KOJO NNAMDIYou're tuned in to The Kojo Nnamdi Show from WAMU 88.5. I'm broadcasting from home. Welcome. Later in the broadcast how area residents with mental and intellectual disabilities are affected by the Coronavirus pandemic. But first for those who are elderly, sick or have disabilities home health workers are a lifeline providing assistance in everything from cooking and cleaning to dressing, personal hygiene and overall welfare. Most home health aides are also women predominantly women of color earning minimum wage.

KOJO NNAMDISo how safe are these jobs in the era of stay-at-home orders and social distancing? Are nurses and health aides receiving proper protective equipment? What supports do they need? And what happens if they get sick? Joining me to discuss the plight of home health workers on the frontline of the pandemic is David Broder. David Broder is the President of Virginia's chapter of Service Employees International Union, SEIU, which represents home health care workers. David Broder, thank you for joining us.

DAVID BRODERThanks so much for having us on, Kojo.

NNAMDIDavid Broder, before we go any further can you first describe the role of home health care aides. What kind of work are they doing?

BRODERSure. They're doing vitally important work. Home care workers are providing hands on care to help older adults and people with disabilities live independent healthy lives in their homes and in their communities. They're helping them get out of bed in the morning, get dressed, get medicine. They help them work and volunteer and engage with their families and essentially be full parts of the community just like any of us would want.

NNAMDIWell, what you seem to be saying is that home health care aides, home health aides by nature of what they do cannot really maintain social distance with the people they're taking care of. Can they do that?

BRODERNo, they can't. You're exactly right, Kojo. There is no social distancing for home health aides. This is by its nature hands on work and it's vitally important. It was vitally important before this pandemic, but now it's even more critical, because they are providing care to those most at risk from this Coronavirus, the older adults and people with disabilities. They are going into their homes and there is simply no way to do that via telework.

NNAMDIDavid Broder, what do we know about the demographics of this workforce?

BRODERSure. So this is a workforce that is 90 percent women. It is majority people of color and it's almost one-third immigrant. And the reality -- what we're talking about, Kojo, today is a racial justice issue as much as it's a healthcare or an economic justice issue, because the work that home care workers do just like the work of childcare workers or domestic workers or any other work traditionally done by women of color has long been devalued. And so even going into this crisis, workers have been denied the basic benefits, protections, rights on the job that they need. That isn't new. But the Coronavirus is shining a spotlight on it and how dangerous it is for them, for the people they care for and for all of us in the community.

NNAMDIHow much are Virginia's home health aides paid on average, David?

BRODERNot enough, I can tell you for the heroic work they do. On average, Virginia's home care workers make just above $11 an hour, and that comes with few or no benefits at all. And that's one of the real challenges in this crisis is they don't have paid sick leave. They don't have the kind of leave that sometimes we take for granted. And that's particularly challenging right now, because it's forcing home care workers to make impossible decisions about whether they go to work sick and potentially expose someone they're caring for or do they stay home and not get paid and miss paying their bills. It's a terrible choice that we are forcing them to make, and again, it's a public health crisis during this pandemic.

NNAMDIIn case you're just joining us, we're talking about home health aides in this region and the work that they do during the Coronavirus pandemic. David Broder, how do the earnings of home healthcare workers compare in Virginia to the rest of the region? In other words, are Maryland and D.C. home health aides paid much different?

BRODERYou know, sadly this is a national problem that, again, because it's been work traditionally done by women of color society simply hasn't viewed it, and so home care workers have come together in our union. They've advocated. They've seen improvements, but it's a national crisis we have that home care workers simply don't make enough to live. And so it is particularly challenging in Virginia. But it's true throughout our region.

BRODERAnd in fact in Virginia a full 44 percent of home care workers are at 200 percent of the federal poverty level or below and 40 percent rely on one public assistance program or another. And so the work they're doing is extraordinary. Anyone who's ever had a home care worker care for a loved one and I know our family has, I'm sure many of your listeners have, they know this work is invaluable. We're not paying folks anywhere near what they're worth.

NNAMDIAre home aides considered an essential part of the workforce?

BRODERI believe that they're essential. Any one, any family who uses them believes that they're essential. Under the governor's executive orders, they're still permitted to go and do work, most folks in Virginia are. But as we read them, the executive orders haven't supplied any home care workers with what they need. And so what they need like any frontline worker right now is personal protective equipment. They need masks, gloves, gowns. They need paid leave and they need hazard pay and that has not been provided yet in the Commonwealth.

NNAMDIThey're not getting personal protective equipment? So what happens if home health care workers start getting sick?

BRODERIt's really terrifying to think about. What would happen to them and their families? What would happen to the older adults and people with disabilities that they care for? But then again what happens to the community? Many home care workers take public transit to get to work. Many home care workers, because of the low pay have to work for multiple clients. So they're going in and out of multiple homes, and so it's a real crisis we have on our hands.

BRODERAnd we know that there's not enough PPE to go around right now. But we need to make sure that as we're working to get nurses and doctors and others PPE we have to lift up the urgent need for home care workers. And I got to say, Kojo, we need the federal government to be doing everything in their power to provide more PPE. And we are just stunned that they are not doing more. It is criminal. It is dangerous.

NNAMDIWe're talking about home health aides with David Broder. He is President of Virginia's chapter of the Service Employees International Union, SEIU, which represents home health care workers. And joining us now is Joyce Barnes, who is a Home Health Aide in Henrico County, Virginia. She's been doing this work for more than 30 years. Joyce Barnes, than you for joining us.

JOYCE BARNESThank you for having me.

NNAMDIAs I mentioned, you've been doing this for more than 30 years. Tell us about the work that you do.

BARNESThe home care work that I do, I go into the people's home and I provide care like bathing, cooking, light housekeeping, going to the store for them, doctor's appointments, anything that they may need me to do. It's very important that I do this for them. And I have two clients that I'm doing work with right now. I have a patient that's a double amputee and he needs a lot of help. And then I have one who just had a stroke, and that one needs a lot of help. What you have to do for them, because they can't do for themselves especially when it's cooking and getting and trying to walk and assisting them. I have to be with them at all times.

NNAMDILet's hear from Ann Marie here in Washington D.C. Ann Marie, you're on the air. Go ahead, please.

ANN MARIEThank you and thank you all for what you're doing for all of us by being there. And this is terrific and very important topic. I couldn't agree with more with your observations and your guest's observations. We have a wonderful home health care worker with whom we contract directly for my 99 year old mom. She's an integral part of our family for many years. We do pay $15 an hour, paid leave and vacation as well, paid sick leave and we provide personal protective equipment for her as with every member of our family. We don't expect any hero awards, but it's what we can afford.

ANN MARIEThat said one of the specifics that I'm wondering about is if any of your listeners might be lawyers or tax lawyers, who could speak to whether we as direct employers of a Schedule 8 employee for tax purposes, FUTA, FICA, Social Security being paid, etcetera, might qualify for the payroll protection plan loans as an employer of a single employee so we could keep them employed during this really really tough time for your families and ours and all. And, again, thank you for being there.

NNAMDII have no idea. David Broder, do you?

BRODERI don't, and I'm betting that someone in your audience does. But I'll say Ann Marie is right on. What she is doing is what any of us would want to do for the home care workers, who make such a difference in our lives. And it's time for the Commonwealth of Virginia and for Congress to step up and do exactly what she's doing, which is provide PPE, provide a living wage, provide paid sick days for these health care heroes.

NNAMDIJoyce Barnes, how has your work changed since the Coronavirus?

BARNESWell, since the Coronavirus for me, my agency hasn't supplied me with anything, no gloves, no masks, no hand sanitizer. They haven't supplied us with anything. We go out here every day. You know, one day came in the building the other day and I asked about -- she had a paper mask on. I said, "Is that made out of paper towel?" She said, "That's what my agency gave me." I said, "They gave you a paper towel and rubber bands to wear around your ears?" She said, "Yeah." I said, "Wow." But I couldn't complain because they did do that for her. Mine gave us nothing.

BARNESWe take a chance every time we go out here and try to help these people. We're taking a chance. And they gave us -- they supply us with nothing. And to go in and out, it's very hard, especially me with two jobs. One is $8.25. The other one is $9.40. I wish I was getting paid $15 an hour and paid sick time and vacation pay.

BARNESWe don't get that here. Right here in Richmond, we are the forgotten ones. We don't get none of that.

NNAMDIOne job pays $8.25 an hour. The other pays $9.44. Have you ever gotten a raise?

BARNESNo.

NNAMDII guess that was the answer that I was expecting to that question. We're going to have to take a short break. When we come back, we will continue this conversation on home health aides. I'm Kojo Nnamdi.

NNAMDIWelcome back. We're talking about home health aides with David Broder, President of Virginia's chapter of the Service Employees International Union, SEIU, which represents home health care workers. Joyce Barnes is a Home Health Aide in Henrico County, Virginia. She's been doing this work for more than 30 years. Joyce Barnes, you have said that home care workers are on the frontlines too. However, do you feel you've gotten the same respect that doctors and nurses are getting during this pandemic?

BARNESNo. We have not. We are the forgotten ones. We have not got that respect. We have nothing. We haven't gotten anything and it's not fair.

NNAMDIHow do you do -- go ahead, please. You go ahead.

BARNESI'm like not even sick time. We don't even get that, not even paid sick time. We have to go. If we're sick, I have to shuffle up and go to work and go to work sick. I've done that before, and one time I went to work the patient looked at me. She said, "Honey, you look worser than I do. You should be at home." And I told her, "I have to come. I feel bad. I'm hoping that you don't catch anything. You know, but I have to come to work, because if I don't come to work I can't pay my bills."

NNAMDIHere now is Fisa, who identifies as being with the D.C. Home Healthcare Association. Fisa, you're on the air. Go ahead, please.

FISAYes, Kojo. How are you today?

NNAMDII am doing as well as I can.

FISAYes. Thank you. So the issue that we have here is that home health agencies bring a vital support into the healthcare facility. You know, the personal protective equipment were not delivered appropriately and that we are not getting to provide care. As you know, our service is one to one. All our aides are going to a patient's house. And then all our nurses may probably see five to six patients a day.

FISASo there's a higher risk of cross contamination in utilizing the same like gloves or masks and stuff like that. So we are looking to see how to get more PPEs. You know, our deputy council at this point in time (unintelligible) has helped us out a lot in trying to get what we ask for, but it's not enough. Everyone at DHCF Department of Care Finance and DOH are trying their best, but we need more and more supplies.

FISARight now I was on the Amazon website trying to get masks. You know, the price are going like thousands of dollars more and delivery is pushed out to June. So there's a challenge of trying to get PPE to provide these vital healthcare service. That's all I have to say.

NNAMDIThank you very much for sharing that with us. It does seem however that home healthcare workers in the District may be doing a little better than home healthcare workers in the Commonwealth of Virginia. We got a tweet from Christy who says, "How are home care workers not considered essential. I know my grandmother and father wouldn't have gotten by without their help, especially essential in a system without adequate healthcare and social services." Joyce, how do you do your job while maintaining the recommended six feet of social distancing?

BARNESI can't.

NNAMDII thought as not.

BARNESBecause my patients, I have to lay hands on. I have to be closer than six feet. I can't do what they recommended we do. I have to do, you know, what I can do for them, because they can't do for themselves. So I can't stay away.

NNAMDIHow are you able to balance work with your own personal life?

BARNESYou know, by the time I finish work and I'll do like a 16 hour day when I come home I'm wore out. All I do is go to bed and that is my life. And get up the next morning and do it again.

NNAMDIWhat would happen if you got sick?

BARNESThat happened to me before and I hope that it never happens again, but I pray each day that I go to work. I pray and ask God to give me strength to keep going on, because I have gotten sick. I've gotten sick, where I was taking care of patients and I took care of her, and then something that patient that I came down with. And it's a new patient, which I went into the home do what I'm supposed to do. Did not notice the lady had it nor did the lady tell me that she had it. Next thing I know, the doctor called for her to go back into the hospital. Next thing I know, three weeks later I'm in the hospital with the same thing the patient had.

NNAMDIWhoa. Here is Sally in Arlington, Virginia. Sally, you're on the air. Go ahead, please.

SALLYHi, good afternoon. I'm a home care nurse. And I would like to say that the home health aide workers are an integral, important part of the healthcare team. They are overworked. They are sometimes abused. They are underpaid. Many of the agencies charge a family $22 to $25 an hour. And these workers are getting anywhere between $10 and $15 an hour. They are in frequently unsafe situations. It's a very very difficult job and we owe them all a real debt of gratitude.

SALLYI'd like to say one other thing. The PPE situation in home care is terrible. Most home care workers, nurses and aides do not have the PPE equipment that they need to protect themselves, the patients that they're taking care of and subsequent patients that they travel to. So they get in their cars. They leave a patient. If they're lucky, they'll have a gown. If they're lucky, they'll have the proper mask.

SALLYMost of us don't. You go from one patient's home to another patient's home to another patient's home. We need PPE equipment and I am asking every person listening please, doctors, nurses, people that are in healthcare, I beg of you, please, call you leaders and tell them that all healthcare workers are risking our lives, because we don't have the proper PPE equipment. Thank you very much.

NNAMDIAnd thank you very much for your call, Sally. And good luck to you. We got an email from Claude who says, "One must realize part of the problem compensating aides is not the care companies, but insurance. My father has good long term care insurance, which is unavailable in today's market. But even he did not get coverage for home health aides, when he was recuperating from falling down a flight of stairs. He was fortunate to have the savings to pay for several weeks of 24 hour care, but many don't. The aides certainly deserve to make more money, but they would then be unaffordable." David Broder, what steps therefore can state and local leaders take to support home aides?

BRODERState and local leaders need to be leaders in this moment especially, because this president is not even trying to make a difference. Most home care work is funded through Medicaid, which is a state and federal match. It is up to each legislature and each governor about how they use these funds. And so here is a real opportunity for our governors to be leaders. We know that our governor cares about home care. He's got a long history of working with our members. We are very glad to see that a five percent pay raise for home care workers served this very tough budget freeze we're in right now. So I want to acknowledge the governor and legislative leaders like Senator Janet Howell, Delegates Torian and Sickles.

BRODERBut we need to do more. We need to use the federal funds that are coming to Virginia to make sure that we get PPE in every home care worker's hands and that we have paid leave, hazard pay. And at the very least free access to testing for every home care worker as well as affordable health care for everyone. Now is the time for states to lead.

NNAMDIHere's Frederick in Columbia, Maryland. Frederick, your turn.

FREDERICKGood afternoon, Kojo. I'm an 88 year old war veteran from the Korean War. I have a service that the VA provides to me called Veterans Directive Care. They give me X amount of dollars. I am able to hire my own home healthcare nurse as well as get food from wherever it's available. And it's being reimbursed by an agency that handles the money. What I have to say, the home healthcare nurse that I have working for me now was being paid $12 an hour for the agency she worked for. The agency was getting $35 an hour from the VA and she was only getting $12 with no benefits. I have hired her at almost twice as what she's getting before and I'm paying for it from the money VA gives me.

NNAMDIOkay.

FREDERICKI also provide gloves and masks for her when she comes to my house. Now that we have the problem with the virus, I have let her stay at home most of the time for fear of her contaminating her own children as well as me.

NNAMDIFrederick, thank you very much for sharing that story with us, but we're almost out of time. And I wanted to ask Joyce Barnes, what supports do you need right now to continue doing this very important work and doing it safely?

BARNESWhat we need is the equipment to work with. We need the gloves, the masks, the gowns. We need it all. We don't have that.

NNAMDISarah messages us on Facebook, "Regarding home healthcare workers in our region what can we do to help?" David Broder.

BRODERIt's a great question. If you want to help the absolute heroes like Joyce and Sally and everyone out there on the frontlines contact your legislators. Contact the governor. We need the Commonwealth of Virginia to act today.

NNAMDIAnd I'm afraid that's all the time we have. David Broder and Joyce Barnes, thank you both for joining us. We're going to take a short break. When we come back we'll be talking about how area resident with mental and intellectual disabilities are affected by the pandemic. I'm Kojo Nnamdi.