Repeal of Companionship Exemption Helps Neither Patients Nor Caregivers

Repeal of Companionship Exemption Helps Neither Patients Nor Caregivers

September 17, 2013 04:45 PM


For additional information:

Barbara D. Woolley
National Association for Home Care & Hospice
(202) 547-7424


Repeal of Companionship Exemption Helps Neither Patients Nor Caregivers

WASHINGTON D.C. (September 17, 2013)–This statement is released by the National Association for Home Care & Hospice and its affiliate the Private Duty Homecare Association:

 “Like many things that emanate from Washington, the repeal of the companionship exemption is not what it seems.  While ostensibly intended to help hard working caregivers, it will have the very opposite effect,” said Andrea L. Devoti, Chairman of the National Association for Home Care & Hospice. “Also, according to the advocates for persons with disabilities, it will trigger great harm to many of this nation’s most vulnerable citizens,” stated Devoti.

 “It will mean that people will receive less care.  Home care companies will have little choice but to employ workers part time rather than full time as Medicaid payment rates and consumers with limited incomes cannot afford higher costs.  Caregivers will in the end receive less pay.  The term “companionship,” which is found in the statute, is being reinterpreted and narrowed in new rules released today by the U.S. Department of Labor.  The revised rules limit the exemption from overtime pay requirements for those caregivers who spend 80 percent or more of their time on fellowship activities.  To put this another way, it bars a caregiver from spending more than 20 percent of their time on hands-on care.  The new rules also narrow the interpretation of what is known in the industry as “live in” domestic help.  Families will have a much more difficult time affording the costs of “live in” care for their disabled loved ones.”

“Federal programs such as Medicaid will end up paying a great deal more with no material improvement in access to care or in its quality.

“Like the disability community, we believe it is better policy to affirm the decision of the U.S. Supreme Court which unanimously sustained the validity of the companionship exemption as it had been applied for over 35 years.  We believe that there is much that Congress can do to put this matter right—which means helping people to receive the quality care they need and at the  same time giving caregivers a fair and honorable wage.  The federal wage and hour laws were written when most health care was received in institutional settings. Today, more and more care is delivered in the home setting. These laws need to be re-evaluated by Congress in total rather than in piecemeal fashion.  The central focus of this review should always be what is best for the people needing care,” said Ms. Devoti.


The Private Duty Homecare Association of America (PDHCA) is an affiliate of the National Association for Home Care & Hospice (NAHC). It is a trade association of home care providers dedicated to providing an array of home care services, including non-medical and supportive services to the aged, infirm, or disabled client to help maintain safety and independence at home, wherever home is. PDHCA focuses on providing valuable information and education to its members as well as educating consumers as to the options to remain at home with home care. The focus of member services is in consumer education, industry advocacy and agency support. To learn more about PDHCA, visit

About NAHC

The National Association for Home Care & Hospice (NAHC) is a nonprofit organization that represents the nation’s 33,000 home care and hospice organizations. NAHC also advocates for the more than two million nurses, therapists, aides and other caregivers employed by such organizations to provide in-home services to some 12 million Americans each year who are infirm, chronically ill, and disabled. Along with its advocacy, NAHC provides information to help its members provide the highest quality of care and is committed to excellence in every respect. To learn more about NAHC, visit