Who’s Protecting Home-Care Workers in the #MeToo Era?

June Barrett, a Miami-based home-care worker, had been out of work for months worrying about how to pay rent or buy her necessary prescription medication, when her agency finally placed her with a new client. She was so relieved, she says, that when her client asked her to come to his bed on her first night on the job, she didn’t suspect what would come next. “He said, ‘No, lie on the bed with me.’ It started there, and then the groping started. After that, the forced kissing started. It was horrible.”

Barrett told me recently, “Sexual harassment, it is happening every day with domestic workers. For many years, I didn’t talk about it.”

In an unstable and low-paid job like home health care, Barrett explained, the workers are often at the whims of their client, particularly if they are live-in workers. At another job, she was subjected to racist abuse and forced to sleep on a couch rather than the guest bedroom. But sexual harassment can be particularly humiliating, especially if, as Barrett was, the worker is unable to immediately leave. “When I told the story recently,” she said, “Two young women came to me and said, ‘We don’t understand. Why would you not leave? I would have left.’ They don’t understand. I was out of work, which means that rent had to be dealt with, I depend on medication to live.”

Much like any worker who has to choose between a sexually predatory boss and the realities of the rent  coming due, care workers often have to make these unpleasant calculations in order to get by. But the situation is complicated when the abusive person is not really a boss, but a client, a patient, someone for whom the worker is charged to care. “I am responsible for those lives when I am with them,” Barrett said. “I am totally responsible for them until the next shift comes.” So what, then, is one to do when the client can’t keep his hands or his mouth to himself?

About nine in ten home-care workers are women, and more than half of them people of color. There are an estimated 2.9 million people like June Barrett working in homes as health care and personal care attendants, a range of work that exists under a patchwork of state and federal labor protections and is paid for by a patchwork of public and private funds. All of this means that it’s very easy for workers to slip through the cracks, to remain unprotected by the law.

Domestic work, from which home health care grew, was excluded from New Deal-era labor protections because at the time it was a field mostly staffed with black women, just a generation or two removed from slavery. Along with agricultural workers—mostly black as well—the women who cleaned other people’s homes and cared for other people’s children were exempted from minimum wage and overtime protections. The racist legacy of those exclusions has combined with a centuries-old assumption that women’s work isn’t really work, and it lingers to this day—in 2014, in Harris v. Quinn, the majority of the Supreme Court voted to put home care workers who were paid with public funds into a category separate from other workers. In the words of Justice Samuel Alito, they were “partial public employees.” What happened in the home, the attorneys in the case had argued, was not really work, and unions had no place representing workers whose workplace was someone’s private domain.

The care that such workers provide is not seen as a skill; instead, it is presumed to be part of these workers’ essential nature. Women are born more caring, nurturing, kind and patient, according to this sexist logic. In truth, as Lisa C. Ruchti wrote in her study of nursing, Catheters, Slurs and Pickup Lines: Professional Intimacy in Hospital Nursing,, care is “a series of intimate acts” performed with purpose and professionalism by the worker. The more skilled the worker, the more natural their care will feel. “Rather than define care as a personality trait that some individuals possess,” Ruchti wrote, “this analysis reveals that ‘to be caring’ is a social act that changes at the structural and ideological intersections of race, gender, and nationality.”

In other words, the same assumptions that have led our society to devalue the labor of women like June Barrett encourages clients to treat her as though she is there for their pleasure, whatever that pleasure might be. Yet talking about sexual harassment has been hard for caring workers, Ruchti wrote, because it challenges our expected understanding of what a harasser is. Nurses and other caregivers who work out of hospitals or other facilities certainly do face harassment from the boss, but with home-care work, the identity of “employer” and “patient” are oddly intertwined. In the U.S.’s profit-based health-care system, Ruchti pointed out, because health care is defined by capital and patients treated as consumers, they can feel more entitled to services because they are paying for them. And when the worker is on what is perceived as the lowest rung of the caring field, doing the “dirty” work that doesn’t require a medical degree, clients and others assume that they are disposable.

“They believe that your only job with the elderly is to wipe their butts,” Barrett said. “People see people with less education and therefore, the work that we do does not have any value. My work has a lot of value. My work is very important work.” It is this association with “intimacy and dirt,” as Eileen Boris, Hull professor and chair of the Department of Feminist Studies at the University of California Santa Barbara, has said, that has at once led clients to harass care workers, and care workers to have little legal recourse.

That sexual harassment is an expression of power is by now a commonplace idea, yet with caring workers the power dynamics too are complicated. Barrett held her client’s life in her hands; if she chose to leave, what would happen to him? Yet he controlled her ability to get paid, which in turn meant she could get the medications she relies on. This interdependence makes sexual harassment even more complicated—patients can harass as a way to push back on their own uncomfortable feelings of dependence and to reestablish dominance in a gendered and often racialized relationship.

So what is to be done?

The protections of Title VII of the Civil Rights Act of 1964 only apply to workers whose employers have fifteen or more employees. That leaves out those at smaller businesses, as well as those who are independent contractors—like many home care and domestic workers. The National Women’s Law Center suggests amending these laws to extend to all employees and independent contractors as a start.

Protecting immigrant workers who come forward to report harassment is also an important part of the solution. “Oftentimes you’re choosing between risking losing your family and your own physical safety,” Ai-jen Poo, director of the National Domestic Workers Alliance (NDWA) said in 2015, and the risks have only gotten higher with Trump in office. Unscrupulous employers can use this fear to take advantage of workers.

But for June Barrett, it is also important for workers like her to take their fate into their own hands and to organize. Barrett organizes with NDWA and the Miami Workers Center, has spoken out about healthcare reform and the need for labor rights for domestic and home care workers. In New York, Hawaii, California, Massachusetts, Oregon, Connecticut and Illinois organizing by domestic workers has led to Domestic Workers Bills of Rights being passed through the legislature. And in 2015, thanks to similar organizing, the Obama administration eliminated the “companionship exemption” for some care workers, which allowed private home care agencies to profit while paying their employees less than minimum wage.

Such organizing, Poo said, was an opportunity to make domestic workers the center of a discussion about what kind of economy to create in the future. “If it’s possible to devalue any one form of work, then it creates a downward gravitational pull within our economy. It makes it possible for other sectors to create special exclusions and exemptions and all of a sudden we’re looking at an economy where 30 percent of the workforce is working in contingent and unstable part-time temporary kinds of work arrangements.”

In Seattle, Elvia, who did not want her last name used for fear of reprisals, has been part of the organizing for a new Domestic Workers Bill of Rights in that city. Part of her motivation for joining the campaign was hearing about the sexual harassment that her colleagues faced—one woman arrived at the house where she worked to find the employer naked, waiting for her in the bedroom. Another friend was followed through the house by an employer, touching himself. For these women too the choice was simple: leave and lose the job, or risk their safety by staying.

With Casa Latina, a worker center that organizes in Seattle’s Latino community, Working Washington, a nonprofit worker organization that grew in part out of Seattle’s Fight for $15, and support from SEIU Local 775, a union that represents healthcare workers, Elvia and others descended on Seattle’s City Hall March 15 to call for action. They built a display of houses made of diapers and rubber gloves representing all of the carers and cleaners in the Seattle area who have no protections currently. Elvia noted, “Because I don’t have those rights, I couldn’t stay for the whole event, couldn’t take a day off, I had to work.”

They are demanding a bill of rights that would protect immigrant workers like Elvia from discrimination and harassment, whether full-time or part-time, live-in or live-out, that would mandate written contracts so that workers and employers both understand the terms of employment. The biggest challenge of any such bill, though, lies in enforcement, and on that front the workers and their organizations are looking at a model of a worker council that would include domestic workers as well as employers and city officials, that would come together to create standards and include workers in deciding how to enforce the law.

Such legal protections would not magically end the problem of sexual harassment—that will take time, time and a revolution in the way we see and treat women, particularly women of color, at work and everywhere else. But for now, we have a set of circumstances that give employers and clients every incentive to assume that they can mistreat the workers who care for them and their families, and expect those workers to keep showing up and pasting on a smile.