Tuesday, July 21, 2009

A Fair Wage for Caregivers

The New York Times recently ran an editorial advocating that home care workers be paid in accordance to federal labor laws that cover other employees, including paying at least minimum wage and overtime.

Currently in several states home care workers can be covered under a “companion” exemption and paid less than minimum wage, with no overtime requirements.

One the one hand, I completely support this change. I believe that ALL caregivers should be paid a fair wage. Far too many caregivers, in a variety of care settings, are paid so poorly that they are eligible for food stamps, Medicaid and other benefits that we all end of paying for. In addition, poor pay is a leading cause of turnover and the inability to attract the best and brightest individuals into this field. That hurts all of us.

Let me play devil’s advocate for just a moment, however. Let’s say that my mom needs someone at her home 24 hours a day. She needs assistance to the toilet, and someone available if she should fall during the night hours as well as during the day.

During the daytime while she’s awake, my mom needs a considerable amount of assistance – bathing, dressing, meal preparation and laundry, for example (in this hypothetical situation). At night, she sleeps soundly with rare exceptions, at least 8 hours each night.

With a minimum wage requirement, I’d be forced to pay at least $7.25 per hour for the nighttime person, even if they slept through almost all nights. With the companion provision, I’d might be able to pay a flat rate for nighttime that would allow me to keep my mother at home longer. I’d also be able to have a caregiver, conceivably, work evenings helping my mom get ready for bed, then sleep through the night. The caregiver might be “working” 10 – 12 hours, but actually sleeping 6-7 hours of that time. The change in the law would require overtime pay at a minimum of $10.88 per hour for those extra 2-4 hours each evening.

In the end, the round-the-clock care would cost me at least $175 per day, not including the time I need to cover meals and breaks. That’s over $5,000 per month. According to Genworth Financial, the average monthly rate of assisted living is $3,008 (2008); clearly, that would be the more financially feasible solution.

It’s a challenging dilemma for all of us to consider. I think it’s possible that business interests may well create their own solution. Agencies employing home care workers that treat those workers fairly and pay them well will retain their workers. Their reputation will grow and they’ll experience success.

Conversely, those agencies that choose to cut corners on pay and benefits will see the results in high turnover, resulting in poor services and an even poorer reputation.

Today, home care agencies are expanding at an exponential rate. Communities – and families – typically have more than one choice. If we do our own due diligence as consumers and check out the reputation and turnover rate of an agency before we sign up for services, we may be able to directly affect this process and support those that treat their workers well and fairly.

For those who have no choice – typically those receiving publicly funded services - we may well need to change the law to support those who provide the most basic care for our loved ones in their homes.