PHI, the Paraprofessional Healthcare Institute, has issued three new publications to dispute claims that the Department of Labor's proposal to narrow the companionship exemption--and require time and a half for overtime hours--is unaffordable.
Let's look at their side.
In Can Home Care Companies Manage Overtime Hours?, three agencies are profiled who have implemented similar staffing and scheduling practices to maintain continuity of care for clients while keeping overtime hours within a manageable budget.
In Home Care Jobs: The Straight Facts on Hours Worked it is suggested that even without incentives to manage overtime, the industry is not using excessive overtime hours. Less than 10 percent of home care aides report working overtime, according to their findings.
According to PHI, the home care industry is among the fastest-growing industries in the country. A third PHI fact sheet, Growing Labor Industry Can Afford Labor Protection shows that revenues for the industry have doubled from about $40 billion to $84 billion between 2001 and 2009. At the same time, home care workers have seen their wages stagnate. In 2010, the average hourly wage was $9.40 an hour, about equivalent in inflation-adjusted dollars to the $8/hour wage workers were making a decade before. As a result, nearly 50 percent of home care aides live in households that rely on some form of public assistance.
Ok, now the other side of the coin.
Criticism of the proposed regulations has focused primarily on the increased costs of companionship services, both to consumers and to taxpayers. There has been little discussion regarding the impact - both regulatory and practical - of the proposed regulations on the operations and record-keeping practices of agencies providing third-party companionship services. The proposed regulations would require providers to "make, keep and preserve a record showing the exact hours worked" by each employee. Until now, employers have been permitted to simply keep an agreement as the basis for establishing hours worked in lieu of maintaining time-records.
Live-in companions typically work unsupervised in their clients' homes for periods up to and sometimes exceeding twenty-four hours. All of this time, however, is not compensable. In most states, companions are not entitled to compensation for meal times and/or time spent sleeping during the shift. The employer, either an individual or agency, under the proposed regulations, will have the burden of keeping adequate records of these non-compensable periods and, in many states, the precise "clock-in" and "clock-out" times for each such break. Employers will have little ability to monitor or audit the time submitted for meal and sleep periods. Moreover, the failure to properly record times of these periods will not only constitute a violation of the recordkeeping requirements of the regulations, but will also be construed against the employer in any DOL investigation, litigation or quasi-judicial hearing.
It is easy to say that we need to meet in the middle. But it is true. I believe that consistent assignment benefits the patient with a better experience and gives the health care worker piece of mind of having consistent work. And while that can happen in part time situations, full time work in the industry would probably go a long way in improving experiences. That would probably reduce overtime costs but increase benefit costs.
But to achieve that, the industry does need to become more efficient. And to achieve that usually involves automation and that in turn involves modern technology to track staffing, care and quality. No matter how you slice it in home care, those who make investments in their workforce and their operations will stand out. Because the marketplace will become more crowded with competition and making these improvements will actually become good marketing and sales strategy too.
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@Tristan Paviot, Getty Images
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