In This Section

With 1 Million New Yorkers Expected to Need Home Care Soon, and Home Care Jobs Driving Employment in NYC, New Survey Reports Experiences and Priorities of Home Care Workers, Seniors, People with Disabilities and their Families.

New York, NY— ALIGN and the NY Care Council released a groundbreaking survey report on New York City’s current and anticipated home care needs. Findings from more than 1,200 surveys, as well as focus groups and interviews, reveal aspects of the home care system that are in greatest need of change.

The new report, Caring Across New York City, was released at the Murphy Institute for Worker Education, with approximately 100 members of community, worker, senior, faith-based, disability, and policy and advocacy organizations in attendance. Panelists discussed survey findings and recommendations to ensure the financial security, health and safety, and dignity and respect of both caregivers and people who receive care.

Survey author and Senior Policy and Research Analyst at ALIGN, Maya Pinto, explained how demographic and political shifts are having a profound impact on home care in New York City and across the country. “Baby Boomers will drive a huge increase in home care jobs, and the rollout of the Affordable Care Act and Medicaid Redesign has placed the home care system in a state of flux. If we act now, we have the opportunity to create good new jobs and ensure quality care for everyone who needs it.”

Over 1 million New York City residents interact with the home care system, either as paid or unpaid caregivers or as seniors and people with disabilities who receive home care. One in five New Yorkers is a caregiver, and home care jobs are projected to drive employment growth in NYC in the coming years. Currently, one in seven low-wage workers in NYC is a home care worker.

Survey participants identified issues related to financial security as the top concern with the current home care system. Sixty-two percent of home health aids and home attendants and 92 percent of domestic workers surveyed reported that their annual household income is under $25,000. Both care workers and people who receive care overwhelmingly chose “raising wages for home care workers” as their top priority, suggesting that New Yorkers perceive a connection between the quality of care jobs and the quality of care that people receive.

“Home care agencies employ more than a hundred thousand workers in New York City and home care is the fastest growing sector of our economy,” said Helen Schaub, New York Policy and Legislative Director of 1199SEIU United Healthcare Workers East. “While New York State wage parity legislation has improved the quality of these jobs, too many workers still struggle to provide for their families on the wages they make, leading to high turnover. We still have work to do to build a stable home care workforce and ensure the highest quality care for our city’s seniors and people with disabilities.”

People who receive care or would like to receive care also struggle with financial security. Sixty-nine percent of survey respondents with unmet care needs cite inability to afford the care they need as the reason for not receiving required care.

“The findings in the report support our experience that the vast majority of individual employers want to see home care workers paid fairly and adequately and receive benefits,” said Sue Lob of Hand in Hand: the Domestic Employers Association, a national network of employers of nannies, house cleaners, home attendants and our families and allies. “Many employers, however, particularly older people and people with disabilities, cannot afford the care they need. It is crucially important that home care be affordable for those who need it, while providing living wage employment for care givers.”

While more than half of survey participants were satisfied with the quality of their care, nearly 40 percent rated their current quality of care very poor, poor, or fair.

“The quality of home care training that workers receive and the quality of care people receive are inexorably linked,” said Carol Rodat, NY Policy Director for PHI, a national nonprofit that focuses on improving the quality of direct-care jobs in order to improve the quality of care. “The voices of both the caregiver and the care receiver are found in the survey results and guide us towards the policies and practices we need to ensure that both are treated with dignity and respect, and that both receive the care and support they deserve.”

Overall, “providing better quality training for home care workers” ranked as the third most important priority for all New Yorkers surveyed, and the second most important priority for people who receive care.

All survey respondents chose “ensuring health care access for home care workers” as an objective they would like to see the New York Care Council pursue. In New York City, non-union home care workers who do not qualify for Medicaid are unlikely to have health insurance.

“I wish this job provided health insurance for me and my family,” says Nicia Hassell, a domestic worker who cares full-time for a senior in Staten Island. “Right now I don’t have insurance and I pay for everything myself—when I’m sick or my two daughters are sick, and for all of my older daughter’s medicine.”

Fifty-two percent of people who receive home care chose “improving monitoring of abuse/neglect of home care recipients” as a top priority. Elder abuse is a serious problem in New York. Family members are the primary perpetrators, according to a recent report by the New York City Department for the Aging. Home care workers can serve as a first line of defense against elder abuse.

“Over the course of their lives, senior citizens have contributed to the growth and prosperity of this nation and continue to play a vital role in their communities,” said Maria Alvarez, Executive Director of New York StateWide Senior Action Council. “Just like all members of society, the elderly have a right to remain at home, among their families and friends, receiving good quality and affordable health care that will allow them to live with dignity and respect. As a civilized society, it should be our pleasure, not a burden, to ensure that our parents and grandparents receive the best care possible.”

In the next two decades, it is estimated that 1 million more people will require home care. Fifty-one percent of all survey respondents anticipate that they or a loved one will need home care for the first time in the next ten years. The home care system will be the single biggest driver of employment in New York City in the coming years. Certified home care workers are projected to grow faster than any other group of workers in the city between 2010 and 2020, seeing an almost 50 percent expansion, and adding over 76,000 jobs.

“As the baby boomers age, America’s largest generation, a generation of people who are fiercely independent, will face, along with their families, choices around care and support,” explained Trishala Deb of the national Caring Across Generations campaign. “This unprecedented need creates a challenge and an opportunity to ensure a strong economy with robust job growth. By ensuring the quality of jobs in long term care, we will ensure that our seniors are able to receive the quality care that they choose.”

Caring Across New York City outlines several broad strategies to build a better home care system. The recommendations contained in the report are actionable at the city and state level, and directly address the top concerns and priorities of survey participants.

The report can be downloaded from the ALIGN website at:


ALIGN: The Alliance for a Greater New York’s mission is to create good jobs, vibrant communities, and an accountable democracy for all New Yorkers. Our work unites worker, community, and other allies to build a more just and sustainable New York.

Caring Across Generations is a campaign for quality care and support, and a dignified quality of life for all Americans, across generations. The New York Care Council is building a coalition of community, worker, elder, faith-based, disability, policy and advocacy organizations and individuals committed to justice, dignity and high-quality care for both care givers and those receiving care.