I have said many times in this blog that the best senior care blog is The New Old Age, from the The New York Times. I still firmly believe it and recommend it highly. I am now forced, however, for the second time, to disagree with a posting from that excellent source.
The article I am very concerned about is A Fair Wage for Home Care Workers. At Support For Home, we absolutely agree with that premise. In fact, we pay 20%-30% more than most home care agencies in our area. We pay as much as 50% more for 24-hour care. We believe that if we want to hire the best people, we should pay the best wages.
Agreeing with the principle of “a fair wage” for caregivers, however, does not mean that The New Old Age gets this one right. We need to look at details for this situation, not platitudes.
The issue has nothing to do with minimum wage. Frankly, that is a false issue and an emotional crutch some folks try to use in arguments. In California, the minimum wage is $8.00 per hour. Our Home Care Aides make at least 30% more than that rate for hourly shifts. Most of our employees make 138% to 150% of minimum wage for such shifts.
The real discussion is around the existing federal (and state, in California) exemption from overtime provisions of labor law for personal attendants / home care aides. What this means is that, currently, for a client needing a twelve (12) hour shift for support of her / his Activities of Daily Living (ADLs), one of our Home Care Aides will be paid $11 per hour for the entire shift. The client is charged accordingly. If the overtime exemption is removed, the bill to the client will increase by 11%, to cover the increase direct labor and other personnel expenses (OPE) associated with overtime.
For the vast majority of home care clients, the cost of home care is borne directly, not by Medicaid, as implied in The New Old Age article: “1.8 million home care workers, who are trained professionals, often paid by Medicaid…” Only the lowest income individuals have care through Medicaid funded state or county programs.
The 11% increase in costs referred to above would severely impact many clients who are responsible for their own home care costs, reducing care — and reducing employment of Home Care Aides.
The situation is even worse when we look at clients requiring 24-hour care. In our case, that is 15%-20%. Our Home Care Aides, following Wage Order 15 in California, are paid for every one of the 24 hours they are on the job, even if sleeping. Here is the scenario that would take place if the overtime exemption were removed, following California labor law for non-exempt workers:
| Current Exemption | Without Exemption | |
| Direct Labor Cost | $ 192.00 | $ 304.00 |
| Other Personnel Expense (25%) | $ 48.00 | $ 76.00 |
| Labor Cost, 24-Hour Shift | $ 240.00 | $ 380.00 |
| Increase in Labor Cost | 58% | |
| Increase in Cost to Client | 47% |
The discussion about a “fair wage for home care workers” needs to move away from platitudes and knee-jerk philosophy and labor union rhetoric. It needs to focus on real numbers — real wages and opportunities for home care aides and real costs and risks for the clients they have chosen to support.
Your thoughts are very welcome.
Best wishes, Bert
Support For Home In-Home Care 