Executive Summary*

Michigan’s statewide ballot in November will include Proposal 4, described officially as “[a] proposal to amend the state constitution to establish the Michigan Quality Home Care Council and provide collective bargaining for in-home care workers.” If approved by the voters, the measure would have two general effects. 

First, the proposal would place in the Michigan Constitution a provision that in-home caregivers who provide basic care services to recipients of state aid, such as Medicaid, be considered public employees. They would be classified as public employees, however, solely for the purpose of collective bargaining with a government agency through a union; they would not “be entitled to any other legal benefit reserved to such employees.” The care recipient would continue to act as the in-home caregiver’s employer for all purposes other than collective bargaining, retaining the right “to select, supervise, train and direct, or terminate, an individual provider.”

Second, the proposal would create a state agency known as the Michigan Quality Home Care Council. The MQHCC would collectively bargain with any union representing the in-home caregivers, though the negotiated compensation standards would be nonbinding. Compensation would still be set by the Legislature.

The MQHCC would largely assume the responsibilities of the existing Michigan Quality Community Care Council by providing (optional) training opportunities for in-home care providers and care recipients, and by maintaining a registry of in-home caregiver candidates, who would be subject to background checks. The MQHCC would also provide care recipients with “financial management services,” such as generating their employer tax forms and making payroll deductions on their behalf. Such financial management services are currently provided by the Michigan Department of Community Health.

Michigan’s experience with the Michigan Quality Community Care Council does not suggest that establishing the MQHCC would increase the percentage of care recipients receiving lower-cost, personalized in-home care. State audit figures show that the number of disabled people receiving in-home care through Medicaid’s Home Help Program rose from 51,372 to 55,382 between 2002 and 2004, when the Michigan Quality Community Care Council was established.
In 2010, however, the average monthly number in that program was 53,516 — no improvement, and even a small decline. Any potential cost savings were never realized.

A line-by-line review of Proposal 4 indicates that it
would provide:

  • No programs or services that have not been available to in-home care recipients in the past, with no constitutional amendment necessary
  • No provisions creating new taxpayer savings
  • No provisions for improved care
  • No new options for care recipients.

Proposal 4 would, however, validate the convoluted and disputed unionization of in-home caregivers implemented in 2005 by the Service Employees International Union and the Michigan Quality Community Care Council. This process has led to more than $32 million in Medicaid money intended for in-home caregivers being diverted to the SEIU for “collective bargaining” with an obscure government entity that had no ability to give the caregivers a raise or improve their working conditions. Collective bargaining with the proposed MQHCC would be no more effective.

Proposal 4 would enshrine in the Michigan Constitution a radical legal approach that classifies people as public employees if they indirectly receive government money for providing a private service. This approach goes against previous labor law and against laws passed by the Michigan Legislature. It has been employed in other states to unionize foster care parents and home-based day care providers.

There has been no threat to the Medicaid-financed Home Help Program at issue in Proposal 4. This program will continue whether or not Proposal 4 is approved. Furthermore, such services as training, registries and background checks for the in-home care program have been provided, and can continue to be provided, without a constitutional amendment. Michigan residents who favor such services need not chain them to the controversial unionization process that would be enshrined by Proposal 4.

* Citations are provided in the main text.