Harris v. Quinn Is About the Right of Home Care Workers to Improve Their Wages

The Supreme Court is expected to decide Harris v. Quinn, a case of major importance for American workers, in the next few days. Many observers predict a disastrous decision that will cripple union organizing and collective bargaining for home health aides, child care workers, and other direct care aides. But the Court could go much further and threaten the ability of all public employees to form unions and bargain collectively with any state or local government.

The case involves the ability of public employees to bargain for a provision in their contracts (known as an agency fee) requiring every covered worker to pay his or her fair share of the cost of maintaining the union, negotiating a contract, and enforcing its provisions. A majority of states allow such provisions, but so-called right-to-work states do not.

Why is this so important? Wages in most occupations have stagnated or fallen since 2000, even as profits have climbed to historic heights and inequality has worsened. The erosion of the minimum wage, rising CEO pay, and many other factors have played a role, but the decline of unions is near the top in importance. Business and conservative groups have lobbied around the nation to impose right-to-work as a way to weaken unions and keep wages low. It’s a successful strategy: research shows that workers in right-to-work states are paid $1,500 a year less, on average, than employees where unions are free to bargain for agency fees. Negotiating and administering union contracts, organizing employees, and winning elections is expensive, especially when outside groups and politicians mount well-funded opposition campaigns, as recently occurred at Volkswagen in Chattanooga, TN. Right-to-work laws allow employees to get the benefits of union contracts without paying their fair share, drying up a key source of the funds unions need to survive.

No one needs a strong, effective, well-funded union more than home care workers, who have long been at the bottom of the ladder in terms of wages, benefits, and respect at work. Historically, their wages were so low—minimum wage or less—they had nowhere to go but up. And beginning in the 1990’s, when they began to join unions, their wages did go up. Counter to the trend in the rest of the economy, home care worker union membership grew over the last 20 years, creating bargaining power they had never had before. The result has been improved wages, benefits, and working conditions.

Inflation-adjusted wages for direct care aides working outside an agency rose from less than $9.73 an hour in 2002 to $11.09 an hour in 2012—a 14% increase. By way of comparison, from 2000 to 2012, inflation-adjusted hourly wages for the typical worker fell slightly, by 0.1 percent. The difference was the direct care workers’ growing unionization.

Direct care aides working in homes for people who receive reimbursement from the state to pay for the aides’ services had no way to organize a union until state laws were changed to make the state or a specially created agency their “employer of record.” Once the law allowed the home care aides to band together and bargain with a single entity, their voice was heard, their needs were recognized, and state legislators were persuaded to increase the reimbursement for the aides’ services—their wages. They became union members and members of collective bargaining units with contract rights instead of independent contractors whom everyone ignored.

Here is a partial list of the gains that a bad decision in Harris v. Quinn will jeopardize:

Better jobs, better care, and less turnover


15% of the nation’s home care providers are in California. California home care and childcare were minimum-wage industries before SEIU began organizing them in the early 1990s. Before 1995, no in-home supportive service (IHSS) worker was paid more than the state minimum wage and none received health insurance. IHSS is the California agency that pays for in-home care. By 2004, only 8% were still paid only the minimum wage. Roughly 25% earned $2.75 or more over the minimum wage and had access to health, dental, and vision care insurance.

This transformation was accomplished by legislation that authorized the creation of public authorities to be the employer of record for the workers, allowing them to organize unions and bargain collectively. That law was followed by a 1999 law that mandated their creation in every county. Today, including benefits, workers in some counties earn more than $15 an hour, and most counties pay more than $2.50 over the minimum wage.

Turnover plummeted once wages increased. A study of workers in San Francisco County found that retention rates nearly doubled when pay increased from the minimum wage of $6.75 to $10.00 an hour. Turnover in San Francisco is lower than in Los Angeles, where pay is lower and benefit coverage is less. Higher retention rates translate into greater continuity of care for clients, which is an important component of high-quality care.


The union contract under attack in Harris v. Quinn raises wages from $11.55 to $13.00 this year. It requires the state to pay for safety and health training, and to pay for gloves for the home health care workers. The contract also establishes a labor-management committee and a grievance procedure.


In Washington State the pre-collective bargaining pay rate was less than $8.00 an hour for independent home care providers. The latest union contract raises wages up to $14.34 an hour, plus $2.60 an hour for health insurance. Aides are paid while engaged in training, and wage increases come with successful completion of additional training.

A study commissioned by the Washington State Homecare Quality Council and funded by the Centers for Medicare and Medicaid Services found that (union-negotiated) improvements in wages, health-benefit access, and paid leave, and the implementation of a referral registry system, resulted in several statistically significant beneficial outcomes for consumers. Between 2004 and 2006, turnover declined by 26 percent, and the percentage of workers leaving the industry declined from 10.4 percent to 8.9 percent.


The first union contract in Massachusetts provided an increase for personal care attendants from the pre-unionization hourly wage of $10.84 to $11.60 in July 2008, $12.00 in July 2009, and $12.48 in July 2010.

Unionized homecare workers get better training

Greater training and professionalization—for instance, through credentialing—improves the quality of services to consumers, improves economic mobility for home care workers, and improves retention. The State of Washington has become a leader in the field of homecare worker training and professionalization, in large part because of the efforts of SEIU, the union that represents homecare independent providers paid by the state.

Unions improve benefits even more than they improve wages

The Center for Economic and Policy Research looked at 15 low-wage jobs, including home care workers, home health aides, and child care workers, and found unionization raised workers’ wages by just over 16 percent—about $1.75 per hour—compared to those of non-union workers. The union impact on health-insurance and pension coverage was even bigger. Union workers were 25 percentage points more likely to have employer-provided health insurance and 25 percentage points more likely to be in an employer-provided pension than similar non-union workers in the same low-wage occupations.