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Terry Bucher

The U.S. cannot build the home care workforce it needs to care for the aging baby-boomer generation unless home care workers are paid fairly, argues an op-ed published in the Orlando Sentinel on April 27.

The op-ed was written by Terry Bucher, the president emeritus of the Florida Professional Association of Care Givers.

In the op-ed, Bucher explains that Florida is one of 29 states that do not offer home care workers basic wage protections, such as minimum wage or time-and-a-half overtime pay. The federal Fair Labor Standards Act similarly excludes home care workers from such protections.

“Florida’s home-care workers are dedicated and diligent,” Bucher writes. “But until they are guaranteed a fair wage, Florida will simply not be able to attract enough qualified workers to meet the growing need for home-care services.”

Hope for a Federal Rule Change

In late 2011, the Obama administration proposed a federal rule change that would finally extend basic wage protections to home care workers.

Bucher notes that the Department of Labor received 26,000 public comments regarding the proposal — most of them in favor of the change.

The DOL must act to extend overtime and minimum wage protections to home care workers, Bucher writes.

She cites PHI research (pdf) in arguing that the $84 billion home care industry can easily afford to pay its workers a fair wage.

Additionally, better wages for home care workers would lower worker turnover, Bucher writes. High turnover rates are costly to home care companies and result in lower-quality care for elders and people with disabilities.

– by Matthew Ozga

Ai-jen Poo, the director of the National Domestic Workers Alliance, was selected as one of the 100 most influential people in the world by Time magazine.

Poo’s advocacy on behalf of domestic workers — including home care workers — demonstrates “the humanity of a long devalued kind of work,” wrote Gloria Steinem in a brief essay for Time. Steinem also hailed Poo’s “gift for creating worker-led groups and empathetic tactics.”

In addition to her role as the National Domestic workers Alliance director, Poo is the co-director of Caring Across Generations, a coalition of 200 organizations that includes PHI in its leadership. The coalition is undertaking a national campaign to provide quality care and dignity for aging Americans and their caregivers.

Poo has also been instrumental in the drive to achieve fair pay for home care workers.

Last December, she spoke about the necessity of paying such workers fairly at a Department of Labor press briefing (pdf), shortly after President Obama announced that his administration would pursue a rule change extending basic wage protections to home care workers.

– by Matthew Ozga

An analysis of 6 million caregivers in California who provide services and supports to family members or friends found that those who are paid by Medi-Cal to assist low-income elders and people with disabilities were the most likely to be “economically insecure.”

In Hidden in Plain Sight: California’s Paid Medi-Cal Caregivers Are Vulnerable (pdf), researchers at the UCLA Center for Health Policy Research report that of the 290,000 Medi-Cal paid caregivers assisting family or friends — most of whom are likely to be employees of the In-Home Supportive Services (IHSS) program — more than half (57 percent) had incomes below or near the federal poverty level (average monthly income of $1,970).

The analysis also found that of these paid caregivers for Medi-Cal recipients:

• Nearly a third (31 percent) were uninsured;
• Nearly a third (31 percent) had food insecurity (reduced meal size or skipped meals due to lack of sufficient resources); and
• 16 percent were likely to stay in the job for less than a year, “suggesting a high client turnover.”

The researchers compared Medi-Cal paid caregivers to all paid caregivers, unpaid caregivers, and non-caregivers, finding that Medi-Cal paid caregivers fared the worst on the economic indicators.

Nearly half (49 percent) of all paid caregivers (450,000, which includes the Medi-Cal paid caregivers) in the study had poverty or near poverty incomes.

Little Pay for Hard Work

“Paid caregivers do a lot but get paid very little,” said Geoffrey Hoffman, the study’s lead author. “They play a critical and complex role caring for our aging or disabled parents, grandparents, friends, and neighbors yet can earn only a little more than minimum wage.

“When we talk about caregiving, we should be thinking not only of the supportive services we provide to older adults but also the vulnerable people providing those services,” said Hoffman, who added that proposed cuts to the IHSS program and the downsizing of the state’s Adult Day Health Care program will not only hurt consumers but “will also harm paid caregivers.”

“Of course, all of us promote the value of family members caring for one another through thick and thin,” said San Francisco IHSS Public Authority Executive Director Donna Calame, who is also a PHI board member. “What the larger public — and unfortunately many policymakers — do not understand is that paying family members the relatively low wages we do in IHSS keeps families together.

“Family members are not paid for things like cooking or cleaning the house,” Calame continued. “They are paid for doing things like bathing, dressing, or helping their loved one use the toilet. The average IHSS consumer uses about $1,500 per month. Parents caring for severely disabled children especially save the taxpayer from annual institutional costs of about $250,000-$300,000 per year. That IHSS pays family members is a humane and cost-effective use of public dollars.”

– by Deane Beebe

PHI President Steven L. Dawson and Center for Economic and Policy Research Co-Director Dean Baker, in an op-ed published in The Washington Post on March 29, contend that the exemption of home care workers from federal minimum wage and overtime protections under the Fair Labor Standards Act is an “issue that affects the welfare of women,” but gets little attention.

In “Home Health Aides Deserve a Living Wage,” Dawson and Baker write that “caregiving in America is a female occupation.” Women are the vast majority of family caregivers and comprise 90 percent of the paid home care workforce (pdf) — which explains why home care workers have been excluded from basic federal labor guarantees.

“Caregiving, like other forms of domestic service, has traditionally been considered less important than jobs done by white men,” Dawson and Baker write. “The idea that domestic work is not ‘real work’ has kept wages low for all types of ‘women’s work.’” The annual income of home care workers is $16,600.

“Extending minimum wage and overtime protections to home-care workers is another step in America’s progress toward ending gender and racial discrimination,” Dawson and Baker write. “But fairness is not the only reason to make this change,” they add, noting that it would also help to reduce costly turnover and meet the rapidly increasing demand for these workers as the nation’s population ages.

“The country needs a national solution that helps us all meet our family responsibilities. That includes building a skilled, stable workforce by treating caregiving as real work and paying those who provide these services a living wage,” Dawson and Baker advise.

More Media Coverage on the Companionship Exemption

PHI National Policy Director Steve Edelstein was interviewed by America’s Workforce Radio on March 30 on the proposal to revise the companionship exemption.

National Domestic Workers Alliance Director Ai-Jen Poo and Jobs with Justice Executive Director Sarita Gupta, the co-directors of Caring Across Generations (CAG), discussed workers’ rights with Bill Moyers on his new PBS television show. CAG is a coalition of 200 organizations, including PHI, that seek to provide quality care and dignity for aging Americans and their caregivers.

For other media coverage and more information on the companionship exemption, visit PHI’s Campaign for Fair Pay site.

– by Deane Beebe

Workers gather in Mass. State House in Boston

Approximately 1,000 direct-care workers employed by state and private human services agencies throughout Massachusetts rallied for better wages at the State House on April 2.

The direct-care workers earn an average of $12 per hour and have not had a wage increase since 2008, according to the Associated Press. As many as 185,000 direct-care workers are employed by human services agencies in Massachusetts.

“I really love getting up in the morning and going to work and trying to make a difference, but it’s getting harder,” Claras Nowden, a residential director at the Center for Human Development, told WWLP, a local television station. “With the cost of living, you know, you’re taking on second jobs and it’s really getting harder to stay in human services.”

Workers Deserve Dignity and Acknowledgement

Human services workers “care for people’s extremely personal needs,” said State Senate President Therese Murray, who spoke at the rally. “They keep people alive, they keep people going to work, and the [caregivers] actually pay taxes so you know they really deserve some dignity and some acknowledgement of the work they do.”

Murray said that she is committed to improving wages for direct-care workers but only if the state has enough revenue in the budget to do so.

“If there’s more, I will promise you more,” she said.

The Massachusetts human services budget has been slashed by 25 percent over the past four years.

“The situation in Massachusetts is emblematic of the difficulty we face in many states in trying to improve the quality of direct-care jobs,” said Steve Edelstein, PHI national policy director. “Everyone agrees that these jobs are essential, but efforts to improve wages are stymied by budget choices.”

The direct-care workers provide care to people with developmental disabilities, people with physical disabilities, people with mental illness, children, elders, and other vulnerable populations.

The rally was organized by The Caring Force, an advocacy group affiliated with the Massachusetts Council of Human Service Providers, Inc.

– by Deane Beebe

Steven Edelstein

SUMMARY: Steve Edelstein, PHI national policy director, discusses the background and current status of efforts to extend federal minimum wage and overtime protections to home care workers on the America’s Work Force radio program in Ohio.

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download podcast (mp3)
Recorded: March 30, 2012
Duration: 12:00
File Size: 16.5 MB