Union’s billboards depict the plight of home care workers during the pandemic

One of the union's billboards is on Columbus Avenue in Roxbury.Lane Turner/Globe Staff

Throughout the pandemic, the 100,000 home care workers in Massachusetts have been a largely invisible workforce, assisting older adults and people with disabilities behind closed doors.

The workers, the majority of them women of color, many making close to the minimum wage and living in low-income communities hit hard by COVID-19, have to don protective equipment to bathe and dress and assist clients. Some of them never received hazard pay and have struggled to get the masks and gloves they need to do their jobs. Few have been publicly recognized for the essential work they do.

In an attempt to draw attention to these workers, the union representing roughly half of them, and seeking to bring in more, has put up billboards in six hard-hit cities — Boston, Brockton, Lawrence, New Bedford, Springfield, and Worcester — to illustrate what it calls the “deep cracks in the overstretched and underfunded long-term care system” that the pandemic has exposed.

Four Black workers grace 13 billboards bearing the messages: “Black homecare workers are leading the fight against COVID — and racism” and “Homecare workers are fighting to be seen and heard because our lives matter.”

The goal is to prod elected officials in Massachusetts to invest in home care and to better regulate nonunion home-care agencies, said Dana Alas, organizing director for 1199SEIU United Healthcare Workers East, which is part of the Service Employees International Union and represents 50,000 personal care attendants whose program is overseen and paid for by the state. The 50,000 home health aides who work for independent agencies, on the other hand, have less oversight, lower pay, and less political power to demand protective equipment and hazard pay, she said.

The Home Care Aide Council and the Home Care Alliance, which represent more than 225 private-pay, state-contracted, and Medicare- and Medicaid-certified agencies in Massachusetts, noted that there is a robust oversight system in place for these agencies, including a minimum of 40 hours of training for workers, who are supervised by nurses, and annual agency audits. Between April and the end of July, MassHealth and the state increased the rates provided to agencies by 10 percent, which was used to boost wages and cover higher costs during the pandemic. The advocacy organizations are working to make the rate increase permanent and noted that agencies have also supported workers during the pandemic by increasing  communication with aides in the field, handing out grocery store gift cards, and holding a Home Care Aide Recognition Day in June.

All together, this home care workforce has largely been left out of the narrative of both COVID and Black Lives Matter, Alas said.

“Those workers sit squarely in that intersection, and we wanted to highlight that to the public and also to let these workers know that we see them,” she said. “There’s no system in place to make sure that the work that these workers do is respected and valued.”

The work is also growing rapidly. From 2016 to 2060, the 65-and-over population in the United States will nearly double, and by 2026 the home-care workforce is projected to add more jobs than any other occupation in the United States, according to PHI, an advocacy organization for caregivers of older adults and people with disabilities.

Democratic presidential candidate Joe Biden released a $775 billion plan focused on caregivers, including raising wages for home health workers and early childhood educators. One out of six home care workers lives below the federal poverty line, and more than half rely on public assistance, according to PHI.

In addition to the billboard campaign, 1199SEIU successfully pushed for Governor Charlie Baker to join other states in naming Sept. 4“Home Care Day” in Massachusetts and sent a letter to Baker, Senate President Karen Spilka and House Speaker Robert DeLeo calling on the state to expand access to affordable child care for essential workers.

“The state must take action to address the needs of families that do not have the means to hire tutors, engage in ‘pod’ learning with other families, or send their children to paid alternative programs that offer full, in-person options,” wrote executive vice president Tim Foley.

A spokesman for DeLeo noted that the House “continues to examine the range of issues relating to the healthcare workforce as we confront the medical emergency.”

Elizabeth Davis, a 69-year-old home health aide in Springfield, is one of the workers featured in the union billboard campaign. Davis has been in the home health care field for 35 years and makes $13.50 an hour. If she didn’t qualify for Medicare, she said, she’d be paying $75 a week for health care; when she gets sick, she has to get a doctor’s note to stay home.

Davis has been working 55 hours a week during the pandemic to help cover for younger co-workers who need to stay home with their kids. One of her clients has a 19-year-old son who frequently has friends over, and although Davis wears a mask and tries to stay out of their way, she worries about all the people in the house. The two agencies she works for don’t do much to support her, she said, and she’s been working with 1199 to try and organize her fellow workers.

“I’m not valued,” she said. “We risk our lives every day stepping out the door. We don’t know if we’re coming back with COVID.”