Tiers as a Model for Racism

As parents and caregivers are well aware, childcare during this pandemic has been an obstacle that our community has had to tackle together. However, caregivers have often had to go at this alone. Like in all times of crisis (Hurricane Katrina, 2019 wildfires in California, Hurricane Sandy, etc), the gaping social inequalities present in our communities are even more exacerbated. Further, responses to meet the needs of those who are deemed essential and vulnerable are prioritized and continue cycles of oppression rooted in racism, sexism, classism, and educational elitism. In the state of Wisconsin and the Madison community, this is happening with our child care system. 

The Department of Children and Families (DCF), as of March 26, released information for families, providers, and who they consider essential workers, about child care resources. The information circulated by DCF is representative of Governor Evers’ Stay-At-Home order, where essential activities have been deemed those that “engage in activities or perform tasks essential to their health and safety.” 

Yet, there is an order to who is prioritized to be essential. The order suggests that child care settings should prioritize care for families based on a tier system. The tiers are as follows: 

Tier 1: employees, contractors, and other support staff working in health care 

Tier 2: employees, contractors, and other staff in vital areas including but not limited to military; long term care; residential care; pharmacies; child care; child welfare; government’ operations; public safety and critical infrastructure such as sanitation, transportation, utilities, telecommunications; grocery and food services; supply chain operations; and other sectors as determined by the SEcretary of the Department of Children and Families. 

The elements of this order that I want to draw attention to are bolded. 

Broadly speaking, long term care and residential care (nursing home facilities, assisted living) in other settings are not considered as entirely separate from other health care workers. They are all direct care workers who perform tasks essential for health and safety. However, this separation is natural for the government and powerful people because it is representative of covertly and overtly racist policies that have contributed to segregation. This separation of direct care workers is based on the workforce demographics and educational and occupational status. 

The Paraprofessional Healthcare Institute (PHI), a national organization that works to ensure quality care for older adults and people with disabilities by creating quality jobs for direct care workers, has studied the demographics of direct care workers, including long term and residential workers. In their 2020 annual report, they indicate that 59 percent of direct care workers are people of color. Home care workers, which would fall into the Tier 2 category, are 62 percent workers of color. Further, the direct care workforce heavily relies on immigrant workers where approximately one in four were born outside of the US. 

The health care staff that are privileged in Tier 1 can be considered hospital workers, such as nurses and doctors. As of 2017, the nursing workforce in the US is 80.8 percent white, reported by the National Council of State Boards Nursing. Overall, when holistically compared to the long-term care workforce, nurses and doctors have higher educational and occupational statuses which often come from means of access to wealth and privilege. Based on how the systems of domination operate in the US, we all know that whiteness is increasingly interrelated to wealth and privilege. 

Overall, the Stay-At-Home order Tier system intensifies the gap between white folks and communities of color’s equity in access to child care–an essential service. Even before the pandemic, accessible and affordable child care services in Madison was slim to none and reaching crisis levels. The majority of services are not affordable for low income communities, do not accommodate the second and third shift workforce, and do not reflect culturally responsive care. Ultimately, while this analysis is centered on race, it is absolutely necessary to acknowledge the intersections of identity to include that it is primarily Black and brown women who are feeling the effects of this system most intensely. 

Right now, we need to collectively recognize the fundamental value of all care workers and recognize divisive measures that claim we need to “prioritize” accessibility. Since the Tier system in the executive order is not being considered for edits, it is important to understand access to child care as an indicator for broader, systemic issues and as a service that severely affects the wellbeing of families who are part of communities of color and one-parent households.


DCF Covid-19: https://dcf.wisconsin.gov/covid-19/childcare/providers 

Tony Evers Stay-At-Home Order: https://evers.wi.gov/Documents/COVID19/EMO12-SaferAtHome.pdf 

PHI 2020 Annual Report: https://phinational.org/wp-content/uploads/2020/01/Its-Time-to-Care-2020-PHI.pdf

National Council of State Boards Nursing national nursing workforce study: https://www.ncsbn.org/workforce.htm  

Transformative Action Network

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