What 30 Rock Tells Us About Home Health Workers

WomansWork_30Rock_Elisa

On television and in real life, home health aides are an underpaid, overworked, and invisible workforce. Like Elisa (Salma Hayek) on season three of 30 Rock, they feed, bathe, cook, and clean for the nation's elderly folks and people with disabilities in their homes. Yet these workers struggle to make ends meet; on average, they make less than $10 an hour. They receive no overtime pay, and their work can often be physically demanding. Moreover, home health aides work in private residences where their labor receives little oversight and where they lack a support network to help them advocate for better compensation. And these injustices to home health aides matter now more than ever because—guess what?—with a growing elderly population, it's the fastest growing occupation in the U.S. So while Elisa's plight is played for laughs against Jack's one-percenter lifestyle, the sitcom offers a surprisingly frank glimpse of an undervalued workforce, one that's comprised overwhelmingly of women and women of color—and one that hides in plain sight in homes all across America.

On 30 Rock, Jack (Alec Baldwin) falls for his mother's nurse and home health aide Elisa. The problem is, she's a working class Puerto Rican gal with two jobs, and he's a privileged, white male executive who expects his girlfriend to be at his beck and call. Elisa does demanding work taking care of the ailing (and tart-tongued) Colleen Donaghy (Elaine Stritch). So how can Elisa possibly say yes to dinner at Jack's place when his home is one of her workplaces? Fair enough, Jack thinks. How about dinner and a show? "Are you kidding me? I'd love to go out, get all dressed up, tip maître d's and be all like, 'Thank you, Roger. This table was super duper!'" she says. But in order to make enough money to get by, she's stuck taking care of her other client as well, the dementia-addled Mr. Templeton. "Why can't I have fun like an upper middle class person?" she wonders aloud. So Jack decides to treat both Elisa and her senile patient Mr. Templeton to a great night, including a Broadway show and a fancy restaurant.

WomansWork_30Rock_ElisaAndJackBroadly speaking, 30 Rock kind of nails it. Of the two million home health workers in the U.S., 95 percent are female and only about half are white, reports the CDC. Marisa Penaloza of NPR says that the high demand for labor attracts immigrants to the job, and about one in four home health aides are foreign born. Moreover, Elisa's struggle to pay the bills is not uncommon; Jennifer Ludden of NPR says, "About half of home care workers are in households so poor they themselves rely on public benefits, like food stamps and Medicaid." And it's not surprising that Hayek's character feels so frustrated by work that she starts to push Jack away. Milly Silva, the Executive Vice President of the New Jersey division of 1199/SEIU United Healthcare Workers East said the following in a New York Times roundtable last week:

I think that [home health aides'] day to day work experience can in some ways be an isolating one. If you are a home care worker and you are going to someone's home to provide care for someone who's in need, you really are there one on one with that person. So who are the people who can listen [to you]? Who's your sounding board? Who can you vent to in terms of what you're experiencing on a day to day basis, both in terms of your job and also just being able to get by day to day?

To be sure, not all personal care aides are necessarily disenfranchised. Workers with additional qualifications may potentially earn more than the average hourly wages. And women who seek part-time work might be drawn to home health care; depending on your clients and whether you work independently or through an agency, the hours can be flexible. But for workers who have have been scraping by on poverty wages, this struggle is an urgent one.

So how has this sector gone underpaid and overworked for so long? Shockingly, it's because the Fair Labor Standards Act, which guarantees workers a minimum wage and overtime pay, excludes caregivers including personal care aides and babysitters. That is, the women who comprise this workforce have been ignored for decades. Their physical and emotional labor provides vital support for patients in need across the nation—but our institutionally sexist and racist job market favors cognitive labor, the kind of work to which privileged, white men like Jack have had outsize access.

But the disenfranchisement of home health aides may soon change. Bryce Covert says in The American Prospect, "As of 2011, the National Employment Law Project found that 15 states gave these occupations minimum wage and overtime protection, and seven more guaranteed only minimum wages." Moreover, "The White House appears to be close to announcing a rule change to the Federal Labor Standards Act, finally including home health aides." If and when that happens, this previously invisible workforce can then be eligible for the increased minimum wage that Obama announced in last week's State of the Union address.

So for Elisa and the two million or so underpaid and overworked home health workers like her, change is in the air. And if and when it happens, it won't be a (satirical) Cinderella story like on 30 Rock. It will be a hard–won success in a fraught labor rights battle that has to do with gender, race, and class—a battle that's not often shown on TV but rages on in real life.

 

Read more of this guest blog Women's Work, which explores TV portrayals of young women in the workforce.

Comments

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meh, I thought it was a

meh, I thought it was a pretty stereotypical depiction of a Latina. Furthermore, whenever she spoke Spanish she didn't even change her accent (Hayek is Mexican but Elisa is Puerto Rican) thus supporting the notion that all Hispanics are the same, that there are no meaningful differences between countries. The status of a Puerto Rican in the U.S. is very different from that of other immigrants.

Before you change the law, show us the money!

I am writing this as a homecare worker of 36 years, not for any homecare agency.
The President has ordered changes to the Fair Labor Standards Act (FLSA)to Domestic Service which, if put into effect, will seriously reduce the take-home pay of countless numbers of homecare workers such as I and make the lives of the people with disabilities we assist less manageable and expensive.
The changes would require the payment of minimum wage to homecare workers and mandate that homecare workers must receive time and a half pay for every hour over 40 hours per week of work done. Medicaid would bear most of the burden.
This sounds like it would be a major victory for me and my fellow homecare workers, right? But there's one big problem: where is the money to pay for this? If the law says we can't work without minimum wage or time and a half pay but the money's not there, then we won't be allowed to work those hours! Home care agencies will simply divide up the hours between more workers.
That means, instead of increasing our take-home pay, the proposal will slash all hours beyond 40 per week of our pay. For me, that's 416 hours and $4,742.40 per year I will lose.
My fellow workers who currently put in 84 hours per week will suffer a 44 hour loss -- over half their pay!
Healthcare insurance will also be more precarious since it's based on the number of hours worked.
In fact, home care agencies, to make sure they don't have to pay overtime, will likely split workers' hour in half and hire someone else to work the other half. I would be reduced from working 48 hours per week to just 24 and make healthcare even harder to get!
As a result, many workers will be forced to seek out second or third jobs to make up the loss.
And, for the people we assist, their lives will be harder. They will likely bear the cost, through higher co-pays, of any over time that's paid. And they will either endure a reduction in homecare hours or will have to deal with more workers. That means more poorly paid people in their homes with even less incentive to do a good job. Care receivers who can't afford the higher co-pays will be forced to hire nonprofessionals or ask family members to quit their jobs to stay at home and assist them. Many people with disabilities have a hard enough time right now managing their assistants. The added strain will cause many to just give up and move into nursing homes.
Who benefits from this proposal? Certainly the nursing home industry. Also the homecare unions which will receive more dues-paying members even as all the members' average standard-of-living declines. Even the most poorly-paid worker in a closed shop is required to turn over at least $25.10 per month in union dues. That's a windfall for union coffers even as the average standard of living of the workers plummets. And the politicians supporting this change can say they created more jobs even though the jobs pay little better than lemonade stands.
What can we do? We can demand that, before this proposal is put into effect, funding for it be allocated and in place to begin payment immediately. Finding this money won't be easy. The federal government is 16 trillion dollars in debt (that's $16,000,000,000,000: a lot of zeros!) The states and municipalities aren't doing much better. But, until we are shown the money, this proposal is nothing but a shell game which promises a reward but leaves us worse off than before.
Please, my brothers and sisters, before too many of you fall for this pie-in-the-sky scheme, we must see the money.
Right now the rule change is before the White House Office of Management and budget. Common sense would tell them not to release the rule change which would allow it to take effect. But politics may prevail ahead of common sense. Contact the White House: 202-456-1111. Tell them, before they end the minimum wage and overtime exemption, first SHOW US THE MONEY!

Home Health Care Aides

In terms of the description of the work Home Health Care Aides do, this article is pretty spot on, but you haven't done enough research about HOW these workers get paid. Many work over 40 hours a week to eek out enough money to survive and in many cases, if there is overtime it is only time-and-a-half of minimum wage, not their actual hourly rate.

But you're missing an important point. Almost every one works through some kind of agency. There are for-profit & non-profit. Both types of agencies get reimbursed by Medicaid (or the government in some fashion). What the unions will not talk about is if you force these agencies to increase the amount of money the aides get, the agencies will just cap their hours. Now, the aides will not even have the OPTION to work more to make more money. They will LOSE money.

These "glorious" rules that the unions are pushing does not come with an increase in Medicaid reimbursements. This will actually HURT home health care aides.

What the unions also won't discuss, is what will happen to the people who need aides in order to live in the community independently. Many of these aides are like family to those they care for. When the aides' hours are capped, there will have to be new people brought into an individual's house to cover all of the hours. New aides who will help people bathe, go to the bathroom, etc.

We talk about women having control over their own bodies, yet in this instance they lose control over who gets to see them naked. No one's standing up for them, though.

So feel free to ask Milly Silva why the unions won't push for increased funding for the increase in wages, because if this comes to fruition, it will not have the effect they say it will.

As a home-aid worker, I found

As a home-aid worker, I found 30 Rock's depiction fairly spot on, or rather, I found Jack's dismissal of it spot on. The hours are long, the wages are ridiculous, and no one seems to get (just like Jack doesn't get) how much work it is, both emotionally and physically, all the time. The main problem I have is how subjective pay is: my male co-worker makes 15 dollars an hour because his job is "harder", whereas there's an un-examined sexist assumption that my caring work is easier and "natural". Blerg.

HHA's Need to Organize

Didn't see the 30 Rock episode, but I've thought a lot about this issue since my father's illness and death in 2005. After electing not to treat his cancer (he was 86), he was able to get "home hospice" services. Like most elderly in the US who have insurance, he had "managed care." He was encouraged to have an HHA in the house to help with daily tasks. He and my mother reluctantly agreed. This is all arranged through the hospice services which are part of a bigger hospital affiliated health service. Several HHA's were sent. Some my parents had "issues" with, including theft. One finally "stuck." Rosa, she was great. Mostly though she just listened to my mother who seemed sometimes to be having a harder time than my dad. Because she wasn't getting much more than minimum wage, we started supplementing what she was being paid. More time passed before my father finally began to weaken and seriously decline. I contacted the hospice RN and social worker about having Rosa there for more than the 20 hours a week. They refused, despite the fact that my mother was frail and couldn't care for him, and my sister and I were already there as much as we could be. At one point the nurse said, "If he needs that much help, maybe he should be in the hospital." This was insane. The whole point of home hospice was to allow him to die at home. Although my parents wouldn't have wound up paying more with insurance, a hospital stay or institutional hospice would have been much more expensive. Rosa told her agency she couldn't work more than her 20 hours, and we paid her to be there more hours.. She brought in her sister-in-law, who wasn't certified, but did an excellent job. During the last couple of weekends, they even brought in another relative. My father needed help going to the bathroom. Weak as he was, he wanted that. He didn't want a hospital bed, so he needed someone by his bedside to make sure he didn't fall off. My mother was having problems being with him at the end. Someone needed to sit with him, but also to pay attention to her.

We were lucky to have had the resources to pay these workers. They were lucky to have found a family willing to pay them a decent wage.

These women were more important to us during those final weeks than any nurse, doctor or social worker. They deserve to be paid more. The agencies that manage them bill more than 3 times the hourly wage that the workers receive. So many people get a cut. Granted this is the most "entry-level' of entry-level work, but there must be some way to professionalize this, so that workers can get more of the hourly reimbursement for their labor.

Why can't I have fun like an

Why can't I have fun like an upper middle class person?" she wonders aloud. So Jack decides to treat both Elisa and her senile patient Mr. Templeton to a great night, including a Broadway show and a fancy restaurant garcinia cambogia extract