Raising Cane
By Rob Perez
A demanding and vital job
still pays a pitiful wageIt's astonishing that Gail Yonemura, Deborah Bagood and many of their colleagues haven't had a pay raise in nearly 12 years, especially considering Honolulu's inflation rate during that period rose roughly 30 percent.
It's even more astonishing considering what they do.
As employees of the nonprofit organization The Arc in Hawaii, the two women and their 200-plus colleagues care for mentally retarded adults, a job that is physically and emotionally demanding.
On a daily basis the caregivers can be kicked, scratched, spit on, punched. They regularly deal with adults who have trouble communicating or who may need help bathing, feeding or going to the bathroom. Some clients wear diapers.
Caring for such clientele is hard, unglamorous work. On top of that, the pay is lousy.
Yonemura, for instance, has worked for Arc, one of the state's largest care providers for mentally retarded adults, for 16 years, but has earned only slightly more than $8 an hour for the last dozen or so. Bagood, who has more than 30 years with Arc, has made slightly more than $10 an hour since around 1990.
Most of Arc's less-senior caregivers earn $7 or less an hour, and most of them don't even get sick leave, vacation time or holiday pay.
A handful of the organization's residential managers, who are provided housing at the dwellings they manage, earn only the state's minimum wage of $5.75 an hour.
"It's far from a decent living wage," said Joni Fabrao, resident manager for an Arc apartment complex in Pearl City.
Given the importance of their jobs -- caring for roughly 270 clients in Arc facilities and programs on Oahu and Kauai -- such low pay is mind boggling, especially in a high-cost state such as Hawaii. Inflation has meant the workers have fallen farther behind financially, with some saying they're earning wages below the poverty level.
It's no surprise, then, that the organization has been plagued by constant staff turnover.
It's no surprise, either, that the high turnover -- less than a third of the work force has been with Arc more than three years -- and the difficulty in attracting qualified replacements have affected quality of care.
It's also no surprise that the low pay and poor work conditions, another offshoot of Arc's strapped finances, have led to employee unrest.
The rank-and-file became so frustrated that last year they took the unusual step -- particularly for a nonprofit organization in this line of work -- of turning to a labor union for representation.
The National Health Care Union local and Arc's management have been in negotiations for months, but still have no contract. Pay is a key issue.
"These people are earning about as much as a guy making french fries at McDonald's," said Richard Zamora, executive director of the local representing the Arc workers.
Garrett Toguchi, the organization's executive director, acknowledged that the low pay and high turnover have created problems. But he said Arc does the best with the resources it has.
Serious financial problems throughout the 1990s prevented Arc from giving pay raises, including for management, and from keeping up with maintenance, staff training and other needs, he said.
Arc gets almost all its $9 million annual budget from the federal and state governments, primarily through contracts with the state. Medicaid, for instance, pays for care for most Arc clients.
The organization's major financial woes began in the early 1990s when some government funding sources were curtailed at the same time Arc was incurring substantial debt to pay for a major expansion of facilities. The state's decade-long economic slump, which hurt all nonprofits, only exasperated the crunch. By the mid-1990s, Arc was about $1 million in debt, could barely meet payroll and had to borrow money from its reserves.
Only in the past year has Arc been in the position to start giving raises, Toguchi said, although wage adjustments for those represented by the union must be addressed in contract negotiations.
As for quality of care, Toguchi said it is sufficient to meet basic client needs, but he acknowledged shortcomings, particularly because of the turnover and lack of resources.
That was partly reflected in the numerous state and federal rule violations that state inspectors found over the past year at Arc's licensed homes.
None of the violations were life-threatening or serious enough to prompt the state to take immediate actions, such as revoking a license or shutting down a facility, according to Diane Okumura of the Department of Health, which inspects Arc's licensed facilities. In addition, the violations have since been corrected or Arc has submitted satisfactory plans to correct the deficiencies, Okumura said.
Still, the citations raised some red flags. Among the violations:
>> Emergency medical situations, injuries or unusual incidents weren't recorded in a client's records or the appropriate case manager wasn't informed, a violation found in all 14 of Arc's domiciliary homes (those providing intermediate levels of care).At 11 Arc homes that provide the most intensive residential care, state inspectors also found a variety of violations, including some that seemed serious.>> Medication or supplements taken by a resident weren't properly recorded, an infraction uncovered in 12 of the 14 homes.
>> Twelve homes violated the rule requiring that physician orders be re-evaluated and signed by the physician every three months or at the next doctor visit.
Several homes, for example, failed to ensure appropriate measures to protect clients from the spread of communicable diseases or infections.
One home was cited for failure to consistently ensure that clients "were free from unnecessary drugs and were provided sufficient active treatment to reduce dependency on drugs."
Another was cited for failure to ensure that medications were administered in accordance with physician orders.
Toguchi said some violations sounded more serious than they actually were and some were technical in nature. In some cases, the required information was recorded but just not where the inspectors looked, he said.
Regarding the citation for failure to guard against the spread of communicable diseases, that could have simply been workers who didn't wash their hands after scrubbing dirty dishes, he added.
"I'm not trying to trivialize the citations," Toguchi said. "I know there are some real ones ... But you're only getting one side of the story, basically."
Despite the organization's financial and staffing problems, several parents who have sons or daughters in Arc homes said they were satisfied with the level of care provided, though they acknowledged that staff turnover was a problem.
Violet Eguchi said her 43-year-old son, who has been in Arc programs almost his entire life, is adequately cared for.
"He loves school, and the staff treats him real well," Eguchi said.
Such compliments, however, won't be enough to placate the meagerly compensated workers, who have gone far too long without raises.
They're demanding a living wage and to be treated with respect. From this corner, that doesn't seem like an unreasonable demand.
Star-Bulletin columnist Rob Perez writes on issues
and events affecting Hawaii. Fax 529-4750, or write to
Honolulu Star-Bulletin, 500 Ala Moana Blvd., No. 7-210,
Honolulu 96813. He can also be reached
by e-mail at: rperez@starbulletin.com.
