Category Archives: Home Health Workers

Building Bridges Radio: Domestic Workers Uniting – Your Home, My Work

Source: Mimi Rosenberg and Ken Nash, WBAI’s Building Bridges: Your Community and Labor Report, March 7, 2008
(audio)

From the summary:
Domestic workers to tell their stories – of their pains, their pride and their efforts to organize. Women of color, from around the world work as domestic workers. Most are employed without a living wage, health care, and basic labor protections.

Laws of Care: The Supreme Court and Aides to Elderly People

Source: Eileen Boris and Jennifer Klein
Dissent
Fall 2007

“There’s no place like home”–unless you’re one of the 1.4 million home aides who assist elderly and disabled people but whom the Supreme Court last June abandoned to the feudal manors of the past. In Long Island Care at Home v. Evelyn Coke, the justices unanimously determined that the Department of Labor had the authority to place providers of home care outside the labor law. For seventy years, the Fair Labor Standards Act (FLSA) has guaranteed minimum wage and overtime compensation to the nation’s workers, but somehow one of the fastest growing occupations of the twenty-first century doesn’t deserve the status and protection of formal employment.

Family Caregiving to the Older Population: Background, Federal Programs, and Issues for Congress

Source: Congressional Research Service

Family caregiving to older individuals in need of long-term care encompasses a wide range of activities, services, and supports. Caregiving can include assistance with personal care needs, such as bathing, dressing, and eating, as well as other activities necessary for independent living, such as shopping, medication management, and meal preparation. In addition, family caregivers may arrange, supervise, or pay for formal or paid care to be provided to the care recipient.

Family caregivers fulfill the majority of the need for long-term care by older persons with chronic disabilities in the United States. As a result of increases in life expectancy, as well as the aging of the baby-boom generation, demand for family caregiving to the older population is likely to increase. However, demographic trends such as reduced fertility, increased divorce rates, and greater labor force participation among women may limit the number of available caregivers to older individuals, as well as the capacity for caregivers to provide needed care.

Although many family caregivers find caregiving for an older family member a rewarding experience, other life circumstances, in addition to caregiving, may increase caregiver stress. For example, family members may not live in close proximity to the care recipient, they may face the competing demands of child care and elder care, and they may have to manage work with caregiving responsibilities. As a result, family caregiving can lead to emotional and physical strain and financial hardship. These effects are more likely to be felt among those caring for persons with high levels of disability or cognitive impairment. Caregiver stress has been linked to nursing home admission for the care recipient, thus interventions that can reduce stress may also reduce nursing home placement.

Recognizing family caregivers as an important part of the nation’s long-term care delivery system, the federal government has established programs and initiatives that provide direct supports to caregivers, such as respite care, education and training, tax relief, and cash assistance. These benefits are targeted at family caregivers to reduce stress and financial hardship, and to improve caregiving skills, among other things. Other federal programs and initiatives provide home- and community-based long-term care services and supports to the care recipient. These programs can indirectly benefit caregivers in relieving caregiver burden by either supplementing the informal care they are providing or substituting with paid support.

Three sets of policies that would provide direct assistance to family caregivers to older adults are briefly discussed in the last section of this report. These policy issues, which have been the subject of discussion among federal policymakers and other interested stakeholders, include the following: caregiver services and supports, flexible workplace accommodations and income security, and additional tax credits.

CMS Announces Payment Changes for Medicare Home Health Services

Source: Centers for Medicare & Medicaid Services (CMS), 42 CFR Part 484, [CMS-1541-FC], RIN 0938-AO32, 2007

From press release:
The Centers for Medicare & Medicaid Services (CMS) today issued a final rule to refine and update the Home Health Prospective Payment System (HH PPS) for Calendar Year (CY) 2008. This final rule reflects the ongoing efforts of CMS to support beneficiary access to home health services and improve the quality and efficiency of care provided to Medicare beneficiaries through more accurate payments for services rendered. Refinements to the Medicare HH PPS as well as the annual update to the Medicare payment rates for home health services will disburse an estimated additional $20 million in payments to home health agencies in CY 2008.
Home Health Prospective Payment System Refinement and Rate Update for Calendar Year 2008; Final Rule with comment period on display in the Federal Register on August 22, 2007
Fact Sheet

2007 National Home and Hospice Care Survey to Begin Including New Home Health Aide Supplement

Source: National Center for Health Statistics, Centers for Disease Control and Prevention, June 29, 2007

From press release:
The 2007 National Home and Hospice Care Survey (NHHCS) conducted by the National Center for Health Statistics, Centers for Disease Control and Prevention, will begin in August 2007 to collect information on this important segment of health care in America. The latest in a series of surveys about home health agencies and hospices, the 2007 survey will include a first-ever, nationwide survey of home health aides, the group that provides the majority of direct care to the Nation’s 1.5 million home health and hospice patients.

See also:
National Home and Hospice Care Data

Low Wages Prevalent in Direct Care and Child Care Workforce

Source: Kristin Smith and Reagan Baughman, Carsey Institute, University of New Hampshire, Policy Brief no. 7, Summer 2007

One in every two direct care workers and one in every three child care workers live in a low-income family (below 200 percent of the poverty line), and many live in poverty. Hourly wages for the caregiving workforce are low and many lack health insurance. Despite work, these families struggle to make ends meet. Our society depends on the care work of many paid professionals-direct care and child care workers-to help meet the daily needs of our children and the elderly. To stem turnover and provide quality services to young children and the elderly, job conditions among the direct care and child care workforce must improve, and increasing wages is a promising place to start.

Home Is Where the Work Is: Inside New York’s Domestic Work Industry

Source: Domestic Workers United and DataCenter, July 2006

As immigrant workers nationwide battle for basic respect, a leading domestic workers’ organization released a full, unprecedented report detailing exploitative conditions and demographics of the nation’s most hidden low-wage industry. The report combines statistical analysis of data from over 500 mostly immigrant workers with personal stories of workers and employers, in a joint effort between DataCenter and Domestic Workers United. Dr. Robin D. G. Kelley’s introduction explains how the nation’s troubled history of race, gender and class inequality come shamefully together in its domestic work industry. New York University’s Immigrant Rights Clinic delivers a historical look at why the law continues to ignore household labor, perpetuating ancient views that domestic labor is not “real” work.

Behind Closed Doors: Working Conditions of California Household Workers

Source: Mujeres Unidas y Activas, Day Labor Program Women’s Collective of La Raza Centro Legal, DataCenter, March 2007

In 2002, Mujeres Unidas y Activas and the San Francisco Day Labor Program Women’s Collective of La Raza Centro Legal came together to analyze and to strategize to improve the household work industry. Because there is no official data available about the number of household workers or information about their work conditions in California, these membership-based and membership-led organizations of low-income immigrant Latina women, many of whom are household workers, joined with the DataCenter and the San Francisco Department of Public Health to create a participatory research project to assess the industry. Over thirty immigrant women were trained to administer the survey and together they collected two hundred and forty surveys from their peers in the San Francisco Bay Area. The hour-long surveys were conducted on buses, in parks, at Laundromats and in the homes of household workers. As the Household Worker Rights Coalition Survey (HWRC Survey) results make clear, this is a very vulnerable industry. Rampant abuses of household workers must be addressed.