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Home health care workers rally against fast food wages.

She is also suffering from ovarian cancer. And like most of the about 37,000 other home health care workers in Illinois, she has no health insurance.

Home health care workers are “family members, social workers, nurses and maids all in one,” says home care worker Lisa Marie Alexander. They attend to the basic medical needs of the 68,000 clients in Illinois, in addition to making sure their surroundings are clean and helping them through periods of emotional distress. “It’s physically stressful, because we are lifting people and turning people over, things like that,” says Alexander, 35, who also works doing child care at a YMCA for what are sometimes 13-hour work days. “But even more, it’s emotionally tiring.”

“You have to be a loving, caring person to do home care work,” says Helen Miller, 66, a home care provider and president of Service Employees International Union (SEIU) Local 880, which represents about 13,500 home care workers. “Clients look for their home care workers sometimes more than their families, because they know you’ll be there.”

Despite all their duties, home health care workers in Illinois are paid only $5.75 to $7 an hour, no more than one would make at a fast food joint. And that’s with few or no paid holidays, vacation days or sick days—not to mention that 58 percent have no health care benefits. SEIU Local 880 has been campaigning for almost two decades to secure raises and benefits for home care workers, who are hired by a variety of private and government agencies and paid by the state, either through the Department of Aging for elderly clients or the Department of Human Services for the disabled.

Despite tireless lobbying, marching and letter-writing, the union so far has gotten little but broken promises. A $1-an-hour raise for all home care workers was passed in Illinois’ fiscal year budget, which was supposed to take effect on July 1. But a state budget crunch derailed that plan, and the program was gutted—the raise was repealed, and hours for each client were cut back, meaning less time with an attendant for housebound elderly and ill people and less money for already cash-strapped workers. Now, the union is pressing the state legislature to restore the $1-an-hour raise as well as a 3 percent cost of living increase that was supposed to take effect last August but was also cut. The bills mandating the raise and increase will be reintroduced during the state legislature’s veto session in November.

Workers note that the cuts in home care service are illogical, because the service actually saves the state money by keeping people at home instead of in institutions, which cost approximately three times as much. “We keep grandparents, fathers and mothers from having to be sent to nursing homes,” Miller says. “We save the state millions.”

Home care workers report they are forced to come to work sick and to work two or three jobs just to make ends meet. And that hurts the clients, too. Because of the stress and low pay, home care worker turnover is high—35 percent annually for those caring for the elderly and 23 percent for the disabled. “I felt like they wanted to do a good job but they couldn’t,” says Tiny Mae Rucker, 78, of the workers who have come to her home on Chicago’s West Side. “Sometimes they wouldn’t show up at all, and they wouldn’t call.”

The average home care worker is a middle-aged, African-American woman who works full time, is the single head of her family, and wants more training in the health care field, according to a study by the SEIU. Many of the workers are also welfare-to-work participants, which means that even if they don’t feel educationally or emotionally capable for the job, they can’t turn it down without risking the loss of public aid benefits.

Though workers want more training, there is little financial incentive or even opportunity to get it, since they are offered no extra pay for the qualification. Alexander, for example, is a certified nurse’s assistant and former paramedic, yet even after 20 years’ experience in the health care field, including 10 years in home care, she makes less than $7 an hour.

“They’re saying we’re not doing nursing work, but then what do you call it?” asks Alexander, who, along with busloads of other Local 880 members, will go to the capital to lobby and march in November. “They try to make us feel like our jobs aren’t worthwhile, like we’re not assets to the community, but we are. It’s time our voices are heard.”