On December 15, 2011, President Obama announced that the Department of Labor planned to amend the Fair Labor Standards Act (FLSA) to guarantee minimum wage and overtime protections for 2.5 million home care workers. Since 1974, when Congress amended the FLSA to include domestic workers, home care aides have been subject to the “companionship exemption,” which equated their employment with that of teenage babysitters and denied them the same basic labor protections as other American workers.
Home care workers—90 percent of whom are female, and half of whom are people of color—are the foundation of our system of long-term services and supports. They provide assistance with dressing, bathing, toileting, mobility, and meals for millions of elders and people with disabilities. In some cases, they also provide medical-related assistance, helping to manage medication, taking vital signs, assisting with exercise programs.
Our families rely on home care aides to ensure that our loved ones can remain as independent as possible. That’s why home care is one of our nation’s fastest-growing occupations. With 10,000 baby boomers turning 65 every day, the number of Americans who need assistance is growing rapidly. Within the next decade, the workforce is expected to grow by an additional 800,000 workers.
The outsize demand for home care aides, however, doesn’t guarantee that there will be compassionate, skilled workers to take these jobs in the future. Home care may be one of America’s largest and fastest-growing occupations—but it also among the most poorly paid and supported. Wages average $9.40 per hour, but more than half of workers are part time employees. As a result, annual wages average about $16,600.
These wages reflect the severe undervaluing of the skills and dedication of our home care workforce. These workers play a vital role in our health care system—often reducing overall costs by noticing changes in a client’s appetite, mental clarity, or strength and communicating these changes to a family member or medical professional. With their daily visits to client’s homes, home care workers are the eyes and ears of the health care team.
Yet, for nearly 40 years, as home care has grown into an $84 billion industry, these workers have been denied the most basic labor protections under the FLSA. Home care agencies have used the “companionship exemption,” which was intended to apply to a neighbor who came to sit with grandma for a few hours, to lower labor costs across the board. Confirming this attitude, in a recent article in USA Today, the government relations director for the National Private Duty Association, the industry’s for-profit trade association, said of home care workers, “For them, this isn’t really a job, it’s a lifestyle.”
Tell that to the 2 million women trying to feed their children on poverty-level wages. Though most workers earn above minimum wage, many are not paid for travelling time between clients or for the cost of gas (now nearly $4/gallon). Only fifteen states have wage and hour protections that guarantee time and a half for overtime for home care aides. As a result, at the end of the day, home care workers have so little income that nearly half live in households that rely on public benefits such as Medicaid and food stamps.
The proposed change to the Fair Labor Standards Act, which would narrow the companionship exemption to workers hired by individual households to provide companionship (not personal care), is long overdue. As our nation ages, we need to strengthen and stabilize the home care workforce. Better wages will reduce turnover, which is notoriously high and disruptive to quality care. Moreover, basic labor protections are sign of respect—an acknowledgement that our nation’s 2.5 million home care workers have a true vocation that we value as a society.
The Department of Labor’s proposed rule to provide home care workers minimum wage and overtime protections is open to public comment through March 12. Please add your voice in support of home care workers by visiting www.companionshipexemption.com. Easy instructions and sample comments are available at the website.
— Karen Kahn, director of communication, PHI — Carol Regan, director of government affairs, PHI
PHI is a national nonprofit dedicated to transforming eldercare and disability services to ensure dignity, respect, and independence for all who receive care and all who provide it.