Ending home care workers’ exclusion from the Fair Labor Standards Act will help prepare America to care

Today, thanks to our nation’s 2.5 million home care workers, many elders and people with disabilities are able to live independently in their communities.  These workers help clients to bathe, get dressed, eat, take medications and more.  According to Bureau of Labor Statistics, this workforce is projected to grow to nearly 4 million by 2020 to meet the growing demand for these services.

But the challenge we face is how to attract people into these new jobs.  The work is vital, but also difficult and often dangerous.  Yet the pay is low – on average, less than $10 an hour.  Nearly one in three have no health coverage.  Many workers are not even reimbursed for mileage when driving between clients.  But perhaps the most shocking fact about how we compensate this essential workforce is this: Home care workers are not subject to the federal minimum wage and overtime protections virtually all other workers enjoy.

A year and a half ago, the Obama administration took an important first step to address this injustice.  On December 15, 2011, President Obama announced his intention to end the exclusion of home care workers from the Fair Labor Standards Act, our nation’s most basic labor protections.  Within days, the Department of Labor posted new proposed regulations.  Over the next three months, DOL received over 25,000 comments from the public with over 75 percent in favor of the proposed new rule.  More than one year later, home care workers are still waiting for fair pay.

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This month marks the 75th anniversary of President Roosevelt’s signing of the Fair Labor Standards Act, a signature piece of legislation of his New Deal.  It provides the federal minimum wage and overtime protection afforded to most American workers. What better way for President Obama to mark this important anniversary than to move forward with his proposal to ensure minimum wage and overtime coverage for home care workers, one of our nation’s largest workforces? 

Building a skilled, stable home care workforce will help to address our long-term care needs while also strengthening our health care system and our nation’s fiscal health.  Home care aides, in our current system of care, are an underused asset. They are treated as low-skilled, casual laborers, denied even the most basic labor protections under the Fair Labor Standards Act.

But think about it. We have millions of aides visiting patients every day. We need to recognize the vital role they can play in a well-coordinated health and aging system. Because of their intimate, daily contact with the individuals they assist, home care aides, with appropriate training, can work with health care teams to manage chronic disease; ensure adherence to prescribed medication regimens; promote healthy lifestyles through education on diet and exercise; and bring valuable insights to care planning and symptom management. The result—better managed care and lower costs for our health care system overall.

The end result of creating advanced roles for home care aides is better health and better health care for frail elders and people with disabilities—at lower cost over the long term. With budget discussions dominating the policy conversations in Washington and in states, such an approach is a welcome change from the arbitrary cuts to provider reimbursement that policymakers typically deploy to curb Medicare and Medicaid spending.

In short, these workers are vital to our health and aging services.  They deserve better, and we will all gain by compensating them fairly.  It is time for the Administration to finalize their new regulations extending minimum wage and overtime to home care workers.  The baby boomers are aging.  There is much work to be done.  Let’s get started.

Edelstein is national policy director for PHI, an organization that advocates for home care workers.