When Zhen Li, 65, was working 24-hour shifts as a home care worker, her weight dropped to 110 pounds. Li worked four 24-hour shifts a week for HumanCare and Community Care for 12 years. She suffers from chronic pain in her neck, hands, and shoulders. 

Ka Lai Leong worked 24-hour shifts as a home health aide for Platinum Home Health Care for ten years. Even though she’s retired now, Leong said the painful consequences of those shifts still plague her. 

“All the pain has come up and is getting worse,” Leong, who wears a wrist brace, said. “We don’t sleep well. We are not able to recover. The pain is getting worse and worse.”

Home health aides like Li and Leong have been fighting for better working conditions for over a decade. They were the closest they had been to achieving their goal of ending 24-hour shifts but, after another delay from city council to vote on their bill Int 303, workers announced a hunger strike starting April 16. 

Int 303, or the No More 24 Act, would limit home health care employers from scheduling shifts longer than 12 hours and shifts that amount to more than 12 hours in one 24-hour period. Home care workers and advocates have held six protests outside City Hall over the past month and they announced on April 8 that they will go on a hunger strike starting on April 16 until the bill passes. Around a dozen home care workers are planning on hunger striking.

Council Speaker Julie Menin promised home health care workers in March that she would bring their bill to a vote in April, but she did not submit the bill to the council before April 8—the deadline for the first city council meeting this month. There is still a possibility for the bill to be voted on during the second city council meeting on April 30. A city council spokesperson told The Indy that the decision to not submit the bill by April 8 is due to ongoing discussions about the specific language of the bill. 

The bill was initially introduced by Council Member Christopher Marte in 2022, but was also previously stalled for years by former Speaker Adrienne Adams. 

“We’ve been doing the sit-in here for a month. Mayor Mamdani and Speaker Menin have still not passed the No More 24 Act. We are very disappointed,” Cai Qiong Liu, a home care worker, said in a statement.

Home care workers are also especially calling on Mayor Zohran Mamdani to voice his support for the passage of this bill, as he once did while on the campaign trail. 

Home care workers and advocates say this passage is long overdue. Under the current norm, upheld by the New York Court of Appeals in 2019, home care attendants must be in the patient’s home for 24 hours, but are only paid for 13 of them, since three hours are set aside for meals, and eight for sleep. 

Xue Zhen, who worked in the home health care industry for 11 years, said for the whole 24 hours she thought about the health of her patient. 

“Every time I ate I had to at the same time take care of the patient. At nighttime we had to take care of the patient. So we did not have continuous sleep, often interrupted. We had to wake up a lot,” Zhen said. “For long-term, that also became a disease, insomnia. Even though I don’t work anymore, I still have problems with sleep.”

The decade-long fight led by home care workers originated with these eleven hours of unpaid labor and fighting to get back these stolen wages, Sarah Ahn, an organizer with the Ain’t I A Woman campaign coalition explained. Home health care aides sued the state’s Department of Labor in 2023 for dropping their wage theft cases. But over the years the fight began to focus on ending the 24-hour workday. 

“It’s not just about money. This is about workers’ health and workers’ lives,” Ahn said. “The campaign is trying to fight injustices of the past but also trying to set a new standard in the industry moving forward.” 

Ahn also said the fight is about how home care workers are majority immigrant women. 

“If it wasn’t a population that they thought they could abuse, we wouldn’t have it,” Ahn said. “This is actually an age-old racist stereotype we have in this country: immigrant workers love to work hard, love to be exploited.”

Despite the rise in attention, there has been pushback against Int 303 from unions representing home health care workers and from the Legal Aid Society representing patients who need round-the-clock care. 

1199SEIU, United Healthcare Workers East, has issues with Int 303 because the union estimated that splitting 24-hour shifts into two 12-hour shifts would cost Medicaid another $460 million a year, split between the state and federal governments. The union asserts that City Council should align itself with the state’s budget process in order to avoid patients being sent to nursing homes due to a lack in state Medicaid funding for the split-shifts. 

Rose Ryan, a 1199SEIU press secretary, reaffirmed that the union “fully supports” a bill that ends 24-hour shifts and “includes full Medicaid funding for the additional hours to prevent consumers from being forced into nursing homes and subsequent job losses for their dedicated caregivers.”

Council Member Marte told Gothamist that he revised the bill with these concerns in mind, and that the bill would not take effect until April 2027, which would give time for adjustments to the state budget. But, since Speaker Menin did not submit the bill to a vote, considerations of the wording of the bill are likely still taking place. 

The Legal Aid Society in coalition with disability rights groups also oppose the passage of the bill, and rallied in front of City Hall in early April. The organizations argue for city council members to work with state lawmakers on the Medicaid funding before changing the city mandate for employers. They are skeptical that the state would figure out funding after the bill is already passed, leaving the 13,000 people in the city reliant on 24-hour live-in care at risk for institutionalization. 

Ahn labeled these critiques of Int 303 as fear-mongering.

“You have entities that profit off this really broken system—insurance companies and homecare agencies that would love for this to continue. To me that’s what’s at the root of it,” Ahn said. 

Mireya Silva, 73, who did 24-hour shifts of home health care for 17 years, has had operations on both of her hands and her hip. She now suffers from chronic headaches and lapses in her memory. 

After 10 years of organizing as a retired home care worker, Silva said she feels hopeful and determined. 

“We’re going to win,” Silva said.

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