NAHC, PDHCA Release Overtime Exemption National Survey Results

The National Association for Home Care & Hospice (NAHC) and its affiliate Private Duty Home Care Association (PDHCA) released the results of a national survey of home care agencies on the impact of the U.S. Department of Labor’s (DoL) proposed rule that effectively eliminates the companionship services overtime exemption in home care.

The survey was conducted in December as a joint project with the National Private Duty Home Care Association. Nearly 1,500 responses from home care companies in all 50 states, the District of Columbia, U.S. Virgin Islands, and Puerto Rico were received.

The survey results show that eliminating the overtime exemption for personal care attendants and home care aides will have serious negative consequences for workers, clients/patients, and home care companies. The predominant impact on workers is the restriction in working hours triggered by the home care companies’ efforts to control costs through avoiding overtime hours. Nearly 63 percent of the respondents currently obligated to pay overtime under state law report that they restrict overtime hours. More than 86 percent of the companies that will face a new overtime requirement if the proposed rule takes effect, report that they will restrict the hours worked by staff to prevent overtime costs.

Clients/patients also face adverse impacts from a change in the law to require overtime to all personal care workers. The survey indicates that 81.8 percent of companies expect to increase their private pay billing charges with 23.7 percent anticipating a need to scale back their availability of care. These expectations are warranted as 45.2 percent of companies currently required to pay overtime have increased their charges and 10.4 percent reduced care access.

The greatest negative impact on clients/patients reported by respondents is the loss of continuity of care brought on by the need to assign multiple caregivers to control overtime costs. A common remark in this regard is that the clients are then driven into the underground economy, hiring workers “under the table” where they lost the quality control and oversight that an agency worker provides.

Over 93 percent of companies that would pace a new overtime obligation report an expectation of a moderate to significant increase in business costs. This mirrors the actual experiences of companies with a current overtime requirement where nearly 69 percent report moderate to significant business cost increases. The primary cost increases are in human resources, 67.4 percent expected/38.2 percent actual, and staff training costs, 67.9 percent expected/38.3 percent actual.

The business adjustments that companies are or will make include cutbacks on employee benefits and pay increases, withdrawal from Medicaid services, terminating live-in care, and reduction of current base pay of personal care workers.

The full survey report is available here. NAHC thanks Home Care Pulse for its extensive support in managing the survey and developing the analyses.

The survey report is just one of the advocacy actions steps underway in the effort to stop the DoL proposal. NAHC has commissioned a study by a labor economist into the overall economic impact of the proposed rule on business, workers, third-party payers such as Medicaid, and on the consumers of the care. The Small Business Administration Office of Advocacy has scheduled a formal” roundtable” that will bring DoL representatives together with affected business to discuss the projected impact of the proposed rule on small businesses. Also, NAHC continues to enlist the support of Congress for H.R. 3066, a bill that would leave the existing, 37 year-old, standards governing the exemption in place. A full discussion as to what you can do with Congress on this issue is available here along with helpful tools to get your message to Congress. Finally, NAHC and the Home Care Association of Florida will be drafting formal comments on the rule that will be made available to the membership in time to develop your own comments by the February 27 deadline.

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