co-op.care

The manifesto · April 2026

Of the community.
By the community.
For the community.

A health system run by the people who live in it. Care from neighbors. Membership owned by everyone who contributes. Physician-attested. Built in public on the backs of AI.

Boulder Startup Week · 2026 · May 4
Blaine Warkentine, MD · Josh Emdur, DO

The thesis · five pillars

Behavior is where it starts.
Ownership is what makes it stick.

01

Community ownership

LCA legal form. Patron-member share. One vote. Patronage dividend.

02

New infrastructure

Built around the patient — wallet, vault, ledger, agents. Not retrofitted.

03

AI educates · physicians attest

AI scales the question. A licensed physician signs the answer. Hashcare-receipted.

04

Behavior → ownership compound

Every behavior becomes an attested record. Every record lives in your wallet. Every wallet is a member-share.

05

Scale through reciprocity

Not extraction. The contributors are the owners. Investors structurally cannot buy them out.

The unit economics

The same shift
pays twice.

Patient pays — $19/mo membership, OR contributes 10 hours / year.

↓

A neighbor caregiver shows up. Drives mom to the appointment. Cooks the meal. Sets up the smart speaker.

↓

An attested SDOH observation is captured. Physician-reviewed. Hashcare-signed. ICD-coded.

↓

The payer pays — $5–15 PMPM for the attestation feed, plus risk-adjustment uplift.

↓

The same shift just paid twice. The contributor owns a share of the system that received both checks.

If everyone contributes 10 hours a year

We become the most valuable company in the world —
owned by the people whose lives it runs in.

1,000

members × 10 hrs

Boulder neighborhood pilot. Everyone at this talk fits in this number.

100,000

members × 10 hrs

A US city. A school district at full enrollment. A mid-state Medicare Advantage book.

10,000,000

members × 10 hrs

A major employer's full benefits cohort. A state plan.

1,000,000,000

members × 10 hrs × $25/hr

$250 billion / year of coordinated mutual aid. Owned by the contributors themselves.

Mondragon at 80,000 sustained workers is the largest cooperative ever built. The architecture of the most valuable company that has ever existed.

Boulder · today

15,000 → 30,000

Boulder residents over 65 today. By 2030, thirty thousand.

You are one of them, you love one, or you are about to become one.

What Boulder families pay today

$55

per hour
out-of-pocket

$16

per hour
the caregiver takes home

77%

annual caregiver
turnover, nationwide

PHI National 2024 · home-care industry baseline

Hands up if your family has lived this. · audience prompt

The math doesn't work
for anyone.

Not the family. Not the caregiver. Not the agency.
And not the mother.

Why we exist

So that the person who cares for your mother
earns enough to stay,
is trusted enough to decide,
and owns enough to never sell out.

The reframe

Not an agency.
Not an app.
A care grid.

Infrastructure the way we plug into water, electric, internet. Anyone can plug in. Every neighborhood needs one.

What a "talent" looks like

Ten skill categories. Every neighbor has one.

01

Food

Meals · groceries · Sunday dinner

02

Transport

Rides · errands · appointments

03

Hands-on care

Bathing · dressing · transfers

04

Movement

Walking buddy · PT support

05

Housekeeping

Cleaning · laundry · repairs

06 · teens

Smart home

FaceTime · Nest · tablets

07

Companionship

Sitting · listening · reading

08

Clinical

RN · OT · PT · CNA · MSW

09

Administration

Insurance · bills · scheduling

10

Witness

Directive signings · hard talks

Tap the one you'd offer · vote stays anonymous

Look at this list. Find yours. · reflect 30 seconds

The generational bridge

Smart Home Badge. Boulder teens to Boulder elders.

Fairview. Boulder. Centaurus. Monarch. Thousands of tech-fluent teenagers — and hundreds of elders who need one.

Service hours

Required for college apps, NHS, scholarships.

Care tokens

Transferable to your own grandmother's care — any state.

Cash

Paid gigs at $18/hr. Below clinical rate. Real money.

How people get on the grid

Two entry points. One grid.

01 · Clinical

BCH discharge QR

Every patient leaves Boulder Community Health with a QR code. 60-second intake. Thousands of patients routed into the grid per year. One partnership conversation.

02 · Community

Nextdoor share button

Every Nextdoor thread ending "…can anyone help?" routes into the Exchange. Hyperlocal already. We just give it rails.

Which entry would your family use? Tap to vote

Week 1 of membership

A home assessment. Then the LMNs.

A neighbor — PT, OT, CNA, or RN — walks your home in the first week. Every flagged improvement runs through our LMN flow. Physician-attested. §213(d)-compliant. Pre-tax dollars unlock 22–37% off — depending on your bracket.

Mobility

Stair lift, walk-in shower, grab bars, wheelchair ramp, lever doorknobs, wider doorways

stair lift · $3,500 → $2,400 effective

Fall prevention

Pathway lighting, non-slip flooring, both-side handrails, toilet risers, fall sensors, bed rails

bathroom retrofit · $1,200 → $840

Dementia safety

Stove auto-shutoff, door alarms, locator devices, smart locks, pill dispensers, memory aids

CookStop + locator · $600 → $420

Sensory

Better lighting (cataracts), hearing loops, closed-caption TV, visual smoke alarms, strobe doorbells

lighting overhaul · $2,000 → $1,400

Sleep & respiratory

Adjustable bed, CGM, HEPA air purifier, humidifier, sleep tracker, blackout curtains

adjustable bed · $2,800 → $1,960

Connection tech

Telehealth tablet, easy-button phone, video doorbell, family-call hardware, fall pendant

teen installs all of it · slide 8

The same neighbor who delivers care also assesses the home. The same cooperative coordinates the install. The same membership unlocks the LMN. A typical first-year home retrofit: $8,000–$15,000 spent, $2,400–$4,500 saved pre-tax.

Last Saturday · Boulder, CO

Jess moved her father into the house next door.

He has mild dementia.

They signed his advance directive at the kitchen table.

Josh was on video, from Boulder.

It took 43 minutes.

Then they had pancakes.

Nobody had to call a lawyer at 2 AM. Nobody had to drive to Denver. The caregiver coming on Thursday already works for the cooperative her father now belongs to.

Turn to the person next to you. Tell them about the closest version of this in your family. · small group · 90 sec

Hold one in mind

Where would you plug in?

Six ways neighbors are already showing up. We're not asking you to choose now — just hold one in mind. Q&A in three minutes.

01

Care for someone you loveAging at home instead of a facility

02

Be the caregiver$26/hr W-2 · real equity · patron-member

03

Help an elder with smart-home techBoulder teen → Boulder elder · service hours + tokens + cash

04

Offer one of the ten skillsFood · transport · housekeeping · companionship · more

05

Get a ComfortCard$19/mo · Apple Wallet · same card families and neighbors carry · comfortcard.org

06

Trade 10 hours for free membershipChildcare · errands · a ride · an hour of company · we keep the receipts

07

Bring this to your corner of BoulderRefer a family · intro a hospital · host a kitchen-table conversation

Tap the one that's yours. Anonymous · we'll show the live tally after Q&A. Same card on both sides — same membership, same identity. We can all belong if we have something to offer.

The call

Contribute 10.
Get the future you want.

10 hours of mutual aid a year covers your ComfortCard membership for the year, free. And you own a share of the cooperative — vote, dividend, governance. Not a subscription. Not a club. New infrastructure for the people you love, owned by the people who built it.

co-op.care/contribute  ·  co-op.care/manifesto

Q&A · open mic

Ask anything. Tell us what we got wrong.

BSW is a no-agenda zone. We'd rather argue with you for ten minutes than pitch you for one. Five seeds in case you need one:

What would make you not do this?

What did we miss in the math?

Who's the next family we should call?

Where in Boulder, beyond Walnut Street, should we go next?

What would your version of this look like in your neighborhood?

Tap to flag your question · or just raise your hand

          Or — get one email when Boulder opens enrollment
        

co-op.care · Boulder · find Blaine + Josh at the back after

★

BSW exclusive · in this room only

First 100 in the room get a free year of ComfortCard.

comfortcard.org/bsw →

Your turn

Rate what landed. Drop your own idea.

Twelve slides. Tap thumbs-up on what resonated. Thumbs-down on what didn't. Write us your version of this in one sentence at the bottom — anonymous unless you tell us who you are.

01Build a care grid. Plug in.

0215,000 → 30,000 (Boulder over 65)

03$55 / $16 / 77% — the math today

04The math doesn't work for anyone

05Why we exist (stay · decide · own)

06Not an agency, not an app — a care grid

07Ten skill categories

08Smart Home Badge — teens ↔ elders

09Two entry points · one grid

10Last Saturday in Boulder · Jess + her dad

11Where would you plug in?

12Q&A · open mic

co-op.care · Boulder · ratings stay anonymous · ideas read by Blaine + Josh