In-Home Caregivers: At Risk of Missing Out on Rising Minimum Wages

Posted by Michael Collins in Life After Paralysis on April 11, 2016 # Quality of Life Grant Spotlight, Advocacy and Policy

America's politicians love to jump on a "bandwagon," especially when that cause will make them popular and garner votes come election day. The push to require employers to pay a $15 per hour minimum wage is one of those feel-good issues that sounds great in campaign speeches and when being discussed by legislators. Unfortunately there is a darker side to these proposals, and those who will be impacted negatively include people with disabilities and the cadre of homecare workers that allow them to remain healthy and independent.

The movement to require a $15 minimum wage started in individual cities, and has now expanded to statewide status in our two largest states, California and New York. Other states are considering it. In most cases, this is more than a 50% increase above existing minimum wages and twice as much as the current federal minimum wage.

Presidential candidate Bernie Sanders has made the minimum wage increase to $15 a cornerstone of his stump speeches. He assures voters that, if elected, he will make this a federal requirement, thus covering every state. Sanders' Democratic opponent, Hillary Clinton, has scheduled an appearance in New York to show her support for the increase as well.

Senator Sanders also pledges that he will make that new minimum wage applicable to those who now earn subminimum wages working in supported employment. Surprisingly, there has not been much discussion about the impact of requiring employers to pay $15 per hour to a person with a significant disability who cannot produce at the same level as fellow employees and whether it will result in increasing levels of unemployment for a population that desperately desires work.

To soften the blow to business, the proposed minimum wage increases are being implemented slowly--over a few years. In most cases, very small employers are also being exempted. While that sounds fine, John Kabateck, a business consultant and owner of Kabateck Strategies in California, pointed out in a recent blog that appearances can be deceiving when it comes to a $15 minimum wage. I agree with him on that point.

Part of the problem is that many members of the caregiving network that is supported through the Medicaid Home and Community-Based Services waiver program will likely miss out on those proposed minimum wage increases.

The reason that many caregivers would not be able to take advantage of the increases is because some states that participate in this waiver treat caregivers as independent contractors rather than employees, or require the person needing care to serve as employer. That status means that caregivers must file self-employment income tax returns; most miss out on the employee benefit programs that are usually offered by larger employers.

Anyone who deals with attendant care on a regular basis knows that qualified caregivers are very valuable, and not easy to find. The situation is especially true for those who are in the Medicaid waiver program. Things will get worse if lower state-approved wages for those who work in homecare are not raised to match rising minimum wages; that will make it even more difficult to attract individuals to work as caregivers when many other potential employers will be offering the new higher minimum wage and competing for the same employees.

Don't get me wrong; the $15 minimum wage sounds like a good thing--and long overdue--for the many people who are struggling to support their families on current substandard minimum wages. Since the political leaders, including governors, in those locations where that has already been approved for implementation are so quick to brag about the need why are they willing to reduce the benefits for those who care for those who struggle to live at home? Illinois, Many states are doing a lousy job of supporting the program that is needed in order for the promise of the ADA and the Supreme Court's Olmstead Decision to become a reality for all.

This whole situation creates a real problem, as state borders can now make a huge difference in the level of support available for people with disabilities who wish to live in the community. Since the Supreme Court verified in Olmstead that the right to live in a community setting is the law of the land, why should states be able to refuse to apply for Medicaid waivers that would support those who need attendant care at home while those states still receive their allotment of Medicaid funds?

Fortunately there is hope of improvement in the future, thanks to the work of the advocates at ADAPT. The organization worked withSenator Charles Schumer of New York who introduced the Disability Integration Act of 2015. The bill has received a lukewarm reception thus far, with only five co-sponsors in the first four months since its introduction, but one of those co-sponsors is Senator Sanders. Secretary Clinton has already issued a public statement in support of the bill, so it is hoped that public announcements showing support for this bill by both Democratic presidential contenders will end up as a cause that everyone running for president, or any position, will endorse.

There will be much discussion about increasing the minimum wage in coming months, and probably for years after that. While the politicians involved in the implementation will brag about the great job they did, it is time they took responsibility for the plight of the providers in the care network. That network needs to be in place, and healthy, in order for everyone who needs homecare to have an opportunity to live their lives in the community setting they desire, deserve and are entitled to. Fair, and competitive, compensation is an important component when it comes to the health of that network.

© 2016 Michael Collins

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