By Ledge King, Fort Myers News-Press
Florida’s home health care industry is warning an Obama administration proposal that mandates minimum wage and overtime pay for thousands of its workers will drive up costs and ultimately harm home-bound patients.
Workers’ advocates counter a fairer pay scale would mean less turnover and better care.
The issue is critical to one of the nation’s fastest-growing industries. Almost 12,000 firms nationwide — including about 2,100 in Florida — employ about 2 million home health care workers who help an aging population stay in their homes by providing care such as cooking, bathing, cleaning and companionship.
Such around-the-clock care can be expensive, which is why Congress in 1974 continued to exempt home health care employees from federal minimum wage and overtime laws, even as it guaranteed that benefit for other domestic workers.
President Barack Obama said the growth and transformation of the multibillion-dollar industry over the last four decades means workplace rules must change as well.
“They’re still lumped in the same category as teenage baby sitters when it comes to how much they make,” the president said in December when he announced the proposed rule. “That’s just wrong.”
The administration is taking public comments on the proposal through today before issuing a final rule. A congressional panel held hearings Tuesday to examine the proposed change. A Republican bill in the House would block the proposal.
Fifteen states mandate minimum wage and overtime pay for home health care workers. Another six, plus the District of Columbia, require only minimum wage. Florida is one of 29 states that essentially let companies decide what to pay these workers performing non-skilled jobs.
The trade group that represents scores of Florida’s home care providers says workers are treated fairly.
The industry pays workers $9.79 an hour on average in Florida, more than the $7.25-an-hour minimum wage, said Kyle Simon, government affairs director for the Home Care Association of Florida.
The industry’s concern is the overtime rule, which Simon said would force providers to compensate workers, such as live-ins, whether they’re actively working or sleeping.
“When they’re actually working, they’re getting paid a minimum of $9.79 per hour,” Simon said. “But whenever you stretch it out over the 24-hour period that they’re in someone’s home, that’s when it looks like they’re getting paid less.”
Trisha McPherson, owner of Accessible Home Health Care of Naples, said some of her caregivers work as many as 60 hours a week. She said if the administration’s rule becomes final, she will have to reduce their hours to cut costs.
“A lot of the elderly struggle to be able to afford the care in the first place,” she said. “There’s a great need for caregivers in our community, especially in South Florida, … and I think this law is going to have a tremendous impact.”
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On any given day, about 150,000 Floridians receive subsidized home health care, usually funded by Medicaid through the state, according to Simon.
AARP, with 2.6 million members in Florida, supports the proposed rule.
Advocates for workers say the industry can afford to pay workers wages they deserve.
Many of the more than 420 new home health care agencies that started operating in 2011 are for-profit and concentrated in a handful of states, including Florida, according to the Medicare Payment Advisory Commission, the independent board that oversees Medicaid.
The industry’s average profit margin was so high — 19.4 percent in 2010 — MedPAC is recommending Congress reduce reimbursement rates to home health care companies.
Advocates for home health care workers say the industry distorts the often arduous tasks employees face when they care for someone struggling with dementia or physical limitations.
Joan Leah, a home health aide from Davenport near Orlando, said the work is often nonstop.
“You’re not some simple companion,” said Leah, president of the Florida Professional Association of Care Givers. “You’re pretty much everything to them when you walk in the door. You are helping people go to the toilet. You’re bending. You’re lifting. You’re driving them. They count on you to make sure all of their medications are there and that they understand what they’re taking.”
