Circle of Life: The Washington Homecare Model

Circle of Life Caregiving Cooperative based in Bellingham, WA and serving Whatcom County came into existence 10 years ago. It was the first care giving co-op in Washington and created what has become the model for home care co-ops in the state.


As the Co-op’s website points out, Circle of Life, like the other home care co-ops in Washington has largely followed a “top-down” model of organizing. Activists in the community pitched the idea and then found willing caregivers to take the plunge. In cases such as Peninsula Homecare, the champions showed up quickly and leapt at the chance–other projects have had a bit tougher climb. In any event, CoL’s model has worked and there are now four caregiving co-ops in the state with a couple more in pre-development  stage.

Once of the features of CoL’s success is the location (and this is true for the other co-ops as well). Bellingham has a strong history cooperation. There are a number of Ag co-ops (seafood production and berries), preschool co-ops, credit unions, and the food co-op is almost 50 years old. The founder of Circle of Life, Jo Ana McNerthney who worked as its administrator, but was not actaully a member, was part of the Hoedad Cooperative.

Circle of Life adopted a private pay model that has also become the Washington model. To access medicaid billing, an agency needs three years of experience. This prevented CoL from starting out with medicaid. By the time that they were eligible, other hurdles popped up such as a desire by the state that they agree to cover a larger area (which would have driven up administrative costs). By then, they were also doing quite well and didn’t really need the state dollars.

It isn’t always easy getting this type of home-care co-op off the ground, especially since Washington has two registries and independent contractors can access medicaid billing through the state. Nevertheless, Circle of Life blazed a trail that others have now followed.

The lessons of CoL, and a successful top-down strategy:

  1. The champion needs strong administration skills and commitment to the co-op model
  2. The community needs a familiarity with co-ops and history of cooperation.
  3. The founding caregivers need the grit to see the project through.
  4. There needs to be significant support from the co-op community (technical assistance providers and financial support).

10 years on, Circle of Life has shown a resiliency and fortitude. The caregivers have created a model followed by other communities in the state in Port Townsend, Olympia, and Port Angeles. Circle of Life created a model that works for its community and many of the communities throughout Washington. Imagination is the only limit to cooperation.


Note: One of Circle of Life’s staff members, Deborah Craig, joined on with NWCDC the same year that I did and leads the Center’s efforts to develop home care co-ops.

About John McNamara

John spent 26 years with Union Cab of Madison Cooperative and currently helps develop co-ops in the Pacific Northwest. He holds a Ph.D. in Business Administration and Masters in Management: Co-operatives and Credit Unions from Saint Mary's University.
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