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Bronx Home Health Care Cooperative Is Fixing the Field One Aide at a Time

By Claire Molloy | June 4, 2017 5:18pm
 The Cooperative Home Care Association aims to reduce turnover by offering workers a seat at the table.
Cooperative Home Care Association Training
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BRONX — Zenobia Hernandez swung the wheelchair in front of her students, demonstrating how to maneuver a patient in it when there is no ramp present.

“The first thing I’m going to do is take the brakes off,” Hernandez said, in Spanish, as she flipped a lever below the wheelchair.

“I pull the chair towards me and place my leg here,” she pushed her right leg next to the base of the chair. “Then I’m going to use my hip to support the weight.”

Eleven women, dressed in scrubs, watched carefully as Hernandez demonstrated proper technique at the Cooperative Home Care Association — which trains them to become home health aides — near Fordham University in The Bronx. The program, which allows students to learning how to help patients out of bed, check blood pressure and look for signs of worsening conditions, is as close to reality as possible, with fake bathrooms in the building, complete with a shower and a tub for training aides how to assist in bathing.

In the next 10 years, home care work is projected to add more jobs than any other occupation in the United States due to the country’s aging population. Job quality is one of the reasons people are not entering the field. Home health aides are paid minimum wage, have inconsistent hours and the work is both physically and emotionally demanding.

But the Cooperative Home Care Associates, which trains 600 people every year, is attempting to change that by offering workers multiple incentives to stay in the industry, from free training to a chance to be a worker-owner in the company.

“Our role is to try and fill the gap,” said Michael Elsas, senior strategist and former president of Cooperative Home Care Association.

The home care gap is what analysts refer to when talking about the changing age demographics in the United States. By 2050 the population of adults over the age of 65 is expected to almost double, according to the U.S. Census Bureau. Meanwhile the female working-age population, those who become home health aides, is expected to stay approximately the same. So despite the projected growth of home care jobs, there will be a smaller pool of people able to fill them.

In creating the cooperative, Elsas wanted to help improve the lives of home care workers. As a worker-owner, home health aides participate in the governance of the company. When the company is profitable the workers share in the profits through a dividend. The cooperative also provides individual and family health coverage, under a union contract, and a 401(k) retirement plan.

“It gives me a voice. If I see something I can call attention to it. I can make decisions,” said Zenobia Hernandez, a worker-owner at the Cooperative Home Care Association.

Hernandez has been working as a home health aide for over 20 years.

“I like serving other people. You can see the happiness in their face and that’s a blessing,” she said.

Worker-owners only get extra money when the company is profitable. Hernandez estimates it amounts to an extra 10 percent of her monthly income.

“It helps me buy extra groceries and take care of rent sometimes,” Hernandez said.

The majority of home health aides in the United States are minority women. Nearly a quarter of them live below the federal poverty line, and over half of the workforce rely on some kind of public assistance. Wages for home health aides have even gone down over the past 10 years, from a national median of $10.21 per hour to $10.11 per hour, according to the Paraprofessional Healthcare Institute.

Issues in income and job quality cause the annual turnover rate for home health aides to be 40-60 percent, according to the Paraprofessional Healthcare Institute.

But under the incentives Cooperative Home Care Association created, their turnover rate dropped to 15-25 percent.

“If you provide a lot of support and worker-ownership, the turnover rate doesn’t have to be 40-60 percent,” Elsas said.

Improvements in income and health coverage are great news for women like Hernandez, who despite the immense difficulties, love their job.

Now Elsas is working on improving the income for home health aides.

“We need to have a living minimum wage,” Elsas said. “As the demand is higher. They need to get paid more.”