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Although the Department of Labor’s 2015 Home Care Rule — which extended Fair Labor Standards Act minimum wage and overtime protections to more home care workers — has benefited home care workers to some extent, earnings lag behind other full-time occupations with similar education and training requirements, according to a study by the Government Accountability Office.

But the study predicted that home care employment will grow almost 40% over the next decade to meet demand from an increasing population of older adults and people with disabilities.

The GAO also found that in the years since the Home Care Rule took effect, some states changed their Medicaid programs to limit home care workers’ hours in their Medicaid programs to avoid overtime costs. For example, in Oregon, newly hired home care workers provided through Medicaid generally were limited to 40 hours per week.

In addition, some states changed service delivery in their Medicaid programs by discontinuing services such as live-in care. Conversely, several states did not make any major changes to their Medicaid programs’ home care services.