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Private Duty Today
Welcome to Private Duty Today,
the bi-weekly electronic newsletter for Private Duty Home Care Leaders
from Leading Home Care ...a Tweed Jeffries company. In this issue, we
bring you ideas, information, and insights to help you grow your Private
Duty Home Care business.
Private Duty Today is a permission-based
newsletter. It is only sent to our recent customers and those individuals
who have requested it, or who have given permission for their address to
be included on our list of subscribers.
I'm Jason Tweed, Director of Business Development for
Leading Home Care, and Editor of Private
Duty Today.
Private Duty Today is published every
other Wednesday, and currently goes to over 6000 subscribers.
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I spent the whole week so far talking with frustrated
people in Illinois and Georgia, among other states. These states have
recently created their regulations for home care licensing and both are
extensive. Furthermore, state regulators are, generally speaking,
overworked and not very helpful.
In Illinois the new licensing takes effect in slightly over a
month. Many organizations who've been in business for years, even
decades, are struggling to get their licenses at the last minute.
Leading Home Care is trying to help by offering products such as our Policies and Procedures Manual,
but besides words of encouragement, there is little we can do to speed
up the process.
Here are the
frustrations I'm hearing:
- State
regulators tell us our policies are too vague.
- Home
health providers are encouraging the state to eliminate private
duty.
- Home
care agencies are trying to eliminate registries.
- State
agencies aren't very helpful.
- Nobody
asked us for guidance when creating the regulations.
- The
regulations are too detailed.
The list goes on.
Unfortunately, we as an industry are partially to blame. We
estimate that there are in excess of 15,000 home care agencies
providing private duty home care nationwide. Unfortunately, only
a few hundred of them are members of the national associations
representing private duty home care. Even fewer companies attend
one or more conferences and meetings. Of those who attend these
conferences, most of you are there to get marketing tips and recruiting
advice, not to influence the direction of your industry.
It's time to start thinking BIG PICTURE. As owners, executives,
and administrators part of your job is to think outside your own
company and your own community.
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State Regulation: The
Good, the Bad and the Ugly
Personally, I'm in
favor of a certain amount of state regulation and licensing. The
fact is that there are companies in our industry who don't treat
seniors and people with disabilities with respect, and have been known
to take advantage of us and put us at risk. One of the jobs of
government is to protect those who can't protect themselves.
The Good:
Requiring agencies to be licensed eliminates the people pretending to
run a home care agency.
There are some people who, frustrated with their job, decide it's a
good idea to take care of older people and get paid. They post
flyers in the supermarket and classifieds in the Pennysaver, and
actually get one or two clients. These individuals, while some of
them well-meaning, often make mistakes that lead to problems with
families and clients. Take a quick poll of your client base, and
you'll find that a huge number of them had this type of first
experience with home care.
Licensing establishes the minimum criteria to operate a home care
company within a state. By raising the bar slightly we improve
the perception of our industry. This is beneficial to good
quality companies interested in providing good service.
Another benefit is that licensing is the most basic level of
organization of an industry. As an industry, we could use this
organization. If home care associations had a list of licensed
agencies, it would be easier for them to reach out. Companies
like my own would also be able to improve their marketing. While
this may seem selfish of us, the reality is that running a business in
a vacuum is also dangerous. Home care owners need to be able to
connect with other owners, and firms like ours need to be able to teach
best practices to more companies.
The Bad:
In 1992 soon-to-be President Clinton and future Senator Clinton were
campaigning together. One of their principal campaign messages
was the reformation of healthcare in America. We had a broken
healthcare system that was overpriced, over profitable, under regulated
and less than scrupulous. Medicare fraud was rampant, including
the home healthcare industry.
While massive and sweeping regulation never actually occurred under the
Clinton administration, healthcare was reformed. You see, by the
time that President and Mrs. Clinton were in office and the ball could
get rolling in the House and Senate, the healthcare industry recognized
impending doom and began to self regulate. They started listening
to their consumers more. While some would argue that this
reformation needs to happen again today, the reality is that this was a
great example of self-determination of an industry.
We don't have self-determination in private duty home care. While
some organizations have created voice, by and large, they don't
represent the industry in sheer numbers.
I'm proud of the fact that over 8000 people have chosen to receive our
free newsletter, but I'm saddened to think that Private Duty Today is
probably the most unifying presence in this industry. Heck, some
of you even delete me once in awhile.
I hear that you want more influence in state and national regulation,
but what are we doing about it? Of the 8000 people who subscribe
90% of you don't belong to your state home care association, and 95% of
you probably haven't attended a national industry conference in the
past year. Finally, nearly 100% of you have never voiced your
opinions directly to state or national elected officials.
If we aren't organized we can't self regulate. If we are unable
to self regulate, the states will do it for us.
The Ugly:
Lobbying, outside influences, excessive regulation... and it's going to
get worse.
When I started this newsletter five years ago a handful of states
required licensing of non-medical home care. Most of them simply
required it as a way of managing Medicaid dollars.
Today licensing is required in over 60% of the states, and at the rate
things are going there will be licensing in every state within the next
five years.
Licensing and regulation is the ugly side, and we've seen many
instances of it lately. Here are a few bullet points to emphasize
the ugliness.
- This is EASY
legislation to pass. State Representatives are happy to pass a
bill that protects our seniors. Loving senior citizens is
definitely a bipartisan effort!
- Because it's
easy, the legislation doesn't always have clear direction.
Generally it says "license home care" then they assign
$2 million to rent a small office and hire a director and a couple
of assistants.
- This new
director creates a series of regulations and requirements for
licensing. These new policies are often excessive. The state isn't
interested in making it easier to run your business, and they are
looking for maximum protection for their dollar.
- During the
creation of these policies the director and his/her staff
frequently look for advice. They call other states to find out
about their regulations. They hold small public meetings. And
finally, they reach out to the industry organizing bodies.
In
some states we've seen regulation for the sake of regulation. In other
states we have seen influence of lobbyists with vested interest in
preventing new businesses from getting started.
We haven't seen recognition by states that non-medical home care is
something different then home health care. By and large the regulations
tend to follow a medical model rather than an ADL model. This is sad
because it doesn't hold the best interest of good private duty
companies, nor their clientele.
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Time to
Think -- and Act -- Big Picture
Self-determination and self-regulation both begin with
SELF.
It's actually a relatively simple process. First, join one or
more of the excellent national associations that represent private duty
home care. If your company is a home health care agency that also
offers private duty, make sure to join the private duty specific
associations as well.
Join your state home care association.
There is a catch 22 with state home care associations. Private
duty company owners tell me that they joined, but eventually left
because there wasn't enough programming that was private duty specific.
State home health associations tell me that the reason they don't offer
more programming and education for private duty is that the owners
don't join, and if they do, they quit.
Company Owners: Join today and stick with it. Become an
active participant. Industry associations in any industry are a
reflection of the participation of their members. If you clearly
demonstrate that you want different programming, your association will
change.
Association Directors: It's time to dedicate more resources to
private duty. Many of you have done an excellent job representing
the home health care industry. The non-medical home care industry
needs you now. Step up to the plate and invest the resources, the
membership will come to you.
Special message for certified home health care agencies: This is
a dangerous message for me personally to send, but I'm going to risk
it. We provide many services through our parent company, Leading
Home Care, to certified agencies, and the largest portion of our
revenue (and my personal salary) depends on you. But here goes...
I want certified home health care companies to be more open to
"competitors" in the private duty sector. Some of the
regulation that's occurring is being influenced by you, and the
organizations that represent you. It's leading to excessive
regulation that benefits certified agencies.
Non-medical home care is just that. This morning I got out of
bed, dressed and showered, ate breakfast, and came into the
office. I did all of that without the help of a medical
professional, although I had a well-trained and dedicated caregiver to
assist me.
Companies that provide a non-medical model of home care are incredibly
valuable to their clientele. Frequently we're asked to advise home
health agencies how to improve their private duty program and
inevitably we find the companies who are struggling are focused too
much on the medical model. This model doesn't work in private
duty because it isn't efficient, and furthermore your customers don't
like it.
Private duty companies, home health agencies, and state and national
associations need to work together to promote the big picture in home
care. Creating a strong industry with clear direction and a
self-determined code of ethics will encourage state governments to
provide support rather than regulation.
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Two
Conferences for Private Duty Owners this Fall
2008 Home Care Sales Professional
Sept. 17-19 -- The Westin Riverwalk, San Antonio, Texas
Don't miss this exciting opportunity to participate in one-on-one
coaching to hone your selling skills.
The
National Private Duty Insider Business Builders Conference & Expo
Nov. 17-19 -- Omni
Resort Orlando at ChampionsGate, Orlando, Florida
Discover how to
grow referral sources and tap into the resources you need to ride the
explosive growth of the private duty sector to success.
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