The Reveal News Story - Not the Whole Story

Reveal News Story - Not the Whole Story

You've probably seen the Reveal articles on RCFE worker exploitation:  "Elder care homes rake in profits as legions of workers earn a pittance for long hours of care.  It appeared in The Washington PostThe New York Times, and U.S. News and World Report.

And in case you missed it, “The uncounted costs of elder care” podcast aired the week of May 21st, 2019 on Reveal. It ran on 450+ public radio stations across the country, soon to be followed by a piece for PBS NewsHour.  The investigative reporter, Jen Gollan, contacted CARR over the last few months for background and details to make sure she was getting the content right. 

After reading her expose, CARR recognized there was much unsaid.  This commentary is intended to level the playing field for consumers and policymakers, to give recognition to the broader issues at play and the assisted living facilities who are playing by the rules.

But first, let’s talk solutions to protect caregivers’ rights.

Proposed Legislation

Gollan reports, "Currently, there is no requirement that care-home operators undergo any training around wage and hour laws."  A caregiver says, “But we were helpless. We didn’t know our rights. How could we leave?”

CARR, with Golden Gate Law (GGL) School’s Associate Professor of Law and Director of the Women’s Employment Rights Clinic, Hina Shah, has been pressing for legislation that would improve caregiver rights.  In 2018, we proposed legislation mandating training on worker’s rights and employment law for both RCFE employees and facility owners to members of the Assembly Committee on Aging and Long-Term Care but received no interest. 

Our proposal, CaRE: Caregivers’ RCFE Employment Law Act, would require:

  • 3 hours of mandatory training for licensees, owners, and administrators on state and federal employment law, wage law and compliance, employee classifications, Workers’ Compensation Insurance, payroll taxes, and whistleblower protections.
  • 1-hour mandatory training for caregivers on employment law minimum wage, overtime, sick leave, working conditions, sleep deductions, time cards, and whistleblower protections.

This legislation is easy to implement, cost-effective, and improves the plight of caregivers (education is power). This proposal would also assist California’s Department of Labor’s Wage and Hour Division and local District Attorney offices in their outreach to RCFE caregivers on this matter.

Small, Board and Cares are Different than Large, Senior Communities

The article says that “California leads the nation with more than 7,300 residential care facilities licensed by the state.”  This figure, 7,300, includes corporate chains like Brookdale, Sunrise, etc.  These chains are senior, resort-style communities that are licensed exactly the same as small board and cares. They are all, in the eyes of statute, considered “residential care facilities for the elderly,” whether the physical structure is a converted house or part of a senior community campus.

Only Small Operators are Profit-Driven

Gollan’s narrative suggests the “dark side” and “exploitation” documented by her reporting are “rampant” in the 6-bed segment of the industry.  It is a disservice to the industry to suggest that greed and worker exploitation is limited to smaller homes.  Aside from cases of human trafficking involving small facilities, greed extends to large operations too. Here are examples based on the REVEAL’s references:

  • The shell company strategy and applying for a new license to evade accountability is routinely used by large, corporate entities.
  • From a resident’s point of view, one staff for six residents is just as alarming as 2 staff for 100 residents.  The “no staffing ratio” requirement and “skeleton crew” approach is used by both large and small operations to save money and is made possible by vague statutes, and weak Title 22 regulations.
  • The YouTube opportunist advertising small facilities as a money-making opportunity is no different from the Real Estate Investment Trusts (REIT) sites touting large potential profits to corporate investors. 

The Assisted Living Industry Engages in Illegal Activities

Within every industry, there are good and bad actors.  Families absolutely should be asking about worker’s rights, employee empowerment, and training programs in any facility they choose.  But, the many smaller facilities statewide who are leading the way in caregiver rights, empowerment, and fair wages, were neither mentioned nor distinguished from the bad actors.  The reportage created the perception that the entire small-facility segment of the industry is shady. It is not.

What is True & Why You Should Care

The entire industry operates within a society that grossly undervalues caregiving in any form—from childcare to senior care, formal and informal.  But in senior care, the combination of underpaid and overworked is real and detrimental to residents.  Obvious worker exploitation manifests as low-to-slave wages, no breaks or time off, sleep deprivation, and sub-standard living conditions.  It also manifests more subtlety as not investing in meaningful training; not purchasing the tools needed for caregivers to deliver safe, quality care; not creating a pathway for professional development or career advancement; not encouraging engagement or boosting morale. 

Caregivers are the backbone of the senior care industry.  They are consistently shown to be the single most effective predictor of resident health and safety.  When caregivers suffer from overwork, burnout, or feeling trapped, the older adults who rely on them are impacted as well - by an elevated risk of abuse, neglect, errors, or general mistreatment. 

What You Can Do To Help

Something must be done to ensure caregivers’ basic rights, and to protect them from the bad actors.  CARR’s legislative proposal is ready to go.  It makes worker’s rights part of the industry’s mandatory training requirements.  If you know a legislator willing to tackle these issues, let them know that CARR/GGL has proposed legislation, and you want it implemented.

Final Thoughts

In 2017, 1/3 of working family members left their jobs to care for the daily needs of an older adult because they couldn’t find trustworthy, qualified paid help.  As California ages, the frequency and intensity of caregiving obligations will increase.  Bolstering California’s caregiver workforce is vital to our economy, and essential for our communities.  Caregiver wages at the state minimum are comparable to other service jobs, yet caregiving work is more physically and emotionally demanding.  The industry already has difficulty with staff retention stemming from low wages, hard work – not to mention the complications of exploitation. The last thing California’s elders need is to lose more caregivers. 

Will you join us in protecting them?

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