Home Care Unionization Efforts Beginning To Tick Back Up

The home care workforce has traditionally been a tough one to organize. But efforts have ramped up over recent years, leading to more workers opting into unions across the country.

Recently, University of Rochester Medicine Home Care (URMHC) workers “overwhelmingly” chose to join a labor union. They aligned themselves with 1199SEIU United Healthcare Workers East, which is one of the largest health care worker unions in the country.

About 115 URMHC workers – across multiple counties – will now join the union, looking for better pay, working conditions and more say in day-to-day operations.


More broadly, after a strike at the University of Rochester Medical Center last year, more than 1,600 home health aides and personal care attendants joined unions in Rochester and in the broader New York State, according to FingerLakes1.com.

Unionization in home care

Because home care workers are remote, they remain one or the least unionized groups of health care professionals in the country.

“We don’t want this kind of third party interference between employers and employees, but there’s a tension that’s happening in this system,” Denise Delcore, then a part of the law firm Polsinelli, said in 2022. “Home care providers have had greater challenges than we’ve ever seen before. As employees are struggling to deal with those — particularly in the wake of COVID — there’s a renewed effort to organize this industry.”


Part of what URMHC workers want out of unionization is better pay, which is a problem for most home-based care providers that accept Medicaid or Medicare.

While providers do set wage rates, those wages are largely determined by reimbursement from state-sponsored programs. Therefore, leaders may want to raise wages, but don’t always have the vehicle to do so.

In essence, provider leaders worry that organized efforts to raise wages across the board could be a threat to the overall business’ bottom line.

Unionization efforts were picking up major momentum before COVID-19, but like much else, they stalled once things went the virus began to spread.

Now, there’s some anecdotal evidence that efforts are picking up again.

Another issue that URMHC workers cited was working hours, which could – in theory – be fixed by providers. One of the biggest reasons for turnover in home-based care is volatile scheduling.

“I think that’s a problem we’re going to have to solve,” FirstLight Home Care CEO Glee McAnanly told Home Health Care News earlier this year. “Because if you talk to caregivers, they say they want 30 hours. The average client is 20 hours, and so you’ve got a disconnected 10 hours. So, we talk about retention, but how are we going to [satisfy] that caregiver?”

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