Home health agencies and state health officials have repeatedly called for a delay. Prior to the release of the rule last year, federal law had allowed an exemption from minimum wage and overtime compensation for work that is classified as “companionship services.” It also exempts “live-in domestic services” from overtime compensation.
Home health agencies and state health officials argue the change will result in staff shortages and an increase in people being relegated to nursing homes rather than remaining in home care.
For example, in Kansas Medicaid beneficiaries are given two choices when they need personal attendant services. They can either have the state's Medicaid agency oversee the process of hiring an individual or the individual can “self-direct” their care and hire their own provider. The state argues the rule will have a dire impact on these individuals, versus those who are allowing the state to oversee this part of their care.
“Implementation of the new DOL rule, in its current form, could force many Kansas Medicaid waiver program participants into institutional settings, which are both more restrictive and more costly,” Kari Bruffett, secretary of the Kansas Department for Aging and Disability (PDF), said in a letter sent earlier this summer.
The National Association for Home Care & Hospice has similar concerns. Home care companies will likely employ workers part-time rather than full-time to avoid the new requirements and because consumers with limited incomes cannot afford higher costs, the association argues.
It has launched legal action against the Labor Department for attempting to alter the exemptions for "companionship services" and “live-in domestic services.”
“Like many things that emanate from Washington, the repeal of the companionship exemption is not what it seems. While ostensibly intended to help hardworking caregivers, it will have the very opposite effect,” Andrea Devoti, chairwoman of the trade group, said in a statement.
Organized labor, however, wanted the new requirements to go into effect as planned and worried about recent reports, now proven true, that the department was considering a delay.
“Two million workers will continue to be shut out of the most basic federal wage protections, which nearly every other worker in the nation is able to take for granted,” the advocates said in a letter (PDF). “Workers in 29 states will continue to have no minimum wage or overtime rights at all and workers in five states will miss out on a scheduled state minimum wage increase.”
Follow Virgil Dickson on Twitter: @MHvdickson
