Almost unnoticed, more than 2 million workers in the burgeoning home health care industry finally have gained wage protection.

The federal minimum wage was first established in 1938 at 25 cents an hour, but it took 36 years for the government to decide that maids and other domestic workers deserved to be covered by pay minimums and overtime rules.

Now, after 40 more years has passed, it’s the turn of home health care workers — the subset of workers who provide elder and disability care — to gain wage protection.

In a major win for such workers, a federal appeals court has approved Obama administration rules that will require minimum wage payments and overtime for aides who help ill and disabled people with everyday tasks.

Since 1974, home health care workers hired through third-party staffing agencies have been exempt from the wage-and-hour rules of the Fair Labor Standards Act.

That changed last week when the U.S. Court of Appeals for the District of Columbia Circuit ruled that U.S. Labor Department has the power to interpret the law to revoke that exemption, overturning a lower court’s block on the rules that were first proposed four years ago.

That paves the way for pay protections for some of the poorest workers caring for some of the most vulnerable people in our communities.



The home health care industry has evolved into a major component of care. Workers tend to a range of physical and social needs of clients, including feeding, bathing, managing medication and providing rehabilitation and recreational activities.

Many of the responsibilities of the job require ongoing professional training, along with extreme hours (being on-call around the clock for intensive medical needs) and considerable manual labor (lifting fragile clients).

As one such worker Meriam Jawhar put it, the reforms are less about pay scales than about recognizing her vocation as dignified work. “I want people to know that the home care is an occupation that deserves honor and validity,” she said.

This ruling comes as a growing “gray wave” of Baby Boomers are increasingly seeking community- and home-based care instead of nursing homes and as mothers, daughters and sisters, who might have taken on care-giving duties a generation ago, are now working outside the home.

The senior care industry has grown to fill this need, but the wages have stayed flat at around $9.40 per hour, leaving home aides doing God’s work for a pittance, under extremely stressful and often exploitative conditions. The yearly turnover rate is an estimated 50 percent.

The fact that this sector, like other domestic workers, largely attracts females, immigrants and people of color reveals much about how gender and racial divides marginalize low wage workers.

The wage hike only goes so far, since most employers offer pay and many states (though not Virginia) require wages that exceed the federal wage floor of $7.25 an hour.

Home health care workers are hurt most by the current failure of the government to provide affordable, high quality services to families at all income levels.

Home health care was largely unaddressed in the Affordable Care Act, and in coming years demand for services is only going to increase as patient populations mushroom.

The government will need to play a role in creating a long-term care system in America that works for everyone, including home health care workers. That’s why this court ruling is so important: It strengthens a workforce that will be so critical to the long-term care system that we are going to need.

The writer is a contributor writer for The Nation magazine.

Agence Global