Although New York state has passed $15 minimum wage legislation, there are thousands of home health care workers, mostly immigrant women of color, who are paid only half of the hours they work.
Epifania Hinchez, who immigrated to the U.S. from the Dominican Republic in her 40s, worked as a home health care worker for 17 years in NYC. The heavy-lifting – her last patient weighed 290 pounds and could not walk – required in her job led to shoulder and wrist injuries, as well as nerve damage which has required surgery. For her entire career as a home health attendant, she has only been paid for 13 hours of her 24-hour shifts.
This didn’t stop Hinchez from caring for her patients. Hinchez, who is Catholic, said, “I treat my patient as if they are my own family members because that’s the right thing to do as a Christian. I had to work with love and care.” Despite the physical toll, she kept working because she wanted to provide a better life for her children, whom she brought over from the Dominican Republic, and her grandchildren.
Home care aides, or home health attendants, are jobs that are increasingly in demand. That’s because over the past decade, New York state has moved away from allocating Medicaid dollars to nursing homes, directing funding instead toward assistance for the elderly in their own homes. According to Village Voice, in New York City, where more than 75 percent of the state’s 224,400 home health attendants reside, 93 percent of attendants are women and 79 percent are immigrants.
Many attendants in New York City are assigned elderly patients who are bed-ridden and require 24-hour, around-the-clock care. The job is incredibly demanding. Yet, they are not compensated for all their hours.
This phenomenon is not a case of employers violating laws, but rather is written into the state’s labor regulations, which make an exception for “home care aides” in its minimum wage laws.
Attendants are only paid for 13 hours of their 24-hour shifts. The remaining eight hours are uncompensated via Medicaid because attendants are supposed to “sleep” and “eat.” However, that is hardly ever the case.
“I flip her body every two hours, I change diapers at 9 p.m., 12 a.m., and 3 a.m.,” Shao Huan Yu, a home attendant, described her care of an elderly woman. “At 5 a.m., I make congee, wash her butt, wash her clothes, and feed her breakfast.”
According to testimonies of attendants submitted in courts, attendants report getting up multiple times a night in response to patients’ cries for help, or to flip their bodies around to minimize skin damage, as directed by their agencies’ nurses. Most attendants report that it is impossible to get more than two to four hours of consecutive sleep. This should be little surprise given that the patients are ill enough to have been approved by the Department of Health to receive 24-hour care, which is why the attendants are required to stay in patients’ homes during the entire shift.
Many attendants take on several 24-hour shifts a week in order to economically survive; some say that they are told by agencies that only 24-hour shifts are available. Working such long shifts over the course of years takes an immense physical toll. One attendant wrote in her testimony that once she was so tired during a shift she “didn’t even have the strength to hold a towel.”
“Now I became the patient that needs the care of a home attendant,” wrote one of the attendants. The work has “destroyed my health and life,” wrote another. Health attendants report experiencing insomnia, high blood pressure, neurasthenia, sprained wrists and so on, not to mention neglect of their families, as a result of their work.
The treatment of attendants has alarmed even patients and their relatives. Shirley Ranz, whose mother was taken care of by an aide, told the Village Voice, “If the aide can’t get to sleep at night, it’s a danger to my parents as well as to her.”
Organizing to change worker conditions
Since 2014, health attendants have been organizing under the Ain’t I A Woman Campaign , working with two workers’ centers – National Mobilization Against Sweatshops and Chinese Staff & Workers Association – to demand fair wages and schedules. They have campaigned for abolishing the 24-hour workday, asking to split 24-hour shifts into at least two shifts, which is standard practice in other cities. In Buffalo, N.Y., for instance, home attendants work three 8-hour shifts instead of a single 24-hour shift.
New York City home health attendants have won court rulings in their favor, as the courts determined that the state was violating its labor laws. The Department of Labor responded to the court rulings by issuing an emergency amendment to its labor laws. The department wrote that its minimum wage laws should not be construed to apply to a “home care aide who works a shift of 24 hours or more.” In other words, this is legalized wage theft, or labor exploitation on the books.
Consequently, attendants are handcuffed when it comes to seeking proper compensation. If they aren’t able to sleep and have to work more than 13 hours, the Department of Labor instructs them to report this to their agencies and obtain compensation. But many agencies argue they don’t have enough Medicaid funding to pay for all 24 hours. Thus, some have responded by instructing attendants not to work after 8 p.m., and to simply ignore any cries of the patients past that time and to call 911 if it’s serious.
Many attendants refuse to ignore the needs of the patients, with whom they’ve developed relationships over time. “This is heartless,” Yu said. What’s more, attendants who have filed overtime claims have experienced retaliation from their agencies. In her testimonial, Yu wrote that her 1199 SEIU union representative told her she was fired from Chinese-American Planning Council for documenting her night work.
According to Mika Nagasaki, one of the Ain’t I A Woman campaign organizers, this undervaluing of domestic labor is part of the “super-exploitation” of women of color. Indeed, studies have found that wage theft violations occur mostly frequently when it comes to foreign-born women.
In light of the attendants’ testimonies, the Department of Labor has taken a practical tack, claiming that paying the attendants for the full 24-hour shifts would dry up resources and bankrupt the home health care industry. But it is odd that one of the richest and wealthiest cities in the world would struggle to fund one of society’s most important social services. The problem, then, is not about whether there are sufficient resources, but about whether we have the right economic system in place to distribute them.
Where is the church’s voice in all of this?
Christian sacred texts do not necessarily point toward one economic system over another. But they do provide a set of ethical principles around wages and labor that followers should heed.
Deuteronomy 24:14-15 states, “You shall not withhold the wages of poor and needy laborers … you shall pay them their wages … because they are poor and their livelihood depends on them.”
Jeremiah 22:13 writes, “Woe to him … who makes his neighbors work for nothing, and does not give them their wages.”
James 5:1-4 is perhaps harshest of all: “Come now, you rich people, weep and wail for the miseries that are coming to you … Listen! The wages of the laborers who mowed your fields, which you kept back by fraud, cry out, and the cries of the harvesters have reached the ears of the Lord of hosts.”
Hinchez said that she attends Christ the King, a Catholic church, in the Bronx. Her faith has been important to her since she was a little girl. When asked if her church has been a support to her through her struggles at work, she said, “I never talked to the priest about my struggles.”
She added, “I see my job as the work of God, but God is angry because he sees that my job is making me sick needlessly and is mistreating me. We have been treated like slaves.”
Sarah Ngu (@sarahngu) is a freelance writer based in Brooklyn, NY. Sarah is a co-founder of Church Clarity, a host of Religious Socialism podcast, and has written for Splinter, Jacobin, Sojourners and Public Radio International. She attends Forefront Brooklyn Church.
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