Home health attendants work long hours with heavy lifting and save the public a great deal of money by enabling elderly and disabled people to remain at home instead of moving to institutional settings.
In Missouri, aides who are paid with state Medicaid dollars have been doing this work for an average of $8.60 an hour.
That’s a pathetic wage. Many of the aides are the sole financial providers for their families. They are devoted to their clients and work long hours, making it unfeasible to take a second job.
As a result of negotiations between the workers’ union and the Missouri Quality Home Care Council, a board appointed by the governor, most aides should receive a pay raise, up to $10.15 an hour. As part of the bargaining agreement, the patient will have a say in the precise amount of an aide’s pay. Up until now, that decision has been made by the vendor administering the program.
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Even at the top of the new scale, caring for elderly and infirm Missourians won’t be a lucrative profession. It would pay slightly more than $21,000 a year for a 40-hour work week and offer no vacation time or sick leave.
But that does represent a small improvement. The problem is that the aides have yet to see it.
Gov. Jay Nixon’s administration disagrees with the American Federation of State, County and Municipal Employees Council 72, which represents the workers, on the process for implementing the raises.
Lawyers for the administration believe language written into a statute in 2008 requires the raises to be enacted by a formal administrative rule that is vetted by the General Assembly. That process could take six to nine months.
The union thinks the governor has the authority to simply amend contracts with the vendors.
This may have to be a matter for a court to sort out. But whatever happens, it needs to take place on a glide path.
The increase won’t cost the state any extra money. Missouri’s Medicaid program currently pays vendors $15.56 an hour for every patient requiring home health care. While aides’ salaries have remained low, vendors have used about 45 percent of the money for administration and other purposes, such as helping patients afford medical equipment and medications.
Those are important functions, but they shouldn’t be undertaken at the expense of the workers on the front lines. It’s past time for home health aides to receive their raise, modest as it is.