Will family caregivers hoping to be paid with money from WA Cares be required to pay some of their income to a union to have the job? Not necessarily is the short answer — but it’s complicated.
For years, “stay tuned” has been the answer to this question for those following the issue. So when I saw that two of the WA Cares Fund webinars being promoted were titled “What Providers Need to Know” and “Spotlight on Paid Family Caregiving with WA Cares,” I tuned in anxiously. But what some providers need to know was not supplied.
Instead, caregivers were directed to register with home-care agencies — some that require union participation — or with the Consumer Direct Care Network of Washington (CDWA). That network is linked to Service Employees International Union (SEIU 775) and operates under a statewide collective-bargaining agreement representing all individual providers (IPs). Those IPs are subject to dues or fee deductions.
I’ve now learned from a community-relations and outreach program manager for WA Cares that family caregivers will eventually have a non-union option. Again, stay tuned.
That’s good — and as it should be. Caring for your aging husband or father and taking advantage of the WA Cares program he has paid into during his working years should not require you to pay a union a portion of the money you receive. But without this information about a non-union option, some might assume union participation is mandatory and enroll unnecessarily.
The two options for family members to either work for CDWA or a home-care agency are part of the original statute that created WA Cares (RCW 50B.04). A third option — one for family caregivers — has been recommended by the Long-Term Services and Supports (LTSS) Trust Commission. Rulemaking for this third option is not expected until the program is underway.
I was told by the Washington state Department of Social and Health Services, “We are still working to develop a third option for paying family caregivers. We will be collecting data on what family members need as we start providing benefits to determine a path forward for the third option design.”
Until that process is completed, every webinar, flyer and webpage talking about how to become a WA Cares provider needs to include this information.
Helping Washingtonians with long-term care — or helping unions?
WA Cares Fund providers will not be considered state employees but private employees of CDWA or a registered home-care agency, even though caregivers will be paid with state-collected money. This structure allows the state to treat the workers as private employees rather than public ones, thereby sidestepping the U.S. Supreme Court's Janus ruling that bars mandatory public-sector union fees.
This is one of the reasons Washington Policy Center has been concerned with WA Cares since its inception: Its design seemed to be more about expanding unionized caregiving under SEIU 775 than it did helping Washingtonians with long-term care (LTC) or even limiting state Medicaid costs. In fact, people with both financial and LTC needs are already eligible for a safety net through Medicaid. They could receive taxpayer help without having to give away 58 cents for every $100 earned during their working years via a payroll tax. Oftentimes, people with needs other than long-term care will have a portion of their wages taken and redirected to LTC benefits for individuals with higher incomes and more resources — who are not in need of taxpayer dependency. This is WA Cares at its worst.
WA Cares' lifetime benefit of $36,500 will not be enough to cover what most LTC patients need. When eligible recipients exhaust that benefit, if they haven’t saved independently, they’ll turn to Medicaid anyway. That means the program could end up adding pressure to the Medicaid budget rather than relieving it.
Taxpayers would have been better off if lawmakers were preparing for the coming silver tsunami with reforms to Medicaid that target help to taxpayers in true need. See more about possible reforms to better protect vulnerable populations and taxpayers in my policy paper, “Strengthening a safety net requires reforms to long-term care through Medicaid.”
As WA Cares recruits caregivers — including family and non-family providers — SEIU 775 will be adding to its ranks. The union boasts that it is the largest health-care union in North America with more than 1.1 million members. It can also boast significant influence in Washington’s political landscape.
On Oct. 29, 2024, the Washington State Standard wrote of the 2024 campaign cycle, “By far the largest donor this cycle is SEIU 775, the caregivers union that’s all in on the campaign against the long-term care initiative. To date, the union and its various branches have spent nearly $18 million this year.”
WA Cares' administrators need to finalize the third option and offer future family caregivers clear, accessible information. Right now, it’s looking like they want these family providers to be left in the dark.
