Purple hats and gold thunder sticks carrying the message, "Enough is Enough", filled Albany's West Capitol Park on Thursday as some 5,000 1199SEIU caregivers rallied to protest another round of healthcare budget cuts proposed by New York's Governor David Paterson.

The Governor's proposed $278 million in Medicaid cuts would cause the state to lose a total of $746 million, when federal matching funds are figured in. For every dollar cut in state Medicaid funding, New York loses $2.60 from Washington.

In the past two years, healthcare funding has already been cut six times by the legislature, with a combined loss of over $2.2 billion, resulting in the loss of several hospitals and nursing homes in distressed areas.

Ros Hampton, an LPN and longtime 1199SEIU Delegate in Buffalo, rally inspired the crowd when she asked, "Governor Paterson, is this any way to treat the most vulnerable members of our society that have paid their dues? Our elderly need to be treated like the kings and queens they are, but how can we do that with these outrageous budget cuts?"

Paulette Abrams, an 1199SEIU homecare worker with the Social Concern Homecare Agency, told the rally, "I've been a homecare worker for 19 years and I'm here to tell Governor Paterson that our patients and all of our families cannot survive any more cuts to homecare. Our clients won't be able to get the care they need and we won't be able to pay our bills."

1199SEIU caregivers came to Albany from as far away as the tip of Long Island and up to the Canadian borders of Western and Northern New York. They were joined by hospital and nursing home executives, who understand the devastating impact of these cuts.

Why being in a union makes you more likely to have health insurance; H1N1 sick leave bill introduced, and news from around SEIU locals in Michigan, California and New York.

42,000 MI Home Care Workers Win Raise In Tough Budget Year: After months of activism and lobby days at the state capitol in Lansing, home care members of SEIU Healthcare Michigan won a significant victory yesterday. Michigan Governor Jennifer Granholm signed a budget yesterday that provides a $0.50 raise across the board for all workers who provide care through the Home Help program.

The Face of Furloughs: After working for the state of California for over 30 years, SEIU Local 1000 member Renee Lee is speaking out about her fight to save her home. Joining thousands of CA state employees who have suffered the brunt of the state's economic crisis, the mandated time off w/out pay have decreased her monthly salary by over $450 per month and left her home in jeopardy. Watch the full video by CBS KOVR in Sacramento.

Faith Leaders in LA Turn Up Heat on Healthcare: In an event yesterday organized by SEIU, African American faith leaders made hundreds of calls to urge Congress to get healthcare reform done. Using SEIU's "faith line," leaders from across the community spoke out about the need for affordable healthcare for some of the community's most vulnerable members. Watch full story on Fox 11:

Union Members 25 Percent More Likely to Have Health Insurance: Today, a new report by the Employee Benefit Research Group shows that unionized workers are 25 percent more likely to have employee-paid health insurance. According to the report, "in September 2007, 83 percent of union workers were covered by health benefits through their own job, compared with 58 percent of nonunion workers." Read the report here.

H1N1 Flu Emergency Sick Leave Bill Finally Here: Rep. George Miller (D-CA) and Rep. Lynn Woolsey (D-CA) announced emergency temporary legislation today that will guarantee five paid sick days for a worker sent home or instructed to stay home by their employer for a contagious illness like the H1N1 flu virus. Next steps: According to Reuters, the House Ed & Labor Committee will hold a hearing on the legislation the week of November 16.

Accountability for NY State Home Care Industry: 1199SEIU UHW-E has launched a new website, HomeCareCrisis.org, as the first step in campaign to shine light on the economics of the home care industry. For example...Medicaid pays about $19 per hour for in-home care. Yet caregivers frequently receive as little as $7.50 per hour w/ no affordable healthcare benefits or paid time off.

Do you know a home care agency worthy of 1199SEIU's home care industry Hall of Shame? Nominate them here.

Turning States Purple on Election Day: Down to the wire, purple canvassers are out in force this Election Day--turning out the vote in key races in Maine, Maryland, Minnesota, New Jersey, Virginia and Texas. Stay tuned tomorrow as we report on the where and how our members helped make the difference.

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In yesterday's "Fair Pay for Caregivers," the New York Times editorial team urged the Department of Labor to change the regulation within the Fair Labor Standards Act that classifies home care workers as "companions," making them exempt from minimum wage protections and overtime pay. Citing the hard work and critical role they play with an aging boomer population, the NY Times editorial declares that "Home care aides should not have to wait any longer for the fair pay they have been denied for so long."

It's been over two years since the Supreme Court ruled to uphold the 1974 interpretation of the FLSA law ("Long Island Care at Home v. Coke"), denying home care workers a living wage and overtime compensation. That definition of the law essentially put the teenager who occasionally watches your kids on the same level with a worker trained to provide full-time and long term care for seniors and disabled persons with essential care needs. Under a new administration, this ruling did give the Labor Department--not the court--the right to change that interpretation under a new administration. However, more than two years later, the regulation still stands.

Sadly, one of the women who played a leading role in the fight for increased wages and paid overtime for in-home care aides, Mrs. Evelyn Coke, passed away today. Ms. Coke was the plaintiff in the "Long Island Care at Home v. Coke" case challenging the "companionship exemption" for home care workers. Read more about Mrs. Coke in the New York Times article highlighting her struggle for justice and a fair wage.

Support to extend federal overtime and minimum-wage requirements to home care workers--a growing labor force that earns average hourly wages lower than that of all other jobs in healthcare--has been increased in recent months. In June, a group of 15 Senators led by Senator Harkins (D-IA) sent a letter to Secretary of Labor Hilda Solis advocating for the Department of Labor to expand federal wage and hour laws to the estimated 1.5 million home care workers in the U.S.

"In the three decades since the exemption was created, the numbers of home care workers and their responsibilities have expanded dramatically as the population has aged and more and more people are choosing long-term care services in their homes rather than in institution," reads the letter sent to the DOL.

Secretary Solis responded with a statement saying she shares the concerns of the Senators who are advocating for fair treatment of home care workers, telling an AP reporter that her department was looking into whether the exemption should be overturned. Since that time, no real steps have been taken towards the federal reform that is urgently needed to provide home care workers with the compensation and respect they deserve. Please ask Department of Labor Secretary Solis to include home care workers in the Federal Fair Labor Standards Act

Home care aides in Wisconsin are celebrating a new state budget signed yesterday by Gov. Jim Doyle that includes breakthrough improvements for home care workers and their clients.

Currently, many families in Wisconsin have difficulty finding experienced home care aides on their own, as their only resources to do so are by recruiting through classified ads or community bulletin boards. The new budget sets up the Wisconsin Quality Home Care Authority (WQHCA), which will create a registry to aid seniors in finding qualified independent home care workers, provide training to caregivers, and allow workers to choose whether to unite as a union.

The improvements give approximately 5,000 home care workers in Wisconsin the freedom to unite with SEIU.

A group of 15 Senators led by Senator Harkins (D-IA) have sent a letter to Secretary of Labor Hilda Solis, urging the Department of Labor to expand federal wage and hour laws to an estimated 1.5 million home care workers in the U.S., one of the fastest-growing professions in the country today.

In-home care providers belong to a growing labor force that earns average hourly wages lower than that of all other jobs in healthcare. These front-line caregivers also lack employment security, healthcare benefits, or even workers' compensation.

When the Department of Labor (DOL) amended the Fair Labor Standards Act in 1974 to cover domestic workers, it was to address concerns that wage and overtime protections would be extendeded to "companionship services" provided by teenagers, family members or friends on an occasional or informal basis [example: babysitters].

In reality, the FLSA has been anything but fair when it comes to home care workers. In the summer of 2007, the Supreme Court ruled to uphold the 1974 interpretation of the FLSA law ("Long Island Care at Home v. Coke"), which excludes home care workers. The Court's decision to deny home care workers a living wage and overtime compensation by upholding the "companionship exemption" essentially put the teenager who occasionally watches your kids on the same level with a worker trained to provide full-time and long-term care for seniors and disabled persons with essential care needs.

However, this 2007 court ruling also gives the agency -- under a new administration -- the right to change that interpretation. "[...] A professional caretaker is simply not the type of informal and casual relationship that Congress sought to exempt," reads the letter to the DOL.

"In the three decades since the exemption was created, the numbers of home care workers and their responsibilities have expanded dramatically as the population has aged and more and more people are choosing long-term care services in their homes rather than in institutions. Home care, increasingly, has become not casual work performed by a friend or family member but a full-time regular type of employment.

"It is critical that these professional workers, who provide essential services to our nation's elderly and disabled, have the same right to minimum wage and overtime pay as enjoyed by other workers."

SEIU, as part of a coalition that aims to shave $2 million in healthcare spending by implementing changes to care delivery in the long term care field, sent a letter to the Obama administration last week recommending cost savings by expanding home- and community-based services. Secretary Solis said on Friday that she shares the concerns of the Senators who are advocating for fair treatment of home care workers. "As secretary of labor, I intend to fulfill the department's mandate to protect America's workers, including home health care aides, who work demanding work schedules and receive low wages," Solis said.

Sitting among the insurance executives, business leaders, and Washington lobbyists in the audience of yesterday's roundtable on health care reform were a handful of frontline caregivers from SEIU. They came from across the country to be on Capitol Hill yesterday, and they served as a powerful reminder of the people the debate over health care reform is really about - patients and their caregivers.

Two SEIU Healthcare leaders - Dr. L. Toni Lewis, MD and Cathy Stoddart, RN - took notes on their time in Washington and offered to share their perspective as caregivers. For Dr. Lewis, the importance of yesterday's hearing set in before she even arrived on Capitol Hill:

On the way to the Senate, we were talking about health care reform - sharing our thoughts on how we KNOW it's happening this year because so many people are so committed to it. Our cab driver, Germaine, asks if he can share his story. He tells us that he is 64, works more than 12 hours a day and still can't afford health care - Germaine has diabetes, and the cost of his supplies, medications and follow up are overwhelming. Mind you, Germaine is not upset - he understands hard work and appreciates that - he is glad to tell us his story. Germaine believes that we are getting ready to get this done - so he gives us an encouraging smile as we leave the cab and enter the Senate building.

In the hearing, Cathy Stoddart was encouraged by many of the senators' serious commitment to fixing health care:

Senator Menendez rocks! He did not mince words, which I think the American public are tired of. He asked straightforward questions and focused on the fact that the time is now - and that no one assembled was against reforming health care.

Senator Schumer was right on, too. He talked about the playing field for a public health insurance option vs. present private insurance plans. He talked about the lack of trust Americans have in private insurance companies and how they have been the gatekeepers of access to care; they are, in essence, rationing care for my low and middle income patients.

The discussion left Dr. Lewis excited that we're finally talking about true health care and not the "sick care" that our current system promotes:

I loved the fact that there was a discussion not only on coverage, but also on oral health, home care, end of life care, prevention and wellness, and primary care. We're actually talking about comprehensive coverage!

Both Toni and Cathy agreed that the people who need to be leading the movement to fix health care aren't the ones in Washington - it's the caregivers at the bedside. Cathy summed it up well:

There is something about returning someone to health so that they, too, can contribute to a better society. It feels good; it's a legacy to be proud of. It is what people deserve and it is why I become a nurse. We have a big role to play in this movement. We've all got to put our hand in and steer it in the right direction.

More than 800 healthcare workers at St. Elizabeth's Medical Center, the largest medical center in the Caritas Christi Health Care chain, voted last Thursday to unite together with thousands of healthcare workers in 1199SEIU.

"This is a time of great challenges and unprecedented opportunities," said 1199SEIU President George Gresham. "Now that St. Elizabeth's workers have a union voice, we can all work together to defend healthcare funding, expand access, and make life better for the caregivers at St Elizabeth's and their families."

Over the past 35 years, workers have attempted to form a union at St. Elizabeth's at least three different times, to no avail. Under new leadership, Caritas Christi Health Care reached an historic accord in January 2009 with 1199SEIU and the Area Trades Council, which established a code of conduct under which workers would be free to make their own decisions on whether to join together as a union under fair secret ballot voting conditions.

"We are overjoyed and thrilled. People were crying with joy in the halls Wednesday night," said St. Elizabeth's PCA Sonia Marshall, "We believe in the mission of St. Elizabeth's, and we're excited about working together to make our hospital the best that it can be for our patients and also for hospital workers and our families. We look forward to the day when all of our sisters and brothers across Boston are able to have free and fair union elections." Workers at St. Elizabeth's have pledged to help organize healthcare workers at other Massachusetts hospitals, including other Caritas Christi facilities, where union election campaigns are expected to launch in the near future.

Read more at www.StElizabethsWorkersTogether.org

Yesterday, we told you about Rush Limbaugh's rant against the measures to improve health IT in the Economic Recovery Act. Normally, Rush goes largely unnoticed by most of the general public. But his irresponsible comments about health IT have hit a nerve with the health care community.

In the last 12 hours, newspapers have received more than 2,000 letters from caregivers across the country. Their messages - largely based on professional experience in the health care industry - debunk Rush's scare tactics and clear the air about the benefits of health IT.

We thought we'd let the experts on this issue - health care professionals - speak for themselves:

As a nurse and caregiver, I take the quality and affordability of patient care seriously. The Economic Recovery Act gives health care providers the resources to invest in new technology and update existing health IT. This will save both patients and hospitals money by making delivery of care faster and more efficient. It will reduce time caregivers spend on paperwork so they can spend more time with patients. Most importantly, these resources will improve patient safety by helping to catch and eliminate medical errors. The pundits who are opposed to this Act are spreading unfounded fear. Let's bring healthcare to the 21st century...it's about time!!! - Mary Ann, MI

I am a registered nurse working in Savannah for over 35 years. [My hospital] is using many of the IT heath care solutions that President Obama is referring to in his stimulus package. Every minute we don't have to spend writing things in a paper chart are minutes we can be by our patient's bedside. This would save money in clerical bookkeeping and wasted caregiver hours, as well as lawsuits for harmful errors. Every nurse I know would rather be with their patients than keeping records already recorded somewhere else. - Linda, FL

I am an APRN in Connecticut. I didn't educate myself to this level to push a pen at the nursing desk. I want to be at the bedside to deliver care. - Patrick, CT

There are even more great letters after the fold...

Since SEIU began its Healthcare United campaign last February, the state of emergency room care has become a reoccurring topic on this site.  It’s not especially by design, but nonetheless, it’s happened because the nurses, doctors and caregivers that make up the Healthcare United community consistently bring it up as an issue.

A new study has just made its way to our desk, illustrating just how broad these concerns are.  We’re not especially surprised with the findings - after all, we read and react to what all of you send in.  Still, we can’t help but become overwhelmed by these numbers.  

This particular study, funded by the federal Agency for Healthcare Research and Quality and published by the Annals of Emergency Medicine, sought to measure how truly widespread the problems that face our emergency rooms are.  While there have been plenty of studies around the emergency room, this study is particularly interesting because it seeks to measure the opinions of caregivers like you.

A total of 3,562 emergency medicine staffers were surveyed in 65 hospitals, asking for their perspective on the state of ER care.  Researches sought to measure opinion in four different categories: physical environment, staffing, inpatient coordination, and “information coordination and consultation.”  

Overall, here’s how the responses broke down:

• A majority of ER caregivers - 65% - thought that there was insufficient space for delivery of care either some or most of the time.  
• A very clear majority - 82% - felt that “the number of patients exceeded ED capacity to provide safe care most or some of the time.”
• Only 41% of ER caregivers “indicated that most of the time specialty consultation for critically ill patients arrived within 30 minutes of being contacted.”
• Approximately half of respondents “reported that ED patients requiring admission to the ICU were rarely transferred from the ED to the ICU within 1 hour.”

You can read the abstract by heading here.  A full-text version requires an account.

WASHINGTON, DC - SEIU Healthcare Chair Dennis Rivera issued the following statement today regarding the 2008 Colorado Health Care Summit:

"The more than 2 million working families of SEIU commend Former Senator Tom Daschle and the Obama healthcare transition team for their commitment to fixing health care--and we look forward to doing our part to promote this vital effort across the country.

"Senator Daschle's announcement today confirming the commitment of the new administration to address the healthcare crisis in America is great news for patients, caregivers, and employers alike. Senator Daschle has long been a champion for working families, and his announcement today is a tribute to his proven record of standing up for improvements to the healthcare system.

"More broadly, the recognition by Senator Daschle and the Obama team that rising healthcare costs are putting pressure on families and on businesses offers hope the mounting crisis will be addressed early in the next administration to help get our economy back on track. Clearly, any solution must expand coverage, reduce costs, and improve quality--the very priorities spelled out by Senator Daschle in Denver today.

"Today, SEIU's working families applaud Senator Daschle for his ongoing innovation, his steadfast commitment to fix the healthcare system, and his bold proposals for engaging Americans in the solutions. The fact that the Obama team is proposing some of the same tools that worked so well during the presidential election to ensure the voices of ordinary American families are part of the debate--including soliciting ideas by Internet and at house parties--demonstrates their commitment to addressing the problems on Main Street in a real way. SEIU healthcare workers plan to attend these house parties so we can share what we hear every day: working Americans need quality, affordable coverage they can count on.

"It is both fitting and telling that Senator Daschle's announcement should come from an event in Colorado, where Senator Ken Salazar has also shown great leadership in the movement to reform the healthcare system. With the Partnership for a Healthy Colorado citing each Colorado family will spend more than $934 to care for the uninsured by the end of 2008 and Families USA showing premiums for the average family have risen 82 percent in the last six years alone, Colorado exemplifies the severity of the situation nationwide. Senator Salazar has consistently shown he recognizes Coloradoans--and Americans overall--can't wait any longer to hear solutions to the healthcare crisis.

"SEIU members--more than one million of whom went to work today in hospitals, nursing homes, and as home care providers--are committed to work together with Senators Daschle, Salazar and other elected and business leaders to rebuild the healthcare system and the economy so they work for working people again."