Jennifer Klein and Eileen Boris,
"Organizing Home Care"
(page 2 of 4)
Home care, as a distinct occupation, emerged in the Great Depression
both as work relief for New York's unemployed Black women who had
previously worked as domestic servants, and as an alternative to
fiscally strained public hospitals.[5]
The New Deal employed what at
the time were called visiting homemakers directly through the Works
Progress Administration (WPA) to help poor families and individuals with
medical emergencies, chronic illness, and health problems surrounding
old age, while curtailing the costs of institutionalization. The WPA
also initiated programs to move such people out of hospitals and give
them the necessary assistance to become 'independent' at home.
While New Dealers developed home care as a form of relief for both
providers and receivers, they ignored it as an occupation. When the
Democratic Congress passed old-age insurance, unemployment benefits,
collective bargaining, minimum wages, and other labor standards, it
excluded nurse companions, homemakers, and in-home workers from
coverage.[6]
Even when Congress amended the FLSA in 1974 to include
domestic workers, it specifically exempted home care workers from
coverage. The Supreme Court reaffirmed this exclusion in 2007.
After World War II, New York City's Department of Welfare offered the
most successful model of a public program for home health care services.
It directly employed home aids, still called homemakers, worked closely
with private social welfare agencies, secured federal funding, and
extended the service from child to elder care. Home care further grew as
both an expansion of the hospital and as an attempt to alleviate the
number of charity and chronic cases overburdening hospitals. The Great
Society, the domestic programs initiated by President Lyndon B. Johnson
in the 1960s, enhanced home care through new services for the aged and
poor, especially Medicare and Medicaid. Specifically, War on Poverty
training programs sought to channel poor women into these jobs.
Recruited from families on public assistance, homemakers cared for
others from the same social class.
From 1945 until the 1970s, these workers belonged to a booming
municipal public sector, despite their actual workplaces being private
homes. New York defined them as public employees able to receive
benefits with limited Civil Service protections. Unlike a typical
domestic, city homemakers officially worked a forty-hour week and
received health insurance, sick leave, and paid vacation. In the early
1960s, the City employed 263 full-time workers, covered by a collective
bargaining contract with the American Federation of State, County, and
Municipal Workers (AFSCME).
In the late 1960s, however, New York State started to change course
as it sought to counter militant public sector unionism, the welfare
rights movement, and growing public welfare spending. After 1969, it
began to privatize the home aide workforce, reclassifying workers as
independent contractors. A new part-time and casualized employment
structure emerged. Renamed home health attendants, their numbers soared
to over 12,000 by the mid 1970s.
Page: 1 | 2 | 3 | 4
Next page
|