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Law Professor Finds Home Health Care Workers Have Few Legal Protections

hrow rug on the floor of a client's home can pose a `trip and fall' hazard to a health care worker as she attempts to assist a client with limited mobility."

Smith observed that in terms of health and safety, the greatest hazard to workers stems from the amount of client lifting that can often lead to severe muscle injuries. "Home care work is exceedingly dangerous when measured in terms of the injury rate to workers. For example, they experience back injuries at a rate that is nearly three times the rate for nursing aides in hospital or nursing home settings."

Smith said that the high rate of injury is not surprising. "Whereas workers in institutional settings can rely on co-workers to help lift patients or can use lifting devices, home health care workers typically work alone and without the aid of patient transfer devices or equipment like adjustable beds."

Because judges and policy makers are reluctant to apply labor standards to private homes that serve as workplaces, Smith said there is little effort to think seriously about how to improve the workplace safety of home health care workers. Smith added that the current legal atmosphere cheats not just the home health care worker, but also the elderly, because they often receive sub-standard health care.

"It seems to me that we ought not fund health care for the elderly on the backs of poorly paid workers," she said. "All too often, when policymakers consider home health care work, they focus on it solely from the perspective of the consumer, and rarely consider the interests of the workers. If we are to make headway in this area, we need to appreciate the connection between treating workers with respect and improving the quality of the service that they provide."

Smith has little expectation that Congress or the legal system will change that atmosphere. Instead, she sees some hope in organized labor negotiating with state governments to improve worki
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