Yet another government induced conundrum

So if you have read any of my previous posts, you most likely know my opinions on overtime pay for direct care staff. Direct care staff go by a number of different names depending on where you are from but the people I’m referring to are the people who, for myself, take care of people in their home. Again, for myself and my own personal needs, these needs range from toiletry needs, feeding, dressing, among other daily tasks. There are two common types of people who do this kind of work, when payment is involved, people either work for agencies or they are independent providers. Agencies, in Ohio, currently receive about $21\hour from Medicaid and out of that money, they pay their employees. In the cases of independent providers, people independently contract with the county and are basically their own business. From Medicaid get paid about $18\hour and they receive payment directly from the county/state. You might be wondering why everyone doesn’t become an independent provider instead of working for an agency since you make more. There are a number of advantages and disadvantages with being an independent provider that I’m not going to discuss as it is not the purpose of this article.

There is another aspect of how both independent providers and agencies get paid that I must explain for clarification. When a person with a disability receives in-home personal care services, the number of hours per day, week, month or year are based on what kind of needs the individual has. I, myself, need help with feeding, toiletries and other personal hygiene and daily tasks. So based on these needs, it is figured out that I need assistance for X number of hours each day. Then from this, it is calculated how much money it is going to cost for the entire year. With this amount, Medicaid allocates this amount to my services. Now it is mostly up to myself to be sure to budget this amount of money to last me the entire year. If I have $7,665 allocated to me, that equals 1 hour per day for 365 days through an agency. I could use 2 hours per day if I wanted but that would mean I would run out of my funds in six months and be without services for the second six months of the year.

With the new requirement to pay in-home care workers overtime compensation, it throws an interesting and screwed up kink into things. If you haven’t read my previous articles on this topic, I encourage you to do so at the following links to get an idea of what is going on and how it is going to hurt agencies and the people who have disabilities and receive services.

You get a pretty good idea from those articles as to what I think is going to happen with agencies and individuals with disabilities due to this new requirement. This time I want to introduce you to complications with this new requirement and independent providers. We just learned that a person with a disability might receive in-home personal care and has money allocated to them to pay for this care/service. It is up to the individual to choose whether they want an independent provider(s) or an agency(ies) to provide this service. Just like there are advantages and disadvantages to being an independent provider, there are also advantages and disadvantages for the person with disability to have an independent provider. I like the security that an agency gives me but I absolutely support those who choose to hire independent providers.

These independent providers are in-home personal care workers so under the new law, they are required to receive overtime compensation for any amount of work they perform that is more than 40 hours in a single week. So say an independent provider works 60 hours a week, they would receive $720 for the first 40 hours and then they would get paid $540 for the remaining 20 hour since they would be getting $27/hour for that last 20 hours (overtime is 150% of your normal pay). The problem with this is, that $27/hour is going to eat up my allocated funds much faster. So if I have 10 hours per day, 7 days a week, allocated to my services at $18/hour, I am going to have $65,700/year ($1,263.46/week) allocated to my services. But what happens when my independent provider works 60 hours in a week? They are going to get paid $1,260 and then the other provider that works the remaining 10 hours that week is going to get paid $180. Simple arithmetic tells us that $1,260+$180=$1,440. This is more than the amount I have allocated which means I am going to run out of funds before the year is up.

A more interesting point of view is when an independent provider works with more than one client, which does happen since the idea of being an independent provider is to make a living and if one client doesn’t provide enough hours to make that living, then you will need another client. So let’s say an independent provider works with client #1 40 hours in the first five days of the week, they would get paid the normal $18/hour. Then the sixth day of the week, the independent provider works with client #2 for 10 hour. These 10 hours are over 40 for the week so they are required to be paid 150%, $27/hour, for those hours. That extra $9/hour comes out of client #2’s funds which then screws up the second client’s budget! How is that fair to the client #2 and how do you compensate for this? Client #2 doesn’t have a right to tell the independent provider that they can only work with their client #1 for 30 hours a week. And if I’m client #1, I don’t want to worry about if my provider will go over 40 hours in a week! I have needs that need met, period!

This is just one more example of how governmental regulation throws a wrench into things. If this overtime rule is not reverse, it is going to create some very interesting situations and problems. It is not feasible to simply raise individual’s allocated funds because, for one, the government does not have the money to do so. Second, how are you going to predict how much an individual is going to need for overtime coverage? And thirdly, can you imagine how much people might take advantage of this? If I can work that many hours and make quite a lot of money, why not? If you are an independent provider or employ one, you better prepare for a roller coaster!