New Social New Social Co-ops & Co-ops &

Community Community Based CareBased Care

Social Co-ops & Social CareSocial Co-ops & Social Care

What is social care?What is social care? From a social & economics perspective, social From a social & economics perspective, social

care revolves around the notion of care revolves around the notion of ““relational relational goodsgoods”” and the types of organizations that are and the types of organizations that are best suited to provide such goods.best suited to provide such goods.

Relational goodsRelational goods

Relational goods are are those goods such as care Relational goods are are those goods such as care giving, which are services to giving, which are services to personspersons and which are and which are characterized by the exchange of characterized by the exchange of human relationshuman relations..

In relational goods the quality of the personal In relational goods the quality of the personal relationship is at the core of what is exchanged relationship is at the core of what is exchanged between the provider and the recipient and can be between the provider and the recipient and can be optimally produced only by the provider and the optimally produced only by the provider and the recipient recipient togethertogether..

The principle of citizen-directed care demands an The principle of citizen-directed care demands an organizational form that embodies the principle in organizational form that embodies the principle in governance and control rights. governance and control rights.

Social co-ops are uniquely suited to the provision Social co-ops are uniquely suited to the provision of social care because they can transform people of social care because they can transform people from being merely the passive from being merely the passive recipientsrecipients of care, of care, to being to being protagonistsprotagonists in the design and delivery in the design and delivery of their care.of their care.

Reciprocity is the basis of the model.Reciprocity is the basis of the model. Democratic control is how itDemocratic control is how it’’s implemented.s implemented. Social co-ops are social enterprises with a Social co-ops are social enterprises with a

democratic structure.democratic structure.

HistoryHistory

Social co-ops were a response to the demand for Social co-ops were a response to the demand for new, and better, social servicesnew, and better, social services

Grew against a backdrop of an authoritarian, Grew against a backdrop of an authoritarian, bureaucratic and inefficient state, and a freeze on bureaucratic and inefficient state, and a freeze on public sector hiring.public sector hiring.

Everywhere, changes in the role of government vis a Everywhere, changes in the role of government vis a vis public services, citizen dissatisfaction in quality of vis public services, citizen dissatisfaction in quality of care & cutbacks in funding have led to a rising care & cutbacks in funding have led to a rising interest in co-op models of service delivery.interest in co-op models of service delivery.

Size of social co-op sectorSize of social co-op sector

24,000 social co-ops in Italy employ 280,000 24,000 social co-ops in Italy employ 280,000 employees of which 30,000 are disadvantaged employees of which 30,000 are disadvantaged workers.workers.

23% of paid labour in non-profits; 2% of non-profits23% of paid labour in non-profits; 2% of non-profits In Bologna, 87% of social services provided by In Bologna, 87% of social services provided by

social co-ops.social co-ops. Quebec: 6,000 jobs, 81,000 members, 6 million Quebec: 6,000 jobs, 81,000 members, 6 million

hours of homecare by 101 social enterprises, 47 hours of homecare by 101 social enterprises, 47 are social co-ops.are social co-ops.

LegislationLegislation

The purpose of a social co-operative is to The purpose of a social co-operative is to ““pursue the pursue the general interest of the community in the human general interest of the community in the human promotion and social integration of citizenspromotion and social integration of citizens””..

Legislation stipulates that social co-ops have a Legislation stipulates that social co-ops have a special mandate to provide for the integration of special mandate to provide for the integration of disadvantaged persons into society.disadvantaged persons into society.

Local authorities have a common interest with social Local authorities have a common interest with social co-ops in serving the community.co-ops in serving the community.

Social care services provided by social co-ops Social care services provided by social co-ops are not seen as a are not seen as a replacementreplacement of public services; of public services; they are seen as a they are seen as a complementcomplement to public to public services.services.

Social co-ops receive public funding & employer Social co-ops receive public funding & employer benefits for the services they provide.benefits for the services they provide.

Multi-stakeholder Co-opsMulti-stakeholder Co-ops Makes possible the collaboration of different stakeholder Makes possible the collaboration of different stakeholder

groups to co-produce the service provided.groups to co-produce the service provided. Typically include: users, workers/carers, community Typically include: users, workers/carers, community

stakeholdersstakeholders Benefits:Benefits:

– Commitment to user/membersCommitment to user/members

– Eliminate information inequalitiesEliminate information inequalities

– Allow for blended fundingAllow for blended funding

– Give all key stakeholders control rightsGive all key stakeholders control rights

– Promote innovation & problem solvingPromote innovation & problem solving

– Allow for volunteer contributionAllow for volunteer contribution

Role of Local AuthoritiesRole of Local Authorities

Identifying local needsIdentifying local needs Commissioning services, based on detailed localized Commissioning services, based on detailed localized

plansplans Negotiating service rates, quality controlsNegotiating service rates, quality controls Managing & monitoring service contracts (multi-year; Managing & monitoring service contracts (multi-year;

competitive bidding; competitive bidding; Participating/partnering in co-ordinating bodiesParticipating/partnering in co-ordinating bodies Investing in joint projectsInvesting in joint projects

Co-op Elder Care in Canada

A Call to Action

National Task Force on Co-op Elder Care

 Written by John Restakis

June 2008

National Task ForceNational Task Force

Key Findings:Key Findings:– Higher levels of user satisfaction – linked to Higher levels of user satisfaction – linked to

control righstcontrol righst– Lower costsLower costs– Higher quality & responsiveness of careHigher quality & responsiveness of care– Stronger sense of communityStronger sense of community– Ability to remain in communityAbility to remain in community

Four key models: life leases; equity co-ops; home Four key models: life leases; equity co-ops; home care; foster carecare; foster care

Social Franchise ModelSocial Franchise Model

Key elements:Key elements:– ReplicabilityReplicability– Lowering of costs; higher efficienciesLowering of costs; higher efficiencies– System support for local projectsSystem support for local projects– Quality assurance & monitoringQuality assurance & monitoring– Local controlLocal control– Multi-stakeholder structureMulti-stakeholder structure– Flexible financingFlexible financing

Key MessagesKey Messages

Tenders should be used to achieve service quality Tenders should be used to achieve service quality not cost savings.not cost savings.

People in need should be supported to be people in People in need should be supported to be people in control.control.

There should be a shift in the balance of power There should be a shift in the balance of power between service users and service providers.between service users and service providers.

Local authorities should hold genuine conversations Local authorities should hold genuine conversations with their communities. Power sharing is essential.with their communities. Power sharing is essential.

Commissioning strategies should promote and Commissioning strategies should promote and reward reciprocity as an outcome of care.reward reciprocity as an outcome of care.

Welfare State to Welfare Welfare State to Welfare SocietySociety

Co-op models can help address the following Co-op models can help address the following issues:issues:– An alternative to state delivery on the one hand, An alternative to state delivery on the one hand,

and privatization on the otherand privatization on the other– A model for democratizing careA model for democratizing care– A model for supporting people receiving direct A model for supporting people receiving direct

paymentspayments– A model for containing costs while improving the A model for containing costs while improving the

quality and responsiveness of social carequality and responsiveness of social care– A means for building a decent society through A means for building a decent society through

reciprocity reciprocity