The Department of Labor is considering expanding the Fair Labor Standards Act (FLSA) to cover the estimated 2.5 million home health aids working in the US. As its name implies, the FLSA mandates minimum wage and overtime pay for employees.
Home health aids assist elderly, ill and disabled persons with shopping, cooking, housecleaning and laundry to help them stay as independent as possible in their own homes—and out of expensive and oftentimes dehumanizing long term care institutions.
Currently, home health aids are considered companionship services, like babysitters, and as such are excluded from FLSA protections. These exclusions benefit for-profit home health and hospice agencies, an $84 billion industry—and growing, thanks to our aging (and dying) population. Republican US Senator Johanns (Nebraska) is sponsoring a bill in Congress to permanently block home health aids from FLSA protection. He is also backing repeal of the Affordable Care Act.
Home health aids are dear to me. I got my start in nursing as a home health aid in the North End of Boston, tending to several elderly first generation Italian immigrants. I was jumping out of the Ivory Tower of Harvard University at the time, on my way to becoming a Harvard dropout. One of my professors of health policy recommended I work for a home health agency to gain first hand knowledge of health care needs in the community. It was hard work and didn’t pay enough to keep me working in it for long. But it was rewarding and the experience convinced me to apply to nursing school.
Home health aids are a part of my life today. My 89-year-old father with advanced congestive heart failure is able to live at home with the help of home health aids. They are skilled, dedicated, and caring workers and not some glorified passive ‘companions’—and they deserve fair labor standards.