NY Times Editorial: Home Care Workers are More than Companions

A New York Times editorial delves into the issue of home care workers and the contested companionship exemptions that stand to impact two thirds of the nation’s 2.5 million home care workers. Home care workers are more than simply companions, the editorial argues. 

The exemption is currently awaiting a final labor department rule. The New York Times writes

“…The existing exemption mainly serves home-care franchises, an $84 billion industry that is one of the most profitable in the United States. Congressional Republicans and industry representatives like the National Association for Home Care and Hospice invoke the debates of the 1970s to defend a rule that allows the industry to squeeze additional hours of unpaid labor from “companions.”

They offer a false history of “companionship.” From the 1930s until the 1970s, no such job as “companion” existed, though there were community volunteers who would check in with a “shut-in” or other homebound individual. New Dealers named the job “visiting housekeeper,” financing a work relief program that sent unemployed domestic servants into the homes of chronically ill or elderly adults. After World War II, family welfare agencies renamed the position “homemaker”; hospitals defined it as health aide. Aiming to develop “manpower” for the booming service sector, President Johnson’s War on Poverty trained home aides. Once Medicaid funds became available after 1965, states embraced the term “home attendant.”

The title may have changed, but the work has remained the same: a combination of basic bodily care and housekeeping. That care workers substituted for the unpaid labor of wives and mothers further confused their status. So did the home location. As one 64-year-old worker told Congress in 2007, “I would get time and a half pay for my overtime hours for performing the same tasks for Mrs. G. if she were in a nursing home facility. But because my work helps her to stay in her home, I am deprived of overtime pay.”

The “elder companion exemption” has allowed staffing agencies to avoid paying overtime. It treated women who labored to support their families as if they were teenagers picking up some spending money. Conveniently, this exemption came just as home care became a growth industry, aided by changes to Medicare, Medicaid and other government programs. Beginning with the Omnibus Budget Reconciliation Act of 1981, these programs funneled more public money to for-profit firms, generating a vast home health industry — with a tenfold increase in for-profit agencies during the first half of the 1980s alone. By the 1990s, home care was the fourth largest occupation….”

Read the original article at NYTimes.com

Written by Elizabeth Ecker

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Elizabeth Ecker
Director of Content at Home Health Care News
Curious about all things, when not writing about senior housing topics, Liz is an avid explorer of food. She loves trying new recipes, new restaurants and new ice cream flavors. (Current favorite: Goat cheese with red cherries.)



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