NYC home care workers urge end to 'torture' of 24-hour shifts

Home care workers are ramping up protests to end 24-hour work shifts they liken to "torture" and to pressure New York City Council Speaker Julie Menin to advance a local law capping their shifts at 12 hours.

A dozen current and former home care workers began a hunger strike last week to draw attention to their bid to end the 24-hour shifts, for which the workers say they also are undercompensated.

The workers and their supporters have also protested in front of Menin’s Upper East Side home and rallied in front of City Hall, urging the speaker to fulfill a pledge she made to bring the bill to a vote. At a rally launching the hunger strike, protesters argued that 24-hour shifts are bad for workers’ health and chanted, “No more torture! No more 24!”

But the bill's critics say the legislation risks disrupting the services thousands of elderly and disabled New Yorkers rely on to remain in their homes and to perform everyday tasks such as eating, bathing and getting out of bed. Menin’s office said on Thursday there’s no timeline for moving the legislation forward, despite her announcing support for the measure in the spring.

Home care is both a major industry in New York, employing more than 600,000 statewide as of last year, and a lifeline for many elderly and disabled New Yorkers.

While hundreds of thousands of New Yorkers on Medicaid receive home health services, those receiving care from aides working 24-hour shifts make up a much smaller segment — about 13,000 city residents as of 2022, according to state data obtained by the healthcare union 1199 SEIU and shared with Gothamist.

The conflict over the City Council bill is the latest episode in home care workers’ decadelong fight against what they regard as exploitation baked into the shifts. Under state policy, the workers providing the care — many of them immigrant women of color — can be paid for just 13 hours of each 24-hour shift, based on the assumption that they will have eight hours of rest, at least five of which are uninterrupted, and three hours for meals.

Richard Blum, an attorney at the Legal Aid Society who represents both home care workers and people with disabilities, said the idea that workers are getting the rest they’re entitled to under the law is often a “fiction.”

But Blum also has been one of the most vocal critics of the bill to ban 24-hour shifts in New York City.

“Thousands of people, very disabled people, would go without care, probably meaning that in most cases, they'd be institutionalized,” Blum said.

The Legal Aid Society and 1199 SEIU — both of which represent home care workers in different contexts — have argued that any changes to 24-hour shifts need support from the state because home care is largely regulated and funded through the state-run Medicaid program.

Amid the conflict over the bill, some city councilmembers revoked their support — it now has 14 sponsors, down from 17 in the spring. Mayor Zohran Mamdani advocated for an end to 24-hour shifts as a state assemblymember, but hasn’t lent the bill his support since taking office.

“The Mamdani administration remains committed to working with the City Council and the state to ensure home care is adequately funded so we can strengthen protections for workers while preserving the high-quality care that patients and families rely on,” said Cassio Mendoza, a spokesperson for the mayor.

For Caiqiong Liu, 69, this is the second time she went on hunger strike this year to try to pressure Menin to bring the No More 24 Act to a vote. She said she only drank water for seven days during the last hunger strike in April.

Liu said she spent nine years working 24-hour shifts in the home of a stroke patient before she retired, staying in her client’s home for three- to five-day stretches at a time.

She said she developed back pain from lifting and carrying her client, spent a lot of time away from her children and got little sleep. At night, Liu said, she had to turn her client’s body every two hours, give her water and change her diaper.

Advocates for the “No More 24 Act” say that if 24-hour shifts are banned, they will just be divided into two 12-hour shifts instead.

But such shifts — known as “split shifts” in the home care field — represent a higher level of care that Blum said must be approved by the insurance companies that administer Medicaid. To change the way shifts are approved, there would have to be state action, he said.

Splitting up 24-hour shifts would also cost the Medicaid program more than $400 million per year, 1199 SEIU has estimated.

Councilmember Christopher Marte, the primary sponsor of the No More 24 Act, said he has been in talks with Gov. Kathy Hochul’s administration about bringing state regulations and funding in line with the bill if it passes.

“The state has been dragging their feet on this and I don't think they want to do this,” Marte said. But he said if the Council passes his bill, “we’ll put pressure on the state to act.”

Kassandra White, a spokesperson for Hochul, said the governor does not comment on pending legislation, but has taken other action to support home care workers — including raising their minimum wage at a cost of about $13 billion since 2023.

Marte said he has also been working to amend the language in the City Council bill to address critics’ concerns.

Marcus Johnson, a home care recipient and disability rights advocate, said he worries that the Council bill makes it too hard to have home care workers stay longer than 12 hours if needed, even with the limited exceptions the bill provides for in case of an emergency.

“You're going to leave the person at home, literally alone and in danger,” said Johnson, who receives split-shift care himself.

But not all disability rights advocates oppose the bill — and some have come out to support the workers at their rallies.

Zishun Ning, an organizer with the campaign to end 24-hour shifts, was dismissive of the critique that reform has to happen at the state level. “It’s simple,” he said of whether the city should ban 24-hour shifts. “It’s just torture.”

Ning added that workers have little faith in Hochul to support reform at the state level because her Department of Labor hasn’t adequately enforced existing labor laws to ensure workers were properly compensated for 24-hour shifts.

Asked whether splitting up shifts might also create a shortage of workers, Blum said that could be a concern. But he said he also believes that home care workers on 24-hour shifts are being exploited — and improving their conditions could help alleviate that problem.