Supporters and opponents of two controversial Connecticut unionization efforts are closely watching a U.S. Supreme Court case that could have implications for the organization of home care and day care workers.

The high court heard arguments Tuesday in Harris v. Quinn, an Illinois case that challenges the designation of a union to represent workers who provide home care to people covered by Medicaid. The lawsuit, brought by eight women who provide home care, says the state violated their right to freedom of association by requiring home care workers who serve Medicaid recipients to accept a union as their exclusive representative and pay it fees.

It asks for the court to overturn or limit a 1977 U.S. Supreme Court ruling, Abood v. Detroit Board of Education, that allowed for unions to serve as exclusive representatives for public sector workers and collect fees. A brief filed on behalf of Illinois suggested the plaintiffs had a broader agenda, saying they were trying to remove collective bargaining from the options available to the government in all circumstances.

A federal district court and appeals court ruled against the home care workers, but the U.S. Supreme Court agreed to take the case. (For more on the case, click here.)

Connecticut joined a group of six states in filing an amicus brief urging the court to uphold the lower court rulings. Meanwhile, a group of child care providers in Connecticut joined a separate amicus brief supporting the home care workers who sued.

Unionization of home care workers and day care providers has been a controversial matter in Connecticut. Gov. Dannel P. Malloy in 2011 issued an executive order granting limited negotiating rights to certain home care workers — often referred to as personal care attendants — and home day care providers paid by public programs. The following year, state legislators passed a law granting both groups collective bargaining rights.

The home care workers and day care providers are considered to be employed by the people or families they serve, but the funds used to pay them come in part or entirely from state programs. Supporters of unionization say it’s a way for workers who typically receive low pay and no benefits to gain clout in seeking more funding from the state, and could improve the quality and stability of the workforce. Opponents say the personal care attendants and day care providers shouldn’t be considered public employees. They worry that unionization could interfere with clients’ ability to direct their employees, and that if negotiations lead to higher hourly wages without an overall increase in funding, clients could receive fewer services.

The amicus brief filed on behalf of Connecticut and five other states argued that collective bargaining helps stabilize the workforce of people who can provide home care. It said the field has a high turnover rate, which leads to higher costs for states and can potentially drive more people into institutional care, at higher costs to taxpayers.

“A stabilized and quality homecare workforce is good for the aging and disabled clients who need these services and for state budgets,” the brief said. “The collective bargaining tool should remain available to states that have made the policy decision to use it, and to states who may see our success and adopt this approach in the future.”

Meanwhile, the Sandy Hook-based Connecticut Family Daycare Associations Network Inc., and other groups argued that laws like the one in Illinois violate the First Amendment and silence the voices of individual, competing businesses by requiring that they be represented by one group that lobbies and bargains with the state.

“The representation imposed upon providers would be like the government designating the American Association of Retired Persons as the mandatory representative of all senior citizens on Medicare; ACORN as the compulsory voice of all individuals who receive government-subsidized housing; or the American Banking Association as the mandatory trade association for all financial institutions receiving Troubled Asset Relief Program funds, and then forcing the members of each group to pay these organizations to lobby the government for more money and benefits from these programs,” the brief said.

Deborah Chernoff, spokeswoman for the New England Health Care Employees Union, District 1199, SEIU, which represents personal care attendants, said the implications of the case for Connecticut will depend on how broadly or narrowly the court rules.

“I think it does really pose a serious threat to the ability of states to do what they want to do, both from a humane and compassionate but also from a financial perspective, which is to be able to shift the delivery of services away from a centralized institutional setting to people’s homes or community placements,” she said. Allowing people to receive care at home requires a sustainable workforce, which Chernoff said isn’t possible with the low wages that workers often receive.

But Stephen Mendelsohn, an outspoken opponent of the Connecticut unionization effort, said even a narrow ruling in favor of the Illinois home care workers could have a dramatic effect on personal care attendant and day care unions nationally.

While proponents argue that unionization is needed to stabilize the workforce so people can receive care at home, Mendelsohn said the opposite can be true because in the state’s Medicaid program, there are limits on the cost of care for people receiving home care. If home care wages increase, some people with disabilities could hit their cost caps with fewer hours of service, potentially leaving them unable to remain outside of a nursing home, he said.

Malloy announced last week that the state and the union representing day care providers, CSEA/SEIU Local 2001, had reached an agreement on a contract. It must be ratified by the union and approved by the General Assembly.

The union representing personal care attendants is still in negotiations with the state.

Arielle Levin Becker covered health care for The Connecticut Mirror. She previously worked for The Hartford Courant, most recently as its health reporter, and has also covered small towns, courts and education in Connecticut and New Jersey. She was a finalist in 2009 for the prestigious Livingston Award for Young Journalists, a recipient of a Knight Science Journalism Fellowship and the third-place winner in 2013 for an in-depth piece on caregivers from the National Association of Health Journalists. She is a 2004 graduate of Yale University.

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