While workers usually earn more than the federal minimum wage of $7.25 an hour, when they serve multiple clients their travel time often isn’t compensated and those extra hours could take them below that level, Edelstein said, adding this stands to change with the new rule.

Regulations often take effect 60 days after being issued. This rule is delayed until Jan. 1, 2015, to give families that use home-care workers and state Medicaid programs time to prepare, according to Laura Fortman, principal deputy administrator for the Labor department’s wage and hour division.

The U.S. Chamber of Commerce and Republican Representatives John Kline of Minnesota and Tim Walberg of Michigan are among those who say the change could make home help too expensive.

“While the delivery of care has changed in recent years, the crucial need for affordable in-home companion care has not,” the lawmakers said in a Sept. 17 press release. “Faced with higher costs, some individuals will have no choice but to leave their homes and enter institutional living.”

Public Dollars

About 75 percent of home-care services are paid for with public dollars, PHI estimated based on U.S. Census Bureau data from 2010.

A semi-private room in a nursing home costs about $6,235 per month, based on 2010 data compiled by the U.S. Department of Health and Human Services, or about $75,000 annually.

In-home health aides cost $21 an hour on average, based on the data. That means a 40-hour week of care would cost $840, and a year about $44,000. Round-the-clock care, however, would be more expensive.

The new overtime-pay requirement could hurt home-care businesses, since many clients require more than 40 hours worth of care, said Jay Perron, vice president of government affairs and public policy at the Washington-based International Franchise Association.

If companies rotate caregivers to avoid paying time-and-a- half overtime, it could interrupt continuity of care, said Perron, whose group’s members include Interim HealthCare Inc., a care, hospice and medical-staffing company, among other home- care franchises.