The Home-Care Workforce Walks Out as Its Wage Floor Is Cut

About 450 Mass General Brigham home-care clinicians, registered nurses, occupational and physical therapists, speech-language pathologists, and social workers, began a seven-day strike on July 8, according to the Massachusetts Nurses Association. Negotiating their first contract after voting to unionize in June 2024, they joined 4,000 striking Brigham nurses in what the union calls the largest nurse and healthcare-professional strike in state history, picketing at five sites before consolidating at MGB's Somerville headquarters.

The walkout arrived as the federal government moved to lower what home-care labor is guaranteed. A proposed rule would strip Fair Labor Standards Act minimum-wage and overtime protections from more than 3 million home-care workers, reversing the 2013 Obama-era rule that first extended those guarantees to the industry, according to a report on the proposal. The rollback would land on a workforce already marked by high turnover and low pay.

The shortage has run mainly as a supply problem thinned by immigration enforcement, and that thread hardened this week. PolitiFact Florida, examining whether ending Temporary Protected Status for Haitians will cause a caregiving crisis, found experts expect the exodus to hit hardest where the Haitian care workforce is dense. Rep. Mike Lawler noted roughly a third of the 350,000-plus lawful Haitian TPS holders work in healthcare, and Rep. Ayanna Pressley warned seniors will lose their caregivers. Their authorizations expire July 10.

The sector's answer names a pool it never counted. Home care has treated the shortage as if its workers lived outside the homes it serves, McKnight's argues, when the daughters, husbands, and adult sons managing medications, bathing, and appointments are becoming the workforce the industry needs; Lance Slatton makes the parallel case that family caregivers are the hidden healthcare workforce. For the relative already doing the work, the new title arrives without a paycheck.