OLMIS

by Dwayne Stevenson
Published Jun-22-2010

The Beginning of Home Care Workers Compensation Reliance on Home Care Jobs Conclusion

Providing in-home care to the elderly and people with disabilities began in 1980 with a Medicaid waiver for Oregon, allowing an individual to live independently in their community rather than in an institutional setting. Oregon became nationally recognized for this consumer-driven program. The quality of life for the home care consumer improved and the move reduced costs to taxpayers.

The establishment and growth of this program created a new occupation - home care workers. In Oregon, approximately 11,000 home care workers are employed at any one time by seniors and people with disabilities. Many of these workers are family members or friends of the consumer, working in their employer's home.

In 2000, the Oregon Homecare Commission (OHC) was established and funded to address job placement and training concerns. While the clients hire, supervise, and schedule the home care workers, OHC is the employer of record providing payroll and other centralized functions. One of the key centralized functions is a criminal background check on every home care worker applicant. OHC also oversees the provision of training courses that cover topics such as infection control, communication, and abuse recognition.

Once home care workers are on the job, their paid work activities are limited to what are called activities of daily living. Cheryl Miller, the executive director of the Oregon Home Care Commission, says, "The home care worker can't go chop wood for example. That's not a Medicaid-authorized service. But assisting someone with their activities of daily living, helping them with medication management or shopping, those are the types of tasks a home care worker provides for a consumer-employer in their own home."

For this work, home care workers earn $10.20 per hour. If they work on a live-in basis, the hourly rate depends on the level of care - $10.20 per hour if providing some level of direct assistance or $4.55 per hour for helping the client self-manage and for being available on a 24-hour basis. Relief or substitute home care workers receive either the $10.20 hourly rate for shifts of 12 hours or less, or a $175 flat rate for a 24-hour shift.

While about 11,000 home care workers are employed in a given month, about 18,000 work at some point during the year (Table 1). Of these, 10,740 work exclusively as home care workers and another 2,500 have this work as their primary job. Over 5,100 (or two thirds of multiple job holders) individuals working as home care workers have other primary employment. This makes sense when considering the need for weekend and relief coverage.

Just over half (9,400) of home care workers did not work in all four quarters of the selected year. Such home care workers include those beginning, ending or waiting between jobs as well as those who are marginally attached to this work.

This leaves just under half of home care workers who worked in all four quarters. Almost 4,400 worked at least 350 hours (an average of more than 26 hours per week) in all four quarters. Most of these (2,400) also had another job.

The home care workforce has certainly grown and reshaped itself over the years. It appears to be made up of two primary components: those significantly or exclusively employed in this field, and those secondarily (with other primary jobs) employed in this field. Both components are probably driven more by care for their client-employers or for relieving other caregivers than by the compensation or career opportunities. While wages are low, these workers make a big difference in the quality of life for seniors and people with disabilities.