UDW members elected by their peers to be delegates gathered in San Diego on June 7-9 for our 16th Constitutional Convention. Under a slogan that reflects the work we do and what it takes to do it— “Caregiver Strong”—we set a course for UDW’s future that focuses on protecting IHSS, raising the pay and status of caregivers, and standing up for the values we share as working people.

UDW bylaws call for conventions to be held every three years. At convention, we bring our experiences and our wisdom to the table to report on what we’ve accomplished so far and prepare for the challenges that lay ahead of us.

UDW President Editha Adams shared some of our successes and challenges during her President’s report, including: demanding and getting an audit of the IHSS payroll system, winning the option to use online timesheets, overtime pay and restoration of the seven percent cut to IHSS made during the budget crisis. She also talked about the issues we continue to fight: Federal interference in our program from Medicaid cuts and Electronic Visit Verification (EVV) and our most important issue UDW has and will never stop fighting for: raising caregiver pay.

“As I look back on the last three years, I am both proud of what we’ve done and excited for what we can yet accomplish,” said Adams.

When he addressed the convention, UDW Executive Director Doug Moore urged delegates to look to the bigger issues of social justice if we want to truly better life for ourselves and our families.

“As a union, we have always fought for more than just wages and benefits to better our members’ lives,” said Moore. “We know that helping ourselves, our clients and our families means helping our communities and the people in them. UDW is shaping the future by investing in people, always looking for ways we can lift each other up where others try to keep us down.”

Several special guests joined us to show their support for the work that UDW caregivers do. Assemblymember Shirley Weber, AFSCME International President Lee Saunders, President Pro Tem of the California State Senate Toni Atkins and Executive Director of the Solidarity Center Shawna Bader-Blau all addressed our delegates, offering support and perspective for the work caregivers do at home and in their communities. All speakers expressed gratitude and respect for the work that caregivers do.

“I see compassionate people making it possible for the sick and elderly to live in their own homes with comfort and dignity,” said Bader-Blau as she looked around the room.

For UDW member and convention delegate Maria Vega from Orange County, the convention was a valuable learning opportunity. “You learn more, you get to ask questions—everyone’s so helpful!” she said. Vega, who cares for her mother, said she learned about how the union works and is governed, but also about using new technology tools like the UDW App that help her everyday as a caregiver. And, of course, she learned to stay motivated to protect IHSS and our clients. “You keep fighting,” she said, “and you never give up.”

At convention we also passed several resolutions to help guide our future work (see full list below), and made changes to our constitution.

“I felt so privileged to be able to attend,” said UDW caregiver Denise Justice of Santa Barbara County. “Seeing resolutions being passed was very cool and exciting – it gave me the extra push to get out there and be active. The solidarity and comradery of my brothers and sisters at convention was amazing.”

After two days of hard work, we wrapped up convention with a Saturday night gala. Caregivers, who rarely get a night out, put on our dancing shoes and celebrated all that we accomplished together.


See pictures from the 2018 UDW Convention here.


2018 Convention Resolutions

  1. Restore the 7% Permanently
  2. Fair Labor Standards for Homecare Workers
  3. Stop Electronic Visit Verification
  4. Support Family Caregivers
  5. Universal Long Term Care
  6. Support for Safer Interactions between Law Enforcement and People with Disabilities
  7. Collective Bargaining for Child Care Providers
  8. Stop Sexual Assault and Harassment
  9. In Support of Pay Equity
  10. End Dark Money Interference in California Politics
  11. Affordable Housing
  12. Climate and Electric Vehicles
  13. Support Immigrant Workers
  14. Support of Peace and Justice in Palestine
  15. Support for Cannabis in Healthcare
  16. Protective Supervision
  17. Share of Cost Notification

IHSS provider Rose Montano and her daughter Nicolette

Earlier this year UDW and working people across the country stood up and successfully stopped multiple health care repeal bills. We protected IHSS and Medicaid from cuts that would harm our clients and loved ones. The message sent to Congress was millions of voices strong: Protect Medicaid. Don’t cut our care.

Now they need to hear our voices again. Congress is working to pass a federal budget and a new health care repeal legislation that would make even worse cuts to Medicaid and home care in California. The new legislation is being rushed through Congress to beat a September 30 deadline. We must stop it before then.

The new proposal, known as Graham-Cassidy, will make devastating cuts to the overall Medicaid program which partially funds IHSS. In addition, the proposal will allow states to get rid of important consumer protections and essential health benefits and undermine or eliminate protections for people with pre-existing conditions.  All of this adds up to potentially devastating impacts for disability services and home care in our state.

California stands to lose $35 billion per year, even more than under previous ACA repeal proposals, because Graham-Cassidy deliberately shifts resources from large, densely-populated states that embraced and implemented the ACA, to smaller, more sparsely-populated states that did not. States like California, New York, Maryland, and Massachusetts that were successful in enrolling millions of people in the marketplace and on Medicaid would face disproportionately larger cuts – intentionally and explicitly. For more information on the threats posed by Graham-Cassidy, click here.

Call your members of Congress today 1-866-584-5792 and tell them to VOTE NO on Graham-Cassidy and on any budget or legislation that cuts Medicaid.

We must protect home care and the programs that our clients and loved ones rely on.

For Immediate Release
June 22, 2017
Contact: Dan Arel at 619-814-3337

Health care repeal would cut California’s home care program by over $400 million
New website—www.cutshurtCA.com—shares the stories of some of the 500,000 seniors and people with disabilities at risk

 Senate version contains deeper Medicaid cuts than bill that passed the House

 Repealing Obamacare will not only cut care for millions of Americans, but lead to devastating cuts to California’s Medicaid-funded home care program IHSS – a program utilized by half a million vulnerable and low-income seniors and people with disabilities in our state. Through the quiet elimination of the Community First Choice Option, the House version (called the AHCA) would immediately slash $400 million from IHSS and put the care of those who rely on it in jeopardy.

Senate Republican leaders released their draft of the bill today, and it features even harsher cuts to Medicaid than the House version. Republican leaders in the Senate plan to rush a vote by next week—these drastic, inhumane cuts could hit IHSS and Medicaid before the public knows what happened.

For the nearly 100,000 IHSS workers in California represented by United Domestic Workers of America (UDW/AFSCME 3930), cutting IHSS is unthinkable – so we’ve launched a new website to bring our stories forward and stop this cruel and destructive bill from becoming law. The interactive website allows users to see which California lawmakers voted for AHCA, meet the constituents who will be impacted by their vote, and easily send letters to their representatives in Congress.

“Cuts to Medicaid and IHSS would be devastating for Barbara,” says Turlock, CA care provider Lidia Rodriguez of her IHSS client who lives with MS, and whose story is featured on the site. “She told me that she would rather die than go to an institution and receive substandard care there. She is happier and healthier at home.”

In-home caregivers provide vital, cost-effective care that allows the state’s most vulnerable residents to live in their own homes with comfort and respect. Cutting or eliminating this program would lead to horrific consequences for California families, with thousands suddenly faced with insurmountable care costs, displacement and/or homelessness and, potentially, needless deaths.

Repealing health care for millions and cutting Medicaid would have a devastating impact on vulnerable Californians who rely on in-home care to survive and live with dignity. UDW members are united in fighting for the IHSS program and the clients they serve.

To read more stories of caregivers like Lidia Rodriguez or to learn about the health care repeal’s threat to California’s seniors and people with disabilities, visit www.cutshurtCA.com.



United Domestic Workers of America (UDW)/AFSCME Local 3930 is a home care union made up of nearly 100,000 in-home caregivers across the state of California. UDW caregivers provide care through the state’s In-Home Supportive Services program (IHSS), which allows over half a million California seniors and people with disabilities to stay safe and healthy at home

Howard Bedlin, NCOA, May 23

Straight Talk for Seniors®: 10 Ways the Administration’s Budget Would Impact Senior Programs

The White House released its first full budget proposal today, and it includes historic cuts to—and even elimination of—programs that older adults and their families have relied on for more than 50 years.

Congress has indicated that it will develop its own FY18 budget, so the Administration’s proposal is just that—an outline of its funding priorities. However, it does set up the debate for the coming fiscal year.

Here are 10 ways the Administration’s budget—if enacted—would impact senior programs:

Medicaid: Cut by $627 billion

The budget cuts Medicaid by $627 billion over 10 years. This is on top of the $839 billion proposed cut in the House of Representatives’ American Health Care Act, which would repeal and replace parts of the Affordable Care Act. Taken together, this would mean almost $1.3 trillion in Medicaid cuts over 10 years, an estimated 45% reduction in 2026. Nearly 7 million low-income seniors rely on Medicaid for their health and long-term care.

Senior Community Service Employment Program (SCSEP): Eliminated

The budget eliminates the nation’s only job training and placement program specifically for older adults. Last year under SCSEP, 70,000 older adults received on-the-job training while providing nearly 36 million hours of staff support to 30,000 organizations.

Medicare State Health Insurance Assistance Program (SHIP): Eliminated

The budget eliminates this program that each year supports 15,000+ counselors who provide free, state-specific assistance to over 6 million beneficiaries.

Low-Income Home Energy Assistance Program (LIHEAP): Eliminated

The budget eliminates this program that helps low-income individuals pay for their heating and cooling costs. About a third of the 6.8 million households receiving LIHEAP benefits include an older adult aged 60+.

Block Grants (SSBG, CSBG, CDBG): Eliminated

The budget eliminates the Social Services Block Grant (SSBG), Community Services Block Grant (CSBG), and Community Development Block Grant (CDBG). These programs provide states and localities with funding to improve economic security and independence for low-income families and seniors through services like home care, congregate and home-delivered meals, and transportation. SSBG is the only source of federal funding for Adult Protective Services. An estimated 4.4 million older adults receive services under SSBG and CSBG.

Senior Corps & AmeriCorps: Eliminated

The budget eliminates both of these national service programs that enlist older adults in volunteerism and serve seniors in communities nationwide. Last year, 245,000 Senior Corps volunteers provided 74.6 million hours of service.

Supplemental Nutrition Assistance Program (SNAP): Cut by $194 billion

Federal SNAP funding would be cut by $194 billion over 10 years. The budget also shifts more funding responsibilities to the states and erodes policies that streamline access for seniors and people with disabilities. Almost 5 million seniors rely on SNAP benefits to afford food.

CDC Falls Prevention: Eliminated

The budget eliminates $2 million in falls prevention funding in the Centers for Disease Control (CDC) budget. However, it retains $5 million in falls prevention funding in the Administration for Community Living budget. Every 19 minutes, an older adult dies from a fall; every 11 seconds an older adult is treated in an emergency room for a fall-related injury.

Chronic Disease Self-Management Education (CDSME): Cut by $3 million

The budget cuts federal funding for community-based workshops for people with chronic conditions from $8 million to $5 million, or 37.5%. Over 90% of older adults have at least one chronic disease and two-thirds have two or more.

Older Americans Act (OAA) and Elder Justice Act (EJA): Increases reversed

The budget reverses the modest FY17 increases for Supportive Services, Senior Nutrition, Caregiver Support, Native American programs, and the Elder Justice Act.

Download our funding table for a complete list of aging services programs.

What happens next?

Congress takes the budget from here. The House will write its own version, which may include some of these proposals or scale them back. Members of both parties have indicated that the cuts the Administration is proposing may be too deep.

The FY17 budget expires on Sept. 30, so the clock is ticking for Congress to adopt a new budget by then. Stay tuned for details as they unfold.

Andrew Joseph, Stat News, February 21

FENTON, Mo. — When Kim and Rich Rankin decided to adopt, they figured they would bring home an older child. They were almost finished raising seven children, and thought they were done with babies.

Then they saw a photo of “Baby S,” with his soft eyes and round cheeks. Rich suggested putting it on the fridge.

“We’re going to bring that baby home if we put his picture on the refrigerator,” Kim recalled saying.

That was what they did with the picture, and that was what they did with the baby. They called him Nathaniel — God’s gift.

Adopting Nathaniel also meant taking on his host of medical issues. Most seriously, he was born with extra tissue in his already abnormally narrow airway. He needed a tracheostomy tube inserted at the base of his neck to breathe. If it came out — which it sometimes did — they had less than two minutes to replace it.

As the Rankins recast their lives as parents of a medically demanding infant, one reassurance was that Nathaniel’s health care would be covered; as an adopted foster child, he could stay on the state’s Medicaid program. The Rankins would have to monitor Nathaniel’s many health problems, but they wouldn’t have to worry about whether they could afford to do so.

Now, though, the Rankins don’t feel so reassured. The Trump administration and congressional Republicans are weighing changes to Medicaid that could lead to cost savings and innovative reforms, but could also force states to cover fewer people and provide fewer services.

Care for patients like Nathaniel is expensive. The cost of the medical supplies he goes through just at home — suction catheters, oxygen tubes, tracheostomy ties, and so on — is about $5,000 each month.

“If the goal is to cut back,” Kim said, “these are the kiddos that will be hit.”

Now a headstrong 4-year-old with those same soft eyes and round cheeks, Nathaniel bounces through the Rankins’ home here outside St. Louis. He rings up his toy cash register and crashes his remote control car and sneaks into the toy closet. Outside, he digs in the dirt and pushes his red-and-yellow Fisher-Price car and stomps through woodchips.

But he is small for his age and hits milestones late. He may have permanent cognitive deficits, but it might just be that he’s spent so much time as a patient that he couldn’t keep up as a kid. He has heart and hand abnormalities. His medical team spans nurses, therapists, and specialists in two states. He will never be able to speak.

A photo of Nathaniel the Rankins were given before they adopted him. He was identified as “Baby S.”

The Rankins know they are not the poster family for Medicaid, which is often described as a safety net for the poor. Except for Nathaniel, the family has had private health insurance through Rich’s work as a carpenter.

Yet their case underscores how Medicaid covers a far more diverse population than is typically recognized; with more than 70 million beneficiaries, it is the largest insurer in the country. It covers some women who might not typically qualify if they are diagnosed with breast or cervical cancer. It is the main provider of long-term services for seniors and people with disabilities and pays for one-fourth of all mental health and substance abuse treatments. Forty percent of children rely on Medicaid.

The cost of the program is split between state and federal governments, with the federal government picking up a greater proportion in poorer states. If expenses grow, because a recession causes more people to enroll or the cost of expensive new drugs, for example, the federal government doles out more money. (The federal government pays for the large majority of the optional Medicaid expansion under the Affordable Care Act, which Missouri did not pursue.)

President Trump and leading Republicans — including House Speaker Paul Ryan and new Health and Human Services Secretary Tom Price — have proposed capping the amount of federal tax dollars delivered to each state. The plan could take the form of a block grant or a per capita allotment, but the goal is to cut spending and give states more authority to reshape their Medicaid programs.

“Caring for the most vulnerable patients must include not only ensuring they receive the care they need, but it must include ensuring programs like Medicaid that provide such care are sustainable,” House Republicans wrote last weekoutlining their health policy plans.

Some states, with permission from the Obama administration, have already launched Medicaid experiments, adopting cost-sharing provisions and pushing beneficiaries to consider how they get care. In Indiana, for example, some enrollees have to pay what are essentially premiums and can get penalized for using the emergency department for a non-emergency.

But supporters of block grants want states to be able to go further in their reforms, without being delayed by a federal review. Some Republicans, for example, have proposed letting states require able-bodied adults to work to remain eligible.

Seema Verma, Trump’s nominee to lead the Centers for Medicare and Medicaid Services, said at her confirmation hearing last week that block grants and per capita caps should be on the table.

“This is about putting states in a leadership role so that they can manage their programs better,” said Verma, who helped design the Indiana plan. “States are closer to the people that they serve than the federal government and they have a better understanding of what can work in their state.”

With limits on federal contributions, though, states would need to account for the lost funding as expenses rise. They could increase their contributions, but advocates and experts say they are more likely to charge beneficiaries, cut the amount they pay to clinicians, slash the services they provide, or limit who gets care.

“It’s a very effective policy if you want to reduce spending, but the question is, at what cost?” said Sayeh Nikpay, a Vanderbilt University health economist who recently wrote about Medicaid caps in the New England Journal of Medicine. “You end up reducing costs by covering very few people and covering very few benefits.”

Nathaniel Rankin waits for lunch at his home.

Nathaniel almost died the first night he spent in his new home.

A glob of mucus plugged his trach tube, robbing him of the ability to breathe. At the time, he was eight months old. His oxygen levels plummeted. His body turned gray, his lips blue. Finally, Kim was able to insert a new tube, and Rich pumped air into his lungs.

Kim and Rich couldn’t legally adopt him until after a six-month interim period, but that night, he became their son. Kim, 50, calls it their and Nathaniel’s birth story.

“You’re holding him in your hands, and life and death is right there,” Rich, 56, said. “That’s when I felt like I would grieve just as much for this child as I would any of my biological children.”

(Rich had two children from a previous marriage and he and Kim had five biological children; their other children are now between 17 and 34 years old.)

As his parents, Kim and Rich have fought to get Nathaniel the best care available. Last year, he underwent an operation at Cincinnati Children’s Hospital Medical Center that stopped him from aspirating food and liquids into his lungs. It also helped stabilize his airway so it’s not such an urgent emergency if his trach tube comes out.

But the surgery also made it impossible for him to ever be able to speak.

When Nathaniel cries, tears roll from his eyes and a silent strain is etched on his face, but he does not wail or whimper. The only sound he makes is a wet wheeze from the hole at the base of his neck, which grows louder and faster as he gets more upset. And when he cries — or laughs, or eats — he brings up phlegm into his airway that needs to be suctioned.

“God is our refuge and strength, a very present help in trouble. Therefore we will not fear,” reads a mural in the Rankins’ home, quoting Psalm 46.

Adopting Nathaniel has brought plenty of challenges for the Rankins and reshaped their lives in unanticipated ways. Kim thought she would be able to return to graduate school after a year of taking care of Nathaniel, but she is still his full-time caretaker.

“The simple answer is, ‘God gives the grace to accept changes,’” she said.

But there have been countless gifts from falling in love with Nathaniel. Kim and Rich have seen their other children become more compassionate since they’ve had their new little brother.

Raising Nathaniel has also altered how they view politics.

“It’s been a wrestle,” Kim said. “Some of the things we believe are upheld by the Republican party and yet we have this child that we dearly love who is likely going to have services cut by people in the Republican party. It’s hard.”

In the end, despite the disagreements he had with her, Rich said he voted for Hillary Clinton in the 2016 election because he felt Nathaniel would be better served by her policies. (Kim didn’t want to say whom she voted for.)

The Rankins are not sure what Nathaniel’s future holds and are weighing what kind of school he should, or could, attend. But their goals also include enabling him to experience life like any 4-year-old boy would want to, maybe even joining the Boy Scouts one day.

Still, there are risks. He loves to play in water, but any water that gets into his trach tube goes straight into his lungs. During one airway emergency, when Nathaniel aspirated vomit into his lungs, the hospital treated him as a drowning victim.

“I just want to go backpacking with him,” Rich said. “I want to take him up a mountain.”

Nathaniel Rankin in 2013.

The big fear for the Rankins is that Nathaniel could lose access to his care or have it interrupted with the potential Medicaid changes. It’s taken plenty of phone calls from them, and letters from their doctors, but with his coverage, Nathaniel has been able to get what he needs: the operation by the airway specialists in Cincinnati, visits to his team of doctors in St. Louis, regular appointments with occupational and speech therapists.

There are other changes the Rankins worry about as well. Nathaniel used to be in a managed care plan, which is designed to coordinate care at lower costs. But Kim said it was harder to get the nursing support the Rankins felt Nathaniel required and took more involvement from his doctors, so he moved to a fee-for-service plan. If the state cuts Medicaid services, would he have to go back to managed care?

Nathaniel’s providers have said he should stay on Medicaid so his care isn’t disrupted, but if needed, the Rankins could add Nathaniel to their private insurance plan. But there are hitches there, too. The ACA prohibits insurance companies from setting limits on the expenses they will cover for individuals, but if the law is repealed and that provision is lost, the cost of Nathaniel’s care could quickly surpass any newly imposed limit.

“There is a lot of advocating we have to do for his care, so to add advocating for his insurance, that would just compound it,” Kim said.

Here in Missouri, state tax dollars account for 17 percent of the Medicaid budget, with 51 percent coming from the federal government and 31 percent coming from a tax on health providers. And some parts of the program are already facing cuts. In his recent budget plan, Governor Eric Greitens, a Republican who took office last month, proposed trimming Medicaid reimbursement rates.

Timothy McBride, a health economist at Washington University in St. Louis, said Missouri already had some of the strictest Medicaid eligibility requirements in the country, so if it lost some share of federal funding, it would have limited options.

“It would have to be dropping services and cutting back on provider payments,” said McBride, who chairs the state’s Medicaid oversight committee. “There’s really nothing else they could do.”


Nathaniel and his speech pathologist, Jane Keegan Quarles, were making Valentine’s cards on a recent day at St. Louis Children’s Hospital, and she was showing him how to get his augmented communication device — a special app on an iPad — to say that word. She tapped a few symbols on the iPad and a computerized voice echoed: “Fold.” Quarles creased the card and handed it to Nathaniel, who doodled on it.

As they have thought about Nathaniel’s coverage, Kim and Rich have also wondered if potential cuts to Medicaid would discourage people from adopting children, especially those with intense medical needs. That would mean fewer kids like Nathaniel might find families like the Rankins.

“We took a risk in falling in love with Nathaniel, because there was no guarantee he was going to live,” Kim Rankin said one night at home. “I think so much of our culture, we want to guard against risk taking, we want to be certain that not only are we going to be OK, but that the people we love are going to be OK.

“And every day I wake up and I don’t know if Nathaniel is going to be OK,” she continued. “There are things that could happen to him that even now, after his airway surgery, could take his life that a normal child could breathe right through. But I think the rewards of taking risks for the sake of love has really been the most valuable lesson to me.”

Quarles and Nathaniel finished making their card and handed it to Kim. Quarles held up Nathaniel’s device and coached him to “use your words” to tell his mom something. She pointed, and he jabbed his finger at two symbols. “Love,” the voice said. Two more jabs: “You.”

“Ah, I love you too, Nathaniel!” Kim said.

Nathaniel stepped to his mother, who swallowed him in a hug.

Frequently Asked Questions about ACA and Medicaid

We’ve all heard a lot of talk about repealing the Affordable Care Act lately. But did you know Medicaid is also on the chopping block? Congressional Republicans have long talked about changing Medicaid, and any changes to Medicaid will impact IHSS providers and home care recipients.

Here are some common questions and answers to help make sense of what’s going with our health care and home care.

What is Medicaid?

Medicaid, which is called Medi-Cal in California, is an entitlement program that provides health coverage for millions of low-income Americans – including children, seniors, pregnant women, and people with disabilities.

What is an entitlement program?

An entitlement program is a government program that guarantees benefits to individuals who meet the program’s eligibility requirements. In the case of Medicaid, this also means the state is guaranteed federal funding to pay for the cost of Medicaid programs like health insurance and IHSS.

What does the Affordable Care Act have to do with Medicaid?

The Affordable Care Act (also known as the ACA or Obamacare) went into effect in 2014. The ACA expanded Medicaid eligibility to cover many Californians who did not qualify before – including 47,000 UDW caregivers.

In addition, half the funding the state uses to pay for the IHSS program comes from Medicaid.

How does Medicaid funding work?

Right now, the federal government provides at least $1 for every $1 each state spends on Medicaid. To ensure those in need always have access to health care programs, Medicaid funding increases as need for Medicaid programs increase. In fact, during the most recent recession, more than 10 million additional people were able to enroll in Medicaid.

How have Republicans proposed to change Medicaid?

Republicans want to limit the amount the federal government spends on Medicaid. They plan to do this by putting a cap on the amount of money states receive to pay for the program.

One proposal would be to use block grants to limit states to a preset amount of funding for Medicaid.

Another proposal known as per capita caps would give states a set amount of funding per individual or per group of Medicaid covered individuals, such as children, seniors, and people with disabilities.

What’s wrong with these proposals?

Right now, federal funding for Medicaid increases as the need for Medicaid programs like health care and in-home care increases. However, if the amount of money states receive is capped by block grants or per capita caps, states would not receive additional funding even if they need it.
Individuals and families would either have to go without insurance, or states would have to cut funding to programs like IHSS to afford the additional health care cost. Either way, many Californians could suffer.

How would my family and my IHSS client be impacted if the Republican proposals are passed?

If California receives less federal funds for Medicaid, the state will have to make choices that will hurt the families and clients of IHSS providers.

To reduce the amount of money the state spends on Medicaid, the state would make the eligibility requirements for Medi-Cal and IHSS stricter, which means many people in need of services like seniors and people with disabilities who need IHSS, would no longer have access to them.

Other essential public services UDW caregivers and California communities rely on, such as education and law enforcement, could also be cut to pay the additional cost for Medicaid programs.

Bottom line:

Sources: http://www.cbpp.org/research/health/policy-basics-introduction-to-medicaid
Justice in Aging – Issue Brief: Medicaid Funding Caps Would Harm Older Americans

With a new president in office and a new administration at work, changes are coming that will affect IHSS providers, our clients, our families, and our communities.

This year, UDW caregivers face challenges in Sacramento and Washington D.C. Protecting health care and home care, our children, our paychecks, and keeping people with disabilities safe are all top priorities for our union.

Here’s a closer look at our legislative priorities in 2017:

Protecting—not repealing—our health care

Tens of thousands of IHSS providers get our health insurance through the Affordable Care Act (also called ACA or Obamacare). As Congress works to roll back and dismantle the ACA, UDW stands firm in our commitment that the access, affordability, and quality of our health care should be improved, not cut.

Protecting the IHSS program

Like Obamcare, Medicaid is also on the chopping block. Not only does 60% of Medicaid spending go to seniors and people with disabilities, it also provides an estimated 54% of the funding for the IHSS program. The administration’s plan to change Medicaid from a federal entitlement to a block grant program will have a negative impact on our home care clients because it will mean less federal funding for IHSS. UDW is committed to protecting home care by working to protect Medicaid.

Keeping our clients safe

In the past few years, we’ve sponsored legislation with the goal of keeping people with developmental and intellectual disabilities safer in our communities. This year, we will build upon that work by sponsoring a bill that seeks to improve the state’s emergency response systems by giving first responders – law enforcement, firefighters, and EMTs – information that will help prevent negative interactions with people in their communities with mental impairments and developmental disabilities.

Improving the IHSS payroll system

Last year, we urged the Legislature to address problems with the IHSS payroll system that cause all too frequent paycheck delays. We succeeded in winning a statewide audit of the current system. The results of the audit are expected in March, and UDW will use the audit’s findings to sponsor legislation to finally fix the payroll system, and ensure providers are paid in a timely manner.

Improving California’s child care system

Family child care providers run daycares in their home where they provide care and early education for many of our children while we work. Unfortunately, like IHSS providers, family child care providers often experience paycheck issues and delays. UDW is working with family child care providers to urge the state to make changes that will ensure providers are paid faster and are notified when there are changes in family eligibility.

Want to help? Click here to call your local office to see how you can get involved in these fights and more!

Election Day 2016 has come and gone, a new president is in the White House, and the U.S. Congress is now in session. No matter how you voted in November, one thing is certain: the decisions of the new administration and Congress will impact IHSS caregivers and recipients. And if what we’ve seen so far is any indication, we’re in for quite a fight.

“Medicaid pays for 55% of all IHSS funding,” said UDW caregiver Susana Saldana of Merced County. If Obamacare is repealed, Medicaid could be nest on the chopping block.”

“We need to stand together to show that we’re united, that we’ll fight to protect our children, people with disabilities, and seniors.”

Many UDW members share Susana’s concerns, but we also know that we have a long history of fighting back against threats to IHSS and our clients.

UDW caregivers in action

Betsy Herrera takes care of her mother in their home. She also brings her with her to rallies and lobby visits at the Capitol so that they can fight for IHSS together.

Back in 2009, when former Governor Arnold Schwarzenegger tried to eliminate the IHSS program altogether, UDW caregivers stopped him. Three years later, when Governor Jerry Brown tried to cut the IHSS program by 20%, we stopped him, too. And we continue to fight back against cuts and other threats to IHSS every time the state throws them at us. (click here for a timeline of our victories!)

In 2015, after the governor went back on his promise to pay us overtime, we fought back and won. Last year, for the first time in history, IHSS providers finally began receiving the overtime pay that most working Americans have enjoyed since 1938.

UDW caregivers do a vital and selfless job and have always stood strong against attacks on home care and our clients. We advocate for each other, for the health and dignity of seniors and people with disabilities, and together we have had a direct role in each and every one of our victories. The threats we face in 2017 will be no different.

What’s next

UDW caregiver Julie Otero speaks out at a rally to protect the Affordable Care Act in Bakersfield, CA.

This year, we’re already fighting back against an attempt by Congress to repeal the Affordable Care Act (also known as Obamacare). Because of the ACA, an estimated 75,000 UDW caregivers are now eligible for free and affordable health coverage.

“The ACA is important,” said Betsy Herrera, an IHSS provider from Stanislaus County who takes care of her mother Margarita. “Both my mom and I depend on it. There is no way we would be able to get the medical care we need without it. And without Medicaid, I’d be out of a job.”

Betsy is right, and she echoes the worries of many other IHSS providers as well. Attacks on the ACA are an attack on our health care, but an attack on Medicaid – which House Speaker Paul Ryan has spoken about for years – is a direct attack on IHSS.

Medicaid, a federal program, provides 55% of the funding for the IHSS program. That means if Medicaid is cut, changed, or eliminated, IHSS recipients and providers will feel it.

But not all of the threats we face in 2017 will come from the new administration or Congress.

An out-of-state, corporate billionaire-backed, anti-home care organization known as the Freedom Foundation began targeting IHSS providers last year. The Freedom Foundation says they want to help home care providers save money by trying to convince us to leave our union, but what they don’t say is that the victories we have won threaten their agenda.

Freedom Foundation claims they understand IHSS workers and our clients, but they don’t. One of their executives called caregivers a bunch of “babysitters.”

“Groups like that don’t care about us or our clients, they care about power,” said UDW caregiver Sharon Duchessi of Placer County.

The Freedom Foundation tells union members to give themselves a raise and stop paying union dues.

“They are telling providers that the union doesn’t do anything for us,” said caregiver Julie Otero of Kern County, “but who is there when our hours are taken away? ‘Giving ourselves a raise’ means not having back up and no one to fight for us – leaving UDW means we stand alone, but in unity we have strength.”

Fight, Protect, Win!

LaTrese Lofton fights to protect IHSS for clients like her daughter Sha’Quonna, who lives with Angelman syndrome.

UDW caregivers will face some tough challenges in 2017, and the road ahead of us will not always be easy. However, if we keep our goals of strengthening and protecting IHSS in sight, and we work together, we can win!

“Together we stand, divided we fall,” said LaTrese Lofton, who provides care for her daughter Sha’Quonna in Riverside County. “This is the time for us to fight as hard as we’ve ever fought before.”

So get ready, UDW caregivers. Let’s make 2017 our best year yet.

For more information about getting involved and joining the fight to protect home care, call your local office or visit www.udwa.org.


On Saturday, January 21st, millions of women, men, and children in hundreds of cities around the world stood together in unity as part of the Women’s March on Washington. In California, it is estimated that 880,000 or 1 in every 45 residents attended a local march in dozens of cities across the state.

For UDW members, the reasons to march were as diverse as the nearly 98,000 IHSS providers our union represents, but a sense of urgency and a passion to fight for our rights united us all. We were among the huge crowds of people standing up for the environment, equal rights for women and people of color, immigrant rights, the rights of people with disabilities, and LGBTQ rights, home care, and our health care – rights that millions feel are under attack.

“I marched because women should be able to make decisions about our bodies,” said UDW member Luz Cedeno from Orange County. “And I marched because taking away the Affordable Care Act without a plan, and potentially cutting Medicaid would be harmful.”

The day before the march, an executive order was signed to push federal agencies to weaken the Affordable Care Act (ACA) also known as Obamacare. Changes to the ACA that don’t include a plan to improve and replace it could be particularly detrimental to UDW caregivers and our families, because an estimated 75,000 of us are now eligible for free or lower cost health insurance because of it.

“I marched because everything that many before us fought and even died for is at risk of being undone,” said UDW Vice President Astrid Zuniga who spoke at the Women’s March in Modesto.

As a union, we have been fighters for many social justice causes. We do this work because none of us are only caregivers. We are women, men, young people, older adults, immigrants, members of the LGBTQ community, people of color, people with disabilities, Republicans, Democrats, Independents, low-wage workers, the middle class, formerly incarcerated people, and so much more. We don’t let these differences divide us, instead we meet at the intersection of all of these identities and fight together for justice for us all.

“It was so amazing and liberating to stand up for the rights of our clients and for home care,” said Kym Icke, a UDW member from San Diego County. “By marching, we told our elected leaders that we are here and we are important.”

“I marched to ensure our rights aren’t violated,” echoed UDW member Camilla Bradford from Riverside County. “Our health. Our choice. Our bodies. LGBT rights. Everything. We must unite, stand together, and fight. We can’t put women back 300 years.”

Desmond Prescott, also from Riverside County, was one of the many men who marched. “I marched to support my fellow caregivers, and celebrate the contribution these women make to our society.”

No matter your reason for marching or not marching, it was a historic day that our country and the world will remember for decades to come. “I took my granddaughter with me,” said Cassandra Sambrano, a UDW member who attended the march in Riverside. “She’s eight years old, and I took her because I wanted her to be part of history.”

We want this beautiful moment of solidarity to spark a movement that is not fleeting, but instead creates a ripple effect that continues to move people to action on issues facing our families and communities. Many UDW caregivers have been social justice activists for years, but some of us are new and need help figuring out what to do next. Some suggestions include:

  1. Stay active with our union. Click here to become a UDW member then click here to contact your local office, and find out how you can get involved in our work to protect the IHSS program and improve our communities.
  2. Take part in ongoing actions that matter to your fellow caregivers, your family, and our IHSS clients. For example, click here to stand up for our health care by calling your Congressional Representative and telling them to support the Affordable Care Act and Medicaid.

Let’s keep moving forward, together!

UDW caregivers started 2016 off with a bang. In fact, we made history.

Overtime pay

On February 1st, for the first time ever, eligible IHSS providers began receiving pay for the hours of overtime we work – a right we fought hard to secure throughout 2015.

Throughout the year, we worked with the state to make sure overtime was a benefit for all providers. With our help, the state developed exemptions to the tough new IHSS overtime and workweek rules that helped prevent unfair disruptions in our clients’ care.16043034094_ef299c64df_z

Social Security and unemployment benefits for ALL caregivers

In 2016, we also began our work to win unemployment, Social Security, and Medicare benefits for IHSS providers who care for their spouse or child – an issue that has affected many of us personally, including former IHSS provider Cathyleen Williams from Barstow.

“I was Caleb’s mother, but I was also his home care provider,” wrote Cathyleen in an op-ed in the San Diego Union-Tribune. “Caleb passed away and my job as his home care provider ended, I applied for — and was denied — unemployment.”

With Cathyleen’s and so many other stories to push us, we fought hard to get our sponsored bill, AB 1930, passed through both the Senate and the Assembly. The bill would have convened a committee to look into the financial impact exclusion from basic benefits like unemployment pay has on parent and spouse providers. Although AB 1930 was passed unanimously by the legislature, Governor Brown vetoed it in late September.

“I don’t think I will ever be able to truly put into words the pain of losing a child,” continued Cathyleen. “But I know I want to help lessen this pain for other parent and spouse home care providers who have to navigate the world without their loved one and no social safety net.”

Instead of looking at the veto of AB 1930 as a defeat, UDW caregivers can take solace in the fact that our elected leaders and the public heard us, as we can continue our work to win these benefits in 2017.30582507155_8a77a34884_z

$15, paid sick days, and more

In April, we helped win one of the toughest battles facing working people today – the Fight for $15. Because of rallies, marches, lobby visits at the Capitol, demonstrations and more work alongside other low wage workers, our elected leaders agreed to a plan that will raise California’s minimum wage to $15 by 2022 and give IHSS providers paid sick days.

“This a huge victory for all working Californians, but especially IHSS providers,” said UDW President and our fellow home care worker Editha Adams. “We’ve been denied paid sick leave and a livable wage for far too long.”

We celebrated this amazing achievement, but we also used it as a stepping stone. We know the work of IHSS providers is worth far more than minimum wage, which is why UDW caregivers went All In for Care. At the state level in Orange, Riverside, and San Diego counties, and at the county level in other UDW counties, we will continue to demand respect, dignity, as well as fair pay and benefits for our work at the bargaining table.

Cuts to the IHSS program have a direct impact our caregivers and our clients. The 7% cut to our clients’ hours of care was restored for one year in 2015. In 2016, we also lobbied and successfully urged our elected leaders to restore our clients’ hours for another three years.


Your IHSS paycheck

As we all know, the current IHSS payroll system is far from reliable. Early this year, UDW caregivers decided that enough was enough. We’re tired of waiting for late paychecks and timesheets, and we’re tired of not knowing if and when we’ll be able to pay our bills.

In May, we testified at a joint Legislative Audit Committee hearing at the Capitol to ask the legislature to approve an audit of the IHSS payroll system. Claire Kaufman, an IHSS provider for her daughter Katie in El Dorado County, was one of the providers who told her story. “Last November, I submitted my IHSS timesheet for the first 15 days of the month and waited for my paycheck,” said Claire. “I waited days and then weeks, unable to get an answer about the delay.” Claire was finally paid just before Christmas in 2015, but her family had to sacrifice their holidays so that she could catch up on their bills.

The committee approved the audit, and we expect to receive the findings in early 2017. UDW will then use them to create legislation that will address and fix the problems with the payroll system.

We didn’t stop at the audit, though, and throughout the year we continued to urge the state to make improvements. Finally, in October, after a lot of pressure from UDW, the state announced it would offer an electronic timesheet option in 2017.


Election Day 2016

In addition to our UDW fights and victories, we elected a new president in 2016, and despite our feelings – good or bad – about the outcome, President-elect Trump will take office in January. The incoming president, his administration, and the Republican led Congress have all expressed opposition to programs on which IHSS providers, recipients, and working families rely.

The election sets the stage for some major fights in 2017:

House Speaker Paul Ryan has long threatened to cut Medicaid, which provides 55% of the funding for IHSS.

Senate Majority Leader Mitch McConnell said repealing the ACA, which has made an estimated 75,000 UDW caregivers eligible for free or low-cost health coverage, would be “the first item up in the new year.”

The Freedom Foundation

And an anti-home care organization known as the Freedom Foundation has begun targeting UDW caregivers – making themselves a major threat in 2017. The Freedom Foundation tells IHSS providers to quit their union in order to save money. Unfortunately, they don’t tell the full story. As a union, we’ve fought and won big victories, not only this year (see a list of our many victories together here). No one provider could do alone what we do together. The Freedom Foundation wants to weaken strong unions like ours, in order to further their corporate billionaire-backed agenda.

Preparing for 2017

In 2017 we will continue to urge the state to fix the IHSS payroll system once and for all, and we will keep pushing for Social Security, Medicare, and unemployment pay for spouse and parent providers.

It will also be our time to prove that when UDW home care workers stand together, we can fight back against attempts to take our healthcare, weaken IHSS, or weaken us as a union by taking our voice and power. The stakes have never been higher, but we have protected home care and our clients time and time again – if we stand together, next year will be no different.

We look forward to fighting for home care with you in 2017. Happy New Year!img_2728

Fight for Our Health Coalition


December 20, 2016

CONTACT:   Mike Roth, 916.444.7170; Maria Elena Jauregui, 818.355.5291 (Spanish-language)

Bakersfield, CA –  Today, Congressional Majority Leader Kevin McCarthy (R-CA)’s Central Valley District became Ground Zero in a massive effort to fight back against Trump and GOP proposals that would strip 30 million Americans of health care under the Affordable Care Act (ACA) and create chaos in the health care system we all count on.

“As a constituent of Congressman McCarthy, I am here to tell him we can’t go back to being uninsured,” said Carmen Morales-Board, a nurse practitioner who has worked at Kern Medical for 24-1/2 years and is an active member of SEIU’s statewide Nurse Alliance. “It means that my patients will have to go without their prescriptions to give their kids lunch money.  Republicans promised to replace Obamacare, but they have no plan – meanwhile our patients’ lives are hanging in the balance.”

Over 100 of Republican Majority Leader Kevin McCarthy’s constituents who stand to lose health coverage under a Trump Administration and GOP Congress rallied outside his office to deliver a “Prescription for a Healthy New Year” that includes strengthening the ACA to protect the five million Californians who have health coverage under the landmark health care law. Last month, McCarthy told reporters he supports repealing the ACA with no replacement plan in place for the millions who would lose coverage, breaking with years of GOP claims to “repeal AND replace” the ACA.

McCarthy’s district includes portions of Tulare and Kern counties, which have the greatest proportion of residents insured by Medi-Cal in the state. McCarthy’s leadership position and the striking number of his own constituents who would lose healthcare under President-elect Trump and GOP Congressional Republicans have made Bakersfield Ground Zero in the fight to protect healthcare for millions of Americans.

Over the last 8 years, California has done more to expand health care access, expanding care to more than five million people in our state. Now, the progress that we have made is at risk under a Trump administration and GOP Congress:

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The Fight for Our Health Coalition includes Health Access, SEIU California, SEIU Local 521, SEIU-UHW, SEIU Local 2015, UFW Foundation, Dolores Huerta Foundation, UDW/ AFSCME Local 3930, UWUA 246, Planned Parenthood Mar Monte, Project Inform, CIR/SEIU, California Alliance for Retired Americans, Community Health Initiative of Kern County, Faith in Action Kern County, California Partnership, Kern, Inyo, and Mono Counties Central Labor Council. 


Call 1-866-584-5792, and tell your Congressional Representative to vote to protect the Affordable Care Act and Medicaid


President-elect Trump and Congressional leadership have committed to repealing the Affordable Care Act (known as the ACA or Obamacare) as soon as January 2017. House Speaker Paul Ryan has argued for years in favor of cutting vital programs like Medicaid (known in California as MediCal). And just this month, Senate Majority Leader Mitch McConnell said repealing the ACA would be “the first item up in the new year.”

That means the health coverage our families rely on is on the chopping block and under attack. And Medicaid could be next.

This is urgent!

We’ve fought hard to secure health care our families can afford, and as home care providers, our top priority is always the health and safety of our clients. The incoming administration and Congress are looking to unravel decades of our hard work.

MediCal’s eligibility requirements were expanded to give more Californians access to health insurance because of the ACA. In fact, an estimated 47,000 UDW home care workers are now eligible for MediCal. And 28,000 additional UDW members qualify for health care subsidies through Covered California, another ACA program. All in all, repealing the ACA will cut the health care coverage of tens of thousands of UDW caregivers and our families, as well as more than 20 million Americans nationwide.

We cannot let this happen, and we cannot allow disruptions in our IHSS clients’ care.

Medicaid provides 55% of the funding for the IHSS program. That means changes to Medicaid could cause cuts to the number of home care hours our IHSS clients receive, put unfair limits on care, and negatively impact our ability to care for our home care clients.

Our clients and families can’t afford for us to wait and see what happens to these vital programs. We have to take action NOW.

Call 1-866-584-5792, and tell your Congressional Representative to stand up for seniors, people with disabilities and working families by voting to protect the Affordable Care Act and Medicaid.

A new president means a new administration and new policies. And new policies or changes to existing ones can have effects on the IHSS program. While we don’t know what will happen yet, there are some things IHSS providers and recipients should be aware of as we continue our work to protect and strengthen California’s home care program.

What could that mean for IHSS? Benefits and eligibility for Medicaid-funded programs like IHSS here in California could be cut if federal funding is reduced. Remember, 55 percent of funding for the IHSS program comes from Medicaid, so changes to Medicaid funding will be felt by providers and our clients.

What could that mean for IHSS? Right now, many UDW caregivers and our families are among the estimated 20 million people who get their health insurance through the ACA. Many of us receive subsidies through Covered California, or receive Medi-Cal through the ACA’s expanded eligibility. In addition, California participates in the Community First Choice Option (CFCO), a program available through the ACA that provides increased funding to states who promote home and community based services like IHSS.  Changing or repealing the ACA could mean reduced funding for IHSS and leave many of us without health coverage.

What could that mean for IHSS? If this happens, federal funding for overtime pay goes away. This likely means the State will stop paying IHSS providers overtime pay, as our law states that it’s only required if authorized by federal law.

What could that mean for IHSS? The majority of our IHSS clients depend on SSI as their only or primary source of income. If SSI is cut, our clients’ quality of life could suffer.

Because IHSS is funded by the state and federal government, its future is tied directly to what happens in Sacramento and Washington D.C. That’s why we must be stronger together – to fight to protect our clients and loved ones in the face of these potential threats to our program.

UDW will keep you posted on how the recent election can and will affect providers, clients, and our families. Want to get involved in our efforts? Call your local UDW office today.