Part Of The Family

Anyone who has ever visited with relatives in another part of the country or another part of the world has likely experienced the reassuring effect of being around family and friends in a different and less familiar place.

Before I moved to California, I spent my formative years in the Chicago area. I used to look forward to going back to Chicago to visit friends and family, but as I get older, there are fewer friends and family to visit, and the city feels less and less like my old home town. Most of my recent visits to the town have been for funerals.

So when ComForcare, the national home care company that I belong to, decided to hold this year's annual conference for its franchise owners in Chicago, I wasn't all that excited.

Now, having just returned from the Conference, I have tell you I was very pleasantly surprised --- not so much by the locale and climate, but by the overall experience. This is the fourth ComForcare conference I've been to, and yet again, I was impressed by the great commitment of my fellow ComForcare franchise owners to delivering in-home care services in a manner that ensures clients, family members, and caregivers/employees are treated ethically, with dignity and respect. Though the conference is built around learning about the latest trends in home care management, and sharing tips and techniques that make for high-quality operations, the actual result of having all the owners together is so much more.

On the third night of this year's conference, just after the annual awards banquet, one of the newcomers, a husband of a franchisee, introduced himself and said "wow, what a great family ComForcare is." He was absolutely right.

My office serves the North County area of San Diego, and occasionally my clients move to other areas of the country, either permanently or for seasonal vacations. It truly creates a sense of family to know (as I do) that there are over 80 ComForcare offices around the country (and around the world -- there's new offices in Canada and Great Britain), that I can rely on when making out-of-area referrals. And over the past four years, there have been many times when I've called upon a fellow franchise owner's insight, experience and advice in dealing with problems I've faced -- much as anyone would with a good friend or family member.

An Insurance Agent That Went Above And Beyond

I was really impressed recently when a local insurance agent called me to obtain care for her longtime client. It's been my experience that many agents are not that involved with their clients years after they've sold the policy.

The insurance agent's client was seriously in need of help, and had been paying for a long term care policy for years. For some reason, the client was reluctant to use her long term care benefits. Had the agent not happened to check in on the client, it could have been a grim situation. Instead, we were able to provide care to the client right away, 7 days a week.

Nearly all long term care policies provide not only coverage for assisted living and skilled nursing home services, but also for services provided at home. But no long term care policy is worth anything unless you use it when you need care.

We often assist clients in accessing their long term care benefits and can help with determining coverage, answering questions, and interacting with the insurer.

A Development To Add To My Last Post

Last Friday, August 22nd, I wrote about the VA Aid and Attendance benefit, and mentioned that my uncle had been swindled by a financial advisor who said he would help my uncle apply for the benefit. Yesterday, I learned that the Illinois State's Attorney office will be pursuing my uncle's case and investigating this "financial advisor's" practices. Some oversight after the fact is much better than no oversight at all, but once again, if you're working with a third party organization to help you apply for this benefit, check them out carefully.

Veteran's Home Care and Assisted Living Benefits: Buyer Beware

The Veteran's Administration has a great little pension program known as VA Aid and Attendance that pays for up to $1400 or so in home care or assisted living for veterans of active duty who meet certain qualifications.  I recommend it to many of my clients.  

Problem is that it's quite complicated to pay for this benefit, and approval normally takes months.

That's why hundreds of companies and services have sprung up to help veterans access Aid and Attendance benefits.  And as you might suspect, while many of these firms are doing good work, helping vets to afford vital services, some are more like sharks that smell blood in the water.

One of these sharks found my uncle earlier this year.  My aunt had recently died, and my uncle was living alone in an apartment within an assisted living community in suburban Chicago.  The assisted living's management gave this "financial advisor" complete access to its residents. Within a matter of minutes, he had introduced himself to my uncle, who has slight dementia and was grieving the loss of his wife.   

It didn't take long for him to talk my uncle into signing up, and signing away not only $1500 -- the "advisor's" fee for processing the applications -- but also power of attorney on my uncle's investment accounts.  

Fortunately, my uncle mentioned this transaction to my father, who, after much threatening,  was able to retrieve from the "advisor" my uncle's original discharge papers from military service, as well as the signed power of attorney.  The $1500 is gone.

VA Aid &Attendance can be a valuable source of home care or assisted living funding.  But if you or someone you know is looking at quickly accessing this benefit through an assistance company, make sure you're dealing with a reputable, established organization (ask for references -- both clients and professional references). Many of these companies do require up-front fees ranging from $500 to $1500.  Others require no up-front fee, but charge an ongoing fee for managing the care provided under the benefit.  Or contact a local non-profit VA services organization in your area -- most have representatives who can help you fill out the paperwork if you're able to deal with the 4-6 month waiting period for approval from the Veterans Administration.

Investing In Something I Hope I Never Use

Just recently, my wife and I bought Long Term Care Insurance.  We're in our late '40s, healthy, and far from retirement. So why spend over $2000/year on something that we may not use for years to come, or never?

Quite frankly, working in the home care industry has opened our eyes...we've seen people ranging in age from 46 to 99 years old find themselves in situations that suddenly required around the clock care for anywhere from a few months to the rest of their lives.  According to a recent MetLife survey the cost of this type of care in San Diego County averages about $19 per hour.  That's about $450/day, and over $13,000 per month.  

It was easy for us to see that, if needed, long term care insurance can pay for itself pretty quickly.  And the odds are pretty good that it will be needed.  Plus, the odds increase the older you get.  According to the Health Insurance Association of America, 1 in 5 will need long term care by age 50, 4 in 10 by age 65, and 7 in 10 by age 75. 

These days, I talk about long term care insurance with just about everyone I know and nearly every customer I meet -- and I don't even sell it...I just hate seeing people stuck in difficult situations without options.  For many of us, long term care insurance, if a serious illness or injury occurs, can mean the difference between an extended stay in a nursing home or the option of recovering in our own home.  I'd rather have that choice.

Certification..the Next Best Thing

For a few years now, CAHSAH, the lobbying arm of the home care industry in California, has been working with a State legislator to try to get a law passed requiring home care providers in California to be licensed by the State.

"That's strange," you say..."An industry lobbying group that wants its industry regulated?"

You see, in California, anyone can become an in-home care provider agency. All that's needed is a business license. The result of this non-regulation is that there are well over 200 home care agencies in San Diego County alone. Many of them operate without any liability or workers' compensation insurance, without written customer contracts, and without doing any type of screening or background checks on their caregivers. A large number are just referral agencies that don't really employ their caregivers or pay any payroll taxes -- that often leaves the customer holding the bag.

Since last February, the bill that would have regulated home care agencies in California, AB 853 (Jones) has been placed on inactive status. It seems the main sticking point is the cost entailed in creating and running an oversight agency that would enforce the provisions of the bill.

Late last month, CAHSAH announced the next best thing -- its own certification program for Home Care Aide Organizations. The program requires agencies to present annual proof that they employ their caregivers, that they have adequate amounts of liability and workers' compensation insurance, that they are bonded, do proper criminal background checks, and have both written client agreements and written pricing information.

Yesterday I received notification that our agency has been one of the first designated as a Certified Home Care Aide Organization by CAHSAH. It's not the perfect solution to California's need for regulation of the home care industry, but in my book it's the next best thing.

Professional Referrals Aren't Always So Professional

The message on our urgent line was definitely a cry for help...

It seems that the caller had driven down from Bakersfield to visit her dad, who had been released just the week before from a local skilled nursing and rehabilitation center.   The caller, his daughter, had arranged for 24-hour coverage through an in-home care agency recommended to her by the rehab center.  

She had initially become suspicious when the social worker at the rehab center told her that her dad had to stay an extra week, so that the home care agency could "line up" its caregivers.  Now that he was finally home, she had travelled down from Bakersfield to visit, and was greeted at the door by an unkempt, barefoot caregiver.  The house was an absolute mess, and her mom, who was previously communicative and able to care for herself with a bit of assistance, had gone silent from the shell-shock of the agency's constant caregiver changes.

When she met with the owner of the home care agency (I'll call him Chad) the next day, he still had not presented her with a contract or pricing for his services, but he told her "not to worry."

Upon further discussion with Chad, she discovered that the main reason the rehab center social worker had made the referral to him was the social worker's strong personal friendship with Chad.

Fortunately, I was able to help her quickly extricate the agency and its caregivers, and our team set to work on cleaning up the house immediately.  Within a few days, my new client's parents were comfortable once again in their own home, and she had enough peace of mind to return to her job in Bakersfield.

The vast majority of social service and healthcare professionals do a conscientious job of making referrals to other providers.  They realize a bad referral will reflect badly upon them.  But for some, referrals are more about looking out for their friends.  Moral of the story is that when you get a referral from someone, you still need to do some homework to make sure that recommendation is really a good one.