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Home Care

Driving Industry Change through Employee Ownership

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Home Care Legacy Program for Agency Owners
Learn More

Home Care in the Wake of COVID-19: A Path Forward for Independent Agencies
Read ICA’s statement

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The Cooperative Difference in Home Care

In an industry with a caregiver turnover rate of over 64%, home care cooperatives average a turnover rate of only 30%. Why? Because home care cooperatives are fundamentally structured to value, support and reward caregivers.

As the American population ages, the home care industry faces a difficult task in recruiting and retaining a workforce large enough to support demand. Despite unprecedented job growth, workers are not flocking to the home care field, and for good reason: wages are low, benefits are limited, hours are inconsistent, career ladders are nearly non-existent, and the job is emotionally and physically taxing. With few incentives and little support, few workers look to enter or stay in the field.

As worker-centered businesses, cooperatives prioritize improved working conditions including better training, higher wages, and job supports, resulting in increased worker satisfaction, decreased turn over, and ultimately higher quality, consistent care.

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14 home care cooperatives across 9 states

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2800 caregivers employed by cooperatives

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48% of cooperative caregivers are employee-owners

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“From the beginning, we set out to be a ‘different’ type of home care company. The type of company that valued the home care worker and understood that to deliver quality care we needed to create quality jobs for our workforce. More than 30 years later, our investment in our workforce continues to fuel our field-leading outcomes and has made CHCA the largest worker-owned cooperative in the country.”

– Adria Powell, President Cooperative Home Care Associates

As worker-led businesses, cooperative home care agencies:

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Pay higher than industry standard wages and build caregiver wealth

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Provide advanced training and on the job supports

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Provide leadership and career advancement opportunities

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ICA’s Approach

We have three goals for transformative impact in the home care industry:

Stabilize and Strengthen

Provide business tools and supports to ensure the financial and operational sustainability of new and existing home care cooperatives, and position them for growth.


Grow the sector through expanded industry networks, group purchasing, and by transitioning traditionally structured home care businesses into worker cooperatives.


With scale, home care cooperatives and the organizations and institutions that support them can push for policy change that addresses our nation’s systemic underinvestment in home care.

Contact us to learn more about ICA’s expertise in the home care sector.

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Building the Home Care Cooperative Sector

Together with our partners, ICA strives to support a robust ecosystem of business support, training, and resources. This fertile ground helps existing cooperatives thrive, provides support to new cooperatives in their early developments, and helps the home care cooperative field grow.

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Home Care Initiative

Together with the Cooperative Development Foundation and other key partners engaged in the Homecare Cooperative Initiative—a national consortium of organizations invested in growing the home care cooperative sector—ICA is working to build a robust ecosystem of business support, training, and resources. This fertile ground helps existing cooperatives thrive, provides support to new cooperatives in their early developments, and helps the home care cooperative field grow. Key initiatives include the annual National Home Care Cooperative Conference, the bi-monthly technical assistance and peer exchange call, direct technical assistance to home care cooperatives across the country, and the development of supportive tools and resources. From start-up assistance to thought leadership on sector scale strategy, ICA’s work touches every stage of the home care cooperative life cycle.

Tools & Resources

ICA develops tools and resources to support the financial and operational success of home care cooperatives. Whether you are a new cooperative just getting started, an operational cooperative looking to fine tune your business operations or pursue growth, or a developer supporting home care cooperative development, the ICA Group has a variety of resources to meet your needs. Browse our growing list below.

Go to Ensuring Your Legacy: Exit Planning Guide PDF
Go to What's It Worth? Valuation Guide PDF
Go to 2019 Home Care Cooperative Benchmarking Report PDF
Go to Introduction to Financial Management PDF
Go to Home Care State Reports
Go to resources

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Industry Research & Aligned Consulting

In addition to our direct support of the home care cooperative community, the ICA Group supports local and national growth in the sector through industry research and aligned consulting. Our work is grounded in our deep experience in the worker cooperative field, expertise in business and market analysis, and our knowledge of the home care and long term care industries. Through this work we aim to increase the capacity, knowledge, and effectiveness of our partners and clients as we pursue our shared goal of creating quality jobs for caregivers.

Go to The Cooperative Solution to the Caregiver Crisis PDF
Go to Case Study: Cooperative Care PDF
Go to Revenue Growth and Diversification Guide PDF

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In addition to maximizing profit, many exiting home care business owners want to preserve their legacy and ensure their business continues serving the community long after they sell. Selling to employees can achieve these goals while improving recruitment & retention, increasing staff compensation, and engagement in the business. ICA is a national leader in employee ownership transfers. Contact us to receive a free consultation and explore whether a conversion to employee ownership is right for you and your business.

4 Reasons selling your business to your employees is good for you, your staff, and your community:

1. Home care cooperatives have significantly better recruitment and retention than traditionally owned agencies, with a turnover rate less than half of the industry average

2. Employee ownership rewards employees and strengthens your community.

3. The sale can happen gradually, at a pace that suits your needs.

4. Home care cooperatives are supported by a national network of other cooperatives and supportive institutions.

Contact us to explore whether a transition to worker ownership might be right for you.

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Contact Us


Support our work to advance businesses and institutions that center worker voice, grow worker wealth, and build worker power.

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