ICA Group’s David Hammer Unpacks Opportunities, Challenges for Home Care Cooperative Sector


While key to keeping seniors and the disabled out of nursing homes and hospitals, home care providers working at traditional agencies are some of the lowest paid and most exploited workers in the U.S., said David Hammer, Executive Director of the ICA Group, an organization that works to curb job loss and create stable communities by developing worker cooperatives.

“On a whole, the home health care industry views caregivers as commodities,” Hammer told attendees of the inaugural Home Care Cooperative Conference, organized by the Cooperative Development Foundation (CDF) and held in Dulles, Virginia last month. It’s not surprising, then, that the industry experiences a more than 60 percent average annual turnover, according to PHI, a national strategy center working to ensure quality home care through quality home care jobs.

During a presentation that spanned both opportunities and challenges facing home care worker cooperatives, Hammer said home care co-ops are poised to upend the industry by optimizing wages, training and career advancement opportunities for worker-owners.

“Co-ops have an obligation to provide the best jobs,” he told attendees. “But if we want to provide the best jobs, we need the best leadership, and the best leadership is paying attention to the data. We need to be smarter than the competition.”

That means spending time studying industry reports. “The [home care] trade associations’ views on workers are deplorable. But they’re also one of the best resources of information for what is happening in the industry,” Hammer said.

According to industry reports, home care is projected to be the biggest occupational growth sector through 2024, as Baby Boomers age and require care. “This is where job growth is happening,” Hammer said. To take advantage of this demographic shift and the dynamic nature of today’s labor market, the home care co-op sector needs to be “big enough to have economies of scale so you have a benefits package and training options that are qualitatively and quantitatively better than the competition,” he added.

Industry reports also indicate that when caregivers are recruited through referrals, their turnover rate drops from 60 to 43 percent. “I’m not saying don’t advertise, but if the only way you’re recruiting caregivers is through advertising and you’re not building your networks through word of mouth and reputation, that’s going to impact your operational capacity,” Hammer said.

Strong health care co-ops must also have a plan to pay competitive wages. Home care trade associations cite caregiver shortages and workers demanding a living wage as the top threats to the industry, Hammer said. “The way they characterize it is a little insulting, but it’s hard to raise wages as a business. It’s even hard for co-ops to raise wages. It’s a legitimate challenge.”

But when wages go up, so do caregiver retention rates. Bronx, NY-based Cooperative Home Care Associates (CHCA), the nation’s largest worker co-op, is a perfect example. Its 2,300 caregivers enjoy competitive wages, regular hours and family health care insurance. Meanwhile, CHCA benefits from just a 15 percent caregiver turnover rate.

But offering a living wage isn’t enough if home care co-ops want to “fundamentally change the health care system,” Hammer said. Going forward, the home care cooperative sector must prioritize growth benchmarks if they really want to “transform” the industry, Hammer said. “What’s our path to $2.6 million in revenue? If you want to be competitive, you need a path to that,” he said.

“So this is really a call to think big,” he added.

Click here to watch Hammer’s full presentation.

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