One of the most impressive worker-owned cooperatives around is Home Care Associates of Philadelphia (HCA), one of the largest and oldest cooperatives in the sector.  HCA was founded in 1993, based on the belief that to provide quality care, home care workers must have quality jobs, training, and support. HCA began through affiliation with the Paraprofessional Healthcare Institute (PHI), a non-profit that advocates for fair wages and benefits for home care workers, and higher standards of care for clients. HCA was modeled after another PHI-affiliate Cooperative Home Care Associates (CHCA) in Bronx, New York, which is now the largest worker cooperative in the country.

Throughout its history HCA has put being a quality employer at the forefront of its business model. Through balancing the costs of providing training with good wages and providing health benefits, HCA has worked tirelessly to be a model for what the home care industry should be like. The co-op enjoys a thriving membership culture and extremely long tenured and committed workforce.  Ninety-five percent of the cooperative’s workers are women, and 96% people of color. All workers at HCA enjoy the opportunity to share ownership of the company with their fellow workers and have a say in its strategic direction and operational policies.

The home care business is a perilous one however, and government reimbursement rates have long lagged the private market and often do not even cover the basic costs of providing care for Medicare and Medicaid-eligible clients. Recent changes to state policy in Pennsylvania have eroded HCA’s market share, and the cooperative was slow to adapt to market changes, resulting in a measurable decline in revenue. Never a business flush with cash, the situation became perilous in the fall of 2023. Co-op leaders put together an ambitious turnaround plan which included new staff members dedicated to growing their share of the higher-paying, private pay market, as well as implementing an immediate increase in base salary for all employees. Unlike most of its competitors, HCA offers healthcare and other benefits to its workers, but base wages have lagged in recent years. Other changes implemented included lowering some base expenses and dedicating more resources toward the recruitment of new caregivers to replace those lost during the pandemic.  FJWO supported this turnaround plan with a $300,000 loan to help the Co-op to jumpstart these necessary changes. Our loan was offered in combination with a dedicated program of technical assistance from our parent nonprofit, the ICA Group, an expert in the homecare industry.

So far, the results have been encouraging. While HCA is not out of danger, they have seen a gain in client hours and are currently meeting their goals for new revenue.  In addition, the co-op was able to achieve a long-term goal, launching their own training institute as an affiliate nonprofit organization. Staff training has always been a real strength at HCA, and now they are able to more readily offer these services to others in the field and be compensated for their expertise.

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