Home-care workers' bid for higher pay faces uphill battle

Home-care workers nationwide took to the streets last week to join fast-food employees in calling for a $15-an-hour minimum wage. But analysts say that kind of pay hike may be unrealistic for home health providers, many of whom have been squeezed in recent years by state Medicaid pay cuts.

Low-wage workers in as many as 150 U.S. cities protested to demand higher pay and broader workers' rights. On Chicago's South Side, about 50 home-care workers were part of a crowd of more than 200 lining the sidewalks in front of a McDonald's restaurant holding picket signs that read “Fight for 15.”

As a personal care aide for an adult with Down's syndrome, Evangela Bryant, 50, works 40 hours a week at an hourly wage of $8.75. With a child in college and another in high school, she said money is always tight, making it difficult to pay monthly bills. “I'm struggling now,” said Bryant, who participated in the protest. “I wouldn't struggle with $15 an hour.”

But Toby Wann, founder of the Obsidian Research Group, said most home-care companies “are already kind of barely surviving as it is. You're squeezing (providers) on the revenue side and now you're going to potentially increase their costs from a labor standpoint. It would force more smaller mom-and-pop shops out of business.”

If home-care providers are forced to pay higher wages, they likely will have to ask the states to boost Medicaid hourly rates, said Kevin Ellich, senior research analyst with asset management firm Piper Jaffray. Elderly patients who don't have Medicaid coverage for home care might not be able to afford those higher rates, he added.

But Peter Lazes, director of the Healthcare Transformation Project at Cornell University, argued that higher wages would lower staff turnover rates, which would reduce training costs for home-care agencies.

The median hourly wage for home health aides, whose duties include treating wounds, managing medications, bathing and dressing elderly and disabled patients, was $10.10 in 2013, according to the U.S. Bureau of Labor Statistics. Personal care aides had a median hourly wage of $9.67. There were about 1.2 million personal care aides in 2012, a number that is expected to grow 49% by 2022, according to the agency.

One in four home health workers has household income below the federal poverty line, and more than 1 in 3 do not have health insurance, according to the Paraprofessional Healthcare Institute, an advocacy group for health workers who care for disabled people.

The Service Employees International Union's decision to encourage its members who are home health workers to join in the wage fight follows a June U.S. Supreme Court ruling that home-care workers who receive state funding for their services, but are employed by a private client, cannot be forced to pay member fees if they refuse to join a union.

Liliana Cordero, a non-union home health aide in Chicago who makes $9.75 an hour, said she works for two home-care agencies to make ends meet. She said many aides struggle to afford gas and upkeep for their cars, which they often use to transport patients. “I love what I do,” she said. “I don't want to go somewhere else because they pay more, considering that my passion is taking care of the elderly.”

Adam Rubenfire is a freelance writer based in Detroit.

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