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.
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 GrossePointeToday.com. Before that, she worked for 20 years in Fort Wayne, Indiana.
Ask supporters of Proposal 4 what it's about, and they will answer as one: The registry.
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