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OldKae Asked November 2016

Does anyone know about the laws for caregiving agencies?

The agency I am working with still provides 24 hr care, by one assigned caregiver, who is a non-medical caregiver. In other words she is licenced, bonded, and supposedly certified, but is not a nurse, or a medical caregiver. It was brought to my attention recently that the law changed and unless caregivers are paid OT, for night hours, the agency cannot do 24 hr care for non-medical. I was told several agencies had to stop 24hr care provided by one caregiver. Two per day, daytime/nighttime is fine, but 24hr care by one person they said was no longer allowed. Is this agency working under a loophole or is there an ethical problem here we need to be concerned with? It is so much easier to have one caregiver. Anyone know?

trying2doright Nov 2016
I have had the same situation and yes it is true. Labor law requires that employees that work "over-time" be paid time and a half. Home Healthcare Aides were not getting time and a half. Add to that the new issue where Medicare/Medicaid will not pay /reimburse an agency for HHC services beyond 40 hours by one aide. They say this is also a safety issue because many aides were working 60-70+ hours. So, to cover a 24 hour shift, you need two aides and in a week you need 4-5 aides to cover 24 hr/7days since the aides can only log 40 hours with an agency and a client. Ridiculously, the aides can work for two agencies in a week and get their 70+ hours, it just can't be with the same employer or on the same client. This has caused significant issues. In my mom's case, she has dementia which requires consistency - she can't have oodles of different aides - it frightens her, is confusing and there is no bonding and trust. Plus, it is a safety issue to have too many aides coming and going. For the aides, who do not get paid much (maybe $10-12 an hour) 40 hours doesn't provide them with enough income to support themselves and often their families. So these ladies are humping it working multiple agencies and clients just to earn enough to live, while they themselves will speak about the importance of continuity and their desire to remain present and bond with their clients. For the agencies, they cannot afford to pay and absorb all the OT (excess of 40 hours). A number of agencies have gone out of business because of it. The change may have been well intentioned, but were not executed well and did not take the seniors or disabled into consideration, nor the aides or the practical side of the arrangements and what we all try to accomplish as a team. It has been a very disturbing and detrimental turn of events. So, yes, what they tell you is true, at least here in NY. I hope this helps!

MsMadge Nov 2016
I hire through a California agency - I pay OT for same person working more than 9 hours a day if they do 12 hours as an example

My overnight 8 hour shift is the same base rate as daytime

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Llamalover47 Nov 2016
I did the caregiving solo.

Jetcitygirl Nov 2016
Your can't work people 24/7 like an animal.

pamstegma Nov 2016
Guenter, North Carolina is pretty skimpy on home care, even with Medicaid. Do your best to bring home to her. Bring in her favorite quilt or lap blanket, her favorite pictures and her favorite music.

Guenter Nov 2016
My wife is now in a long term institution, she has dementia.She needs to be fed, diapered, cleaned and dressed. She is on MedicAid. I would love to take her home. What can Medicaid offer for home care ?

Jopang5 Nov 2016
Workers get overtime pay now if the work 24 hrs shift; typically the cost is gained by the agency - but also passed on by the agency to the families

Moonflower Nov 2016
Because of the 40 hour work week. As an Ombudsman, I have encountered this problem many times. They would have to pay time and a half for overtime hours, cheaper for them to pay 2 people straight time.

anonymous10656 Nov 2016
I'm not sure what state you live in, but each one has different rules, regulations for their Home Care agencies. I'd check with the Department of Health or whatever state government agency that oversees this type of care for more clarification.

pamstegma Nov 2016
The loophole is there for live-in caregivers in California and other states.

freqflyer Nov 2016
The professional Agency I had used for my Dad, whomever was on the night shift had to remain awake for those 8 hours.

Thus, I wouldn't want one person working 24 hours each and every day. One needs quality sleep and time at their own home to recharge, and to be with their own families.

The Agency didn't charge me a higher price for night service, so either the caregiver got the same paid rate or got more of the rate, I don't know. I have heard of a new labor law that if a caregiver works more than 40 hours per week, then that caregiver is entitled to over-time pay.

I did pay over-time for holidays.

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