8 surprising facts about domestic workers and in-home care

MIAMI - FEBRUARY 25: Robert Granville reaches for a medicine bottle as he takes his prescription pills on February 25, 2009 in Miami, Florida. Because of budget constraints and a high level of need, Robert is on a one-year waiting list for home care, which many elderly advocates fear may be even longer if funding is cut for these programs due to the economic meltdown.

 (Updated July 1, 2014 in light of a Supreme Court ruling on the topic)

 This week the Supreme Court ruled that home-care aides who tend to a sick or disabled person and are paid by the state through Medicaid cannot be compelled to pay union fees like other public employees who work directly for the government. Pamela Harris, one of the plaintiffs, an Illinois mother who cared for her disabled son, praised the victory.  "Families in Illinois can relax knowing their homes are safe from being a union workplace and there will be no third party intruding into the care we provide our disabled sons and daughters," she said.

Unions and other critics of the ruling warned it will ultimately hurt work-place standards for home-care aides, allowing "free-riders" who benefit from higher wages and other protections brought by collective bargaining to avoid paying for the unions that represent them. "The court's decision will not only make it significantly harder for these dedicated employees to get a fair shake in exchange for their hard work, but will make it harder for states and cities to ensure the elderly and Americans with disabilities get the care they need and deserve," the White House said.

In light of the ruling, here's a list of 8 things you may not know about home-care workers. 

1. Home health aides and personal care aides are the two fastest growing jobs in the United States.  The number of these jobs is expected to grow 70 percent between 2010 and 2020, according to forecasts from the Department of Labor.  The growth has a lot to do with aging Baby Boomers who will need more care-giving in coming years and don’t want to move into nursing homes.  As the New York Times reports, “six million of the 40 million Americans older than 65 need some form of daily assistance to live outside a nursing home. Federal officials estimate that the number will double to 12 million by 2030.”

2.  The median rate a home-care agency charges a family for a licensed home health aide is $19 an hour.  The median rate charged for a licensed personal care aide is $18 an hour.

3.  The median wage for home health and personal care aides was $9.70 an hour, and $20,170 a year in 2010, according to the Bureau of Labor Statistics.  About 20 states exempt home care workers from their wage and hour laws.  A national survey of domestic workers in 2012 found that 23 percent were paid below the state minimum wage. Seventy percent were paid less than $13 an hour. 

4. Nearly 40% of home care workers rely on public benefits such as Medicaid and food stamps, according to former Secretary of Labor Hilda Solis. In a national survey of domestic workers (including home care workers) 20 percent report there were times in the previous month when there was no food to eat in their homes because there was no money to buy any. 

5.  Until September 2013, if you worked as a home health aide or personal care aide, you were not covered by federal minimum wage and overtime laws.*  That’s because your job, which commonly includes things like changing bed-pans, bathing and preparing meals for an elderly or disabled person, had been classified in the same category as casual baby-sitting, and was thus exempt from the Fair Labor Standards Act.  Last week, the Obama administration announced new rules that will, in most cases, reclassify home care work, and extend minimum wage laws and overtime coverage to those aiding elderly and disabled people in their homes. *The new rules go in to effect in 2015. 

6.  Minimum wage and overtime laws still won’t apply to you if you’re hired directly by a household, and provide mostly "fellowship and protection" to an elderly or disabled patient. The rules the Obama administration set in 2013 will apply to all home care aides hired through outside agencies.  Most aides fall in to that category.  But, if you are hired directly by a household, the rules will only apply if you provide mostly "care" as opposed to mostly "fellowship and protection."  Meaning, you’ll  get overtime and minimum wage protection if you spend most of your time doing things like dressing, grooming, feeding and “toileting” a patient or assisting them with taking medications, preparing meals, and light housework.  If most of your work for the patient involves things like playing cards with them, reading to them, and taking them out on walks, you won’t be covered under minimum wage or overtime laws. 

7. Until 1974, federal minimum wage laws excluded an even wider range of domestic workers employed directly by a household—including housekeepers, cooks or gardeners. In 1974, Congress extended those laws to cover many domestic service workers, but certain kinds of work within that category were left out, including home care workers who tended to the elderly or disabled.  

8. Domestic workers weren’t eligible for Social Security benefits until the 1950s, even though Congress passed the Social Security Act in 1935.  In 1950, the law was extended to cover domestic workers regularly employed by a single employer.  In 1954, domestic workers with jobs at multiple employers were also included.  Farm work took a similar path. 

About the author

Krissy Clark is the senior reporter for Marketplace’s Wealth & Poverty Desk.

Comments

I agree to American Public Media's Terms and Conditions.
With Generous Support From...