The “direct care workforce” includes Nursing Assistants; Personal Care Aides; Home Health Aides and related direct care occupations. Together, they comprise the fastest growing profession in the State of New Mexico. This workforce--88% of whom are women and largely women of color--performs the invaluable, life-saving work of caring for those who are elderly and those with disabilities.
Nationally, more than 3.2 million direct care workers were employed by facilities and agencies in three occupations in 2012: Nursing Assistants (1,420,020); Home Health Aides (839,930); and Personal Care Aides (985,230). Another estimated 800,000 independent providers, not captured in these counts, were employed across the country in public programs that provide personal care services. Independent providers are employed directly by consumers.
In New Mexico, there are more than 61,000 of these workers, also known as “caregivers,” and the demand for them will grow exponentially: by 2030, NM will rank #4 in the nation in terms of percentage of population age 65 and older.
In spite of present and future demand, the direct care workforce earns only $9-$12/hour on average, a wage that requires they work two (or three) jobs just to make ends meet. This condition also affects a provider’s ability to retain good employees.
The federal Fair Labor Standards Act (FLSA) sets standards that require payment of at least the applicable minimum wage, overtime pay of at least time-and-a-half for more than 40 hours worked in a workweek and pay for time spent traveling between clients in the course of the caregiver’s workday. FLSA protections were extended to domestic service workers in 1974, but direct care workers providing what were deemed “companionship services” were excluded from the otherwise broad guarantees of minimum wages and overtime pay.
In 2015, the U.S. Department of Labor (DOL), recognized “the changes to the home care industry and workforce” and revised FLSA regulations to extend minimum wage and overtime protections to the nearly 4 million homecare workers in the United States. Known as the “Home Care Rule,” these new rules extended a floor of basic labor protections intended to improve working conditions to these workers, a step seen not only as benefiting workers, but as important for strengthening the direct care workforce.
As DOL stated in the Preamble to the Final Rule:
“Studies have shown that the low income of direct care workers continues to impede efforts to improve both the circumstances of the workers and the quality of the services they provide. Covering direct care workers under the Act is, thus, an important step in ensuring that the home care industry attracts and retains qualified workers that the sector will need in the future” (78 Fed. Reg. at 60458).
“[T]he Department believes that ensuring minimum wage and overtime compensation will not only benefit direct care workers but also consumers because supporting and stabilizing the direct care workforce will result in better qualified employees, lower turnover, and a higher quality of care” (78 Fed. Reg. at 60459-60).
SJM 6 was passed by the New Mexico legislature during the 2017 legislative session. The memorial created a task force to study direct care programs funded by Medicaid. The New Mexico legislative memorial directed New Mexico Direct Caregivers Coalition (NMDCC) to convene stakeholders named in the legislation (see Acknowledgements).
SJM 6 directed the Task Force to recommend short-term and long-term actions to ensure that the state complies with federal law, implements policies that best meet the needs of individuals receiving long-term supports and services and promotes a stable and growing workforce to meet the needs of seniors and individuals with disabilities who rely on these services to live independently in their communities.
Furthermore, SJM 6 charged the Task Force with preparing:
- A first report of recommendations focused on ensuring that the state’s Medicaid home and community-based [HCBS] services programs comply with federal regulatory provisions of FLSA;
- A second report of recommendations on promoting long-term stability, retention and expansion of the direct care workforce to meet the growing needs of New Mexicans needing those services.
The Task Force has submitted a list of recommendations to Legislative Health and Human Services on New Mexico’s HCBS Medicaid programs as they relate to the federal Home Care Rule.
Read the recommendations and complete report for Phase 1: Senate Joint Memorial 6 Task Force Phase 1 Final.
Also, check out the Senate Joint Memorial 6 Task Force Phase 1 Q&A
The Task Force held Listening Sessions in five locations around the state (Las Cruces, Roswell, Las Vegas, Farmington and Albuquerque) to hear issues and comments regarding the direct care workforce. The compiled list of issues and comments discussed at the Listening Sessions can be viewed here: Comments from 2018 New Mexico Statewide Listening Sessions