Home health care workers—more than “companions” and helpers

Ten years ago, I conducted a survey of low-income new mothers in Flint, Michigan, as part of an infant mortality reduction effort there. I was astonished by the heavy percentage employed as home health care workers, assisting elderly or disabled people.  Since then I’ve met more than a few women and men who make their living bathing the disabled, cleaning seniors’ homes, and more.

This is important, sometimes difficult work. It’s not incredibly well-paid or respected. It’s also work that many of us will someday need. Today’s New York Times includes an beautifully-written and important op-ed by Eileen Boris and Jennifer Klein, titled Home-Care Workers Aren’t Just “Companions.”

Boris and Klein note that the home health and personal care workforce includes 2.5 million people. It’s the second-fastest-growing job category in the country. For complicated, but rather shameful historical reasons, these women and men do not enjoy basic labor protections that other workers take for granted. People who perform personal care work in other people’s homes, and those who receive these services, are both rather stigmatized groups. Both are poorly-positioned in the political process to demand better conditions.

At one level, the home care industry is able to employ people at less favorable wages and working conditions. At another level, though, it’s wrong to point fingers at the industry. We taxpayers and consumers are complicit in, and benefit from, these exploitative arrangements. It’s also about honoring the dignity of work–including the hard work that many of us do caring for our own loved ones or for others who cannot do basic tasks for themselves.

President Obama has proposed to change Department of Labor regulations to address this problem. House and Senate Republicans oppose these measures. Nebraska Senator Johanns and others have introduced the Companionship Exemption Protection Act, which would in its own words, “preserve the companionship services exemption for minimum wage and overtime pay under the Fair Labor Standards Act of 1938.” Reading the particulars here is fairly cringe-inducing to anyone who has seen (say) The Help:

‘companionship services’ as used in section 13(a)(15), means those services which provide fellowship, care, and protection for individuals who, because of advanced age or physical or mental infirmity, are unable to care for themselves, including but not limited to, non-medical in-home care or household work related to the care of the aged or infirm individuals (such as meal preparation, bed making, washing of clothes, errands, assistance to appointments, laundry, medication reminders, bathing, assistance with incontinence and grooming, and other similar services). Such term may also include the performance of general household work.

The last time I wrote about Senator Johanns, he was arguing that the Affordable Care Act imposed intolerable burdens through the “1099 collation calamity.” Apparently, those annoying tax forms imposed greater burdens than does the lack of minimum wages or overtime pay for millions of people who perform intimate care tasks.

Just whom does the Senator and his co-sponsors expect to bathe and clean them when they get old?