GAO Releases Report on Impact of Home Care Rule

On Monday, the GAO (General Accounting Office) issued a report to Congress on the impact of the 2015 Home Care Rule, which extended Fair Labor Standards Act (FLSA) minimum wage and overtime protections to more home care workers. This report updates the GAO’s initial report in 2014, which reported that key stakeholders had differing perspectives on the potential impact of the Home Care Rule. The new report assesses the implementation and effects of the Home Care Rule using available data and interviews with various stakeholders, including HCAOA members, who were interviewed earlier this year.

The following is a summary of the findings:

• Some State Medicaid programs limited home care workers’ hours to avoid paying overtime costs.
• Other states changed service delivery and discontinued live-in care.
• Providers restricted workers’ hours to limit overtime costs however this required hiring more workers leading to increased costs for recruitment, training and scheduling.  
• An analysis of national data found that home care workers when compared to occupations with similar education and training requirements, were more likely to work full-time but did not earn significantly higher earnings following the Home Care Rule.  
• Many stakeholders described ongoing challenges consumers face in obtaining home care services.  

The report also includes wage information and enforcement activities of the Rule. In 2019, there were 779 FLSA compliance actions involving home care agencies, which represented the majority of complaints. Of these actions, 89% found an FLSA violation. Another area of concern expressed by HCAOA was that the Rule caused some agencies to stop providing respite care for families due to the cost of overtime and this has resulted in additional stress for family caregivers. 

Read the full report here.