Raising the minimum wage seems to be a trending economic push within city councils, state assemblies, and the federal government. Since the beginning of the year, the White House has been actively lobbying Congress to raise the minimum wage by proposing an hourly jump of $2.85, bringing the national minimum wage to $10.10 an hour. Protests, strikes, and lobbying efforts made by hard-working Americans, ranging from retail assistants to fast food employees, are finally starting to be noticed.
However, despite these recent efforts, the hourly federal minimum wage still stands at a meager $7.25. A group of unprotected workers commonly known as “home healthcare workers” or “in-home care workers” are actually making less, which is surprisingly permissible by federal law. Home healthcare workers assist with daily living activities including ambulation, facilitating medication regiments, bathing, and toileting.
Continuing to advocate for income equality, the Obama Administration vowed to bring home healthcare workers up to the current minimum wage at the start of 2015. However, this month, the Obama Administration said it would delay its new rule to pay home care workers their long overdue guaranteed federal minimum wage.
Home healthcare workers missed their chance to become a federally protected class of workers guaranteed a minimum wage when labor standards were first implemented after the Great Depression. President Roosevelt’s enactment of the “New Deal” included the Fair Labor Standards Act of 1938, which provided minimum wage standards for protected workers. Due to the “companionship exemption,” qualified in-home workers who provide care and protection for people whom are elderly or disabled are not required to be paid the minimum wage or overtime pay. The overtime exemption has been slowing economic growth in low-income communities, encouraging unnecessary institutional placements, and forcing home healthcare workers to take on additional jobs.
What is today’s issue with protecting a class of workers who primarily serve people with disabilities and the aging communities? One word: Cost.
With the Obama Administration’s delay, 2 million in-home healthcare workers are left without guaranteed pay at the federal minimum wage, with the average worker continuing to earn approximately $17,000 annually. More than 90 percent of home healthcare workers are women, who already earn 23 percent less than men on average, and a majority of these workers are people of color who earn even less than their white female counterparts.
Even though the most obvious immediate fix in regards to income equality for home healthcare workers is raising the minimum wage and providing protections, some disability rights advocates voice concerns about the proposed policy changes. Some disability rights advocates argue that health care workers may work less if wages are raised without government funding available to cover the additional costs. State Medicaid funding would need to be increased in order to cover the mandated pay raise and proposed overtime protections. However, the nation’s largest disability rights organization, the American Association of People with Disabilities (AAPD), says going forward with the new policy will increase the quality of home healthcare workers “by drawing on the workforce that currently only works in institutional settings.” This workforce is rapidly expanding and will likely want to secure the highest pay available. In fact, the Bureau of Labor Statistics projects that “personal care attendants represent the fastest growing field in the United States with an estimated 1.3 million new jobs being added before 2020.”
Understanding the rise of these workers, President Obama brought the importance of providing federal labor standards to home healthcare workers to the forefront through an official announcement in 2011. The Department of Labor gave states 15 months to implement the final rule issued on October 1, 2013. Some states have not yet budgeted for application of the new rule to the respective Medicaid programs.
Seth Harris, Cornell alumnus ‘83 and former acting U.S. Secretary of Labor, argues that both paying workers less than the minimum wage and having the quality of care diminish because of home care pay increases are equally unjust. Mr. Harris, currently a Cornell ILR School Distinguished Scholar, proposes the federal government does what is necessary to “provide the amount of money that is required to provide all the care that people with disabilities and seniors need.”
Disability organizations, including the Center for Disability Rights, stand with the White House in favor of suspending the upcoming rule, fearing that seniors and people with disabilities will not be able to afford the same amount or same type of quality home care. Meanwhile, other organizations, such as The Paraprofessional Healthcare Institute, have voiced the crucial need for granting home care workers new labor protections.
While the fight to raise the minimum wage continues in the United States, workers in one of the fastest growing fields are fighting just to get to a minimum wage and to secure the most basic labor rights. Not providing these protections perpetuates decades of disadvantageous working conditions for the most marginalized groups in the United States. A disproportionate number of women and people of color are left without a guaranteed minimum wage, which is already arguably not enough to live comfortably on, and most people requiring in-home care, people with disabilities and the elderly, may be left with less quality care and a lesser quantity of it.
Just printed out your article for a resident I am working with now on her palliative rotation. This fits nicely into a discussion we were having about the care the elderly and/or disabled can afford in their home. Many individuals can not afford home health aides even when they, the patient or family, would desperately like to stay at home. Apparently our country does not provide well for these patients or those who take care of them.