Improving the Home Health Care Model

Cooperative Home Care Associates Succeeds by Putting Employees First

Cooperative Home Care Associates

New hires at Cooperative Home Care Associates receive four weeks of hands-on training.
Photo by Kevin Chu + Jessica Paul

Cooperative Home Care Associates, a home health care provider in the Bronx, New York City, is the largest worker-owned cooperative in the nation, acclaimed for linking quality care to quality jobs. CHCA employs more than 2,300 staff, most of whom are African-American or Latina women. The company offers twice the amount of training required by law along with good pay, health insurance and regular hours.

The company’s generous policies keep its employee-turnover rate at 62 percent less than the industry average. CHCA’s high employee retention means clients receive more consistent, better care, and a steady workforce and satisfied clients are profitable for the business.

Executive Vice President Adria Powell essentially grew up at CHCA. She started as a summer intern in college and then joined the staff as a coordinator in 1993. She worked her way up to the second-highest position in the company and now oversees administration, clinical services and finance. Powell’s mother was a founding CHCA worker-owner, too. “We invest in our workforce. We absolutely believe that the way to get people to deliver quality care is by delivering quality jobs,” Powell says.

How CHCA Creates a More Inclusive Economy

As the population ages, home health care is one of the nation’s fastest-growing occupations. But with the erratic schedules, few benefits and low pay offered by many companies, direct-care providers have high turnover rates, and patient care suffers as a result.

CHCA improved patient care by creating a company owned by the caregivers. The company trains about 640 inner-city residents every year. New hires receive four weeks of training — twice the federal requirement — and are guaranteed a job when they finish. The co-op’s union contract, with Service Employees International Union Local 1199, provides benefits that include family health coverage, a 401(k) retirement plan and paid time off.

That’s right: Cooperative Home Care Associates’ employees both own the company and belong to a union that negotiates their employment contract.

Establishing the coop-union relationship took time, CEO Michael Elsas says. “For the union, the notion that management may be in alignment with the union is something that’s pretty hard to comprehend, and for the coop, the notion that a union would care as much about their workers as the coop (does) is also hard to comprehend.”

“Coaching, training, better wages and benefits — all of these things are designed to promote what we refer to as a culture of retention,” Elsas says. After three months on the job, each employee may purchase a share of the co-op and become a worker-owner. Many, like Adria Powell, move up the career ladder to become mentors or take on other administrative positions.

Denise Clark came to CHCA after reading a newspaper article about the company. She was hired in 1992 as a home care aide and worked her way up to supervisor. Clark knows firsthand the difficulties care workers face in their patients’ homes. That’s why CHCA sends peer mentors out to help home care workers solve problems, reinforce skills and resolve issues with clients and families. Because the care providers, mentors and managers all have company ownership and firsthand experience with caregiving, “there’s no miscommunication,” Clark says.

This article originally appeared as one of four companies employing the “unemployable” and creating an inclusive economy in the Pathways department of the Summer 2016 issue of B Magazine. Read about the other companies profiled: Cascade Engineering, Jack’s Bar & Grill, and Greyston Bakery.

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