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Valued Social Butterfly
Posts: 1,693
Registered: ‎06-25-2013

Re: Costly Change To pay this Minimum Wage & Overtime Protection

Message 21 of 53 (885 Views)

Again,  you are using a broad brush to paint.  It may be true where you live.  But not everywhere

 

"For Medicare or Medicaid to pay, the agency, many times a "non-profit agency, has to be cerified with Medicare."

 

You forget that although Medicaid is a federal program,  each state is allowed to set different rules.

In our county,  every elderly or disabled person who is Medicaid-approved and eligible for a home health aide (They are NOT certified CNA's) gets one from the group of contractual workers that the local social services office hires.  They do not get them thru an agency (yet,  the state may go to that eventually) But for now DSS contracts with them directly.  Altho they are getting better than average wages for our area,  most of them leave a lot to be desired.  Neglect and failure to follow instructions all the way up to petty theft  ( or "mysterious disappearance"  LOL)  They go thru a cursory,  local police check.  Fingerprinting,  yes.  But don't you know that is not to check nationwide to see if they have a record elsewhere?  Nah.   Those fingerprints are useful After a crime has been committed.  The public  here really gets fooled on that one. 

So please emphasize that what you post is only applicable to your area,  not necessarily the U.S. as a whole.   

Thanks.

Valued Social Butterfly
Posts: 17,923
Registered: ‎11-09-2011

Re: Costly Change To pay this Minimum Wage & Overtime Protection

Message 22 of 53 (884 Views)

rk3 - Now is definately the time to look into home care services - when you really need it, it's sorta like when you really need the ER - no time to price compare.

On a lighter side, cruise ships cost $500-600 a week, making them a real deal comapred to home care, so if you and your spouse are still ambulatory when the time comes, you might consider the

 

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Valued Social Butterfly
Posts: 7,323
Registered: ‎08-18-2008

Re: Costly Change To pay this Minimum Wage & Overtime Protection

Message 23 of 53 (885 Views)

Olderscout66 wrote:

The idea that those who care for our parents and grandparents deserve lower pay than those who cut our hair or clean our streets is typically Republican. Just another small group that they decided could be enslaved without many people noticing. So now emancipation comes, and the RW react like the plantation owners did 150 years ago. Why is it only ONE political party that always opposes acts that benefit those in the 99%?

 


1.  The origins to the law that classified these workers as a type of babysitter originated in 1974.

"In 1974, Congress extended the minimum wage and overtime protections of the Fair LaborStandard Act to almost all domestic service workers. At the same time, it created limited exemptions from the law for casual babysitters and companions for the aged or infirm. But Labor Department regulations issued the following year defined “companionship” overly broadly, so that home care workers were included in the companionship exemption. The impact of this overly broad exemption grew as the home care industry, barely in existence four decades ago, ballooned into a major component of our nation’s healthcare system."

 

http://www.nelp.org/page/-/Justice/2013/NELP-Fact-Sheet-Companionship-Rules-Reform.pdf

 

Medicare and/or Medicaid could have changed this decades ago when these sort of workers became so important to the health care industry.  But like drawpoker said,  Medicare and Medicaid go through agencies (nonprofit and for profit) to pay for these workers.

 

I do not think this was a result of any partisanship - I just think this part of the law wasn't change when home care started to explode.

 

BTW, the classication of "companionship" did not change. 

http://www.dol.gov/whd/regs/compliance/whdfs25.htm

 

Per the above link:  "Employees providing "companionship services" as defined by the FLSA need not be paid the minimum wage or overtime."

Valued Social Butterfly
Posts: 7,323
Registered: ‎08-18-2008

Re: Costly Change To pay this Minimum Wage & Overtime Protection

Message 24 of 53 (723 Views)

For Medicare or Medicaid to pay, the agency, many times a "non-profit agency, has to be cerified with Medicare.

Medicare and Home Health Care Handbook

http://www.medicare.gov/Publications/Pubs/pdf/10969.pdf

 

Same thing for Hospice care.

 

Medicare even has a listing with data of many of them on the website.

Medicare Home Health Compare: 

http://www.medicare.gov/homehealthcompare/About/What-Is-HHC.html

 

Those of us who employ independent home care workers (self-pay) get references and do all the checking and verifying.  In my state part of getting their license is a thorough background check with fingerprints.  I also used a service to do an additional check when they were first employed many years ago.

 

The smart ones will develop their own agency and work together in their case load.  They are independent contractors. employed by their own firm in tax structure.  They set their pay, they pay their own taxes, including employment taxes, they have their own liability coverage, bonding coverage and workmans comp under their business tax structure.

 

The very subject of this thread, in the initial post by me, addresses the pay issue for those working outside of an employer/employee relationship. 

 

However, the other problem is that people try to hire those who will work for near nothing - I think every person can be an expert in whatever they do and if the service is needed and they are good / great at what they do, they can earn a very nice living.

 

One of my elderly aunts' that just passed away wanted to be at home rather than in a nursing home.  We did a reverse mortgage on her home and she was at home, cared for in every way, until the end - all of this was for 24/7 care; upwards of $ 12,000 per month..  Those CNA's ( a mother and daughter team effort) became like members of our family.  When my aunt died, we gave the daughter CNA my aunts car since she had been the one driving it for many months. 

 

The home that my aunt lived in for many years helped her in the end to be where she wanted to be during her last months of life.  I just wished she could have stayed around to use up all of its value but sometimes dying is best when the body does not function anymore - quality over quantity.

Valued Social Butterfly
Posts: 19,052
Registered: ‎03-04-2009

Re: Costly Change To pay this Minimum Wage & Overtime Protection

Message 25 of 53 (723 Views)
We live in a society in thwich the culture is that we don't take care of our elderly. In many countries it would be unheard of not to take care of the elderly in our families, parents, grandparents, uncles, aunts etc.
But here is everyone for themselves. so,, we have the problems that the type of culture fosters.
Valued Social Butterfly
Posts: 17,923
Registered: ‎11-09-2011

Re: Costly Change To pay this Minimum Wage & Overtime Protection

Message 26 of 53 (725 Views)

The idea that those who care for our parents and grandparents deserve lower pay than those who cut our hair or clean our streets is typically Republican. Just another small group that they decided could be enslaved without many people noticing. So now emancipation comes, and the RW react like the plantation owners did 150 years ago. Why is it only ONE political party that always opposes acts that benefit those in the 99%?

 

Valued Social Butterfly
Posts: 1,693
Registered: ‎06-25-2013

Re: Costly Change To pay this Minimum Wage & Overtime Protection

[ Edited ]
Message 27 of 53 (736 Views)

Here's how it works in my neck of the woods :

All of the good ones go on to get either their C.N.A. or G.N.A. certifications,  keep them current, and get regular either hourly or salaried  (usually hourly) jobs in the nursing homes.  Where they receive starting pay much higher than minimum,   have o/t protection,  workers comp,  sick leave, etc.

The real problem is with the so-called "home health agencies".  They don't do any hiring of employees so don't fall under the labor laws.   They use independent contractors (IC),  issue them 1099s at the end of the year,  and expect them to report their income as a self-employed person on Schedule C.  (yuk, yuk)  The IRS did go after one of these in my area a few years ago,  fined them for misclassifying ICs as bona-fides. (ooops,  mean they misclassified workers who were performing the same work as bona fide employees)    But they got a lawyer,  we-wrote and re-structured themselves a bit,  and went right back to business as usual.   

The reality is that most of these agencies utilize most anyone who wants a job,  does only the minimum as far as background or credit check ( police check is local only,  who cares if the person is wanted in Delaware for grand theft.   Attempted Murder.   Or abuse of vulnerable person. 

I fail to see how this change in minimum wage is going to address the real problem of raising the standards and getting a better class of people for these jobs. 

If you live in an area where there is a top-notch agency that rigorously screens and closely monitors these home health aides,  operates with employees,  not ICs    --    you are very lucky.   

Valued Social Butterfly
Posts: 7,323
Registered: ‎08-18-2008

Re: Costly Change To pay this Minimum Wage & Overtime Protection

Message 28 of 53 (745 Views)

rker321 wrote:
And who qualifies for these services, I mean the over 65 seniors. what are the qualifications and how easy or difficult is to obtain them.

1.  people on Medicaid who they are trying to keep at home rather than in a nursing home or under VA healthcare for those that qualify for Aid and Attendance VA program

 

2.  under Medicare -during a recuperation period and being at home instead of being in a rehab center, if medially feasible

 

3.  under Medicare end of life time period - usually under hospice

 

4.  self-pay for their services to the elderly or the disabled

 

Just to name a few -

 

CNA - Certified Nursing Assistant Definition and General Job Description

http://www.ehow.com/about_5485210_certified-nursing-assistant-definition.html

 

Valued Social Butterfly
Posts: 19,052
Registered: ‎03-04-2009

Re: Costly Change To pay this Minimum Wage & Overtime Protection

Message 29 of 53 (752 Views)
And who qualifies for these services, I mean the over 65 seniors. what are the qualifications and how easy or difficult is to obtain them.
Valued Social Butterfly
Posts: 7,323
Registered: ‎08-18-2008

Re: Costly Change To pay this Minimum Wage & Overtime Protection

[ Edited ]
Message 30 of 53 (760 Views)

It helps to understand the terminology and purpose.

 

From the Dept. of HHS:  Eldercare - Home Health Care

 

http://www.eldercare.gov/ELDERCARE.NET/Public/Resources/Factsheets/Home_Health_Care.aspx

 

From the link:

"Home health care helps seniors live independently for as long as possible, given the limits of their medical condition. It covers a wide range of services and can often delay the need for long-term nursing home care.

 

More specifically, home health care may include occupational and physical therapy, speech therapy, and even skilled nursing. It may involve helping the elderly with activities of daily living such as bathing, dressing, and eating. Or it may include assistance with cooking, cleaning, other housekeeping jobs, and monitoring one’s daily regimen of prescription and over-the-counter medications.

 

At this point, it is important to understand the difference between home health care and home care services. Although they sound the same (and home health care may include some home care services), home health care is more medically oriented. While home care typically includes chore and housecleaning services,. . . . "

 

more valuable information at the link.