Policy Solutions
Here are just a few examples of the actions state and local governments have taken to protect quality care by reducing the high worker turnover that results from low wages and poor benefits.
For more information on these examples and other effective strategies to improve the quality and sustainability of the direct care workforce, please visit http://phinational.org/
Massachusetts mandates that all subcontractor agencies within the Massachusetts Home Care Program pay a minimum average hourly rate to employees. The minimum level is set annually by the state. In 2009, the rate was $11.56 per hour.
Between 2001 and 2007, New York City as well as Westchester, Nassau, and Suffolk counties passed local ‘Living Wage Laws’ that established minimum levels of compensation for all workers employed on contracts with city or county governments – regardless of whether their positions were subcontracted. All four laws apply to home care workers whose clients receive care through the state’s Medicaid Home Attendant/Personal Care programs. In fact, home care workers are the largest single group affected by these laws.
Current Living Wages
| Suffolk: | $11.01 per hour plus health benefits; $12.54 without benefits |
| Nassau: | $12.90 per hour plus health benefits; $14.61 without health benefits |
| Westchester: | $11.50 per hour plus health benefits; $13.00 without health benefits |
| New York City: | $10.00 per hour plus health benefits; $11.50 without health benefits |
However, many home care workers are employed by agencies which subcontract to providers in the State Medicaid program, and so are not covered by municipal living wage laws. In New York City, a typical worker in this subcontracting system earns only $7.50 per hour, with no health benefits. As a result, workforce turnover within New York City’s non-living wage home care sector is estimated at four to five times that of the living wage programs.
For more on the difference between living wage and non-living wage home care, see this fact sheet from HomeCareCrisis.org.
Beginning in 2006, the New York State Office of Mental Retardation and Developmental Disabilities (OMRDD) targeted funds to allow not-for-profit agencies to provide employees with new or expanded health care coverage. This includes reduced premiums, reduced out-of pocket expenditures, or in certain circumstances, offsets for a portion of the employer share of premium increases. As of October 2008, 371 agencies had implemented at least one of these healthcare enhancements.
OMRDD also has established a ‘Direct Support Workforce Advisory Committee’ to further improve the quality and sustainability of the workforce serving its clients and to plan for future initiatives.