Hawaii has recently made a groundbreaking change in how it values the time carers spend at home looking after family. The state will now offer up to $70 a day to contracted providers for services like cooking, cleaning, and transport on behalf of citizens who spend large amounts of their lives undertaking unpaid care work.

Caring for ill, disabled, or elderly family members can require incredible time and resources. For many - mostly female - primary carers, it means having to work fewer paid hours or taking a break from a career, which can mean cumulatively lower income as time goes on.

“Older women are much more likely to live in poverty in later life,” said Elizabeth Broderick, UN Special Rapporteur on discrimination against women. “Unpaid caring work doesn’t come into our productivity calculations, but without it - if women were to step away from that - we would have a huge crisis,” she said.

“Superannuation [the state pension system] here in Australia, for example, follows a very strong male life cycle. It assumes you’ve been in full-time work for 45 or 50 years, and we know that’s not the reality of women’s lives,” she added.

"Is poverty to be the reward for a lifetime spent caring?"

In Broderick's native Australia, women make up the vast majority of primary carers and their retirement incomes end up, unsurprisingly, being just over half those of men. By the age of 60, one in three single women in Australia lives in poverty.

“We have tried to reframe the whole issue of care work in Australia to really ask the question - is poverty to be the reward for a lifetime spent caring? Because that’s where many women in Australia are at - so that’s what we want to shift,” she added.

Australia is by no means unique: in most countries – including the US and UK – elder women have smaller retirement incomes and are more likely to live in poverty.

“Kupunas” in Hawaii

Across the other side of the world, Hawaiian lawmakers have just made a decision that could be the start of a worldwide conceptual shift about the value of domestic and care work.

This year, the state is launching the groundbreaking Kupuna Caregivers Program. Kupuna means elder or grandparent in Hawaiian – but what’s so innovative about the scheme is that it gives financial benefits not to old people who need care, but to the working family members who carry out that care to spend on services.

Primary caregivers who also work at least 30 hours a week outside the home can receive up to $70 a day to cover spending on anything that helps them meet their responsibilities without having to leave the labour market - from home-delivered meals and cleaning to transport and emergency care.

"Most of those unpaid caregivers, like the vast majority of family caregivers across the US, are women"

Hawaii faces a particular challenge – it has the highest life expectancy in the US, and a very high concentration of elderly people. “In Hawaii, nearly a quarter of a million residents — 18.7% of the state’s population — are age 60 and older,” said Terri Byers, Director of Hawaii’s Executive Office on Ageing.

Consequently, the small island is home to about 154,000 unpaid caregivers. The prospect of private nursing or home help is unaffordable to many, as high costs of living combined with a high demand for services for the elderly mean that nursing homes charge double as much as on the US mainland.

“Most of those unpaid caregivers, like the vast majority of family caregivers across the US, are women,” said Byers. “Although men also provide assistance, female caregivers may spend as much as 50% more time providing care,” she added.

Female caregivers in Hawaii face a much larger career and income toll from family obligations than even their male caregiver counterparts: they’re more likely to leave the workforce and seven times as likely to move into part-time work.

"It enables caregivers to continue to be in the workforce and remain productive members of society"

The hope is that the new legislation will reduce these figures, helping women to stay in work and protect their future careers and retirement income.

“The program is an amazing opportunity to support our caregivers and let them know how valuable their services are. It allows our kupuna to stay at home in the dignity of their own homes, and enables caregivers to continue to be in the workforce and remain productive members of society,” Byers said.

A second group that could benefit from the scheme are the workers whose services will be bought by caregivers with suddenly increased finances. “In Hawaii, like everywhere else, there are also workforce constraints. While there may be available funding for contracting services such as cleaning, cooking, and care, many of these jobs remain vacant because of the low pay and instability.  We hope that this bill will create some stability in care jobs,” said Byers.

However, for now, uncertainty about the impact – and the sustainability – of the program lingers. One worry is finances – “Governor David Ige's budget request this year includes $600,000 for the program. We are looking at this first year as a pilot,” said Byers. “The long-term funding is a concern, because we are anticipating high demand. We need to ensure that money and staff will be there to support the agencies."

If all 154,000 carers claimed the maximum immediately, that budget would not even cover payments for one day. That won't happen - it will take time to determine eligibility and interest from the population, but the low budget is, all the same, striking. "As the new program was only launched in mid-December 2017, we did not and still do not have data to make informed decisions on demand, eligibility, need or provider capacity,” said Byers.

The UK’s caregiver credit

However, a UK scheme targeting a similar demographic – working age carers whose family responsibilities are taking a toll on their labour market participation – has actually faced the opposite challenge: a remarkable lack of uptake.

In 2010, the UK government introduced pension credits to carers who provide at least 20 hours of unpaid care a week, a move that had the potential to redress old age gender inequity by valuing the unpaid work done inside the home. The idea was popular: “We even looked at the UK caring credit scheme, and suggested a modelling of the caring credit scheme for Australia,” said Broderick.

"If there are lessons to be learned from the UK, they would be in terms of making the process of application and eligibility as automatic as possible"

But recent figures have revealed that just one in 12 eligible workers apply for the benefit, meaning that 140,000 carers will miss out on up to £240 ($334) every year of state pension upon retirement. While the scheme goes nowhere near as far as Hawaii’s, this strikingly low uptake suggests there are clear lessons to be learnt around the importance of design.

In the UK, carers have to apply for credits by first getting a "care certificate", a detailed form certified by a doctor and health or social work professionals. Hawaii's scheme does not have an application form to fill out - instead, individuals need to be assessed by phone and/or in person - through the Ageing and Disability Resource Centre. Whether this system has better success is yet to be seen.

“My main point about the carer’s credit is that whilst it is a good idea in principle, in practice schemes of this sort tend to suffer from very poor take-up,” said Steve Webb, the UK’s former Minister for Pensions. “They often have complex rules and are little-publicised and fall well short of delivering on their initial promise. If there are lessons to be learned from the UK, they would be in terms of making the process of application and eligibility as automatic as possible,” he said.

Hawaii's scheme could be the start of a revolution in how we value women’s time, but the real impact will only be seen in the implementation.

(Picture credit: Flickr/Ewen Roberts)

Odette Chalaby
odette.chalaby@apolitical.co