Cooperative Home Care Associates (CHCA) is a worker-owned cooperative and employer-based training program that provides home health aide services in New York City’s South Bronx and Northern Manhattan. The cooperative was launched in 1985 as part of a strategy to improve the low-wage occupation of the home health aide. This case study documents the organization’s evolving approach to operating as part of the home health industry, noting its strategies and accomplishments in the areas of improving the quality of jobs, developing career ladders, influencing industry practice and effecting policy change. Details on the organization’s operations and approach to training are also provided.