New York’s home care workforce had median annual earnings of $25,738 in 2023, and 39% of workers lived in or near poverty, according to a Cornell University report examining private equity in home care.
The statewide figures cover the home care workforce as a whole, rather than only employees of private equity-owned agencies. The September report, published by Cornell’s Worker Institute, draws on workforce data from PHI as well as interviews with workers and industry experts.
The findings add a statewide earnings picture to the agency working conditions described in FL1’s Oct. 6 coverage of the research. New York had 566,160 home health and personal care aides in 2023, and the report cites projections for nearly 200,000 additional jobs by 2030.
Low annual earnings extend across the workforce
Women account for 87% of New York home care workers, and 81% identify as people of color, according to the workforce data cited in the report. Two-thirds were born outside the United States.
The report puts the share of workers living in or near poverty at 39%. It also says 46% faced a housing cost burden and 61% relied on some form of public assistance.
Annual earnings reflect both pay and the amount of work available. Nearly half of home care workers work fewer than 35 hours a week, and about one-fifth work only part of the year, the report says.
Among the workers interviewed at private equity-owned agencies, most reported being unable to secure more than 20 to 25 hours of work a week. Short assignments and travel between clients could make it difficult to assemble a dependable income. Workers also described payroll errors, unpaid work and schedules that changed with little notice.
Interviews describe gaps in support and care
The researchers conducted 40 interviews, including 25 with home care workers and 15 with key informants. The worker interviews covered five agencies acquired by private equity firms, with 15 respondents in the New York City area and 10 in the Buffalo-Rochester region.
About one-third of the workers had been at their agencies both before and after an acquisition. The others described conditions after the ownership change. The interviews document those workers’ experiences; they do not establish how frequently the problems occur across all New York agencies.
Workers described difficulty reaching managers, incomplete information about clients’ needs, inadequate responses to harassment and discrimination, and limited benefits at nonunion agencies. Some said automated scheduling failed to match aides’ skills with the care a client required.
Some respondents reported being told to leave when a shift ended even if care tasks remained unfinished, rather than receiving additional paid time. The researchers argue that weak oversight and pressure to contain costs can undermine both job quality and care.
The project also examined the public money flowing through the industry. Private equity-backed agencies received more than $2.32 billion in Medicaid revenue in 2022, according to the research.
The report separately discusses private equity-backed Public Partnerships LLC’s role as the statewide fiscal intermediary for the Consumer Directed Personal Assistance Program. That administrative role concerns a program representing roughly half of New York’s home care Medicaid spending.
Researchers recommend stronger worker protections
The researchers recommend higher pay supported by adequate Medicaid reimbursement, more reliable hours, better benefits, stronger enforcement of labor protections and more responsive agency support. They also call for paid, in-person training, worker participation in decisions and greater transparency about ownership and the use of public funds.
Other recommendations include support for worker cooperatives and mission-driven nonprofit agencies and limits on financial practices that divert public care funding to investors.
The project was supported by the Robert Wood Johnson Foundation. Its authors are Anne Brady, Zoë West, Sanjay Pinto, Robyn Rowe and Michael Lenmark.
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