City Limits | by Nicole Javorsky | May 27, 2020
Even before the coronavirus caused the number of FDNY medical 911 calls to skyrocket from an average volume of 4,000 per day to more than 6,500, New York City’s first responders faced significant dangers on the job, including the risk of contracting diseases.
Some might have thought of emergency medical service (EMS) workers as “just ambulance drivers,” says Oren Barzilay, president of FDNY EMS Local 2507, but they are the first ones to make contact with patients and conduct physical examinations in a medical emergency. Barzilay adds, “With fire, you can see the fire. With police officers, you can see the criminals. With infectious diseases, these are invisible bullets.”
Despite the clear dangers they take on in their work, the EMS workforce has faced low wages for years. Their pay today is, on average, $16 per hour — just a dollar more than the city’s minimum wage. However, the concept of government-mandated hazard pay for essential workers during the COVID-19 public health crisis is catching on. With shrunken state and city budgets, the most viable hope for frontline workers like first responders to see bigger paychecks is at the federal level. The Heroes Act, which passed the House and will go to the Senate next, includes a $200 billion fund to provide hazard pay for essential workers.
The New York City Council also introduced a bill in late April that would require employers with more than 100 employees to give non-salaried workers hazard pay bonuses, but these requirements would not apply to city workers like first responders whose paychecks do not come from private businesses. The Council legislation would apply to essential workers employed privately at places such as grocery stores, drug stores, restaurants open for food deliveries and home-healthcare agencies. If enacted, the bill would require large employers to provide bonuses of $30 for a shift under four hours, $60 for a shift of four to eight hours, and $75 dollars for any shift over eight hours until the state of emergency is lifted. However, the legislation lacks a funding mechanism, which has raised concerns among leaders of home-healthcare agencies and the owners of small businesses that are large enough to fall under the bill’s purview.
Home-healthcare agencies warn
The City Council’s proposal to require premium pay for essential non-salaried workers is part of a package of bills introduced at the same time to address the massive burden essential workers, often for low pay, have shouldered during the crisis as the rest of the city shut down. Majority Leader Laurie Cumbo and Speaker Corey Johnson sponsored the premium pay bill.
“Essential workers are putting their lives on the line every day to keep this City running and to keep New Yorkers safe. We must treat these workers with the respect and dignity they deserve,” said Majority Leader Cumbo. “The bill that I am sponsoring with Speaker Johnson would ensure these critical workers are compensated in a way that reflects their critical contributions towards our City’s health and economy in the short and long-term.”
Home health aides are a clear example of the kind of worker the bill is designed to benefit. Often paid hourly rates that hover around minimum wage, home health aides had to leave their homes throughout the COVID-19 crisis to provide assistance and health care to some of the most vulnerable New Yorkers. The tasks these workers perform tend to require contact with the patient as well.
Ira Wincott, counsel for the Save New York City Home Health Care Coalition, says home health agencies have had trouble maintaining enough staff, because some aides have been ill, couldn’t travel to the patient, or had to make tough choices about the risk of exposure. He says hazard pay would not only be a sign of appreciation, but could also provide an incentive to continue working as a home aide. However, Wincott warns that the City Council’s bill lacks a funding mechanism and he says “expect agency closures, jobs losses” and patients potentially having to move into nursing homes if the hazard pay requirements become law in New York City without the federal or state government swooping in to pick up the tab.
This month, the coalition of 28 home care service agencies based in New York City, which Wincott represents, released a statement saying the City Council’s bill “threatens their entire industry’s survival, unless the federal and state governments come to the table with added funding to support proposed premium pay, if passed.”
Wincott explains that among the home-healthcare agencies that he represents, about 95 percent of the caseload comes from Medicaid. The Council bill doesn’t include provisions for increasing Medicaid payment rates (which would likely have to come from the state level because of how Medicaid is administered) to cover hazard pay, and it doesn’t offer other funding to cover the proposed premium pay. Meanwhile, Wincott says the COVID-19 crisis has already increased costs for home-healthcare agencies, such as for the PPE needed to protect their employees.
Christy Johnston, vice president of governmental & managed care services at Premier Home Health Services, which operates in seven states, including New York, says that adding more unfunded costs would not work, given the current system of home health. They cannot raise prices for their clients like some private businesses in other sectors can.
“We’re grappling with new costs that we’re already trying to deal with. A bill like this just adds more unfunded costs on top of it that are not sustainable in the current system,” she says.
Now that leaders in the home-healthcare industry have aired their concerns, Johnston says she hopes a more “thoughtful process” will happen because “understanding the differences between industries is critically important.”
A spokesperson for the City Council said in a statement to City Limits, “This bill had a hearing and is going through the legislative process, which includes reviewing feedback from industry stakeholders. The Council will continue trying to protect essential workers with this feedback in mind.”
Who will provide the cash to cover hazard pay?
On May 13, Mayor de Blasio spoke about the federal funding that can make its way to essential workers if Congress passes The Heroes Act.
“This is something that people who are working right now who have fought through this crisis deserve and it’s coming from the place that can actually manage to do it on a vast scale, the federal government,” he said.
Given that the Heroes Fund might shrink once the Senate weighs in, and the fact that timing of receiving funding is still uncertain, some small business owners in New York City fear how the passage of the Council hazard pay bill could further damage the chances of their business surviving the pandemic.
Even the structure of some big businesses that operate in the city could prove a challenge to the success of the city council bill. For example, Dunkin’ Brands employs thousands of New Yorkers, but they operate under a franchised system. This means that while there’d likely be enough profits to go around over at the company’s corporate headquarters, it’s the individual business owners and franchisees who would have to come up with the money to fulfill the hazard pay premiums their employees would be eligible for under the City Council’s proposed legislation.
And even if The Heroes Act passes with the $200 billion hazard pay fund intact, it’s still unclear whether this funding would clear up concerns about how businesses that are more financially vulnerable will have enough money to cover pay premiums without contributing to job loss.
The text of The Heroes Act defines a “COVID-19 front line employee” (who would be eligible for hazard pay) as “any individual who performs at least 1,000 hours of essential work.” This would cover public health professionals, health care professionals and support staff, and essential workers (as defined by a state, tribe, locality, or territory). This means the $200 billion fund would potentially cover a vast percentage of the national workforce. Depending on how Secretary Steven Mnuchin might administer the funds (the Treasury would administer the COVID-19 Heroes Fund) and given the bungled rollout of the Paycheck Protection Program (PPP), there’s cause for concern that the federal government still might not come to the rescue.
Still, Barzilay hopes the hazardous pay does make its way to first responders. The same first responders who are getting recognition because of the public health crisis, who are being called heroes, have had to live out of their cars or at their friends’ and parents’ houses because of their meager pay, he explains.
“I think it will show the value of EMS. It will show it’s a true service the city provides,” he says.
Barzilay adds that most FDNY EMS workers leave after two to three years, often to pursue careers in other areas of healthcare and public service offering higher pay. Meanwhile, research suggests having more experienced paramedics in the workforce improves performance, which can mean the difference between how many lives are saved each day.
And given the intense trauma people working on the frontlines of the COVID-19 crisis have faced already over the span of several months, the dangers posed for their mental health are just as real as the risk for physical illness. Barzilay hopes the city will also move to identify funding for addressing trauma and potential cases of PTSD in the months ahead.
Nicole Javorsky is a Report for America corps member.