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Public sector

Proposal 4: Home health registry and unionization

Ask supporters of Proposal 4 what it’s about, and they will answer as one: The registry.

Ask its detractors the same thing, and they say: The union.

And therein lies the debate. Proposal 4, which would amend the state constitution to create the Michigan Quality Home Care Council and allow home-care workers collective bargaining rights, presents different faces to voters.

At issue is how to handle the roughly 40,000 individuals who seek employment as home health-care aides, many for their own family members. Working in a twilight zone somewhere between skilled nursing and household help, these aides do everything from errands and housekeeping to meal preparation and help using the toilet or bathing. They’re paid little – $8 an hour is the state average – and work under the Medicaid Home Help program for Medicaid-eligible individuals, most of whom are elderly and/or disabled. Home Help is one of several programs that divide about $2 billion in Medicaid funding for long-term care in the state.

Advertising in favor of the proposal features older people interacting with home-care workers, emphasizing the role these aides play in keeping the elderly and disabled living independently and out of nursing homes. The role of the Service Employees International Union in the issue is never mentioned, but is central to the actual ballot proposal. At stake in this proposal is $6 million in annual union dues to the SEIU.

On the other side, the part played by SEIU Healthcare Michigan takes center stage in the political drama. The work of the proposed home-care council – background checks on home-care workers, keeping a registry of qualified aides – could easily be accomplished by legislative action, these opponents say, using words like “skim” and “scheme” to describe the union’s role.


The split began when, under Gov. Jennifer Granholm, an interlocal agreement between the state’s Department of Community Health and several Area Agencies on Aging formed the Michigan Quality Community Care Council, known informally as MQC3. The council was charged with maintaining a registry of home-care workers, providing training where needed and performing background checks. The council answered a real need, said Mary Ablan, executive director of the Area Agencies on Aging Association of Michigan and a supporter of Proposal 4.

“The way it worked before MQC3, people would sign up through state Department of Human Services,” she said. Applicants would submit their forms and then be asked whether they knew someone they wanted to hire to provide the work. Many named adult children, parents, nieces and nephews.

The problem came with people who had no family, neighbors or other known parties willing to do the work.

“Some people didn’t have anyone,” Ablan said. “The DHS would give them a list.”

The lists, she said, were frequently unhelpful, with out-of-date names and phone numbers. And the people on them hadn’t been screened for criminal backgrounds.

“If you knew someone, you were OK, but if you didn’t, you were in a bad way,” said Ablan. “That was what prompted the (registry’s) formation.”

From registry to organizing

The conflict came in the interlocal agreement’s designation of home-care workers as public employees. That allowed them to organize. A Citizens Research Council memo on Proposal 4 states that, in 2005, SEIU Healthcare Michigan was recognized as the bargaining unit for approximately 43,000 home-care aides statewide. An election was held, with ballots sent to that many; 6,949 ballots were returned with yes votes, 1,007 had “no” and 589 ballots were spoiled. Dues withholding of 2.75 percent began in November 2006.

The Mackinac Center for Public Policy, a conservative policy group in Midland, has made the issue a special focus for its work since, and runs a “skim tracker” widget on its Michigan Capitol Confidential site, estimating more than $32 million has been collected in union dues and agency fees since 2006.

The Legislature defunded MQC3 in 2011, and in 2012, Gov. Rick Snyder signed a bill specifically excluding home health-care workers from public-employee status. The matter is still in litigation, and the dues collection continues.

The registry, however, is on shakier ground. MQC3 Executive Director Susan Steinke said the council has been getting by with financial contributions from various agencies on aging, nonprofit agencies serving the disabled and the SEIU.

“But it’s not been the same,” she said. The registry has served a total of 485 clients seeking help in the last year, 6,728 since its inception.

Opponents say they don’t object to the registry, although they describe the interlocal agreement as little more than a framework to allow the SEIU into the mix.

“The SEIU is looking to amend the state constitution to recognize about 40,000 home-care workers as government employees,” said Wendy Block, director of health policy and human resources for the Michigan Chamber of Commerce, which opposes the proposal. “It’s a skim. There’s no other word.”

Block said that with so many of these workers caring for family members, the union intrusion is particularly unwelcome.

“Look at the case of a dad taking care of his child with cerebral palsy. What is the union going to do to help that dad in terms of getting him higher wages or any other benefit?” she said. “The SEIU is just taking money that would go toward taking care of his family. That’s a pure scam.”

After the passage of Public Act 76, which stripped the workers of their public-employee status, “the union is now trying to get this in the constitution. It’s not about quality of health care, it’s about taking Medicaid dollars and giving it to unions for their political agenda.”

Further, cementing such a designation into the state’s foundational legal document could open a can of worms, and any professional who uses public money to serve private citizens could ask for public-employee status, she said.

“Could a landlord (who takes federal Section 8 dollars as rent) qualify?” she asked. “Could a doctor who treats Medicaid patients?”

For others, the issue comes down to questions of how the issue should be addressed. Keith Angelocci, who owns BrightStar of Novi, a private home-care franchise, asks, “How can you have collective bargaining for people on a registry with no fixed employer? These people are contractors.”

Angelocci said the indigent should get quality care, but “they are policy questions. I don’t know why this is a constitutional question.”

Should Proposal 4 pass, on its effective date the MQC3 would cease to exist and the similarly named Michigan Quality Home Care Council would take its place, Steinke said. Labor contracts with SEIU would remain in place.

Should it fail, the registry would be cast into limbo, Steinke said. Both sides agree it provides a valuable service, “but what would it look like? Who would fund it? We don’t know.” She estimated the registry could be kept running for a minimum of $600,000 per year, but said as of now there’s no backup plan to raise it, should the proposal fail.

Staff Writer Nancy Nall Derringer has been a writer, editor and teacher in Metro Detroit for seven years, and was a co-founder and editor of, an early experiment in hyperlocal journalism. Before that, she worked for 20 years in Fort Wayne, Indiana, where she won numerous state and national awards for her work as a columnist for The News-Sentinel.

At a glance: Proposal 4

WHAT VOTERS WILL DECIDE: If you vote for Proposal 4, it is effectively a vote for the unionization of – and dues collection from – home health aides, be they employees of private firms or members of the patients’ own families. If you vote against Proposal 4, you are effectively supporting a return to home health policies pre-2006.

WHAT THE ADS SAY: Proponents of Proposal 4 have used ads to argue that passage will improve the quality of home health care and ensure that home health aides go through a criminal background check. Opponents of Proposal 4 have used ads to argue that the constitutional amendment is simply an effort by SEIU, a union, to collect millions in dues off of home health aides.

WHAT THE TRUTH SQUAD SAYS: Reports by the Michigan Truth Squad have found that ads favoring Proposal 4 were somewhat fair, though a technical foul was called for couching the ballot proposal as mainly a safety issue when even proponents have acknowledged that a key focus of ads – criminal background checks for home health care workers – were going on now without passage of the proposal. The Truth Squad has not reviewed any ads directly opposing Proposal 4. However, ads broadcast as part of a general “no” on ballot props campaign were found to have problems in asserting motivations without factual support.



This proposal would:

Allow in-home care workers to bargain collectively with the Michigan Quality Home Care Council (MQHCC). Continue the current exclusive representative of in-home care workers until modified in accordance with labor laws.

Require MQHCC to provide training for in-home care workers, create a registry of workers who pass background checks, and provide financial services to patients to manage the cost of in-home care.

Preserve patients’ rights to hire in-home care workers who are not referred from the MQHCC registry who are bargaining unit members.

Authorize the MQHCC to set minimum compensation standards and terms and conditions of employment.

Should this proposal be approved?

YES ___

NO ____


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