Reward home care firms that pay living wage

Proposed legislation would provide more reimbursements to firms that do

WHILE MASSACHUSETTS LEADS the nation in a number of vital healthcare markers, the state is facing a crisis in one crucial area – its home care industry. The population is rapidly aging, and the number of home care workers is not keeping pace with increased demand for services. When combined with inconsistent state oversight and a lack of clarity related to quality measures, families in the Commonwealth are increasingly challenged to secure dependable services for loved ones.

We need to be sure workers – who care for our most vulnerable residents, seniors, and those living with a disability, and comprise the fastest growing employment sector in the state – are well-trained, fairly paid, and work in an industry effectively regulated by the state’s public health officials.

There are currently only 20,000 homemakers and personal care aides in the state, serving 60,000 senior and disabled individuals who rely on home care programs to remain in their communities. Massachusetts should choose to lead when it comes to ensuring residents have access to quality, dependable home care services and home care employees have the option of a career – not just a part time job. To do so, Massachusetts should pass legislation to elevate industry standards by requiring licensure and better compensation of home care aides. This could be accomplished by tying program reimbursement to the adoption of responsible employer standards by providers, which include elevated wages for home care aides and financial reporting.

Currently, Massachusetts industry advocates say that the average wage for home care workers is between $13 and $14 an hour, barely above the $12.75 minimum wage in effect this January. Many of these workers work part-time. This combination of lower wages, part time employment, and often difficult working conditions creates unsustainable annual turnover rates well over 50 percent industrywide.

Additionally, Massachusetts currently has limited reporting requirements for home care agencies, which means a potential inability to proactively identify a decline in a provider’s financial health and care quality. Many agencies submit no comprehensive cost reports or annual audited financial reports – both of which are required of nursing homes and hospitals operating in the state.  A well-designed licensure and reporting regimen will serve to better inform and protect both home care beneficiaries and industry employees by ensuring greater transparency as it relates to performance among individual providers.

An Act Strengthening the Massachusetts Home Care Program, a bill crafted by Sen. James Welch and Rep. Daniel Cullinane, represents a good start to crafting the legislation needed to avoid a crisis in the Massachusetts home care industry and it should be looked to as the foundation on which to build the licensure, reporting, and rate structure required to safeguard and preserve this important service.

All home care agencies in Massachusetts should be required to obtain a license, be subject to consistent state audits, and meet basic financial reporting requirements. This bill does just that; it directs the Department of Public Health and the Executive Office of Elder Affairs to regulate the home care marketplace by creating a well-designed licensure, auditing, and reporting system for participating home care agencies.

Agencies that meet increased performance expectations, transparency obligations, and responsible employer standards, including paying a minimum wage no less than $.50 above the prevailing state minimum wage, will receive a boost in their provider rates paid by the state for their services. The bill provides $25 million in badly-needed increased reimbursement to home care agencies that meet the established criteria. New home care agencies will be required to obtain a license prior to providing home care services.

How crucial is crafting comprehensive legislation to the future of the home care industry and its workers? 1199SEIU, the state’s largest and fastest growing healthcare union, is working on this issue with Elara Caring, one of the nation’s largest providers of high-quality, home-based care with locations in Worcester, Tewksbury, New Bedford, Newton, Leominster, Lee, Chicopee, Byfield, Easton, Bellingham, and Boston.

Meet the Author
Meet the Author

Lesley Nolan

Regional vice president, personal care services, Elara Caring
1199SEIU and Elara Caring are jointly advocating for the additional state oversight of home care agencies and improved rate reimbursement directed at responsible employers included in this legislation because we both fundamentally believe that these reforms are essential to ensuring the Commonwealth is able to meet the rapidly growing demand for the home care services required for seniors and individuals with disabilities to continue to live independently at home and enjoy the benefits of community.

Tim Foley is the executive vice president of 1199SEIU United Healthcare Workers East. Lesley Nolan is the regional vice president of personal care services northeast at Elara Caring.