Taking Back Time

Sofia Chiongbian Khu spoke with activists pushing for widely supported, yet stalled legislation capping work hours in New York's home healthcare industry. Many of the leaders of this movement are not the young idealists you'd expect, but elderly women, near the end of their careers, who've been scarred by difficult work conditions and want to improve things for the next generation.

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It was a rainy day in early spring–basically still winter in New York City–when I walked into a hunger strike on the streets of Manhattan. 

I had been looking for the protestors, circling the triangular block that’s home to New York City Hall, when a twenty-something with spiky hair and an earring offered me a flier and pointed me in the direction of a small outdoor tent surrounded by people.

The man was welcoming and friendly, and he quickly asked how I found out about the event. Several days before, I was scrolling on Instagram when I heard about the women on hunger strike. They are part of a coalition of diverse community organizations, advocacy groups, and individual citizens called “Ain’t I a Woman.” Named after Sojourner Truth’s famous 1863 speech, this movement focuses on fortifying the rights of women of color. 

That day, a group of home health aides–almost all of them retired, or close to retirement–were on hunger strike to support the passage of a City Council bill, INT 175, to split the 24-hour workday into two 12-hour shifts. 

Most of them were quite old, and many frail from their years of demanding work. As I walked up to that tent on the perimeter fence of New York City Hall, I knew very little about the issue. But I was surprised and confused by the fact that people were still legally working 24-hour days in New York City, and out of all the people who were outraged at this fact, some of the most dedicated were Chinese women in their sixties and seventies. 

There on the sidewalk, hovering on the outskirts of all the commotion, I caught glimpses of the hunger strikers wearing headbands in Chinese and English to signal their participation. The women were swaddled in blankets and coats, and under the tent were camping chairs and sleeping bags for the rest of the night. They chatted amongst themselves in Cantonese, Fujian, and Mandarin. 

The young people, meanwhile, were securing tarps around the tent to block out the wind, and moving a few camping chairs from the sidewalk inside the tent. Others brought a tureen of soup from a nearby van, and moved a bin full of fliers. 

It’s tiring, often thankless work to gather forces, plan actions, and participate in hours-long protests and sit-ins. But at the hunger strike, and in the weeks and months afterwards, I saw old and young knit together in a powerful coalition. The elderly and retired are not just the face, but the very heart of this movement.

The hunger strike lasted five days, through the cold and the rain. Currently, the bill is still stalled in the City Council. But the home care workers continue to fight for what they see is the only way forward for future generations of immigrant workers.

The 24-hour shift

Most people who hear about this movement are shocked (often to the point of disbelief), just as I was, that a 24-hour workday even exists. The law permits a 24-hour workday with 13 hours of pay, given that the worker is permitted an 8 hour sleep break with at least 5 hours of uninterrupted sleep, as well as 3 hours of meal breaks. This is known as the “13-hour rule.”

If any of these break conditions are not met, the worker is due full payment for the 24 hours worked. 

However, this rule often goes unenforced. When an aide is caring for a patient in dire condition, it’s not always possible to get 5 hours of uninterrupted sleep. Even if a worker wanted to report a violation of work hours, none of the usual mechanisms are in place to support this. Home care workers do not work in front of a watchful public, or even alongside other coworkers. They most often work alone, secreted away in the homes of their patients in a vast city.

It’s ultimately the word of the worker against the word of their boss.

Splitting the 24-hour workday into two 12-hour shifts would entail a significant change for the whole industry. Many agencies, lawmakers, and the union that represents home care workers adopt a hesitant position, wondering if the realities of the home care industry can handle such a significant change. 

According to their official statement, the 1199SEIU-United Healthcare Workers East estimates that split shifts would cost $1 billion. The union states that this additional cost must be provided by the government.

CPC, a home care agency in Chinatown, takes a similar stance in pushing for a statewide bill. They allege that their hands are tied when it comes to ending 24-hour shifts:

“The Chinese-American Planning Council (CPC) and our subsidiary, CPC Home Attendant Program (CPCHAP), are in full support of home care workers in their call to end 24-hour shifts and to make two 12-hour split shifts universal. Unfortunately, 24-hour shifts are mandated by State law and determined by insurance companies. Like all home care agencies, CPCHAP does not have the power to split 24-hour shifts on our own.” 

Many such state-level bills have been introduced year after year since 2018. They have all languished in the legislature. 

New York’s Homecare Industry Dynamics

Between 2012 and 2022, the number of home health aides in New York state almost doubled according to a 2022 report by the Empire Center. 

This increase points to a significant underlying need: Baby Boomers are aging, and home health aides can allow a growing elderly population to “age in place,” instead of relocating to nursing homes. Medicaid subsidizes the home health program for this exact reason. 

According to some accounts, New York state has a crisis-level shortage of workers despite significant expansion of the industry. This was an important factor in the Department of Labor increasing the minimum wage for such workers in 2022. Today, NYC aides earn $17 per hour. Agencies claim the shortage is an important source of pressure driving extended working hours. 

New York state spends about $12 billion annually on home care, eight times the national per capita average, according to the Empire Center. According to a Medicaid report published in 2023, New York State accounted for 23% of national long-term care spending in the 2020 fiscal year, compared to 35% for Pennsylvania, Florida, and California combined.

The same Empire Center report raised concerns about the program's efficacy and vulnerability to fraud. It notes that New York's spending growth has far outpaced its elderly population growth by a factor of ten. Despite this, home care programs haven't reduced the nursing home population relative to the national average.

This expensive program is a necessary one, though its current iteration fails to hit its marks–primarily, improving care for the aging population. In an industry increasingly flush with government money, both home care workers and the patients that they care for are caught in the middle.

Changing the Industry

It’s difficult to pinpoint the origins of this movement, perhaps because the effort is fundamentally a grassroots one. It grew out of various anti-sweatshop protests, and its organizational hubs are workers centers and associations like the Flushing Workers Center, Chinese Staff and Workers Association (CSWA), and National Mobilization Against Sweatshops (NMASS). 

CSWA and NMASS sit side-by-side on bustling Grand Street in the Lower East Side. Both spaces have become gathering places for home care workers and organizers–staff workers and volunteers alike–as well as workers from other trades. While CSWA represents Chinese workers, the Ain’t I A Woman coalition is a multiracial, multi-trade alliance. 

I visited the CSWA office in early summer. Several months after the March hunger strike, the organization conducts a weekly Wednesday morning picket outside of CPC’s office building.

After a busy morning of flyering to raise awareness about the first picket, home attendants and staff organizers returned to the headquarters to cool off and chat. Conversation flows in four languages: Fujianese, Cantonese, Mandarin, and English. One of the workers, whose name I don’t catch, comes around and pushes a few slices of orange into my hand (Later, when I’m on my way out the door, she hands me one whole peeled orange for the road). 

Sitting in the CSWA office after the first CPC picket, Yolanda introduces me to Hei. 

Hei’s Story

We sat in chairs in the main room of CSWA, huddling together to hear one another over the din of other volunteers, home attendants and staff workers. Hei is most comfortable speaking in her native tongue, Mandarin, so between us sat Zishun Ning, a staffer at CSWA, who translated.

Hei is a soft-spoken yet straight-talking home care worker who lives and works in Brooklyn. After her 24-hour shift the previous night, running on very few hours of sleep, she had taken the subway from Brooklyn into Manhattan Chinatown to picket in the humid July heat. 

Already in her sixties, she hopes to retire within the next year or two. Before becoming a home care worker in New York in 2014, she worked various odd jobs, and before that, she had a thirty-year stint as an accountant in China.

When she first began working as a home attendant, she told me, she had been eager for a change in her working life, and wanted to really put her heart into her job. 

From the beginning, she has always cared deeply about each of her patients. When asked about her career, she speaks about the months or years spent with each of them. 

Hei described a life that became more and more dictated by the illnesses, health, and quirks of the patients she cared for. 

Her very first case–for which she did not work 24-hour shifts–was a very particular older woman who had a bad temper and wanted everything–from her laundry to her eggs–done in a specific way. Hei began working with her as a substitute; the woman was so impossible that no one at the agency wanted to take her on. But Hei was able to handle it, and the patient requested that she become her full-time aide. 

Hei eventually began to work 24-hour shifts with another patient, with whom she was assigned 3 shifts per week. She rose to the challenge and resolved to do her best; she understood that the patients that require 24-hour care are often in bad condition. They might have Parkinson’s, dementia, or severe diabetes, and need help with the most basic tasks such as eating and going to the bathroom. 

Hei explained how some patients with dementia no longer have regular sleeping or eating schedules. One of her patients often woke up in the middle of the night, needing Hei to prepare food. 

As her career has progressed, she has taken on more and more 24-hour shifts. The work got more and more demanding as she proved her capabilities at the job. It seemed like the better she performed, the worse things got.

It’s not as though she’s actively chosen to work 24-hour shifts. A patient can require daytime care at first, and then gradually shift to requiring 24-hour care as their condition worsens. 

There’s also the snowballing effect of job experience: When Hei began working for a different agency, they saw 24-hour shifts on her resume, and began to schedule her for those. 

And lastly, there’s not much recourse for Hei. I asked her if she’d considered leaving the industry, and she said that simply wasn’t possible. “My English is bad,” she said. Home care, she feels, is simply her best bet for making a life in this country.

“We have pressure living in the U.S.,” she said. “We need to make enough money.”

Hei wants to retire soon. After nearly a decade of insufficient, interrupted sleep and round-the-clock physical work, she has developed vision problems and insomnia. 

Still, she comes out to picket and flier, week in and week out. I ask her how she has the energy for all this, gesturing to the worker’s center around us.

“This is the right thing to do,” she says calmly. “We got hurt.”

Hei has little else to say on this question–the answer is simple, and she doesn’t stand in its way. 

“It’s also for the home attendants, and the Chinese who are discriminated against. We unite and help each other,” Hei adds.

Embedded in her ideals is a sense of community and relationality to her fellow home care workers and fellow Chinese immigrants. And in fact, her community has buoyed her sense of moral direction when it comes to this fight. I asked Hei about how she manages to keep the fear at bay–the fear of retaliation from her bosses.

Hei explains that she used to be more afraid. 

As a non-union home attendant, she was able to take direct legal action against her past employers for wage theft (unlike many other home care workers, who are represented by 1199-SEIU, and are legally obligated to undertake official arbitration and are barred from suing their employers). 

She has held off suing her current employer thus far. Her past employers, upon hearing of the lawsuit, called her directly and refused to assign her any future work. And that was scary for her. 

But she tells me that she doesn’t really care anymore whether they know or not. 

The Chinese Staff and Workers Association and other workers that she’s connected with have brought her strength. They come together and support each other, talking one another through overcoming their very tangible fears of retaliation. 

“We’re not making this up… If we’re making this up, then we have to be responsible for this…but what we’re saying is the truth. We have to let the public know… that this really exists,” said Hei.

“We need to make a living and we have to have our health. Because of the work, we sacrifice our life. We’re not hostile towards the home care agencies, we’re just telling the truth.”

Her vision for the future–the future of home care workers, the future of Chinese immigrants–is one where people’s lives are not completely dictated by their work. And it takes a community of support to envision a future like this. The togetherness dispels fear.

“Usually, people think ‘Chinese people don’t speak up.’ But it’s different now,” Hei said. 

What does this mean for the rest of us?

In 2022, the state bill to end the 24-hour workday devolved into fights around a weekly hour cap. Some argued that such a cap was necessary to protect workers from exploitation; others, most notably union representatives, stated that overtime pay was necessary for some of its members to make ends’ meet.

As it stands, the rules don’t reflect the ways in which choice obscures the power differentials in this line of work, where 60% of New York state home care aides are immigrants, 90% are women, and 18% live below the poverty line. 

This fight is not simply about eradicating wage theft in the home care industry. It’s not even about the idea of fair compensation in general. Rather, it’s about the intangibles, like health and time. For those who are literally working twenty-four hours straight, there is no time left in the day for other parts of life like family, community, friends, hobbies, let alone rest. 

The workers’ demand is to simply cap the home attendant work day at 12 hours. It’s not about better wages–they’re not asking to be paid a premium for working long, arduous hours. They are fighting so that no one has to work these kinds of shifts at all. 

Wing Lam, veteran organizer at CSWA, tells me that no one else seems to be fighting for a plain-and-simple cap like this. Fights for workers’ rights usually involve raising the minimum wage or increasing benefits, which are certainly a positive development, but are often a stopgap solution to the larger issue at play, according to Wing.

With rising costs of living, these incremental increases still leave workers on the hamster wheel, working long days to make ends meet.

This question of time echoes past the confines of industry, and perhaps even into the privileged echelons of society. Wing asks me a rhetorical question: “Do young people have time?” 

It depends. Based on our socioeconomic status, we have differing levels of time–as time is money. But most of us have to give most of our hours to someone else. And the classic American model is to work so that you can afford to retire; in this norm, your time comes largely at the end of your life. 

We are accustomed to thinking of free time as our own selfish time, space for our personal hobbies or rest. And I think this is why we do not discuss this in public spheres–time is seen as a luxury, a commodity that can be acquired for yourself with enough wealth and resources. 

But time also means time for one’s community; our time is shared. 

I don’t know what it’s like to work a 24-hour shift; I can only imagine that most people who must work for 24 hours straight spend much of their week in survival mode, focused only on their patients’ survival as well as their own. 

For those of us lucky enough to work from 9-5, we still subscribe to the classic retirement model. This lifestyle involves a manageable daily amount of work, with several days of vacation a year, until we save enough money to retire ideally in our mid-sixties. This lifestyle provides a comfortable existence for most. 

Nowadays, amongst office workers there is the FIRE movement: Financial Independence, Retire Early, which involves drastically cutting costs, investing aggressively, and often working multiple “side hustles” to quit your day job years before you hit your mid-sixties. To live the retired life you desire, you must spend both your working life and your retirement in self-imposed scarcity. 

Both models of spending your time share a similar scarcity mindset. The realities of work shape a mindset that free time can only be for self and near family, because there is not enough of it to spend beyond that. 

This is why I am so taken by the women fighting to end the 24-hour work day. They have escaped this scarcity mindset. By all accounts, they have no time, and yet they create it, and that time is shared in community. Hei and others like her know the importance of community support in changing society. They know that pushing forward together is the only way to achieve their aims–for themselves, and for the people who come after them.

They don’t wait for time to arrive on their doorsteps. They are taking it back.