CHCA/1199SEIU:

1. CHCA/1199SEIU: Our Collaboration

2. Cooperative Home Care Associates A home care agency licensed by the New York State Department of Health Structured as a worker cooperative Based in the South Bronx (NYC) Total Employees: 1,550 Client-Assignments: More than 3,550 annually Projected CY 2009 Annual Revenue: $40 million Established in 1985 to provide jobs for unemployed South Bronx residents.

3. 1199SEIU United Healthcare Workers East • The largest union local in the world, representing more than 300,000 members and retirees in New York, Maryland, the District of Columbia and Massachusetts. • They improve and expand the quality of patient care, while protecting and improving the lives of our members and their families– as well as support working people in its communities and around the world.

4. Unionizing NYC’s Home Health Aides • In 1998, 1199 affiliated to the Service Employees International Union (SEIU), which---with 1.8 million members---is the largest labor Union in North America. • Given its expanded scale, in 2001, 1199SEIU decided to unionize all of New York City’s licensed home health service agencies in a single coordinated campaign.

5. CHCA’s Initial Reaction • In 2003, CHCA negotiated a neutrality agreement with 1199SEIU with respect to organizing our home health aides; • Initially, both members of our Board of Directors and employees were skeptical of the benefits of unionizing CHCA; • Therefore, CHCA helped our employees to understand the potential of earning more Medicaid funds by working in collaboration with 1199SEIU---as well as further improving the quality of home health aide jobs.

6. Creating Higher Quality Jobs As detailed in this presentation, CHCA has created high-quality jobs for home health aides with: Full-time hours; Wages and benefits that total 80 cents of every dollar earned in revenue; Worker-ownership and 401(k) retirement accounts; Support from peers and supervisors; and Referrals to public benefits and social services. In collaboration with 1199SEIU, CHCA has further expanded the benefits provided to our workers.

7. Standard Industry Conditions Unfortunately, most licensed home health service agencies provide poor quality jobs, that offer inadequate: Wages and Benefits; Hours (only part-time jobs); Training; Support from supervisors and co-workers; Career advancement opportunities.

8. SEIU’s Initial Perception of CHCA • Since many licensed home health service agencies talked about how much they valued their workers (and then implemented policies that created poor-quality jobs) 1199SEIU initially was skeptical of the quality of our home health aide jobs. • Only after several years of working with CHCA, did 1199SEIU fully recognize the depth of additional services and support, that we provide to our home health aides.

9. Health Insurance • As our first work with 1199SEIU, CHCA changed the health insurance of our home health aides to a union-administered plan. • CHCA was in the awkward position of mandating that our home health aides to accept health insurance from SEIU’s Home Health Benefit Fund… • …since many relied on Medicaid or had insurance from their spouse.

10. Health Insurance • This health insurance plan required participants to work 120 hours for two consecutive months, which caused a number of our home health aides to lose their coverage. • CHCA ultimately decided to pay more money to SEIU’s Home Health Benefit Fund on behalf of home health aides who worked less than this threshold (for many different reasons) to maintain their eligibility for health insurance, regardless of their actual work schedule.

11. Collective Bargaining Agreement In 2004, CHCA began negotiating its first collective bargaining agreement with 1199SEIU. • Although contentious at times, this process resulted in our home health aides receiving several new benefits: • 1199SEIU overruled a decision by CHCA’s Board of Directors to reduce the number of sick days earned by home health aides from 12 to 6. • Now, home health aides earn: 8 sick days during their first year; 10 during their second, and 12 during their third and each year thereafter.

12. Reinstatement Rights • 1199SEIU also secured the right of reinstatement for home health aides who had to resign after using all their personal and Family/Medical Leave Act Time---upon obtaining a medical clearance from their doctor. • 1199SEIU also helps home health aides who have been terminated by CHCA to regain their jobs, by assisting them in resolving specific problems, through referrals to drug treatment and anger management programs.

13. Employee Grievances • Before CHCA’s unionization, very few home health aides used our grievance process. • After our unionization, 1199SEIU helped home care workers understand that they could use this process to contest anytermination. • However, 1199SEIU also came to appreciate the reasons that CHCA discharged workers and began focusing more on helping them resolve problems that result in terminations.

14. Employee Assistance Program Specifically, through an Employee Assistance Program, 1199SEIU assists home health aides in resolving: • Alcohol and substance abuse addictions, parenting concerns, and landlord/tenant disputes; as well as receive • Bereavement counseling, mental health services, and early intervention support regarding a potential job loss.

15. A Labor Management Committee CHCA and 1199SEIU also agreed to create a joint Labor/Management Committee to achieve the following three goals: Preparing more home care workers for leadership responsibilities in our cooperative; Strengthening the partnership between CHCA and 1199SEIU; and Establishing a model for collaboration between 1199SEIU and home care agency executives throughout New York City’s home care industry.

16. A Labor/Management Committee After an intensive planning process, CHCA and 1199SEIU agreed that our Labor/ Management Committee would create three workgroups: Service Delivery to improve CHCA’s delivery of home care services to clients. Communications to improve the dissemination of information among CHCA’s employees. Child-Care to research and then address our workers’ unmet need for child-care services.

17. 1199/SEIU’s Education Fund Finally, we promote classes funded by 1199SEIU to home health aides interested in pursuing career advancement opportunities, including: • English-as-a-second language, general equivalency degree, computer literacy, college preparation, and licensed practical nursing courses. • CHCA also offers flexible work-schedules that allow employees to complete these classes.

18. In Conclusion • Working together, CHCA and 1199SEIU provide home health aides with more support and services than either organization working independently--- • Especially in creating new opportunities to involve our home health aides in organizational decision-making, through our joint Labor/Management Committee.