Click here to download this article as it appears in the magazine, with accompanying artwork.

Editors’ note: This article is from the Summer 2022 issue of the Nonprofit Quarterly, “Owning Our Economy, Owning Our Future.

In the past two years, the U.S. economy has revealed an undeniable truth: it runs on care work. The essential work of cooking and delivering food, caring for children and the elderly, and cleaning homes and offices is both necessary for our lives and not paid a living wage. This labor, done mostly by women of color, is often made invisible: performed quietly and cheaply by those at the margins of society, who work hard without good pay or protections. How do we counter this tendency of capitalism to devalue what is most important and intrinsic to our survival?

The pieces all articulate in common that care work is work—and that it’s time to value it as such.

We asked four leaders of care organizations to put the consequences of this problem—and creative solutions to it—into words: Ai-jen Poo of Caring Across Generations coalition and National Domestic Workers Alliance; Adria Powell of Cooperative Home Care Associates; Dennis Hogan of Service Employees International Union, District 1199NE (SEIU 1199NE), who cowrote with Dulari Tahbildar of the Rhode Island Child Care Training Program for SEIU Education & Support Fund (ESF); and Ellen Vera of Co-op Cincy. All are part of national or local organizations at the forefront of fighting for economic and racial justice in care work, advancing policy to create change in the sector, and building democratic models that remake the care economy.

Respondents were invited to speak to this year’s theme of “Owning Our Economy, Owning Our Future” directly, or to use it as a point of departure to talk about an aspect of the sector of their choice. The pieces all articulate in common that care work is work—and that it’s time to value it as such.


Poverty-Wage Care Work: Unsustainable Before, Unthinkable Now

by Ai-jen Poo

The narrative about care in our culture has long been misaligned with the reality of care in our society and economy. The capacity to care for children, disabled family members, or older loved ones is either taken for granted—work that should be quietly performed by family members, particularly women, before or after hours of full-time work outside the home—or assumed to be something that underpaid care workers, often women of color and immigrants, will quietly enter our homes to do for us. Care is poverty-wage work, seen and treated as unskilled and unprofessional, and yet it could not be more valuable. And despite all of us requiring some form of care at some point in our lives, if we struggle it is treated as an isolated, personal problem—even a personal failure. When we’re doing our best, it never seems to be enough to relieve the mounting pressures, especially with baby boomers aging and millennials having families of their own.

As a society, we must take ownership of the care economy we rely on and invest in the strength and resilience of our care programs, our caregivers, and our care workforce. From child care to home- and community- based services, care work is an essential part of the infrastructure for a strong workforce and economy.

Access to child care enables parents to work. Access to home- and community-based services enables many older adults and people with disabilities to live in the home and community, work, stay healthy, live whole lives. Investing in care jobs would transform what are now poverty wage jobs without benefits into jobs with real economic security, so that care workers can care for their own families, too.

What would this look like? Investment in home- and community-based services would advance equity— supporting women and especially women of color, who shoulder a disproportionate amount of care work, whether as family caregivers or formal care workers. Young workers would join the home care workforce with the confidence that this was a career worth investing in. Tens of millions of family caregivers would have the support they need for their family members while continuing their own careers. States would save money in the long term, because home care is much less costly than nursing home care.

The pandemic revealed some of the risks of our cultural norms and narratives about care, and helped us all see that we have care in common. Our time in quarantine helped us see that we need more than individual sacrifices and patchwork programs if we are to recover, sustain, and succeed in the future. Social distancing and COVID protocols shut down the minimal care supports we had, and millions of mothers and family caregivers were pushed out of the workforce. Now, two and a half years later, we have an opportunity to transform our culture around care work.

Care work wasn’t considered infrastructure or a part of the “real” economy before the pandemic. A part of our economy long governed by norms rooted in gender discrimination and the legacy of slavery, care work can no longer be sidelined. The status quo was unsustainable before the pandemic, and it’s unthinkable now. The post-pandemic care economy must be one that is dignified for all, including care workers, their families, and all of us who rely on care.

Investment in a solid care economy will enable future generations to care for their families from birth to death. Future generations are counting on us.


Making the Invisible Visible: Fair Pay For Home Care

by Adria Powell

One of the most significant challenges home care workers face today is the lack of value society accords them and their critical work—work that runs the gamut from daily assistance with getting out of bed, bathing, dressing, and meal preparation to assistance focused on helping clients with physical disabilities maintain gainful employment—allowing older adults and people with disabilities to remain in their homes and communities safely and independently. That we allow society to undervalue these jobs and not invest in these workers is inexcusable. These workers face inequities across the board. It is a result of who does the work (overwhelmingly, women, people of color, and immigrants), the legacy of slavery, and where the work is carried out (in someone’s home) that a bias emerges toward viewing the work as obligatory and undeserving of adequate compensation.

Perhaps it’s connected to the declaration I hear from so many home care workers that they “love” what they do, that their passion for this work comes “from the heart,” or that they feel like they are “part of the family” that we believe it is reasonable—even acceptable—to provide home care workers with poverty-level wages. When it comes to human services work, there seems to be a direct correlation in our society between work coming from the heart and low pay. Of course, reasonable people understand that workers deserve to both love what they do and be fairly compensated for the services they deliver.

The lack of value placed on these workers and their jobs results not only in low wages but also minimal investments—training, ongoing support and development, career advancement, and so forth. And because home care workers work within someone else’s home, they are largely unseen and unheard. They work alone, and the job can feel excruciatingly isolating. It is the perfect setup for invisibility.

At Cooperative Home Care Associates (CHCA), we have worked for decades on building a model home care agency designed to demonstrate how investing in quality jobs is important for both home care workers and clients. Established in 1985, CHCA is now the largest worker-owned cooperative in the United States, growing from twelve home care workers to a prepandemic high of twenty-three hundred workers. We have long recognized that these jobs need to be good jobs—jobs that engender dignity and in which workers are treated with respect. Our worker-owned cooperative structure is ideal for countering the issue of invisibility. Workers in a cooperative are owners, and with ownership comes the opportunity to vote on key decisions, serve as part of a governing body, and have a stake in profits generated by the work.

CHCA develops and trains workers to advocate for policy changes needed to improve jobs in the field. And within the organization, we improve job quality by providing robust training both in how to be a home care worker and what it means to be a member of the cooperative. Workers are encouraged to participate in all aspects of the organization at whatever level feels attainable to them. The continuous learning and opportunities for advancement demonstrate to workers that they are valued and that their work is respected.

But the challenges home care workers face cannot be overcome by one organization. We are part of an enormous ecosystem in healthcare that is fraught with inequity and deep-rooted system failures. The long- standing problems must be addressed and corrected at the macro level. In New York State, we are part of an historic coalition of home care stakeholders seeking to bring about this correction. The coalition is engaged in a campaign: Fair Pay for Home Care. For two consecutive years, we have had the Fair Pay for Home Care bill introduced. The bill would increase home care worker wages from $13.20 per hour in some regions of New York State to $22.50 per hour (or 150 percent of the highest regional minimum wage) in New York State, which would help to lift hundreds of thousands of women, people of color, immigrants, and their families out of poverty and represent fair compensation for home care workers.

The coalition has achieved a modest gain for home care workers in the New York State 2023 budget. Home care workers will see a $3 hourly increase over the next two years. Additionally, New York State will invest over $2 billion annually for bonuses for healthcare workers who earn less than $125,000 per year (unfortunately, home care workers were eliminated from this pool because they received the $3 increase over two years in the budget). We are part of the Fair Pay coalition that has remained intact for the past two years, is a political force, and has gained considerable momentum. We will continue to work to reach the end goal of Fair Pay for Home Care—a real and achievable solution to the lack of investment in these workers and jobs, with effects that are positioned to reach well beyond just the home care workforce in New York State.


Child Care: The Linchpin of Our Economy

by Dennis Hogan and Dulari Tahbildar

Child care has always been the linchpin of not just the care economy but also the economy more generally. Parents who have access to affordable, high-quality child care are able to participate in the labor force, earn more money, and advance in their careers. The pandemic has only amplified the need for affordable and reliable child care as a key part of our society’s larger workforce strategy.

Child care providers are often the very first teachers a child has (not to mention the adults with whom they spend much of their time), and experience with a skilled early childhood educator has benefits for developing children. Yet, training, compensating, and valuing child care workers is too frequently an afterthought. This is in part because the work is overwhelmingly performed by women—many of them women of color, and many of them immigrants. Indeed, the profession has been devalued because it is considered “domestic” work—that is, work that in many places and contexts has been performed by women, in the home, and often for little or no compensation.

In Rhode Island, family child care providers came together in 2013 to change that reality—first by unionizing with the Service Employees International Union (SEIU) 1199NE, and then by successfully negotiating for a training fund benefit and partnering with the SEIU Education & Support Fund (ESF) to administer and leverage that benefit. ESF recognizes that the reality of professional child care today requires a worker- centered, relationship-based educational and training model that allows child care providers to reach their highest professional potential.

By coming together to assert and celebrate their value as well as grow together as professionals, the providers who pursue professional education through their union training fund demonstrate the values of collective action.

Rhode Island’s collectively bargained family child care training fund benefit represents a truly unique offering in the world of early childhood education: working closely with members themselves, ESF staff design and deliver programming targeted specifically to the population of home day care providers in Rhode Island, with a special focus on culturally competent education that meets personal as well as professional needs. ESF programming is offered in both English and Spanish—and during the evenings, when providers are more likely to be able to attend. Beyond providing a pathway for providers to grow as professionals and achieve certifications that move their facilities into higher-quality ratings and higher compensation levels, ESF likewise offers providers ownership over their own educational progression, through a peer mentoring program that pairs experienced providers with new participants and offers courses taught by providers themselves. Finally, ESF cultivates a space of sharing, conviviality, and mutual support—a crucial function for a workforce that experiences isolation from peers, where providers work individually and gather only infrequently.

Training funds have long been an established norm among unionized workers in other professions, from healthcare to the building trades. For employers, training funds guarantee an adequate supply of highly trained professionals with a demonstrated commitment to the work and the workplace. For workers, training funds offer not only a path to greater stability and greater benefits but also a chance to participate in a collective endeavor of self-improvement. By adopting this model and reinventing it to suit the unique home- based child care workforce, members of SEIU 1199NE are taking ownership of their businesses as care workers, and changing their own lives in the process.


Creating Our Own Solutions in the Face Of a Broken Child Care System

by Ellen Vera

The child care system in the United States is broken. On average, families are paying the unsustainable amount of over 10 percent of their monthly income; child care workers are some of the lowest- paid workers in the country, making an average of $13.31 per hour; and the number of child care businesses have decreased by 10 percent (or sixteen thousand facilities) since the start of the pandemic, because market conditions are so challenging. This field is in dire need of a complete overhaul and significant investment from our federal government.

The United States is one of the few industrialized countries that does not have a strong state-sponsored child care system. The monthly Child Tax Credits that the federal government issued during the pandemic were an important and impactful start, bringing 3.7 million children out of poverty. But unfortunately, due to political stalemate in Washington, even this relief has disappeared.

It is in this vacuum of not having a large, systemic, government- driven solution that families, child care workers, and business owners are coming together to create better child care solutions for their communities.

In Cincinnati, Co-op Cincy has been researching and working to create teacher- and parent-owned child care cooperatives since 2017. We started by digging into the economics of our local child care system, which had recently received a substantial amount of public funding through passing a local ballot initiative: Cincinnati Preschool Promise. The initiative articulated options for how our city could fulfill a commitment that was made during the campaign to raise the minimum wage from an average of between $10 and $11 per hour to $15 per hour, as spelled out in the report Strategies Towards Wage Equity in Early Childhood (Cincinnati Union Co-op Initiative, September 17, 2018). These options included the possibility of creating a shared services cooperative to help small child care businesses achieve economies of scale.

In 2017, Co-op Cincy also began supporting an alternative co-op child care model: parents coming together to lower the cost of care while paying a living wage, through a small nanny-share cooperative called CareShare Cooperative. Co-op Cincy is also part of a national cohort of co-op developers who are working to launch and support child care co-ops, including Wellspring Cooperative, in Springfield, Massachusetts; Cooperation Jackson, in Mississippi; and Cooperación Santa Ana, in California.

Most recently, Co-op Cincy has been helping existing child care centers to preserve their legacy—and keep their businesses in the hands of the people who helped build them—by selling them to their teachers through our Business Legacy Fund program. In January 2022, the owner of the small, nature-based Montessori child care center, Shine Nurture Center, sold the center to her workers, saying that she wanted to give the employees an opportunity to make the business their own. “It’s just such a great group,” she notes on Shine’s website. “I really wanted to take myself out of it, let them take Shine in the direction they see fit. I honestly think it will get better and better.” She continues, “The responsibility of a business like that on one person’s shoulders is a lot. When you can spread it over 5 shoulders, there’s more opportunity for growth.” And Co-op Cincy is currently working with a second child care center in the Greater Cincinnati area, one that has been an anchor in the community for over four decades and that is preparing to transition to worker ownership within the next few years.

Broadening ownership in our community through these types of transitions is such an important strategy for opening the door to wealth building for the families of these workers, in a way that otherwise would not have been possible; and for the community, these successions are anchoring important child care centers in the community for the long term.

The inadequacy of our current child care system is a universal problem across our country—and until our government decides to create a universal solution, the only choice our communities are left with is to come together to form our own solutions. Creating the best models we can—to make care more accessible to families, make wages and working conditions better for workers, and create viable long-term businesses in our communities and co-ops—is an important step along the way.