While some consider the U.S. Department of Labor’s (DOL) proposal to reinstate the companionship exemption a “win” for the home care industry; others have opposed it. Now, LeadingAge is joining the voices of those in opposition to the proposal.
“We understand that many in the industry support this proposal especially when it comes to overtime needs,” Linda Couch, senior vice president at LeadingAge, told Home Health Care News in an email. “But this is a short-term solution to a much more systemic problem with this workforce. We need to invest nationally in home care services for all populations, Medicare, Medicaid, private pay, making these careers livable and sustainable.”
On Friday, LeadingAge, the association of nonprofit providers of aging services, including home health, submitted comments urging the DOL to withdraw its proposed rule. The organization called the proposal “incongruent with and in fundamental opposition to our organizational vision for ‘an America that values older adults and those who serve them.’”
Proponents of reinstating the exemption, including the Home Care Association of America (HCAOA), said that it would benefit providers.
In their comments, LeadingAge explained that the home care sector’s challenges with recruitment and retention are the result of systemic demographic and policy issues, not the Fair Labor Standards Act (FLSA) requirements.
LeadingAge stated that the reinstatement of the companionship exemption would incorrectly exclude many home care workers from FLSA protections.
“We argue that under the original definition of companion services, by virtue of their federal and state training and certification requirements, home care workers now fall under the exclusion granted to trained professionals such as registered and practical nurses,” LeadingAge wrote. “Given the long-standing and ongoing professionalization of this workforce, third-party employers of these employees should not be granted the exemptions for these workers.”
The organization also said that finalizing the DOL’s proposal would limit access to home care.
“There is significant risk in the loss of overtime protections,” LeadingAge wrote. “Working longer work hours, and/or receiving lower pay for those hours, could negatively impact the retention of
home care workers and lead to increased employee turnover and difficulty attracting skilled workers to the sector. Particularly at a time when the home care sector and its workers and consumers are facing serious threats from Medicaid cuts, changing immigration policies, and lack of realistic long-term services and support (LTSS) options, removing basic labor protections from home care workers will only exacerbate the crisis.”
LeadingAge stressed that ensuring a living wage for home care workers is an unachievable goal as long as Medicaid remains the default long-term care funding option, as it continues to underpay providers.
“The financial situation Medicaid faces in the next decade is tenuous at best, catastrophic at worst,” the organization wrote. “There is no doubt that our country’s approach to financing long-term care is failing millions of families daily. And with the impending growth of older adults who will need comprehensive LTSS in the next decade, it is essential that the federal government support a comprehensive and equitable long-term care financing system.”
Looking ahead, LeadingAge wants to see more investments in the home care workforce, as well as meaningful immigration pathways.
“At this time we’re not sure what the administration will do, but we are hopeful they look more carefully at investments in this workforce through apprenticeships and supporting positive immigration policies,” Couch said.