Carolyn Kaster, Associated Press
WASHINGTON — The Obama administration announced a plan Thursday to extend minimum wage and overtime protections to home health care workers, a move that would boost living standards for nearly 2 million domestic employees but could mean higher costs for the elderly and disabled.
President Barack Obama said it's inexcusable for in-home care employees to be paid less because "they're still lumped in the category as teenage baby sitters."
"They deserve to be treated fairly," Obama said at a White House ceremony surrounded by more than a dozen home health care workers. "They deserve to be paid fairly for a service that many older Americans couldn't live without."
It was the latest step taken by Obama to try to boost the economy without going through Congress.
Home health care aides have been exempt from federal wage laws since 1974, when they were considered companions to the elderly and compared to neighborhood baby sitters. But the number of full-time home care workers has surged, along with the growing number of retirees who need help with a range of daily tasks, from taking the right medication to getting cleaned and dressed.
Currently, 29 states don't require minimum wage or overtime for home health care workers.
"These are real jobs as part of a huge and growing industry," said Steve Edelstein, National Policy Director for the Paraprofessional Healthcare Institute in New York. "They deserve same basic labor protections that other workers enjoy."
Unions and advocacy groups say nearly half of all home care workers live at or below the poverty level and receive public benefits such as food stamps and Medicaid. Poor working conditions, low wages and high turnover make it challenging to meet the growing demand to provide care for the elderly in their homes instead of in institutions.
More than 90 percent of home care workers are women. About 30 percent are black, and 12 percent are Hispanic.
With the size of the U.S. population over 65 expected to nearly double in the next 20 years, millions more will rely on long-term health care from domestic workers.
Health services companies that employ home care workers have opposed efforts to expand hour and wage laws, arguing that it would drive up costs for elderly clients who can ill afford it.
"We are in full support of adequate and fair wages of those doing such admirable work," said Jordan Lindsey, a spokesman for the California Association for Health Services at Home. "However, it needs to be carefully balanced with the unique needs of seniors and people with disabilities who need home care and keeping that type of care affordable."
For a patient with dementia who needs 24-hour care, for example, a family is currently allowed to pay home aides at a flat hourly rate. If overtime rules apply, Lindsey said, it could triple the cost of care.
Once the Labor Department formally proposes the new rules to extend wage laws to home health workers, there will be a 60-day period for public comments. The rules could take effect early next year.
The Clinton administration initially tried to extend federal wage rules to home aides, but President George W. Bush stopped the effort.
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