The New York Times "The New Old Age: Caring and Coping" Blog: A Fair Wage for Home Care Workers
July 20, 2011
The New York Times
A Fair Wage for Home Care Workers
By PAULA SPAN
Let’s say a home care agency employee comes to your parent’s residence, changes the sheets and does the laundry, helps him bathe and dress and makes his lunch before moving on to her next client. Should that employee receive minimum wage and, if she works longer than 40 hours in a week, overtime pay?
If that aide performed the same tasks in an assisted living facility or a nursing home, she would be covered under the federal Fair Labor Standards Act, like a vast majority of American workers, and would be guaranteed the minimum wage.
But in 1974, when Congress added domestic employees to the act, it exempted those providing “companionship services.” “The idea was to carve out the teenager down the street,” said Catherine Ruckelshaus, legal co-director at the National Employment Law Project. “Companions were more like elder-sitters.”
No longer the neighbor who occasionally spends an afternoon with the old woman next door, home care workers have been battling for years to get rid of that exemption. “To exclude this huge set of 1.8 million home care workers, who are trained professionals, often paid by Medicaid — it’s an enormous unintended consequence,” Ms. Ruckelshaus said.
When lawmakers introduced the exemption, she added, “they weren’t thinking of this industry. It barely existed then.”
But now that industry does exist. Home Instead, for example, employs more than 65,000 caregivers in all 50 states. And the industry wants to keep the exemption right where it is. Compel such agencies to pay workers more, executives warn, and they’ll have to raise prices for consumers. “There’s only so much a senior and a family can afford to pay,” Paul Hogan, chairman of Home Instead, told me in an interview.
If you think this discussion sounds vaguely familiar, you’re right. In its waning days, the Clinton administration proposed revising the Fair Labor Standards Act to include home care workers. The arriving Bush administration reversed course. In 2007, a lawsuit by Evelyn Coke — who was retired and ailing, and who’d never gotten overtime in her many years as a home care aide on Long Island — reached the Supreme Court. The justices unanimously ruled against her.
Now, here we are again. The Labor Department has announced that it intends to re-examine the companionship exemption. If the department decides to change the regulations, a comment period will follow during which all interested parties can weigh in, pro or con. It’s a slow process, with no final decision likely for many months, perhaps even a year or longer.
At the same time, the Direct Care Alliance, which represents the women (primarily) who provide hands-on care in facilities and in private homes, is pushing a legislative solution. Bills introduced in both the Senate and the House would extend the requirements of the Fair Labor Standards Act to home care workers and provide state grants to improve their training. “Given the hard-fought battles in the past, we thought we needed a law,” said Leonila Vega, director of the alliance.
Unsurprisingly, the industry paints a bleak picture of what might happen if the bill passes and agencies raise the rates for home care. “Clients will have no choice but to choose nursing homes,” Leann Reynolds, president of Homewatch CareGivers, which has franchises in 36 states, said in an e-mail statement.
Or perhaps, as Mr. Hogan predicted, clients will turn to independent caregivers who don’t work for agencies, the so-called gray market. This may not always be a perilous choice when consumers have a way to check employees’ backgrounds and experience, but it does give families all the responsibilities of employers. Not everyone wants to shoulder them.
As it happens, 21 states already mandate the minimum wage for home care workers, and another 15 require overtime payment (the bigger issue for employers). The sky doesn’t appear to have fallen.
Nevertheless, Home Instead, the nation’s largest provider of nonmedical home care, is seeking a Congressional sponsor for another bill that would not only leave the companionship exemption intact but also prevent any future administration from changing the rules. “We’re asking that the decision-making be removed from the Department of Labor,” Mr. Hogan said.
“Two economic forces keep butting heads,” he added.
Families already struggle with the high cost of agency home care, which averages $19 an hour nationally for a homemaker and $21 for a more skilled home health aide, according to the latest MetLife Market Survey.
But home care workers struggle, too. Theirs is among the fastest-growing and lowest-paid jobs in America. They have high injury rates, often from lifting and repositioning their clients, yet often lack health insurance. Small wonder that turnover is high.
“These need to be middle-class jobs,” Ms. Vega said. “We save a lot of money by keeping people out of nursing homes and hospitals.”
The Labor Department has set two “listening sessions” next week, and it would be a pity if lobbyists were the only folks the regulators got to hear from. You can call in, too, and say what you think about paying these home care workers minimum wage and overtime.
The first session is Monday, July 25, from 4 p.m. to 5 p.m. Eastern time; the second is from 4 p.m. to 5 p.m. Eastern on Wednesday, July 27. At those times, call (888) 730-9140 and use this passcode: 34478.
Paula Span is the author of “When the Time Comes: Families With Aging Parents Share Their Struggles and Solutions.”
Note from A Family Member HomeCare
A Family Member HomeCare assigns only certified Home Health Aides, Certified Nurse Assistants, RNs, LPNs and Companions. All A Family Member HomeCare certified Caregivers must have the appropriate experience to match Client needs. Our proprietary screening processes go far beyond the State of Florida requirements and include:
- Liability coverage to $1,000,000 and theft coverage to $100,000
- Worker’s Compensation Protection
- Nationwide Background Screening
- Social Security Number Trace
- Motor Vehicle Report
- Drug Screening
- Written and Clinical Skills Test by RN
- Credentials Check
- Physical Health Screening
- Reference Verification
Being a good Caregiver is a difficult and sometimes thankless job, so we support our Caregivers with a responsive, live 24-hour support team, comprising a Client Manager, Care Relations Manager, Director of Nursing, and a Telephony Manager. Our Caregivers receive prompt administrative support giving them the respect and dignity that they deserve.
“Because we treat our Caregivers well, they have less stress in their lives and are better able to focus on providing the loving care and compassion that our senior Clients deserve.”
— Brian Gauthier, A Family Member HomeCare CEO
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