A growing number of New York seniors in need of caregiving support are opting to stay in their homes, instead of moving into nursing facilities. This is partially a result of Medicaid programs changing to accommodate more at-home caregiving, often saving money and better meeting elderly preferences at the same time.
As a result, more and more attention is being paid to home caregivers. In particular, some are voicing concern about potential negligent care. Obviously, caregivers can fall far short of standards no matter what the setting, from nursing homes to traveling support. One particular concern with home caregiving aides is that, unknown to many, they actually fall under an exempted category in the Fair Labor Standards Act–the federal law which includes issues like the minimum wage, overtime pay, and more.
At least that was the case. According to new rules released today by the U.S. Labor Department, the specific definition of the “companionship exemption” under which these caregivers previously fell will be narrowed. Beginning in 2015, home caregivers will no longer be exempt, leading to significant changes in their employment status and, some hope, the quality of their work.
Changing Rules = Better Home Caregiving for Seniors?
In the past, home caregivers could be paid a pittance (below minimum wage) and were denied many employment requirements (overtime pay, breaks, vacation time, etc.). The poor protection for these workers meant that turnover was high, as employees often left as soon as they found a better position.
As discussed in a recent Modern Healthcare story, labor unions fought vigorously for the rule change. The SEIU President remarked, “For too long this vital occupation, upon which the health and independence of millions depend has been treated as marginal and casual work to be performed under poverty conditions. This has been so, even as the occupation has become among the fastest growing and most vitally important within the American healthcare system.”
On the other side of the debate, owners and operators of home-care companies argue that the rule will force businesses to cut back on caregivers in order to account for higher wages. It is unclear if these claims will bear fruit. Senior care advocates point out that the home-care industry brings in billions annually, and so the “gloom and doom” claims made by industry executives may be nothing more than posturing.
In any event, the rule change is a reminder that all New York families should pay attention to the quality of services being provided by caregivers in all settings, including at-home aides. One way to increase the odds of receiving appropriate care is by securing private funding, often via long-term care insurance, instead of relying on Medicaid.