AHS

June 4, 2013; Edmonton Journal

Whether it’s in the U.S. or Canada, we often see little hints of a governmental war against small community-based nonprofits—and in this case, cooperatives—couched in the rhetorical puffery of scale and efficiency. This is a story about a nonprofit home healthcare cooperative in the province of Edmonton, Canada, but nothing in the story suggests that this couldn’t or doesn’t happen in the States, south of the 49th parallel.

More than 15 years ago, disabled people living in a condominium in Edmonton established and ran their own home-case service. Described in the article as a mini-cooperative, Creekside Support Services seemed to operate pretty well. Suddenly, on Friday, the 15 disabled residents in the condominium received a letter that the province would be turning all home healthcare services over to five large providers. Creekside’s role is over, announced Alberta Health after almost no consultation with the residents. As one of the disabled residents put it, “This is basically privatization, and everyone knows what happens then—the quality goes down and the prices go up.”

A year before the letter was sent, the Alberta government told the residents that there might be changes in their contract on the horizon, but, according to the Journal, “The government warned residents then not to speak out or their contract would not be renewed.” One of the residents called the government instruction of a year ago “in effect a gag order.”

A cooperative is more than a mere nonprofit. At Creekside, according to the Journal, “each disabled person pooled the funding that came with their assessed home-care hours. They hired a part-time manager and each did some volunteer hours to make the system work.” One of the founders of Creekside, Larry Pempiet, unpacked the loss of autonomy and self-redirection from the province’s decision. “It was started so we could have some control over the service which is something so important to people’s daily lives,” Pempiet told the press. “It enhanced the independence of people and promoted growth of each individual…[now] they will be directing the care, not us.”

The work of small, nonprofit, often cooperative home healthcare organizations in the U.S.—and we’ll guess in Canada, too—has often been an interesting dual success, providing better wages and job protections than their for-profit competitors and improving the care received by patients in their homes. Is the government’s achievement of simplicity and purported economies of scale through schemes like Alberta’s that much superior to the activity of a small, community-based—and in this case, disabled community-controlled—home healthcare provider like Creekside?—Rick Cohen