190,000 New York home care workers file for a union election

The union 1199SEIU United Healthcare Workers East filed with the National Labor Relations Board on Sept. 22 for an election among roughly 190,000 New York home care workers, according to Gothamist, which reported that nearly 200,000 workers are eligible to vote. Home Health Care News put the number of caregivers at 190,000.

The workers are caregivers in the state’s Consumer Directed Personal Assistance Program, known as CDPAP. The program lets Medicaid recipients choose and employ their own aides, who are often relatives. The union has collected about 70,000 signed authorization cards, well above the one-third of eligible workers needed to trigger an election, Gothamist reported. The NLRB will work with the union and the employer to set the rules and timeline for the vote, and a simple majority of votes cast decides the outcome.

CDPAP is nearly 30 years old and costs $11 billion a year, according to The City Reporter. The program was once run by about 600 fiscal intermediaries. The state has since consolidated it under a single contractor, Public Partnerships LLC, known as PPL. Gov. Kathy Hochul previously called the fragmented program “a racket” and “one of the most abused programs in the State of New York,” citing cost control.

Yvonne Armstrong, president of 1199SEIU, told Gothamist: “These are essential workers doing work families cannot live without, yet they are struggling to put food on their own tables.” Home Health Care News reported that the union cites insurance coverage disruptions, administrative hurdles and other problems that followed the move to PPL. The outlet also reported that 1199SEIU already represents more than 75,000 home care workers in New York City.

Workers divided

Aides interviewed by Gothamist and by New York Focus did not speak with one voice. Felix Cepeda, a CDPAP worker, told Gothamist that a union “can really support” advocacy in Albany for program funding and improvements. Maggie Ornstein, an aide who cares for her mother, told New York Focus that without a union, better health insurance “definitely won’t happen.” She also told Gothamist that the union has “been supportive of this PPL takeover without doing anything to help the workers who have really been struggling this past year.”

New York Focus spoke with more than a dozen aides in June, and eight opposed unionization or expressed doubts. Saba Nakhai, who cares full time for her mother, said: “Maybe if I was working at a corporation, I would want a union. But here, who’s the enemy, my mom?” Sophie-Anais Renois, who cares for her grandmother, described repeated underpayment caused by timekeeping errors and asked, “Is this union looking out for my best interest?”

The PPL question

The union has taken a position of neutrality toward PPL and pledged not to use strikes as leverage, New York Focus reported. Keith Joseph, 1199SEIU’s vice president for home care workers, told the outlet: “We know that our interests are aligned, because the funding comes from the decision the elected official makes in Albany.”

PPL settled a wage theft class action for $162 million in June without admitting wrongdoing, New York Focus reported, and Home Health Care News reported that a federal judge approved the settlement in July for about 200,000 CDPAP workers. The Justice Department sued New York state and PPL in June, alleging the contract went to PPL through a “sham” bidding process, according to The City Reporter. The governor’s office denies the charge. PPL says it has “a long history of rooting out fraud, waste, and abuse in state Medicaid programs” and has saved New York taxpayers more than $1 billion, Home Health Care News reported.

Other groups are watching the outcome. Caring Majority advocates returning the program to smaller intermediaries, Gothamist reported. Bill Hammond, a conservative analyst, warned that unionization could raise program costs. A rival union, Home Healthcare Workers of America, would be shut out if 1199SEIU wins, according to The City Reporter.

New York Focus also pointed to Massachusetts, where 1199SEIU won raises for 58,000 home care workers in 2023 and the state later cut $32 million from the program by reducing the hours aides can spend on meal preparation.