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Home Care

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About Home Care

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.

Worker-owned home care cooperatives have unique advantages that position them to win in a low-wage, service-focused industry. At scale, home care cooperatives can have a transformative effect in this difficult industry, improving the quality of jobs in the field, the quality of care delivered, and access to care in low-income communities. Today there is a growing movement of cooperatives to leverage the benefits of worker ownership to stabilize the home care industry. These co-ops have already shown worker retention that surpasses industry averages, a key metric in both quality of care and business sustainability.

ICA focuses on five worker-focused investments to support the recruitment and retention of home care workers:

1. increased wages

2. access to employer-sponsored health insurance

3. quality training

4. peer mentoring

5. opportunities for advancement

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ICA’s Solution

The ICA Group has three goals for transformative impact in the home care industry:

Stabilize and Strengthen

ICA supports the existing and emerging field by prioritizing the financial stability of home care cooperatives, creating purchasing cooperatives to stabilize and improve margins for small businesses, and developing new and innovative training and recruitment systems. This approach will help to attract skilled workers to the field, diversify income streams, and advocate for better philanthropic and government support.


In order to grow the field, new entrants must be supported and have access to necessary tools. This will not only help individual businesses maximize their chance of success, it positions the industry for lasting and significant impact. Group purchasing, growing industry networks, and transitioning conventionally structured home care companies into worker cooperatives are all part of ICA’s solution.


A lack of high-quality jobs is ultimately a political problem, one that requires institutions to push for policy changes that address systemic underinvestment. ICA is committed to improving job quality for all home care workers which includes increasing wages, adding benefits, providing training, creating opportunities for advancement, and building a culture that values and respects home care workers.

Consulting and Technical Assistance

The ICA Group also provides specialized supports to businesses in the home care field, including:

  • Direct technical assistance and business consulting for home care worker cooperatives

  • Development of field-wide resources and convenings

  • Consulting for innovative worker-centered home care business solutions

  • Expertise on long-term care, home care, business and financial analysis, and business development skills

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

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Impact Profile

Cooperative Care provides quality home care in rural Wisconsin

Cooperative Care, a worker-owned home care business in rural Wisconsin, is committed to maintaining a culture of respect and understanding while providing the highest quality of care. ICA has helped the business strengthen their management culture by providing technical assistance, strategic planning, and leadership development.

Providing quality home care in rural areas presents a number of challenges for American businesses operating in the home care field: clients are spread across a large geographic area, retaining skilled staff is difficult but also critical to maintain specialized care, and wages are very low in the sector. For the past four years, the ICA Group has helped Cooperative Care, a worker-owned business in central Wisconsin, achieve success in the home care space. Creating a business culture that values and appreciates workers who provide meaningful care in their communities lies at the core of Cooperative Care’s success. With ICA’s support and guidance, the business operates in six different counties today, serving a diverse array of clients including seniors, people living with disabilities and mental illness, and children with autism. 

The ICA Group began their work with Cooperative Care by providing consulting services including the development of a plan for expansion of the business, technical assistance, and management and board training that supported Cooperative Care’s values. ICA assisted managers with financial and technical analysis, which led worker-owners to make important decisions about hiring practices and plans for the future. 

ICA helped Cooperative Care identify a management structure that supported the business’ commitment to accountability and transparency, and created a plan to improve employee retention. Articulating a plan that put employees at the center of its operations helped worker-owners develop their leadership skills, and encouraged the business to increase its advocacy within the home care sector. Cooperative Care’s management team shared,

“Our new management structure, and our work with the ICA’s technical assistance team, has allowed us to truly educate the board of directors and create much needed transparency. This alone has deepened our Cooperative Culture by better understanding the business model and the subsequent development of our leadership skills. With these new skills, our members have been given the opportunity to attend and speak at two national conferences with a focus on worker cooperatives.” 

As Cooperative Care continues to grow, it continues to face challenges as a rural home care business. This requires regular evaluation of its business model, rigorous analysis of national trends impacting the home care industry, and internal reviews of both management and staffing. The ICA Group will continue to support the business by developing a strategic analysis for growth and facilitating a strategic planning and training retreat. While pay in the home care industry is still far too low and operating a home care business in a rural area continues to be challenging, Cooperative Care serves as a leader in the sector, maintaining a culture where home care professionals have autonomy in their careers and where quality care and performance is rewarded. That focus is what drives the management team forward: “We have focused all our recruitment and retention efforts around the Cooperative Difference. Individual membership is the life blood of our organization!”

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Industry research

ICA conducts market assessments, feasibility studies, and industry research to support local and national growth in the home care industry.

The Cooperative Solution to the Caregiver Crisis: A National Strategy Analysis

Solving the Home Care Crisis: Co-ops poised to impact America’s fastest-growing industry

Moving to an Employee Ownership Model

Additional Resources

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Building the Home Care Field

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 field grow.

Home Care Initiative

Together with the Cooperative Development Foundation and other partners, the ICA Group launched the Homecare Cooperative Initiative. The initiative develops business resources, best practices, and serves as a thought leader in the home care cooperative field.

Local Partners

ICA collaborates with local partners (including the Northwest Cooperative Development Center and the Center for Cooperatives at the University of Wisconsin) to support local home care cooperatives and identify strategies for regional growth.


In 1985, ICA developed the business plan for Cooperative Home Care Associates, the first home care cooperative and the largest worker-owned cooperative in the United States.

Home Care Conference

ICA co-hosts the annual National Homecare Cooperatives Conference with the Cooperative Development Foundation. The conference provides training and resources for homecare worker cooperative members and developers and supports growth in the national field. Learn more about the National Home Care Cooperatives Conference.

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Contact Us


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