Home Care Workers Denied Basic Wage Rights

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.

13 Responses to Home Care Workers Denied Basic Wage Rights

  1. Hi Kathryn,

    thank you so much for this story. It really speaks to the importance of home care work and how advocates have to continue for better rights for home care workerers.Jobs with Justice is working with the National Domestic Worker Alliance on a new campaign called Caring Across Generations. Please contact me at lshelton@dclabor.org so that I can tell you more about it.

  2. […] I recently wrote, the District’s minimum wage law covers home care workers, though federal minimum wage rules […]

  3. TJ says:

    Forcing overtime to be paid will significantly increase the cost of service to the elderly people who need the care. Who wouldn’t want to be paid overtime for sleeping, reading, studying or watching TV in the next room while an elderly client sleeps. The only way live-in care is remotely affordable is to exempt it from overtime.

  4. Kathryn Baer says:

    The home care workers at issue aren’t full-time, live-in sitters for elderly people, TJ. More importantly, we shouldn’t have rules that control costs by denying basic labor protections to any class of workers. Once we start down that road, we’ll be undermining core purposes of the Fair Labor Standards Act.

  5. Meme Wagner says:

    TJ is being realistic. Having had 5 years experience hiring 24 hour care through some home health care agencies the price tag for 24 hour care 365 days a week is a whopping $160,000+. If you had to add overtime to that just imagine what the cost would be to an elderly person. No one gets this type of care unless they have the where with all to pay for it out of pocket as few insurance policies or health policies pay for this care. What would actually happen if overtime must be paid is that the home health aids would only be employed to work an 8 hour shift and then someone else would come in for the next 8 hours, etc. You would end up with home health care worker working less time on the job and therefore making less money than before. No client is going to say OK charge me more because I want the same person for more than 8 hours in a row. That client is going to say I need 24 hour care so I need 3 caregivers per day all working an 8 hour shift. You have basically accomplished nothing for the worker by making this class of employee eligible for overtime and at this point and may have even reduced their income.


  6. Kathryn Baer says:

    There’s no doubt that the costs of home health care are a problem for many of us, Meme. But so are other costs. I don’t think the solution is to deny any class of workers the pay they deserve under our fair labor laws. I’d much rather see both the public and the private sector develop solutions that would make long-term care affordable and a more viable career.

  7. Molly's mom says:

    On one hand the industry claims that is charges family’s around $22 an hour and pays the worker a little more than $9.00. That’s an outrage. The CEO’s f these compnaies make millions and they want to deny workers overtime pay. Come on…

  8. Kathryn Baer says:

    I agree. But I think the situation is somewhat more complex, especially for small home are agencies and for individuals who hire home care aides independently. Another post on this issue coming soon.

  9. […] I wrote some time ago, the exemption reflects an over-broad interpretation of a carve-out Congress made […]

  10. […] occupations are in service areas where wages are characteristically low — retail sales, home care, food preparation and other restaurant work, […]

  11. […] as little as $7.25 an hour — even less if they’re home care workers, who’ve got no minimum wage or overtime rights at […]

  12. […] I’ve written before, home care workers aren’t covered under the Fair Labor Standards Act rules that […]

  13. […] first wrote about the home care worker issue more than two years ago. So a brief review to begin with and then […]

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