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New York State Offers Useful Lessons on How to Tackle COVID-19

April 15, 2020

COVID-19 has upended our lives in so many ways—from how we work, to how we learn, to how we interact with others. These changes are especially apparent in New York State, which has about 34 percent of U.S. cases (as of this article’s publication).

As PHI’s State Policy Manager and a resident of New York, I’ve been closely following New York’s response to the pandemic. In particular, I have focused on understanding the implications of this crisis on home care workers. These workers are playing a vital role in mitigating the impact of COVID-19 in our communities, but at considerable risk to their own health and financial wellbeing.

To inform the response here and in other states around the country, this article describes what New York has done to manage the COVID-19 crisis—and, as importantly, what still needs to be done.

Designate home care workers as essential workers and ensure their access to PPE

The New York State on PAUSE executive order designates home care workers as “essential workers,” which enables them to continue serving their clients while accessing critical workforce supports, such as free childcare. However, despite providing essential services, home care agencies currently fall below the priority level for receiving PPE. According to a recent survey by the Home Care Association of New York State, 67 percent of the state’s home care and hospice agencies don’t have sufficient PPE, a percentage that is expected to grow. As the next step, New York state and local government leaders must ensure that home care workers are included in PPE calculations and distribution chains.

Ensure home care workers’ access to childcare

With schools closed, many home care workers need childcare in order to continue working. To address this need, the state has required school districts to submit plans for setting up daycare for essential workers. For example, New York City has established Regional Enrichment Centers that home care workers can access. The centers, which are open every weekday from 7:30 am to 6:00 pm, offer remote instruction, three meals per day, art, music, physical education, and more.

Extend paid leave to home care workers

Emergency paid leave is vital for ensuring that home care workers can afford to stay home if they become infected, thus protecting their clients, their families, and themselves. New York has taken the important step of legislating emergency paid leave that covers workers who are not eligible for federal emergency paid leave, including home care workers employed by agencies with more than 500 employees (or fewer than 50, in some cases). Even better, through the newly released budget for fiscal year 2021, the legislature and governor enacted legislation to provide permanent paid sick leave to New York state residents statewide.

Create additional financial protections for low-wage workers

With median annual earnings of just $19,000, New York’s home care workers face dire financial consequences if they lose hours or need to take time off due to COVID-19. To support home care workers and other low-income workers, New York State on PAUSE includes a 90-day moratorium on evictions, and an earlier executive order prevents utilities from being turned off due to non-payment during this emergency. A follow-up response will be needed once these protections are lifted, since workers who already live paycheck-to-paycheck will struggle to pay back three months of rent and utilities even when their incomes are restored.

Take immediate steps to strengthen the workforce pipeline

To quickly shore up the long-term care workforce, the federal government has waived certain entry-level training and certification requirements for nursing assistants in nursing homes, requiring them only to pass a facility-level competency assessment before entering practice. This waiver could provide a particularly valuable employment opportunity to home care workers in New York who have lost work hours during the crisis. However, if New York State implements this waiver, it must also issue parallel guidance to nursing homes about how to thoroughly assess the competency of new workers to ensure they are well-prepared to provide high-quality care.

New York State should also implement a range of workforce development strategies that will ensure enough home care workers (and nursing assistants) in the months ahead. Some possibilities include: launching a home care recruitment campaign that targets newly displaced workers in particular; quickly assessing the feasibility of temporarily providing home care training online (including entry-level and COVID-19 content) and/or conducting competency evaluation virtually; and increasing funding to direct care training providers to enhance their training infrastructure.

Overcoming all these hurdles might seem daunting, but New York has already shown what states can do to move in the right direction. As a long-time policy leader in long-term care and the direct care workforce, New York provides lessons for other states about how best to support home care workers through this pandemic.


Editor’s Note: One less promising development: The New York State budget for fiscal year 2021 includes significant cuts to the state’s Medicaid program, which will hamper direct care workers, home care agencies, nursing homes, hospitals, and other essential pieces of the statewide response to the coronavirus crisis. We’ll continue to monitor this development and advocate for policies that strengthen direct care workers and their clients.

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