Home healthcare aides launch hunger strike to end 24-hour shifts

Home care workers escalated their years-long fight to end 24-hour shifts this week, launching a hunger strike outside City Hall after the City Council failed to advance legislation that would overhaul one of the city's most contentious labor practices.

Fifteen home health aides began what they described as an indefinite hunger strike Thursday, joining a weeks-long protest over a system that allows workers to be scheduled for 24-hour shifts while being paid for just 13 hours. The policy, permitted under state Department of Labor rules, assumes workers receive eight hours of sleep — five uninterrupted — and three hours of meal breaks.

Workers say those conditions rarely materialize.

The city's home care workforce numbers roughly 300,000 — its largest healthcare labor segment — composed largely of immigrant women earning a mean annual income below $41,000.

Framing their fight as one that extends beyond their own working conditions, aides say the structure of 24-hour shifts ultimately shapes the care that vulnerable New Yorkers receive.

Workers say round-the-clock shifts — often paid for just 13 hours — harm both caregivers and patients.

Harper Freeman / The Chief

'We can't do something this inhumane'

Hui Ling Chen, who spent 16 years working 24-hour shifts, described the toll of routinely working four such shifts a week in a testimony for the No More 24 campaign.

“A long period of doing 4 days a week, 24-hour shifts to take care of the patient is really exhausting,” she said. “I’ve been dealing with insomnia, waist strain and bone pain. In order to make a living, I’ve neglected my own family to do 24-hour home attendant work.”

Chen added that workers are sometimes pressured to cut corners in ways that conflict with their responsibilities to patients.

“The company has not only underpaid us. In order to avoid paying us for work we have done during the night, the company told us not to give water to patients at night, not to get up to change their diapers, to ignore the patient when they call for help,” she said. “We can’t do something this inhumane. The patient needs 24-hour care, and our responsibility is to do the job well. That’s why the 24-hour workday system is inhumane for both the patients and the home attendants.”

Ignacia Reyes, who worked 24-hour shifts for two decades, said in a testimony that the effects of the long shifts continue to linger.

“All those years I could not sleep,” she said. “Now, even though I stopped working in 2018, it’s not easy for me to fall asleep. All those years of having to be vigilant and alert to my patient’s needs have affected my sleep and my health.”

“I have high blood pressure from all this stress. I have such pain in my two legs from having to stand so much and having to support my patients,” Reyes added. “For any of us, 24 hours is inhumane.”

The demonstration marks the latest action in a years-long campaign led largely by immigrant women in the home care workforce, many of whom say round-the-clock shifts leave them physically depleted while earning pay for only a fraction of the hours they work. Some report remaining in clients' homes for up to 96 consecutive hours without meaningful rest.

Workers also describe being discouraged from documenting sleep interruptions and losing wages to employer underreporting — issues linked to the home care sector recording the city's highest number of wage theft violations last year, according to a report from former City Comptroller Brad Lander.

Harper Freeman / The Chief

Legislation failed to advance

Galvanizing the workers is legislation introduced by Council Member Christopher Marte that would end 24-hour shifts by capping workdays at 12 hours and requiring additional staffing. First introduced in 2022 and reintroduced this year, the bill has become a flashpoint among worker advocates, unions, city officials and disability rights groups.

Yet despite growing political attention, the bill has stalled amid concerns over funding and implementation. Home care services are largely financed through Medicaid, and opponents warn that eliminating 24-hour shifts without additional state funding could destabilize care for vulnerable patients.

The immigration news outlet Documented reported that a previous version of the bill was gaining traction in March before Mayor Zohran Mamdani, influenced by District Council 37 and the Legal Aid Society, moved to block the legislation. Governor Kathy Hochul has since pressured the Council not to advance the bill, Documented reported.

Union officials allege that they support ending the practice in principle, but only if reforms preserve workers’ access to overtime and ensure continuity of care. City officials have echoed those concerns, cautioning that the transition to shorter shifts could require a significant expansion of the workforce.

Yet Marte, whose mother was a home care worker, continues to push the bill as both a labor and human rights issue. “To people all around the world, New York City stands as a beacon of workers’ rights. In thousands of homes across this city, immigrant women of color are working forced 24-hour shifts and only receiving 13 hours of pay," he said.