Fair Pay for Caregivers

Fair Pay for Caregivers

Comments

[Gertrude]

Thank you for the link to the editorial. Unfortunately, the result (low pay) gets a lot of discussion, while underlying issues do not.

I am a homecare provider, a Florida licensed CNA. Although I advertise my services through local papers and on-line, I generally find work through agencies or 'registries'. There is a reason for that, which I will get to.

I currently provide 24-hour care and companionship for an elderly blind diabetic. I love my work. My pay is $110 per day, for a 24-hour day. The rational, I believe, is that I must be sleeping for at least 8 of those hours, for which I naturally don't need to be paid. I am a '1099' service provider. I file my own estimated taxes and where appropriate, self-employment (SS) taxes. I provide and drive my own car for the client's needs, since my client has none, and I purchased my own professional liability insurance policy.

I am 'employed' on a contract basis by a 'nurse registry' in Florida. My services are covered by a LTC insurance policy the family had obtained for my client. The reimbursed rate is $200 per day, however that can only be paid to a qualified provider (not me, the client, or the client's family).

I believe I am adequately qualified (http://eldercarenotebook.blogspot.com/) and I am able provide my own licensed nursing oversight, at least equivalent to any agency's capabilities.

So why can't I provide direct care service? Why do I need to accept these terms of engagement?

Because I am not, nor can I realistically become, an 'eligible provider' for insurance or Medicare reimbursement. While I can meet the medically related requirements - proper training, nursing oversight, insurance - I can't meet the operational ones - such as maintaining a commercially zoned and staffed office, and having a client base of at least 10 patients (Medicare's minimum, and insurer's generally use Medicare provider eligibility as a requirement as their own standard).

So why should anyone hire me? And why should a qualified provider pay me more than a contrived minimum wage?

I understand the need for oversight and licensing. But until there is a provision for dedicated caregivers like myself to offer our services directly on a competitive basis, it's difficult to see how this will all change.

Thanks again for the NY Times link, and the opportunity to air all this.