By: Lynnette M. Booker
Dorothy Fraser-Laird, 55, of East Flatbush, Brooklyn, has a demanding work schedule. A home health aide, she’s gone from home four nights a week, taking care of patients across the metropolitan area.
One night she could be in Harlem, another night in the Bronx, or Westchester County.
Even with all the work, she finds it difficult to make ends meet. She said she makes $10 an hour, and has a rent of $850 a month to pay in addition to other living expenses and money she sends home to her family in Kingston, Jamaica.
“I have to do what I have to do to survive in this country,” Fraser-Laird said.
Dorothy Fraser-Laird is one out two million home health aides working in one of the fastest-growing professions in the country. The home care industry has grown dramatically over the last several decades as more Americans choose to receive long-term care at home instead of in nursing homes.
Even with this growth and the fact that home health care workers increasingly receive skills training and perform work equivalent to registered nurses, home health aides remain among the lowest paid in the medical field.
Joseph M. Macbeth is the executive director of National Alliance for Direct Support Professionals, an organization that strives to enhance the quality support provided to people with disabilities and the aging sector.
“When a direct care provider posses quality, knowledge, skills, and value, they should earn higher wage,” he said.
Macbeth works with national organizations that try to influence policy change that will improve the recognition, and improve wage, and career ladders who do this work.
“If all of us live long enough, our common destiny will be the need for direct professional in our life. It’s a fact, we have to make sure we build profession on sound research, universal skills, and professional skills as other professions do.”
A humble immigrant from Kingston, Jamaica, Mrs. Fraser-Laird has no problem being a home health aide she has a problem with substandard wage that is attributed to her subsistence living. Naturally, wages under $10 an hour is hard to call it a career yet despite the economic stress Laird who is barely making ends meet refers to her job as a chosen career.
“I love my job, I love taking care of people but the pay is not up to standard, “said Mrs. Fraser-Laird.
Over the course of a day, Mrs. Fraser-Laird commutes 45 minutes on the New York City transit to help families meet many of the most basic physical, emotional, and social needs of the old and disabled.
Ella Johnson, one of her clients has first stage dementia. Unable to care for herself, she requires around the clock care providing her two home attendants to care for her daily needs. Mrs. Fraser-Laird is Mrs. Johnson’s overnight aide, from Friday to Tuesday, she feeds, bathes, cooks, and cleans the house for her. While Mrs. Fraser-Laird fulfills the needs for her clients, her needs are left unmet, like sufficient pay and health benefits.
“Not a lot I am asking for but based on my pay and my performance I should be to live more comfortably,” said Mrs. Fraser-Laird.
Low-pay is a systematic problem in home health care. The average annual earnings are just over $17,000, and the median hourly wage for home attendants is $9.38, according to PHI Quality Care Through Quality Jobs Facts 5 February 2014 Report. PHI (Paraprofessional Healthcare Institute) is the leading authority on the direct-care workforce, which promotes quality direct-care jobs as the foundation for quality care.
The report also states that more more than one in three workers are without health insurance, considerably higher than for the general population, while the rate of employer-provides insurance is considerably lower.
However, for the past 20 years, Mrs. Laird has worked as a home attendant, predominantly for private cases due to her immigration status. In 1955, she entered the America on a visiting visa, which immigrant visitors are not permitted to accept work or work in the United States. She recently received her permanent residency green card in June 2013 a year after she married. Now, working for Tradition Home Care for the city for the last year, she feels little power to assert her rights because she is still in the preliminary stage of her immigration.
Immigrant women in United States (documented and undocumented) comprise of more than half of all immigrants, and many of them work as home health aides. In fact 24 percent of home health aides are foreign-born (PHI Facts).
Both the overall higher standard living and low salaries for home attendants make care-giving for older persons on economically undesirable job for most native citizens.
One contributor to low wages is that, for nearly 40 years, direct care workers have been exempt from federal minimum wage and overtime laws.
But on January 2015, things will change for all direct-care workers in America. The Obama administration has published a new rule narrowing the “companionship” exemption of the Fair Labor Standard Act (FLSA).
When implementation begins in 2015, the majority of home care workers will finally be granted basic labor protections. A large proportion of home care services is financed through government programs like Medicare and Medicaid.
Medicare and Medicaid covers 73 percent of home care services when this industry makes $61 billion in annual revenue.
Despite low wages, home health care occupation is projected to grow 48 percent between 2012 and 2022, a rate of nearly five times that for all occupations. This growth is expected to result in over a million new jobs in home care over the coming decade.