The nature of, and demand for, home care work has changed significantly since 1974. In an attempt to reflect contemporary practices in the home care industry, the United States Department of Labor (DOL) proposed amendments to the regulation in 1993, 1995, and 2001. In each instance, the proposal was withdrawn without DOL taking any action. This policy brief provides an update to the Direct Care Alliance Policy Brief No. 2 of June 2009, in which Peggie Smith provided a comprehensive description of the 2001 DOL proposal and the rationale for DOL to use its authority to revise the companionship exemption. Using the letters submitted by stakeholders during the 2001 public comment period, this brief represents a detailed consideration of the responses to the earlier proposed change and the framework various stakeholders used to articulate their positions with respect to the exemption. It also offers suggestions for strategies to influence the rulemaking process in the interest of ensuring that a workforce of capable, competent caregivers be available to the aging and disabled public.