Arizona Primary Purpose and Major Goals
A new concept called the Human Service Cooperative (HSC®) is transforming the traditional model for human services by bringing together individuals who use human services. Each member of the cooperative is an owner/director who works alongside other members to collectively direct their service needs. The cooperative works to become incorporated and then applies through the state in which the members live to become a certified human services provider. As certified providers, cooperatives are able to partner with their choices of traditional service providers to best fit the needs of each HSC member. More information is available at http://www.federatedhsc.coop/.
The grant’s primary purpose was to determine the effectiveness of HSC companies in addressing the need for self-determination and empowerment, and for implementing self-directed services for people with physical and developmental disabilities in Arizona. The grant had three major goals: (1) to develop HSC companies within a sustainable infrastructure; (2) to develop a Federated HSC Development and Support Center (Federated HSC) to provide technical assistance to HSC companies in Arizona and other states; and (3) to prepare educational, training, and outreach/marketing materials for developing HSC companies.
The grant was awarded to the Arizona Department of Economic Security, Division of Developmental Disabilities. The Division contracted with Bohling Inc. (an organization that promotes participant-driven services) to implement several grant activities, including developing the Federated HSC and assisting member owners of HSCs in implementing business and program operations and establishing provider relationships.
Role of Key Partners -
The University of Colorado Health Sciences Center provided research expertise to the Federated HSC to develop training materials, and also evaluated grant activities.
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ResCare—a human services company supporting people with developmental and other disabilities, youth with special needs, adults experiencing barriers to employment, and older people in their homes—provided paid and in-kind technical assistance to the HSC companies in a wide range of areas (e.g., payroll, staff training and supervision, licensing and certification requirements, and other management activities).
Major Accomplishments and Outcomes -
A contractor helped self-advocates and family members to form three HSC companies. All are currently operating and financially solvent.
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The grant contractor assisted self-advocates and family members from two Arizona-based HSC companies in forming the Federated HSC, owned collectively by the HSC membership. The purpose of the Federated HSC is to provide HSC companies with technical assistance in cooperative governance and business operations, such as information on fundraising, group purchasing agreements, recruiting, screening, and training procedures; and how to run a board, conduct meetings, and obtain insurance.
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The Federated HSC, with assistance from a contractor, developed a national purchasing program to provide best-price purchasing agreements with retailers such as Office Max, US Bank, and Medline to HSC company members and affiliates. The Federated HSC also created a resource library of business start-up tools and training for HSC companies.
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The membership from two HSC companies in the State established the HSC Educational Foundation—a 501(c)(3) nonprofit that uses tax-deductible donations to provide funding for the Federated HSC, and to enhance educational and outreach efforts and assist individual HSC companies.
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The Federated HSC has expanded beyond Arizona and has contracted with consumer-related organizations in Michigan, California, Tennessee, and Illinois to provide technical assistance to develop HSC companies in their communities.
Enduring Systems Change -
HSC companies increased the use of participant-directed supports and improved the quality of services through service user ownership and input into service provision. They also increased the availability of services by using flexible approaches to find and share workers, in addition to using standard advertising methods. For example, the use of affordable Internet communications has facilitated the development of “grapevine systems” whereby members can contact one another and coordinate scheduling and staff sharing to ensure coverage.
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The establishment of the three HSC companies and the Federated HSC promoted community integration of people with disabilities by enabling them to employ their own personal care attendants from the community and to purchase adaptive equipment and supplies needed for their care from local businesses.
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Business start-up tools developed through the grant can be used in other states to develop HSC companies.
Key Challenges -
Because of the “newness” of the HSC concept, it was difficult to attract start-up capital from private investors, grants, and the community at large through fundraising. Consequently, service users and contractors developed community partnerships with other traditional providers, such as management companies, and worked out creative financing packages with local banks and lenders to facilitate acquisition of capital funds. They also have begun to develop alternative revenue streams such as loans and charitable contributions through the new HSC Educational Foundation.
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Community businesses and professional organizations were unfamiliar with HSC companies, which made it difficult to establish business partnerships to arrange for group discounts for adaptive equipment, supplies, and other products. The HSC companies and the Federated HSC educated these businesses and organizations about the HSC concept through ongoing communication and participation in local advocacy groups, professional associations, and individual member contacts and outreach.
Continuing Challenges
Current HSC companies are gradually establishing a strong financial base. However, they must continue to educate new members in the cooperative governance process. The Federated HSC continues to struggle with inadequate resources to provide ongoing technical support to existing and newly forming cooperatives. They have limited human capital and have difficulty raising funds to pay expenses, including premiums for business liability insurance.
Lessons Learned and Recommendations -
Many individuals with disabilities and their families have extensive knowledge and experience, and in the cooperative governance system they are able to establish policy and guidelines to ensure that their needs are met and that funds are allocated to do so. The companies report that their administrative expenses are lower than those of traditional agencies and that direct support workers often receive higher payment through HSC companies, and provide better services when working directly for service users than for an agency.
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As interest in HSC companies grows, they must have strong technical business support and educational opportunities for their newly forming boards. Training for new members regarding management of state-funded services, the cooperative governance process, and their responsibilities as members is essential.
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It would be beneficial for significant new initiatives, especially those supporting participant and family self-direction, to be funded for more than 3 years. Three years is sufficient to get started, but organizations as complex as an HSC company based on cooperative governance require more time to establish a firm foundation.
Key Products
Outreach Materials
The Federated HSC created information packets about the HSC mission, vision, business design, and contact information to help members to develop HSC membership, recruit staff, and establish business partnerships.
Educational Materials
HSC members and contractor staff developed a training manual to meet the needs of HSC Boards of Directors, provider staff, and state government staff on how to, respectively, run, serve, and work with HSC companies. Also, HSC members, self-advocates, families, and professionals developed a coordinated training curriculum on how to develop and establish HSC companies.
Technical Materials
HSC members and contractors developed business start-up tools and a set of templates for policy and procedures that can be used by individuals who are developing an HSC company.
Reports
The University of Colorado Health Sciences evaluated HSC activities and developed a report, The Arizona Human Service Cooperative: Final Evaluation Report.
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