New Social Co-ops & Community Based Care

Social Co-ops & Social Care n What is social care? n From a social & economics perspective, social care revolves around the notion of “relational goods” and the types of organizations that are best suited to provide such goods.

Relational goods n Relational goods are are those goods such as care giving, which are services to persons and which are characterized by the exchange of human relations. n In relational goods the quality of the personal relationship is at the core of what is exchanged between the provider and the recipient and can be optimally produced only by the provider and the recipient together.

n The principle of citizen-directed care demands an organizational form that embodies the principle in governance and control rights. n Social co-ops are uniquely suited to the provision of social care because they can transform people from being merely the passive recipients of care, to being protagonists in the design and delivery of their care.

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

History n Social co-ops were a response to the demand for new, and better, social services n Grew against a backdrop of an authoritarian, bureaucratic and inefficient state, and a freeze on public sector hiring. n Everywhere, changes in the role of government vis a vis public services, citizen dissatisfaction in quality of care & cutbacks in funding have led to a rising interest in co-op models of service delivery.

Size of social co-op sector n 24,000 social co-ops in Italy employ 280,000 employees of which 30,000 are disadvantaged workers. n 23% of paid labour in non-profits; 2% of non-profits n In Bologna, 87% of social services provided by social co-ops. n Quebec: 6,000 jobs, 81,000 members, 6 million hours of homecare by 101 social enterprises, 47 are social co-ops.

Legislation n The purpose of a social co-operative is to “pursue the general interest of the community in the human promotion and social integration of citizens”. n Legislation stipulates that social co-ops have a special mandate to provide for the integration of disadvantaged persons into society. n Local authorities have a common interest with social co-ops in serving the community.

n Social care services provided by social co-ops are not seen as a replacement of public services; they are seen as a complement to public services. n Social co-ops receive public funding & employer benefits for the services they provide.

Multi-stakeholder Co-ops n Makes possible the collaboration of different stakeholder groups to co-produce the service provided. n Typically include: users, workers/carers, community stakeholders n Benefits: –Commitment to user/members –Eliminate information inequalities –Allow for blended funding –Give all key stakeholders control rights –Promote innovation & problem solving –Allow for volunteer contribution

Role of Local Authorities n Identifying local needs n Commissioning services, based on detailed localized plans n Negotiating service rates, quality controls n Managing & monitoring service contracts (multi-year; competitive bidding; n Participating/partnering in co-ordinating bodies n Investing 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 Force n Key Findings: –Higher levels of user satisfaction – linked to control righst –Lower costs –Higher quality & responsiveness of care –Stronger sense of community –Ability to remain in community n Four key models: life leases; equity co-ops; home care; foster care

Social Franchise Model n Key elements: –Replicability –Lowering of costs; higher efficiencies –System support for local projects –Quality assurance & monitoring –Local control –Multi-stakeholder structure –Flexible financing

Key Messages n Tenders should be used to achieve service quality not cost savings. n People in need should be supported to be people in control. n There should be a shift in the balance of power between service users and service providers. n Local authorities should hold genuine conversations with their communities. Power sharing is essential. n Commissioning strategies should promote and reward reciprocity as an outcome of care.

Welfare State to Welfare Society n Co-op models can help address the following issues: –An alternative to state delivery on the one hand, and privatization on the other –A model for democratizing care –A model for supporting people receiving direct payments –A model for containing costs while improving the quality and responsiveness of social care –A means for building a decent society through reciprocity