Taking Care of Home Care Workers

4 Comment(s) Posted by Dee Mahan

Even though she'd had a heart attack and several "mini-strokes" and couldn't walk, my mother-in-law was able to live in her own apartment until she died at age 90. That was important to her. She was able to do that because she had round-the-clock care provided through an agency that contracted with her state's Medicaid program.

Her wonderful caregivers fixed her meals, took her around the neighborhood, shopping, and to the doctor. They made sure she took her medications, helped her to the bathroom and helped her dress, and made sure she didn't fall. You probably know someone - a grandparent, a parent, another family member, friend or neighbor - who has benefited from such care.

The home care workers who made it possible for my mother-in-law to live in her own home are part of one of the fastest growing segments of the American workforce. A segment that is excluded from the minimum wage and overtime protections that apply to workers - such as cooks, butlers, valets, housekeepers, and gardeners - in other professions. Home care workers are put in the same category as "casual babysitters" or people who provide "companionship services" – jobs that don't have these protections.

We have an opportunity to change that now, and you can help. On December 27, 2011, the Department of Labor issued a Notice of Proposed Rulemaking, "Application of the Fair Labor Standards Act to Domestic Service." This rule proposes to extend minimum wage and overtime protection to home care workers.

But it isn't final yet! The rule could still get held up or changed - a lot could happen. But the more people who let the Department of Labor know that making this rule final is important, the more likely it is that it will get through the rulemaking process. It's important that you make your voice heard. The home care agencies are making their voice heard, and they're saying that giving overtime protection to home care workers would be too expensive.

You can make a big difference by telling the Department of Labor that you support this rule by submitting a comment. It doesn't have to be technical or in legal jargon, they just need to hear from you. Here are some things you might include in your comments:

  • Home care workers provide critical services to people with disabilities and the elderly. They provide more than "companionship services." They make it possible for the people they care for to live in their own homes without getting hurt.
  • We have to make home care jobs good jobs. There's a nationwide shortage of home care workers at the same time that there is a dramatic increase in the number of people needing home care. Unless home care workers are assured good pay and overtime protection, these jobs won't be filled and more and more people will end up in expensive nursing homes.
  • We can afford to pay home care workers minimum wage. Home care industry revenue grew at an average rate of 9 percent from 2001 to 2009, with revenues increasing even during the recession.
  • Home care workers deserve to be treated with dignity and fairly compensated for their work. Home care work is challenging, often strenuous, and even dangerous, and critical to keeping seniors and people with disabilities safe. Yet even while the industry's revenue was growing, home care workers were paid so poorly that nearly half had to rely on public assistance, such as food stamps, to supplement their low wages, and on Medicaid for health care. The industry is profiting from low wages at the expense of workers and taxpayers.
  • The Department of Labor should finalize the rule. In your comments, don't forget to tell the Department of Labor to move quickly and finalize the proposed rule giving home care workers minimum wage and overtime protection.

You can include those points in your comments, or you can use sample comments prepared by PHI-the non-profit organization representing home care workers.

You have to send your comments by February 27 - so send them as soon as possible! Click here to make an electronic submission. The Department of Labor will read and count every comment they receive. You really can make a difference.

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Comments

  1. Bob Kafka's avatar

    Bob Kafka

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    One should talk to organizations like ADAPT to bet input from people with disabilities before making blanket statements supporting the DOL rules.
    It is apparent from the proposed rules that there was little or no input from organizations representing people with disabilities.
    ADAPT will be submitting detail concerns and strongly recommending that DOL bring ALL stakeholders together before these rules go any further. We have an expression in the disability community: NOTHING ABOUT US WITHOUT US! The DOL proposed rules flies right in the face of this principle.
    Thank you, Bob Kafka
  2. Bruce Darling's avatar

    Bruce Darling

    Permalink
    I am deeply concerned about this policy direction.

    The Department of Labor suggests that Medicaid and Medicare rates will INCREASE and that increase will offset the additional costs associated with these changes, however the Obama administration has proposed CUTTING Medicaid over the next decade and supported efforts by states to reduce their spending on the program through rate reductions. By increasing the cost of home and community based services without increasing the Medicaid rates, these proposed changes will REDUCE the availability of home and community-based services that allow people with significant disabilities to live in the Most Integrated Setting.

    Even if the administration and states were not actively cutting Medicaid, home and community based services are most frequently structured in a manner that caps the available funding. Under this zero-sum model, INCREASING THE COST of services will result in a REDUCTION IN HOURS of personal assistance and promote institutionalization.

    The proposal would limit the availability of family and friends as paid attendants in consumer directed personal assistance programs, reducing the available workforce and potentially forcing people with disabilities into unwanted institutional placement.

    The necessity to balance efforts to enhance workers’ wages and benefits with the needs of people with disabilities was identified and addressed in Guiding Principles which were developed between SEIU and disability advocates. According to those Guiding Principles, signed on November 16, 2011, “As a general principle, enhancements to workers’ wages and benefits shall be paid for through increased funding.” The DOL proposal does not do this.

    Because of the intense pressure on state Medicaid budgets and the determination of policy makers to curtail spending on long term services and supports, ATTENDANT WILL NOT BENEFIT from the proposed rule. In fact, the changes are likely to negatively impact them as well. For attendants who work in Medicaid-funded programs, these changes will result in reductions in the hours that attendants may work, downward pressure on their wages, and the obligation to work for more agencies to sustain a living. This is not conjecture; we have already seen this occur.

    Consequently, organizations which are concerned about Medicaid recipients who use long term services and supports should call upon the Department of Labor to postpone implementation of these proposed changes until it has worked with disability and labor advocates to develop an approach that can enhance workers’ wages and benefits without eroding the availability of long term services and supports.
  3. Renee Peek's avatar

    Renee Peek

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    I worked in this field for 10 years Attendant deserve to have minimum wages.We help people lead productive lives and work real jobs.If the workers aren't paid well they will look for jobs elsewhere.People who do Attendant care do it because they love it .
    I'm also mom to a 14 yr old son who requires attendant care.If I can't pay my attendants good wages my son could be institutionalized.That is the last thing I want for my son.I have a self directed waiver in GA I want to give my attendants a good job so my child has continuity of care.I think the DOL should talk to people and parents of people using Attendants before making any changes.
  4. Cathy Robles Cranston's avatar

    Cathy Robles Cranston

    Permalink
    I've worked as an attendant for over 31 years. Upon first hearing about the proposed DOL regulation change, I thought how awesome if we could be paid overtime and minimum wage. Then I gave it more thought. The reality for attendants that work for people on Medicaid funded home and community based service programs is that unless the federal government increases funding to Medicaid funded programs there is no way home health agencies could afford to pay for the overtime. As it is now, our state is already tightening it's belt so people receiving Medicaid funded attendant services in our state are having their hours cut. This also impacts the attendant. Our hours are cut too. My concern is that if this proposed change goes through, what will happen for us is we will have to piece together more jobs in order to meet our living expenses. The attendant and the person we serve depend on each other. So, I do not believe that the proposed regulation change will meet both the attendant and the client's needs. As an advocate for attendants and people using attendant service programs, we should tell the DOL to postpone the implementation of these proposed rules until it has worked with all stakeholders involved to come up with an acceptable approach regarding the implications of a strategy to improve the well-being of all stakeholders. Thank you.

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