Article by Erik Smith. Published on Friday, March 04, 2011 EST.

No Money for Home Care Worker Training, Says Governor, But Plucky Program Plugs Ahead 

SEIU home-care workers rally at the Capitol in January.

By Erik Smith

Staff writer/ Washington State Wire

OLYMPIA, March 4.—In one of the most astonishing survival stories ever, a plucky home-care training program backed by one of the state’s most influential public-employee labor unions seems to be beating the odds in this year’s brutal legislative session.

            The brand-new program, backed by the Service Employees International Union, is steaming full ahead. In the next two-year budget it will cost taxpayers $55 million.

            That’s about the same cost as the state food program for the poor, the state children’s health program, or state stipends for the disabled. Those programs have been proposed for termination this year as lawmakers struggle with a multi-billion-dollar shortfall. But even as programs for the needy and disabled go over the side, the state is launching the union-backed training and certification program right on schedule.

            Its staying power might be the envy of any interest group in Olympia. Last December Gov. Christine Gregoire recommended that the program be put on hold for another three years. “There’s no money,” she explained.

            But lawmakers missed two opportunities to pull the plug when they passed budget bills in December and February. So the program quietly took effect on Jan. 1. Critics say the program is being kept alive while SEIU pushes a “compromise” proposal that keeps the program in place for state-funded home-care workers. Meanwhile, the ramp-up is costing the state $1.1 million a month. And lest anyone think the program is going away, the Department of Social and Health Services sent an email to residential providers Thursday saying that without action by the Legislature the rules will be enforced as written.

            “It’s just absolutely insane,” said Cindi Laws of the Washington State Residential Care Council. “It doesn’t make sense when programs are being cut – really important programs – and yet this one continues. I mean, what is going on?”

            A Big Initiative With No Money Attached

            It all started with an SEIU initiative in 2001 that gave the union the right to organize Washington’s 43,000 state-funded home-care workers, a group that until that point hadn’t been considered full-fledged state employees. Since then a sympathetic Legislature has given the union the right to essentially operate a closed shop, requiring all state-paid workers to join. In 2008 the union succeeded in passing another initiative that imposed stiff new training and certification requirements on everyone in the business.

The state is supposed to pay for workers in its employ. The problem with I-1029 was that it didn’t offer a penny to pay for it, and the presumption was that the money would come from the state’s cash-strapped general fund. Lawmakers solved that problem once already in 2009, with a rare two-thirds vote that temporarily put the program on hold. But they didn’t continue the suspension last year, which is why the program kicked in Jan. 1.

            It’s a big effort – a significant expansion of training requirements already on the books. Anyone hired after Jan. 1 must take a 75-hour training course, and workers who have been in the field longer than that are subject to continuing education requirements. There’s also a state exam and a criminal background check. The Department of Social and Health Services estimates that 25,000 to 30,000 workers will be subject to the basic education requirements each fiscal year. A total 70,000 to 75,000 will be required to take the continuing education courses. The certification requirements kick in 150 days after the law takes effect – meaning June 1.

An Enormous Fiscal Note

Only now is the financial impact becoming clear. Back when the initiative was on the ballot, the Office of Financial Management estimated that the new requirements would cost state government $30 million in the first two years, about $13 million of it from federal Medicaid money.

            But now that estimate has ballooned. A new and more precise “fiscal note” from OFM says that the program will cost the state about $7 million during the first six months and $55 million during the subsequent two-year budget period. Of that $55 million, some $32 million comes from the state general fund and the remainder from the feds.

            Keep in mind that figure reflects only the cost for the home-care workers who are caring for Medicaid-funded patients. The rules also apply to those who care for private-pay patients, through residential homes or agencies, and even to those who advertise their services by tacking up cards at the local Safeway. They have to pay out of their own pocket – an expense estimated at about $1,000 apiece.

            That’s why the private providers have been battling the training program ever since it made the ballot. It’s not as if workers who earn $10 an hour are going to be able to foot the bill. Agencies and homes will have to pay it. And then they’ll have to jack up prices for consumers. It’s also not clear whether there are training courses that can accommodate the demand, and the private providers say the training isn’t suited for their needs in the first place.

            The union’s compromise proposal has yet to surface in a formal way in the Legislature, but the basic idea is that the privates might be exempted for two years while the requirements for the state workers are allowed to remain. It all depends on how the proposal is configured, of course, but it may not save the state a dime. And in a year like this one, critics say they can’t believe the state would consider going through with it. “It’s still a ton of money,” said Leslie Emerick, lobbyist for the Washington Private Duty Association.
             You have to think the state could find a better use for its $32 million, she said.

            Provides a ‘Career Ladder’

            Bills that would put the entire program on hold are making their way through the Legislature, but at a snail’s pace. Senate Bill 5473 and House Bill 1548, introduced at the request of the governor’s office, would delay the program until Jan. 1, 2014. The fiscal note from OFM points out that the longer the Legislature waits to take action, the more it costs. But the bills got their first hearing only last week, a month-and-a-half into this year’s legislative session, suggesting that lawmakers don’t consider suspension an urgent matter – and offering a strong clue that the union proposal, at the very least, is winning favor. Since then no action has been taken.

            The union’s representatives said the training program is essential because it will professionalize the state’s home-care efforts. Glenda Faatofe, a Lacey home care worker and a member of SEIU’s executive board, said workers need a “career pathway” that could lead them to more advanced positions in the medical field. “This is really an important way to keep them in our field,” she said.

            And union lobbyist Misha Werschkul said a further delay raises the question of whether the Legislature ever will allow the new standards to take effect. “It is not just a delay that we’re looking at here,” she said. “It is really a question of whether we ever take the steps to reform our state’s training system.”

            The union is open to other compromise proposals, she said. But SEIU has another card to play. It also could go to the voters again. Last month it was in the field with a poll for a new initiative that not only would re-enact I-1029 but also force the Legislature to restore recent cuts to the number of hours worked by home care workers. The potential price-tag: $100 million.
            Passage would test the Legislature’s willingness to take another two-thirds vote to suspend an initiative.

            Spending Called Unconscionable

            It’s not that anyone seems to question the value of home care workers, state-paid or otherwise. By assisting patients in their own homes or in residential settings with things like toileting and feeding, the state avoids having to pay for far more costly nursing home or institutional care. But at a time when home care worker hours are being cut, many say it’s hard to see how the state can justify spending for classroom training.

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