Also by Reinvestment Fund
Success Story

Cooperative Home Care Associates


In mid-March, as much of the world began to shelter at home in the face of the pandemic, many people watched news of coronavirus’s impact on New York City with growing worry and disbelief.

So far, more than 200,000 cases of Covid-19 have been documented there. And among the five boroughs, the Bronx has been hit the hardest. While doctors and nurses on the frontlines were responding to coronavirus in hospitals, home health aides from the worker-owned Cooperative Home Care Associates (CHCA) were also rising to the challenge — continuing to venture into people’s homes to provide health care. Based in the Bronx, CHCA provides health care services for people who are elderly, chronically ill, or living with disabilities. Its health aides are predominantly low-income women of color who the agency meets through the free job training it offers to 600 women each year.

The home health aides of CHCA have provided essential care services to Bronx residents since 1985. Reinvestment Fund financing in 2019 had helped CHCA obtain working capital to maintain its operations as it transitioned to a new managed long-term care plan. CHCA has over 1,000 worker members, who together provide 2.7 million hours/year of home-based care to 1,250 patients.

In March 2020, Governor Andrew Cuomo declared homecare workers to be essential personnel — putting an official stamp on the critical role homecare workers were to play in the pandemic as they tried to keep high-risk people healthy and away from congregate settings like hospitals and nursing homes. Their job was to continue to provide quality care to their clients, but the context in which they had to do it had changed dramatically, and CHCA didn’t initially have the infrastructure they needed to keep their aides and their clients safe from coronavirus.

In a typical flu season, CHCA orders 7,000 protective masks over six months. After the onset of coronavirus, CHCA needed 10,000 protective masks every single week. The scale of investment in PPE was unprecedented for the agency. N95 masks had to be ordered for the very first time, and CHCA needed to source them quickly despite limited availability and skyrocketing prices. As state and local governments were focused on getting PPE to hospitals, rather than home health aides, CHCA’s team worked diligently to source PPE from a variety of partners, including the Carolina Textile District co-op and the B-Corps community.

The new PPE came with important new protocols, which meant that CHCA needed to develop a virtual training program for its aides so that they would remain safely social distanced from each other. The job of a home health aide is challenging and isolating in the best of times, and as CHCA’s home aides navigated new stresses and fears due to coronavirus, the agency turned to technology to help aides feel connected and supported while working in isolation.

Managing new supply chains, safety protocols, and ongoing education for aides — all while continuing to provide quality home care to people in need — has required the dedication of the entire CHCA team. The increased cost of operations, combined with reduced revenues from clients who opted out of home care for a variety of reasons, has led to financial concerns in a time when the agency is working harder than ever. A loan deferral from Reinvestment Fund, and the collaboration of values-aligned networks like other worker-owned co-ops and certified b-corps, have been critical in helping CHCA continue to offer quality home care in a way that keeps its health aides and clients safe.

Amidst the daily problem-solving, CHCA President Adria Powell, sees reason for hope: the services of home health aides are finally gaining some hard-earned visibility. More people are beginning to realize the critical role that home care workers play in helping people age in place or live with disabilities within their communities. Ms. Powell is hopeful that this recognition will lead to increased wages and respect for the people who dedicate their lives to the profession of caring for people in their communities.