Omaha firm: Change in overtime rule bad for home caregivers, elderly

October 26, 2011

Omaha firm: Change in overtime rule bad for home caregivers, elderly

By Joseph Morton and Paul Goodsell

WASHINGTON — Home health care providers are warning that potential changes in federal rules would leave families paying a lot more for professional help to look after their elderly and ailing relatives.

It’s a big concern for the Omaha-based Home Instead Senior Care, which oversees franchises that provide nonmedical assistance to people who would rather stay in their homes than move to a group housing facility.

The changes could force overtime pay for caregivers who work an overnight shift at an elderly person’s house, even if the worker is sleeping part of the time. That could mean higher costs, some worry, but it also could force more frequent shift changes that could be upsetting to some senior citizens.

“You’ve got pretty close to six or seven people who are coming on a regular basis,” said Carole Williams, who arranges 24/7 help for her mother-in-law in Omaha. “You want to keep that at a minimum. The more people coming in, the more confusing it is.”

Many home caregivers are not covered by the minimum wage and overtime provisions in the Fair Labor Standards Act, under what is called the “companionship” exemption.

The reasoning behind the exemption is that home care services are different from other jobs. For example, the worker could be sleeping for half of a 12-hour overnight shift.

But the Department of Labor has announced that it plans to offer revisions to the exemption sometime this month.

Rep. Lee Terry, RNeb., has met with Labor Department officials and has proposed legislation that seeks to bring some certainty to the situation and preserve the overtime exemption. He said lawmakers also are talking about holding hearings on the issue.

“We want to make sure they’re not killing an industry with a rule,” Terry said.

In a speech two weeks ago, U.S. Secretary of Labor Hilda Solis said she was “taking a hard look” at the companionship exemption.

“We know the duties these professionals perform have grown more demanding over time, requiring greater autonomy, responsibility and skill,” she said.

Workers are providing these services in both home and community-based settings, she said.

“Often, they’re serving people with physical and developmental challenges, as well as people with chronic and terminal conditions,” she said. “It’s demanding work.”

Home Instead’s founder and chairman, Paul Hogan told The World-Herald that the overtime exemption is key to keeping its services affordable. The minimum wage exemption is not really an issue, he said, because the market already dictates minimum wage for caregivers.

But the overtime rules are different. Hogan cited the example of someone working four to five overnight shifts a week. They go to the client’s house to help an elderly person get ready for bed, and they are on hand to help them get ready in the morning.

Such shifts can run 10 to 12 hours, but the worker might spend half of that time sleeping. If they do five overnights a week, that adds up to 60 hours.

If the exemption were eliminated, Hogan said, “as soon as they hit 40, we’d have to charge time-and-a-half for basically someone sleeping in a senior’s home.”

Williams said her mother-in-law has her own apartment and eats most of her meals at an independent living facility in southwest Omaha. But the 87-year-old also receives round-the-clock help from caregivers hired through Home Instead.

Williams said the workers assist with bathing, dressing and light housekeeping for the woman, who uses a walker. They drive her to appointments, remind her to take medications and prepare lunches.

“It’s working out well,” Williams said. “The thing is, they’re consistent in the people who are there. She wants the same people all the time.”

Consistency could be difficult to maintain, she said, if overtime pay were required. With total caregiver costs already close to $100,000 a year, she said, paying more is out of the question.

“I just don’t see how people could afford the time-and-a-half thing,” she said.

Hogan said higher costs will lead people to go to the “gray market” of at-home care providers, who don’t come with the same screening, training, supervision and insurance that professional agencies offer.

“It just puts seniors at a much higher risk,” he said.

He also said it will make it more expensive for families to pay for the care and could result in people turning up more quickly on Medicaid.

“The faster a family burns through their money, the sooner the state has to pay, and for a lot of them, they’ll be forced into a nursing home,” he said.

Contact the writer:

202-630-4823, [email protected]

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