Published: May 8, 2020

COVID-19 long-term-care call to action: Policies needed to protect workers and patients.

SEIU 503, Oregon’s largest union of long-term care workers, released a set of policy proposals today to ensure that a successful reopening of Oregon includes reforms to the long-term care system.

Nearly 60% of the coronavirus deaths and 17% of the reported illnesses are from long-term care settings. Earlier this week the state shut down a long-term care facility in Portland for failing to meet basic infection control processes after the largest and deadliest outbreak of COVID in Oregon. In Salem, another facility has become a Marion County hotspot. Homecare workers who may see up to 10 clients a week have almost no access to PPE. Across the state workers, seniors, people with disabilities and others who depend on these facilities to be safe are at increased risk during the pandemic.

“As Oregon begins the process of reopening the state, we must not forget the people working in long-term care, who are on the front lines of this crisis,” says Melissa Unger, Executive Director of SEIU 503, which represents nursing home workers, homecare workers, child care workers and adult foster care providers. “We are hearing from our members that they are deeply worried. They wake up every day not knowing if this is the day they will encounter this dangerous disease or inadvertently spread it to their patients or their families. We need to adopt new policies to ensure they are protected.”

SEIU 503, in consultation with other long-term care unions in Washington and California, has issued a report outlining both the immediate and systemic issues with long-term care facilities which are chronically understaffed and underfunded. The COVID-19 pandemic has exacerbated those conditions, highlighting the need for both short and long-term changes necessary to reduce risk and improve care.

Download the full report at

Among the report’s recommendations:

Two weeks minimum paid time off if a worker exhibits COVID-19 symptoms or test positive for COVID or have been exposed to COVID. This will ensure workers do not suffer financial repercussions when they have to stay home to avoid affecting others. States should either recognize that their state paid home care workers are covered by the Families First Coronavirus Response Act benefits or should provide equivalent benefits.

Pandemic Hazard Pay for all long-term Care workers. When grocery stores and other industries are providing hazard pay, it is long past time for long-term care workers to receive similar compensation. Long-term care work is difficult and low-paying under normal circumstances. During the COVID-19 pandemic workers are working under intense and difficult conditions. To protect staffing levels – which are too often too low – and patient safety, it’s time to provide hazard pay for all long-term care workers.

Increase staffing & training specific to the care needs in the COVID and post-COVID world. All long-term care workers should receive a paid standardized training that follows Centers for Disease Control (CDC) guidelines for working under conditions of pandemics and/or infectious diseases. When possible training should be provided through joint Labor-Management partnerships.

Personal protective equipment (PPE) for all long-term care workers in home, community and facility settings. All long-term care facilities should have adequate PPE to handle outbreaks and to make sure that PPE is accessible even if there is not an outbreak to keep staff and consumers safe. Nursing home workers must have sufficient PPE to change according to public health recommendations between residents and shifts. And homecare workers must have accessible PPE to make sure they can change PPE between consumers to keep staff and consumers safe. Today, that is not the case.

Testing. There is inadequate testing at facilities. Today, in too many facilities, testing happens only after someone exhibits symptoms, which is too late given the nature of this disease. Testing should be available to any worker – free of charge – who wants one, whether they have exhibited symptoms or not. Testing should be done universally at Long Term Care facilities that have had at least one positive case of COVID 19.

The report lays out longer-term policy recommendations including higher staffing ratios, increased wages and benefits for workers, and safety protocols that would allow families to visit their loved ones in facilities even during infectious disease events.

Unger says that the union has been working with some facility owners to improve safety for workers and patients. The focus of these negotiations have been ensuring that workers have enough PPE and paid time off, as well as winning hazard pay for people who are being exposed to the coronavirus.

“COVID-19 is shining a spotlight on the shortcomings in our long-term care system,” says Unger. “If this is a test we’re failing.People living and working in long-term care – as well as their families – are experiencing high risk, high anxiety, and lack of support. We do have an opportunity right now, with all the attention COVID-19 has brought to long-term care,  to change this system for the better.”