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Home Health Aides Seek Labor Protections
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Home Health Aides Seek Labor Protections

Law

Home Health Aides Seek Labor Protections

Home Health Aides Seek Labor Protections
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Home health aides are currently not covered by Labor Department regulations on minimum wage and overtime pay. Employers and states argue that an increase in pay would cripple the industry and greatly affect Medicare and Medicaid costs. The issue has worked its way up to the Supreme Court.

JACKI LYDEN, host:

This is ALL THINGS CONSIDERED from NPR News. I'm Jacki Lyden.

Tomorrow, the Supreme Court will hear arguments in a case that could have far-reaching effects on the pay and working hours of home health aides. These are the workers - most of them low-income women - who help keep the elderly out of nursing homes.

Ms. JOYCE LANE(ph) (Home Health Aide): My name is Joyce Lane(ph). We are the eyes and the ears and whatever else for the patient. Sometimes, it's difficult to get them into the tub, it's difficult to get them out, get them dressed. So - but I try my best.

LYDEN: The U.S. Department of Labor considers these women elderly companions, a category along with babysitters that is excluded from minimum wage and overtime requirements. The Court of Appeals in New York ruled that home health aides should receive minimum wage and overtime pay, and now the question is before the Supreme Court. Nancy Solomon explains.

NANCY SOLOMON: More than two million people work in the homes of the sick and elderly. Joyce Lane, for one, lives in a small, tidy house in Queens, New York. She's in her late 50s. Her children are grown, and she's been a home health aide since moving here from Guyana in 1990.

Seven days a week, she leaves for work just after 6 a.m., takes three buses to get to her patient's house, works for 10 hours, and arrives back home after 7:30 in the evening.

Ms. LANE: As for overtime, hmm - Saturday and Sunday, we don't get nothing -the same pay we get holidays, the same pay we get. So we don't have nothing more, just the same, you know, flat rate. It's $7.25 an hour.

SOLOMON: Overtime pay is the provision most likely to change if home health aides win their case. The federal minimum wage of $5.15 an hour lags behind the market, and home health aides tend to make anywhere from $7 to $10 an hour.

In 1938, when Congress enacted the original minimum wage and overtime laws, they excluded domestic workers. At that time, 60 percent of all African-American women were domestics. University of Iowa law professor Peggie Smith says gender and race were underlying themes of the congressional debate.

Professor PEGGIE SMITH (Law, University of Iowa): And you see over and over again these references to the fact that women of color, black women in particular, did not require as much in order to live, the notion that their families simply didn't need the same level of pay as did, for example, white families in order to make a daily living.

SOLOMON: Some domestic workers eventually gained coverage in 1974. But Congress created an exception for babysitters and elderly companions. Even as home health care for the elderly became professionalized, those women continued to be categorized as companions, not eligible for minimum wage or overtime.

Ms. JUDITH ZANGWILL (Executive Director, Sunnyside Community Services, Queens, New York): They are deserving. They're very hardworking and they're very valuable. It's just the - not having the resources in order to do it.

SOLOMON: Judith Zangwill is the executive director of Sunnyside Community Services in Queens, a nonprofit that contracts that the city Medicaid program to provide home health care. There's no money in that budget for overtime pay, so in response to the recent appellate court ruling, she began limiting her workers to 40 hours a week. But that just sent the home aides to other agencies to take on a second job to add more hours. And the agency has been flooded with complaints from the families of the elderly who are upset that three or four aides split a 24-hour day instead of two and that that can be confusing and upsetting for the patients.

Disconnection between patient care and working conditions is the focus of Paraprofessional Health Institute, a group trying to improve home care for both the patient and the workers. Its president, Steve Dawson, says the country is facing a care gap. There is already a shortage of home health aides, and baby boomers aren't getting any younger.

Mr. STEVE DAWSON (President, Paraprofessional Health Institute): It's essential that if people expect when they need long-term care to be able to pick up the phone and find a worker that they, as consumers and the state's best(ph) payers, have to invest in this workforce so that it will show up.

SOLOMON: And that means better pay and working conditions, Dawson says. The kind of planning needed to figure out how to pay for the country's growing home care needs just isn't being done, he says. And fighting over paying home health aides overtime isn't going to help. For NPR News, I'm Nancy Solomon in New York.

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