Why So Many of Us Don't Have Health Care Insurance

Don Krutsinger, 2009 Voices Institute graduate November 11, 2009 I work as a direct support professional with developmentally disabled adults in residential settings. One thing I have in common with just about all my coworkers is that we need to work more than 40 hours a week to make ends meet – and even so, too many of us can’t afford our employers’ health care coverage. With the recent cutbacks by our state (Minnesota), most of our residential programs have cut out overtime and cut down the number of full-time positions, reducing the number of positions that receive health insurance and paid time off. That means nearly all of us have to work two to three jobs to make ends meet. Chances are, we don’t get enough hours from any one of them to qualify for health insurance. That’s a difficult, demoralizing way to live, especially for those of us who are dedicated to direct support work and have invested years of our lives in our careers. I’ve been a direct support professional for 21 years. From 1988 to 2004, I worked in residential and day services programs in Kansas. I received a social work degree and worked as a targeted case manager in Iowa. In 2006, I moved to Minnesota to become a group home supervisor. My supervisory experience has taught me how difficult it is to train and retain quality staff. I’ve found the best way of supporting our residential programs is to float between homes, filling in where I’m needed because someone couldn’t show up that day. For a while, I worked full-time at another residential program on a day shift while floating part-time at my group homes, but the other program had to eliminate their full-time day shift positions after the cutbacks. I now work full-time in my float position while working part-time during the day as a personal care attendant. As a PCA, I help an elderly man with multiple sclerosis get up in the morning. I also help a professional man with cerebral palsy use the restroom at his workplace twice a day. Although I work for fairly good agencies that would provide some benefits if I were full-time, the distance between jobs and the short hours of support with each client make it difficult to put in 40 hours I’d need to be eligible for health insurance – and to afford the premiums. A few of the people receiving PCA services need assistance during every waking hour or around the clock. You might think the PCAs who work with these individuals would qualify for health insurance, but the cutbacks have changed that too. There are now limits on how many hours a week PCAs can work, so agencies don’t have to pay overtime. Some people’s hours are so limited that they don’t qualify for health insurance either. It wasn’t easy to make it on one PCA job before the cutbacks either, but we had it better than most. The only reason we qualify for overtime is that Minnesota requires it, but less than half of the 50 states say home care workers are entitled to overtime pay. If you live in one of the others you’re out of luck. The federal Fair Labor Standards Act, as interpreted by the U.S. Department of Labor (DOL), does not cover workers who provide “companionship services” to people in their homes. http://www.directcarealliance.org/index.cfm?pageId=538#no_minimum_wage The DOL ruling was challenged in court by Evelyn Coke, a home care worker who had been paid only $7 an hour throughout her 30-year career, receiving no overtime pay even though she worked regularly over 70 hours a week. She made it all the way to the Supreme Court, but the court ruled against her. This is an issue that can and must be decided on the federal level. We need legislation to include all home care workers in the federal Fair Labor Standards Act. We need to pay people fairly for the work they have done, so home care workers can afford health insurance and other basic benefits. Until we do, we won’t be able to find and keep enough quality personal care attendants to meet the needs of the elders and people with disabilities who want to remain in their homes. originally published in the Direct Care Alliance e-newsletter