The exclusion dates back to 1974, when Congress extended the law to cover domestic workers but carved out exemptions for casual babysitters and individuals who provide “companionship services.”  Legislative history shows, however, that Congress meant only to exempt companions who “are not regular breadwinners or responsible for their families’ support.” Today, rising demand and responsibilities for home care workers mean their jobs are often their primary vocation and main source of income. Millions of American families depend on this income, and millions more of Americans depend on the services of this industry.

Unfortunately, with an average national wage of $9.34 per hour for work that is both emotionally and physically demanding, morale among today’s home care workers is low and workplace injuries are common. One in five lives below the poverty line, and in 29 states the average hourly wages are low enough to qualify workers for public assistance, according to PHI, a national advocacy group for the direct care workforce.

The low wages, long hours, and poor working conditions also threaten the future of home care.  Over the next two decades, the U.S. population over age 65 will grow to more than 70 million. With people living longer, the demand for caregiving is expected to grow significantly. An estimated 27 million Americans will need direct care by 2050, according to the Department of Health and Human Services. The industry already faces serious employee recruitment and retention problems, and labor shortages could prevent us from meeting the rapidly growing need for home care.

Fortunately, the home care crisis is not inevitable. Two important changes to U.S. Labor Department regulations would improve these jobs and ensure the availability of home care for our loved ones. Neither change requires new legislation from Congress.

First, the U.S. Labor Department should provide that workers employed by a home care agency or other third party are not exempt from federal wage and hour laws. Second, it should narrow its definition of “companionship” to include just fellowship and protection, so that workers who assist with important daily activities and paramedical tasks are covered by the law.

Some would argue that having to pay minimum wage and overtime would sink this fast-growing industry, but it’s an argument that carries no weight in reality. 21 states and the District of Columbia already provide some coverage of home care workers under state minimum wage and overtime laws.  And some home care employers, including one of the nation’s largest for-profit home care agencies — Addus HealthCare — are already paying overtime despite the federal exemption. They keep overtime costs low by spreading caseloads more equally across a larger workforce with the help of modern scheduling and management systems, and with no impact on quality of care. The rest of the industry should follow suit with these modest investments in their workforces.

These simple and sensible reforms are long overdue. And momentum for change is building. This week, hundreds of workers, recipients of home care services and advocates will meet in Washington, D.C. to make the goal of stabilizing the home care industry a reality. Convened by the National Domestic Workers Alliance and Jobs With Justice, the Caring Across Generations campaign seeks to improve jobs for home care workers and ensure quality, dignified care for the recipients of their care. One of its key goals is to narrow the companionship exemption.

The Obama administration should make this fix and finally provide federal minimum wage and overtime rights to the 1.7 million workers who provide vital care for our nation’s elderly and people with disabilities. It’s time to improve standards for the home care workforce and modernize the industry so it can meet its future needs. We can’t afford not to do so.

Catherine Ruckelshaus is legal co-director with the National Employment Law Project. Ai-jen Poo is executive director of the National Domestic Workers Alliance.