The State’s Largest Union Wants to Assist Caregivers—and Grow Its Own Ranks

Service Employees International Union unveiled an audacious strategy Feb. 27 in the form of a bill that would shift the balance of power in an industry that provides care for some of Oregon’s most vulnerable citizens.

The state’s largest public-sector union, SEIU represents 72,000 workers and spends millions every election cycle to support Democratic candidates. On Feb. 27, leading Democratic lawmakers introduced a bill on SEIU’s behalf that the union calls a “top priority.”

Senate Bill 1138 would create a board to oversee working conditions in the direct care industry and give that board extraordinary authority. The board, appointed by the governor and led by an executive director, would set pay and staffing standards for the roughly 60,000 people who provide care to seniors and developmentally disabled Oregonians. Nearly all the pay for those workers comes from Medicaid money, a mix of federal and state dollars allocated by the Legislature.

Unlike most of the state’s more than 250 boards and commissions, the new board would have real teeth, including the authority to make workplace rules—and to subpoena records from nursing and group homes, to depose management under oath, and to sue if employers violate board rules.

As an example of SEIU’s clout with the Democratic supermajorities it helped get elected to the Legislature, SB 1138’s sponsors include Senate President Rob Wagner (D-Lake Oswego) and House Speaker Julie Fahey (D-Eugene), along with their respective majority leaders. That means it has an excellent chance of passing.

Felisa Hagins, executive director of SEIU’s state council, says SB 1138 is the logical extension of a quest the union embarked on with a 2000 ballot measure that allowed home health care workers to organize.

“When we look at the federal government, we see no path to change for this workforce,” Hagins says. “So it’s up to the states to change the dynamics for these workers.”

As the Oregon Journalism Project has reported (“Mr. Big,” Jan. 22), private agencies, led by a Grants Pass company called Rever Grand, have carved out a large niche, paying people to take care of family members with developmental disabilities. Those private agencies pay more than SEIU-represented state jobs and are siphoning workers away from the union. The Oregon Department of Justice indicted Rever Grand for Medicaid fraud last year, however, casting a shadow over the company’s business model. Rever Grand has denied wrongdoing, but it and other private agencies would likely suffer from SEIU’s bill.

The union imagines a twofold benefit from the proposed legislation: improving the lot of a critical workforce and expanding SEIU’s membership and, by extension, its influence.

SEIU and care industry employers may be in an escalating power struggle, but they agree on a couple of things: The demand for service is growing rapidly, and it would be great if workers got paid more. But Phil Bentley, CEO of the Oregon Health Care Association, which represents long-term care providers, says SEIU’s bill is a vast overreach.

“This board is simply not needed,” Bentley says. “Everything it proposes to address can be done by the Legislature today. Oregon has some of the strongest staffing and regulatory standards in the country, and some of the highest caregiver wages.”

SEIU disagrees with Bentley’s assessment. The union points to what it says are high rates of abuse, neglect and licensing violations in Oregon community-based care facilities.

The bill comes at a time when Medicaid funding is under a microscope in Washington, D.C., and after union membership nationally hit a historic low last year of 9.9%.

Oregon also faces what some have called a “silver tsunami.” Between 2020 and 2045, Portland State University’s Population Research Center says, the number of Oregonians over 75 will more than double, increasing at 32 times the rate of Oregonians aged under 24.

Both the union and service providers see that demographic wave coming, but they disagree on how best to meet it. The real question for lawmakers is how any change will affect conditions for people who cannot help themselves.

Hagins says workers such as Kyra Carl, 23, who works in a Polk County assisted living facility, are typical of the industry. Carl (who declined to identify her employer because she’s not authorized to speak to the press) earns $18.03 an hour delivering medications and helping residents get dressed, eat and go to the toilet. She likes the work but says chronic staffing shortages make it challenging.

“One day it was just me taking care of 60 residents for a few hours,” Carl says.

Hagins says the emotionally and often physically grueling work of taking care of seniors and people with disabilities has long been undervalued. The work is often the province of women and recent immigrants who work individually or in small group settings, she adds, which lessens workers’ ability to seek better conditions. Turnover is high—51%, according to figures SEIU got from the state.

“Our perspective on this bill is, fundamentally, how do you change an industry as a whole?” Hagins says. “How do you change the standards around the workforce across the industry in a very big way?”

In recent weeks, Bentley and his peers who provide care for developmentally disabled Oregonians met with SEIU and key lawmakers ahead of the bill’s release. Hagins calls the meetings “contentious,” while Bentley says he concluded from the meetings that the bill could be a disaster.

“This board will have the power to impose new mandates that could substantially increase the cost of care. But there is no explanation of how the costs of the new mandates will be paid for,” Bentley says, adding, “Medicaid rates are too low to cover the cost of care today.”

He says the legislation puts a cash-strapped industry at risk, citing as an example Haven House Retirement Center in Fossil.

“Haven House is a small nonprofit that is struggling to keep pace with the rising costs of care,” Bentley says. “Rural Oregon has experienced several assisted living closures in the past few years, and others are teetering.”

Hagins says the goal is not to harm employers but to increase the Medicaid funding that pays most of the workers’ salaries.

“The board would have to go back and get those wages funded by the Legislature,” she says.

The reality for most direct care workers, Hagins notes, is poverty: Nearly half of workers nationally rely on some form of public assistance. In Oregon, the state Employment Department pegged 2023 wages at $17.93 an hour for home health and personal care aides and $21.58 for nursing assistants, orderlies, and psychiatric aides.

(By contrast, Rever Grand currently offers direct service providers $24 an hour to start, with overtime at $36 an hour, according to its website. The feds match state contributions 2 to 1, which extends a lifeline to family members who not long ago provided care for free.)

In addition to raising compensation, the new board, Hagins says, would hold employers accountable in a way that state agencies, including the Oregon Bureau of Labor & Industries and the Department of Human Services, do not.

“The state hasn’t funded a level of enforcement and auditing that actually goes through and holds these facilities accountable,” Hagins says. “The Workforce Standards Board is designed to create a space where workers can come together and make improvements.”

As an example of why the industry needs more regulation, she points to the example of Rever Grand’s indictment.

To give the board teeth, SEIU proposes empowering it to subpoena records from employers, depose managers under oath and, if necessary, sue them for violations of rules the new board makes. Hagins concedes that’s far more power than most state boards have.

Marci Kallinger, director of the Ron Wilson Center for Effective Living, a group home in Monmouth, says such authority would be excessive.

“This board is bureaucracy on top of bureaucracy, with no discernible benefit to the people we serve or our staff,” Kallinger says.

One group that would likely benefit, in addition to workers, is SEIU itself.

SB 1138 includes a section, for example, about worker training, saying “the board would also delegate professional training to a ‘worker organization’ and it would be able to compel employers to turn over all workers’ telephone numbers, home addresses, personal mailing addresses to ‘worker organizations.’”

Opponents of the legislation say that language effectively delegates training to SEIU and gives the union extraordinary access—through home addresses and personal phone numbers—that would be helpful in a union organizing drive for workers at Rever Grand and other agencies.

SEIU already represents about 30,000 home health care workers in Oregon. That total includes about half of the workers who would be governed by the new board. Hagins acknowledges that her union would do well by doing good.

“My goal at SEIU is to always grow our union and ensure more workers have a voice on the job,” she says.

Through a spokesperson, Gov. Tina Kotek declined to comment on the bill. It gets a first hearing March 17.

This story was produced by the Oregon Journalism Project, a nonprofit newsroom covering rural Oregon.