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The U.S. Department of Labor has released its employment projections for 2010 to 2020, and the numbers related to direct-care workers are staggering.

Direct-care workers are projected to increase in number by nearly 50 percent over the coming decade, adding 1.5 million new jobs. Of these jobs, 1.3 million will be in home care.

In fact, home care occupations, known by the occupational titles of Personal Care Aides and Home Care Aides, are projected to be the first and second fastest-growing occupations nationally in the next decade.

Personal Care Aides are projected to increase by 70 percent, and Home Health Aides by 69 percent. Additionally, Home Health Aides and Personal Care Aides are ranked third and fourth, respectively, in the number of new jobs projected to be added over this time period.

By contrast, jobs overall in the U.S. economy are projected to increase by only 14 percent.

Additionally, the two industries in which home care workers are employed — Services for the Elderly and Persons with Disabilities (SEPD) and Home Health Care Services — top the list of the fastest growing industries, with expected growth of 87 and 81 percent, respectively, over the coming decade.

– by Abby Marquand, PHI Policy Research Associate

On November 3, the Office of Management and Budget (OMB) announced that it had accepted for review proposed regulations from the Department of Labor (DOL) addressing the companionship exemption to the Fair Labor Standards Act (FLSA).

Currently, the companionship exemption excludes home care workers from FLSA overtime-pay and minimum-wage requirements.

PHI’s Campaign for Fair Pay calls for the OMB and DOL to issue new regulations revising the exemption to allow home care workers receive those basic wage protections.

In recent weeks, the Senate Committee on Health, Education, Labor and Pensions and a group of more than 40 economists and other researchers have separately urged the DOL and OMB to move ahead with new proposed regulations revising the companionship exemption.

– by Matthew Ozga

Workers in nursing and residential care facilities experienced the highest injury rates of any occupational setting in 2010, according to data (pdf) recently released by the U.S. Bureau of Labor Statistics (BLS).

Overall, the country’s private-industry employees suffered nonfatal injuries and illnesses at a rate of 3.5 cases per 100 full-time workers last year, down from 3.6 in 2009.

But private nursing and residential care facilities reported an injury/illness rate of 8.3 per 100 workers — higher than couriers and messengers (7.2), air-transportation employees (8.1), and people involved in performing arts, spectator sports, and related industries (6.7).

Combined, the health care and social assistance industry reported a higher injury/illness rate than any other private sector.

Public-Sector Injury Rate Even Higher

Nursing and residential care facility workers employed in the public sector suffered even higher injury rates than their private-industry counterparts, the BLS report additionally found.

The injury rate among nursing and residential care workers employed by local governments was 11.4 per 100 full-time employees. Those employed by state governments, meanwhile, recorded an injury rate of 15.1.

BLS reports a total of just 218,200 workers in public-sector nursing and residential care facilities, compared with more than 3.1 million such workers in the private sector.

Labor Secretary Expresses Concern

“We remain concerned that more workers are injured in the health care and social assistance industry sector than in any other, including construction and manufacturing,” said Department of Labor Secretary Hilda Solis in a statement.

“The Department of Labor’s Occupational Safety and Health Administration will continue to work with employers, workers, and unions in this industry to reduce these risks,” Solis added.

Many of the people employed in the nursing and residential care industry are direct-care workers.

“Direct-care workers in nursing and residential care settings face a greater injury rate than nearly any other job type in the country,” said PHI Government Affairs Director Carol Regan.

“Unfortunately, more than one in four lack health insurance (pdf). It is wrong that direct-care workers who get sick or hurt while caring for others cannot get comprehensive care for their own injuries or illnesses,” Regan added.

In 2008, Regan appeared in a short video, “The Most Dangerous Job in America,” to highlight the inordinately high injury risks that nursing assistants face each day.

– by Matthew Ozga

Economists, social scientists, and policy researchers from more than 40 universities and organizations sent a letter to U.S. Department of Labor (DOL) Secretary Hilda Solis and Director of the Office of Management and Budget (OMB) Jacob Lew urging them to extend minimum wage and overtime protections to home care workers under the Fair Labor Standards Act (FLSA).

The Economic Policy Institute, the Center for Economic and Policy Research, and PHI were among the organizations that signed on to the letter.

The October 28 letter (pdf) lists some of the benefits of narrowing the companionship exemption to its original purpose, which was to exclude casual eldercare companions from FLSA protections:

Dean Baker

• modest improvements in the earnings and working conditions of home care workers;
• long-run improvements in the quantity, quality, and reliability of labor supply; and
• reduced turnover among workers, with concomitant reduction of transaction costs to employers and improved continuity of care to clients and consumers.

“Home care workers should get the same protections as any other worker in the country,” said Dean Baker, co-director of the Center for Economic and Policy Research, who signed onto the letter.

“It’s a fairly simple issue: why would you single out a group of workers to not get what everyone else has?” he said.

Nancy Folbre, an economics professor at the University of Massachusetts, Amherst who also signed the letter, recently blogged about the “outmoded” companionship exemption in “The Depreciation of Care at Home,” in The New York Times.

DOL Developing Revised Regulations

DOL hosted two listening sessions on the companionship exemption this summer and has said that it is in the process of developing revised regulations.

PHI — along with the National Employment Law Project, SEIU, AFSCME, and the Direct Care Alliance — have been calling on DOL to revise its regulations to the companionship exemption to end the exclusion of 1.7 million home care workers from basic labor protections.

Visit PHI’s Campaign for Fair Pay to learn more about the “companionship exemption” and how to contact DOL and OMB and signal your support for revising the companionship exemption.

– by Gail MacInnes, PHI National Policy Analyst

During the week of July 25, the U.S. Department of Labor (DOL) Wage and Hour Division hosted two telephone conferences with stakeholders in order to hear perspectives on DOL’s plan to issue revised regulations, this fall, for the companionship exemption in the Fair Labor Standards Act.

The rule in question is a 1974 amendment to the law, which created an exemption from minimum wage and overtime protections for workers described as “casual babysitters” and persons “employed in domestic service employment to provide companionship services for individuals who (because of age or infirmity) are unable to care for themselves.”

Participation on the calls was spirited.

Home Care Has Transformed

Individuals supportive of a revision of the exemption noted that 21 states and the District of Columbia have already instituted minimum wage protection for home care workers, and 15 states provide overtime, without the catastrophic consequences predicted by opponents of the change.

Supporters, including home care aides, PHI, the National Employment Law Project (NELP), and National Consumer Voice for Quality Long-Term Care, also argued that the workforce must be afforded basic labor protections in order to strengthen the home- and community-based workforce and improve recruitment and retention.

A home care employer in Arizona with 30 years of experience spoke up in support of a revision, saying that in her decades of experience, home care has transformed from companionship into skilled care.

Opponents of revising the exemption, including the National Private Duty Care Association, Home Care Association of New York State, and large home care chains like Home Instead, said it would be more difficult to pay home care workers additional wages for overtime due to low reimbursement rates from Medicaid.

Opponents also suggested that more care would be provided through the “grey market” if minimum wage and overtime protections were extended to home care workers, resulting in decreased tax revenue and greater vulnerability for consumers and workers.

DOL noted that participation in the calls does not substitute for formal comments on the revised regulations when they are issued.

Campaign to Revise the Companionship Exemption

PHI, along with NELP, SEIU, AFSCME, and the Direct Care Alliance, have been calling on DOL to revise its regulations to stop the exclusion of 1.7 million home care workers from basic labor protections.

Visit PHI’s Campaign for Fair Pay to learn more about the “companionship exemption” and how to contact DOL Secretary Hilda Solis regarding the exemption.

– by Gail MacInnes, PHI National Policy Analyst

Next week, the Department of Labor (DOL) will conduct two “listening sessions” regarding the companionship exemption to the Fair Labor Standards Act.

During the sessions, the DOL will solicit public opinion on whether it should modify the exemption to give home care workers federal minimum-wage and overtime protections.

The sessions will be conducted between 4 p.m. and 5 p.m. EST on both July 25 and 27. Those interested in participating should call (888) 730-9140 and enter the passcode 34478.

Advocates for home care workers — including the PHI Campaign for Fair Pay and the National Domestic Workers Alliance — are encouraging supporters to call and tell the DOL that home care workers deserve minimum wage and overtime protections.

Supporters are urged to call in early, as there will likely be a queue to speak.

– by Matthew Ozga