"Who is running it?" Towards Equitable AI Deployment in Home Care Work

We present a qualitative study that investigates the implications of current and near-future AI deployment for home care workers (HCWs), an overlooked group of frontline healthcare workers. Through interviews with 22 HCWs, care agency staff, and worker advocates, we find that HCWs do not understand how AI works, how their data can be used, or why AI systems might retain their information. HCWs are unaware that AI is already being utilized in their work, primarily via algorithmic shift-matching systems adopted by agencies. Participants detail the risks AI poses in sensitive care settings for HCWs, patients, and agencies, including threats to workers' autonomy and livelihoods, and express concerns that workers will be held accountable for AI mistakes, with the burden of proving AI's decisions incorrect falling on them. Considering these risks, participants advocate for new regulations and democratic governance structures that protect workers and control AI deployment in home care work.