As the home- and community-based services segment continues to grow, some HCBS workers are trying to change current laws that prevent them from receiving overtime pay and minimum-wage protections, according to recent reports.

Under a 1974 amendment to the Fair Labor Standards Act, certain home workers were extended minimum wage and overtime pay protections. But at the time Congress decided to exclude what they considered casual workers, including home-care workers. Now, union groups, including the Service Employees International Union, are pushing lawmakers and Secretary of Labor Hilda Solis to overturn that stipulation, The Wall Street Journal reported. Some advocates for workers’ pay reform say that increased pay for home-care workers equals better care for the elderly, and that reduced quality of home care could force seniors into nursing homes, which cost more to Medicare and Medicaid, reports the Journal. Meanwhile, HCBS providers are concerned that the extra money required to fund the overtime requests would bankrupt the system.

There has been a steady trending toward HCBS in the last few years, and efforts to shift money away from nursing homes to the home-care programs have been ramped up during the healthcare reform debates. A recent study finds that, while nursing homes still receive the majority of Medicaid funds overall, some states have started allocating more money for HCBS than for traditional skilled nursing care. (McKnight’s, 3/4)