The Department of Labor (DOL) has proposed changes in federal labor rules that will have a significant negative impact on people with disabilities. These changes will most seriously impact people who have the most significant disabilities and rely on Medicaid services to live in the community.
Labor advocates have urged people to support these rules to assure that attendants get paid minimum wage and are paid time-and-a-half for overtime work. The disability community recognizes the invaluable role that attendants play. We don’t oppose the requirement that attendants be paid minimum wage, but the overtime requirement will have a serious negative impact on people with disabilities. In short, the proposed changes will:
Force seniors and people with disabilities into institutions!
Increasing the cost of home and community based services by requiring overtime pay, without increasing the Medicaid rates or raising the Medicaid caps for available funding, will result in a reduction in hours of personal assistance, forcing some people with disabilities into unwanted institutionalization. The Department of Labor, itself, identified that some people would be forced into institutions because of these rules.
Cut the take-home pay of attendants!
Because Medicaid and Medicare rates are not being increased to cover the additional cost associated with these changes, states and home care agencies will simply limit the hours attendants can work, forcing attendants who currently work more than 40 hours a week to work for multiple agencies in order to match their current standard of living.
Reduce the attendant workforce!
Family and friends frequently work as attendants in consumer directed programs. These attendants won’t do attendant services for someone else. Consequently, we will lose those hours. By limiting the availability of family and friends as paid attendants in consumer directed personal assistance programs, the Obama administration will reduce this vital component of the attendant workforce and that will further threaten the independence of Americans with disabilities.
Force people with disabilities to hire strangers as attendants!
The Department of Labor dismissed concerns that their proposed rules would require people with disabilities to hire additional attendants. They noted that in traditional programs, turnover is high. However, they never considered that consumer directed programs are different. Attendants in those programs – some of whom are friends and family – may work for an individual for many years. With the hours attendants may work capped, people with disabilities will have to cut the hours of these trusted workers and bring strangers into their homes who will assist them with their most personal care.
Devastate consumer directed programs!
The Department of Labor did not adequately assess the impact of their proposed rules on consumer directed programs. In their analysis, the Department of Labor stated that “There is no consolidated source of data on state consumer-directed programs” even though there are several national resources devoted to the services within the disability community. It is our understanding that the Department of Labor has decided to determine who is the “employer” using an economic determination, which would determine that the agency is the employer in the vast majority of consumer directed programs. Even though the individual hires, trains, supervises, and dismisses their attendants. This approach disenfranchises the vast majority of people with disabilities who receive Medicaid services.