Group items tagged

Although Health Minister Eric Hoskins has vowed that this year's portion of the raise will eventually be doled out retroactively to April 1, the delay has caused "a lot of confusion, uncertainty and frustration," among PSWs in the home and community care field, according to Kelly O'Sullivan, the chair for CUPE Ontario's health-care workers. "It adds to the ongoing precarious nature of this work," she said. "You can't even depend on a wage increase that's been promised to you by the government."

The government's PSW Workforce Stabilization Strategy was designed to make home-care work less precarious, not more. PSWs deliver more than half of all home-care services, helping clients to dress, bathe, prepare meals, tidy up and manage medications, among other tasks. Yet their paycheques are traditionally smaller and their schedules more erratic than those of PSWs who work in hospitals and nursing homes, making it difficult to retain quality workers in home and community care. Persuading PSWs to choose the home-care field is essential to the Ontario government's efforts to keep people out of hospitals and nursing homes for as long as possible - a way to stretch increasingly scarce health-care dollars and respond to the public's desire to heal and age at home.

People interviewed for this story were quick to praise the Liberals for trying to improve the lot of home-care PSWs and their clients by raising their minimum wage to $16.50 an hour from $12.50 over three years. The intention was laudable, they said. The execution of the plan was not. "This should be the best news story ever," said Deborah Simon, the chief executive officer of the Ontario Community Support Association, which represents hundreds of non-profit agencies that help people at home. Instead, Ms. Simon said, the Byzantine rules around the pay hike have created an "administrative burden" for organizations.

At the heart of the problem is which workers - and which kinds of work - qualify for the government-funded pay bump. While the government set a wage floor of $16.50 an hour as of 2016-17, it delivered the public funds through a "wage enhancement" that only applies when PSWs are providing "personal support services" funded by Local Health Integrated Networks (LHINs), the province's regional health authorities.

That means time spent in training, travelling to clients' homes or performing tasks such as food preparation do not qualify for the higher rate. Initially, even statutory holidays were paid out without the increase, although that has been reversed. Jason Lye, national head of independent living services at March of Dimes, says his agency spent months clarifying provincial rules, only passing on the first phase of the raise retroactively to workers in February in the form of a "blended rate" that takes into account how they historically have divided their time.

"The way I like to interpret it is when you see the whites of the clients' eyes, you are paying the $1.50," Mr. Lye said. There were other complications. The raise goes to all PSWs doing work that qualifies, meaning the $4 increase goes to everyone, whether they are making a base wage of $12.50 or $22 an hour. That has put pressure on employers to give raises to others, such as registered practical nurses and supervisors.

The rules also exclude some PSWs because of where they work or because the provincial funds that pay for their services do not flow through the province's 14 LHINs. The result is that PSWs within the same organization can be treated differently. Kingsway Lodge Fairhill Residence in the southwestern Ontario town of St. Marys chose to reject the increase because it would create an untenable disparity in its already well-compensated PSW work force. Hourly wages there range from $17.73 to $20.44. The organization operates a nursing home with round-theclock care, a retirement home and six supportive-housing suites where residents receive a few hours of personal support per day. The wage enhancement would have applied only in the supportive apartments. "There would be no way to do it because our staff flow between the three levels of care," said Theresa Wakem, the facility's administrator. At Traverse Independence, an agency in Kitchener that serves adults with physical disabilities and acquired brain injuries, management had to find $27,000 in a $6-million budget to give eight PSWs working in a day program the same raise as their colleagues. "It was a hardship," said CEO Toby Harris. The agency eliminated half a supervisor's job to cover the increase.

The wage enhancement helped a little bit, but we're still on the losing side," said the PSW, who asked not to be named. The company's London employees are not unionized. The PSW said some workers in London are refusing to serve clients outside the city because they are paid so little to travel there. "If I drove six hours in the county, I'd be lucky to get paid for three hours," the PSW said. Dr. Hoskins said before the Liberals committed to the pay increase, "we didn't have a tremendous amount of information about our PSWs - who they're working for, how much they're being remunerated."

The ministry is gathering data so it can "fine-tune" the second year of the program, including whether future increases should apply to all PSWs, even those already earning much more than $16.50 an hour, he said. He added that nearly 500 health-service providers have passed the increase on to their PSWs and the government expects the 27 holdouts to follow suit. As for Revera's changes, "I find that unacceptable," Dr. Hoskins said. "The ministry would be looking into those circumstances if they were brought to our attention." Ms. O'Sullivan, the CUPE representative, called the program's rollout "a reflection of a broader problem" with home and community care in Ontario.

If we can't figure out - we as in the government, the agencies and the unions - how everyone should be getting something as simple as a wage increase in an equitable way, can you imagine if you are a family member or a patient needing care, what the system must be like?" This is the first article of a Globe investigation into the challenges of moving health care out of hospitals and into the home. If you have a personal story to tell, contact Elizabeth Church at echurch@globeandmail.com and Kelly Grant at kgrant@globeandmail.com.

Mayor Michael Bloomberg is fighting this change

A similar law enacted in 2003 in Los Angeles requires companies receiving city subsidies to pay workers $10.42 an hour or $11.67 without benefits. Despite warnings that the city would lose projects, Donald Spivack, a development official in Los Angeles, said at a Council hearing last month that those predictions were wrong and that he was unaware of any project that was canceled because of the wage requirement. The Center for American Progress found that 15 cities with living wage laws, including Los Angeles, Philadelphia, Cleveland and San Francisco, “had the same levels of employment growth” as other similar cities without the requirements.

Mayor Bloomberg’s arguments against this modest wage increase contrast with his endorsement of a 2002 city law that now sets a minimum of $10 an hour for about 60,000 workers employed by service contractors hired by the city, many of them home health care workers. Home care workers got a similar increase as part of Gov. Andrew Cuomo’s Medicaid redesign this year.

This minimum wage rise came right on the heels of a campaign in which Ontario healthcare workers advocated for a $14 minimum wage. Healthydebate.ca had a lively debate between Dr. Ritika Goel and Mike Craig. Dr. Goel and other advocates argued that increasing the minimum wage would increase the income of the poorest patients, thereby improving their health.  While this seems like a logical argument, does the evidence agree? The answer might surprise you.

“They work hard and play by the rules,” President Obama said

“Today’s action will ensure that these men and women get paid fairly for a service that a growing number of older Americans couldn’t live without.”

These workers, according to industry figures, generally earn $8.50 to $12 an hour, compared with the federal minimum wage of $7.25 an hour. The White House said 92 percent of these workers were women, nearly 30 percent were African-American and 12 percent Hispanic. Nearly 40 percent rely on public benefits like Medicaid and food stamps.

many do not receive a time-and-a-half premium when they work more than 40 hours a week. Twenty-two states do not include home health care workers under their wage and hour laws.

PHI PolicyWorks, a nonprofit group that seeks to improve conditions for home care workers

six million of the 40 million Americans older than 65 now need some form of daily assistance to live outside a nursing home. That number, government officials say, is expected to double to 12 million by 2030

the proposed rules, which might be modified after a 60-day public comment period

some companions employed by individuals for activities like helping them take walks or engage in hobbies would still be exempt from minimum wage and overtime coverage

estimated that Medicare or Medicaid, which cover 75 percent of the nation’s home care costs, would pay $31.1 million to $169.5 million more each year toward home care aides, which she said would represent 0.06 percent to 0.29 percent of federal and state outlays for home care

In 1974, the Labor Department exempted “companionship” workers from coverage under the Fair Labor Standards Act, a move that focused on baby sitters at a time when the home care industry was in its infancy.

In 2007, the Supreme Court issued a decision involving a New York home care aide, Evelyn Coke, who often worked 70 hours a week, ruling that she was not entitled to overtime pay under existing regulations. The court said it was up to Congress or the Labor Department to change the rules.

nearly 90 percent of the nation’s home care aides work for agencies

And dozens of occupations, some that you've never even heard of, are exempt from basic rights entirely. "Keepers of fur-bearing mammals" have no right to minimum wage. Sod layers have no limits on their daily hours of work. Shrub growers don't get a lunch break. The system is so complicated that the Ministry of Labour has developed a special online tool to help decipher who's entitled to what. But as the province reviews its antiquated Employment Standards Act, critics argue that its confusing web of exemptions makes it harder for the so-called precariously employed to defend their rights - and easier for bosses to ignore them.

"When you distil it down to what these exemptions are seeking to achieve, really they are to give employers more control over work and more control over wages," says Mary Gellatly of Parkdale Community Legal Services. "It sends the message to employers that they can get away without complying." The Act was first introduced in Ontario in 1968 to set basic work standards, especially for non-unionized employees who don't have a collective agreement to provide extra protections. But there are at least 45 occupations in Ontario that are exempt from a variety of its fundamental entitlements, many of them low-wage jobs in industries where precarious work is rife.

The Ministry of Labour says many of the exemptions are "long standing" and related to "the nature of the work performed." But York University professor Leah Vosko, who leads research into employment standards protections for the precariously employed, says exemptions have come at least in part from industry pressure, leaving the Act a "complex patchwork that is difficult for workers and even officials to comprehend." Even when there are clear violations, speaking out can come at a cost. Reprisal is illegal under the Act, meaning bosses can't penalize employees for exercising their workplace rights. But the Act gives workers no protection against wrongful dismissal. Employers do not have to give cause for firing someone.

Unionized employees are generally protected by their collective agreements, and workers can sue employers if they think they have been unfairly terminated. But most precarious, low-income employees are not unionized, and most do not have the money to take legal action against an employer, says Parkdale's Gellatly. "It's the big reason why many people can't do anything if they're in a workplace with substandard conditions, because they can get fired without cause." Linda Wang, who worked at a Toronto cosmetics manufacturer for four years, was fired less than two weeks after asking her employer for the extra pay she was owed for working a public holiday. She says no reason was given for her termination. Wang, a mother of two, claims her employer repeatedly bullied her and her colleagues, and says she believes she was dismissed for asking for the wages.

She has filed a reprisal complaint with the Ministry of Labour, but Wang cannot afford to take her employer to court. "I feel the system is against workers," she says. "It's in favour of employers." "Whatever job you have, you put so much of yourself into it," adds Gellatly. "The fact that employers can just fire you without a reason is incredibly devastating for folks." The Act also contains significant gaps when it comes to sick leave and overtime. The legislation provides most workers with 10 unpaid days of job-protected emergency leave, which means they can't be fired for taking a day off due to illness or family crisis. Critics call this measure subpar by most standards, since it still causes many workers to lose a day's income for being ill. An estimated 145 countries give employees some form of paid sick leave.

"Unfortunately, we stand out for our inadequacy," says Brock University professor Kendra Coulter. But the 10-day protected leave doesn't apply to almost one in three of the province's most vulnerable workers. An exemption that excludes employees in workplaces of fewer than 50 people from that right means 1.6 million workers in Ontario are not even entitled to a single, unpaid, job-protected sick day. Fast-growing, low-wage sectors such as retail, food services and health care are most likely to be exempt according to a recent report by the Workers' Action Centre. While many small businesses voluntarily give their employees paid sick days, the loophole leaves many workers - especially the precariously employed - exposed.

Toronto resident Gordon Butler asked his employer, a small construction company in Markham, for one day off work after he sliced his thumb open on the job. He says his boss told him not to come back. "I didn't believe him," says Butler, 44, who has an 8-month-old child. "I tried to plead with him, and he said 'No, too bad.'" "The way it's stacked up right now is there are very few options for people who are in low-wage and precarious work to actually take sick leave when they're sick," says Steve Barnes, director of policy at Toronto's Wellesley Institute, a health-policy think-tank. "They not only have to worry about lost income, but the potential for losing their jobs," adds Brock's Coulter. "It's unkind and unnecessary." The stress caused by the province's meagre sick-leave provisions is compounded by exemptions to overtime pay, to which around 1.5 million don't have full access.

As a rule, employees should get paid time and a half after 44 hours a week on the job, according to the Employment Standards Act. But in 2014, more than one million people in the province worked overtime, and 59 per cent of them did not get any pay whatsoever for it, Statistics Canada data shows. This, experts say, is partly because enforcement is poor. But in Ontario, a variety of occupations don't even have the right to overtime pay, including farmworkers, flower growers, IT workers, fishers and accountants. Managers are also not entitled to overtime. Vladimir Sanchez Rivera, a 45-year-old seasonal farmworker in the Niagara region, says he has worked 96-hour weeks doing back-breaking labour picking cucumbers and other produce.

We don't have access to protections when we are working in agriculture," he says. "And our employers tell us that." Low-wage workers are even more likely to be excluded from full overtime pay coverage, according to the Workers' Action Centre's research. Less than one third of low-income employees are fully covered by the Act's overtime provisions, compared to around 70 per cent of higher earners, because they are more likely to work in jobs that aren't eligible. Workplaces can also sign so-called "averaging provisions" with their employees, which allow bosses to average a worker's overtime over a period of up to four weeks. That means an employee could work 60 hours one week and 50 the next, but not receive any overtime as long as they don't work more than a total of 176 hours a month.

Critics say the measure means more work for less pay, and paves the way to erratic, unpredictable schedules. "That's a huge impact on workers and their families in terms of lost income and having to work extra hours," says Parkdale's Gellatly. "It's certainly not good for workers, for their families, and it's not good for creating decent jobs in terms of rebooting our economy," she adds. For many of the precariously employed, falling through the gaps ruins lives. "Even now, when I think about the working environment, I feel very depressed," says Wang, who, 10 months later, is still waiting for the Ministry of Labour to issue a ruling on her complaint. "I feel panic."

Sara Mojtehedzadeh can be reached at 416-869-4195 or smojtehedzadeh@thestar.ca. By the numbers 1.6 million non-unionized Ontario employees with no right to an unpaid, job-protected sick day 59%

of Ontario workers who worked overtime in 2014 did not get any pay whatsoever for it 71% of low-wage, non-unionized Ontario employees don't have full access to overtime pay 29%

of high-income employees don't have full access to overtime pay Sources: Workers' Action Centre, Statistics Canada Proposed solutions A recent report by the Workers' Action Centre makes a number of recommendations to rebuild the basic floor of rights for workers. The proposed reforms include: Amending the ESA to include protection from wrongful dismissal

Eliminating all occupational exemptions to ESA rights Repealing overtime exemptions and special rules Repealing overtime averaging provisions Repealing the emergency leave exemption for workplaces with less than 50 people Requiring employers to provide up to seven days of paid sick leave

Since Prime Minister Stephen Harper assumed power in 2006, the number of foreign temporary workers admitted into Canada has grown by 40 per cent. The temporary worker stream is now larger than the stream of permanent workers intending to set down roots and become citizens.

When Canada introduced its temporary foreign worker program in 2002, the governing Liberals vowed never to adopt the European model route in which “guest workers” are paid less than nationals and treated as second-class residents. But under Harper, the country is now moving in that direction.

“We feel it's a race to the bottom,” said Bill Hulme, community care lead for the Service Employees International Union Local 1 Canada, which represents 10,000 home care workers including those at St. Joseph's.

Kim Ciavarella, president of St. Joseph's Home Care. “We introduced this new tier so we'd be able to bid on those contracts. It positions us very nicely.”

The 190 workers came close to striking over the two-tier system that sees lower wages go to staff working on any new contracts

That's also below the starting wage of $16.07 for personal support workers, dietary aides, health aides and home cleaners.

The low wages, combined with a lack of job security, have made home care the most unstable sector of the health care system and the hardest in which to retain staff, says Jane Aronson, a home care researcher and director of McMaster's school of social work.

“I find it unfathomable that at the same time the provincial and federal governments keep saying home care is very important, it's organized so those who are its front line staff won't have security and in this instance won't even have a living wage,” she said. “It's not a field people can afford to work in very long so we lose people with skills.

home care workers make far less than the hourly wage because they're often not paid for their transportation time between clients

The province halted competitive bidding in January 2008 to try to resolve some of these issues. It's expected something new will be in place this fall.

St. Joseph's Health System is testing what it calls “bundled care,” which involves the province giving a set amount of money to provide diagnostic, hospital, long term care and home care to patients with a co-ordinator overseeing it all and acting as a point of contact.

The Service Employees International Union said it couldn't comment on the delay because it is looking for more information. The main thing we do know is that the raise will be retroactive to April 1. We championed this wage increase for 30,000 PSWs across Ontario which resulted in the $1.50 raise last year and the promised additional $1.50 this year," said Gilleen Witkowski, media relations for SEIU Healthcare.

Personal support workers in the home care sector can be paid as little as $12.50/hour compared to hourly rates of $18 to $23 for their hospital-based colleagues.

Similar disparities have also been observed for other care workers, including registered nurses.

In addition, home care workers often do not get steady hours

According to Stella Yeadon, a representative for the Canadian Union of Public Employees, this is largely because union organizing is very challenging in the home care sector. Unlike the hospital environment where workers are in a single building, home care workers rarely meet one another.

support for family caregivers was notably absent from both Ontario’s Action Plan for Healthcare and the year-one update released last month. Support for caregivers is part of Ontario’s new Seniors Strategy, but it remains to be seen how much of this strategy will translate into action.

According to a report from the Ontario Health Coalition, another contributor to lower wages is the Ontario government’s procurement policy for Community Care Access Centres (CCAC), which requires CCACs to contract out home care services. While competitive bidding for contracts has been somewhat successful in keeping costs down for CCACs, it has done so largely by “driving down wages,”

Low wages and limited benefits across an entire sector raise concerns about the possibility of recruiting skilled care workers. “

low wages could pose real barriers to recruiting and retaining staff.

Health care workers face substantial health risks as part of their work, due to their exposure to infectious diseases, violence from patients/residents with dementia, allergic reactions from chemical agents, and injuries resulting from lifting patients.

There is currently limited data on the occupational health risks of delivering care in the home. However, some care may be riskier in the home, where workers are more likely to be without either backup from other staff or mechanical assistance (such as patient lifts), as compared to workers in a hospital or a long-term care facility.

turnover as workers leave home care for higher paying jobs at hospitals is bad for patients

patients who need home care do not have families to care for them

there’s no one to care for them but me and they need more help.”

lower wages and riskier environments raise the possibility that the quality of care may be negatively affected as services are moved from hospital to community settings.

Nearly 2 million women, half of whom are women of color, provide support and assistance

The idea that domestic work is not “real work” has kept wages low for all types of “women’s work.” For home-care workers, the average wage is $9.40 an hour. Annual incomes average $16,600

Many workers are unable to find full-time employment. About 50 percent of home-care workers live in households that rely on public benefits such as food stamps and Medicaid to make ends meet. A third of these workers lack health insurance coverage.

excessively high turnover rates plague the industry. Annual turnover of 50 to 60 percent costs the industry about $2 billion, money that could otherwise go to improving wages, training and workplace supports. Moreover, high turnover undermines quality of care, as clients try to cope with a revolving door of caregivers.

Lack of access to quality care imposes real costs on society. Research published last year by AARP shows that family caregivers suffer high levels of stress and ill health. They often lose significant income during the years they are helping elderly parents, and they use up their savings, making their own retirements uncertain. Workers with substantial caregiving responsibilities are also less productive on the job.

The country needs a national solution that helps us all meet our family responsibilities. That includes building a skilled, stable workforce by treating caregiving as real work and paying those who provide these services a living wage.

The investigation also found that 27 mostly non-profit health-care agencies across the province are refusing to accept the government-funded increase and pass it on to their workers, while one of the largest privatesector employers of personal support workers in Ontario cut what it pays in mileage and travel time just after the first phase of the raise kicked in last fall, leaving some employees worse off than they were before the wage-enhancement program began.

The raise also has been more expensive than expected, costing the province at least $77.8-million in 2014-15, well above the $50-million earmarked for the first year of the pledge. Mr. Hoskins said he was surprised by the difficulties his government has encountered in implementing the wage hike. "I certainly wouldn't have predicted that this was as complicated as its turned out to be in some regards," he said.

The increase, when it is implemented, will be retroactive to April 1. Personal support workers deliver more than half of all home-care services, helping clients to dress, bathe, prepare meals, tidy up and manage medications, among other tasks, yet they generally make less and face more unpredictable schedules than their counterparts working in hospitals and nursing homes. Stabilizing the industry is key to provincial plans to shift an increasing portion of the care for the sick and the elderly out of expensive hospitals and longterm care facilities and into the home. Those efforts are being jeopardized by delays to the longpromised raises, opposition politicians said Monday.

This has been rolled out so poorly that it has created even more disarray in the home-care system," said NDP health critic France Gelinas. Without the promised increase, Ms. Gelinas said personal support workers will continue to leave the home-care sector, causing hardship for their clients. "At the end of the day, the most vulnerable in our community are the ones who end up stripping naked in front of a stranger every week because a different PSW comes and gives them their bath," she said. Bill Walker, the deputy health critic for the Ontario Progressive Conservatives, called delaying the second phase of the PSW wage increase, "unacceptable."

"[This is] yet another case of the Liberals breaking a promise," he said. "I mean they came out and basically said anything they could to get re-elected. They now have gone back on their word again ... they set the expectation high for those [PSWs] and now they're not coming through, once again." Mr. Walker was particularly incensed at the Health Minister's admission that the Liberals did not fully understand the complexities of the home-care work force or how those workers were paid before promising them a $4-an-hour wage hike just two days before introducing a budget that was ultimately defeated, triggering last June's election.

Most recently, the government allowed teachers to strike for five weeks before they ultimately surrendered last fall. The wage package they accepted - a 7.25 per cent increase over six years - was essentially the same one the government had been offering throughout most of the negotiations. It remained steadfast that teachers accept the same measly terms to which other public-sector unions had agreed. This brings us to Alberta. Of the many pre-budget signals that Premier Jim Prentice has been sending out, one of the strongest has been to public-sector workers. The rich deals they have struck over the years can't be sustained in the current economy. In fact, Mr. Prentice believes they can't be managed even when the economy improves.

These contracts have always been a pet peeve of provincial governments across the country because of the domino effect they created. Alberta wages for virtually any group - nurses, teachers, doctors, civil servants - have always been the benchmark used by counterpart unions and professional associations elsewhere.

Not only have other provinces been forced to cough up more money than they've wanted to, they've also had to watch many of their top people flee to Canada's version of the United Arab Emirates to earn the kind of living they could never hope for at home. The most recent Statistics Canada numbers from January put Alberta on top for salaries among nurses, teachers and unionized workers generally (which would include the bureaucracy). The latest figures from the Canadian Institute for Health Information also indicate Alberta doctors earn the highest wages in the country.

As Mr. Prentice has pointed out, many of these deals have been achieved only by pillaging oil profits that rightly should have been put aside for future generations. That oil and the riches they produce are not the sole domain of the generation alive today. The Alberta Premier is right: The province has been living beyond its means for years now.

And there is a long-term reckoning on the short-term horizon. The B.C. Premier, meantime, has no doubt Mr. Prentice will use this crisis as an opportunity to get public-sector wages in line with the rest of the country.

"Over the years other [Alberta] premiers have been big spenders on public-sector wage increases and it's been a real problem, especially for B.C., because nurses, doctors, teachers, they all have the chance to go right across that border. "We, on the other hand, have had to go through strikes and our unions have had to swallow a lot of zeroes over the years and yet it's made us more efficient in many areas like health care, where we have the secondleast expensive system in the country per capita and yet we have great health outcomes."

t may sound like bragging, but much of it is true. Now B.C. and the rest of the country will watch as the Alberta government struggles to get control of wage costs that were always too rich for the province's blood.

Driving down the compensation of public sector workers won't address the growing income inequality gap between working people and the richest Canadians. We need real action that will help all Canadian workers - public and private sector alike. Affordable and accessible child care, strengthened public health care, an expanded Canada Pension Plan that will give millions of Canadians a secure retirement income, and building an economy that is based on good jobs with fair wages for all.

Paul Moist, National President, Canadian Union of Public Employees

Only four years ago, when fast-food workers first began holding marches to demand a $15-an-hour minimum wage, they were dismissed as impractical dreamers. Now, in a twist that has surprised economists and activists alike, that dream is becoming a reality in some parts of the country.

Portland, Ore.

If there are costs as a result of the higher wages, the question is how they compare with the benefits, said Ben Zipperer, an expert on the minimum wage at the Washington Center for Equitable Growth. “Both [costs and benefits] may arise,” he said. “How people feel about the trade-off is more complicated.”