Residence Care Aides Battle to Finish 24-Hour Shifts in NYC Metropolis Council

For eight years, Lai Yee Chen labored 24-hour shifts, as much as 5 days every week, as a house care aide for bed-bound seniors in New York Metropolis. She cooked, cleaned, modified diapers and turned her sufferers at the very least each two hours to forestall bedsores.

Ms. Chen, 69, has since retired, however she nonetheless jolts awake at night time, as if she’s nonetheless on name.

“The 24-hour workday is inhumane. It’s violence against workers,” she mentioned in Cantonese.

Ms. Chen has now joined a push amongst New York Metropolis dwelling care employees to ban 24-hour work shifts by a bill that was introduced within the Metropolis Council on Thursday.

New York’s inhabitants of older adults is surging. The variety of home aides who care for them has greater than doubled within the final decade, surpassing half one million statewide as of 2022, with many of the progress in New York Metropolis.

And the sector is predicted to continue to grow. Nationally, there are extra new jobs anticipated in dwelling care over the subsequent decade than in another occupation, mentioned Kezia Scales, the vice chairman of analysis and analysis at PHI, a nationwide analysis and advocacy group for direct-care employees.

Making the job extra humane is essential to maintaining with the elevated want: It would assist appeal to individuals to the job and make it sustainable, employees and advocates say.

“We have a massive aging population, but we’re decreasing the number of people who want to take care of them,” mentioned Christopher Marte, a councilman representing Decrease Manhattan who launched the invoice to finish the 24-hour shifts. “This work is killing them.”

Residence care aides are allowed to work 24-hour shifts due to a longstanding interpretation of state regulation that assumes they need to solely be paid for as much as 13 hours of the day. Trade rules are premised on the concept employees get three hours of dinner time and eight hours of sleep, together with 5 hours of uninterrupted relaxation.

However that’s hardly ever, if ever, the case in observe, due to the all-hours nature of the job, employees and labor teams mentioned.

“How can they sleep eight hours?” requested Vincent Cao, an organizer on the Chinese language Employees and Employees’ Affiliation, which helps banning 24-hour shifts. “Are they going to leave the patient to die?”

Opponents of the invoice say that banning the all-day shifts is misguided.

The price to offer round the clock take care of a affected person would balloon beneath such a ban, mentioned Al Cardillo, the president and chief government of the Residence Care Affiliation of New York State, which represents well being care businesses and insurance coverage corporations.

And it might drive dwelling care businesses, that are supported by state and federal funding, to spend extra per affected person, probably creating gaps in protection for the neediest residents.

Changing 24-hour shifts with two 12-hour shifts — successfully doubling the whole variety of hours paid — might price an extra $645 million a yr in New York Metropolis, in keeping with an evaluation by 1199SEIU, a big union representing well being care employees.

However teams in assist of the ban say the burden shouldn’t be borne by low-wage employees, a lot of whom are additionally getting old and may wish related care.

No different trade for the reason that pandemic has added extra jobs to New York Metropolis’s economic system than dwelling well being care. It additionally stays one of many lowest paying fields within the metropolis, with a mean wage of about $32,000, or near minimal wage, in keeping with James Parrott, the director of financial and financial coverage on the Heart for New York Metropolis Affairs on the New College.

Demographic shifts and a desire for in-home providers are fueling the trade’s progress. Between 2021 and 2040, whereas New York State’s total inhabitants is predicted to develop 3 %, the variety of individuals 65 and older is projected to develop 25 %, and the 85-and-older inhabitants might leap almost 75 %, according to a City University of New York study.

In New York Metropolis, almost 90 % of dwelling care employees are girls. They’re typically immigrants, and have a tendency to skew older, with greater than half over 45 years outdated, Dr. Scales mentioned. Nearly 10 % are 65 or older.

Whereas it’s unclear what number of dwelling care aides work 24-hour shifts, there have been 17,780 New York Metropolis residents who acquired Medicaid-funded, live-in care in 2019, in keeping with 1199SEIU.

After two years of unsuccessful lobbying, a gaggle of well being employees say they’ll go on a starvation strike in mid-March to stress the town to abolish the observe.

“They don’t want others to live the lives they lived,” Mr. Marte mentioned.

A model of the Metropolis Council invoice that sought to ban 24-hour shifts for dwelling care aides and restrict the variety of hours they will work per week was launched in 2022, however was by no means dropped at a vote.

Rendy Desamours, a spokesman for the Metropolis Council, mentioned the hassle was misdirected, as a result of dwelling well being care is funded primarily by Medicaid, which is managed on the state stage.

“It has been counterproductive and harmful to mislead people into believing that this can be resolved at the city level,” he mentioned in an announcement, including that Adrienne Adams, the council speaker, deliberate to introduce a invoice to induce the state legislature to enhance working situations for dwelling care employees.

Nonetheless, there are different proposals to assist dwelling care employees, mentioned Carmela Huang, a senior lawyer on the Nationwide Heart for Regulation and Financial Justice, a nonprofit authorized advocacy group.

A invoice launched late final yr within the state legislature, the Residence Care Financial savings & Reinvestment Act, would lower out personal insurance coverage corporations that handle the fee of Medicaid-funded providers. That would save the state greater than $1 billion a yr, proponents say — cash that might fund wage will increase for employees. Critics say the financial savings are overstated.

Valeria Guerrero, 63, a former dwelling care aide from Honduras who labored 24-hour shifts for over 20 years, mentioned she averaged three to 4 hours of sleep an evening. She blames her worsening diabetes on her poor sleep schedule.

At her final project in 2022, in a two-story home within the Bronx, she spent 4 days every week caring for an older girl with restricted mobility who used an oxygen tank. When she wasn’t getting ready meals, taking the affected person to the toilet or adjusting medical gear, Ms. Guerrero mentioned, she would sleep on a settee.

Feeling drowsy one morning, she fell down a flight of stairs and harm her again and left ankle, she mentioned. Unable to work after the damage and left with little financial savings, she now lives together with her niece within the Bronx. She mentioned she was paid $15 an hour for 12 hours of the day, regardless of frequently working extra.

Now she is in search of fee for 1000’s of unlogged hours, in keeping with NMASS, a employee organizing group that’s serving to together with her declare. Based mostly on a criticism she submitted to the State Division of Labor, she could possibly be entitled to over $177,000 in unpaid wages and damages.

Ms. Guerrero hopes {that a} ban on 24-hour shifts might assist different dwelling well being employees.

“I spent most of my birthdays at work,” she mentioned in Spanish. “You don’t get to have a life.”

Talmon Joseph Smith contributed reporting.