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Nearly 200K NY home care workers to decide whether to unionize with 1199SEIU
By
Caroline Lewis
Published Sep 22, 2026
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By
Caroline Lewis
Published Sep 22, 2026
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Nearly 200,000 home care workers in New York’s Consumer Directed Personal Assistance Program will decide whether to join the healthcare union 1199SEIU after the union on Tuesday said it filed with the National Labor Relations Board to hold a union election.
If successful, it will be the largest unionization of workers through a single election in United States history, according to 1199SEIU. Joshua Freeman, an emeritus professor of labor history at CUNY, said the largest election until now was SEIU’s unionization of 74,000 home care workers in California in 1999.
The CDPAP program allows New Yorkers to get paid by Medicaid to care for sick or disabled people at home — and those they care for are often their own family members. The union said it has so far gotten nearly 70,000 CDPAP workers to sign cards of support, surpassing the required third of workers needed to hold a vote. The union said its goal is to help home care workers fight for better pay as the cost of living goes up.
“These are essential workers doing work families cannot live without, yet they are struggling to put food on their own tables,” Yvonne Armstrong, president of 1199SEIU United Healthcare Workers East, said in a statement ahead of a press briefing Tuesday morning.
PPL, the company that manages the CDPAP program through a contract with the state, said it has signed an agreement with 1199SEIU to remain neutral throughout the unionization effort.
The unionization drive comes at a time when Medicaid is facing massive cuts by the Trump administration, which has also accused the Hochul administration of mismanaging CDPAP in a recent lawsuit.
Supporters of the unionization effort said they hope 1199SEIU can use its influence in Albany to help protect the program for the disabled New Yorkers it serves and maintain its Medicaid funding.
But some CDPAP workers have questioned the union’s motivations.
A survey 1199SEIU conducted of over 31,000 CDPAP workers who signed cards supporting the vote found that nearly two-thirds were just getting by or finding it difficult to get by financially over the past year, the union said.
But CDPAP workers and consumers who spoke to Gothamist expressed mixed opinions about 1199’s organizing effort.
Felix Cepeda, a Harlem resident who cares for his mother through CDPAP, said he was optimistic that 1199SEIU would be able to advocate for workers in Albany, where policy decisions around Medicaid and CDPAP are made. The union already represents some 450,000 healthcare workers, including home health aides who are employed by traditional staffing agencies.
“It’s a government program, so I feel like by ourselves it will be harder to make the program better and keep funding for it,” Cepeda said. “A union can really support that.”
But others were skeptical of 1199SEIU, noting that the union supported the Hochul administration’s selection of a single company, PPL, to take over administration of the home care program, despite the move being unpopular among many CDPAP workers and consumers.
New York previously contracted with hundreds of organizations statewide that acted as intermediaries to track CDPAP workers’ hours issue and paychecks. The state inked a deal with PPL in 2024 to take over administration of the program, with the transition taking place the following year.
According to the Hochul administration, the move has saved taxpayers more than $1 billion so far. But the transition was rocky, with some workers saying they were missing paychecks and having trouble communicating with PPL.
In June, PPL reached a $160 million settlement with CDPAP workers over unpaid wages. That same month, the U.S. Dept. of Justice filed a lawsuit against PPL and state health officials alleging the company was chosen through a “sham” selection process and misrepresented the benefits it would provide to taxpayers — claims the Hochul administration has denied.
CDPAP aide Maggie Ornstein said she doesn’t yet trust 1199SEIU to have the workers’ best interest at heart. “They have been supportive of this PPL takeover without doing anything to help the workers who have really been struggling this past year,” Ornstein said.
Caring Majority, an organization that has been advocating for CDPAP workers and critical of PPL, did not take a stance on the unionization effort, but expressed hope for 1199SEIU to work to improve the CDPAP program.
“We hope that 1199 will fight for the workforce — to ensure workers are paid for every minute they work and to fix PPL’s broken, dysfunctional systems,” Julia Solow, Caring Majority’s organizing director, said in a statement. But she also added that the organization believes the program should be put back in the hands of smaller intermediaries.
Bill Hammond, a healthcare policy expert with the conservative Manhattan Institute, said the consolidation of CDPAP under PPL helped pave the way for 1199’s organizing drive. If it’s successful, he said, the union could help the multi-billion-dollar program grow, potentially making it more expensive for taxpayers.
The union requires a simple majority of the workers who cast votes to be successful.
Tagged
Health and Science
economy
new york state
Caroline Lewis
Caroline Lewis is on the health care beat for WNYC and Gothamist. She has covered COVID, a nurses' strike, the overdose crisis and New York’s marijuana legalization effort, and spent a year investigating patients' medical bills. She always wants to hear about how everyday New Yorkers experience the health system. Got a tip? Email [email protected].
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Gothamist is funded by sponsors and member donations
Gothamist is funded by sponsors and member donations
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