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Proposal 4: The Unionization of Home-Based Caregivers

Election Update: In the Nov. 6, 2012 election, Proposal 4 was voted down, meaning that the unionization of home health care workers was not incorporated into the state constitution. The primary impact of this amendment would have been forcing home help providers, many of whom are family members, into paying union dues for providing care.

Mackinac Center analysis indicates
Prop 4 would do the following:
  • Prop 4 concerns “home help providers” — private citizens who provide basic personal care to disabled adults in those adults’ own homes. (The majority of these home help providers tend family members; often, they are parents caring for their children.)
  • Prop 4 would sanction the statewide unionization of home help providers as government employees and allow $6 million of Medicaid money to continue to flow as so-called “union dues” and “agency fees” to the Service Employees International Union each year.
  • Prop 4 would override recent legislation meant to end this unionization.
  • Prop 4 would create a government “council” that would keep a registry of providers who have undergone background checks. The council would initially be composed of members friendly to the SEIU, and it would act as the providers’ so-called government employer, even though the council would not set the providers’ wages or choose, hire, fire, compensate or supervise them.
  • The SEIU’s “collective bargaining” with the council would not determine the providers’ compensation, which is set by the Legislature. The providers would continue to be employed, hired and fired by the disabled adults they care for.
  • Prop 4 would not create a home help program; that program has existed for 31 years and would continue regardless of whether Prop 4 passes.

Mackinac Center
Publications on This Proposal


Prop 4 Op-Ed in Detroit Free Press Ungrounded

Prop 4 Would Put Union Scam in Constitution

Pennies on the Dollar

Unions in Perpetuity


In the News

Union's role in home care heart of Proposal 4 controversy

Proposal 4: Improving home care or union swindle?

Proposal 4 would ensure quality, affordability of senior home care

Health care union dues law delayed,

Snyder Signs MQCCC Bill

SEIU Trying To Get MQCCC Into Constitution

SEIU took $28M in “dues” from Mich. Medicaid

Loving Parents or Union Workers?

SEIU Collects ‘Union Dues’ from Medicaid Recipients

Union Siphons Dues from Medicaid


Click here for the 100-word Prop 4 summary to appear on the Nov. 6 ballot.

Click here for the complete language of the proposed amendment.

Frequently Asked Questions

What’s the main purpose of Proposal 4?

This constitutional amendment was created to allow a continuation of the statewide unionization of people who care for disabled adults in their own homes. The majority of these home help providers are caring for family members. Approximately 40,000 providers are currently part of this so-called unionization.

SEIU Local 79, the supposed collective bargaining agent for home help providers, currently captures approximately $6 million annually in so-called “dues” and “agency fees” from the Medicaid checks meant to reimburse the providers for their services.

The Legislature has enacted two laws — 2012 PA 45 and 2012 PA 76 — in an effort to end this unionization. This ballot initiative is the union’s attempt to override the legislation.

How long has Michigan had a Home Help Program to allow disabled people to be cared for in their own homes, rather than in nursing homes and long-term care facilities?

The Home Help Program started in 1981. It is financed through Medicaid.

There are no proposals to end the program. Regardless of whether this amendment passes, the Home Help Program will continue.

Would passing Proposal 4 help more disabled adults get served by the Home Help Program?

The number of disabled adults served by the program has remained at around 53,000 statewide during the last decade, both before and after the unionization of home help providers.

The unionization has not led to an increase in the number of people served by the Home Help Program. There is no reason to believe that continuing the unionization would change this fact.

What is the “Michigan Quality Home Care Council” that would be formed under Proposal 4?

The Michigan Quality Home Care Council would be a governmental entity replacing the current Michigan Quality Community Care Council and assuming the MQCCC’s rights and responsibilities.

The MQCCC was created almost entirely to act as a so-called “public employer” of home help providers so that they could be unionized by SEIU Local 79. The so-called unionization began in 2005, a year after the MQCCC was created through an agreement between the Michigan Department of Community Health and the Tri-County Aging Consortium.

Isn’t the MQCCC providing important and necessary services?

Proponents contend that the MQCCC and the Michigan Quality Home Care Council are meant to aid Home Help Program recipients by supplying them with such services as a registry of available home help providers and background checks of these providers.

But the Department of Community Health could easily compile a registry of providers and perform the cursory and incomplete criminal history checks presently done by the MQCCC. These criminal checks are of limited use in any event, since most Home Help Program recipients and providers are related.

Regardless, neither activity requires the creation of agencies like the MQCCC, the unionization of home help providers or the passage of a constitutional amendment.

Isn’t there a report that the MQCCC saves the state money?

There is. The report is largely based on the observation that paying for in-home care is less expensive than paying for long-term care in an institution or nursing home. Thus, more Medicaid money would be saved if more people received their care in their homes.

But as noted in Question 3 above, the number of people participating in the Home Help Program both before and after the creation of the MQCCC has essentially stayed the same. This finding indicates that the MQCCC’s activities have not increased the number of Home Help Program participants, and that the MQCCC has not generated savings.

Why do you say “the so-called unionization” of home help providers?

Under Michigan law, only the state Legislature can designate a group of people “public employees” and permit them to be unionized by a government union. The Legislature never did so with home help providers in Michigan. Unfortunately, a state agency nevertheless permitted a unionization election contrary to the law.

In 2012, the state Legislature passed two laws clarifying that home help providers were not and are not public employees, and that they are not subject to unionization by government employee unions.

Why would home help providers ever be considered public employees?

Home Help Program recipients receive Medicaid money to purchase home help care from the provider of their (or their guardian’s) choice. According to a novel labor theory advanced by government labor unions, because home help providers indirectly receive this Medicaid money, they are performing a government service and are therefore government employees.

This is a radical notion. Under this theory, landlords, grocers and doctors across Michigan could be unionized as public employees because their tenants, customers or patients receive rent assistance, food stamps or Medicare. In Oregon and Washington, even foster parents have been unionized as public employees.

But didn’t the home help providers vote for unionization?

Yes, technically, but the context matters. Of the 40,000 home help providers affected, fewer than 8,000 voted.

There are reports that during the election, a number of mailed ballots were returned for having the wrong address. The head of the agency overseeing the election later said that new ballots were mailed only if an alternative address was provided and there was “time permitting.” It is also likely that people were unaware of, or confused by, the concept that they could be unionized as government employees simply because they received Medicaid support for tending to disabled adults — frequently their family members — in their own homes.

Can’t the union bargain for better wages and working conditions?

No. The union “bargains” only with the MQCCC. The MQCCC does not pay the providers; it does not control the budget; it does not set wages or working conditions. Neither would the proposed MQHCC under Proposal 4.

The Medicaid money ultimately paid to home help providers comes from the federal government, passes through state government and is then mailed to the Home Help Program recipient, with the provider listed jointly on the check. The MQCCC never touches the money except to act as a middleman for the so-called “union dues” and “agency fees.”

Any “agreement” bargained between the union and the MQCCC is not binding. It is merely a suggestion to the state Legislature about provider compensation. In effect, the MQCCC joins the union in lobbying the Legislature for something neither the union nor the MQCCC controls. The same would be true with the proposed MQHCC.

Have home help providers received any pay increases?

There have been some small increases in pay, often to keep providers just above the minimum wage. These increases were approved solely by the Michigan Legislature and the governor.

Wasn’t the MQCCC defunded by the Michigan Legislature?

Yes, in fiscal 2011-2012. The MQCCC remained afloat because the SEIU and other private entities provided the MQCCC with money. The union’s funding of the MQCCC — the “employer” with which the union “bargains” — is an inherent conflict of interest for both parties.

Can’t home help providers already get out of the so-called union?

Proponents of Proposal 4 frequently suggest that unionization is not a big step, since employees can withdraw from a union.

While it is true that employees can withdraw from a union, the courts have ruled that employees who withdraw can still be required to pay (presumably smaller) “agency fees” to “compensate” the union pay for grievance and collective bargaining “services.”

And with home help providers, the option to withdraw is beside the point. The unionization was illegal. These people should never have been shanghaied into a government union in the first place; they were not and are not government employees. Saying they are free to withdraw from the union and pay agency fees overlooks the fact that they should be paying nothing at all.