Minnesota Personal Care Assistants Face 20% Pay Cut

Tim Plant

We Minnesotans used to be full of pride for our prudent government and our tradition of fairness and equality for all citizens. Minnesota is the home state of “Happy Warrior” Hubert Humphrey, a former vice president of the United States and a lifelong champion of civil rights.  But our proud state is becoming a national embarrassment, and some of our personal care assistants are about to pay a heavy price for our political dysfunction.

Most of you have probably heard about our failure to pass a state budget by the due date of June 30, which led to a state government shutdown for several weeks earlier this summer. When Governor Mark Dayton reconvened the legislature for a special session, it was conducted behind closed doors. The secretly approved budget that finally emerged includes dramatically fewer resources to help our most vulnerable citizens because the “no tax increase for millionaires’’ philosophy ruled the day.

The budget included a 1.5 percent across-the-board cut for all health care funded by Medical Assistance, Minnesota’s Medicaid plan. In addition, several targeted cuts reduced payments for particular populations. The most unfair of these was a 20 percent cut for personal care assistants who provide services to a relative, which goes into effect on October 1. According to the law, “relative means the parent or adoptive parent of an adult child, a sibling aged 16 years or older, an adult child, a grandparent, or a grandchild.”

For example, a PCA providing care to a relative for $10 per hour will probably be earning $8 under the lower reimbursement rate, while other PCAs with the same amount of experience at the same agency will continue to earn $10. In addition, the agencies that employ these critical caregivers will have to find other ways to cut costs, since their reimbursement rate will be cut by significantly more than $2 an hour for PCAs who are related to their clients.

This will likely put some of these organizations out of business. Most are non-profits and small businesses, and nearly all are operating on very thin margins or spending every penny they earn while keeping wages and overhead low, which leaves little room for cost-cutting.

As anyone familiar with our work knows, many factors make it necessary to give people who need personal assistance care the option of hiring relatives. Recent immigrants who do not speak English need caregivers who speak their language, and if their language isn’t widely spoken in their area, it may be difficult to find anyone other than a relative who is fluent enough to communicate with them. Even for native English speakers, it is often next to impossible to find anyone other than a relative who can provide the needed help in isolated rural areas. And some people—particularly the members of certain ethnic communities—have a strong preference for kinship care. Statewide, DHS estimates that 28 percent of all PCAs fit the law’s definition of a relative.

We can’t expect the relatives who respond to these needs to abandon their obligations to themselves and their families, giving up other paying work to provide a service for less than fair market wage.

Since this news became public in late July, many activists in our community (mostly people from ARC and Legal Aid, service recipients and PCAs, PCA business owners, and state employees) have worked tirelessly to attempt to convince legislators, the governor and his staff, and our Department of Human Services (DHS) administrative staff that this action will unfairly and arbitrarily punish PCA recipients who prefer or require care by a relative. A coalition of agencies devastated by this news is currently developing a legal challenge in support of their clients, caregivers, and business rights.

In response to a recent public challenge, Governor Dayton said he deeply regretted the lack of oversight (both his own and that of DHS administrative staff) that led to passage of this cut, but he has not yet been willing to direct DHS not to enforce the cut pending review by the courts or legislative reversal in the next session.

Interestingly, DHS issued a request for public comments over the next 30 days last week, opening a new avenue for direct care workers and their allies to protest the cuts. You can add to the public comments by emailing your opinion to DSD.PublicComments@state.mn.us. Help us let the state know how wrong it is to try to balance the budget on the backs of our hard-working PCAs.

Read more

A summary of the coming cuts by The Minnesota HomeCare Association

The text of the budget bill

7 Responses to “Minnesota Personal Care Assistants Face 20% Pay Cut”

  1. Excellent article Tim!

    It is so important that we get the word out about this bill, as well as educate people as to what the bill states and what employers are required to do, versus what they are choosing to do to balance their own budgets!

    Here is a link to an article I wrote in our recent edition of the I am DSPAM newsletter. Please take the time to read it- more info about what the reimbursement rates were/are for PCA providers and how DSPs and recipients of PCA services can advocate for staff wages and benefits and indentify other employer options!

    http://rtc.umn.edu/dspam/I_am_DSPAM_Summer_2011_Newsletter.pdf

    Page 5: Is there a 20% wage reduction in your future?

  2. Deb Binder says:

    Thank you for your wonderful article!!!

    This is my letter to DSD public comments:

    Dear Sir or Ms,

    It’s just unconscionable that PCAs have to take the hit again for the state budget cuts. I have kept the person that I work for in good health for 30 years. I have saved the State of Minnesota hundreds of thousands of dollars by keeping the person healthy and living in a community environment. This saves the state from institutional medical and housing costs that the state will have to pay. If my client was in a nursing home, which is his only other alternative, it will now take a minimum of eight people to replace me for 24-hour care — all of them making a much higher wage per hour than I make. His housing costs will skyrocket compared to living in the community in subsidized housing.

    For 30 years of hard work and excellent care, I get a huge pay cut. The second one in just a few years. I was capped at 275 hours per month. I work many more because my client can’t find anyone to replace me. I have put up with the unfair wage policy of home health workers. We don’t get overtime until after 48 hours per week, even though everyone else in America gets overtime at 40 hours per week. It doesn’t matter that much because most employers don’t even pay overtime at all. I have to pay my own health insurance. And to top it all off, I don’t get sick days. I work seven days a week, 365 days a year.

    I did this job to help make the world a better place. You can ask my boss and the doctors that care for my client. I do an excellent job. The legislature has destroyed this program. You all want the highest quality of care for the vulnerable and disabled, but you continue not pay PCAs what they are worth. In fact, you continue to take away their pay. How in the world are you going to attract PCAs to care for the disabled and vulnerable people? I can deliver pizza and earn more. I won’t have to clean and strip a bed that has been soiled at three in the morning because the disabled person I care for had a bowel movement. I am not a babysitter or companion. I am vital to my client’s ability to stay alive.

    None of you that are able bodied have the slightest understanding of the needs of someone that is paralyzed from the neck down. It’s not just that you can’t move. Nothing works. Not your bowels, bladder, fingers, lungs, muscles, stomach, well basically everything that you take for granted, they don’t have. They need help with everything. So what do you want cut out? The number of times that they can void or have a bowel movement? Dressing? Eating twice a day instead of three times? When the PCA hours were cut, what do you cut from the vital services for the client? We kept doing it all because we are caring people. When we quit because we need a livable wage, who will take our place?

    Will you please reconsider this cut to PCAs and the 275 hour cap? Thank you for you time.

    Respectfully,

    Debra Binder

  3. Brigette Menger-Anderson says:

    Awesome letter Ms. Binder!

    Are you a member of DSPAM? We need engaged and passionate workers like you to join us and help educate, empower and mobilize this workforce about these cuts and the power that they have collectively to reverse these changes and create better wages and opportunities for their profession!

    I am sharing your letter with the MN Consortium for citizens with disabilities! They are seeking letters from workers!

    Please contact me at iamdspam@gmail.com or look for us on facebook at
    Direct Support Professional Assosciation of Minnesota.

    We are also looking for new board members for the 2012 term!!!!

  4. James Calvert says:

    Thank you for telling it like it is.
    There have to be many other ways of budget cuts. It certainly will affect my family.

  5. Laura Lewis says:

    My name is Laura-Ann Lewis, and I would just like to send in my complaint over the change in pay for PCA workers for family members. I have been caring for my client for four years by myself and while I love that I am able to do it, it is becoming exceedingly difficult for me to continue living with the wage that I receive especially when my pay was cut to 7.25/hour and there is a cap on how many hours I am able to work for her.

    I have to say that people that need constant care really appreciate that they are able to be taken care of by somebody that they know and trust. Imagine being dependent on somebody 24/7 and not knowing them, having them take care of your most intimate needs.

    PCA workers that care for their family members not only work the hours that are allotted to them but they usually work double duty caring for them during the hours that are not logged in as an official PCA work. I work my hours that they let her receive care and then I care for her for the other 16 hours of the day. I also feel that is unfair to pay me at one wage while somebody else in my office gets paid more and has less experience and maybe puts in less hours than I do.

    Please change the wage for PCA workers for relatives back to their original wage. It is hard enough to live with the salary that we were getting, but to downplay the work that we do and the difficulty that comes with this kind of care is an insult to those that step up because they love their family members and want to give them the most comfortable living experience that they can have. We get no paid vacations, sick leave or overtime at my place of employment and if we want or need a day off to recharge it is with a day of no pay.

    It would be better to pay us a fair wage than to force us to leave our jobs that we enjoy and end up spending even more money to have those people put into a home care facility. Or just end up paying another person that they don’t know a higher wage when us family members have o quit caring for those we love. Please consider what I have said and look into reinstating our wage and removing the cap on how many hours that these vulnerable adults receive care.

  6. Wonderful letter Laura! I’m going to share it on our DSPAM facebook page! Please consider submitting it to DHS as well!

  7. Amy says:

    I am a client myself with a Relative Caregiver. My caregiver puts in many more hours than can ever be billed. They save the state so much money by doing this.

    Strangers, they tend to not care about it, or take longer to help us. Relatives, they know us best and have been around us long enough to know what to for us and do it quickly. Also, as a relative, they are allowed to do things for us stranger PCA’s cannot do. As my Mom, she can help me cath myself (has to be off the clock, but because she is my Mom and loves me, she does this). If I have surgery, she changes my bandages. Other PCA’s are not allowed to do this, thus a nurse has to come and that really costs the state lots of money! My Mom spends many nights with me when I am not doing so well, and she doesn’t get paid for this.

    If her pay is cut, she will be forced to get a different job where she can pay her bills with. This will leave me with strangers that come and go like flies, my care goes down the drain and I get very ill and end up in the hospital. That really costs the state big bucks.

    I work part time, and no stranger PCA can go with me to my job and assist me as my hours don’t equal their hours. Therefore, without my Mom, I cannot do my work. More loss in revenue as I pay sales tax on the items I make and sell, income tax on my income, and without doing this work, I am depressed and see a therapist. More cost to the state.

    I cannot tell you how many nights my Mom has stayed with me without charging those hours to the state, and you want to cut her pay even more? I probably wouldn’t be able to stay in my own place without her continuing to work for me. At the very least, my need for more PCA hours would dramatically increase. Also, strangers tend to come in late to work, or leave early, stealing from the state. Parents tend to always come in early and stay late and never charge. I don’t understand why anyone would even think cutting the wage for relatives is a good idea?

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