May is Older Americans Month, a time to honor our nation’s aging population. Elder care is a crucial concern for many seniors and their families. As the desire to age in place remains strong among an overwhelming majority of Americans (88%), the need for in-home caregiving support is more critical than ever.
The Department of Labor’s 2013 Home Care Rule, which went into effect in 2015, significantly reshaped the regulations that govern companion care and the seniors and vulnerable populations who rely on it. How much do you know about the 2013 Home Care Rule and its effects on caregivers and families? Let’s play “Two Truths and a Lie” to find out!
A. The 2013 Home Care Rule has made in-home senior care more accessible and affordable.
B. The current average annual cost of full-time in-home support for elderly Americans is approximately $80,000, but can run upwards of $230,000.
C. Many families and caregivers have turned to “off-the-books” care.
Let’s take these statements one at a time:
A. LIE! The 2013 Home Care Rule imposed a new test for individuals and households to claim the companionship exemption and prohibited third-party employers from claiming the exemption.
Under the final rule, the definition of “companionship services” was significantly narrowed, and in-home caregivers employed through third-party employers, such as home care agencies or staffing firms, were automatically excluded from the caregiving exemption. The rule also imposed onerous recordkeeping requirements, which include complicated calculations for live-in caregivers.
Previously, households had more flexibility in arranging affordable in-home care. Now, such arrangements are often unattainable.
B. TRUE! The current market is largely confined to home healthcare aides and nurses, even for seniors not in need of significant medical support (tasks like catheterization, injections, and tube feeding). The average annual cost of full-time in-home support for elderly Americans is about $80,000, but can run upwards of $230,000 for around-the-clock care. Medicare does not cover “non-medical care”; therefore, seniors needing assistance that does not require skilled nursing do not qualify for Medicare support.
This might be an affordable option for a portion of the high-income senior population. But for most, especially the many seniors who rely on fixed incomes, it is out of reach. It’s not just seniors who are impacted, but also middle-aged Americans who may be struggling to care for their aging parents.
C. TRUE! Overly strict regulations do not guarantee the fair treatment of workers. Rather, they encourage both parties to operate (illegally) outside of the framework completely, known as “off the books” caregiving, or deter people from entering into caregiving relationships altogether.
These restrictions negatively impact disabled and elderly Americans, as well as independent caregivers in search of lasting employment on their own terms.
Caregivers in search of this type of work can include college students looking for work that provides them with housing while they pursue their educational goals, as well as older women who are nearing retirement, are worried about their finances, and are hoping to save on housing costs as they prepare for retirement.
Bottom Line:
Repealing the 2013 Home Care Rule is a relatively simple way to remove excessive red tape and make it easier for more seniors to access in-home care. Although it won’t solve every problem related to long-term care for the elderly, it’s a crucial initial step toward a better caregiving model.