When Carmen Carrasco arrives at the home of the 95-year-old woman she cares for in Williamsburg three days a week, she immediately changes into clothes she keeps in the apartment, stashing her street clothes in a bag. It’s one of many safety protocols she has established with the other two home health aides who visit the apartment during the week. She also wears gloves and a surgical mask while at work.
“I feel secure because we all take precautions,” said Carrasco, 68, who said she’s not taking any chances in order to protect her client, herself, and her daughter, who’s pregnant. “We disinfect everything in the house, everything we touch.”
But Carrasco says it wasn’t the home care agency she works for that provided her with the equipment she needs to feel safe doing her job; rather, it was the National Mobilization Against Sweatshops (NMASS), a tiny, grassroots labor organization based in Chinatown.
NMASS has been collaborating with a neighboring group, the Chinese Staff and Workers Association, to collect donations, procure protective gear in bulk from suppliers as close as Philadelphia and as distant as China, and distribute it to home care workers throughout the city. So far, the organizations have handed out packages containing a box of 50 masks, gloves, disinfectant, hand soap, and a covering for clothing to more than 200 workers.
Many of the donations for the protective equipment have come from home care workers themselves. “When we distribute the supplies to workers, we ask for a donation from them to pay for more supplies for other workers,” said JoAnn Lum, an organizer with NMASS. “Everyone has been really appreciative. Some have been really generous in their donations and put in $40 or $50.”
But Lum said their capacity to distribute supplies is still very limited, adding, “The government has to step up.”
It’s been more than a month since New York started battling the novel coronavirus in earnest, and the city is still in the process of coordinating the distribution of personal protective equipment to home health aides—a group of workers who tend to come from the communities most impacted by the virus and care for those most vulnerable to it.
In New York City, most home care workers are immigrants and women of color, and more than half are over 50 themselves. During this age of social distancing, they still have to help elderly and disabled clients with such intimate tasks as eating, bathing, and going to the bathroom.
The majority of agencies that employ these workers have struggled to procure a sufficient supply of masks and other personal protective equipment on their own, according to a survey by the Home Care Association of New York State. While government assistance lags, labor groups large and small are stepping up to help fill in the gaps.
Home Care Services for Independent Living, the Midwood-based agency that employs Carrasco along with some 500 other aides, finally started distributing equipment to its employees last week, thanks to a donation from 1199SEIU, the powerful health care union that represents more than 60,000 of the roughly 168,000 home care workers in the city.
“It took a while and it was not easy [to get supplies],” said Kwabena Achampong, director of finance at the agency, who is now going into the office to distribute 100-count boxes of disposable masks to employees twice a week. “We have enough now, but we have to get more as a buffer.”
It’s unclear how widespread 1199’s distribution of protective equipment has been.
It’s been a struggle for the city to coordinate the distribution of personal protective equipment to the numerous home health agencies dispersed throughout the five boroughs, which all have diverse needs, a spokesman for the Department of Health and Mental Hygiene told Gothamist. Even with the Home Care Association offering to help set up a handful of concentrated distribution sites, the city spokesman said there are still logistical challenges.
“This situation is requiring us all to do our best to reach entities that we do not normally supply protective equipment to,” the spokesman said, “but we recognize the importance of getting protective equipment to people who are working on behalf of the health of New Yorkers, despite logistical challenges. There are many agencies of varying sizes and needs and it differs from supplying a hospital system.”
The Home Care Association says because a limited supply of safety equipment is being made available by the city, it is trying to conduct a more in-depth survey of home care agencies to figure out who needs it the most.
Along with other trade groups, the Association is also appealing to the state to establish clear protocols on which aides should be prioritized for safety gear, taking into account the vulnerability of the home care worker, the level of care required by the patient, and whether patient has tested positive for or is suspected of having COVID-19.
The state also needs to establish clear protocols for when an agency should seek an alternate to fill in for someone who can’t work safely, and when the best move is to stop sending an aide altogether, the industry groups say.
Home care agencies, along with aides, patients and their families, have already had to make tough decisions about whether to disrupt care. One in five home care agencies that responded to the Home Care Association survey said they have policies in place that prevent a patient visit from happening when protective equipment is required but not available. Many home health aides are reusing masks, making their own, or completing visits without masks, but 7 percent are resigning or refusing to provide services without proper protective equipment. In some cases, the clients are refusing services because they don’t feel safe having an aide in the home.
Meanwhile, NMASS and the Chinese Staff and Workers Association say aides need more institutional support when it comes to establishing safety protocols in line with Matilda’s Law, which Governor Andrew Cuomo put in place to protect seniors. But while it may be possible to enforce a no-visitor policy or a policy of screening visitors for symptoms of COVID-19 at a nursing home or hospital, doing that in someone’s home, where aides work in isolation, is much more difficult.
Carrasco says she had a talk with her 95-year-old client’s family members and they all decided it would be safer for them not to visit for a while. But she gave up another gig in which she was getting paid through the state’s Consumer Directed Personal Assistance Program to take care of her brother two days a week because there were so many other people coming in and out of the apartment, including people who are still working in the community. (Carrasco shared her brother’s condition with Gothamist but declined to share it publicly.)
She also turned down work from another agency that was short-staffed, saying she didn’t feel safe taking on a new client at the moment.
Many home health aides earn low incomes and may not have the option to leave a gig or turn down new work if it doesn’t feel safe, but Carrasco says she feels good about her decisions.
“With these three days, it’s enough,” said Carrasco. “My life is worth more than money. Everyone’s is.”
