Palm Beach Post

Commentary: Wage change dangerous to senior home health care

By Joseph Bensmihen

Updated: 7:47 p.m. Wednesday, Jan. 11, 2012/Posted: 7:20 p.m. Wednesday, Jan. 11, 2012

Millions of seniors enjoyed the holidays in large part due to the affordability of trusted, licensed home health caregivers who provide daily critical assistance, be it medication reminders, dressing, bathing or cooking.

But as early as March, barring a reversal of an executive order from President Obama, the quality of life enjoyed by many seniors could suffer. Under the president’s Dec. 15 directive to the Department of Labor, home health aides, exempt from federal wage laws since 1974, will have to be paid an hourly wage and overtime (time and a half) for service over 40 hours a week.

Don’t expect insurance policies to extend for this added cost. Home care long-term insurance generally pays a “capitated,” or fixed, amount per day or per week. If the consumer pays out of pocket for all home care now, the one-two punch could be staggering, given diminished returns seniors are getting from such investments as CDs because of low interest rates.

Imagine paying a licensed, trained and background-checked home health worker who now costs $17 an hour $25.50 an hour for 30 hours of overtime. Weekly, that added expense would be $247.50. The annual increase could be almost $13,000 a year.

The options are not pretty:

Individuals may give up their independent lifestyle and shift to institutions that until now were more costly.

Children paying for, or monitoring parents’ expenses might start hiring caregivers independently, skipping over companies that screen employees.

To get around overtime, individuals or their children or grandchildren may create a revolving door of caregivers, an administrative headache that won’t make the client particularly happy, either. “Don’t send me anybody else” is a familiar directive to home health care providers such as myself.

Whether a relationship exists between the caregiver and senior can determine if the senior is comfortable enough to go on an errand or an activity with an aide or stay home, shrinking their world and opportunities for happiness. While seniors are most likely to suffer from a change in the wage laws, physically disabled individuals, perhaps someone injured in sports or an automobile accident, could feel the effects as well. A quadriplegic does not choose whether or not to purchase home care.

Caregivers, on the other hand, do have a choice. If they want to be eligible for overtime they can work in a nursing home, hospital or physical rehabilitation facility. The Fair Labor Standards Act “companion exemption” from 1974 does not apply there.

Yes, individuals who provide this important work for our growing senior population should be fairly compensated. They almost always make in excess of the new $7.67 an hour federal minimum wage. In Florida, caregivers generally earn approximately $10 to $11 an hour, and, depending on their credentials, often make more than double the minimum wage.

So the question becomes, where is the line drawn between government establishing a “living wage” and creating a hardship on the consumer? The Obama administration proposal, particularly when it comes to the overtime provision, can hardly be called “balanced.”

In the category of unintended consequences, the proposal may hurt the worker. Caregivers might have to move multiple times weekly, to accommodate families unwilling or unable to pay overtime. The difficulty of synchronizing multiple client schedules could actually reduce a caregiver’s hours.

The Department of Labor has opened a 60-day public comment period ending Feb. 27 before acting on the president’s initiative. I have written to our 300 homebound clients, urging them to call Congress and the president, to voice opposition based on the anticipated negative impact.

Joseph Bensmihen is owner of Boca Home Care Services in Boca Raton, a state-certified “nurse registry.” He is president of the Private Care Association, whose members are responsible for creating and improving national standards in home care for seniors.