For 10 years, Xue Zhen, a home health aide, has taken care of the same older man in Downtown Brooklyn, working 24-hour shifts for three consecutive days each week. She said that she has developed neck and back pain from lifting him, not to mention insomnia and chronic stomach issues from the long and irregular hours.
But on Wednesday, Ms. Zhen, 62, who would normally use her days off to recover and spend time with her family, sat in freezing temperatures outside City Hall alongside dozens of other home care workers.
They marched, sang and eventually began a daily four-hour sit-in that they expect to stretch into next week. Home care workers and their advocates are pressuring the City Council to pass a law that would all but end the grueling 24-hour shifts that home aide workers have long complained come at cost, physically and economically, because they typically are paid for only 13 hours of the shift.
The bill would limit their shifts to 12 hours, except in case of emergencies. The Council may vote on it later this spring.
“It is inhumane and takes advantage of us and our wages,” Ms Zhen said through an interpreter. “If you are doing your job properly, you are not sleeping, you are waking up in the night to check on your patient, making sure they are OK.”
Home care aides in New York City have been allowed to work 24-hour shifts because of a longstanding interpretation of state law that assumes that the aides work on average for 13 hours of their shift and sleep and take meal breaks during the other 11 hours.
But the aides said that they are rarely able to take breaks and are often pressured to not complain or risk losing work.
As New York City’s baby boomer population continues to leave the work force, the need for these workers is expected to grow. While New York State’s population overall is expected to increase by 3 percent between 2021 and 2040, the number of people 65 and older is projected to grow 25 percent, and the 85-and-older population could jump nearly 75 percent, according to a City University of New York study.
The movement to rein in their long days has been a decade-long battle for the nearly 130,000 home health workers within the five boroughs. Outside City Hall, the demonstrators, almost all of them women and immigrants, chanted, “no more to 24 hours” and held signs displaying Mayor Zohran Mamdani’s face, inscribed with the words, “Mamdani, you promised!”
Advocacy groups say that making the job less strenuous will draw more people into the field, helping meet the booming demand for their services.
Advocates had been hopeful that Mr. Mamdani, who spoke at a rally for home health care workers in December 2024, would provide momentum for reforms.
“Mayor Mamdani has always stood with home care workers in the fight for dignity on the job: fair wages, reliable hours and respect owed to those who make it possible for so many New Yorkers to live safely at home,” Dora Pekec, a spokeswoman for the mayor, said.
“The mayor is committed to working alongside home care workers, the Council and state government to pass stronger protections that improve working conditions for caregivers and ensure they can provide the high-quality care their patients deserve,” Ms. Pekec said.
The bill’s sponsor, Council Member Christopher Marte, said that he was optimistic about the measure, and said that the Mamdani administration had been providing feedback, ironing out legal questions and policy differences.
When Mr. Marte previously introduced the bill, a handful of industry organizations and politicians had opposed it, arguing that it would raise Medicaid costs because workers would be paid for every hour they are present in a client’s home. The State Capitol in Albany is a better venue to consider such a measure because the state regulates Medicaid contracts, industry representatives and some politicians have said.
Local 1199 of the Service Employees International Union, a powerful union that represents health care workers, said that while it agrees with the intention of the measure, it was important to recognize that it would require $460 million in Medicaid funding. Without coordinating the cost with the Legislature, patients could be left in the lurch, they said.
“The City Council should recognize that the state Medicaid program will need to fund an additional 11 hours per day for every 24‐hour case,” Helen Schaub, political director of 1199 SEIU, said in a statement.
The Legal Aid Society, which has filed lawsuits trying to restore back pay or lost wages for home health attendants, echoed similar concerns.
“People who rely on 24-hour live-in care are not authorized for two 12-hour shifts, so coverage cannot simply be split without changes to state law and reimbursement — risking immediate gaps in care for seniors and people with disabilities,” said Belkys Garcia, staff attorney in the Civil Law Reform Unit at the Legal Aid Society.
Shirley Ranz attended the rally on Wednesday after her family’s experience with home care, she said. Her father qualified for 24-hour care after he fell ill in 2018. But Ms. Ranz, who chairs the domestic worker task force for the National Organization for Women, was appalled by the working hours. Her father had to be rolled over in the middle of the night because of bed sores. She appealed the coverage and tried to set up separate 12-hour shifts.
“It was a danger for my father, and it was dangerous for the worker,” Ms. Ranz said.
Her appeal was approved in 2020, she said, the day before her father passed away.
“Ultimately, it was a Pyrrhic victory,” Ms. Ranz said.
Emma Goldberg contributed reporting.
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