No Labor Day Good News for Home Care Workers

September 5, 2013

I had high hopes that the Obama administration would actually do something for workers on Labor Day. And I had something specific in mind — an announcement that it had, at long last, issued a final rule granting federal wage and overtime rights to home care workers.

The title above shows I was disappointed — and I’m far from alone.

I first wrote about the home care worker issue more than two years ago. So a brief review to begin with and then developments to date.

Home Care Worker Exemption

The rule that’s now way overdue would correct an over-broad exemption in the rules that define wage requirements under the Fair Labor Standards Act.

Nearly 40 years ago, Congress broadened the FLSA to include domestic workers, who’d been excluded, along with agricultural workers, from the original law.

But it made in exemption for workers who provide “companionship services for individuals who (because of age or infirmity) are unable to care for themselves.”

The Department of Labor interpreted this carve-out more broadly than Congress apparently intended, as the legislative history in the National Employment Law Project’s brief on the issue indicates.

This is one, though not the only reason that workers who provide in-home paraprofessional health care services and those who assist with homemaking and personal tasks earn so little.

Though their median hourly wage is somewhat higher than the federal minimum, their median annual wage is just $20,170 — slightly over the federal poverty line for a family of three.

Half of the workers make less, of course. And even the median suggests that many employers don’t pay overtime, though a goodly number of home care workers report putting in more than eight-hour days.

They already comprise a significant sector of our labor force, and it’s expected to grow more rapidly than any other through at least 2020.

By then, we’ll have an estimated 3.2 million workers who won’t have any federal wage protections unless the rule is changed.

Halting Progress Toward a Remedy

Back in December 2011, the Department of Labor issued a proposed rule to give home care workers the same wage and overtime protections as the vast majority of hourly workers already have.

Interested parties originally had two months to comment, but the department twice extended the comment period, leaving the window open until March 21, 2012.

A veritable flood of comments — reportedly 9,000.* And federal law obliged DOL to respond to all comments that raised significant issues, explaining how it had accommodated them or why it hadn’t.

This doesn’t mean it had to respond to each comment individually, but it does help explain why DOL didn’t get its draft final rule finished until January of this year.

The draft rule then went over to the Office of Information and Regulatory Affairs, which is notoriously slow, when it acts at all. Health and worker safety advocates commonly refer to it as “the place where regulations go to die.”

So far as we know, the home care rule is still sitting in OIRA. If the office had adhered to the established review timeframe, the rule would have been published — or sent back to DOL — by mid-April.

Hard on this deadline, however, the National Association of Medicaid Directors called for “a more rigorous review” of what it refers to as “a complicated and burdensome rule.”

“Review,” as the letter makes clear, is a euphemism for “send the rule back to the drawing board” because DOL didn’t revise the proposal as we recommended.

DOL nevertheless scheduled publication of the rule for some time in July.

And, in mid-July, the Senate confirmed the President’s appointment of Thomas Perez as the new Secretary of Labor. This seemed a hopeful sign, since he had championed a domestic workers bill of rights when he was a county council member.

More recently, Ai-Jen Poo, the founder and now director of the National Domestic Workers Alliance, told The Nation, that “it could be a matter of days or weeks until … [the rule] get finalized,” as she and her co-advocates understood the state of play.

Look, she said, not only at the Perez appointment, but at comments Vice President Biden made on the 75th anniversary of the FLSA. (He seemed to be speaking for the administration, though that’s not always been the case.)

So, I thought to myself, how better to recognize Labor Day than to announce the final home care workers rule?

But it seems the rule may still be among those The New York Times editorial board cited as “stuck in the purgatory of OIRA” because it’s politically controversial — and opposed by some influential folks.

Heaven knows the White House has more than enough controversy on its plate. But apparently a lot of those home care workers don’t have enough on their plates without food stamps.

* Some advocacy organizations report 26,000 comments. This, if I understand correctly, is the number of signatures on comments filed.


Bad Jobs in Our Very Own Homes

January 14, 2013

We’ve been hearing a lot about good jobs — mostly how we need more of them. Sometimes what could be done to create them.

Now comes the National Domestic Workers Alliance and partners with a report on really bad jobs — specifically, the wages, hours and other working conditions for nannies, housecleaners and caregivers for elderly and disabled people.

The report is based on a survey of more than 2,000 of these workers in 14 metropolitan areas across the country.

Lots of racial and ethnic diversity — though, as you might guess, little gender diversity in these “women’s work” occupations. Many countries of origin.

But the workers all had three things in common because that’s how the survey was designed.

They were at least 18 years old. They’d worked at least six hours the prior week in their domestic help occupation. And they were employed directly by the families they served.

No chance to blame agencies for the rock-bottom pay, lack of benefits and extraordinarily long hours — the last of these mainly for the live-in workers.

A sample of the findings to show what I’m talking about here:

  • The median wage for the workers surveyed was $10 an hour — well under the U.S. Department of Labor’s threshold for what full-time, year round workers need to earn for minimal economic security.
  • Twenty-three percent of the workers were paid less than the applicable minimum wage. And fewer than a third got overtime pay.
  • Ten percent of the workers didn’t always get paid what had been agreed on — or at all — during the prior 12 months.
  • Not surprisingly, 60% of the workers spent more than half their income on housing, and 20% sometimes didn’t have any food in their homes because they couldn’t afford to buy it.

In one respect, we can blame employers — ourselves, at least collectively — for taking advantage of the vulnerabilities of workers who’ve got no job security beyond keeping us reasonably satisfied.

There are vulnerabilities too, the report says, in the fact that domestic work is “invisible.” Who knows what goes on behind the closed doors of private dwellings?

Well, we do. And the report calls on us to be “part of the solution, ” i.e., to provide our domestic workers with contractual agreements, wages, benefits and other working conditions that befit people to whom we entrust the care of our loved ones, our possessions and the intimate details of our private lives.

In another respect, however, we can blame public policies for leaving domestic workers at the mercy of our inclinations.

As I’ve written before, home care workers aren’t covered under the Fair Labor Standards Act rules that generally require employers to pay the federal minimum wage and overtime.

The Act itself specifically exempts all live-in domestic workers from the overtime pay requirement.

Domestic workers are also exempt from the National Labor Relations Act, which establishes basic — if weakly enforced — protections for workers who try to organize and bargain collectively.

And from rules issued under the Occupational Safety and Health Act, which might, in theory, provide some protection.

To make matters worse, only 14 states and the District of Columbia require households to carry workers compensation insurance for their domestic employees, regardless of wages, hours or the number employed.

And unemployment insurance benefits are iffy due to states’ rules on minimum earnings — and more often than not, requirements that exclude workers who can’t accept full-time jobs.

Say, for the sake of argument, that all these laws were amended. A large number of domestic workers still couldn’t assert their rights to the wages and other conditions DWRA advocates for because they’re not authorized to be here.

We don’t know how many there are because the Census Bureau sensibly doesn’t try to find out. We do know they were 47% of the DWRA survey sample, however.

Their wages were lower than those of other workers surveyed. And more of them experienced problems with their working conditions.

But 85% of them said they didn’t complain because they feared their immigration status would be used against them, i.e., that their employers would take revenge by reporting them to the authorities.

So it would seem that improving domestic workers’ jobs would require the long-overdue reform of our immigration laws, as well as elimination of the aforementioned exemptions.

What’s true for immigration laws is also true for other laws, the report says, because “[i]t is difficult to advocate for the rights of domestic workers in an economic and political environment in which the rights of low-wage workers more broadly are so badly frayed.”

So we have to seek public policies that raise standards and improve opportunities for the whole low-wage workforce. But we’ve obviously got to address the occupation-specific exclusions too.

In 2010, there were 726,437 domestic workers in private households — nearly 10% more than in 2004, according to the Census Bureau.

This is probably an undercount — in part because those who are undocumented may understandably have chosen not to share information with any government agency.

Whatever the true number, millions of other workers depend on housecleaners, nannies and other caregivers to free up their time for more rewarding occupations.

We’re told that many say their domestic employees are “like a member of the family.”

Imagine what would happen if we thought of real family members constrained to work so hard for so little — and with so few of the basic legal and safety net protections we usually take for granted.


Proposed Wage Rights for Home Care Workers Triggers New Round of Debate

January 19, 2012

The U.S. Department of Labor has, at long last, moved to close an egregious loophole in its Fair Labor Standards Act rules — the exemption of home care workers from federal minimum wage and overtime pay requirements.

As I wrote some time ago, the exemption reflects an over-broad interpretation of a carve-out Congress made when it extended minimum wage and overtime rights to domestic workers.

That was nearly 37 years ago. So one could say the Labor Department has decided to rectify a long-standing error.

The department itself puts a somewhat different spin on its initiative. Says that home care workers today perform duties and in circumstances that weren’t envisioned when the current regulations were issued.

In any event, it’s issued a Notice of Proposed Rulemaking — the formal step all federal agencies must take before revising their regulations. Anyone who cares to may file comments on the proposed rule up to February 27.

And you’d better bet there will be comments. Here’s a preview of what I think we’ll see.

Support for the Rule Change

Proponents of the rule change will include organized labor and other nonprofits that advocate for low-wage workers, including home care workers specifically.

They’ll argue, as they have for some time, that home care workers deserve the proposed wage protections as “a matter of basic justice.”

They’ll note, as does the Labor Department, that home care is one of our country’s fastest growing industries. According to its projections, the number of home care aides will have nearly doubled by 2018 — from about 1.7 million to well over 2.5 million.

In short, we’ve got a large and growing group of skilled workers who are currently classified as occasional babysitters for adults.

This is bad for them — not least because it depresses their earnings to the point that some 46% live in households poor enough to qualify for public benefits like food stamps and Medicaid.

Also bad for all of us who want our loved ones — and ourselves, should the need arise — to be cared for professionally and, well, caringly.

Not surprising then to find AARP supporting the core thrust of the rule change on behalf of the older Americans it represents.

Objections to the Rule Change

We’re likely to see formal objections from some, though not all, home care agencies and the associations they belong to.

We’ve already heard from this quarter. And the concerns they raise go to the heart of the debate. It’s not the minimum wage requirement they’re so fussed about. It’s the overtime.

Home care workers already make, on average, $9.25 an hour — a very low wage for what they do, but not one that would be bumped up by coverage under the federal minimum wage rule.

But they’re entitled to overtime in only 16 states.

So for a great many, the wage stays flat, even if they spend far more than 40 hours a week actively tending to clients’ needs. And they often get no pay at all for the time they spend traveling from one client’s home to the next.

Some opponents of the rule change purport to have their interests at heart. Laurie Edwards-Tate, for example, warns that home care workers will earn less because agencies like hers will cut hours back to eight-hour shifts.

Also warns that thousands will be put out of work. The thought here seems to be that agencies will shrink or fold because third-party payers won’t increase reimbursement rates to cover the overtime costs.

But opponents, including Edwards-Tate, focus mostly on harms to seniors and others with disabilities.

“The cost of overtime especially will make in-home non-medical care unaffordable for many, if not most, of the seniors and persons with disabilities we serve,” she says. Dire consequences predicted, including costly, taxpayer-funded institutional care and risks of elder abuse.

“The companionship exemption is a significant factor in helping to keep paid, senior caregiving affordable,” says another home care company president. It “helps seniors protect their assets while receiving the right amount of care.”

This isn’t, I think, an entirely self-serving argument.

Mandatory overtime compensation could increase home care costs, though the Labor Department thinks it’s likely that employers will adjust shifts to eliminate or at least minimize the extra hours.

The first scenario could create more home care jobs, though perhaps also reduce wages for workers who are currently putting in as many as 80 hours a week.

The second would drive up home care costs and/or the already high costs of long-term care insurance. By how much is purely speculative.

For some low-income people, mandatory overtime could mean loss of Medicaid-funded home care — either because states that haven’t had to deal with overtime decide to scale back services or because they won’t reimburse for the additional costs.

In the latter case, agencies refuse to serve Medicaid beneficiaries, as some doctors already do.

Still, I think it’s fundamentally wrong to exclude home care workers from basic labor protections because we’ve got an unresolved — and growing — social problem.

We might as well say the affordable housing shortage justifies exempting construction workers from the minimum wage.


DC Councilmember Aims To Put Some Teeth Into Living Wage Law

September 1, 2011

Seems that some health care workers aren’t getting the wages they’re due under the District’s living wage law. DC Councilmember David Catania aims to do something about this, with a bill that would put real teeth into the applicable requirement.

A bit of background here.

As I recently wrote, the District’s minimum wage law covers home care workers, though federal minimum wage rules don’t.

But home care workers employed by agencies with Medicaid contracts are supposed to get more — specifically, the higher hourly wage required under the Living Wage Act.

The same is true for employees of Medicaid contractors that operate community residential facilities and group homes for people with intellectual disabilities.

The Living Wage Act was passed in 2006, but these Medicaid contractors were exempt until the District issued implementing regulations. A mere five years later, it finally has.

Councilmember Catania asserts that he and staff “have been inundated by evidence that frontline workers continue to receive wages that are well below the $12.50 per hour” that the latest annual adjustment in the living wage requires.

Evidence here may include a paycheck review conducted by the SIEU local that represents home care workers at one of the contractor agencies. An organizer told me that all 150 were paid less than the living wage. Shortfalls verified thus far average $1.75 per hour.

Many of the under-paid workers, Catania says, “are unable to care for themselves and their families due to extremely low wages.” This, he implies, may distract from the challenges of providing high-quality care “for our most vulnerable and fragile residents.”

Probably also creates undue pressures on public benefits programs, including Medicaid. If those underpaid home care workers have full-time, year-round assignments, they’ll earn $22,360 — well under the District’s Medicaid income cutoffs for working parents and their children.

What really seems to have gotten Catania’s goat is a recent audit by the DC Inspector General, which found that executives in some of the Medicaid-funded agencies were getting paid far more than industry standards — “more than the President of the United States,” he exclaims.

Lots more in some cases. Salaries for the top five averaged nearly $315,290.

So it isn’t as if these Medicaid contractors can’t afford to pay the living wage. What they can’t afford, if Catania’s bill passes, is to go on ignoring it. Because they would then become ineligible for further funding from the District’s Medicaid program.

Why, I wonder, is there no comparable penalty for all contractors covered by the living wage law? Seems that the worst that can happen to them is an order to pay what they should have been paying all along.

Meanwhile, we District taxpayers are subsidizing their savings because at least some underpaid workers earn so little as to qualify for public benefits. Don’t look for much in tax revenues from them either.

So non-complying contractors profit from our tax dollars, but they effectively put the squeeze on local programs our community needs. On our striving, lower-income residents too.


Home Care Workers Denied Basic Wage Rights

July 24, 2011

My sister died just the way she wanted to. At home, with her bed near the window so that she could look out and watch her cats playing.

This was possible only because she had 24/7 home health care, provided by a quiet, caring, capable aide.

Most people who receive home care aren’t in the last stages of a fatal disease. Some are like my guest blogger Laura and her brother, whose disabilities would make it unsafe for them to be home alone.

Most, however, are elderly people who need some variable mix of services to continue living independently. My mother-in-law, for example, is able to contentedly “age in place” because a home health aide comes in to help with housekeeping, grocery shopping and the like.

All told, more than 10.3 million Americans need some form of long-term care. The U.S. Department of Health and Human Services expects the number to rise to 27 million by 2050.

Will enough qualified care workers be available to serve the many millions who’ll be best off at home? Doubtful unless some major policy changes are made.

Here’s the first — and to me a shocker. Home care workers* are, at this point, exempt from federal minimum wage and overtime requirements.

Twenty-one states and the District of Columbia provide some coverage under their own wage laws. Here in the District, as in five of these states, only the minimum wage is required — not the overtime rate.

As the National Employment Law Project explains, the federal exemptions reflect an over-broad interpretation of a carve-out Congress made when it extended coverage under the Fair Labor Standards Act to domestic workers.

NELP recommends two related regulatory fixes. No Congressional action required — thank heavens! There is, however, a bill pending in Congress that would force the Labor Department to act.

In 2009, the average home care worker wage was $9.34 an hour. The average annual wage would thus have been $20,283, assuming full-time, year-round work and no overtime. Barely enough to lift a family of three above the federal poverty line.

But PHI, which advocates for long-term care workers, tells us that a large percentage work only part-time or for part of the year. Average annual earnings were thus $16,800.

As a result, 46% are poor enough to qualify for benefits like food stamps and Medicaid. Sadly ironic when so many of them indirectly get their wages from Medicaid.

Needless to say, morale is low and turnover high — an estimated 50%-80% a year.

Clients who need stability have to continually adjust to new caregivers — and new caregivers to them.

Employers incur ongoing recruitment and training costs. A vicious cycle here since the more they spend due to turnover, the less they’re ready to invest in turnover-reducing wages.

And, of course, some of the best potential candidates look elsewhere from the get-go.

Still, that average hourly wage is more than the minimum the FLSA requires. And the fixes NELP recommends wouldn’t compel states with higher minimums to cover home care workers.

So what would a more appropriate federal rule achieve? Some important things, I think.

First and foremost, it would entitle all home care workers to the same base-level hourly rates as the vast majority of other workers in the country. This would mean, among other things, that they’d be paid for time spent traveling from one client to the next — and, of course, time-and-a-half for extra long hours.

It would also formally recognize home care work as a genuine paraprofessional occupation — one that entails far more than providing some “companionship” to elderly and disabled people.

These two changes would help ensure a sufficient supply of well-trained, experienced home care workers — the sort we’d want for ourselves and our family members.

Emphasis here on “help” because the FLSA rule change is, as logicians say, necessary but not sufficient. It would, however, rectify what seems a clear case of economic injustice.

There are currently about 1.7 million home care workers in the country. The Bureau of Labor Statistics projects 2.5 million by 2018. That’s an awful lot of hard-working people to leave at risk of poverty.

If you agree, you’ve got a chance to weigh in right now.

The Department of Labor is holding two call-in “listening sessions” on the home care exemption. They’re scheduled for Monday, July 25 and Wednesday, July 27, both 4:00-5:00 EST. Call-in number and passcode here.

* Home care workers belong to one of two occupational categories in the Bureau of Labor Statistics’ classification system — home health aides and personal care aides. This issue brief from PHI details duties and distinctions.


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