The Future of Care in America: An Opportunity at the Intersection of Immigrant and Workers' Rights

By Laphonza Butler and Ai-jen Poo

Source: National Domestic Workers Alliance

As the baby-boomer generation reaches retirement age, a major shift is taking place in the U.S. In order to live out their golden years with dignity, seniors need long-term care. The work of caring for them presents an important social and economic opportunity at the intersection of immigrant and workers' rights.

The number of people with long-term care needs will double over the next several decades, from thirteen million in 2000 to twenty-seven million in 2050. This demographic shift, in which baby boomers expand the senior population, is sometimes known as the Age Wave.

At the same time, the current long-term care workforce numbers only around three million. This number includes domestic workers, who work within a household providing housekeeping and general family care, and home health care workers, who provide essential health-related support in the home.

Basic math shows us that there is a large gap between the amount of care that will be needed and the number of workers available to provide that care. From one perspective, the growing gap could present a social crisis of immense proportions, a “care crisis.” However, there also is a glass-half-full perspective: this moment could lead to the creation of millions of dignified and family-sustaining caregiving jobs.

Home care workers do some of the most vital and intimate work in our nation. They help to ensure that our parents, our elders, and our loved ones with disabilities receive the support they need in order to live safely and independently at home. Yet, currently, many care providers are forced to work under strenuous and often exploitative conditions, and are among the most vulnerable workers in the workforce today.

In addition, care work remains one of the few professions available to immigrant women. Approximately two-thirds of nannies, housekeepers, and caregivers for the elderly are foreign-born. About half of them are undocumented, which makes them particularly at risk to exploitation and abuse. A 2012 study found that 85 percent of undocumented domestic workers who work in substandard conditions do not complain because they fear their immigration status will be used against them.

Take, for example, Thelma, a Filipina live-in caregiver for an older couple in Los Angeles who works for $35 per day. The fundamental labor laws that other workers take for granted have consistently excluded domestic workers by consigning them to the exempt category of “companions,” leaving workers like Thelma with little bargaining power. Thelma is stuck at the bottom of the social ladder with little hope of improving her options or earning a living wage. If she asks for a raise or a sick day, she risks losing her job. She works without basic protections, like the right to meal breaks or uninterrupted sleep time.

Turnover and burnout are common within the care workforce, further compounded by the strains and insecurities that come along with an undocumented status. When a caregiver has to leave a family for whom she is providing care, the results can be catastrophic for everyone involved.

As the elder population explodes, more and more workers like Thelma will be called upon to fill the need for home-based care. However, unless we recognize the essential nature of their work, this social crisis will only get worse.

Source: National Domestic Workers Alliance

In California, there are more than 350,000 home care workers who provide care to low-income seniors and people with disabilities through the state's In-Home Supportive Services (IHSS) program. An additional 100,000 provide care through private agencies or referral services, or begin by simply answering an ad. An estimated 200,000 mostly immigrant workers work as domestic workers, as nannies, housekeepers, and caregivers for the elderly.

Although these workers have made great strides in organizing over the last 10 years, they continue to struggle to achieve the respect they deserve, and the wages and benefits that would stabilize their workforce by reducing its high turnover rate. In addition to low wages, workers who provide care through the IHSS program repeatedly have had to fight proposed state budget cuts that would result in even lower wages or reduced hours. Thus far, they have been successful in staving off cuts, but they continue to struggle financially, unable to cover basic expenses such as rent, utilities, and food for their families.

The impending Age Wave offers a unique opportunity to accomplish two important goals: to transform care jobs into quality jobs with real pathways to economic opportunity, and to create a more sustainable system of care for those who need it. To reach these goals, we need a comprehensive approach to policy change driven by strong leadership. California is well positioned to lead the way in that effort. As one quarter of the 11 million undocumented people in this nation live in California, there is no question that change must start here. By recognizing the importance of all domestic work, including care work, California can go a long way toward establishing basic protections for some of the most disenfranchised workers in the state.

Source: National Domestic Workers Alliance

With the renewed interest within the Obama Administration and Congress for creating a path to citizenship for undocumented immigrants, we can transform the lives of this predominantly immigrant workforce in California and the lives of millions of families who rely on them to provide love and care as nannies, caregivers, and home care workers. We need to reject “us” versus “them” approaches to immigration and labor policy, and instead support integration and opportunity for everyone.

When we talk about caregiving, there really is no “us” or “them.” There are only the needs of our families, and of those who help us meet those needs. The care industry points to ways we all are already deeply interdependent as a nation, both economically and personally.

California has been at the center of many of the demographic and economic shifts that have defined our history. We can draw on these experiences and lead the rest of the nation by promoting a twenty-first century vision for immigration and labor policy. In doing so, we will avoid a potentially dangerous “care crisis,” while providing care workers and their families with a road to real economic opportunity.

Laphonza Butler is the President of SEIU ULTCW, the United Long Term Care Workers' Union. Ai-jen Poo is director of the National Domestic Workers Alliance.

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