Also by Reinvestment Fund
Success Story

Cooperative Home Care Associates


Reinvestment Fund financing is helping Cooperative Home Care Associates with working capital to maintain its operations as it transitions to a new managed long-term care plan.

Cooperative Home Care Associates (CHCA) is an impactful direct healthcare worker-owned cooperative, with over 1,000 worker members and 600 workers trained annually. Together they provide 2.7 million hours/year of home-based care to 1,250 patients who are disabled, elderly or have chronic health conditions; 95% Medicaid-insured.

A certified B-corporation, CHCA is one of the largest worker cooperatives in the United States and serves the Bronx and Manhattan boroughs. Its membership is largely women (98%), immigrants (65%), Black (20%) or Latinx (78%). Together with PHI, a nonprofit CHCA founded in 1992, CHCA maintains an employer-based workforce development program that provides free training for over 600 women annually, who are low-income and unemployed, and serves as a significant driver of employment in the Bronx. About 70% of those trained are employed by CHCA upon successful completion. The remaining 30% are placed at another quality, unionized home care agency.

Data from the Federal Reserve find that Black and Latinx families in the United States have considerably less wealth than White families. Access to well paying jobs and training such as those provided by CHCA are critical opportunities for wealth building for these families.

CHCA’s revenue comes through intermediary health management companies that contract with CHCA and pass through Medicaid funding for client services. In early 2019, CHCA’s largest contractor ceased operations of its health plan. Concerned that would destabilize the home care sector leaving the most vulnerable without services, the NY Department of Health (DOH) stepped in to help craft a solution. It helped negotiate an agreement that moved impacted CHCA clients to another existing and more financially stable managed long-term care plan.

With 750 patients covered by the contract transition, the 30-day delay in revenues threatened CHCA’s ability to meet its $1 million weekly payroll, including taxes and benefits, for its direct care providers. Reinvestment Fund and co-lender, Shared Capital, provided financing to bridge the gap in cashflow as CHCA transitioned to the new contracted Medicaid managed long-term care intermediary. Shared Capital’s loan includes participations from the Cooperative Fund of New England, Local Enterprise Assistance Fund (LEAF) and The Working World.

This financing will also allow bridge CHCA’s pastdue medical insurance premium receivables. DOH coordinated a public-private arrangement to help CHCA and other home-based health providers recoup amounts owed to them over the next three years.