Lawmakers in one state have introduced a bill that would eliminate 24-hour workdays in home care. If it passes, the legislation could mean significant financial strain for home care agencies there.
It’s happening in New York — a state that frequently serves as a starting point for legal trends that then sweep the rest of the county.
The new bill would require providers in the state to break 24-hour care shifts in half or into smaller units — effectively making the state’s 13-hour care rule obsolete.
The rule, which was recently the focus of a contentious lawsuit, says that a caregiver on a 24-hour shift only has to be paid for 13 hours of work. The catch is that the rule only applies if the employee is given breaks of three hours total for meals and eight hours for sleep, five of which must be uninterrupted.
Throughout the past several years, a slew of home-based care workers have sued over that rule, arguing that they should be entitled to 24 hours of pay while working a 24-hour shift. The lawsuits came to a head in March, when the New York Court of Appeals upheld the state’s 13-hour rule after a months-long back and forth.
But caregivers may still have a case: Many 24-hour care workers say they’re forced to work through their state-mandated breaks. Thus, this new bill was born, going around the 13-hour rule rather than directly at it.
Brooklyn State Senator Roxanne Persaud and Manhattan Assemblyman Harvey Epstein announced the legislation last week in an effort to improve working conditions for home-based care employees. The bill says the goal is to help alleviate caregiver fatigue and improve patient care by introducing shorter shifts.
In addition to requiring home care agencies to split 24-hour workdays into shifts of no more than 12 hours, the legislation would ban employers from punishing workers for refusing to work overtime. As such, caregivers could take civil action against employers who deny them that right.
If the bill is successful, it could have the same effect on home care agencies that the elimination of the 13-hour rule would have: a 24-hour care shift would cost them nearly twice as much as it currently does in terms of wages to workers.
While supporters consider the bill a win for overworked home care employees and their clients, opponents have pointed out the legislation’s flaws.
For example, the Home Care Association of New York State (HCA-NYS) argues that funding could be an issue, as the majority of workers in question are paid by state Medicaid or federal Medicare funds. The bill does not outline a plan to finance resultant increased fixed costs, such as wages, supervision and training.
“While noble in its intent, this legislation would impose a new multi-billion-dollar cost impact on the home care system without reimbursement to cover home care providers’ expenses caused by the bill’s expansion in the number of shifts and compensable hours,” HCA-NYS spokesman Roger Noyes told Home Health Care News in an email.
On top of that, the increased costs would come during a time with the New York state Medicaid program is already implementing cuts to home care programs, such as the Consumer-Directed Personal Assistance Program (CDPAP).