New York, New York — The fight over 24-hour home care shifts in New York City just took a desperate turn.
Fifteen home health aides launched an indefinite hunger strike outside City Hall on Thursday, April 16, after the City Council failed to advance a bill that would ban the grueling round-the-clock shifts. Workers have been camped outside the building for nearly a month — and now, with no vote in sight, some say they have nothing left to lose.
The Policy at the Center of the Standoff
Under current state rules, live-in home care workers can be assigned to a single client for a full 24-hour period, but they’re only paid for 13 of those hours — assuming they get at least three hours for meals and five uninterrupted hours of sleep. Workers say those breaks rarely happen in practice.
“We routinely work 96 hours straight,” said one aide at the rally, where about 40 workers held “Stop the 24 Hr Workday” signs in the late-April heat outside City Hall.
The bill at the center of the standoff, introduced by Councilmember Christopher Marte of Chinatown, would replace 24-hour shifts with 12-hour shifts staffed by two different workers. Supporters frame it as a basic labor rights issue. But the proposal has split what might otherwise be a united coalition — pitting worker advocates against disability rights organizations and, reportedly, Mayor Zohran Mamdani against Council Speaker Julie Menin over questions of funding.
Why Nursing Homes Are Watching
The stakes extend well beyond home care workers’ paychecks. If the bill fails — or if it passes without adequate funding — disability advocates warn the downstream effects for nursing homes could be significant.
“I would lose everything. It’s no different than a prisoner going into Rikers Island,” said Jose Hernandez, a South Bronx resident with a childhood spinal injury who relies on home care. Hernandez is among those who say nursing home placement would be their only alternative if home care services collapsed.
Industry estimates from 1199 SEIU, the union representing most home care workers statewide, put the cost of split shifts at roughly $450 million annually in New York City alone. That funding would need to come through Medicaid — a program already under severe federal pressure. The city has no direct control over those dollars, which makes both the mayor and state lawmakers cautious about moving without a funding guarantee.
That tension mirrors a pattern playing out nationally. Home and community-based Medicaid cuts tend to push vulnerable seniors and disabled adults toward institutional care. In New York, that concern has been building since workers first occupied City Hall last month, demanding action on the same bill.
No Deal in Sight
Marte said he’s “optimistic” that a funding agreement between his office, Menin, and Governor Hochul is within reach. Mamdani, who backed ending 24-hour shifts on the campaign trail, told reporters he supports worker protections but wants the legislative process to play out.
A similar bill Marte introduced in 2023 also failed. A previous hunger strike by about two dozen workers in 2024 ended after six days.
For the 15 workers now refusing food outside City Hall, the question is how long they can hold out. For the nursing homes that could absorb the overflow if this fight goes wrong — it’s the same question.
