SHOULD THE STATE EMPLOY HOME HEALTH AIDES?

Should the state of New Jersey employ home health aides? A proposed bill that may be submitted to New Jersey’s Legislature would put New Jersey in the home health aide business. The organization behind the bill is the Service Employees International Union (SEIU). The SEIU would stand to receive union due from home health aides, who, under the terms of the bill, would be compelled to register with one of four “Quality Home Care Councils” that would be created under the bill.

Often, when an elderly individual requires assistance with the activities of daily living (clothing, bathing, feeding, mobility, grooming, etc.), the family will try and retain the services of a home health aide. Hiring a home health aid can be a daunting task.

First of all, home health aides are relatively expensive. A live in home health aide could cost anywhere from $2,300 to $4,500 a month. The variation in cost often turns on whether the family is hiring a home health aide who is really an independent contractor being placed by an agency or a home health aide who is an employee of the home health aide company.

Independent consultant home health aides are frequently foreigners who may or may not be in the United States legally and who may or may not want the family to report the wages of the worker to the government. (Think Zoë Baird – one of President Clinton’s ill-fated choices for Attorney General who withdrew her nomination after it was discovered that she employed a foreigner as her children’s nanny and failed to pay employer’s taxes.) Technically, the family is the employer and the family must prepare any and all employer-employee tax returns and pay the applicable withholding taxes.

If the aide is the employee of a company, the company will typically charge more for the services of the aide. The fact of the matter is, a home health aide company has more invested in the aide (employer’s taxes, benefits) than a placement agency that is finding and placing an aide with a family.

Under either scenario (employee or independent consultant of an agency), the expense of a home health aide can be intimidating.

The second major issue facing a family is finding a worker who is the right fit for the elderly family member. The aide will be living with the elderly individual who may be use to living alone. Finding the right fit can be very difficult.

The third major issue is something that is inherent in the two issues mentioned above, How does the average person – who is obviously distraught over the fact that her parent is deteriorating and now requires long-term care – find the right home health aide and understand her rights and obligations?

The proposed bill would seem to offer the solution to many of these problems. But that’s simply not the case.

The bill focuses on improving the quality of the work environment for the home health aide worker. Don’t forget, the organization behind the bill is a labor union that stands to collect union dues from thousands of new members.

As I read the bill, there is nothing in it that would improve the quality of the aides servicing New Jersey residents or that would improve the quality of the work environment for aides. In fact, many individuals in the industry opine that the quality of service and the work environment would decline since nurse supervision of aides would diminish and claimed wage increases for aides are illusionary.

Arguably, the bill would provide a single source for obtaining an aide. In other words, if I were a family member who wanted an aide, I could contact the appropriate Quality Home Care Council for my region and inquire as to available aides in my area.

But what would the Council provide me? A list of names. What do names do for me? And if I have a problem with an aide to whom do I complain, the State. I hate to sound cynical, but good luck.

Assuredly, this bill would put the vast majority of private home health aide agencies and employers out of business. As a businessman, one thing I can tell you about businesspeople in general, we care about our business and we care about satisfying our clients. Whether you contact an agency or an employer, the company will, more likely than not, take a genuine interest in finding you an aide who is right for your situation. I’ve never taken that impression away from any dealing I have ever had with a government agency.

The real issues surrounding home aides – finding the right aide, being able to afford an aide, paying employer taxes – are difficult issues that are not addressed by this bill.