FACE Hawaii’s plan to

intervene in the growing
home health care sector
FACE has an implicit economic agenda: improving the position of our people on the islands.
FACE's role is to use the power of the organization to make strategic interventions in the
economy of our state by developing these campaigns through the lens of family economics.
Issues which do not impact the economic life of our families are rarely selected at FACE.
Foreclosure, improving union contracts for hotel workers, affordable housing, healthcare reform
and first source hiring laws all passed this filter for determining what to work on. At FACE the
classic Alinsky stick figure is often a drawing of a family, with various economic pressures
surrounding it.
In 2011, following on the success of Obamacare, FACE launched a multi-phase strategy to
improve home health care as a job sector. We will raise wages, create new standards and benefits
and grow the sector. Our campaign is led by home health care workers organized through our
churches and temples and is supported by UNITE HERE and Hawaii's Health Connector board.
The workers themselves are largely ethnically Tongan, Filipino, and Chuukese, almost all new
immigrant workers. Our work on immigration reform in the state, as well as the national work
helped to credential us to this group.
Increasing wages for home health care workers requires a new minimum wage law: FACE
launched an effort to increase the state minimum wage from $7.25 to $9.25 in 2013. These
workers are not represented by a union, nor are there large employers that dominate the field.
The most effective way to increase wages for all home health workers is to raise the floor. FACE
built a coalition with ILWU, UNITE HERE, and Hawaii Appleseed to pass this bill and we
received significant support from the National Employment Law Project. We met recently with
the key opposition in the State Senate and have a handshake agreement to work together on
raising the minimum wages next session.
The current status of the bill is that it has passed the House and Senate in slightly different form,
and did not make it through conference committee in 2013, but the bill remains alive for 2014.
We expect to be able to pass it early in the session. If it is enacted it will be the highest state

minimum wage the United States. According to NELP, it will effect 88,000 full and part time
workers in Hawaii of which 9,000 are home healthcare workers.
Regulating the sector: FACE has worked to change the training standards, licensing and
certification costs for this industry. In 2013, we changed the rules for renewing CNA
certification – covering 1,000’s of workers and allowing them to by-pass formally required
retraining classes that cost $1,500-1,800. We also supported legislation passing a domestic
workers bill of rights which created new protections for workers in this field. We will be
working to define these benefits during in the coming year.
Creating a new mutual benefit society for home health care workers: Home health care workers
are usually not covered by workman’s comp, private insurance, or other benefits. FACE will
address this by creating a large-scale mutual benefit society to collectively purchase needed
insurance. This is particularly important due to the high injury rate for home health care
workers; lifting people is a common task that can lead to injury, leaving the worker out of work
and with no source of income.
About 1/3 on home health care workers in Hawaii work for agencies as independent contractors,
so the workers are expected to pay their own workers comp TDI insurance, taxes, mileage, etc.
$7.50-8.50 an hour contract wage. Consequently, these workers are rarely insured. FACE is
working with the new Health Connector board and the Local 5 Health and Wellness fund. Local
5’s Health and Wellness fund is among the highest standard of benefits in the country, and they
are investigating how they might help us set up a similar fund, or invite home health care
workers into their existing fund.
Expanding the sector: FACE is in the process of creating a home health care worker-owned
cooperative. FACE is also working on the creation of a state funded long-term care insurance
fund. The fund would be paid via payroll tax, and would expand the number of home health
care jobs, growing the sector overall. This is a good fit for FACE’s other goals of addressing the
needs of its aging population in the pews. If this passes, Hawaii will be the first state in the
country to have mandatory long-term care insurance. (Note we have passed this through the
House and Senate twice over the last 12 years – and been stalled by Gubernatorial vetoes each
Unionizing the Sector: Ultimately we are interested in unionizing this sector. FACE has had
several meetings with SEIU about how we might help create a union local among this
population. There are real barriers to this working – most significantly the enmity between
UNITE-HERE and SEIU, as well as the fact that SEIU has no presence in Hawaii. Still talks are
ongoing. Initial conversations with other locally based unions were not successful.
This campaign is a systematic and broad-based grassroots attempt to intervene the fastest
growing job sector in the state. When completed, elements of this campaign will provide a model
for other states.