PCA Wage Increases & The Caregiver Career – Podcast

Jason Dorow, Podcast Co-Host and Producer: Welcome to another episode of the Champions of Homecare podcast. As most of you already know, on this podcast, we explain homecare service programs, and bring you a lot of the latest news about homecare in Minnesota. Plus, we share community resources, tips and tricks for the many older adults and people of all ages with disabilities in Minnesota.

David Hancox, Podcast Co-Host and Accra Chief Administrative Officer: Yeah, thank you, Jason. Each episode we've brought on someone with unique expertise that can help homecare clients, caregivers, case managers, social workers across the state. Today, I'm sure you'll agree with me Jason, that we have another great conversation lined up. Joining us today is Phillip Cryan who is the Executive Vice President of SEIU Healthcare in Minnesota and Iowa. SEIU, briefly, is the union that unites about 50,000 health care and long term care workers in homecare nursing homes, plus hospitals and clinics throughout Iowa and the land of 10,000 lakes here in Minnesota. Phillip, thanks for joining us today. How you doing?

Phillip Cryan, Executive VP, SEIU Healthcare of Minnesota and Iowa: Doing great, really glad to be here with both of you.

David Hancox: Wonderful. Thanks, Phillip. Also joining us today is Gail Larson, who is an Accra employed caregiver. Gail, how are you doing today?

Gail Larson, Accra-employed Caregiver: Wonderful, thank you.

David Hancox: Wonderful. We are so appreciative of both of you being here with us today. We think this is going to be a really valuable and interesting conversation for our listeners to hear. Philip, why don't you start out by just telling us a little bit about SEIU and what the union seeks to secure for homecare workers in Minnesota?

Phillip Cryan: Absolutely. Again, it's really a pleasure to be with you all. SEIU is a union, a workers organization. We, as David just mentioned, represent healthcare workers in a number of different parts of the industry, in hospitals, clinics, nursing homes. But what brings us here today and what brought us into partnership with Accra for a number of years now is our work with home healthcare workers, PCAs, paid parents, other people who are doing home and community based services. Back in 2013, the Minnesota Legislature changed the laws that govern unionization which workers can form a union and how to extend an opportunity for a huge group of homecare workers who didn't previously have the right to organize a union to do so in 2014. The largest union election by far in the history of Minnesota, was won by thousands of homecare workers just like Gail, and ever since then, we have been bargaining contracts with the state of Minnesota where a group of homecare workers and clients sits on one side of the bargaining table, and representatives of the executive branch of state government sit on the other side of the table. We do this every two years, and we bargain over wages, benefits and working conditions. We've made progress in every one of those agreements, sometimes more, sometimes a lot less than we had hoped for. We've been building and building and as Gail will share, at some point in this conversation here on the podcast today, our newest agreement that just went into effect is really a game changer for homecare workers and the people that they serve.

David Hancox: Well Phillip, thank you, that's a great introduction to the value of SEIU and the opportunities that it brings for direct care workers across the state of Minnesota. I don't know if you recall or not. But years and years ago, in my previous life at my previous employer, I recall you and I sitting down having a conversation about the value of organizing direct care workers before all this organizing took place. But we sat down and talked about the value of it and what kind of support the organization that I was with at the time might provide for that. It was a very stirring conversation. I was very excited about the opportunity that it would bring to direct care workers. That being said, as you also mentioned, every two years in the legislature, you and SEIU engage in that negotiation process. Can you talk a little bit about some of the outcomes of this most recent negotiation that took place during the 2023 legislative session?

PCA Wage Increases & Benefits

Phillip Cryan: I will turn it to one of the members of the bargaining team that fought for and won that great contract, Gail, to answer that.

David Hancox: Oh, great. Gail, please.

Gail Larson: Yes, I did have the pleasure of being on the bargaining team and I enjoyed it. It was a great experience to talk with the people across the table from me and get to this contract. It's so exciting. I got goose pimples, we won so much. First of all, what started in July already of this year, we have a few new holidays added to our list. So we have three new holidays. Juneteenth, Independence Day and Veterans Day, along with the other ones, but the most exciting, January 1 of 2024, we go up to $19 an hour, that is exciting. That's a huge up to 25% from the wage from before. So that is very exciting to help people to have a living wage finally. January 1 of 2025, the wage starts at $20 an hour for new workers. And then we start a wage scale, which that is amazing for people that have more experience, get a higher wage. So that's exciting.

David Hancox: And Gail, if I'm not mistaken, in that tiered or wage scale, as you described it, that tiered basis, there are five different categories of wage opportunities?

Gail Larson: I believe so sorry, I don't know the details of it, I just know that I jumped to the highest right away because I have been a caregiver for so long, I will jump to the top tier right away. I was looking to see if I had the tier and I do not have that in front of me.

David Hancox: I bet Phillip knows that.

Phillip Cryan: All of the information about what's in the collective bargaining agreement, the union contract, can be found on our website, which is SEIUhealthcaremnia.org. Then you look for contracts, and then homecare, and then open up your homecare contract. There are five tiers, and it's based on your cumulative hours worked, dating back to I believe it's 2017. That's just because that's when we have data stretching back to. At different thresholds of hours, your starting wage or your minimum wage under the contract could be anywhere from $20 an hour to $22.50. And again, that's starting January 1 of 2025 after going to $19 an hour January 1, coming up. The other thing I want to add to what Gail mentioned that hopefully a lot of you, this is old news by now we certainly have been reaching out a lot to many of you to make sure you get the news that the $1,000 retention stipends are available and there are plenty of them. This is not a situation where they're going to run out or are at all likely to run out. If you have been working for six months or more as a homecare worker in the PCA Choice Program, CDCS or CSG, then you are eligible for a $1,000 retention stipend. There's information on our website, as well as the Department of Human Services website, and we can also help you guide you through the process to make sure that you get that money that we were able to win as part of this union contract.

PCA Retention Bonus

David Hancox: And Philip, would you stay on that point for just a moment? Because I know that that $1,000 retention bonus is going to be very, very important to a lot of employees at Accra. Could you talk for just a little bit more about how to go about accessing that $1,000 bonus, because it's not paid out by Accra as I understand it?

Phillip Cryan: Correct. This is something we were able to win because the state insisted that they couldn't do a big wage increase, which they agreed to until January 1 of next year. We would have six months of our contract without the ability to get a big wage increase for technical bureaucratic reasons. We eventually realized, well, there's something we could do in the meantime, we could do a bonus to help people in the meantime before the big change of the $19 minimum wage kicks in. We ultimately agreed on a $1,000 retention stipend. Again, you have to have worked for six months in the bargaining unit, the SEIU bargaining unit in order to be eligible, and we can check that for you. The way that you apply, it's through a website that is run by a contractor for the state, and it's the same process that some of you will be familiar with if you have ever gotten the $500 training stipend that also is part of our union contracts, that's been in place for a number of years. It's the same organization and the same website that operates this retention stipend. All you have to do is fill out some kind of basic identifying information about yourself, and then we just have to verify your eligibility that you are in fact a worker in the bargaining unit and you have been so for six months or more. There's a bit of a backlog right now because there are so many people who are applying, but, Gail, what was your experience? How long from when you applied to when you got the check?

Gail Larson: I had a paper check, and it was two weeks.

David Hancox: Oh, that's great.

Phillip Cryan: It might be a bit longer than that because of the backlog right now, but the process itself is pretty smooth.

David Hancox: But again, the application process for that it can be found on the SEIU website?

Phillip Cryan: Yes, if you again, go to the SEIU website, and then look for "homecare" under "contracts", you will see a whole guide to how to apply for this as well as how to apply for that $500 stipend, if you complete a set of voluntary trainings, and not to make it too overwhelming for people, but just the day before yesterday, a $200 stipend, also as part of our union contract just became available. We haven't even gotten the word out yet to folks, we will be texting and calling and emailing everybody about this soon. This is to help to defray any costs that homecare workers might face associated with using the new EVV systems that almost everybody is now using. When the electronic visit verification, or EVV, requirements were announced a couple of years ago, we said, "Well, that's a change to our working conditions so the state of Minnesota has to negotiate with us over that." We had a limited negotiation over that, and part of what came out of it was a $200 stipend, and that is now available through that same website.

David Hancox: Okay, great. One of the things that we have not mentioned, and I think, I'm sorry that we haven't up until this point, but we probably should, is that all of these benefits that we're talking about, the increase in the wage both on January 1 of 24 and 25, the stipends that Philip just described and all that, all of these are available to SEIU members who are employed by choice provider agencies, correct?

Phillip Cryan: Correct. All of the benefits of the contracts apply to anyone who works in the PCA Choice Program, or the Consumer Directed Community Supports (CDCS), or Consumer Support Grant (CSG) program. The traditional PCA program is not covered by the union contract.

David Hancox: Right. I always take a moment to point that out when I'm in conversations with folks, because I think it's a very, very important distinction. That being said, just to kind of drill down a little bit, all of these additional benefits, the rate, the wage increases, the stipends and all that, long overdue, and certainly we endorse here at Accra, the best possible opportunities that we can provide for our PCA coworkers. Gail, maybe you could speak to this little bit. These are significant increases, as we've already acknowledged, going from $15.25 to $19 an hour is significant. How is this going to impact your life as a PCA for you and your family, your coworkers? What kind of an impact is this going to have for you?

Gail Larson: It's going to be great because right now, at the $15.25, I have to find another income to be able to survive. That takes me away from my person that I care for in my home. Being able to get to the higher rate of pay helps that I don't have to go outside the home as much to be able to provide care for my significant other. It's huge because when a person needs you, you have more availability to be there for that person. It's just amazing.

Phillip Cryan: If I could add to that.

David Hancox: Please, yes please.

The Caregiver Career

Phillip Cryan: I remember the long late night that we reached this agreement with the state.

Gail Larson: Early morning.

Phillip Cryan: Back in January of this year, early morning hours, one of the other members of the bargaining team, also a homecare worker, young, 20-something, graduate student in college and dedicated caregiver with multiple clients, just sort of had this moment as we saw the wage scale, both the wage floor increase and then especially the wage scale where there's recognition for developing experience and expertise in this workforce. And, where if you have some of that experience, you might have a wage of $21 or $22, or even $22.50, Where she just said, we were all crying, but she burst into tears, and she said, "You know what? I've been planning to leave my work as a PCA to go to nursing school because I want to have a decent life and be able to buy a house and do all the things that people want to do. It's made me so sad because I love being a PCA and that's what I want to do. And, with this contract, with this wage scale, maybe I won't go to nursing school." Just the relief and the joy that she had in that, at that moment, it was such a radical idea. I'll just tell you, since our union represents workers, again, in all different parts of the healthcare industry, that worker, that PCA, Ellen, was was really onto something when she had that moment, because actually, the starting wages for this work are jumping ahead of the starting wages for CNA, certified nursing assistant and other kinds of somewhat similar sorts of jobs in not just nursing homes, but also in hospitals. It is a form of recognition for the profession of caregiving, that as you said, David is long overdue. This job has been so invisible for so long, and now not only is it visible, it's actually getting the respect and the fair pay that is even better than some equivalent jobs in healthcare that have had unions and have had the ability to win things like this for a long time. We hope that a lot of people start thinking not only about like Ellen did, staying as PCAs, but becoming PCAs.

David Hancox: Right.

Phillip Cryan: Because they're attracted to having a decent wage.

David Hancox: Right. And you know, Phillip...I'm sorry, Gail, please go ahead.

Gail Larson: I was just going to add too that we had a person on the bargaining team, she had a staff person that was going to leave because we weren't getting paid enough. I'm just getting chills just thinking about it, too. We had a person on the bargaining team that was a client and she got her own apartment now because she's able to get PCAs that would be able to be there for her. That was just exciting for me to hear that.

David Hancox: Philip, you mentioned how for so many years, this particular profession, and I use that word purposely, this particular profession was kind of hidden or not viewed with the level of dignity and respect that it should. And yet, one of the arguments that I often make in conversations with legislators and others that are involved in being advocates and allies for people with disabilities like I am, is that PCAs and other direct care professionals really are, without a doubt, the very front line of healthcare in this country. They are with the individual on a daily basis, they know whether that individual is living in a safe environment, they know if that individual has fresh food in the refrigerator or if fresh food is available to them. They know if there are community resources nearby. They know if they're living in a safe environment free from harm. Are they taking their medications? And if they are, are they taking them at full dose? Or are they splitting them to stretch them a little bit? All those social determinants of health that are so critical in the overall larger, more holistic approach to healthcare, the PCA or the direct care professional, is observing those things on a daily basis. They really need to be integrated into this larger healthcare picture in a much greater fashion. I've worked as a PCA myself. I do continue to work as a PCA on occasion even now. I know that it's not always particularly glamorous work, but it is so incredibly rewarding and valuable and as Gail has described, it brings about such incredible impacts in the lives of individuals who are the recipients of those services. To all of our listeners out there, to Gail, I say thank you so very, very much for the dedicated work that you do. Philip, thank you and SEIU for being that that voice and that advocate for individuals who provide these services. Because again, as I just mentioned, it's not always glamorous, but boy, it is so rewarding and it is so incredibly necessary and needed to prevent those unnecessary out of home placements. It's the frontline of health care. It really truly is. And please respond.

Gail Larson: Yes, it is the frontline and David, you have expressed all of that. We are there making sure that they are taking their medications, we do not give them their medications, but we do medication reminders to make sure that they are taking them and we can see that they are. Maybe they don't get out to do their grocery shopping, we do their grocery shopping, or help setting up those doctor's appointments, those medical appointments or any other important appointments for them. So really, we are the frontline.

David Hancox: Yeah, absolutely. Absolutely. Philip, would you add anything to that?

Phillip Cryan: It's just so rewarding to see, after so many years of effort, organizing and just striving to be recognized as people who do really vital frontline work as you were just describing, David, that that is finally being met with the kind of respect and and understanding of the professionalism that it takes and of the value of that professionalism in improving the lives of people with disabilities and seniors who are who are served by PCAs, by homecare workers. It's a great thing to get to be part. It's taken a lot of time, there's been so many people involved, there have been difficult moments and setbacks along the way, but it feels like, when we started organizing this group about 10 years ago, there were a lot of people in state government, state legislators, people like that who didn't even know what a homecare worker was or didn't know what a PCA was. I think those days are over. I think everybody knows what this workforce is, and the importance of it, and we're beginning to win the respect that people have have long since deserved.

David Hancox: If I'm remembering correctly, Phillip, and maybe you can help me with this, but I thought in the past legislative session, I saw a statistic that came out of the Department of Employment and Economic Development, that direct care workers in the state of Minnesota make up the single largest employee group in the state. Am I correct in that?

Phillip Cryan:That's correct. And growing by double digit percentages every year.

David Hancox: I think that is incredibly significant. To Gail's comment, one of my closest personal friends happens to be an individual who experienced a spinal cord injury many, many years ago and has used PCA services to support his independent life for many years. One of his PCAs has been with him for more than 20 years. If that's not a career, I don't know what is. I think that kind of incredible dedication should be applauded, rewarded, acknowledged in so many different ways. One of the ways that we can do that is by paying a decent wage and by offering other benefits like paid time off, acknowledgement of holidays and things like that. I think that is so critically critically important, in addition to acknowledging and rewarding on different levels as well. Again, having worked as a PCA, myself, I know what the work is like. Gail, and all of your colleagues, your coworkers out there, I just want to say from the bottom of my heart, thank you so much for the dedication and support. I have family members who use PCA services as well. It is a life changer for so many people, because at the end of the day, ultimately, what it does is prevents that out of home placement in an unnecessarily segregating and isolating setting where the individual simply doesn't need to be. So again, thank you. The other side of this coin is the reimbursement rate that is paid to providers like Accra. Out of this last legislative session, we also got an increase that corresponds with the wage increase that will go into effect January 1 of 24 and additionally in January 1 of 25, we understand that that reimbursement rate isn't necessarily keeping pace exactly with the increase in the wages and we're dealing with that and Accra has found a way to make that happen. But we will be continuing to work on that and, and we know that SEIU is acknowledging that circumstance as well and supports our efforts to increase that reimbursement rate as well, but I just didn't want the podcast to go without mentioning that as well. But the real focus here obviously is SEIU and the value that it brings to the lives of the individuals who are their members. But also, ultimately, the real beneficiary of all of this is the client, the individual who needs and uses services. Anyway, I just wanted to say that. Philip, please.

Phillip Cryan: Gail said it before, the idea that there are people who are able to make decisions to live in an apartment on their own rather than in a congregated living setting that they didn't want to be in and were experiencing all sorts of frustrations and even traumas specifically because they know that they're able to offer a wage that's going to keep workers able to come and provide them services. That's what these programs are for. We're tremendously proud of the work that we've done to be able to get to that stage and we know there's so much more ahead of us. While we've achieved a decent wage, and a number of other benefits that we've already mentioned, there's no retirement plan. The options for health care for most homecare workers are very challenging to afford, and so many other forms of recognition for this work that are needed. We will be back at the bargaining table with the state at the end of next year, the end of 2024, for our next round, and we actually have an agreement from the current contract that Gail helped to negotiate with the state to start conversations about retirement in advance of our next round of negotiations. We don't know where those will lead exactly, but it's an indication of a shared intention on both sides of the bargaining table to figure something out to establish some kind of means of secure retirement for homecare workers. It'll be a year and a half before we have any news on that, but I just want to give people a picture of, the fight continues, and we know that there's a lot more progress that needs to be made.

David Hancox: Philip, that is fantastic news. Thank you for sharing that here today. I don't know if our listeners are hearing it here first or not, but if if they are, that's fantastic. I hope that you know that Accra will be right there with you supporting those efforts on behalf of the individuals that we count as coworkers here at Accra who provide that direct service. I think that's a wonderful next step, and we look forward to joining you in that in that effort. Thank you for sharing that. Gail, Phillip, any final words before we sign off here on this podcast? Any final thoughts that you want to leave us with?

Gail Larson: We also won orientation. That was huge. We have an orientation plan that is in the works right now that they're working on to talk about when a person becomes a PCA, they will have an orientation. Us that have already been a PCA can also have this because we're still learning as we go along. We continue to learn everything and new things: where to access and how to find out information. But this orientation will give us information about the union, the different programs and everything that they're working on, and then you'll get another bonus for having taking the orientation.

David Hancox: Fantastic. That's great. Philip, could you please remind listeners of where they can find information about this new, current contract? For those that are already members of SEIU that may not be aware of all the benefits that are now available to them as a result of this new contract, but also for folks who might be listening who are not members yet that might be contemplating this.

Phillip Cryan: Absolutely. Our website is SEIUhealthcaremn.org. To find information specific to the homecare contract, go to the "contracts" tab at the top and find "homecare". Also, as David is is mentioning, it's up to you to decide whether you want to be a member of the union and help to make things like we've been talking about during this podcast possible. If you are interested in becoming part of our union family, then you can sign up as a member just on the main page of the website. You don't need to go into the "homecare" section, it's the same membership card wherever you work in healthcare in Minnesota. You can see the information there, you can also reach out to us to talk to one of the staff of the organization if you have any questions. We really do encourage everyone to be a member of the union, to contribute to the next fight, whether that's for retirement or health benefits, or just bringing that wage scale up further, it's really just up to the members. It's a democratic organization. The members decide what we should fight for, how we should fight for it, and then we go to the bargaining table every two years and see what we're able to accomplish with our partners from the state. The last thing I want to say is we really appreciate the opportunity to be here with you all today and to share this good news with homecare workers who are affiliated with Accra. It has really been great over a number of years now to have Accra, and to have you David in particular, representing Accra, as partners in our work at the capitol and everything that we do to move these standards forward for homecare workers. We really appreciate the services that you provide.

David Hancox: Thank you for saying that Philip, I appreciate that very, very much. It's very, very much appreciated. I know that Accra is very genuinely committed to our work with SEIU and moving these issues forward. Again, Gail, Phillip, thank you both so very, very much for being here with us today, for providing information about the new contract for our listeners, and for also for giving information about where they can find more information about SEIU and the benefits of membership. Thank you so very much for both of you for taking time out of your busy schedules to be here with us today and we look forward to continuing our work together.

Gail Larson: Thank you.

Phillip Cryan: Likewise. Thank you.

David Hancox: Thanks, Phillip. Thanks, Gail.

Parent-Spouse PCA Extension Ending

David Hancox: Jason under News and Views, we have an update for parents and spouses who are providing PCA Choice services. We mentioned this news in the last episode, but because the deadline is coming up for parents, spouses, step parents and legal guardians providing PCA services, we thought it was worth mentioning again. As a reminder, the COVID-19-era rule temporarily allowed parents spouses, step parents and legal guardians for children under 18, as well as for their spouses to be paid as PCAs for their family members. The extension of this rule ends on November 11. So, parents and spouses will no longer be able to provide PCA care after that date until the implementation of CFSS. If your family member or your client decides to enroll in another program, such as the Community Cupports Grant (CSG), or the Consumer Directed Community Supports program (CDCS) both of which allow parents and spouses to provide care, you should do so sooner rather than later to ensure the continuity of your care so that it doesn't interrupt or temporarily cease on November 12. If you need more information about this, you can go to the blog on the Accra website at Accrahomecare.org. To learn more. Jason?

National Family Caregivers Month

Jason Dorow: Thanks, David. Really important update for us to get to those PCA parents and spouses. I think we have one other fitting piece of news, a celebration of sorts, that is a great follow-up to our conversation with Philip and Gail. We have this double dose of recognition for caregivers in November. November is National Family Caregiver Month and the week of November 12 through 18 is Homecare Aide Week. So caregivers, thank you for all the hard work that you do to serve your clients and help them live fulfilling, independent lives at home in their community, preventing those out of home placements that you talked about before David. We know this is such a labor of love, but it's also very demanding work too, and it's important we recognize your efforts with the PCA wage increases and also with celebrations like this here in November where all that hard work, all that you've done for older adults, people with disabilities and others throughout the state and beyond to help them live happier lives at home. Thank you to all the caregivers out there.

David Hancox: Absolutely. Thank you for that reminder, Jason. Appreciate that. And listeners, thank you again for tuning in to another episode of our podcast. We hope that you found the interview today with Philip and with Gail to be interesting and informative. I know that I certainly did. I always enjoy my conversations with Philip and it was really really nice to have Gail join us today as well. Jason?

Jason Dorow: With that, we'll sign off. Make sure to follow and review Champions of Homecare on Spotify, Apple Podcasts and watch us on YouTube. See you later, David.

David Hancox: Thanks, Jason. Take care.