Home Health Unions, Advocates Fight Proposed Limit on Hours

Home health care advocates and unions in California are pushing back against a provision in Gov. Jerry Brown (D)'s revised fiscal year 2014-2015 budget that would limit the number of hours such providers can work to 40 hours per week, the Sacramento Bee reports.

Background

The proposal would affect California's In-Home Supportive Services, which consists of about 360,000 home health care employees who work with hundreds of thousands of individuals with physical and mental health issues, according to the Bee. About 83,000 of those employees currently work more than 40 hours per week.

A recent federal order requires in-home supportive services workers to receive overtime pay.

However, Brown's revised budget specifically exempts IHSS from that rule.

Brown noted that the cost of IHSS increased by nearly $250 million between January and May and that the monthly caseload has increased from 317,000 in 2003 to 453,000 in the current fiscal year. As a result, Brown said federal overtime rules could cost the state an additional $186 million annually.

Under Brown's proposal, individuals who need home care services could obtain more than 40 hours of care weekly by using conglomerates of backup providers who would be available on short notice.

Reaction From Advocates, Experts

Patient advocates and labor unions said that not permitting overtime would put financial strain on home health workers and could harm patients, the Bee reports.

Karen Keesler, with the California Association of Public Authorities for IHSS, said the group is "concerned" about the state's ability to "develop a provider backup system." Advocates say the 40-hour cap would disqualify many home care workers from participating in the proposed backup pools, reducing access for patients -- especially those in rural areas.

In addition, some policy experts say Brown's proposal could increase costs and push more patients who rely on home health services into medical facilities.

H. Stephen Kaye, a professor at UC-San Francisco's Institute for Health and Aging, said cutting such services is "not a good way of saving money," adding, "What happens is you end up spending more on institutional costs and you also probably spend more on emergency room visits and hospitalization for people who aren't getting the services they need."

Details of Campaign

In response to the release of Brown's revised budget, several home care workers' unions launched a campaign aiming to change the proposed 40-hour limit.

Campaign workers are discussing the issue with legislators, and six Democratic lawmakers spoke during a labor-organized event last week after the revised budget was released.

Assembly member Richard Pan (D-Sacramento), a physician, said that long-term care workers "are building a relationship with the people they are caring for," adding, "It's not something you can just swap people in and out for" (White, Sacramento Bee, 5/19).