Republicans Stage Fight Over Expanded Home Care Commission

After a personal appeal from Sen. Bates to Sen Winters, SB 1542 skirted through the Senate Wednesday, giving senior citizens a public option to meet their long-term care needs. If the House agrees, the Home Care Commission would expand beyond its Medicaid clientele to serve people paying for in-home caregivers with their own money.

Editor's Note: Deschutes County has several private home care agencies. An earlier version of this article mistakenly said there were no home care agencies in part of Sen. Tim Knopp's district, but his district is entirely in Deschutes County. We regret the error.

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The bill opening up the state Home Care Commission to people without Medicaid survived a last-minute surge from Republicans who sought to kill Senate Bill 1542, largely because it will increase the unionized home care workforce.

“We have one of the nation’s finest programs for taking care of low-income seniors,” Sen. Lee Beyer, D-Springfield, told his colleagues before the 21-9 vote. “Why would we deny anybody the right to pay for that service? When it comes to taking care of my parents and your parents, the last thing I want is to worry about the free market.”

SB 1542 would give middle-class seniors access to the home care registry. But, aside from a $1.3 million start-up cost, safeguards in the bill ensure it will not cost the state any money and  not affect the current Medicaid program where the government offers the service to low-income seniors as an alternative to nursing homes or assisted living.

The Department of Human Services estimates the state’s home care workers will cost $25 an hour, a price that includes payroll taxes and workers’ compensation as well as wages of about $13 an hour. The full price, plus administrative fees, will be borne by seniors or their families.

But Republicans objected to the government offering a program that will compete with private home care agencies, and were especially perturbed that SB 1542 has the potential to expand the workforce represented by the Service Employees International Union.

“This will be another gift of several thousand represented workers to the Service Employees International Union,” said Sen. Doug Whitsett, R-Klamath Falls.

SEIU does enjoy a symbiotic relationship with Democratic lawmakers. The union is among the biggest benefactors of Democratic campaigns, while many Republicans oppose collective bargaining and union rights.

But SB 1542 had much broader support than just SEIU, including AARP and the Campaign for Seniors and Disabilities, which has used the short session to push a raft of legislative and budget items to improve the lives of seniors.

“AARP Oregon supports SB 1542 because it provides another caregiving option for individuals and families. In utilizing the Home Care Commission registry, consumers have some assurances regarding the worker’s background, training and experience,” according to a  statement from AARP.

A key vote on the floor came from Sen. Jackie Winters, R-Salem, who has gone back and forth on SB 1542. She signaled her support after flattering remarks from Sen. Alan Bates, D-Medford, who said she had “always been a huge advocate for seniors.”

Bills do not usually rise to a full chamber vote without majority support, but the Senate has been a place where surprises can happen. With Winters on board, it became clear that SB 1542 had enough votes to pass.

“I really wrestled with this issue,” said Winters, who said she wished the bill had a better cost-benefit analysis of how it would affect the current home care system if the state offers the public option of SB 1542.

Winters opposed the bill in the Committee on Ways & Means because she had been told by someone at a private home care agency in her district that it would negatively impact its business. The bill barely passed the budget committee, and her support came only after a long conversation Wednesday morning with Bates. She promised: “I will continue to champion for seniors and people with disabilities.”

Dale Penn, a lobbyist for the Oregon Health Care Association, which represents some private homecare agencies, said his organization was neutral on the bill after advocates from SEIU agreed to some amendments, particularly on increasing training protocols to align more closely with the private sector.

Private home care agencies often have registered nurses who supervise their caregivers and train them to administer catheters and insulin, something the home care workers in the state program are currently unable to do.

But 14 rural Oregon counties don’t have any private home care agencies -- forcing people in those communities to hire workers through word-of-mouth, Craig’s List or “a note on a bulletin board in a Plaid Pantry,” according to Senate Majority Leader Diane Rosenbaum, D-Portland, the chief sponsor of SB 1542.

Ironically, only two of those counties -- Tillamook and Columbia, which are in Sen. Betsy Johnson’s district, are represented by a Democrat. The rest are in Eastern Oregon, including those represented by Republican opponents Whitsett and Senate Minority Leader Ted Ferrioli of John Day.

Sen. Bill Hansell, R-Pendleton, who represents three of the counties with limited home care worker access, supported SB 1542.

The bill now heads to the House where it has wider support, including such conservative stalwarts as Rep. Dennis Richardson, R-Central Point, and Rep. Tim Freeman, R-Roseburg.

“People across the state will be able to take advantage of this,” said Freeman.

Christopher David Gray can be reached at [email protected].
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