VNAA, Medicaid Directors, Senators Weigh In On DOL Home Health Wage Proposed Regulations
Monday, April 22, 2013
by: VNAA Policy Team

Section: Public Policy and Advocacy

On April 8, the National Association of Medicaid Directors (NAMD) sent a letter to the Office of Management and Budget (OMB) regarding concerns on the Department of Labor (DOL) proposed regulations that would extend minimum wage and overtime protections to home health care workers. To review NAMD’s comment on the proposed rule, please click here.

Currently, under the Fair Labor Standards Act, “domestic companions” including home health care aides are exempt from minimum wage and overtime requirements. The DOL proposed rule would limit the current laws domestic companion exemption and extend the minimum wage and overtime requirements to home health care workers.

VNAA provided comments on this regulations which can be found by clicking here. VNAA supported the principle reflected in the Department of Labor (DOL) rule regarding compensation but raised serious concerns about the practical impact of certain aspects of this rule on patients, families, nonprofit organizations and employees.

In their April letter, Medicaid directors raised concerns that the proposed rule would adversely affect the close, personal relationships that are required between caregivers and Medicaid beneficiaries and drive up the cost of providing services forcing enrollees into more expensive institutional settings. NAMD also raised concerns that the rule would interfere with current home health demonstration projects between states and the Centers for Medicare and Medicaid Services (CMS) that expand home and community-based services.

Senator Lamar Alexander (R-TN), ranking Republican on the Senate Committee on Health, Labor, Education, and Pensions, and four other Republican senators, also wrote a letter to OMB on April 8, requesting that the proposed rule be returned to the Labor Department siting concerns that the economic analysis for the rule’s cost was based on Medicare data which does not cover home based services. To review the Senators’ letter, please click here.

Medicaid is the largest single payer of long-term services and supports for home-based and institutional care in the country. According to NAMD, in 2009 Medicaid paid $126.8 billion, or 43 percent, of all long-term services and supports.

Labor Unions and other advocates for home health care workers are actively lobbying in favor of the DOL proposed rule noting that home health workers number 2.5 million and are expected to grow by 1.3 million by 2020.
DOL sent the proposed rule to OMB for review in January, following the department's review of public comments. The proposed rule generated more than 20,000 public comments during the comment period, which ended March 21, 2012. The initial proposed rule was released December 27, 2011.
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