TOPICS > Health > long-term care

Why home care workers struggle with low wages

March 16, 2015 at 6:35 PM EST
With most aging Americans wanting to stay in their own homes, the need for in-home caregivers is skyrocketing. But unlike most other jobs, there's no federal guarantee that these workers get minimum wage or overtime. Special correspondent Kathleen McCleery reports on the challenge of getting care that’s reasonably priced while still paying caretakers a living wage.
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GWEN IFILL: We now turn to another in our occasional series on long-term care.

As Americans age, most prefer to stay in their own homes and get help when needed with the basics of daily living. A nationwide campaign kicked off last week calling attention to the jobs and the wages of home care workers.

Special correspondent Kathleen McCleery reports.

OLA MAE JONES: Good morning.

THERESA KING: Good morning.

It’s a passion job, so it takes a lot of patience, a lot of kindness.

KATHLEEN MCCLEERY: In Long Beach, California, Theresa King cares for 88-year-old Ola Mae Jones, who suffers from Alzheimer’s disease.

THERESA KING: I’m cooking you some fish.

KATHLEEN MCCLEERY: From cooking, to cleaning, to comfort.

THERESA KING: Don’t you love me, huh?

KATHLEEN MCCLEERY: The job is physically demanding and emotionally draining. King makes $9.70 cents an hour, almost exactly the average for the nation’s two million home care workers.

THERESA KING (singing): I want to shout about it.

KATHLEEN MCCLEERY: About 90 percent are women. Half are people of color. Like King, many don’t work full-time and don’t get benefits. She qualifies for food stamps and says, on her income, she can’t afford some basic necessities.

THERESA KING: It’s not enough to have your own apartment. You know, it’s not enough to have your own transportation without a struggle. You don’t really get to live a good life on the income of a home care worker.

KATHLEEN MCCLEERY: King’s employer, Cambrian Homecare, charges between $18 and $22 an hour for its caregivers. Rhiannon Acree, the company’s founder and president, says her costs go far beyond the workers’ wages.

RHIANNON ACREE, Founder and President, Cambrian Homecare: Your workers’ comp alone will add you $3. So, then you have got your unemployment, and you have got your taxes to match, and you have got your liability insurances on top of that.

The other next big cost is the background check. Then you want to staff, get the coordinators to place the right caregiver at the right house, and you need to make some profit.

KATHLEEN MCCLEERY: With 10,000 baby boomers turning 65 every day, the need for caregivers like Louasa Grant-Morrow in Philadelphia is skyrocketing. Home care work is one of the nation’s fastest growing industries.

But, unlike most other jobs, there’s no federal guarantee these workers get minimum wage or overtime. That’s because the Fair Labor Standards Act, signed into law by President Franklin Roosevelt in 1938, exempted domestic service workers. The reason given?  They performed companionship jobs similar to baby-sitters.

In 2013, the Department of Labor issued new rules narrowing the companionship exemption and extending federal minimum wage and overtime protection to home care workers. But, before the rules took effect, a federal judge overturned them, saying only Congress can change the law. The Department of Labor appealed, and a decision is expected later this year.

Over the years, caregivers’ responsibilities have grown. Grant-Morrow keeps track of medications and helps 85-year-old Elsie Wise transfer from one wheelchair to another. She’s worked for Home Care Associates in Philadelphia for four years. That tenure is unusual for an industry where turnover rates are 50 percent each year.

HCA believes it can retain workers by offering them a better deal. Though Grant-Morrow’s pay is low, just $8.20 an hour, she’s guaranteed full-time work, and she gets a transit pass to use any time she needs transportation. That’s just part of the company’s benefits package, says HCA’s president, Karen Kulp.

KAREN KULP, President, Home Care Associates: They get paid time off, health insurance, dental insurance, a life insurance policy, a 401(k) plan, disability insurance, and the ability to become worker-owners.

KATHLEEN MCCLEERY: That’s right, ownership in the company and a chance to serve on the board of directors.

KAREN KULP: One share is $500. And the way we do it is that we loan you $465 of that $500, so you, from your first paycheck, we take out $35, and then you can pay that back over as many months as it takes to do that, paying $3 a week.

LOUASA GRANT-MORROW: I’m a part of the company. I have a part to the company.

KATHLEEN MCCLEERY: Grant-Morrow bought in, and her investment has paid off.

LOUASA GRANT-MORROW: And if we’re having a very excellent year, of many clientele and so on, a lot of us get nice — we get a nice prize as far as bonuses, gifts, and so on by the end of the year, so it pays off. It really does.

KATHLEEN MCCLEERY: So you have — you have gotten your $500 back?

LOUASA GRANT-MORROW: Oh, I have got my $500 back.

KATHLEEN MCCLEERY: In California, Theresa King would like benefits, but, right now, she’s focused on getting a hike in pay.

THERESA KING: We’re supporting everyone that’s wanting increased wages in America.

KATHLEEN MCCLEERY: She’s spoken at rallies, part of a national effort by a group called Fight for 15 backed by unions to boost wages to $15 an hour for a variety of workers.

THERESA KING: Fifteen an hour would change my life. You know, it would change my life. When you’re making more money, it takes away worry and stress, when you’re making more money. So, of course, releasing me of worry and stress would help me in a whole lot of ways.

KATHLEEN MCCLEERY: Labor unions argue that increasing wages by 50 percent would put billions of new dollars in the hands of workers and would ripple through the economy, creating thousands of jobs.

RHIANNON ACREE: Everybody would like caregivers to make more money.

KATHLEEN MCCLEERY: Rhiannon Acree says agencies like hers have to strike a balance between what families can pay and what caregivers need to make.

RHIANNON ACREE: And, like everything else, if you have to pay more to produce something, and in this, we produce a service, then somebody has to pay for it, and what happens when they can’t afford it?  I think that’s our worry, is, when clients can’t afford home care anymore, what happens?

KATHLEEN MCCLEERY: Karen Kulp in Philadelphia echoes that concern.

KAREN KULP: It would be great to be able to pay folks that. Again, it’s like, where is that going to come from?  Is it going to come from private payers?  You know, are people who employ somebody privately willing to pay that much?  Is it going to come from the government?  Is it going to come from Medicare or Medicaid?

KATHLEEN MCCLEERY: Bridging the gap between livable wages and reasonably priced care is the challenge facing policy-makers and families who need caregivers.

I’m Kathleen McCleery, reporting from Philadelphia for the PBS NewsHour.

JUDY WOODRUFF: And we have more reporting from our series, including options on how to pay for long-term care. That’s on our home page, PBS.org/NewsHour.

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