary of the proposition says it would allow Missouri seniors and disabled residents to "continue living independently in their homes by creating the (council), to ensure the availability of quality home care services under the Medicaid program by recruiting, training and stabilizing the home care work force."
Gwen Beebe, executive director of Springfield-based Integrity Home Care, told the chamber committee that such wording was misleading. She said the bill would create an unnecessary layer of bureaucracy and noted that vendors who provide training for home care workers already answer to the state Department of Health and Senior Services.
The bill, if passed, would make all personal care attendants who work in the state's consumer-directed services program part of one group, and that group could then form a union to collectively bargain with the council for pay and benefits.
"Is (the current system) perfect? No way," Beebe said. "But we have programs in place that are working well. The only group that benefits from this is the unions, lining their pockets, and we can't afford to do that in this industry."
Though the Springfield chamber isn't taking an official stance on Proposition B, numerous health care organizations and companies, including the Missouri Hospital Association and the Missouri Alliance for Home Care, have voiced opposition to the initiative.
Integrity Home Care owner Phil Melugin said his business and others can't afford to entertain union-led wage negotiations.
"We're already offering all the benefits we can right now with the money we have," he said. "We'd have to go back to the state and ask them to raise their reimbursement rates just to meet the demands of the union and keep the company viable. That is bad public policy."
Looking out for workers?
The proposition is the result of a signature petition submitted by a group called Missourians for Quality Home Care and supported by various union groups.
Proponents of the proposition say the bill would benefit the state's home-care workers.
"Currently, the state's 8,000 home-care attendants earn low wages, (receive) no sick time and no benefits, and are classified as 'self-employed' contractors," says a news release from the Service Employees International Union. "As a result, many consumers have lost home services because of funding cuts and high turnover."
Melugin, however, said the unions are unnecessary in that regard. He notes that he is not aware of anyone - consumers, home care companies or even individual workers - who has asked for the ability to unionize.
"Service-level employees aren't easy to come by," he said, noting that home health care workers in his company make between $8.50 and $10 per hour and are often eligible for health insurance and paid leave. "The market demands we do everything we can to offer strong enticement to our company, and then do everything we can to keep that service worker with our company."
Krissi Jimroglou, communications coordinator for Missourians for Quality Home Care, said it's precisely that competition in the service industry that makes the bill necessary. She pointed out that the council also would be charged with other ways to attract and retain workers to home health care, including additional training and recruitment efforts.
"If I'm making $8 an hour, and I have no ability to change the system, I'm going to go get a different job - I'm going to work in retail or fast food," Jimroglou said. "Missouri needs to do a better job of recruiting and retaining these folks."
The issue also could ripple well beyond the health care industry and the business community in general, according to Trey Davis, vice president of governmental affairs for the Missouri Chamber of Commerce and Industry, which opposes Proposition B.
"Where does the slippery slope stop? If they're able to unionize for personal care attendants, why not for other sectors of workers?" Davis said. "Then, what about other parts of the business community around the state? It just opens up a Pandora's box."
MQHC spokeswoman Jimroglou, however, was quick to point out that the bill applies only to a very specific group of workers.
"Proposition B is very clear about the universe of folks that it affects," she said. "It simply gives them the choice to form a union if they vote to do so. We can't speculate on the future."
Melugin, though, is not convinced. He said the proposal is the first step toward widespread unionization in other sectors of the health care and services industry.
"The unions have tried off and on for years to organize in St. Louis, but they've never been able to get enough caregivers to organize there to pull this off," he said. "It underscores the fact that the market-based society has mandated that employers step up and do everything they can if they want to run a successful business to attract and retain quality caregivers."[[In-content Ad]]