Category Archives: Home Health Workers

Can Home Care Companies Manage Overtime Hours? Three Successful Models

Source: Dorie Seavey, Alexandra Olins, Paraprofessional Healthcare Institute (PHI), 2012

From the summary:
A new PHI report examines how three home care companies have successfully managed to control their overtime costs while maintaining their reputation for high-quality care.

The report, Can Home Care Companies Manage Overtime Hours? Three Successful Models, discredits home care industry claims that the Obama Administration’s proposal to revise the companionship exemption to extend minimum wage and overtime protections to home care workers would dramatically increase agencies’ overtime costs, since any overtime worked by aides would have to be compensated at time and half

Caring for Caregivers: Latinos in the Direct-Care Workforce

Source: National Council of La Raza, Monthly Latino Employment Report, February 3, 2012

Due to the aging baby boomer population, America’s older population is projected to experience significant growth over the next several decades. Already, families responsible for finding appropriate long-term care for elderly relatives find their options severely limited; as a result, many turn to home health or personal care aides to provide care. While direct-care industry revenues have climbed, benefits are not shared by workers who provide care, many of whom work long hours at low wages. This Monthly Latino Employment Report offers an overview of Latinos in the direct-care industry and highlights new U.S. Department of Labor regulations that could help improve employment conditions for these workers.

Home Health Care Industry Growth in Indiana

Source: Srikant Devaraj, Michael J. Hicks and Rohit Ravula, Ball State University, Center for Business and Economic Research, January 2012

There are around 1.1 million employees working in 25,686 establishments in home health care services industry in the United States as of 2009. When compared to the year 2000, this sector experienced an increase of 40.5 percent in terms of number of jobs and 59.6 percent in establishments. Figure 2 shows the structure of the industry in the United States. In 2009, 36.6 percent of S-corporations in this industry have employed 36 percent of employees, followed by 30.3 percent corporations employing 33.3 percent employees.

This report provides the background economic information about health care and social assistance sector (NAICS 62) in Indiana and its counties, followed by information about ambulatory health care services (NAICS 621) and home health care industry (NAICS 6216). The industry/commodity
balance sheet, wages of health care occupations, and economic impact estimates are also discussed in this report.

As elder care grows, so do labor battles

Source: Michael Lawson, American university School of Communication, What Went Wrong blog, January 23, 2012

The pay is low, and injuries are common, but nursing care is a rare bright spot in the gloomy economic landscape, adding jobs at a steady clip. As the field has grown, so, too, have efforts to unionize.

Those unionization campaigns are being fought on a shifting battleground, from massive chains to private homes. With baby boomers moving into retirement and beyond, the tensions aren’t likely to abate any time soon.

Cost of Long Term Care Study

Source: Northwestern Mutual, November 2011

From the summary:
In November 2011, the Long Term Care Group, Inc. conducted customized Cost of Care research on behalf of Northwestern Long Term Care Insurance Company of nearly 2,000 home healthcare providers, assisted living facilities and nursing homes in specific regions of the United States.

This research is important in the understanding of accessibility and affordability of different types of care services by geographic location. The findings help consumers make informed decisions about their long-term care options and costs, which may allow them to stay in their homes or within their local communities in the event of functional limitation or cognitive impairment.

Frontline Caregivers: Still Struggling

Source: Eileen Boris and Jennifer Klein, Dissent, Vol. 59 no. 1, Winter 2012
(subscription required)

These workers are America’s frontline caregivers. They number over 1.7 million nationwide. Home care workers earn just a little but more than the minimum wage and historically have had little or no job security, health benefits, or even workers’ compensation. Government programs began subsidizing home care in the 1930s. Yet in every decade since then, policymakers and welfare administrators have acted on the presumption that the intimate labor of caregiving should be the loving and unpaid duty of wives, mothers, and daughters. So home care aides, defined as elder companions rather than workers, are still excluded from the Fair Labor Standards Act, more than seven decades after it was enacted in 1938. Moreover, because they are often poor women taking care of people receiving public assistance, the suspicion and taint of “welfare fraud” has been used to cut their hours of service or pay in times of fiscal anxiety.

Long-Term Services and Supports Opportunities in the Affordable Care Act

Source: Sarah Barth, Julie Klebonis, and Nancy Archibald, Center for Health Care Strategies, Technical Assistance Brief, December 2011

States now have more tools available to rebalance the provision of long-term services and supports towards more home- and community-based services and away from institutionally based care. In addition to the Money Follows the Person demonstration program, the Affordable Care Act created the Balancing Incentive Payments program, the state plan Community First
Choice Options program, and the modified Home- and Community-Based State Plan option (1915(i)). Selecting the appropriate program(s) to implement is made complicated by the sometimes overlapping and differing requirements of these options.

This technical assistance brief describes the different LTSS program options available to states with particular emphasis on their budget impacts;
application processes; and requirements for participant eligibility, care coordination, and data reporting. It also discusses the ways in which the different options for providing LTSS interact with each other and with existing state LTSS structures.

Caring in America: A comprehensive analysis of the nation’s fastest-growing jobs: Home health and personal care aides

Source: Dorie Seavey and Abby Marquand, Paraprofessional Healthcare Institute (PHI), December 2011

From the abstract:
This PHI report provides a thorough analysis of the home care and personal care industries in the U.S., as well as of the workers who provide both types of care. The authors detail the many difficulties facing workers in both fields, including uncompetitive wages with little to no benefits offered, inconsistent and often inadequate training requirements, high injury rates, and unpredictable hours. The report lists several recommendations to improve the quality of these jobs.

Notice of Proposed Rulemaking to Amend the Companionship and Live-In Worker Regulations

Source: U.S. Department of Labor, Wage and Hour Division, December 2011

…Although the regulations governing exemptions have been substantially unchanged since they were promulgated in 1975, the in-home care industry has undergone a dramatic transformation. There has been a growing demand for long-term in-home care, and as a result the in-home care services industry has grown substantially. However, the earnings of in-home care employees remain among the lowest in the service industry, impeding efforts to improve both jobs and care. Moreover, the workers that are employed by in-home care staffing agencies are not the workers that Congress envisioned when it enacted the companionship exemption (i.e., neighbors performing elder sitting), but instead are professional caregivers entitled to FLSA protections. In view of these changes, the Department believes it is appropriate to reconsider whether the scope of the regulations are now too broad and not in harmony with Congressional intent.

On December 15, 2011 the Department announced that it will publish a Notice of Proposed Rulemaking (NPRM) to revise the companionship and live-in worker regulations for two important purposes:

– To more clearly define the tasks that may be performed by an exempt companion
– To limit the companionship exemption to companions employed only by the family or household using the services. Third party employers, such as in-home care staffing agencies, could not claim the exemption, even if the employee is jointly employed by the third party and the family or household.

Additional Information on the NPRM:
Notice of Proposed Rulemaking
Frequently Asked Questions
Remarks by the President on Minimum Wage and Overtime Protections for In-Home Care Workers
Press Release
Blog Post
Fact Sheet: Proposed Rule Changes Concerning In-Home Care Industry under the Fair Labor Standards Act
Comparison of Current vs. Proposed Companionship Regulations
Economic Impact Analysis
State Minimum Wage and Overtime Coverage of Non-Publicly Employed Companions

Additional Information on Companionship and Live-In Workers

Applicable FLSA Regulations

States’ Requirements for Home Health Aide Training Lag Far Behind Nurse Aides’

Source: Deane Beebe, PHI, PolicyWorks Blog, 08 December 2011

A new PHI analysis found that only 15 states require home health aides to have more training hours than are federally mandated, yet 30 states and the District of Columbia require certified nurse aides (CNAs) to have more training hours than the federal requirements.
See also:
Press Release