Worker-owned home-care cooperatives offer a humane answer to the U.S. caregiving crisis

Clara Calvo, an immigrant who once endured wage theft in a garment factory, now works for the worker-owned Cooperative Home Care Associates in Manhattan, where she earns higher hourly wages and participates in governance. CHCA, founded in 1985 by labor organizers Rick Surpin and Peggy Powell, is the nation’s largest cooperative of its kind, employing 1,600 workers, many of whom are owners. While the direct-care sector is projected to add 860,000 jobs by 2032, turnover rates hover around 75 percent and median earnings stay below $26,000, forcing many workers onto public assistance.

In contrast, employee-owned agencies pay roughly $2 more per hour and see turnover near 38 percent, with clients reporting longer stays and better outcomes. The movement has gained momentum after COVID-19 exposed systemic neglect, leading to new networks, secondary cooperatives like Vivid Life Home Care, and grants such as Next50’s $500,000 award to launch a Colorado co-op. However, low Medicaid rates and the consolidation of for-profit chains pose significant obstacles, prompting calls for federal financing reforms and broader policy support.