Home Health Care Worker Pay Outrage!

Great comment, Joe.

Home healthcare workers due the country an enormous service. My mother, before she retired, was an RN who spent her last years of employment working for a home-health agency. Now that she’s disabled, as is my sister who lives with her, she depends on monthly visits from aides. And having them visit my mother and sister in their home DOES save oodles of money for the tax payer. Both my relatives receive Medicare/Medicaid.

Joe
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I already said whatever I had to say about your view on teacher’s unions. However there is one major contradiction in Frum’s thinking that you didn’t note. California doesn’t HAVE to change their stance on home healthcare workers. They can just say no to the stimulus money. Wouldn’t that be the “conservative” thing to do? After all Frum and his ilk think the stimulus bill was an overreach in and of itself. However if the federal government is spending tax payer money then they should be about the businesses of protecting taxpayers.

Watch out, Joe — they’ll accuse you of having empathy.
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btw (and OT), what’s your take on McKiernan being replaced?

Of course you’re correct about the meager pay of health care workers. But merit pay for teachers is debatable, and the reason is simple. Few educational administrators were ever excellent teachers; nor do they understand the complexities of classrooms. Most were previously, at best, mediocre teachers, and fled the demands of that job quickly. Until a method can be found to indentify and reward outstanding classroom teachers without the intrusion of internal politics, unions–although flawed by a kneejerk tendency to protect a few incompetents–are preferable to bureaucrats. We all remember great teachers. How many “great” educational administrators have you met?

“And, by doing so, they save enormous amount of money that would otherwise be spent putting the elderly into nursing facilities….And those $2 are the purest form of stimulus–these are people who will spend every penny in order to try to make ends meet.”

You know, disregarding all the rest of the article, it’s such a refreshing change to see in a media article (1) a consideration of more than just a single piece of the cost/benefit ratio, and (2) the point (which is almost universally overlooked) that for those of us on the lower end of the scale, every penny we get in income goes right back out to pay for things. Up higher on the scale, that money may flow straight to the big credit banks, but down where I am, there’s a backlog in home repairs, car repairs, furniture purchases, etc. simply because there’s no money available to pay for it. The tax breaks on some of these things are nice, but since I can’t afford any of them, it does me little good, and doesn’t help the contractors who would otherwise be coming to my place to replace aging windows, doors and parts of the roof. Not to mention leaking bathroom fixtures which are as old as I am, and removing trees that are in danger of taking out both my phone and power lines. Some of these things I can do (poorly) myself, but that historically replaces one problem with two or more. It’s the old non-profit problem – do you get volunteer help to fix a problem in such a way that it costs more to fix properly later, or do you leave it alone and have it get much worse more quickly?

While on one hand I will agree with you Joe that targeting and cutting costs for home health aides to save money for the state budget is crazy. I do agree with Frum, in that California should have the ability to make budget cuts where they see fit.
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The fact that reimbursement for a home health aide is done in either a lump sum Medicare payment to the home health agency, usually around $2400.00 per episode, 60 days. This includes the cost of a home health aide. HMO and Medicaid reimbursements are averaging about $30.00 per visit. But, it is the home health company who determines how much the aide is actually paid.
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Average pay received by a home health aide is approximately $8.00 dollars/hour to $12.40 per hour.
http://www.msgcpa.com/general.php?category=Industry+Library&headline=Home+Health+Care
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“Median hourly earnings of home health aides were $8.81 in May 2004. The middle 50 percent earned between $7.52 and $10.38 an hour. The lowest 10 percent earned less than $6.52, and the highest 10 percent earned more than $12.32 an hour. Median hourly earnings in the industries employing the largest numbers of home health aides by program in May 2004 were as follows:”
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So, truth be known, Frum is correct in stating Obama IS interferring as he has also done with Chrysler and GM in State business. Obama is dictating to States like California and determining where they area allowed to make cuts in their specific budgets and where they may not. Obama is using the “stimulus” money as a means to strong arm States into spending money how he sees it to be spent. This is not the role of the Federal Government.
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While cutting back on home health funding by California is a bad idea on the part of the California legislature. It is that State’s right to do so. It is not Obama’s role to demand they not cut this program or that one.
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You are wrong yet again Joe, and your “outrage” should be re-directed towards Obama and his merry bunch of idiots in the White House, not Frum and the California Government. The outrage should be directed at the overall government reimbursement, and to call for legislation allowing for more people to be covered under a government or private insurance reimbursement for care in the home, period. For the past 10 years, the Federal Government has been cutting reimbursement rates to Home Health Agencies. This has kept the hourly rate of pay for the hard working home health aides at just above the level of poverty. That is the real shame in all of this.

It’s all those home health care workers living in sprawling homes (they can’t afford) and clogging up Frum’s favorite restaurants to the point of making him wait an extra 30 minutes for a table on a Saturday night that is irritating him.
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Damn them.
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I always laugh when I hear Republicans pisssss and moan about how much teachers make or home health care workers or police or firefighters.
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My dad was a fireman and a tradesman on his off days. I remember when night at a church function when a guy from the neighborhood who was a salesman (and a Republican) had had a few pops and said to my old man, “You make too much money.”
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At first, I thought my old man might give the guy a poke in the nose, but, instead, my dad said, “Hey, you think it’s easy? Take the firefighters test. Leran a trade. What’s stopping you?
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That shut the guy up. I think my old man has done some work for the guy and charged him $90 for a job that took about an 90 minutes.
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I remember one day when were doing some work at a doctor’s office and we were all done before Noon and I started cleaning up. My dad said to me, “Slow down! We don’t want the doctor to think we make more money than he does!”

Frum’s argument that the Federal Government should turn a blind eye when States’ make decisions that run counter to our need to (A) provide better health care at home and (B) stimulate the economy is intellectually correct but wrong on the merits.
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The British made similar arguments during the Irish Potato Famine. They didn’t want to suspend or substantially alter their laws due to a fear of upsetting long established laws and practices. The Irish were starving, yet they continued to export beef and send rents to landlords in England. The English Government was also unwilling to send substantial cash payments due to a fear of upsetting capitalistic principles. In fact, to get relief the Irish landowners had to sign away their property. It was a response driven by intellect but not by common sense.
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We are in a crisis. People are suffering. California’s government is a complete mess. Their laws make the state ungovernable. Obama is right to dictate that Federal dollars be spent in ways that drive the economy.
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I do agree with Rusty that what we pay home health care workers is wrong. We should be paying them (and teachers and other public servants) a wage that places them comfortably in the middle class. I suggest we extract that cash out of the hide of the private health insurance executives who are nothing more than middle men who provide zero value to patients, health care workers, or taxpayers.
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We would never accept having a layer of management in our water utilities that sucked up 35 to 40 percent of gross revenues. Why should we treat health care any differently than another utility than must be firmly managed and controlled by citizens.

Holy sheepsh!^, I’m in agreement with Rusty!
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The bottom line is that neither Frum’s article nor Joe Klein’s provide nearly enough information to determine who’s getting screwed.
My first question was why are home-health care workers state employees in the first place?
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We can all agree that paying the workers an adequate wage is a worthy goal yet have serious reservations about where the money should be coming from. This would represent significantly less of a problem if it weren’t for the religious fervor behind the notion that there’s something inherently evil about taxes and adequate funding for needed government services.

I have to agree with meldoc. As a long time teacher I have found that merit pay is not the be all end all that administrators and outsiders think it it. While good teachers are recommended for merit pay (and I have been one of those),most often the people recommended are those that court favor with the administration (the words brown-nose and suck up come to mind). You will also find it does not foster sharing of ideas and cooperation. Also, in a district where most of the teachers are good, how does one choose? Lastly, whatever gave anyone the idea that good teachers are motivated by higher pay. Raise the pay for all and have the administrators get rid of teachers that do not achieve.

Frum is wrong on a conservative level too: the federal govt. is giving states aid and making ceartin requirements. If Cali doesn’t want to pay the $2 they contractually promised they can go ahead and break that contract. It just means they’ll lose a couple of billion dollars.

The federal government is not an ATM for the states; it has priorities and it owes it to pursue policies that benefit the nation. That extra $2 is as you say the purest form of stimulus; as such it would be insane for the administration to back down.

My issue with Frum is not recognizing the conservative solution; don’t take the money. But then, you become Mark Sanford.

California doesn’t HAVE to change their stance on home healthcare workers. They can just say no to the stimulus money. Wouldn’t that be the “conservative” thing to do? After all Frum and his ilk think the stimulus bill was an overreach in and of itself. However if the federal government is spending tax payer money then they should be about the businesses of protecting taxpayers.
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SG, well said. The federalist concern here is largely imaginary.
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And I agree with Paul Dirks and Rusty – has anyone ever said that before? – about the complexities and questions about home health care aid compensation.

I hope this adds some clarity to the caregiver pay issue. In home supportive services is a part of Medi-cal. The idea is to provide assistance in the home of a person that would otherwise need skilled nursing. There are no qualifications to be an IHSS caregiver. Usually the person receiving IHSS services selects a caregiver from a list of those registered with Medi-cal to provide the services. Home health care agencies wanted in on the opportunity, but since the services were provided by individuals, to individuals they found it difficult. ADDUS was central to this effort in my community. Around that same time SEIU attempted to organize the IHSS caregivers. The main point I am making is, this does not affect all caregivers, just those working through IHSS. The second point is that IHSS was not meant to be a provider of skilled services, but rather supportive services like shopping, house keeping, meal prep, assistance with dressing, toileting, transferring, etc. Please bring a well informed mind to the problem of health care reform.

jerryinchicoca does have a great point about SEIU. And, SEIU I found out today is in cahoots with ACORN’s monetary arm, CCI (Citizens Consulting Inc). CCI is the collection point for all money that receives grants or private donations.
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This gets very deep. The Washington reporter is going to break a story about severeal ACORN members who have been thrown out of the organization for asking questions. Yes, whistleblowers on ACORN and affiliates monetary practices. We have been led to believe that ACORN was all about politics. Its not. It IS about money, and the pursuit of millions of tax payer dollars which are not going to people in need, but in the pockets of corrupt individuals. Individuals who control not only ACORN and CCI, but also SEIU. SEIU gave 33 MILLION dollars to the Obama campaign.
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This could really become serious. I think 2 dollars an hour being ripped off of the hard working home health aides, whether medical aides or the other even lower paid custodial care aides is nothing compared to what may be found out about Obama’s connection with ACORN via CCI and SEIU.
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This is a story you should be writing about Joe Klein.