Toward a More

Caring Minnesota
 Executive Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

Key Findings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4

Recommendations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

Part 1: The current situation . . . . . . . . . . . . . . . . . . . . . . . 8

Part 2: What do we spend money on? . . . . . . . . . . . . . . . . . 12

Part 3: Toward a more caring Minnesota . . . . . . . . . . . . . . . 17

Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21

Toward a More Caring Minnesota is a special report by SEIU Healthcare Minnesota and ISAIAH that examines
the historical context and causes of several interconnected problems facing Minnesota’s care infrastructure, and
offers a basic framework to develop policy to answer those problems.

Special thanks to all the people who have devoted so much time and energy to writing and refining this report.

SEIU Healthcare Minnesota unites more than 35,000 healthcare and long-term care workers in hospitals, clinics,
nursing homes, and home care throughout the state of Minnesota. Our union seeks to secure the American Dream
for all working people, including: a paycheck that supports a family, quality, affordable healthcare, a secure retire-
ment, and the freedom to form a union for a voice on the job.

ISAIAH is a faith-based coalition of more than 100 member congregations that lets communities in Minnesota
more effectively live out their faith in biblical justice and the common good. By uniting local congregations in a
large regional organization, ISAIAH strengthens the ability of people of faith to to address both local and regional
community issues, including sprawl, affordable housing, transportation, and racial inequity.
 Executive Summary
Minnesotans have a long history of caring for each other, respecting elders and providing chil-
dren with opportunities to pursue their dreams. That legacy is at risk because Minnesota’s fal-
tering care infrastructure is being targeted for divestment by a greedy few who are distracting
Minnesotans from their wealth concentration agenda by dividing communities against each oth-
er — shaming and blaming people of color, new immigrants and Muslim Americans for the eco-
nomic struggles faced by families across the state.

Minnesotans have an opportunity to join together to make our state a place where every child,
elder, person with disabilities and care provider has what they need to live healthy, fulfilled lives.
We can build a system of care that is erected on Minnesota’s foundation of heroic altruism. One
that respects both the dignity of the individual and the unique bonds of family and community.
One that is universal, democratic, and just.

The first part of this report examines the history that has led us to our current situation. For
decades, the care infrastructure has excluded many: people of color, single mothers, and LGBTQ
people, in particular.

It is the job of elected officials to ensure that care infrastructure exists in our state. Doing so
will require the wealthiest Minnesotans to pay their fair share in taxes. A small but powerful
coalition led by the Minnesota Chamber of Commerce, the Freedom Club, and the Center of the
American Experiment opposes this course of action and lobbies for cuts in our current, already
underfunded care system. The ascendant faction within this coalition wants to secure for their
members an ever-tightening grip on public life in Minnesota by enacting policies to concentrate
wealth and by criminalizing what they consider immoral behavior. The second part of this report
will look at this coalition, their motivation, and how they divide Minnesotans to advance their
unpopular agenda.

Minnesotans are diverse. We are white, black, and brown. We are young and old. We are rural
and we are urban. We are rich, poor, and everything in between. We were born here and we
moved here from out-of-state and out-of-country. Solving the diverse problems with care we all
face will require a great deal of policy work and discussion in the years to come. While all the pol-
icy answers to ensure strong care infrastructure in our state are not yet clear, the final section of
this report outlines some of the most urgently-needed policy steps for elected officials to take to
begin to address the care crisis. This final section will also summarize some of the conversations
about care needs and solutions that have taken place over the last few months with thousands of
Minnesotans in St. Cloud, Northfield, Albert Lea, Austin, Mankato, St. Peter, Rochester, and the
Twin Cities.

3
 Key Findings
■■ According to a recent survey, 68 percent of
Minnesotans supported a paid family leave
program. Even if it meant an increase in taxes
for some Minnesotans, 67 percent favored a
strong elder care program, including 44 percent
who strongly supported it. 63 percent supported
a paid sick and safe time program. 60 percent
supported a fully-funded child care program. A
comprehensive plan that included all of these was
supported — even if the program would require
higher taxes — by 59 percent of respondents,
including 37 percent who strongly supported it.
■■ The problems facing Minnesota with respect
to care are numerous, but funding shortfalls
and cuts have deepened each. These problems
include rising child care costs, rising insurance
rates, lax enforcement, decreasing availability of
care, low worker pay, inadequate benefits, and
lower quality of life.
■■ These problems exacerbate existing statistical
disparities based on race, gender, and sexual
orientation.
■■ A relatively small circle of individuals and
organizations have originated and distributed
most of the divisive rhetoric that has been
distributed this election cycle, including the
rhetoric underpinning Fox 9’s unfounded “Somali
day care” story and several pro-Jeff Johnson ads
that repeat inaccuracies central to that story.
4
■■ One of the most vocal and public-facing of these
organizations, the Center of the American
Experiment, engages in union busting on
an unprecedented scale. They are currently
campaigning for what would be the largest
decertification election in U.S. history, against a
group of caregivers who are mostly female and
disproportionately women of color.
■■ Center of the American Experiment has a
radical agenda. In January, 2018, they called for
the government to enforce “marriage norms”
with stigmatization and, in some cases, legal
punishments for single parents, divorcees, and
people who live together before marriage. They
have also advocated for billions of dollars in
federal cuts to Medicaid.
■■ A closely connected organization, Freedom Club,
has run a blog called Alpha News since 2015.
Shortly after they were founded, Alpha News
published several highly editorialized stories
by an anonymous contributor which appear to
provide the rhetorical scaffolding of the Somali
day care story.
■■ Alpha News provided early, vocal support of Jeff
Johnson’s campaign for governor. Freedom Club
board member Robert Cummins and his wife
Joan are the primary financiers of a recent series
of pro-Jeff Johnson ads recirculating the Somali
day care story.
 Recommendations
■■ Ensure that all Minnesotans have the time and ability to care for their loved ones and
themselves, through paid sick time and paid family leave policies

■■ Provide all Minnesotans access to high-quality, affordable childcare, by fully funding

public childcare programs.

■■ Enable elders and people with disabilities to live in their homes and communities by
solving the home care workforce crisis through providing higher pay and benefits and
establishing professional standards for home care work

■■ Ensure the safety and well-being of elders living in institutional-care settings, through
requiring safe staffing levels, improving pay and benefits for workers, and getting
resident and community input any time a facility is going to be sold off to a new owner.

5
 Introduction
In 2004, while the rest of the country was facing a shortage of flu vaccines — waiting in lines,
calling clinics, and even leaving the country in search of medicine — Minnesota had more than
120,000 extra shots. “They call it Minnesota nice,” one state health official told the New York
Times. “People feel that they should defer for someone who needs it more.”1

That neighborly concern, that sense of responsibility to the greater good even at personal cost,
has long been Minnesota’s greatest strength. We were the first state to establish a shelter for bat-
tered women to prevent domestic abuse. We came together — Republican and Democrat — and
turned the education crisis of the 1970s into the “Minnesota Miracle.”2 We were one of the first
states, in 1992, to recognize healthcare as a basic right when a bipartisan coalition worked to cre-
ate MinnesotaCare.3

Minnesotans care about each other and are proud when our communities thrive. Yet every day,
many of our neighbors struggle alone to care for our children, our aging parents, our loved ones
with disabilities, and ourselves. These problems are especially acute in Greater Minnesota, and
have been allowed to grow so dire that they now undercut quality of life for most Minnesotans
and even threaten the wellbeing of entire towns. In recent years, New York Mills,4 Worthington5
and Blackduck6 (in the north) have seen hundreds of jobs with major employers go unfilled for a
lack of childcare.

Between 2006 and 2015, Greater Minnesota lost more than 15,000 daycare seats. Families expect-
ing new babies must call dozens of childcare providers, and even then face waitlists of months or
even years. In rural areas, it’s not uncommon for parents to drive 40 miles round trip, twice a day,
to reach a care provider.7 In New York Mills, a small town in central Minnesota, childcare costs
rose so high that the economy was threatened because some employees could no longer afford to
work.8 In metro areas such as St. Cloud, childcare costs can range from $7,500 to $17,000 every
year.9 At the high end, this is about the same as a year at St. Cloud State University, including
housing, food, books and supplies.10
At the same time, there are nearly 8,000 vacancies for the in-home caregiving jobs that allow
seniors and people with disabilities to remain in their homes and communities.11 Coming demo-
graphic changes will lead to more vacancies: the number of Minnesotans turning 65 in the next
decade will be greater than in the last four decades combined while the primary sector that pro-
vides them care — women aged 20–64 — will decrease.12

Care is a basic necessity that everyone needs eventually, usually when they are least able to af-
ford it. When there are no affordable care providers, you are forced to walk a narrow path over a
deep pit. Do you accept lower quality of care? Children and seniors are two of the most vulner-
able populations. Do you go without? Care is not a luxury, and it should not be a privilege. Do
you work longer hours? No one should have to choose between money they need and a child they
love. Do you quit your job? Frequently, workers are barely making ends meet as is. And if a man
6
or, more likely, a woman quits their job, it can end their career or lower their earning potential
for the rest of their life.

In 2014, more than 85 percent of child care workers in Minnesota were low-wage workers, mak-
ing less than $20,000 annually. This was the highest percent of any industry.13 With part-time,
irregular schedules, the situation is even worse for those who provide in-home care to our elders
and disabled neighbors. A smaller percentage are low wage workers (about 70 percent,) but the in-
come gap between workers is greater. The median annual earnings for a home care worker is just
$12,500.14 The financially untenable position of most care workers, along with the high stress of
sometimes being placed in life-and-death situations with inadequate training and support, have
led to a shocking turn-over rate in the industry: 40-60 percent annually.15

Care workers in Minnesota are primarily women and disproportionately people of color, who
face worse orse economic conditions than their white, male peers. The underfunding of care in
Minnesota exacerbates other racial and gender disparities. Low pay and benefits for caregivers
deepen the inequities in our state.

As for loosening regulations, one child care expert described existing low-quality child care in
an almost apocalyptic tone: groups of babies strapped in car seats all day and toddlers plopped in
front of TVs for hours every day.16 And the recent elder-care abuse crisis is a testament to the lax
regulations that already exist across that sector of the industry.

Lawmakers have systematically cut funding to care programs, both by cutting and by failing
to keep pace with inflation. From 2007 to 2017, the Department of Human Services decreased
spending on its childcare program from $237 million to $97 million, while the developmental dis-
abilities program was cut from $132 million to $112 million. Some programs did see their funding
increase, such as the elder care program; we now know this was still inadequate.17 18

The state was forced to make the tough decision to either pay for child care or elder care — a
situation many Minnesotans have faced  — because, in that ten year period, funding for DHS
programs saw a nine percent cut, after inflation.19 20

Dangerously low standards, decades of under-funding, a growing worker shortage; it is the young,
the old, the poor, and the disabled who have been left to bear the burden. In many cases, even
before cuts, these programs were failing to provide a basic level of security and dignity to fami-
lies, workers, and our neighbors who need care. Money is not the problem — Minnesota’s GDP per
household was almost $130,000 at the last census.21 22

7
 PART 1
The current situation
Much has been written about Minnesota’s vast daycare deserts, the elder care abuse crisis, rising
care costs, the stifling and undignified system by which we care for our disabled neighbors, and
the low pay and inadequate benefits of care workers. However, the disparate problems are best
understood as the different faces of a single problem: corporate influence in Minnesota’s democ-
racy has pushed some lawmakers’ to prioritize the economic interest of wealthy corporations and
the greedy few over the needs of Minnesota’s people. These decisions have resulted in widespread
hardships, touching nearly every Minnesotan in some way. In spite of this, many — including
Somalis and other recent immigrants — have worked hard to provide care for their neighbors at
all stages of life.

Children
Since she was a child herself, Charla Attarsaheli has
known she would be a caretaker of children, “ In
elementary and high school, I tried to take care of
younger kids. I don’t know where it came from, I just
have known my whole life I was going to work with
kids.” She went to Mankato State after high school,
where she got an elementary education degree with a
concentration in kindergarten.
Charla has cared for children for nearly two decades.
Most of that time, she has worked out of her home,
but recently she and another provider partnered
to open a daycare center in St. Cloud. They opened
October 30, 2017, and in less than four months, they
were at over 90 percent capacity. “We figured our
infant room would fill up fast, but our toddler and
preschool rooms are filling up faster than we had an-
ticipated.”
Even though the center is doing better than Attar-
saheli and her partner anticipated, they are still do-
ing worse than when they worked out of their homes.
They are doing more for their community, but Attar-
saheli had to take a 30-40 percent pay cut to do it.
Rather than being paid, they are paying to provide
a vital service to their community, and neither the
state nor the city of St. Cloud are helping them. They
received no subsidies or low-interest loans. She and
her partner had to put up their own homes as collat-
eral to open the care center.
She took a huge pay cut, and offers scholarships, but
still had to raise the price. “It breaks my heart that
the children who need it the most can’t afford it,” At-
tarsaheli said. “The upper middle class can afford the
best childcare for their kids that’s out there. The low-
er class has to take what they can afford, and unfor-
tunately that’s not always the best place for the kids.”
Attarsaheli is hesitant to talk about what low-quality
child care is like, but says that she has heard stories
from families. “They’re understaffed, overwhelmed,
and don’t know how to deal with children who are
having problems.”
With two decades of experience in the industry, At-
tarsaheli knows that to solve the crisis the public
must invest in families and teachers like her. Teach-
ers go to college for two to four years to earn $11–13
per hour, she said. “You can go to McDonald’s and
make more.” There are also continuing education
requirements that the teachers have to pay out-of-
pocket, “In the public schools, teachers have inser-
vice days they get paid for. We don’t have that.”
She said that she has seen parents take a lower paying
job or quit work altogether to qualify for assistance or
care for their children because, for some, it is cheaper
to not work. “That’s not right.”

8
Disabled Adults
Lauren Thompson sits on the Minnesota Council on
Disability. The 29-year-old lives in Champlin, MN,
where she receives 24-hour care in an assisted living
facility. Because of her disability, Thompson is not
able to hold a full-time job, but is active on Facebook
where she is an amateur journalist, informing mem-
bers of the disability and PCA (Personal Care Atten-
dant) communities about important events and rule
changes. She also does advocacy work and occasion-
ally meets with legislators. “I just try to keep as busy
as possible,” she said.
Because of her needs, the chronically underfunded
care system affects every day of Thompson’s life. In
her home, the client/provider ratio is 11:1. In the
morning, she has to wait for help to get out of bed,
and again at night to get into bed. “Sometimes, I can’t
get all my home chores done, or I have to skip them
completely. I can’t follow a schedule because I don’t
know when I’ll be able to get up or when I’ll get to
bed.” Adding to the problem, Thompson’s care is lim-
ited to the building, which makes it hard to leave.
Workers
Aysia Morgan is a 24 year-old CNA in the dementia
unit at Parkview Care Center in Buffalo, MN. She
helps her clients get through the day, from dressing
them in the morning, to feeding them at dinner. She
helps them to the toilet, and acts as a companion,
when she can. The nature of her work is such that
most of her clients are nearing the end of their life.
Most of her clients are also confused and have high
levels of care needs.
As the caregiver shortage deepens, Morgan and her co-
workers are expected to do extra work, sometimes for
no extra pay. They receive meager incentive pay for
picking up extra shifts. (“We need to get more incen-
tives,” she said.) But once they are clocked in, they get
paid the same whether there are four people doing the
work or only two. Morgan recalled the last time she
worked a half-staffed shift: “Everybody was trying
to get out of their chairs by themselves, and standing,
and they always need a carry belt around them. It was
hard to juggle everything that was going on.”
9
In May, 2018, Thompson was featured in a Minne-
apolis Star Tribune article by Chris Serres. The ar-
ticle examined the widespread practice of putting
young and otherwise healthy Minnesotans with
disabilities into facilities designed for and primarily
filled with seniors, some of who have dementia. “Too
many people with disabilities live in inappropriate,
more-expensive settings, and that makes me so sad
I’m speechless,” she told Serres.23
Thompson wants to get out of assisted living, but has
been told that the system which theoretically pro-
vides 1:1 care wouldn’t be able to meet her needs be-
cause the pool of employees is too small. She blames
the lack of workers on bad pay and benefits, and poor
support. The supervisor in her building recently quit,
even though they had just started the job. There is a
replacement supervisor, but they are also still com-
pleting their regular duties.
“Right now,” she said, “I’m doing a lot of compromising.”
The lack of resources is evident in training, too. Mor-
gan said that once a month or so, there is computer
training for skills and regulations. These are helpful,
she said, but also of limited value. “A computer can
only tell us so much, instead of actively doing it. We
need to demo it,” she said. For example: the heimlich
maneuver. “You know what you’re supposed to do,
kind of, but you’re not really taught in person.”
Morgan is proud of the work she and her coworkers do,
but knows that there are limits to what can be done
under the current system. Some days, she gets as lit-
tle as half an hour with each patient in the morning.
“With the limited time we get, and the limited staff,
they’re not getting the best care.” She picks up an ex-
tra shift or two every week so that coworkers don’t
have to work short staffed and patients don’t have
to go without necessary care. “I sacrifice and miss
a night with my family,” Morgan said, “I just did it
yesterday, I did it this weekend.” Still, there is rarely
time to take a patient outside for a walk. Instead, they
are expected to sit in their chairs for most of the day.
Elders
Perhaps the most visible failure of Minnesota’s care
system has been the massive elder abuse crisis that
has rocked the state. Many abuses were reported by
the Star Tribune in their ground breaking five-part
series published in 2017 — abuses which include sex-
ual assault, beatings, and retaliation for reporting
abuse.24 Even at its best, however, it doesn’t provide
as much support as it should.
Kim Houle cared for her mother when she could no
longer live independently after a lifetime of health
issues. She was born with double club foot and was
told she would never walk. With help from the Shri-
ner’s, though, she was walking at the age of twelve.
By the age of 48, she was a widow, and was diagnosed
with emphysema. “Her generation used cigarettes as
a fashion accessory,” Houle said of her mother.
She underwent an extensive lobectomy; half of one
lung and ¾ of the other were removed. However, the
emphysema continued, and in 2006 she had a full
lung transplant. She was given three to five years to
live. Seven years later, her health worsened, and her
daughter helped her move from Grand Forks, ND, to
the Twin Cities.
Even with a full time staff caring for her mother,
Houle found the experience stressful. “I had her in
an assisted living facility, and was overseeing the
care there, as well as the bills. It was a lot to take care
of,” she said.
10
Houle would care for her mother for two years. “Ev-
eryone thought I was going to burn out,” she said.
Still, she found it rewarding. “We shared so much, we
laughed, we shared clothes, we did things that we’d
never done. I moved out of the house when I was 18;
we had never really got that time as mother daughter
to just have fun. That was part of what the last two
years of her life was.”
Eventually, Houle’s mother was moved to hospice
and her condition began to deteriorate. The change
was sudden. Houle and her husband had plans to go
to Memphis, TN, for their 25th wedding anniversary.
Houle was concerned about her mother, but after a lot
of thinking, decided to go. “That was really the last
time we got to talk.” When Houle returned, her moth-
er was “in a fog,” she said. Two weeks later, she passed.
Houle’s story is a testament to the importance of
quality care: for the dignity of the patient and for the
emotional and spiritual well being of their family.
“Now that we know there is an enormous crisis in our
care system for elderly,” she said, “we need to tighten
our lens, make sure that our elderly aren’t marginal-
ized and left flailing in the wind.”
How did we get here?
After the second world war, there was a great sense of
American community. The “family wage system” be-
gan to form with the New Deal, and solidified in the
post-war era. Under this system, wives provided free
child care and domestic work. Employers were ex-
pected to pay men what amounted to a double wage
to support this infrastructure provided by women.25
Under this system, women’s wealth was controlled
by their husbands and many others were denied
support altogether: working women, single parents,
and, especially, people of color. A key part of the
family wage system was government-enforced labor
standards and benefits, but labor law deliberately
exempted the kinds of jobs held by people of color:
domestic and agricultural workers. One study found
that farmers of color alone lost over $600 million in
social security benefits because of that exclusion.26
In Minnesota today, people of color make up 19 per-
cent of the state’s population, but 30 percent of direct
care workers.27 Home care workers were not guaran-
“Dog whistle” language is still used by many political operatives,
teed the federal minimum wage until 2016.28
including Center for the American Experiment.
Even for those it benefitted, the family wage system
proved to be short lived. In the seventies, the key Both parties are culpable: Ronald Reagan talked
components of the system began to be weakened and about “welfare queens,” but Bill Clinton delivered
disassembled: unions were muzzled, welfare pro- “welfare reform.”31 Though promising (to those who
grams were defunded, and everyone quietly agreed heard it) to target black and brown people, this slow
that employers weren’t obligated to provide benefits unraveling of vital government infrastructure hurt
or pay a family wage.29 everyone. Notice that Atwater didn’t say that this
To facilitate this unraveling of the safety net, dog whis- strategy was about delivering benefits to white peo-
tle politics were developed by Lee Atwater and other ple, but that “blacks get hurt worse than whites.”
strategists for the Nixon administration. Atwater ex- Since the 70s, wages have stagnated, quality of life
plained the strategy in a 1981 interview in which he has eroded, and inequality has surged for everyone.
used shocking language that may be painful to read:30 The women’s movement normalized the idea of a
“You start out in 1954 by saying, ‘Nigger, nigger, working woman, so when a family could no longer
nigger.’ By 1968, you can’t say ‘nigger’ — that hurts live on a single wage, women entered the workforce.
you. Backfires. So you say stuff like forced busing, In fact, since 1980, 84 percent of the increase in medi-
states’ rights and all that stuff. You’re getting so an family income has come from women entering the
abstract now [that] you’re talking about cutting
workforce rather than from wages keeping pace with
taxes, and all these things you’re talking about
are totally economic things and a byproduct of the cost of living.32 With women working outside the
them is [that] blacks get hurt worse than whites. home, someone had to provide care (especially child
And subconsciously maybe that is part of it. I’m and elder care) and families had to buy what women
not saying that. But I’m saying that if it is getting once provided for free.
that abstract, and that coded, that we are doing
Today, this lack of support now threatens your fami-
away with the racial problem one way or the
other. You follow me — because obviously sitting ly and your neighbors — white, black, and brown.
around saying, ‘We want to cut this,’ is much
more abstract than even the busing thing, and a
hell of a lot more abstract than ‘Nigger, nigger.’

11
 PART 2
What do we spend money on?
The United States is enjoying its longest ever period of economic expansion. For the last ten years,
the gross domestic product has only risen. And yet, for most Americans, and for most Minne-
sotans, the quality of life has fallen. What good is a strong economy if it doesn’t make your life
better? What good are tax cuts today if your health care costs rise tomorrow? Care is at the heart
of a secure, dignified, and fulfilling life. If we’re not willing to pay for that, what good is money?

Caregiving is also a vital part of the infrastructure

Overall Funding for Housing, Health,
than enables corporations and business owners to
and Human Services Block Grants Has
be profitable. The economic developer for New York
Fallen Significantly Since 2000
Mills helped facilitate the daycare deal between the
city and the Brunswick Boat Company. Speaking Change relative to 2000 funding level
about the deal, he told MinnPost that economic de- Adjusted for inflation
velopment “is not just about creating jobs anymore, Adjusted for inflation and population growth
Adjusted for growth in gross domestic product
but about having an infrastructure around those 20%
jobs.”33 In one sense, caregiving is a business expense
10%
that many companies pass on to their employees.
0%
In the absence of a functioning, privately maintained
-10%
care infrastructure, lawmakers could have stepped
in and helped build a public system. However, in -20%
addition to stagnating wages, the last several years -30%
have seen corporate taxes slashed, both in real terms
-40%
and in the form of lax enforcement and a failure to
regulate loopholes as they are discovered. As reve- -50%
20 0

04

06

08

20 9
02

20 5

20 7
20 3
20 1

20 0

14

16
12

20 5

17
20 3
20 1
0

0
0

0
0

1
1

20

20
20
nues have fallen, federal welfare programs have seen
20

20
20

20
20

37 percent of their funding cut34  — more costs that
are passed directly to the people least able to afford
them, while the wealthiest collect a larger and larger
share of the pie.
The elder care scandal offers a bleak look at what
happens when lawmakers do not adequately fund
care. As early as 2010, DHS told the legislature they
needed more staff to investigate elder abuse cases:
“cases involving higher levels of harm are increasing
and it is reasonable to assume that these cases will
be more clinically complicated... this will reduce the
annual caseload for each of the investigators.” 35 That
year, there were about 3,600 cases of abuse reported.
By 2016, that number had risen to over 24,000, with
less than two percent of abuse cases investigated.36
Note: Includes funding from the 2009 Recovery Act. For non-entitlement
programs, 2017 levels represent annualized funding under the current con-
tinuing resolution (which expires on April 27, 2017); final levels for 2017
may end up higher or lower than shown here.
Source: CBPP based on Congressional Research Service reports, agency
budget justification documents, and appropriations legislation. Inflation
data from the Bureau of Labor Statistics; population data from the Social
Security and Medicare Trustees; gross domestic product data from the Bu-
reau of Economic Analysis.
From Center on Budget and Policy Priorities (cbpp.org)
It is the government’s job to build and maintain vital
infrastructure, and to levy taxes in a practical and
equitable way to pay for it. Care is a fundamental
part of that infrastructure, not a profit-generating
industry. When a network of care works like it’s sup-
posed to, no one profits and everyone benefits. Just
look at Lanesboro Middle School.

12
Lanesboro recognized early that care isn’t a privilege
but a critical piece of infrastructure. The small Min-
nesota town enacted a pilot program in 1987 that saw a
childcare center built at their middle school. Original-
ly, the center had 15 seats, but as care costs skyrock-
eted, they expanded to 51 seats. “It’s helped keep the
cost to parents down, by supporting it with district
money,” Lanesboro Superintendent Matt Schultz told
MinnPost. Parents pay about a third less than they
might otherwise, and they have the peace of mind
knowing that their children receive the care and nur-
turing they need to have happy, healthy childhoods.37
Failed Investment
New Flyer of America is one of the largest employers
in St. Cloud, employing 703 people in the city and
nearly 700 more in the surrounding area.39 In 2014,
the company applied for a $1 million grant, along
with a $250,000 loan, claiming that they would not
expand if they did not received the money. The Stea-
rns County Redevelopment Authority gave them the
grant, and took credit for creating 136 new jobs in
the community. 40 That same year, New Flyer Inter-
national gave their executives a 38 percent raise, on
average, raising the total they paid to vice presidents
and above from $5.8 million to $9.4 million. 41
St. Cloud is also home to Geringhoff, which has been
given an undisclosed amount of tax exemptions go-
ing back to 2013. That year, they were also awarded a
$500,000 grant by the city of St. Cloud. Both of these
subsidies were contingent on Geringhoff creating
100 new full-time jobs within two years. As of 2016,
the company had only hired 47 full-time workers, 42 43
and the average pay was below the target. 44 Gering-
hoff had to repay some (but not all) of the grant, and
the city has never said how much tax the company
has avoided. 45
13
Benefits of the investment in the Lanesboro program
are numerous: happy children, affordable childcare,
convenience, security of mind, and improved educa-
tion outcomes. No wonder the program is mentioned
in the town’s pitch for businesses to relocate.38
Private for-profit companies are routinely the benefi-
ciaries of business-friendly legislators who write the
rules guiding business subsidies in Minnesota. The
return on these public investments has never been
demonstrated. There is no means testing; companies
do not have to show that they need help to expand.
Between 2008 and 2017, 60 percent of corporate proj-
ects that took part in one subsidy program — the same
one as Geringhoff — failed to meet their wage goals
but were allowed to keep the grant money.46 This pro-
gram, the Minnesota Investment Fund, had replaced
a subsidy program begun by Tim Pawlenty which
was itself widely regarded as an inefficient failure.47
Business subsidies such as the Minnesota Investment
Fund are questionable at best, but receive millions
of dollars of public funding. Meanwhile, vital care
infrastructure  — proven to benefit individuals and
communities in New York Mills, Worthington, and
Blackduck  — goes underfunded. Charla Attarsaheli
received no subsidies from the city, county, or state
when she opened her care center and no grants or
loans when she took a pay cut to care for more chil-
dren in St. Cloud.
 care
“
Without
adequate funding,

industries wi ll be
forced

competefor scarce
to increasingly

workers.
”
14
15
Lobbying Against Care
In 2015, a broad coalition met in Duluth (which had
the lowest level of access to paid sick and family leave
in Minnesota) to announce a campaign to guarantee
sick leave throughout the state.48 Labor, faith, and
small business groups came together to advance the
issue, which was supported by about 60 percent of re-
publicans and independents in the state, and over 90
percent of democrats.49 A non-partisan white paper by
the Minnesota Department of Health concluded that:
“Attending to these issues is becoming
increasingly important because paid leave
policies, or a lack thereof, do impact health…
Minnesota may see increasing disparities
and unnecessary health care costs if these
issues are not considered and addressed.”50
Despite the well documented need, and the wide, bipar-
tisan support, the bill didn’t make it out of committee.
The next session, a similarly diverse coalition saw
several years of work climax when members of the
DFL introduced a bill which would have guaranteed
12 weeks of paid time off for Minnesota workers who
had long-term illness, who recently had a child, or
who had a loved one experiencing an illness. The bill
easily passed the Senate, but Republicans, with the
help of two DFLers, killed the bill in the House.
Both bills had the support of faith communities, la-
bor, small businesses, health providers, and average
Minnesotans.51 But marshalling the fight against sick
leave was the Minnesota Chamber of Commerce.
(Both Geringhoff and New Flyer are members of the
St. Cloud Area Chamber of Commerce,52 which is
represented on the state Chamber’s board of direc-
tors.53 ) After the Chamber decried the paid family
leave provision for being “a mandate” and “a tax,”54
the House refused to even vote on it.55
The same year, the Chamber helped to extract $258
million from the state’s unemployment insurance
trust fund, and ensured that the fund would teeter at
the edge of insolvency by guaranteeing business tax-
breaks when the fund reaches just 4 percent above the
minimum it needs to survive.56 In 2017, the Chamber
successfully advocated for property tax changes which
cost the state almost $300 million that year alone.57
The Chamber pursues its agenda through a deep-pock-
eted lobbying arm that spent over $2.7 million lobby-
ing in 2016, more than any other organization in the
state and over $600,000 more than the second larg-
16
est spender.58 In fact, they have led lobbying in the
state eight of the last 12 years, and have not been less
than second in spending since 2004.59
The Chamber also turns a blind eye to the exploita-
tion of tax loopholes. Both Medtronic and 3M are rep-
resented on their board of directors,60 even though
both of these companies have been cited as having
some of the largest overseas stockpiles of cash of U.S.
companies — $8 billion between them.61 If they had
allowed this profit to be taxed at the state’s corporate
tax rate of 9.8 percent, the state would have at least
$700 million more in its budget.
$250 million from unemployment insurance, $300
million from property taxes, $700 million in tax
loopholes  — conservatively, the Chamber and its
members have cost Minnesota more than a billion
dollars in just the last few years. (A recent budget
proposal by the governor’s office found that provid-
ing adequate oversight to the state’s licensed elder
care facilities would only cost $1–2 million a year.62 )
The Chamber does not represent all business own-
ers, however. Stephanie Darrow represented Gand-
hi Mahal restaurant before a Senate subcommit-
tee in support of the paid family and medical leave
act. She explained that small businesses who do the
right thing and provide benefits struggle to compete
against businesses that keep prices artificially low by
denying their workers basic benefits. The paid family
and medical leave bill would have given businesses
that compete in good faith a more fair standing. The
very next speaker was the Chamber of Commerce,
whose solution was to leave the problem to be solved
by business leaders, saying the public’s elected offi-
cials had no right to take part in the conversation.63
The Chamber is not always successful in their efforts
however. When groups in the Twin Cities coalesced
around paid sick leave at the municipal level, both
Minneapolis and St. Paul passed them. And when la-
bor, faith, and community groups coalesced around
raising the minimum wage in Minneapolis, the pro-
posal became law. The Chamber has fought these
measures repeatedly, but they do not have the sup-
port of the voters, they do not have the support of
the courts, and so far, they have failed to block these
democratically enacted laws. Aside from their mem-
bers and the legislators they lobby, their proposals
are not very popular.
Distract, Divide, Divest
Those opposing quality care and dignified work are
not a single homogenous group, but a coalition of
different groups with complementary tactics. It in-
cludes “nonpartisan” groups such as the Chamber of
Commerce as well as more explicitly ideological or-
ganizations and individuals such as the Center of the
American Experiment and the Freedom Club.
Freedom Club regularly gives an outlet to some of the
most radical and divisive idealogues in America. They
recently gave a dinner that featured David Horowitz
as the keynote speaker.64 Horowitz — whose website
alleges of the left that they “collaborate with Amer-
ica’s enemies beginning with the communist totali-
tarians of the Cold War and extending now to the Is-
lamist barbarians”65  — used the opportunity to call
for civil war. A blog run by Freedom Club praised
Horowitz’s speech as “blunt to the point of making
Minnesota Republicans uncomfortable, which is per-
haps exactly what they need.”66
Despite the divide between their public-facing brand
values, the factions are two cars going over the same
cliff. During the 2018 primary, the Chamber of Com-
merce endorsed Republican Tim Pawlenty. But in
the 2014 general election, they endorsed Jeff John-
son, the current Republican nominee67 who received
early support from several groups with close ties to
the Freedom Club, including Alpha News68 and Min-
nesotans for Bold Reform.69
America is currently enjoying the longest econom-
ic expansion in its history, but the quality of life of
average people has only declined over that 10-year
period. Voters know that the Chamber’s promise of
a bullish economy improving everyone’s life is naive
at best, and a lie at worst. To mask their apathy to-
ward the concerns of working-class people, that fac-
tion of the big-business coalition has come to rely on
the propaganda network built and maintained by the
Freedom Club to keep Minnesotans distracted and
divided against each other over race, religion and im-
migration status. If you are afraid to take your eyes
off your neighbor, the Chamber, the Freedom Club,
and all their allies know that no one will see them
raid the public coffers.
A recent Jeff Johnson ad paid for by Freedom Club
board member Robert Cummins70 and his wife Joan71
provides a perfect example of a dog-whistle at work.
17
In the ad,72 an exasperated woman plops groceries
onto a kitchen counter and proceeds to tell Minne-
sotans why they shouldn’t trust each other. The ad
tries to drive a wedge between rural and urban vot-
ers, decrying transportation infrastructure spend-
ing in the Twin Cities as something “no one wants.”
The ad scowls that a vague and shadowy ‘they’ “want
socialism.” But the most shameful part of the ad is
the repetition of the ridiculous claim that $100 mil-
lion of child care assistance money is “sent to Soma-
lia”  — this would be half of the state’s entire child
care assistance program.73
The Freedom Club runs the divisive propaganda
blog Alpha News. In 2016, Alex Kharam was both
the full-time executive director of Freedom Club,74
and the quarter-time president of Alpha News.75 76 In
the three years since it began, the blog has built a li-
brary of inflammatory articles. It uses a variety of
tactics, from innocuously reporting on things others
say (“Gubernatorial Candidate and City Residents
Blast Islam and Sharia Law”77 ) to parroting feverish
conspiracy theories (“Are Muslim Students Associa-
tions in Public Schools Cause for Concern?”78 ) Most
notably, days apart, in 2015, Alpha News published a
series of stories by an anonymous contributor which
were later welded together by Fox 9 into the non-
sensical “Somali daycare story,” referenced in that
Jeff Johnson ad: Minnesota Congress members keep up
pressure for Somali money-transfers, is it safe?79 and
More Somali daycare fraud in Minnesota, could abuse
have been prevented?80
Freedom Club is linked to a number of other propa-
ganda factories. Their board of directors includes the
president and CEO of the Center of the American
Experiment.81 (The two organizations share another
board member as well.82 ) Politically, CAE is lock-step
with the fanatical and reactionary Freedom Club.
One bizarre, rambling CAE report on the subject of
“restoring a marriage norm” advocates stigmatization
and legal punishment of single parents, those who live
together before marriage, divorcees, and everyone
else who doesn’t conform to their paleo-conservative
values, demanding that “violators must pay a price.”83
The report was published in January, 2018, and begins
with a glowing introduction by CAE’s founder.
Like Freedom Club, CAE spreads rhetoric designed to
make Minnesotans fear and distrust their neighbors.
They dedicated two pages of their most recent maga-
zine to re-telling the Freedom Club’s widely discredit-
ed Somali daycare story.84 They frequently use racially
charged language. One article criticising racial equity
used the disgusting title “No Thug Left Behind” and
advocated more punishment for black students.85

CAE is also virulently anti-union. They are behind

the push to get Minnesota teachers to opt out of the
teachers union.86 They are also the force behind MNP-
CA, a hazy organization that claims to represent PCAs,
but which takes great lengths to hide its backers. Their
address is a PO Box, their phone a VOIP number from
Skype or Google Voice, and their website was regis-
tered through a proxy.87 There are no names given for
agents or officers of the group on the website. How-
ever, they work with Douglas Seaton,88 senior counsel
at a law firm that “exclusively advises and represents
employers in labor and employment matters,” accord- The Center of the American Experiment co-hosts all of MNPCA’s
ing to its website.89 The firm, Seaton, Peters & Revnew, press conferences. Source: YouTube
P.A, is represented on the CAE board of directors.90

Despite the branding of their front organizations,

these groups are not populist. Their boards and
c-suites are stuffed with some of the richest people in
Minnesota, an array of high-financiers, half a dozen
corporate law firms that specialize in union-busting,
and some of the largest corporations in the nation.
General Mills, Dorsey Whitney, and Comcast are
each represented on the CAE board.91

18
Hoisting the banner
For his part, Johnson has eagerly exploited the hate-
ful paranoia of the Freedom Club and CAE:
Johnson takes the xenophobia to new heights, prom-
ising on his website to close Minnesota even to doc-
umented immigrants living in other states.92 The
fear-mongering — of Muslims, of immigrants, of peo-
ple who live in the Cities — is always in service of the
Freedom Club’s, CAE’s, and the Chamber’s agenda of
less care, cheaper labor, and lower taxes at all costs:
19
It remains to be seen whether the Chamber will turn
a deaf ear to his dog whistles in the hopes of passing
their 2018 “wish list” for the legislature:
“State taxes used to fund state public programs
have become increasingly burdensome... we
rank 7th in the country for highest Medicaid
spending per enrollee – largely driven
by our per-enrollee spending on disabled
individuals (2nd highest nationally) and low-
income children (7th highest nationally).”93
Farther down their wish list, they claim that Minne-
sotaCare’s “very generous benefits increase the pro-
gram’s costs and present enrollees with a disincen-
tive to pursue upward economic mobility.” As though
poverty  — including childhood poverty  — were
something you could just choose to not do anymore.
As though the minimum wage were enough to pay for
food, rent, and basic care (though they also oppose
the minimum wage.)94 The language is reminiscent
of CAE’s claim that the wealthy are a superior breed:
“The marriage norm need not be reinvented entirely.
It is alive and well among Americans with higher in-
comes and college educations. Perhaps all they need
to do... is to tell the rest of America to shape up.”
Other priorities of the big-business coalition include
eradicating public employee benefits,95 workers com-
pensation, and whistleblower protections.96 They
want to slash the corporate tax rate, the estate tax,
and business property taxes to “increase tax compet-
itiveness.”97 This despite the fact that, of all states,
Minnesota already has the third most Fortune 500
companies per capita.98
When you deconstruct the hate-filled messaging of
the Freedom Club, CAE, and the Johnson campaign,
when you dissect the slogans manufactured to cap-
ture the moment, when you break through the razor
wire and violence, their actual proposals are surpris-
ingly monotonous. Johnson, who is such a firebrand
for animosity between Minnesotans, loses all emo-
tion when he explains the actual steps he will take to
#OverthrowTheStatusQuo. The number one solution
in his healthcare agenda reads:
“I will propose tax exemption for
contributions into healthcare benefit
accounts and allowing pre-tax dollars to
accumulate in accounts that can feed HSA’s
and similar vehicles to pay for care.”99
 PART 3
Toward a more caring Minnesota
“It seemed like their solution for everything was to try and scare us into hating immigrants or
people who lived in Minneapolis. How does that help my life? How would their fear-mongering
lower health care costs? How would their scare tactics put more resources in our schools and fill
the potholes in our roads? It seems to me like we need everyone to come together to fix the prob-
lems we all face.” —A letter published in the Albert Lea Tribune after the 2018 primary100
It is easy to convene a closed-door meeting of wealthy happy in their jobs, who know her and how to care
political insiders like Freedom Club, CAE, and the for her, and that she and they could have a good dy-
Chamber. It is hard to seek out the wisdom of average namic. “That would be my wildest dream,” she said.
Minnesotans. However, true democracy demands a Thompson said the first steps are higher PCA pay and
slow gathering of input from all citizens. The role of lower staff-to-client ratios, though eventually she
policy-makers is to implement the will of the people, wants the state to address the widespread, chronic
not to tell the people what will happen. That is why underfunding of the system.
SEIU Healthcare Minnesota and ISAIAH have em-
Aysia Morgan eventually wants elderly people to be
barked on a door-to-door campaign to learn how av-
able to travel anywhere they wanted, “We only live
erage people interact with the care infrastructure of
once,” she said. But she would settle for our elders be-
Minnesota, and to learn what they value. The cam-
ing able to go outside: “I wish we had more PCAs, so we
paign is ongoing and has reached multiple parts of
could just engage with them, and take them outside for
the state, but it got started St. Cloud.
a walk if they wanted to. Play a card game, you know?”
Preliminary results are striking. Of all those surveyed,
Others — such as Kim Houle — don’t care what we do
across the political spectrum, 84 percent were willing
so long as people receive care when they need it, and
to share a personal struggle they were currently ex-
don’t have to sell their homes to pay for it. “If single
periencing with family care. Childcare (23 percent,)
payer is the way, if national healthcare; I don’t know.
healthcare (24 percent), and eldercare (26 percent)
We just need to find a way.”
were the most common causes of difficulty. 101
Across the state, most people agree on the broad strokes
Truly bold, revolutionary ideas came from these
of an agenda. A recent survey spoke to 600 Minneso-
deeply principled St. Cloudites, progressive and con-
tans from the north and the south halves of the state,
servative, white, black, and brown. People envisioned
and the Twin Cities area. Even if it meant a mandate
health care freed from the stranglehold of private
for business owners, 68 percent of all respondents sup-
for-profit insurance companies. They wanted subsi-
ported a paid family leave program. Even if it meant
dized childcare for themselves and their neighbors.
an increase in taxes for some Minnesotans, 67 percent
They wanted a way to access quality care when they
favored a strong elder care program, including 44 per-
retired. They wanted a safety net to stop anyone go-
cent who strongly supported it. Sixty-three percent
ing homeless because of medical debt. Many simply
supported a paid sick and safe time program. Sixty
wanted a guarantee that they or their parents could
percent supported a fully-funded child care program.
die with the same dignity as they lived. One woman
Respondents were white, black, and brown; strongly
said she wanted St. Cloud to get a new VA building.
Democratic, strongly Republican, and everything in
Another man said he just wanted St. Cloud to be pre-
between. A comprehensive plan that included all of
pared for the coming wave of retiring baby boomers.
these was supported by 59 percent of respondents, in-
(No one mentioned health savings accounts.)102
cluding 37 percent who strongly supported it.103
Some of the people who are concerned about the state
Our spirit of community, of commitment to the great-
of care in Minnesota, people such as Lauren Thomp-
er good, is why Minnesota has been a national leader
son, have a modest vision. Thompson said she wants
for more than a century, and why we will be a leader
PCAs that could come when she needs them, who are
in care and a high quality of life for many more years.
20
Six Minnesota Values
Care that flows from our Minnesotan values is root-
ed in neighborly concern. It recognizes that care is
a shared responsibility, that being nice isn’t enough,
that we owe each other more than that. This is care
that recognizes dignity as a basic human right, not a
privilege for the wealthy. This is care grounded in six
principles: dignity, families and community, univer-
sality, democracy, equity, and altruism.
Dignity means respecting the inherent value of all
people. Like Charla Attarsaheli said, all children de-
serve to feel secure, confident, and loved, regardless
of how rich or poor their parents are. When children
reach adulthood, and enter the workforce, they do
not deserve less. Our care system must recognize the
value and dignity of all work: that means the prom-
ise of a fair wage, the security of a strong safety net,
the opportunity to devote some time to your family
when a loved one needs care, and a comfortable and
fulfilling retirement. True dignity is not conditional
on what a person can produce, and when our elders
are past the age of work they must be given the re-
spect, security, and comfort they have earned after a
lifetime of caring for us. They deserve to live in their
own homes or surrounded by a community of their
peers, as they choose. In either case, they deserve to
have their care needs met with quality healthcare,
affordable medications, and adequate staff.
One of the most basic meanings of life is to feel the
love of your family and foster the relationships that
build your community. Our care system must reflect
this, and reinforce these relationships. We need paid
sick and family leave because you should not have
to work while your parent or child is sick or dying.
A single full time job should pay enough for you to
spend time with your family in comfort and secu-
rity; no one should be forced to work two and three
jobs with irregular hours while still facing the spec-
tre of poverty at the end of every pay period. Elder
care should be built so that loved ones are free to
spend quality time with their parents and grandpar-
ents rather than spending their time providing for
tedious basic care and financial needs.
21
Care is a universal need, and the government should
not be in the business of deciding the worth of its citi-
zens. That means that our care system cannot include
carve outs or exceptions. It must be rooted in a simple
truth: all people have dignity. All people deserve a ba-
sic level of comfort and security. It doesn’t matter how
rich they or their parents or their children are. Care
should not be a commodity, and the best of our care
system should not be reserved for the wealthy alone.
A complete, universal care policy will require us all
to be actively involved in our communities. We need
a deeper democracy. We need new tools for commu-
nities to shape the care of their residents. That could
mean a public hearing every time an out-of-state
company tries to buy a nursing home, or giving a
greater voice to caregivers through unionization.
We cannot ignore the injustices that our country has
committed in the past, or else the cycle of discrimina-
tion will continue for another generation. An equitable
care system will actively redress the systemic racism
that exists at all levels of the system. We must reverse
policies that limit the access of persons of color to quali-
ty child care, health care, health benefits, and elder care.
We must acknowledge that while care work has some of
the lowest pay and worst access to quality medical ben-
efits among Minnesota jobs, it is disproportionately un-
dertaken by people of color, especially women of color.
The United States healthcare system has become a
cash cow; there are numerous ways that corporations
and financial institutions have found to profit off of
care. Our care system needs to excise the profit mo-
tive from the industry, to protect our most vulnera-
ble neighbors, and those least able to pay. Our system
should instead be built on a spirit of altruism. We must
care for our neighbors, and that means being generous
with the resources we are fortunate enough to have.
Eventually, improving our care system is going to re-
quire increased revenue. This will be a sacrifice, but
our children are worth every penny; our parents, ev-
ery drop of sweat.
Policy Recommendations to Meet Minnesotans’ Care Needs
More work needs to be done to engage Minnesotans to generate a policy agenda that will address
all our diverse and growing needs for care infrastructure, but we are not starting from scratch.
Some components of the solutions we need are already clear, and urgently needed. Below are
some well thought out policies that should be pursued right away, while we continue the larger
conversation about how we as Minnesotans will get serious about building the care infrastruc-
ture to do right by our kids, elders, family members, and disabled neighbors.

Time to Care
No employer should force someone to work when
their family needs them or when they are ill and
need to take care of themselves. Minnesotans need
time to care, and policies that support a more caring
culture. Establishing statewide minimum standards
that guarantee paid sick time for all employees is a
good place to start.
Hand in hand with that is universal paid family and
medical leave. That means we have to prioritize ac-
cess for everyone with a promise of enough wage re-
placement that low-wage workers can actually afford
to use it, as well as robust job protection. The pro-
gram should offer at least 12 weeks for each quali-
fying event. This program would be funded through
employer premiums paid into a state administered
insurance program.
Right now, some women return to work within a day
or two of giving birth, and most fathers don’t get any
time off. We should give new parents a chance to bond
with their baby after the stress of pregnancy and
childbirth with paid time, in addition to medical leave.
Across our state, there are thousands of unpaid care-
givers caring for disabled and elderly loved ones.
They deserve a break every now and then. We should
fund respite care programs for those who qualify so
unpaid caregivers know their charges are safe and
secure while they enjoy a brief respite themselves.
There are more basics things we could do, too: offer
trainings and support groups; simplify the long-term
care system to make it easier to navigate; and pro-
vide caregiver matching services online or through
call centers.

Childcare
The first step toward taking care of our children is to
fully fund the Child Care Assistance Program so that
every family that is eligible receives support. Along
with this, we need to decrease the income eligibili-
ty levels so more families qualify and increase child
care provider reimbursement rates to recognize the
value of this important work and keep up with the
increasing cost of care and to attract and maintain a
quality workforce. We currently reimburse provid-
ers at 2011 market rates. We need to move to today’s
market rate, and put Minnesota back to where we be-
long, ahead of the curve.
We should fund universal pre-kindergarten, making
it available to all four-year-olds in Minnesota. We
should develop a system the supports both existing
community-based childcare providers and expand-
ing public options.
We have fallen behind on childcare funding. Mov-
ing forward, we should create mechanisms to ensure
policy and licensing requirements are informed by
those most directly impacted: children, providers
and parents.

22
 Home care and nursing home workers
Whether in clients’ homes or in institutional settings,
care work needs to be respected as the hard, vital
work that it is. Broadly speaking, the way we accom-
plish this is by guaranteeing expanded training, pay,
and benefits.
One of the most important steps the state can take to
start treating home care as a real, valued career is to
extend some of the basic benefits most other work-
ers get through their employer to home care workers,
including a living wage and health insurance cover-
age. We can only begin filling the thousands of home
care vacancies in the state by providing a living wage
to caregivers. And the people doing the hard work
of caring for our loved ones deserve health care for
themselves and their families.
While state lawmakers made significant improvements
in funding for nursing homes in 2015, the funding for-
mula led to some groups of nursing home workers being
excluded from the wage increases that resulted from
the new funding. All care workers, in any care setting
and in any part of the state, should make at least $15/
hour — and that should include anyone working in a
nursing home, not just people in certain jobs.
From basic job preparation to specialized trainings
for client-specific issues like dementia, operating
machinery, or managing bowel programs, most care
workers lack access to the training and support they
Care for seniors and people with disabilities
More Minnesotans whose loved ones need long-term
in-home care should be able to to access that care
through high-quality, self-directed programs. To do
this, we should create a “buy-in” option for clients
and families who are not eligible for Medical Assis-
tance. Many Minnesota families who do not quali-
fy for Medical Assistance hire home care workers to
care for their loved ones, and pay them out of pocket.
Many others provide unpaid care themselves. As the
state invests in making home care a real career and
fixing the worker-shortage crisis for state home care
programs, it can expand access to private payers.
When the federal government finally extended min-
imum wage and other provisions of the Fair Labor
Standards Act to home care workers, Minnesota did
not increase funding to pay for overtime. As a result,
23
need to provide quality care. To make care a real ca-
reer, caregivers need not only training and support,
but a career ladder, too: opportunities to increase
their pay through advanced training or gaining ex-
perience in the profession. Workers who pursue and
complete advanced training and education that en-
hances the quality of the care their clients or resi-
dents receive should earn higher pay. At a more basic
level, more experienced caregivers should earn high-
er pay as a reward for their hard-earned knowledge
and recognition of their leadership within the field.
While unionized home care workers in Minnesota
have won access at no cost to CPR, First Aid, and a
few other trainings through their union contract,
there are many other, even more basic preparation
all workers should receive before starting their jobs.
Currently, the only required training or orienta-
tion prior to starting in a home care job through the
state’s programs is an online orientation, though an
applicant can skip right to the simple 25-question
test. All care workers in the state (not just those with
a union) should have basic orientation and training
for the important work they perform.
Finally, very few care workers, whether in home care
or institutional care settings, have access to a pen-
sion, 401(k), or other retirement-security benefit. To
turn this work into a real career, caregivers will need
to have the means to someday retire from these jobs.
most caregivers’ weekly hours were capped at 40, exac-
erbating the worker-shortage for clients and reducing
the income of many caregivers. The state needs to fund
clients’ ability to get the care they need and are quali-
fied for. That means paying overtime to caregivers.
Beyond these two basic policies, we should have pub-
lic hearings whenever there are proposed mergers or
acquisitions affecting nursing homes and other insti-
tutional-care providers, to make sure the change is
in the interests of residents and community mem-
bers; establish safe staffing standards in institution-
al care settings; and enact policies that ensure dis-
abled adults are given dignified homes on their own
or with their peers.
 Conclusion
As Minnesotans, our strength comes from our ability to care for one another. Whether we’re
white, black or brown, we all want similar things for our families. We want to do right by our el-
ders, and we want to provide our kids with the love, care and opportunities they need to pursue
their dreams.

But right now certain politicians and their greedy lobbyist are putting our children’s future at
risk and leaving our seniors and those with disabilities in dangerous, shameful conditions while
they shame and blame people of color, new immigrants or Muslim Americans for our problems.

We will not let them continue to divide us against each other based on race, background and reli-
gion, distracting us from what really matters to all our families. Together, we have the power to
pick politicians who will prioritize caring for all our loved ones. By joining together across our com-
munities, we can make Minnesota a place where every child, elder and care provider has what they
need to live healthy, fulfilled lives. Together, we can ensure that:

■■ Our communities continue to be strong, caring, and supportive.

■■ Every child has quality loving care and access to great education
so they can pursue their dreams.

■■ Our parents and grandparents will have the support they need
to live and die with dignity.

■■ Those of us who are or who become disabled will get the care and support
we need to continue living the lives we want to live.

■■ Caregivers and educators will be highly trained and fairly paid.

■■ None of us will go bankrupt to pay for our healthcare.

■■ Our families will be able to support one another when we are sick
or when a new baby is born, no matter where we work.

24
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26
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88 MNPCA shares a PO box and phone number
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27
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103 Lake Research Partners survey for Caring
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