Supreme Court Exempts Illinois Home Care Workers from Paying Union Dues

The U.S. Supreme Court today ruled in a landmark decision that Illinois home care workers who provide personal assistant care services are exempt from having to join and pay union dues.

The Supreme Court of the U.S. (SCOTUS) ruled 5-4 in Harris v. Quinn, stating that home care workers should not be required to pay dues to public employee unions. 

SCOTUS’s ruling in the case, which originated in Illinois, upholds the First Amendment, which prohibits the collection of an agency fee from the state’s Rehabilitation Program personal assistants who do not want to join or support the union.


Also known as Illinois’ Home Services Program, the Rehabilitation Program allows Medicaid recipients who would normally need institutional care to hire a “personal assistant” to provide home care services. 

“Unlike full-fledged public employees Pas are almost entirely answerable to the customers and not to the State, do not enjoy most of the rights and benefits that inure to state employees, and are not indemnified by the State for claims against them arising from actions taken during the course of their employment,” wrote the Supreme Court in its decision

Illinois law establishes an employer-employee relationship between the person receiving the care and the person providing it. The law explicitly states that the person receiving home care, “shall be the employer of the [personal assistant].”


“Personal assistant” is defined as an “individual employed by the customer to provide…varied services that have been approved by the customer’s physician,” according to Illinois law.

The law also makes clear that Illinois “shall not have control or input in the employment relationship between the customer and the personal assistants.”

Another provision of the state’s law emphasizes that the customer “is responsible for controlling all aspects of the employment relationship between the customer and the personal assistant.”

This includes the locating, hiring, training directing, evaluating and supervising, as well as the disciplinary action against the personal assistant and terminating the employment relationship.

In 2003, the Illinois Legislature amended the Public Labor Relations Act (PLRA), declaring that personal assistants are public employees of the State, but solely for coverage under the PLRA and not for any other purpose.

Following a vote, the SEIU Healthcare Illinois & Indiana (SEIU-HII) was designated as the representative for personal assistants in the State, with the union and the State subsequently entering into collective bargaining agreements that required all personal assistants who are not union members to pay a “fair share” of the union dues.

Records highlighted by the SCOTUS revealed that each year, personal assistants in Illinois pay SEIU-HII more than $3.6 million in fees. 

The argument of whether home care workers should be required to unionize has sparked two sides of debate among labor unions and those providing in-home care. 

On one side are the caregivers who administer non-medical related services for the elderly and disabled, many of which provide informal caregiving to a family or loved one. 

On the other side are those who argue the SCOTUS decision will hinder the state’s ability to provide quality home care services. 

One of those such groups is the Paraprofessional Healthcare Institute (PHI), an advocacy association focused on the direct-care workforce, who urges there is a correlation between collective bargaining and quality of jobs. 

“Illinois aides in the consumer-directed programs have seen their wages double as a result of collective bargaining,” stated PHI President Jodi Sturgeon in a release. “The quality of care is inextricably linked to quality of home care jobs—these better wages help ensure a stable workforce that can provide the consistent and continuous service elders and people with disabilities want and deserve.”

In a report last year, PHI projected that 1.6 million new direct-care positions will arise by 2020, with care aides expected to be the fastest-growing occupations in the U.S. between 2010 and 2020. 

Despite the anticipated growth, PHI has noted that the increasing demand for care workers has had little impact on wages. 

“Unionization has provided a structure for communicating with worker representatives in order to understand the needs and concerns of this workforce, leading to improvements not just in wages and benefits but also in recruitment and training opportunities,” PHI stated in a release Monday. “Together, these improvements support the states’ interest, namely, providing quality home care to its citizens.” 

View the Supreme Court decision.

Written by Jason Oliva

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