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This paper chronicles the SEIU's efforts to organize home care workers in California, Oregon, Washington, and New York. Drawing on interviews with union leaders and organizers as well as secondary source data, I compare the political strategies employed and the outcomes achieved in these states. Across the cases, the SEIU changed its organizing strategy to adapt to the unique environmental characteristics of each state. Despite the anti-union animus of federal labor law, the labor movement can still achieve important organizing successes, albeit at great expense in time and resources. Employees of private-sector companies that rely primarily on taxpayer funds may prove to be fertile sources of new union members, and unions with a track record of success in both the public and private sectors may be best positioned to stem the long-term decline in American union density.