Healthcare Business News

Supreme Court: Unions can't make nonmember home health workers pay fees

By Steven Ross Johnson
Posted: June 30, 2014 - 6:30 pm ET

A U.S. Supreme Court decision handed down Monday struck a blow to unions' efforts to organize home health workers.

In the case of Harris v. Quinn, the high court ruled 5-4 in favor of a group of eight home health workers from Illinois who objected to having to pay fees to the Service Employees International Union-Healthcare Illinois & Indiana as part of the organization's collective bargaining agreement with the state.

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The court did not, however, extend the decision to include all public-sector employees, but instead singled out those who receive state funding for services but are otherwise employed by a private client, which is the case for the Illinois home health workers.

The so-called agency fees charged to Illinois home health workers who don't join the union are intended as compensation for the benefits they receive as a result of the union's efforts.

In the majority opinion, Justice Samuel Alito concludes that the union failed to show the collection of such fees were essential to allowing the organization to function as an advocate for workers.

“Even assuming that SEIU-HII has been an effective advocate, the agency-fee provision cannot be sustained unless the union could not adequately advocate without the receipt of nonmember agency fees,” the decision stated. “No such showing has been made.”

It is unclear what the ruling could mean for other healthcare providers with similar types of arrangements.

Still, the ruling is a blow to public-employee unions, which have seen membership decline but have made inroads with the burgeoning ranks of home health workers.

And even though the decision only immediately affects the estimated 400,000 unionized home health workers in 10 states, the ramifications could reach other public-sector employees because of the way the opinion defines the workers as “partial public employees,” said Zev Eigen, an associate professor of law at Northwestern University.

“The way the court majority carved it out is a function of how that state defines the work being performed,” Eigen said. “If I was the state, and I wanted to make it harder for my public sector workers to unionize, I would change the way the work is organized to make them more like the healthcare workers of Harris v. Quinn.”

The ruling drew praise from the National Right to Work Foundation, which argued the case on behalf of the workers. The anti-union group called the agency-fee provision a “scheme” that “forced parents and other relatives taking care of persons with disabilities into union political association.”

But some industry stakeholders and observers fear the ruling could cause workers to lose some of the gains made through collective bargaining agreements and jeopardize efforts to develop the workforce to care for a growing population of patients who need home care.

“There are at least five people on the Supreme Court who are totally hostile to unions,” said Mike Harper, professor of law at Boston University. “This is a way, in this particular case, to undermine this particular union because they can't be as strong in their bargaining for the relatively poorly paid healthcare workers if they don't have that agency fee.”

The Paraprofessional Healthcare Institute, an advocacy group for health workers who care for the disabled, said in a written statement that the decision would hinder efforts to ensure a stable home-care workforce.

“In short, the court's decision limits the state's ability to determine how best to strengthen its Medicaid home and community-based services by building a sustainable qualified workforce. And unfortunately, it is Illinois citizens who need long-term care, their families, and the underpaid workers who provide their care—who will bear the brunt of this decision," said Jodi Sturgeon, president of PHI.

Follow Steven Ross Johnson on Twitter: @MHsjohnson

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