Cheating the caregivers

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You might think that kindness and care for people who are elderly or disabled should be rewarded. Not in this state. Not in this country. Instead, the low-paid personal care attendants who serve on the front lines of home health care face the awful choice of neglecting the  people they care for or working without pay.

According to the U.S. Bureau of Labor Statistics, the average (mean) hourly wage for PCAs is $10.09, and the average annual earning is $29,980. Average income for Home Health Aides is about the same: $10.54 per hour and $21,920 per year.

Note: Parts of this post were previously published as part of In sickness and in health: Working in Minnesota

New federal rules require that PCAs and other caregivers be paid overtime for more than 40 hours of work per week. Given the already-low hourly pay of caregivers, that’s a long overdue protection. But it has consequences, as described by the Star Tribune:

“Many agencies that employ home care workers say they are cutting hours and rescheduling employees to avoid paying overtime and travel costs, which are now mandated under a federal rule that took effect late last year.

“The cuts have forced vulnerable adults to scramble to find new caregivers at a time when they are in short supply. Unable to fill empty shifts, some people with disabilities report difficulty getting help with basic tasks, from bathing and dressing to being transferred from a wheelchair.”

Sandra Borgstahl wrote in MinnPost’s Community Voices about her need for personal aides:

“I have had four strokes and have lost the use of my right-side leg and arm, and my eyesight is impaired. My doctor has prescribed 24/7 care by a PCA as a live-in aide.”

The Minnesota legislature failed to allocate the money needed to pay overtime to these essential caregivers. Borgstahl writes:

“What is especially upsetting is that House Republicans found the time and resources to insert a $32 million tax break to tobacco companies in the final tax bill, but left out a smaller amount needed to get our state in line with the federal overtime law for home care workers.”

The decision is also cruel to both the people who need care and the caregivers, writes Borgstahl, forcing inhumane choices:

“Like many care recipients, I am allotted over 40 hours per week of care by the state. With the new cap imposed by agencies, that means home care workers like Steve, who cares for me, can only be paid for 40 hours of work. The rest of the hours I need? There are only three options: I try to find someone I trust who will work for just 2 hours a day, or my worker chooses to work those hours without pay, or I go without the care I need.

“In my case it means Steve has given hours of his time to me unpaid because he knows there is no better option. Caregivers like Steve have big hearts, so this situation of working for free is often what happens, and it is wrong. “

The Star Tribune reports another consequence: children forced into the role of caregivers:

“Each day, thousands of Minnesota children, some as young as 8 or 9, serve as unpaid caregivers for family members who are too sick or frail to care for themselves. Behind closed doors and out of public view, they perform complicated tasks that would intimidate most adults — from cleaning feeding tubes to administering medications, often alone and without supervision — while helping with a slew of everyday activities like bathing, cooking and paying bills.”

The Minnesota legislature’s failure to allocate additional funding to pay overtime for PCAs is not only cruel, but also a short-sighted financial decision. Keeping people at home with caregivers is hugely less expensive than putting them in nursing homes.

If and when a special session is finally called, the legislature could add the money needed to pay Steve and other caregivers. Organizing around this issue means:

1) writing to Governor Mark Dayton and telling him you consider money to pay caregivers a top priority for the special session,


2) Telling your legislator the same thing. Send them this blog post. Or send them Sandra Borgstahl’s article from MinnPost. Here’s where to find contact information for your legislator.

Organize: it’s what makes change happen.

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