The single-largest successful union petition in New York this past year is not at an Amazon warehouse or a university or hospital, but at a home care agency on the border of Bushwick and Williamsburg, Brooklyn.
Workers there did not vote to join their union, the Home Healthcare Workers of America. Instead, Anchor Home Healthcare Services signed a union contract with 3,230 of its employees in February 2024, after it voluntarily decided to recognize the union, circumventing the need for an election that would have been reviewed by the U.S. labor board.
The same process played out at more than a dozen other home care companies in New York that voluntarily allowed their employees to join the HHWA in the past five years alone. New York-based home care companies account for 6,700 out of the roughly 40,000 workers nationally whose union was voluntarily recognized by bosses in the past four years, without a vote by workers. All of them are HHWA union shops.
Among them is Five Borough Home Care, also based in Brooklyn. The Five Borough union contract, filed in court records as part of a class-action lawsuit by workers, currently guarantees unionized employees $18.55 per hour — exactly the same rate as if they were not in a union at all under New York’s special wage law for the home care industry.
Minus $30 a month deductions for union dues, unionized Five Borough workers, in fact, make less than minimum wage.
That they were in a union, much less paying membership dues out of their paychecks, came as news to four current and former Five Borough workers interviewed by THE CITY.
“I never received a benefits packet and never met a union representative, ever, in five years working here,” said one Five Borough Home Care worker in Spanish, adding that she was never asked to sign a union card. She spoke on the condition of anonymity out of fear of retaliation from the agency.
Though she last worked for Five Borough two months ago, she stopped receiving pay stubs long before that, she said — paperwork that would have had to show deductions, including for union dues. Supervisors ignored her repeated requests for pay records, she said.
Through such voluntary recognition deals with management, less than a decade after its founding, HHWA has exploded in size. It currently claims some 43,000 members, up from 14,141 in 2018. An investigation into Home Healthcare Workers of America by THE CITY, based on interviews with past and current members, legal records and other public statements, reveals that this fast-growing union is a tool of company management in the form of a labor organization.
For example, the contract in effect at Five Borough, which voluntarily recognized HHWA in October 2020, lays out that workers must arbitrate all claims, including pay disputes.
Asked by THE CITY to review the Five Borough collective bargaining agreement with Home Healthcare Workers of America, labor attorney Daniel Bright concluded: “My opinion is this contract provides some pretty clear benefits to the employer, but I don’t see the employees getting much in return.”
Yet even while being members of a union, Five Borough workers are fighting for pay they claim they are owed. A class-action suit on behalf of hundreds of workers against the home care agency, first filed in 2017 and still pending, alleges that aides routinely worked more than 10 hours per day and 40 hours per week, without getting paid overtime.
After a failed appeal and a COVID pause, the case is now active again, with a hearing Thursday in Brooklyn Supreme Court on Five Borough’s request to dismiss the case. The company argues in court filings the case shouldn’t even be in court to begin with — thanks in part to the requirement for arbitration in its contract with Home Healthcare Workers of America, signed after the suit was filed.
Lawyers for the workers assert the company waived its right to arbitration by claiming that it was bound by those requirements many years into the litigation.
“We feel strongly about our arguments that Five Borough has waived arbitration in this case. They engaged in the judicial forum for over six years and only moved to compel arbitration now,” attorney LaDonna Lusher, who is representing the Five Borough plaintiffs,” told THE CITY. “It would be egregious, prejudicial and a total waste of judicial resources for class members to be forced to arbitrate their claims individually rather than pursue the class action they’ve been litigating for over six years.”
Calls to Five Borough Home Care and its principal were not returned.
Meanwhile, fueled by dues paid by low-wage workers, Home Healthcare Workers of America and its parent union, the International Union of Journeymen and Allied Trades, has amassed both political and actual capital.
Last year, Home Healthcare Workers of America reported to the Department of Labor that it brought in nearly $13 million in dues payments, spending about $4 million of that on operations while funneling millions more to IUJAT.
Both the home care union and its parent organization have become visible players in Albany, where their reps advocate to boost revenue for company owners — pitching it as a win-win that helps workers too.
The low-wage workers’ union dues also pay for the salaries of union officials, many of whom are members of a single family. Longtime president Steven Elliott Sr. died last year, after collecting $1.4 million in compensation in 2022.
In response to a detailed list of questions from THE CITY, HHWA president Joe Pecora said in a statement that the union “is proud of the work it has done advocating for its members and being the leading voice for increased wages and benefits in Albany. Our advocacy is precisely why we are the fastest growing union in New York State.”
“We will continue to fight for homecare aides, a population of workers who are crucial to our state’s health care infrastructure but are too often overlooked,” he added.
Pecora noted that the union’s recent growth “has largely been driven by member referrals which reflect our ability to meet their needs.”
Supercharged Growth
Home Health Workers of America added more than 3,600 workers in New York City in the 18 months leading up to June 2024, according to an analysis of National Labor Relations Board data by the CUNY School of Labor and Urban Studies — more than double the growth of the next fastest growing union, the United Auto Workers.
Home Healthcare Workers of America’s growth coincided with the astounding expansion of Medicaid-funded care for the elderly and people with disabilities at home in New York, fueled by a state program, known as CDPAP, that pays people to take care of loved ones.
As of last year, New York State had 566,000 home care workers, or one for every 1,000 residents over age 65 — by far the highest rate in the country, as calculated by the Empire Center.
New York’s leading health care union, 1199SEIU, has also made strides organizing home care workers, with 71,000 across the state. (Many of their members are currently guaranteed $19.15 per hour, above the state minimum.)
But the industry is notoriously challenging to unionize. Unlike nurses and EMTs, home care workers are siloed to their patients’ homes and often know very few of their colleagues, making it difficult to organize and address issues collectively, notes Rebecca Givan, a professor of labor and employment relations at Rutgers University.
It’s also an environment that favors the Home Healthcare Workers of America business model. Several experts who spoke with THE CITY described HHWA’s history of not petitioning union elections as a red flag. What’s more, the contract in effect at Five Borough renews automatically — a strategy often used to keep other unions out, they said.
Said Givan, who reviewed the HHWA collective bargaining agreement in effect at Five Borough: “This union shows all the signs of being a fake union. They seem to be making a sweetheart deal with management so that the workers don’t consider unionizing with a real union that will actually represent them and provide them with a strong collective voice.”
Home Healthcare Workers of America operates in close partnership with company management, via a trade group founded by a leading attorney representing management at the law firm Littler Mendelson — a notoriously aggressive law firm best known for representing Amazon and Starbucks in their bids to keep their companies union-free. Public records show Littler Mendelson lawyer Ira Wincott founded the Home Health Care Employers Association in 2016.
Two years after the group’s inception, the employers’ association and HHWA simultaneously signed agreements with the same top lobbying firm to lean on the Cuomo administration and state legislature as Albany readied to expand regulation and oversight of the industry.
Wincott is also a lead attorney in a lawsuit, filed by an industry coalition called Save Our Consumer Directed Home Care Program, that aims to stop Gov. Kathy Hochul from moving $9 billion in Medicaid home care spending from a loosely regulated array of some 700 firms, known as fiscal intermediaries, to a single administrator.
And he represents home care agencies with collective bargaining agreements with HHWA at the National Labor Relations Board, where home care firms and unions have been the subject of complaints alleging that they had together improperly steered workers to sign up.
One of those firms, Preferred Home Care, was one of two that reached a $17 million settlement with federal prosecutors and state Attorney General Letitia James this fall. Law enforcement officials found that Preferred and another company sought and accepted Medicaid payments from the state but did not provide the full worker compensation required, during the decade through April 2022.
Before that, Wincott, Preferred and the company’s unions had fought unfair labor practices cases filed at the National Labor Relations Board, which alleged the company improperly established unions without the workers’ knowledge or consent.
In one such case, the NLRB in 2018 ordered Preferred to dissolve its union, Local 713 of the International Brotherhood of Trade Unions, and ordered that union to reimburse members their dues. That union is not affiliated with HHWA or the IUJAT.
Then Preferred agreed to let Home Healthcare Workers of America represent its workers.
New York’s dominant health care union, 1199SEIU, alleged in twin NLRB complaints in 2019 that the company illegally coerced Preferred employees into signing union authorization cards, including by requesting the applications at mandatory worker trainings, and that HHWA “obtain[ed] unlawful assistance from the employers.”
1199SEIU withdrew both charges the following year, over concern of an unfavorable decision by the then-Trump controlled board.
HHWA still represents Preferred’s employees, a company representative told THE CITY in October.
In 2022, Preferred was acquired by Help at Home, a leading home care organization. In response to questions from THE CITY, company representative Kristen Trenaman said that “under new ownership in 2022, after the period addressed in the agreements,” Preferred and the other company “fully cooperated and took these issues very seriously,” adding that the two “instituted rigorous protocols and processes to ensure human resources and benefit compliance programs meet the highest standards and to ensure employees are paid fairly and equitably.”
“The former operators named in the agreements are no longer employed by or in any way affiliated with the day-to-day operations of Preferred,” said Trenaman.
Calls to Preferred’s former operators were not returned. Wincott did not respond to requests for comment.
Huge Paychecks
Even while its low-wage workers have had to battle in court for compensation owed, the union’s leadership collected large paychecks — none more so than founder Steven Elliott Sr., who died last year after decades building IUJAT and HHWA from the remnants of a dying horseshoers union.
Filings with the IRS and federal Department of Labor show that in 2022, Elliott received “president emeritus benefits” of $418,366 from the United Service Workers Union, another IUJAT affiliate, on top of more than $415,000 for “post retirement obligations” while also serving as president of Home Healthcare Workers of America and several other roles among the IUJAT’s family of unions.
His annual compensation package that year totaled $1.4 million, while his daughter, Lori Ames, received nearly $636,000 as the United Service Workers Union president, HHWA secretary-treasurer and IUJAT executive vice-president. Ames’ husband, Jonathan Scott Ames, received $448,000 in compensation from HHWA and related unions.
The elder Elliott’s combined 2022 compensation dwarfed the $268,587 salary of AFL-CIO president Liz Shuler, the federation of labor unions boasting more than 12 million members, earned that same year.
The Elliott family is well known in the larger labor movement — and not fondly. IUJAT locals are notorious for cutting in on other unions’ organizing drives and signing workers on to management-friendly contracts, and the AFL-CIO ejected the union as a hostile force two decades ago. The Service Employees International Union also ended a brief affiliation with the union now known as USWU around the same time.
“They are the only affiliate we have ever thrown out,” said Andrew Stern, the former international president of SEIU. “They were not doing God’s work.”
In lawsuits, formal complaints to the U.S. labor board, and media reports, workers and union leaders have accused IUJAT and its family of unions, including HHWA, of allegedly busting established unions and erecting sweetheart deals in their place, sometimes without the workers’ knowledge or consent.
Voluntary recognition of their unions by employers has been a key part of Elliott-Ames family’s success. Workers can request recognition of their union after collecting signatures demonstrating support from a majority of the workers.
Nationally, only 8% of successful union drives from 2023 to 2024 were a result of voluntary recognition, bypassing an election. In New York City, that figure is 11%. As in the case of Amazon, Starbucks and other major employers, companies commonly take measures to rebuff union drives and try to persuade workers to vote no.
In contrast, companies that sign on to HHWA treat it as a friendly force. According to a source familiar with its organizing, Home Healthcare Workers of America has gotten management of about three dozen companies to agree to accept the union without forcing an election, and collected signatures signaling support for the union from more than 70% of workers in every single company they have attempted to unionize.
But workers don’t always know when a union gets recognized without a vote. While the National Labor Relations Board releases the results of union elections, voluntary recognition of unions by management can happen without public disclosure.
The NLRB lifted the veil from early 2020 until this September, routinely disclosing each new company that voluntarily recognized a union, including those for Grinnell College dining hall workers, New York City Marriott hotel housekeepers and Politico staff.
Though acknowledging voluntary recognitions a strong tool for workers when used properly – union elections can be costly and time-consuming – greater checks ought to be put in place to ensure unscrupulous unions don’t establish deals without buy-in from workers, said Dave Kamper, a policy strategist at the Economic Policy Institute.
“It is not good when members do not know they’re in a union. It is not good when members do not know that a contract is being negotiated on their behalf,” said Kamper. “It is not good when members don’t have any say in how that contract is negotiated, and no self-respecting democratic union operates that way.”
Over the years, labor groups have also accused the IUJAT of interfering in their business.
At a Bronx trash hauling depot, management dissolved a Teamsters local and replaced it with an IUJAT local led by former mobsters, and workers saw their strict wage and benefit requirements vanish. A decade ago, a top official at Laborers’ Local 1010 filed a lawsuit in Bronx state court accusing a Local 175 associate of threatening union contractors to hire his own members. That associate, Roland Bedwell, later served a five-year federal sentence for extorting businesses. Federal prosecutors said that Bedwell intimidated businesses by flaunting his ties to organized crime.
And in two separate cases, the U.S. labor board found that two companies improperly busted contract negotiations and organizing drives by other unions in signing deals with an IUJAT local behind closed doors.
Industry Under Fire
Though the union claims it has agreements with nearly three dozen companies, just how many employers have signed up with Home Healthcare Workers of America remains shrouded in secrecy. From January 2020 through September 2024, the National Labor Relations Board reported new voluntary recognitions of unions by employers nationwide. Fifteen HHWA companies appear on the list.
THE CITY contacted 10 of those companies’ presidents to ask why they would have voluntarily invited a union, without requesting an election. None responded.
The Home Health Care Employers Association did not respond to a request for comment.
Many of these companies are among the more than 600 fiscal intermediaries fighting Hochul to retain their role in New York’s rapidly growing Consumer Directed Personal Assistance Program, or CDPAP, in which patients hire a relative or other trusted person to provide their care. The state estimates that more than 280,000 consumers, and even more workers, now participate.
Hochul has remarked that some intermediaries have turned the program into a “racket” in what she called “one of the most abused programs in the history of New York.” Her move to rein in the fiscal intermediaries comes as cases of apparent fraud are coming into public view.
Brooklyn federal prosecutors recently unsealed an indictment against the owners of a Brooklyn fiscal intermediary called Responsible Care, alleging that enrolled Medicaid recipients there did not in fact receive the services billed for — including some who were outside the country at the time. In exchange for signing up, the patients were promised kickbacks amounting to half of the payments, prosecutors allege. (The defendants have pleaded not guilty, and the company does not appear to be an HHWA shop.)
Even the normal course of business is raising alarms: a November audit by Comptroller Thomas DiNapoli found that New York State paid $14.5 billion for home care services that did not have electronic records backing up the bills, affecting 44% of billings.
Responding to Wincott’s pending lawsuit, the official at the state Department of Health in charge of the program affirmed in an October sworn court filing that the change to a single administrator will save the state hundreds of millions of dollars annually and give the state power to head off bad actors in the industry.
“A substantial portion of CDPAP funding is going to pay the excessive administrative fees of an antiquated, inefficient, and bloated FI system,” stated Deputy Commissioner Amir Bassiri.
Growing Political Influence
The rapid growth of the home care business and its member rolls has spurred a windfall for the Home Healthcare Workers and its parent union IUJAT — and increasing political influence.
They have begun making political endorsements — allowing elected officials to claim union support while supporting business-friendly policies. In 2021, mayoral candidate Eric Adams, aspiring City Council Speaker Adrienne Adams and Queens Borough President candidate Donovan Richards jointly accepted the Home Healthcare Workers of America’s endorsement.
“This is such a significant endorsement,” beamed the mayor-to-be. “We are talking about, how do we finally end the inequalities that really holds back everyday workers.”
Meanwhile, its Albany lobbying for another union affiliate scored a lucrative win for auto dealers last year, dressing up the owners’ demands to obtain more money from vehicle manufacturers to pay for warranty work as a worker-driven campaign. “Where we see our issues aligned, it helps open more doors when you can promote a unified front between labor and management,” IUJAT political director Connor Shaw told New York Focus.
Shaw is now following a similar playbook to win support in Albany to get more money to pay home care employers who have been excluded from an enhanced compensation scheme designed for firms that provide enhanced wages and benefits — that is, firms that have longstanding contracts with the dominant traditional health care union in New York, 1199SEIU.
“I am calling on New York’s elected officials to prevent the collapse of a critical industry that serves New York’s most vulnerable,” Shaw testified at a Senate budget hearing last year, asking for a pay boost for all.
And to be sure, Shaw and HHWA are part of the fight against Hochul’s attempt to wrest control of home care financial management, writing a letter to Hochul in April calling for a halt to the switch.
HHWA and its management partners are taking on 1199SEIU in a battle for industry domination. Hochul has announced that the firm Public Partnerships LLC will become the single fiscal intermediary for CDPAP statewide starting in April. That company has struck an agreement with 1199SEIU that will let that union organize workers, with the aim of getting union recognition for potentially hundreds of thousands in one fell swoop.
In February, Shaw complained to the New York Post that its competitor’s members unfairly benefitted from a provision in the state budget that supplemented the wages of home health care workers — and sided with the bosses in pleading Gov. Hochul’s administration to undo it.
Meanwhile, workers responsible for feeding, bathing, cleaning after and administering medicine for some of New York’s most vulnerable — often working overnight shifts — are caught in the middle.
The Five Borough worker has been out of a job at that agency since the fall, after she quit on an aggressive patient who hurled a bottle of prescription pills at her. After she went to her supervisor to inform them she would not return to that patient, they paid her for the hours worked that week. But in the more than two months since she walked away from her former patient, the agency hasn’t returned her calls for more work.
It’s exactly the kind of situation where she wishes she’d had an advocate in her corner. Five Borough, “paid me for the hours that I worked,” she said.
“I don’t know what the union could have done for me. Would I have liked to know they were there? Of course,” she said. “They’re there, but I don’t know what for.”
