Proposition B meets more opposition

In the beginning, Proposition B, an initiative petition put on the Missouri ballot for the Nov. 4 general election known as the Quality Home Care Act met with little opoostion, but voices raising concern about the issue are growing in number. So have the voices in support of the issue.

The act is intended to make it easier for those who need assistance to remain in their homes. It would create a Missouri Quality Homecare Council to investigate the quality, safety and availability of home care services.

The council could also recommend qualifications for personal care attendants, improve the training of those attendants, engage in collective bargaining with them and recommend changes in the attendants wages and benefits to the General Assembly.

The official ballot language states: "Shall Missouri law be amended to enable the elderly and Missourians with disabilities to continue living independently in their homes by creating the Missouri Quality Homecare Council to ensure the availability of quality home care services under the Medicaid program by recruiting, training, and stabilizing the home care workforce?"

A yes vote would create the council, a no vote would not. If it is formed the council is intended to ensure the availability of quality home care services under the Medicaid program.

An exact cost is not available but estimates put the cost at more than $500,000 each year.

Supporters say the initiative will help both home health care workers and the disabled and elderly Missourians who need them to remain independent.

But others are raising concerns that it is an attempt to unionize home health care workers in Missouri.

It would also allow home health care workers to unionize but would ban them from striking. The Missouri Hospital Association opposes the measure, saying it "Is not about improving the quality of home care services. It is about allowing the 'council' to control the provision of personal care services in Missouri -- services that are vitally important to many disabled and elderly Missouri citizens.

The MHA says "there are no safeguards to prevent them (the council created by Proposition B) from directing referrals to some providers and not others" and no appeal process for workers not on the lists. Thus, the MHA says, if fears a "dangerous conflict of interest precedent for the provision of home care services."

Council members could, the MHA says, approve state-funded workers, even if those workers are their family members.

Additionally, MHA says that Proposition B doesn't establish oversight of this council's policies or its regulatory functions and doesn't delineate any standards.

Union elections could take place if 10 percent of workers call for it, and the MHA questions the fairness of this aspect in terms of the other 90 percent.

Missourians for Quality Home Care say the state is not prepared to meet the growing demand for in-home personal care services, and insist that "the constant churn of workers due to low wages and lack of benefits threatens the ability of seniors to stay in their own homes."

The groups says the 11-member Quality Home Care Coucil would run a satewide worker registry of screened caregivers, create a backup system when workers are unavailable, offer training and opportunities for career advancement and negoiate with workers over wages and benefits if they coose to form a union.

While some newspapers, The St Louis Post-Dispatch and the Kansas City Star, have endorsed the proposition as a solution to some home care issues, saying workers and cilents alike could benefit, others, like the Joplin Globe, are saying no. In an Oct. 14 editorial, the Globe wrote "The Service Employees International Union helped fund the petition initiative to get it on the ballot.

"Proposition B allows too much latitude and could increase the costs of home-health care in Missouri. It could make it more difficult for the elderly and disabled to remain in their own homes."