Use Case: CareBnB

Problem:

Healthcare systems beyond capacity

Solution:

Pivot a FBnB approach towards Care
(Mental Health / Social Care initially)

Core Target:

People-Powered Health Outcomes - Distributed Care

Owner/Shaper:

AAE Coop (Spin Out to a SCE/Eurocoop if traction)

Partners:

Fairbnb - Backend

Insight Centre for Data Analytics, National University of Ireland, Galway - Environmental sensors for Covid safety.

Simplest Thing that Works:

This, but for mental health, also a Coop:

Channels:

Diversion from hospital etc

Referral from providers

Self Registration

Explanatory Text

Basically a ‘Guest’ option for diversion or aftercare - because massive bed shortage, also epidemiologically safer than congested hospital settings.

I’d see about three tiers - high, mid, and low threshold, based on clinical acuity. Length of stay also a factor.

Low Tier you could get significant voluntary buy in - short term respite etc.

Think: First Aid but for Mad

High Tier it has to be basically fully professionally staffed, it’s effectively an emergency service, just with the UX-layer of a normal house, and your mileage may vary in the middle.

So kinda Equal Care Coop mashed with Fairbnb, if that scans, then demo in mental health?

Tourism is currently slightly ‘nice to have’, whereas healthcare is in acute crisis, so why not have both :slight_smile:

Given the whole global situation, being able to spin up any capacity would be a win. The phrase ‘bedblocker’ gets thrown around a lot, but the issue is no move-on capacity constipates the care pathway.

There’s also a massive plus to commissioners of public health - such a system can be easily spun down.

Trial on mental health and social care needs of lower acuity, and upskill / capacity build as you go. I mean, what you’d need a hospital to do 20 years ago can fit in a briefcase, so to speak, plus telemedicine for clinical oversight if required.

The real money would be if you could deinstitutionalise chronic, but that needs serious capacity around assisting independent living given the challenges of the care cohort.

But there’s serious funds given the high cost of institutional living versus independent. Good models out there for this kind of work though, if you could Big Boy Pants:

Anyway I’ve got as far as concept, and validating off probable Early Adopters - potential Hosts, Users, and Care Pros - people ‘get it’, they just have procedural or operational questions, so I’m like, great. Hoping to kick off active service design in the New Year with Adopters to work out kinks and scenarios.

A biggy is around GDPR. Also there’s a chunk of legal - we only really have charities here in this area of the economy.

Why mental health initially:

So might be able to get mindshare at concept stage, to drive adoption during active design period.

That and we have a bit of funding til March to come up with ideas for mental health. Pretty easy to think of Builds to address homelessness, addiction, a few other cohorts.

That and I always admired Basaglia?

Governance Model:

FairShares Solidarity, but Co-Founders aren’t Bdfl - Class Remains Open to Co-Founders, Super Hosts get CoFounder.

Consumer Layer - Incoming ‘Guests’
Peer Producer - Train Guests in Peer Support

Then Host/SuperHost/Pro/Community based on regulatory environment and member capacity

Surplus

51% minimum reinvestment in social per EU Social Enterprise definition.

Then some mix between participatory budgeting (Knapsack? Quadratic?) and dividend.

Alternatively, do PB on all the surplus, register it as a Charity within Coop law, but keep MSH governance, and go for high tax efficiency - it’s an option, it’s about grant versus trade minmaxing. My preference is the former model.

Other Shared Value Surfaces:

Things I’d plug on for fun would be the arts stuff - bit of gentle guitar while Guests are around :slight_smile:

If got any further than that, plug into an Open Food Network plus Last Mile delivery.

I’d also love to mash it with https://thehologram.xyz/ because Cassie rocks?

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Hi Thom, I just love this! Looking forward to discussing it more in detail after the holiday.
(And nice to meet you!! :grin:)

Federico

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Great stuff! I’ll keep spieling away on notes towards service design, before a push in January.

Currently an orienting metaphor I’m using for a lot of stuff is:

Liferings, Lifeboats, and Lighthouses

Think: we know the Titanic is going down, work out emergency logistics.

I think about this a lot in ecology and healthcare specifically. I live in a coastal city, so thats probably why it’s my map.

A Lifering is something fairly adhoc that can be scrapped together, cannibalised from existing resources, doesn’t need a lot of specialist expertise - a quick and dirty DIY support system.

A Lifeboat has more structure, capacity for self-direction, resource base.

A Lighthouse is an established ‘institution’ that’s managed to find relatively-stable ground, and can direct Boats or Rings towards greater safety.

So to map that onto CBnB:

Lifering:

Guesthouse has volunteer capacity to manage low-acuity scenarios - a ‘first-aider’ model of community response. Diversion, respite, step-down care.

This is easiest as temporary, short-term accommodation - you could pull a lot of slack capacity from ‘empty-nester’ types - the commitment needs to be low, to pull in weak ties, and keep the bar to entry down.

Lifeboat:

Guesthouse has a higher level of formal training, and specialist skills - whether voluntary, waged, or some blend of the above. This is envisioned as necessarily involving a significant degree of Peer Supports built in.

At this stage there needs to be more of a Coop member relationship, which I don’t view as strictly necessary in LR.

Lighthouse:

At this stage it’s a care facility, it just happens to be distributed rather than centralised, and look like a ‘normal human environment’ - whether the work is closer to emergency service or longterm care.

So, let’s say a couple of Lifeboats were co-located - a ‘Bridge of Boats’ - then you’re probably going Lighthouse :slight_smile:

More Biz Model:

There’s a potentially huge market-space in care-equity swaps - time-rich and equity-poor, meet equity-rich and care-deficient.

Now doesn’t seem a good time to go to hospital or a retirement home if you are in any way infirm.
Similarly, private nursing homes are highly extractive.

And the social sell is easy - transferring equity to caregivers is human-traditional.

Deinstitutionalization is another pretty huge area - highly fundable if you can do ‘community reinsertion’ for cohorts here.

So social care, aged care, mental health, disabilities should check out? Especially if you can grind out some good comparative outcomes metrics.

Full Power

The more audacious goal is going further towards ‘fractal hospitals’ as a community response to C. 19.

Centralization is so last century, and there’s strong arguments for having lower epidemiological ‘Bacon Numbers’ currently.

Hospitals seemed slightly ripe for disruption even before reality started melting - so there isn’t a need to beat them at super-high-end, just in midrange, think Buurtzorg++

This could look to commissioners as pretty tasty - immediate pain point of capacity and backlog, with some icing on the cake of an ‘insurance policy’ strategy for (by now) presumable-and-precedented disease incidence. And that’s just if you did testing/screening.

Covid strategy has been insanely reactive, generals always fighting the last war - I can easily envision much worse pandemics in my sleep, so scalable ‘mesh network’ healthcare capabilites just seems no-brainer…

(I used joke that the right thing to do in stage one of pandemic was a mashup of a rave and a field hospital…might still come to that…)

Relevant timeline stuff:

We have a few opportunities this side to demo projects / concepts in the health field by around March to get more mindshare.

Currently at the ‘get names on a list’ stage before a check for consensus.

I’m fairly impatient though - the risk/reward ratio on going pretty public makes sense to me, I just want to get a bit more shape on it :slight_smile:

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Strategic Rationale:

My personal belief is that cooperativism arises naturally as a defensive formation to extractivist oppression, through history.

However to remain at a defensive formation is a failure mode - what is required is a destination, which requires an offensive strategy - to take ground, especially where the Opposition is weakest.

Care seems the most suitable area to contest - care for each other, care for place, care for the concept of a future.

Your mileage may vary, but those are my Feels.

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Related data point, found in the Wild:

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My hunch is that the destination should suggest a multiplicity of engagements, perhaps even a cluster of destinations.

It is this attraction to multiplicities and plurals that draws me toward ecosystemic approaches to inter-cooperative resource exchange like coopcreds seems to promise.

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