Weekly column in the Washington Times Communities by Laurie Edwards-Tate

Overregulation is killing the American Dream.

The federal government completes about 4,000 regulations a year. This is about 80,000 pages, the equivalent to 400 sizable novels. These rules pile up year after year, and are rarely eliminated.

These regulations can have significant negative economic effects.

President Barack Obama signed an executive order in February requiring federal agencies to review regulations on their books and “remove outdated regulations that stifle job creation and make our economy less competitive.”

The Department of Labor didn’t get President Obama’s message. It is considering imposing new regulations by removing the “companionship exemption” from the Fair Labor Standards Act (FLSA).  If this is changed, it threatens the quality of home care for many of America’s seniors and disabled adults and will put thousands of people employed in the home care industry out of work.

Currently the FSLA exempts most home care workers (also known as personal care assistants or companion care workers) who provide “companionship services for individual who because of age or infirmity are unable to care for themselves” from minimum wage and overtime pay requirements.

This companionship exemption was recently affirmed by the U.S. Supreme Court.

While it may seem to ensure fairness on the surface, it would be nothing less than a disaster for the home care industry, its workers, and for the seniors and disabled adults who rely on affordable, quality home care to remain independent. All of this would be threatened should the companion care exemption be eliminated.

Members of the National Association for Home Care and Hospice (NAHC) like my company which employs caregivers offer ongoing opportunities for meaningful work among a wide variety of client populations and environments.

Live-in and sleep-over time is vitally important as a critical safety net. It often provides respite to family caregivers. But it is often no more than being available.  Little or no work is being performed for many of the hours of these shifts.

Overtime is difficult to justify under these circumstances. The cost of overtime especially will make in-home non-medical care unaffordable for many, if not most, of the seniors and persons with disability we serve.

Modifying the exemption will have unintended consequences. In California, an agency will employ a live-in caregiver for a 24 hour shift. If the overtime exemption is eliminated, the agency will staff this case with three workers in eight hour shifts instead. The workers’ pay will drop and the client will lose continuity of care and the safety it provides with three workers rather than one.

Loss of an affordable in-home non-medical care option would force many seniors and people with disabilities into institutional care, which is often paid for through Medicare, Medicaid or another government program. This puts an expensive burden on taxpayers.  At a time where the nation is taking a hard look at cutbacks in these programs, this is a cost Americans can ill-afford.

People who need private duty services who can no longer afford the professional, caring services offered through private duty companies will simply employ people through the underground economy. They put themselves at risk for substandard care, even elder abuse. Governments will lose tax revenue, while the caregivers will lose important employee protections.

PHI, a national advocacy organization for home care workers, estimates that personal care aides are projected to be the fourth fastest-growing occupation in the U.S. between 2008 and 2018, increasing by 46 percent.

Most home care providers are small business with limited resources.  Eliminating the companionship exemption would result in reduced availability of care to seniors and the disabled, and increase the costs of service delivery with no corresponding increase from third party payers, such as Medicaid.  Federal and state programs are already in jeopardy, and in no position to increase their payment rates to meet the added costs of overtime compensation.

NAHC warns that a comprehensive rather than a piecemeal approach to worker compensation and working conditions is necessary if access to high quality of care and continuity of services is to be achieved.

The Department of Labor is expected to make its decision by October 2011. Take a few minutes and contact your representatives in Washington. Let them know how these changes will negatively impact your family and your community.

Until next time, enjoy the ride in good health!

NEXT WEEK: Forget Reality TV, Hoarding Can Be Life-Threatening

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