Home health aides are backing a new bill to end the “21st century sweatshop.”

NEW YORK, N.Y.—Calling the half-unpaid 24-hour shifts common in the home health-care industry an “inhumane” 21st-century sweatshop, a group of home-care aides and state legislators rallied Sept. 4 to announce the introduction of a bill to ban 24-hour shifts.

The bill, sponsored by state Sen. Roxanne Persaud (D-Brooklyn) and Assemblymember Harvey Epstein (D-Manhattan) would limit home-care workers’ shifts to 12 hours a day or 50 hours a week, except voluntarily in “unforeseeable emergent circumstances.” It’s intended to supersede a state Department of Labor regulation that home-care aides get paid for only 13 hours of a 24-hour shift, on the grounds that they’re off, either eating or sleeping, for the other 11 hours.

The aides, arguing that they rarely get even five hours of uninterrupted sleep because they have to take care of their patients every couple hours, won several state court decisions that they should get paid for the full 24 hours. But the state Court of Appeals overruled them last March, holding that the Labor Department had made a rational determination that “a patient may need an aide on site around-the-clock without requiring adult care services for all 24 hours of the day.”

“24 hours is inhumane,” Persaud told the crowd gathered at the site of the 1911 Triangle Shirtwaist fire. “No one should be working 24 hours without a break.”

  “We’re not sacrificing patients,” said Epstein. “We’re improving patient care by giving workers a living wage.”

“It will cost money,” he added. He told LaborPress afterwards that it would probably cost the state about $1 billion a year to reimburse home-care agencies for the costs of paying two workers for 12-hour shifts, but that the current situation is “a billion dollars taken out of the backs of workers.” 

About 8% of New York State’s 240,000 home-care workers do 24-hour shifts, according to the Ain’t I A Woman? Coalition, which organized the rally.

It’s been a hard road for home health aides seeking workplace justice.

Home-care aides said those shifts take a toll on their own health and impair their ability to care for patients. “I love this work, but it cost me a lot. It robbed me of my family, it robbed me of my health,” Sileni Martinez, a Dominican immigrant who did 24-hour shifts five or six days a week for most of her 27 years on the job, said in Spanish. “¡No más veinticuatro, no más abuso!”

Mei Kum Chu, a Chinese immigrant who began working in home care when the Chinatown garment industry collapsed after 9/11, said there was “no way” she could get rest regularly while doing 24-hour shifts. She eventually fell and tore a tendon in her hand during a 24-hour shift.

“This is a women’s issue first and foremost,” said Sonia Ossorio, head of the National Organization for Women’s New York City chapter. “This is a workers’ rights abuse that must be stopped.”

“We don’t want this 24-hour workday spreading to Western New York,” Mary Lister, a home-care aide from Buffalo who spoke at the rally, told LaborPress. But in Buffalo, she said, most home-care workers have the opposite problem, trying to piece together a living out of scattered five- and eight-hour shifts. There is only one agency she knows of that hires workers for 24-hour shifts.

The state government is a bigger problem than the agencies, she contends. It pays for most home health care through Medicaid, she says, and caps per-patient reimbursement levels so low that agencies have to pay low wages, and “it was Governor Cuomo’s Department of Labor” that argued in the courts against full pay for 24-hour shifts. (In oral arguments before the Court of Appeals in February, a department lawyer said it’s “unclear” whether a chair next to the patient’s bed would qualify as the “adequate sleep facilities” required by state regulations.)

Persaud and Epstein both dismiss the idea that switching to 12-hour shifts would intensify the shortage of home aides. There will be a need for more workers, Persaud told reporters after the rally, but it’s a “myth” and a “scare tactic” to say that paying workers more would cause a shortage.

“The crisis is that people don’t want to work 24 hours and get paid for 13,” Epstein chimed in.

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