Live-In Care Today - A Need to Know for Discharge Planners
For years, Boardwalk Homecare along with other health care service firms (aka home care agencies) have tried very hard to control costs even though inflation has increased by an average rate of 2% each year.
Between 2010-2018, there was little reprieve for the home care industry as legislators from both Washington, D.C. and Trenton passed new laws, that simply put, drove up home care costs in a big way. While legislators have committed to increasing caregiver wages, the concept of live-in care was not really taken into consideration or perhaps not taken seriously.
To start with, the 2016 Fair Labor Standards Act redefined a ‘live-in domestic worker’. In short, employers are required to compensate live-in caregivers for all 24 hours in a day unless they a) reside at the client’s home ‘permanently’ or for ‘extended periods of time’ and b) have scheduled, uninterrupted time off for sleep, meals and breaks.
Fast forward to 2018 and New Jersey employers must now adhere to the $15 Minimum Wage Act with its first increase scheduled for July 1st. Since hourly caregivers make an average of $12/hr., this law does not currently pose a great threat to the hourly market.
So how does this impact live-in care?
Well, the short answer is that home care agencies really have no way of managing over-time costs. Remember, live-in caregivers by definition must reside at the client’s home on a permanent basis. Since most live-in caregivers work 10-12 hours per day, employers are required to pay 40 hours a week at the minimum wage and another 30-44 hours a week at time and half. The FLSA basically forbids splitting up a live-in case between two caregivers and New Jersey legislators did not offer a carve out for the niche live-in care service.
Have these new laws impacted home care agencies?
Yes. They most certainly have. There was an initial exodus by some live-in care agencies back in 2010 when the Affordable Care Act enforced the employer mandate. The second exodus started about a year ago in response to New Jersey’s mandate for accreditation. Accreditation is required for all home care agencies as a condition of renewing a business license on May 21, 2019.
Unfortunately, this was the straw that broke the camel’s back for many agencies regardless of whether they provided live-in or hourly care services because of the significant price tag associated with the new fees, nursing expenses and compliance.
What can discharge planners expect?
As is often the case with regulation, the microeconomic impact is a consolidation in the market place as well as the potential for a paradigm shift in service offerings. Put more plainly, these laws have caused a number of home care agencies to close their doors altogether or make the decision to not offer live-in care services. Additionally, the majority of home care agencies that continue to offer live-in care have been forced to increase their rates.
For discharge planners, it might be a good time to review those stacks of home care brochures in order to figure out if they are still in business, whether or not they provide live-in care and what those services will cost come July 1st.
Is there a light at the end of the tunnel?
Of course there is! (prepare for blatant marketing plug)
At Boardwalk Homecare, we are aware that seniors would prefer to live out their remaining days at home. For those that suffer from memory impairment or perhaps mobility issues, live-in care is still a very pragmatic and favorable senior care option. In the wake of the minimum wage hike on July 1st, our agency has decided not to raise our rate.
Our mission has always been to educate families about all home care options and help them make an informed decision. While families tend to be more familiar with hourly care, live-in care is unique and requires a higher level of support. This is where our agency’s case management approach thrives!
We are always grateful for home care referrals. For those involved in discharge planning, we hope you will continue thinking of Boardwalk Homecare as another resource for seniors and their family members.