Ways to Win: How Advocates Won Caregiver Support in Hawai’i

Caring Across Generations and its allies won this policy by:

  • Understanding the issue from many viewpoint

  • Building relationships with involved groups.

  • Sharing stories to raise awareness and make progress.

  • Seeking solutions that benefit many people.

As the baby-boom generation crosses the threshold into old age, America is experiencing an age wave. Along with it comes a caregiving crisis of unprecedented scope. Millions of adults are struggling to balance the challenge of caring for elders with the needs of their own children and the demands of paid employment. In the next five years, more than half of working Americans will be caring for an aging adult.

For low-income families, these challenges are compounded. Unable to afford paid help even in an emergency, these families can be thrown into crisis when the needs of aging parents collide with the demands of an inflexible, low-wage job and the daily challenges of child-rearing.

Meanwhile, those who work as caregivers face a crisis of their own. Predominately immigrant women and women of color, care workers struggle with poverty wages and unpredictable schedules in a largely unregulated industry. The result is that many are unable to support their own families even as they work long hours caring for others.

Enter Caring Across Generations (CAG), a collaborative effort spearheaded by Jobs With Justice and the National Domestic Workers Alliance. Together, CAG members developed ways to successfully engage two groups that are more often pitted against one another – caregivers and the families that employ them – in an alliance that has pushed through changes that improve the lives of all involved.

In Hawai’i, Caring Across Generations celebrated in July the passage of the Kupuna Caregiver Act (kupuna is the Hawaiian word for elder), which makes that state the first in the nation to provide direct financial support to family caregivers. The law provides up to $70 a day for eligible families to hire a home care worker to take a loved one to the doctor, for instance, so parents and other relatives won’t have to miss work or skip a parent-teacher conference. Along with providing much-needed respite to exhausted caregivers, this stipend can mean the difference between losing a job and holding on to employment at a critical juncture.

How did a broad-based coalition work together to push this change through? Jobs With Justice Executive Director Sarita Gupta shared some key ways that made this landmark victory happen.

Go to the source.

Before you can tackle a problem, you have to understand it from the perspective of those who are experiencing it. CAG worked with faith groups, unions and others to reach working caregivers, who offered firsthand accounts of their struggle to balance elder care with myriad other responsibilities. Without any economic support in place, these caregivers testified, many were faced with an impossible choice: In order to care for a parent at home, they had to forgo their own economic security.

Research the issue.

CAG partnered with local universities to better understand the demographic shifts taking place in Hawai’i, as well as gathering national data. What they learned, said Gupta, is that “those hit really hard are in the sandwich generation, caught between elder care and child care.” There are 44 million family caregivers across the country. That number will grow to half the workforce in the next five years. Demographic research – including identifying 100,000 families in Hawai’i who would benefit from the new law – helped the coalition “shape a deeper understanding of the challenges these families are facing, and to craft solutions,” Gupta explained.

Identify unlikely allies.

Coalition building is key to movement victories across a range of issues. In Hawai’i, CAG went all in, bringing together not only activists but elected officials, unions, small business owners, the faith community and, crucially, care workers, family caregivers and elders themselves. “Weaving these relationships,” said Gupta, was the key to pushing the work forward.

Find common ground.

Caregiving is lonely work – but just about everyone does it at some point in his or her life. CAG consistently highlighted the universality of the caregiving experience. “Everyone has been or will be touched by this,” Gupta said. “We start every meeting by asking people to get into triads and share their care story – including policymakers. We really pushed people to think about themselves in the story of care. That is what made what has historically felt impossible possible.”

• Change the culture.

CAG worked with the storytelling hub, The Moth, to elevate the stories of family caregivers and held a community showcase with screenwriters in an effort to influence how aging adults are portrayed, and make caregiving more visible. “Storytelling was really important to help people see themselves in the story of care,” Gupta said. “We can do the best organizing, the best policy solutions, but we won’t win fundamentally if we don’t shift the culture.”

Develop mutually beneficial solutions.

The decision to advocate for a cash supplement – as opposed to workplace regulations, for example – was part of a larger idea to “bridge the gap between caregivers and people who need care” rather than “focus on just one slice of the care story,” Gupta said. Because the supplement benefits everyone involved – paid caregivers, family caregivers and those in need of care – the proposal had an immediate natural constituency. “If we’re trying to transform the care economy,” Gupta explained, “we need to center solutions on all of the stakeholders.”

Focus on implementation.

Without ongoing vigilance, hard-won policy changes too often peter out at the implementation stage. CAG is embracing the relationships built during the campaign to conduct ongoing public education to ensure that the new benefit reaches those who need it most.