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Democrats criticize rule change for home health workers

In July, the Centers for Medicare and Medicaid Services announced it would repeal an Obama administration 2014 rule that allowed states to deduct fees for “benefits customary to employees,” including union dues, directly from health workers’ pay.

By Claire Withycombe

Capital Bureau

Published on August 10, 2018 7:58PM

Last changed on August 13, 2018 8:43AM


SALEM — Oregon Democrats on Capitol Hill decried a proposed federal rule change Friday, claiming it would restrict the ability of the state’s publicly-funded home health care workers to unionize.

In July, the Centers for Medicare and Medicaid Services announced it would repeal an Obama administration 2014 rule that allowed states to deduct fees for “benefits customary to employees,” including union dues, directly from health workers’ pay.

CMS says the 2014 change is not consistent with the Social Security Act, which the federal agency says “generally prohibits states from making payments for Medicaid services to anyone but the provider.”

“The law provides that Medicaid providers must be paid directly and cannot have part of their payments diverted to third parties outside of a few very specific exceptions,” Tim Hill, the acting director for the Center for Medicaid and CHIP Services, said in a July 10 press release. “This proposed rule is intended to ensure that providers receive their complete payment, and any circumstances in which a state does divert part of a provider’s payment must be clearly allowed under the law.”

Under the rule, home care workers who become members would be responsible for forwarding dues payments to the union.

But Friday Oregon’s senators and four of its representatives urged CMS to withdraw the proposed rule in a letter to CMS Administrator Seema Verma.

Sen. Jeff Merkley, Sen. Ron Wyden, Rep. Suzanne Bonamici, Rep. Earl Blumenauer, Rep. Peter DeFazio and Rep. Kurt Schrader, all Democrats, signed the letter.

“Prohibiting voluntary payroll deductions for customary benefits like union dues would place an unnecessary burden on independent home care workers,” they wrote. “We are concerned that the proposed rule would interfere with and compromise the ability of workers to join together to form unions and collectively bargain for higher wages, better working conditions, expanded benefits, and new training opportunities to improve the quality of care they provide to Medicaid beneficiaries.”

There are more than 28,000 home care workers who serve Medicaid beneficiaries in Oregon, the lawmakers say. About 20,000 of them are part of SEIU Local 503.

Home care workers have been permitted to unionize in Oregon since 2000, when Oregon voters approved Ballot Measure 99. SEIU represents all Medicaid-funded Oregon home care workers who choose to be union members.

That measure established a home health care commission for elderly and disabled people receiving publicly-funded care at home. Supporters say the change lead to better pay, benefits and training for the state’s home health workers.

Joy’e Willman, of Portland, has been a home care worker and personal support worker for 26 years. She is vice president of Homecare Local 99.

“I can tell you that before we had a union at all, we didn’t have anything,” Willman said in a phone interview arranged by SEIU Friday. “We didn’t have workers’ comp, we didn’t have paid time off, we didn’t have health care.”



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