Take Action on Companionship Exemption Today!

8/13/2025

HCAOA is asking ALL members for help to permanently overturn the restrictive companionship exemption rules put in place in 2013. Thanks to your persistent advocacy and the strength of our members speaking together, HCAOA is making tremendous progress in getting the caregiver exemption restored, but we need YOUR voice to get this goal across the finish line!

The Department of Labor (DOL) has taken two critical steps to make this possible:

The DOL has issued a proposed rule to revise the “companionship exemption” regulations under the Fair Labor Standards Act. If finalized, this will correct the problems created by the restrictive 2013 rule, giving agencies greater ability to meet client needs, offer more hours to caregivers, and reduce unnecessary disruptions in care. This is the change our industry has worked toward for years.
On July 25, 2025, DOL issued Field Assistance Bulletin 2025-4, suspending its enforcement of the restrictive provisions in the 2013 rule. This immediate step restores flexibility and provides clarity for agencies and caregivers while the rulemaking process moves forward. This is a huge win for our industry.

These developments are a direct reflection of what we can accomplish when our industry speaks with one voice! But the proposed rule is not yet final. DOL is accepting public comments until September 2, 2025, and it is critical that they hear from providers like you about how this change will benefit both clients and caregivers.

Please Submit Your Comments to the DOL Urging them to Reverse the 2013 Rule!

If the DOL hears from enough voices in the industry, it is very likely that they will reverse the overly restrictive 2013 rule. So please take action by submitting comments prior to the September 2, 2025 deadline. To make this easy, we have prepared a template letter you can personalize and submit to DOL along with instructions on how to submit the comments.

CLICK HERE to access the template letter and comment submission instructions.

Please take a few minutes to send in your comments before the deadline. Every submission brings us closer to making this long-awaited fix permanent!

Cesar Silverio link

8/13/2025 10:56:05 am

If the federal government rolls back the 2013 Companionship Rule, it would give home care agencies — including Ebenezer Homecare — more flexibility to provide care to more clients, without the same scheduling and cost barriers that currently exist.

Under the current rule, overtime pay requirements often make long or complex schedules financially challenging. This can limit how many hours of care clients receive or force agencies to rotate multiple caregivers, which can disrupt continuity of care.

By restoring the previous exemptions:
• Agencies can serve more clients without being restricted by overtime cost limits.
• Care schedules can be more stable, with fewer caregiver changes for clients who need many hours of care each week.
• Families may pay less out-of-pocket, making home care more affordable and accessible.
• Agencies can grow sustainably, hiring and retaining more staff to meet increasing demand.

For Ebenezer Homecare, this change would mean we could focus more on matching the right caregiver to the right client for as many hours as needed — without having to break up schedules solely because of overtime cost limits. This flexibility would help us deliver consistent, high-quality care while keeping services financially viable for both our agency and the families we serve.

Tina Baker link

8/20/2025 01:18:39 pm

August 20, 2025

Acting Administrator Harrison,

As a home care provider serving multiple locations in Virginia, I write in strong support of the U.S. Department of Labor’s July 2, 2025, Notice of Proposed Rulemaking to reinstate the companionship services exemption under the Fair Labor Standards Act.

This rule is essential to ensure that older adults and individuals with disabilities can continue to receive the non-medical support they need to remain safely and comfortably at home. The 2013 rule change significantly limited access to affordable home care by increasing costs and administrative burdens for home care agencies.

By reinstating the Companionship Exemption, providers, including the company I work for, would be able to assist more people with the vital services they need to be able to stay in the comfort and security of their homes which is more cost effective than Nursing Homes to the state and federal government. By reinstating the Companionship Exemption, we would be able to move Medicaid Members from waiting lists to active service to meet their needs.

It is no secret that there is a National Caregiver shortage and here in Virginia we struggle with the shortage daily. We cannot work caregivers over 40 hours and pay overtime due to the Medicaid reimbursement rate. At an overtime pay rate, providers would be losing significant amounts of money per hour and would not be able to financially survive. For our caregivers they would love to be able to work just one job and not have to have multiple jobs to be able to make ends meet financially. Reinstatement of the Companionship Exemption would attract more workers to come into the In-Home Care Services arena.

Overall cost for Private Pay clients could become steady and not increase as they have over the last several years due to less expenses for advertising for hiring and the cost of the actual
hiring process.

Restoring the exemption will help:

1. Reduce service disruption for vulnerable populations who rely on continuity of care;
2. Help caregivers maintain steady employment by preserving more hours and assignments that would otherwise be eliminated due to cost pressures;
3. Support agencies’ ability to schedule staff flexibly, including for overnight and live-in care;
4. Lower the cost of care for families and public programs already facing workforce shortages and budget constraints; and
5. Promote consumer choice by protecting access to home-based alternatives to institutional care.

I respectfully urge the Department to finalize this proposed rule and fully restore the pre-2013 framework for companionship services. The home care sector is facing a growing crisis in both workforce availability and financial sustainability. This rule is a necessary step to ensure that agencies can continue delivering essential care in the most preferred and cost-effective setting: the home.

Thank you for the opportunity to comment.

Sincerely,

Tina Baker
AmeriCare Plus
Clifton Forge VA 24422

Brooke Belfield

8/25/2025 08:44:35 am

August 25, 2025

Acting Administrator Harrison,

As a home care provider serving multiple locations in Virginia, I write in strong support of the U.S. Department of Labor’s July 2, 2025, Notice of Proposed Rulemaking to reinstate the companionship services exemption under the Fair Labor Standards Act.

This rule is essential to ensure that older adults and individuals with disabilities can continue to receive the non-medical support they need to remain safely and comfortably at home. The 2013 rule change significantly limited access to affordable home care by increasing costs and administrative burdens for home care agencies.

By reinstating the Companionship Exemption, providers, including the company I work for, would be able to assist more people with the vital services they need to be able to stay in the comfort and security of their homes which is more cost effective than Nursing Homes to the state and federal government. By reinstating the Companionship Exemption, we would be able to move Medicaid Members from waiting lists to active service to meet their needs.

It is no secret that there is a National Caregiver shortage and here in Virginia we struggle with the shortage daily. We cannot work caregivers over 40 hours and pay overtime due to the Medicaid reimbursement rate. At an overtime pay rate, providers would be losing significant amounts of money per hour and would not be able to financially survive. For our caregivers they would love to be able to work just one job and not have to have multiple jobs to be able to make ends meet financially. Reinstatement of the Companionship Exemption would attract more workers to come into the In-Home Care Services arena.

Overall cost for Private Pay clients could become steady and not increase as they have over the last several years due to less expenses for advertising for hiring and the cost of the actual
hiring process.

Restoring the exemption will help:

1. Reduce service disruption for vulnerable populations who rely on continuity of care;
2. Help caregivers maintain steady employment by preserving more hours and assignments that would otherwise be eliminated due to cost pressures;
3. Support agencies’ ability to schedule staff flexibly, including for overnight and live-in care;
4. Lower the cost of care for families and public programs already facing workforce shortages and budget constraints; and
5. Promote consumer choice by protecting access to home-based alternatives to institutional care.

I respectfully urge the Department to finalize this proposed rule and fully restore the pre-2013 framework for companionship services. The home care sector is facing a growing crisis in both workforce availability and financial sustainability. This rule is a necessary step to ensure that agencies can continue delivering essential care in the most preferred and cost-effective setting: the home.

Thank you for the opportunity to comment.

Sincerely,

Brooke Belfield
AmeriCare Plus
Tappahannock Va 22560

Celeste Freeland

8/13/2025 10:02:05 pm

Please permanently overturn the restrictive companionship exemption rules put in place in 2013.

Deborah Hardwick link

8/20/2025 12:52:26 pm

Janet Ross link

8/20/2025 01:23:46 pm

Mitzi Jackson link

8/20/2025 01:39:57 pm

Nicole E Jones

8/20/2025 02:41:41 pm

Lisa Webb link

8/20/2025 02:54:06 pm

August 20, 2025

Acting Administrator Harrison,

As a home care provider serving multiple locations in Virginia, I write in strong support of the U.S. Department of Labor’s July 2, 2025, Notice of Proposed Rulemaking to reinstate the companionship services exemption under the Fair Labor Standards Act.

This rule is essential to ensure that older adults and individuals with disabilities can continue to receive the non-medical support they need to remain safely and comfortably at home. The 2013 rule change significantly limited access to affordable home care by increasing costs and administrative burdens for home care agencies.

By reinstating the Companionship Exemption, providers, including the company I work for, would be able to assist more people with the vital services they need to be able to stay in the comfort and security of their homes which is more cost effective than Nursing Homes to the state and federal government. By reinstating the Companionship Exemption, we would be able to move Medicaid Members from waiting lists to active service to meet their needs.

It is no secret that there is a National Caregiver shortage and here in Virginia we struggle with the shortage daily. We cannot work caregivers over 40 hours and pay overtime due to the Medicaid reimbursement rate. At an overtime pay rate, providers would be losing significant amounts of money per hour and would not be able to financially survive. For our caregivers they would love to be able to work just one job and not have to have multiple jobs to be able to make ends meet financially. Reinstatement of the Companionship Exemption would attract more workers to come into the In-Home Care Services arena.

Overall cost for Private Pay clients could become steady and not increase as they have over the last several years due to less expenses for advertising for hiring and the cost of the actual

hiring process.

Restoring the exemption will help:

1. Reduce service disruption for vulnerable populations who rely on continuity of care;

2. Help caregivers maintain steady employment by preserving more hours and assignments that would otherwise be eliminated due to cost pressures;

3. Support agencies’ ability to schedule staff flexibly, including for overnight and live-in care;

4. Lower the cost of care for families and public programs already facing workforce shortages and budget constraints; and

5. Promote consumer choice by protecting access to home-based alternatives to institutional care.

I respectfully urge the Department to finalize this proposed rule and fully restore the pre-2013 framework for companionship services. The home care sector is facing a growing crisis in both workforce availability and financial sustainability. This rule is a necessary step to ensure that agencies can continue delivering essential care in the most preferred and cost-effective setting: the home.

Thank you for the opportunity to comment.

Sincerely,

Lisa B. Webb

AmeriCare Plus Pulaski, Va 24301

Natalie Perkins link

8/20/2025 02:59:13 pm

August 20, 2025

Acting Administrator Harrison,

As a home care provider serving multiple locations in Virginia, I write in strong support of the U.S. Department of Labor’s July 2, 2025, Notice of Proposed Rulemaking to reinstate the companionship services exemption under the Fair Labor Standards Act.

This rule is essential to ensure that older adults and individuals with disabilities can continue to receive the non-medical support they need to remain safely and comfortably at home. The 2013 rule change significantly limited access to affordable home care by increasing costs and administrative burdens for home care agencies.

By reinstating the Companionship Exemption, providers, including the company I work for, would be able to assist more people with the vital services they need to be able to stay in the comfort and security of their homes which is more cost effective than Nursing Homes to the state and federal government. By reinstating the Companionship Exemption, we would be able to move Medicaid Members from waiting lists to active service to meet their needs.

It is no secret that there is a National Caregiver shortage and here in Virginia we struggle with the shortage daily. We cannot work caregivers over 40 hours and pay overtime due to the Medicaid reimbursement rate. At an overtime pay rate, providers would be losing significant amounts of money per hour and would not be able to financially survive. For our caregivers they would love to be able to work just one job and not have to have multiple jobs to be able to make ends meet financially. Reinstatement of the Companionship Exemption would attract more workers to come into the In-Home Care Services arena.

Overall cost for Private Pay clients could become steady and not increase as they have over the last several years due to less expenses for advertising for hiring and the cost of the actual

hiring process.

Restoring the exemption will help:

1. Reduce service disruption for vulnerable populations who rely on continuity of care;

2. Help caregivers maintain steady employment by preserving more hours and assignments that would otherwise be eliminated due to cost pressures;

3. Support agencies’ ability to schedule staff flexibly, including for overnight and live-in care;

4. Lower the cost of care for families and public programs already facing workforce shortages and budget constraints; and

5. Promote consumer choice by protecting access to home-based alternatives to institutional care.

I respectfully urge the Department to finalize this proposed rule and fully restore the pre-2013 framework for companionship services. The home care sector is facing a growing crisis in both workforce availability and financial sustainability. This rule is a necessary step to ensure that agencies can continue delivering essential care in the most preferred and cost-effective setting: the home.

Thank you for the opportunity to comment.

Sincerely,

Natalie Perkins.

AmeriCare Plus Pulaski, Va 24301

Shawna Heltman

8/20/2025 03:18:36 pm

Leighann Cubbage

8/20/2025 04:26:23 pm

August 20, 2025

Acting Administrator Harrison,

As a home care provider serving multiple locations in Virginia, I write in strong support of the U.S. Department of Labor’s July 2, 2025, Notice of Proposed Rulemaking to reinstate the companionship services exemption under the Fair Labor Standards Act.
This rule is essential to ensure that older adults and individuals with disabilities can continue to receive the non-medical support they need to remain safely and comfortably at home. The 2013 rule change significantly limited access to affordable home care by increasing costs and administrative burdens for home care agencies.

By reinstating the Companionship Exemption, providers, including the company I work for, would be able to assist more people with the vital services they need to be able to stay in the comfort and security of their homes which is more cost effective than Nursing Homes to the state and federal government. By reinstating the Companionship Exemption, we would be able to move Medicaid Members from waiting lists to active service to meet their needs.
It is no secret that there is a National Caregiver shortage and here in Virginia we struggle with the shortage daily. We cannot work caregivers over 40 hours and pay overtime due to the Medicaid reimbursement rate. At an overtime pay rate, providers would be losing significant amounts of money per hour and would not be able to financially survive. For our caregivers they would love to be able to work just one job and not have to have multiple jobs to be able to make ends meet financially. Reinstatement of the Companionship Exemption would attract more workers to come into the In-Home Care Services arena.
Overall cost for Private Pay clients could become steady and not increase as they have over the last several years due to less expenses for advertising for hiring and the cost of the actual
hiring process.

Restoring the exemption will help:

1. Reduce service disruption for vulnerable populations who rely on continuity of care;
2. Help caregivers maintain steady employment by preserving more hours and assignments that would otherwise be eliminated due to cost pressures;
3. Support agencies’ ability to schedule staff flexibly, including for overnight and live-in care;
4. Lower the cost of care for families and public programs already facing workforce shortages and budget constraints; and
5. Promote consumer choice by protecting access to home-based alternatives to institutional care.

I respectfully urge the Department to finalize this proposed rule and fully restore the pre-2013 framework for companionship services. The home care sector is facing a growing crisis in both workforce availability and financial sustainability. This rule is a necessary step to ensure that agencies can continue delivering essential care in the most preferred and cost-effective setting: the home.

Thank you for the opportunity to comment.

Sincerely,
LeighAnn Cubbage
AmeriCare Plus
Orange, Va 22560

Melissa Baugh

8/21/2025 08:52:26 am

As a home care provider serving multiple locations in Virginia, I write in strong support of the U.S. Department of Labor’s July 2, 2025, Notice of Proposed Rulemaking to reinstate the companionship services exemption under the Fair Labor Standards Act.

This rule is essential to ensure that older adults and individuals with disabilities can continue to receive the non-medical support they need to remain safely and comfortably at home. The 2013 rule change significantly limited access to affordable home care by increasing costs and administrative burdens for home care agencies.

By reinstating the Companionship Exemption, providers, including the company I work for, would be able to assist more people with the vital services they need to be able to stay in the comfort and security of their homes which is more cost effective than Nursing Homes to the state and federal government. By reinstating the Companionship Exemption, we would be able to move Medicaid Members from waiting lists to active service to meet their needs.

It is no secret that there is a National Caregiver shortage and here in Virginia we struggle with the shortage daily. We cannot work caregivers over 40 hours and pay overtime due to the Medicaid reimbursement rate. At an overtime pay rate, providers would be losing significant amounts of money per hour and would not be able to financially survive. For our caregivers they would love to be able to work just one job and not have to have multiple jobs to be able to make ends meet financially. Reinstatement of the Companionship Exemption would attract more workers to come into the In-Home Care Services arena.

Overall cost for Private Pay clients could become steady and not increase as they have over the last several years due to less expenses for advertising for hiring and the cost of the actual
hiring process.

Restoring the exemption will help:

1. Reduce service disruption for vulnerable populations who rely on continuity of care;
2. Help caregivers maintain steady employment by preserving more hours and assignments that would otherwise be eliminated due to cost pressures;
3. Support agencies’ ability to schedule staff flexibly, including for overnight and live-in care;
4. Lower the cost of care for families and public programs already facing workforce shortages and budget constraints; and
5. Promote consumer choice by protecting access to home-based alternatives to institutional care.

I respectfully urge the Department to finalize this proposed rule and fully restore the pre-2013 framework for companionship services. The home care sector is facing a growing crisis in both workforce availability and financial sustainability. This rule is a necessary step to ensure that agencies can continue delivering essential care in the most preferred and cost-effective setting: the home.

Thank you for the opportunity to comment.

Sincerely,

Amna Khawaja

8/23/2025 08:55:49 pm

Acting Administrator Harrison,

As a Texas home care provider, I strongly support the Department of Labor’s proposed rule to reinstate the Companionship Services Exemption under the Fair Labor Standards Act.

This change is critical to ensuring older adults and individuals with disabilities can continue receiving affordable, non-medical support at home. The 2013 rule drove up costs and created unnecessary administrative burdens that limited access to care.

Reinstating the exemption will:

1. Reduce service disruptions for vulnerable populations who rely on continuity of care.

2 Help caregivers maintain steady employment and avoid juggling multiple jobs.

3. Support agencies’ ability to schedule overnight and live-in care flexibly.

4. Lower costs for families and Medicaid programs already stretched thin.

5. Expand consumer choice by protecting access to home-based care.

Here in Texas, we face a severe caregiver shortage. Without this exemption, agencies can’t schedule caregivers over 40 hours due to overtime pay constraints tied to Medicaid reimbursement. That means fewer hours, more staff turnover, and higher costs for families. Restoring the exemption will let us serve more people, reduce waiting lists, and attract new caregivers into the field.

Home-based care is the most cost-effective and preferred option compared to institutional care. This rule is essential to keep it sustainable.

I urge the Department to finalize this proposal and restore the pre-2013 framework for companionship services.

Thank you for the opportunity to comment.

Sincerely,

Amna Khawaja
CareBuilders at Home
Prosper TX

Comments are closed.

Take Action on Companionship Exemption Today!

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