Hands clenched tight to maintain feeling in their fingertips, tear stains frozen across their faces from gusting winds whipping through at below-freezing temperatures, huddled together in rain-soaked parkas and donated blankets. These conditions are enough to break the resolve of any man, but these are not men; these are women Home Health Aides putting their lives and bodies on the line to protest against the legal and inhumane 24-hour workday in New York City.
Tragically, we were told the experiences observed on day three of this week-long Hunger Strike in front of City Hall are far less detrimental to these women’s health than years spent working as Home Health Aides. Many retirees lined the streets, pleading for Speaker Adrienne Adams to progress NYC Council Resolution 615-2024, or the “No More 24 Act,” to the floor for consideration. Guihua Song, from the Chinese Staff and Workers’ Association, vocalizes through a translator, said that the fight is personal; as retirees, “[…] we have been through this […] we know the damage that 24-hour work days have brought to our health and our families.”
Hunger Strikes are an extreme form of nonviolent protest, and have been linked historically to fights for justice, human rights, and social or political change. Oftentimes, it is exercised by oppressed and vulnerable communities that have exhausted other methods of protest. However, prolonged periods are detrimental to the health of protesters, leading to permanent long-term health complications, and eventually death. According to Radio Free Europe/Radio Liberty, “[It] causes muscle weakness, vulnerability to infections, psychological problems, and, eventually, organ failure.” We raised these concerns with Lily Randall, an Organizer for Youth Against Sweatshops, who confirmed that the organization was aware of the risks; “[…] even though Hunger Strike is a really serious thing […] we realized that with our collective power it was the thing that we had to do.”
Randall went on to explain that “[…] home care workers have been fighting for a decade,” including “[…] six protests outside of City Hall” since the “No More 24 Act” was first introduced in 2022. However, the bill has never received a single vote on the floor of City Council. Juliet Emerson-Colvin, Board Member for National Mobilization Against Sweatshops (NMASS) and Organizer for Youth Against Sweatshops remains optimistic, “I think the City Council is actually as supportive as they’ve ever been. […] But, we don’t have as many co-sponsors on the bill as we used to.”
In a Press Conference held on March 19, 2024, Speaker Adrienne Adams was asked about the demands of Home Health Aides seeking to abolish the 24-hour work day, responding that she “absolutely” supports the workers and “[…] their desire for improved working conditions.” However, the Speaker claimed that New York City has no control over established New York State Department of Labor regulations or Medicaid reimbursement rates. According to Speaker Adams, “[…] the solution to address the 24-hour home care has to occur at the state level.”
While the Speaker’s deferment thwarted further conversation about Council Resolution 615-2024, home healthcare services are no longer covered through Medicaid. In June 2011, then-Governor Andrew Cuomo, introduced a program to reform the New York State Medicaid system, “[…] in ways that will decrease costs while improving the quality of care provided.” This initiative produced Managed Long-Term Care (MLTC) plans, relinquishing state control of home care programs to the private insurance industry. In an interview with Council Member Christopher Marte (NY-1), he divulged that there is financial pressure from lobbyists to keep the resolution shelved. “[There’s] insurance companies, home care agencies, that really don’t want this to move forward because it’s going to impact their bottom line,” Marte said.
New York City Comptroller Brad Lander confirmed in a March 2023 report that, “Care work is one of the fastest-growing components of New York City’s economy – but frequently one of the most neglected.” The Office for the Aging stated in 2019 that the aging population of New York State is expected to grow to over 5.3 million people, representing approximately 25 percent of the state’s population by 2030; the necessity for Home Health Aides will only continue to grow. In 2022, the Empire Center for Public Policy found that“New York employs 138 home health aides per 1,000 residents over 65 […] In New York City, the rate is 236 per 1,000.” This ratio is four times higher than the national average, and as learned during the hunger strike, overwhelmingly represents immigrant women of color.
Council Resolution 615-2024 intends to establish maximum working hours for Home Health Aides, breaking a single 24-hour shift into two 12-hour shifts that would be provided by two separate workers. Under current state law, Home Health Aides work these 24-hour shifts alone, while only being paid up to a maximum of 13 hours of their shift. Not only do these shifts constitute wage theft, but they produce deteriorating health conditions for the workers and compromise the integrity of their patient’s care due to sleep deprivation. According to Dr. Maria Neira, Director of the Department of Environment, Climate Change and Health at the World Health Organization (WHO), “Working 55 hours or more per week is a serious health hazard. It’s time that we all, governments, employers and employees wake up to the fact that long working hours can lead to premature death.”
Guihua Song told us that over 8 years of working as a 24-hour Home Health Aide, her patients had terrible health conditions that required around-the-clock care. As a result, she “couldn’t get good rest […] plus the mental pressure was very high.” She proceeded to inform us that she developed health problems herself, “[before the job] my blood pressure was low but because of this work my blood pressure became very high […] I have pain all over my body; my neck, my back, and my knees all got hurt.” Lai Yee Chan, a former 24-hour Home Health Aide and Member of the Chinese-American Planning Council echoed a lot of the conditions described by Ms. Song, punctuating the experience by exclaiming, “The 24-hour workday is like a long-term murder against us women of color!”
“It’s the most hours you can work in a day. It’s the most extreme form of this exploitation!” exclaimed Emerson-Colvin, who went on to describe Speaker Adam’s failure to bring Council Resolution 615-2024 to the floor for a vote as a “[…] disregard for these women and their efforts to end this exploitative practice […] it’s showing you just don’t care about immigrant workers.” This disregard for immigrant workers echoes recent assaults against migrants, refugees, and asylum seekers by Mayor Eric Adams of New York City, raising fears concerning the health and welfare of new asylum seekers. When pressed on a potential connection between anti-immigrant sentiment from Mayor Adams and Speaker Adams refusal to bring Council Resolution 615-2024 to the floor, Council Member Marte seemed to disagree, “I don’t think so. I think they are semi-different issues.” However, Emerson-Colvin introduced a valid argument, even if there is not a connection between these issues, “I see this as being part of the fight for asylum seekers as well, and protecting these new immigrants from exploitation.”
Are private insurance companies and home care agencies solely controlling the fate of the “No More 24 Act?” It was exceedingly evident that Speaker Adams is the target of the movement, but is there another entity pulling the strings? Home Health Aides are represented by 1199SEIU United Healthcare Workers East, a healthcare union with over 450,000 members on the East Coast, it describes itself as, “[…] the largest and fastest-growing healthcare union in the nation.” While unions claim to use collective voices as a methodology for negotiating with employers in the best interest of their members, 1199SEIU has not been a beacon of hope for Home Health Aides in New York City seeking to abolish the 24-hour workday.
1199SEIU has found several reasons to be opponents of Council Resolution 615-2024, and the former iteration, Council Resolution 175-2022. According to a statement made to Gothamist in 2022, 1199SEIU said it “does not support the concept of 24-hour shifts,” but opposed the bill because it restricted Home Health Aide workers from exceeding 50-hour workweeks. Despite this statement, Stuart Marques, 1199SEIU’s Press Secretary, told Documented, “We want to kill it. Obviously, we’ll be happy with amending it if we have to settle for amending it, but we want to kill it outright.” The reason? According to 1199SEIU, “Converting 24-hour cases to two twelve-hour shifts would cost $1 billion, which must be allocated by the Governor and State Legislature.”
While 1199SEIU has vocalized a need for the 24-hour workday to be addressed by the State, the union successfully lobbied to stall A03145, introduced by State Assemblyman Harvey Epstein in 2022. Assemblyman Ron Kim’s legislative director, David Lee, told New York Focus, “[…] more important than your wellbeing–than your dignity and your working conditions, your right to live a dignified life–is the stability of the home care industry.” With a behemoth like 1199SEIU working to prevent the advancement of the “No More 24 Act,” it appears that Speaker Adams may be a smaller conflict in a much larger war.
These courageous women were once again enduring 24-hours of unsustainable conditions in hopes of having their voices and experiences create meaningful change. Gloria Steinem famously said, “Whenever one person stands up and says, ‘Wait a minute, this is wrong,’ it helps other people do the same.” Day 3 of the Hunger Strike was designated “Women’s Day,” and activist groups were invited to come and speak on behalf of Home Health Aides. However, what was observed can only be described as a public hijacking at the podium. Several activist groups diverted attention away from the “No More 24 Act,” discussing topics related to their own missions. Painstakingly, observers watched as each activist concluded their speech with a raised fist and a “No More 24!” chant; a tactic aimed at constructing a facade to the approval of Home Health Aides and retirees, the majority of which spoke languages other than English.
Elena Shih, Manning Assistant Professor of American Studies and Ethnic Studies at Brown University, used her time at the podium to speak about sex worker activism in Thailand; “[…] In Thailand, sex worker rights activism organizers at the Empower Foundation are part of a leading coalition of women workers who introduced a bill to decriminalize sex work in Thailand. And for decades they have built so much of their global solidarity with the international wages for housework campaign.” She then concluded her speech on sex worker rights by addressing the “No More 24 Act” crowd, “You are part of this massive tide of unstoppable women workers’ resistance around the world bringing light to the shame that Speaker Adams refuses to bring this to the floor.” It remains unclear if Shih’s strategy was implying coalition building among feminist groups achieves results.
Niki from Adolfina spoke about the effects of imperialistic policy in Puerto Rico, “[…] We are a fighting political organization for the Puerto Rican anti-imperialist militant women’s movement that is actively struggling for national sovereignty, genuine democracy, and liberation for all women and gender-oppressed people in Puerto Rico, throughout the archipelago, and the diaspora.”
Phoebe Depadua from Gabriela NYC spoke about gender-based violence experienced by Filipino women, “[…] Gabriela New York fights for the rights and the dignity of Filipino women and gender-oppressed people and for an equitable society led by those that build it. Today I want to talk to you about violence against women. Violence against women includes economic violence. When we talk about violence against women, we’re not only talking about sexual assault, rape, domestic violence, and gender-based discrimination and harassment. We’re also talking about economic violence”
While these are crucial feminist topics, observers are left to wonder why these speeches were not saved for more appropriate events, programs, and venues. These activists took attention away from a decade-long struggle by Home Health Aides and worked to aggressively acquire the attention of supporters and onlookers. It can be argued that these activists failed to comprehend Steinem’s vision, by focusing on their missions, instead of helping others see the inhumane situation faced by Home Health Aides in New York City.
Hoping to catalyze their Hunger Strike into meaningful change, their voices and heart-wrenching experiences demonstrate the strength of these Home Health Aides as they persistently highlight the hardships of the 24-hour workday. After ten-plus years of protest, lingering uncertainty still plagues the future of the “No More 24 Act.” The lack of a definitive executive decision by Speaker Adams, to bring the “No More 24 Act” to the floor of City Council for consideration underlines the struggle that these caregivers undoubtedly will continue to face. Despite the event being marred by what can only be described as a “public hijacking at the podium”, their unwavering dedication to the cause serves as a testament to their commitment to securing fair treatment for themselves, their families, and future caregivers.