The demand is particularly high in Miami, where Hispanics prefer at-home care. Our culture prefers to keep the family member at home, no matter what, Torre says. The first pick is always a home health aide instead of sending them to a place.
The need for direct-care workers which includes home health aides, nursing assistants and personal care assistants is actually not new. Senior advocates have been sounding the alarm for years, but now the looming shortage is expected to worsen faster because the new federal health law tries to reduce hospital readmissions and expands programs that encourage Medicaid recipients to receive in-home care.
But attracting workers to occupations that pay slightly more than minimum wage and offer few benefits is difficult. Though direct-care workers provide about 70 to 80 percent of the paid hands-on care and personal assistance received by the elderly or the disabled, a 37-year-old companionship exemption to the Fair Labor Standards Act excludes them from guaranteed minimum wage and overtime protection. That exemption was supposed to cover jobs like babysitting, but because of a quirk in the law, home health aides ended up falling under that provision.
A handful of states do have some kind of wage and overtime protection, but Florida is not in the group. In addition, home care workers expect a revision of the federal minimum wage and overtime requirements this spring, after President Obama announced a proposal in December 2011 that would narrow the definition of the companionship exemption.
Even then, some say that change wont be enough to encourage more people to enter the direct-care workforce. According to the Paraprofessional Healthcare Institute (PHI), a New York City nonprofit organization that keeps tabs on the industry, the national median hourly wage in 2011 for personal care aides was $9.49 and for home health aides, $9.91, substantially lower than the median of $16.57 for all U.S. workers. (The minimum wage was $7.25 an hour.)
That disparity exists in Florida, too. The median hourly wage in the state was $9.39 for personal care aides, $10.13 for home health aides and $11.19 for nursing aides. In comparison, the median hourly wage for all occupations was $14.79. Whats more, fewer than half of direct-care workers have employer-based health coverage.
We need to seriously look at wages and provide appropriate training and benefits and opportunities for advancement if we want this to be an occupation that people enter and stay with, says Steve Edelstein, PHI national policy director.
Occeas, who has been employed as a direct-care worker for more than 11 years, is an anomaly. Many of her colleagues last but a few months on the job, moving to better paying positions that can guarantee hours and healthcare benefits. She says she has stayed in the profession because she loves caring for the elderly.
I dont know whats going to happen in the future, she says. We need a new generation of workers to replace people like me and where will they come from?