Speaker 0 00:00:00 I'm a big proponent of finding an agency, and I'm, I'm gonna, and it's not just because it's what, what I do for a living, but there's actual logistics behind it.
Speaker 2 00:00:13 As our parents grow older, it can be difficult to guide them through their golden years, while still respecting their autonomy and fitting it into our already complex lives. Welcome to the Parent Projects Podcast, where our guests share practical wisdom to tackle the issues that impact adult children of aging parents. I'm Tony Sievers. Thanks for joining us today,
Speaker 3 00:00:38 And welcome to this week's, uh, addition to the Parent Projects podcast. If, uh, managing your family member's home healthcare solution seems insanely complicated for you, maybe you live in one state, they live in another state. The rules seem different, the groups seem different. What pays for what, how it happens, you're just gonna set it all aside because you think you can figure this out and you're gonna build your own system. Buyer beware. Today is a good opportunity to stay tuned and listen to us as we talk with Julio Brianis. And we're gonna, we're gonna talk specifically about this home healthcare, what the solutions are, some of the risks of that idea, maybe some of the bright spots. So stay tuned. The Parent Projects podcast starts right now.
Speaker 3 00:01:21 Hey, everyone. We're joined this week with Julio Brianis, and he's a business consultant. He specializes in the senior care business growth. He's got a concentration in strategic implementation for these businesses that are trying to pull themselves together, really get out of the gun to offer quality healthcare, home healthcare services to families. And that is no small feat. This is a, a really widely, um, broken up. It is, it is segmented, uh, rules are different from one place to the next. It is hard to rope that all together. This is a man, I honestly, Julio, thanks for coming in today. I, I'd say you probably, you can, you're somebody who can corral and hurdle cats, put them all kind of into one place a lot better. You make sense of a very complicated environment, and I appreciate it. Today, you're, we're gonna have you kind of turn that, not just from that expert advice you're giving to the businesses, but today, talk to a little bit about families about after talking with dozens and dozens, if not over, you know, 80 home healthcare organizations, you've been able to start up, how do, how this would look for us if we just got so frustrated at home, we thought we're gonna go it alone, and we're just gonna hire our own independent person to figure this out.
Speaker 3 00:02:31 Thanks for joining us, dude.
Speaker 0 00:02:33 Thank you for having me, Tony. It's really a pleasure to be here. And yeah, that's, that's definitely a, a tough topic. And a lot of families that I've dealt with over the years, you know, they, they really find themselves in that tough spot. Like, what, what do I do? You know, mom needs help. I have to work. You know, I call these agencies, uh, you know, I can't really afford it, so I think I'm just gonna go out and find somebody on my own. And, and people don't realize there's, there's a lot of, lot of dangers involved with that. There's a lot of things that people can, can get themselves into trouble really quickly.
Speaker 3 00:03:09 So you've been doing this, uh, I want to dig right in kind of in, uh, you know, you, you, you and I were about the same age as we get. I think we both started out in the military off of a background from that standpoint, serving our country in that way. And thank you for your service, by the way.
Speaker 0 00:03:24 Thank you. This
Speaker 3 00:03:25 July 4th holiday. Um, you know, but how, talk to us about how you find a passion for this. How is it that you end up pouring your life's work and your time, talents and treasures pointing you into this area of helping, uh, you know, families transition and building a stronger marketplace here?
Speaker 0 00:03:41 Well, so for, for me, my story began back when, you know, when dinosaurs roamed the earth. When I was 15, <laugh>, you know, my, my mother was, uh, was actually working for a home care agency. My, and, uh, she, she was an office manager, operations director eventually. And she was like, look, I, I want you off the street. So she brought me in and she put me into shadow, a recruiter over the summer, and I just started working and understanding what the business was like, understanding caregivers, you know, and I, I loved the business aspect of this, even at that age. You know, fast forward a little bit of time, I go to the army, other events happen in my life, and all of a sudden, you know, my dad gets sick. And here we are. My family is trying to go through exactly what you help people go through, and that's find a solution for an older loved one that's ill, yeah.
Speaker 0 00:04:40 So my dad developed brain tumors that show a lot. Like, um, if, if you're not familiar with what that kind of what it is to deal with somebody with brain cancer, they start to de degenerate and digress. Kind of the same way that somebody with Alzheimer's or with dementia would, they would start to have the cognitive decline, except it happens really quickly. I mean, they're, they're fine. One minute, very literally, over the span of six months, we completely lost him. You know, he, we didn't know who he, he didn't know who we were. He didn't know who he was half the time, you know, he started getting very aggressive and very difficult to manage. So I, I was off doing my own thing, and my father, my mother, and my sister and my brother, they decided to go out and hire an agency. This agency was awful. They, you know, and I, I hate to, I hate to say this, but the facility he was put in and the agency that was hired, they just did such a poor job that I, I believe this to this day, that my father suffered unnecessarily because of the level of care that he got on that he was gonna Yeah,
Speaker 3 00:05:58 I was just gonna say that. I mean, that is, man, that is the, that is a fear that sits with a lot of us Yeah. As we step into this and your mom going into this had worked in this industry. Yeah. Right? Yeah. I mean, even come into, so she was somewhat informed about that. Where did that she's,
Speaker 0 00:06:11 Yeah. Yeah. She was very informed. And it was actually one, one of her friends that owned the agency.
Speaker 3 00:06:20 Okay.
Speaker 0 00:06:21 Had no clue. No clue what they were doing. Yeah. And she just, you know, it, it, it became a mess. Yeah. Right. I, I know, and I'm conscious of the fact that I'm not gonna sit here and say, oh, they killed him. They didn't, he was gonna die regardless. But there is a difference between going in peace and going in such an agitated state that, you know, and to have to die alone. He, he was eventually put on hospice inside a facility. The caregiver abandoned the shift about two hours before he died. So he had to literally die on his own overnight. Hmm. And it, to me, that's something unforgivable. I was very close to him, you know, and it, it hurt me in a serious way to the point where I sold a clothing store that I was running at the time, and I took a $13 an hour job to go work as a home care recruiter.
Speaker 0 00:07:14 And that, that was, that became like something in my head snapped. And that became my mission. I said, I'm gonna go back to what I know. I'm gonna go, because the one way to fix this problem is by preventing any other family from going through this, by understanding the mistakes and that not the caregiver. Cause I don't blame the caregiver. I look at it then and still do today. That poor care starts with management. Yeah. Whoever's running everything. And it works, and it scales down that way. If you understand how the business works, you understand how, how things need to run and to put these safeguards in place, you're going to give the end user that person that desperately needs your help. You're gonna give them a better experience. You know, and, and this doesn't matter whether you're an agency owner or if you're just trying to find that caregiver that's out there working independently. You have to know what to look for. What are the warning signs? What are the red flags? And how do you mitigate this? Yeah.
Speaker 3 00:08:19 Uh, I, I think that's exactly what, uh, I want to dive right back into. We are gonna take our, our first break, um, here, and when, when we come back from that, uh, I, I, I wanna get into talking of just the sheer the numbers of, of problems that we see out there. What's, what's moved everyone to do some action, including yourself. So stay tuned. We'll be right back with, uh, Julio Brianis as we talk about d i y and home healthcare solutions, the dangers. And if it falls, standby.
Speaker 4 00:08:51 Sometimes I'd like to smack old age, right in the kisser.
Speaker 5 00:08:55 Ow I always get the best parking spot. I think she needs a little more help. Monday, what I really need is a boyfriend that can drive at night. I can make a fashion statement out of anything. I will be fabulous. I
Speaker 6 00:09:11 Have a little crush on my pharmacist. With comfort Care at your side, you can live your best life possible. We know families can't be there 24 7, which is why we can help with as much or as little home care as you need from medication reminders and meal prep to everyday chores and errands, so you can live in your own home on your terms.
Speaker 5 00:09:33 I wouldn't let aging stop me from being me.
Speaker 6 00:09:36 Call Comfort for care now and let us create your personalized care plan and find the perfect caregiver match.
Speaker 5 00:09:42 Can you show that number again? She was texting
Speaker 6 00:09:45 Together with Comfort Care, you can both live your best life possible.
Speaker 3 00:09:50 And welcome back. You know, this week we've asked Julio, Brianna to join us. Now Julio works with franchise support and strategic implementation, where inside the industry, he works to help develop methods that make the owners of these home healthcare businesses take stock of what's going on and move their companies forward in a more positive direction. We just got a Julio, you know, we just got a chance to listen to what's pulled you into all of this. You know, you and I were talking ahead of time, the NIH study, the National Institute of Health study that came back here of just the sheer size of, of, of challenges or problems that families tend to have. Um, with, with, with this, it's, uh, 53% of, of, uh, of situations that, or their com was a complaint based of abuse. Why don't, why don't you throw that back down to me, if you would.
Speaker 0 00:10:41 All right. So one of one, you know, getting into this, and, and when you're looking for like a private caregiver, I'm just gonna go ahead and wrap this in there. The number one thing that you're putting yourself at risk for if you're not choosing right, is that there's a huge potential for exploitation or abuse. And that NIH study mentioned it's 53% of people complaint or families complain that there's some instance of abuse. And the worst part is 33% of them, of the victims of abuse are physical. Yeah. There, there's people that they don't have the patience. They get in this because they think it's easy money a lot times, you know, we'll get into all of these other things, they'll, families will pay people in cash, and they just think they can do whatever they want, you know? And the person, unfortunately, who pays for this is, you know, is, is the senior, is the, or our loved one, you know, whether it's an adult with developmental disability, whether or if it's, you know, uh, our parents, our uncles, aunts, whoever. It's Yeah. It's someone we care about that's gonna pay the price for it. Yeah. And, and it's, it's scary.
Speaker 3 00:11:50 So maybe let's, let's break this up. If we could, as we get in with this, with warning flags and then what you're doing when you're going through that, uh, perhaps we could do this in, uh, when we're going to look for an agency, or when we're going to put that solution together, and then separate that from what we see once somebody's in place. Right. And they're coming at us. Right?
Speaker 0 00:12:09 Well, well, the, when you're looking for an agency versus an independent caregiver, there, there's two very different things. And, and this is some of the protections you get. And Yes, I, I know some of your viewers are sitting there and they're going, yeah, but, you know, agencies are so expensive. I, I'm not gonna disagree with that. There are parts, especially if you go on the private pay route today because of labor shortages, the price of private home care has just gone up exponentially between minimum wages and everything else. Yeah. So, but there's an expression that my grandfather used to always say, and my mother repeats it to this day, you know, it's in Spanish, so roughly translated. It's, you know, what is cheap comes out expensive. Okay. So if you're trying to just cut corners and save money. Yeah. There's a few, I'm, I'm gonna go over six major points that you're, you gotta watch out for, number one, that potential for exploitation or for abuse, we already talked about that a little bit.
Speaker 0 00:13:11 That's a huge warning sign when you're talking to an individual, uh, and you're trying to hire privately. That's something you don't know. You're not doing some sort of evaluation on these people. You have nothing to, no background, nothing. You know, um, most of the time, even if the state requires some sort of licensing for those caregivers to work with an agency, they don't require it for you to hire them privately. So there's nothing, no way for you to verify that this is an actual experienced professional caregiver. Okay. Right. So agencies will protect you from that, doing it on your own, going on Craigslist or care.com won't.
Speaker 3 00:13:53 So most often in that we're saying that those protections apply to the businesses that are conducting that business. Right. They're usually what's being regulated. It may differ across these 50 states, but, um, so make sure to, to look in your, within your own state there. But generally that's what it's aimed at. It's not aimed at the individual because it really is an individual licensure. Right. For, for these, for this particular role, it's just across the board on the business, and really only in a few states that actually have licensure requirements for that type of business. Right,
Speaker 0 00:14:24 Right, right. Well, when we're talking about the private pay space, yeah, you're, you're absolutely right. There are some states that regulate Medicaid agencies, but they won't necessarily regulate the private pay agencies. But the private pay agencies are still regulated under a federal umbrella. There are requirements that they have to meet in order to continue to operate. Yeah. Yeah. So, you know, um, paperwork, documentation, you know, some states don't require nurse visits, but there is supervision that's required. There's a lot of things in place, and most of it is aimed to protect the person being cared for from any form of, you know, exploitation, abuse, or other mishap. Right. You know, another thing on this same, same topic, it's actually two and one background checks. They're not, they're not super easy to do on your own. All right? So if, if I'm, you know, if I'm gonna go out and find somebody, take care of my dad, and I'm going down the street to find Maria who I was told, you know, she knows how to take care of people and, um, you know, I wanna hire her at $18 an hour, as opposed to paying 25 to the agency.
Speaker 0 00:15:34 You know, depending on where you are, those numbers greatly vary, but Yeah. Yeah. You know, but, you know, again, we're coming into the issue of are you going to sit there and do a background check? Are you gonna do a thorough and complete background check? If you're not, you're running the risk of, you don't even know if Maria is her real name. Okay. And you don't know if she's coming in there to, to, uh, watch the house, to see, to set that person up for robbery. I, I'm gonna tell you, in my years of doing this, I've seen it happen a number of times. Yeah. I've seen it happen where clients have gone the d i y route and come to agencies I've been working with and say, Hey, listen, you know, uh, we need to see the background check. We need to see all of this stuff to make sure everything's legit because we hired somebody off whatever location, and they ended up setting us up, and the house got robbed, dad got hurt.
Speaker 0 00:16:28 You know, things like that. Yeah. So that's a big risk. And you know, quite frankly, none of these caregivers that you're hiring independently, none of them are bonded. None of them are insured. You know, none of them went through any sort of, uh, process. And, you know, you're not carrying workman's comp. And a big, big misunderstanding here, when people hire independently, they think that, well, you know, you know, Rover Bites the caregiver. My homeowner's insurance is gonna cover it. It's not, they're not, uh, the only time you may be able to get your insurance to cover it is if you have somebody as a domestic servant, and you can get an additional policy to cover them. Right. But, you know, other than that, that's still
Speaker 3 00:17:16 A writer. That's still a writer on your policy that you've gotta set out to do. And you gotta know how to do those things.
Speaker 0 00:17:21 Right. And they don't. And like, here's another thing that a lot of people don't know to do. Most insurances, most, um, I'm sorry. Most businesses, most home care agencies carry something called E P L I, you know, that that's to protect them for when that caregiver decides that she wants to sue. You know, if the caregiver wants to sue you, even though you're, you're a, uh, you're, you're hiring them, you're their employer now, they can come after you for wrongful termination. They can come after you for discrimination. They can come after you for any number of things, and you're not protected. Yeah. You know, and, and the other last big point that I'm gonna talk about with is before we get to the good stuff, you know, of how to fix it, solutions. Cause that's really what matters. You know, it's workman's comp, disability insurance, payroll tax, social security tax.
Speaker 0 00:18:09 These are all things that you are still responsible for. All right? Even if you're just slipping them the money, cash, you have no clue if that caregiver is gonna file tax as self-employed at the end of the year and put you down as their employer. So now you've opened yourself up to not only failing to pay taxes properly for a domestic employee, you're also opening yourself up for tax evasion or, or improper tax filings and huge fines because you don't know that, you know, Maria does her taxes. Right? Know you're just assuming she's working off the books for cash. Or on the other end of it, if you report it and you fail to hand hand over a proper 10 99 and she doesn't go and report it cause she thinks she's getting paid cash. Right. You know, and now it's, it's a whole series of problems that can really bring you a lot of headaches.
Speaker 0 00:19:05 Now, don't get me wrong, I'm not saying don't ever hire an independent caregiver financially, it's just, it's hard. I, I get it. You know, I'll, I'll give you, I I'll give an example here. I was just, before we came on, I was speaking to somebody who's starting an agency in, uh, Massachusetts. They're charging like $40 an hour up there for care. That's a lot. That, that is seriously a lot of money for a CU family to come out of pocket with. Especially if you're in that weird, if you fall into that weird area where you make, you have too much income, revenue and assets for Medicaid, but you don't quite have enough to sustain long-term care with, you know, through an agency. Like what do you do? What, what do you do if you know you have, you need that 24 7 care, and because of overtime and because of all the other charges incurred, it's anywhere from 22 to $28,000 a month.
Speaker 0 00:20:03 That, that's a, that's a lot if you're not prepared. Yeah. So, so what I would suggest is go find a company that will do background checks for you independently. You can actually, uh, there's a number of them. You just do a Google search, you know, for background check companies. And it usually costs anywhere from five to $25, depending on the level of the background check that you want. And you can have it done. That, that will save a lot of headache for you. Um, if you're hiring an independent person, make them fill out some, some sort of a basic application. You can, again, Google is a great resource. Go online, simple job application, fill it out, have whoever it is you're bringing in, do that, do that, um, paperwork and save yourself the headache. Have them fill out the, um, you know, the W four, the W nine, depending on how you're gonna pay them, if you're actually gonna put payroll in place.
Speaker 0 00:21:07 There's, there's great apps now that make payroll affordable. Like, you know, as cheap as 20 bucks a month. Right. You know, there's some that'll, even some websites that'll even let you run a payroll for a domestic employee for free. As long as you write the check and you're willing to send in the money to the state yourself, save yourself those problems. Like you mentioned before, get a writer on your homeowner's insurance policy to cover domestic employees. They're surprisingly inexpensive. If you're only hiring one or two people, you're not re, you don't have to follow a lot of the same overtime laws because you are, you're not paying them as a L L C or an S-corp. You are paying them as an individual homeowner that is bringing in domestic help. So you're not in most states, again, check your local laws, please. You know, but in most states, you're not even responsible to pay that additional overtime if somebody works, uh, more, more than a certain amount of hours.
Speaker 0 00:22:05 If you can have somebody live, uh, live in the home, and you save yourself a lot of, uh, the Department of Labor hassle that the agencies have to deal with. So there are solutions that you can put in place as long as you properly plan for, for, uh, the event. And just like, as a bonus thing, most of the people that are looking for help like this, they're not looking for it for themselves. So they're people in my age group and your age group, you know, and this is something that they may wanna look into with whoever does their life insurance or, you know, health insurance. Ask them if they carry or if they can refer you to somebody that will provide a long-term care policy. The lo the younger you are, when you put one in place, the cheaper the premium becomes, you can get a solid policy for yourself that'll cover, you know, thousands every month.
Speaker 0 00:23:04 Or you can get lifetime policies that will cover, let's say, two, 3 million over the course of your aging. We're not, as a society, we're living longer. And that retirement at 65, you know, if you're living to a hundred, that's a long time to cover. And sometimes, let's, let's be frank with the ups and downs in the economy, who not everyone is always gonna have a solution to cover a 30 year retirement of aging, of getting sick, of, you know, everything that's, that comes with it. And how long are you really gonna rely on your children? We're living so long in today's world that our children need help while we're still alive.
Speaker 3 00:23:46 Well, and I think, I think that's a, I mean, there is a, a, a real, there's a real pro, there's a real thought around that in the, the US mindset, the way that we work mm-hmm. <affirmative>. Right? So when you, you look at other countries, you look at Central America, you look at South America, you look at the eastern block, uh, you know, we've had a lot of guests and other families we've worked with and talked to who it is about, it's just the way the family lives. Yeah. It is this level is, is deal's family, and, and they live there. And that's how that's gonna work. And then mom and dad live here, and you've got different, you know, different levels or something, whether it's a community living, we're just not built that way. We don't, we don't buy homes that way. Life's not gonna come that way. Mm-hmm. <affirmative>, if it's, if that's something your, your family's looking to jump into, man, there's a whole like, lifestyle of that that you need to be very real for and, and more power to you if your family really wants to jump in to do it. Right. Just have a backup plan and give yourself some grace and a group some grace if that ends up being a lot more difficult than you expect.
Speaker 0 00:24:47 Cause Yeah. Oh yeah.
Speaker 3 00:24:49 It's
Speaker 0 00:24:50 Hard. Culturally. Like my family's Cuban, my wife's finitely Salvadorian. All right. Okay. We're used to this.
Speaker 3 00:24:56 Yeah.
Speaker 0 00:24:57 And it's a huge lifestyle adjustment. Like my mom is, is older, she's close to 80 now. You know, my sister, my brother, I, we, we figure it out of your time. My mother refuses to get help, which is a whole different, you know, set of issues because you know that that's a whole set of problems on their own. Like I, right now as we speak, my mother-in-law's at my house Yeah. Because again, we're, this is what we are used to. We we're very family-oriented. And even with that, it, it takes a lot of preparation, a lot of patience, you know, just a tremendous amount of patience to, to just get everything set up and in place and, you know, being part of that sandwich generation, it's not easy. No. So, yeah. So th that's, I said the, the private caregiver piece that's, um, kind of the way I look at, I'm a big proponent of finding an agency and I'm, I'm gonna, and it's not just because it's what, what I do for a living, but there's actual logistics behind it.
Speaker 0 00:26:00 All right? So if I hire Maria from down the street, all right. To come in and take care of mom, what's gonna happen when Maria catches cold? You know, I, I have nobody else to call. I have to stop my entire life. Yeah. Or I'll, I'll give you, I'll give you an example, um, of some people I worked with, uh, years ago before I went into consulting, when I was still working in home care, this family, they left the agency because they found, they found a caregiver that was gonna stay there. All of a sudden, the caregiver comes in and says, oh, yeah, I forgot to tell you tomorrow I'm going back to my home country for the next six months. You know, what do you do right now? It's not just, oh, I have to rearrange my life for a day. Now you have to scramble and get things put in place. Yeah. That, that you, you didn't have any clue as to what to do.
Speaker 3 00:26:54 Well, and you're looking that our family's looked at this, uh, and, and we, we've got a, we've, we made the promise as a family, right. That family member could stay in their home until they couldn't remember anybody. Right. Right. And we're gonna ride this out. And that, that is a promise that is more difficult to keep than I think we really understood. Yes. At the time in which we did. Now we recognize that means you need to be prepared for how to handle the day before that day. And every day that comes up to it, you have to know, yes. Well, how's that day gonna be taken care of? Right. How do you, how do you do that in a safe way where they're happy? Yes. Healthy. And, and everybody's got this together, um, when you, so you start looking at other solutions to pull through. But really it looks like there's probably going to be a lot of turnover because you're looking, as you think, you're thinking, well, this person doesn't go home at night. They don't have a family, they don't have these other, well, that's, now you're looking that population of people that are available to help you off of this starts whittling down really, really, really real fast,
Speaker 3 00:27:55 Man, real fast. And, and if that's the one, if you're trying to swap that out without having a partner, like an agency that has that is just great at recruiting them and understanding them and keeping them on and, and moving, that, that could be really problematic. If you're the one that's out there trying to flip over and get that next person, you can find yourself actually disrupting life a lot. Filling in those gaps between caregivers. Right.
Speaker 0 00:28:20 Well, yeah. Yeah. And, and the other thing, you know, here, here's something that even, and I gotta say this just in my line of work, I found even agencies don't quite understand it, there's a difference in the demographic and psychological makeup of somebody who's just looking to make a fast buck working, for example, like Medicaid or just trying to pick something up versus who is really gonna be in it for the long haul. Who's that great private working caregiver that has the skillset, the tenacity, the responsibility, personal accountability, and most importantly, compassion and patience to deal with your loved ones. Yeah. There's a big difference in the two. They're, they, they don't live in the same areas. They don't, they don't associate in the same areas. They have a different family makeup. It's, it's a lot of different things that come into play when you're trying to figure out who is gonna be not just a reliable caregiver, but who's gonna be a quality caregiver.
Speaker 3 00:29:23 Yeah. That, that's, I think, uh, excellent way to, to tackle that one. Um, we're gonna take, uh, I think at that, I'm gonna, we're gonna take a knee into our, our second break. Uh, when we come back, we're gonna continue talking with Julio Brianis, who is breaking down some of those secrets, both the, the pitfalls as well as the benefits of thinking about A D I Y for your own home healthcare solution. So stay tuned. We here with the Parent Projects podcast. We'll be right back after this.
Speaker 7 00:29:50 If you're caring for aging parents, you need parent projects connect. Here's why. First, you get access to a verified business network, so you're only working with the most trustworthy vendors who won't take advantage of your situation. Second parent projects guides you through modules and tasks on health, financial, real estate and medical decisions. So you're always prepared for what's next. Third, you can invite family members into your project so your family is in the know and working together. Get started with a free 30 day trial
[email protected].
Speaker 3 00:30:21 And this week we're sitting down with Julio, Brianna Sus, we've asked to come in and talk about what are the dangers, what are the benefits of a D I Y home healthcare solution? Is this something that a family can do? And if we're gonna do it, how do we do it well? What are the things to think about? And then if we get to that point to where you gotta tap out, who is it that you're looking for, or, or what can you be recognizing and when to tap out and how that transition might go in finding a good quality home healthcare solution to come help you out and pour into you. Who, Julio again, Hey man, thanks so much for stepping in and joining me today and breaking down this topic. It's a great conversation.
Speaker 0 00:30:58 Oh, thank you. And again, I thank you so much for, uh, having me on here. You know, it, it, to me, this is just as a, like Irv mentioned earlier, it's such a personal topic for me that, uh, I I could talk about it all day. Yeah.
Speaker 3 00:31:11 Well, you and me both, and, and I know we both have the throes of, of not just a passion of doing it before, but we have it in front of us and Yeah. And kind of in the throes of it now. So, yeah. So you look, you brother, we, we talked about breaking this down maybe at that, um, at that looking setting something like this up where you go to set that up. You did a great job of walking through. I'm gonna try to recap that first segment that, that, that you went through real quickly. Um, and then I, we could jump into, so you got a solution in play. Either it's your own solution that's gone into place, what are, or you've got a company that's in there. What are some of those flags to respond to and, and kind of move to different directions, right?
Speaker 3 00:31:49 But in that, in that first segment we talked about when we're looking, you, you know, you did a great job of pointing out six different major real difficulties and challenges that we're going to need some real planning ahead of time. You talked about that a majority of caregivers out there aren't necessarily bonded or insured, particularly if you're gonna pick them up on their own, if they're a one, a one-off, and they're not covered with under the umbrella of an organization that's coming through, that's gonna take some, some, some detailed work ahead of time to look for and to make sure to get solved. You talked about background checks, uh, that this, it's, it's not an intuitive, I, I'm a former police officer myself. Um, I've, I've worked from that. I understand too that in, and I've been a private, I've done private investigation work too.
Speaker 3 00:32:33 I know that even getting into that, that background check, they vary. You're not always, it's, you need to know what type of background check that you're getting when you do that so that you know mm-hmm. <affirmative> where they're from. You talked about great ways of picking up things like applications. You would need to understand where they've been, everywhere that they have been, so that you can ensure that you've got a background check that has all of that. And you need to know that you legally can do that and do that. Right. Pull that background check in a legal way so that you don't get yourself into trouble. Um, we went into payroll taxes, disability insurancers, workman's compensation, all of the legalities that it comes with being an employer. And, uh, you, you talked, uh, a lot of how to mitigate that, utilizing off the, you know, you could utilize a payroll company that could really help you with domestic employees.
Speaker 3 00:33:20 Again, really a key point to this is, you know, you one company does a lot of this stuff, or what you're, if you're not noticing yet, you can kind of pick up small companies that are picking up smaller tasks for you, but you're going to be engaging other people to help you get through this if you want to do this Right. And not bring more pain upon yourself. Uh, we went through backup coverage. So you, I mean, you talked to a story of that, you know, that that family who left because they found that caregiver who could move in, and then just after they make the transition, the caregiver, you know, is out and they, they're, they head back to their home country to go visit some people for a while. And that is, I think whether it's that or it's, you know, maybe, maybe it's, it's a younger caregiver who meets somebody and decides to start a family needs to leave in the middle of that, like the difficulty of that mm-hmm.
Speaker 3 00:34:08 <affirmative>, whether we broke down that 53% of people were complaining with the NIH study, that there was some form of abuse, 33% of that being physical, the risk of theft and that exploitation of abuse being five and six in your list. Important, important things to ensure, you know, how do you weed through and make sure that this person not only has the right background, they have the right temperament for what it is that they're gonna do. That bedside manner. They're getting professional training and continuing education mm-hmm. <affirmative> and how to keep up on that. How to, how to keep up with the latest greatest of technology, which oh my gosh, is changing. Like, oh,
Speaker 0 00:34:47 By the minute. Yeah.
Speaker 3 00:34:49 Oh my gosh. There's so many new and incredible things that are out there and, and somebody, you know, getting that, that to them and that they're, that they've got that pipeline of continuing education mm-hmm. <affirmative> so they can help your family leverage those things in there. These were great reasons to really consider using an a, you know, a whole takeout plan with the group, but at the same side, you broke down some, some practical ways that your family could start at it themself. How'd we do? How'd we do? Yep.
Speaker 0 00:35:15 Great. Great. Um, so <laugh>, the, uh, alright, so that, I mean, that's a great recap. Um, I couldn't have said it better myself. So the, now let's, let's talk about, um, move into what you mentioned a minute ago. What happens when you've done all, you've done all your homework, you've gone, you've got ground checks. Now you're just like, well, well, what the heck, you know, I need, I need to just go get an agency. What are my options? Okay, so here, here's a couple of things. I'm gonna, I'm gonna talk about this in two different steps, okay? Okay. Number one, I'm gonna talk a little bit about, uh, we'll get a little deeper into the funding. And then the second is to, regardless of the funding, what's, what makes a good agency, right? Cause there's great agencies and then there's really bad agencies. So let's, let's talk about what to look for. Save yourself the headache. If you have to go the agency route, let's find a good one.
Speaker 3 00:36:14 Ok? Ok, let's do it.
Speaker 0 00:36:16 So first you got, you got basic ways of paying for things. If you're a veteran, you got aid in attendance or VA home care, okay? Depending on your disability rating, you'll get va home care, depending on your income status and, um, how knowledgeable people are in helping you. You can get, uh, aid in attendance pension, okay? Uh, those are great. They're, they take a while to get the pitfall. I'm gonna warn you on this, is that there's a lot of companies out there that will help you do the paperwork for aid in attendance. Watch out for the ones that make you take out a loan, not the ones that make, that give you the option. Okay? So there's some that give you the option up to you if you want to get a loan out. There's a bunch of 'em, I think, um, I'm not gonna,
Speaker 3 00:37:01 Yeah. But, but, so that if, if I is a veteran, where I've seen those have been, uh, ones that essentially say, well, we're gonna start this off with a private pay model on there. Yeah. We're gonna ask you to take a loan to cover that private pay now. Correct. And then it's gonna get paid back coming out of here. And whereas others would just say, it's gonna be private pay as we walk through this. You're just note that that's how that is. There's a loan available to you, but they don't, they don't really push you
Speaker 0 00:37:26 Into that loan. Don't, yeah. And the thing is, the reason I warn against that, look, if you're sure that you meet the requirements, go for it. If you need the help, don't shy away from the loan if it's an option, okay? Just make sure it's a reputable company and make sure that, that you are not responsible for the loan, should the company have made a mistake and you get denied the benefit. Yeah. Ok. Those are the big pitfalls there. The next we're gonna talk about another very common way people get help is Medicaid. Depending on the state you live in, please look up your own regulations. It'll cover a certain number of hours a week. Usually, uh, max, most states it's, it's a maximum of like 12 to 16 hours a day. They don't really do a lot of living stuff. They'll, cause it's, it's cheaper for the state to push you into an assisted living than it's right to provide home care.
Speaker 0 00:38:17 When you get into that volume of hours, um, you know, you, you wanna make sure that you know that if you're doing that, that you're following proper procedure. Get some, get one of these companies to help you or, uh, find an elder law attorney that'll help you if you need to do a spend down. Okay? Yeah. So you might have just over the assets and you wanna make sure that you are properly handling the spend down process. Otherwise, in most states, the penalty can be as high as five to 10 years where you'll be penalized against taking, getting Medicaid or any other state funded assistance for doing the process incorrectly.
Speaker 3 00:38:55 Ok? Yeah. You know, and, and, and those are, for those of you that didn't cover in other episodes, we've got these, you can mm-hmm. <affirmative> hashtag or look below, you'll see different things from, from Miller Trust, healthcare Spending trust, okay. All types of different Yeah. Make sure you do look at that and understand that and yeah. In particular, that penalization, let's, let's be clear off of that. Uh, Julio, that means medic. You're gonna start into that at a private pay. And that is essentially Medicaid saying, we're gonna sit on the fence until you've put that much
Speaker 0 00:39:23 So you hit the dollar
Speaker 3 00:39:24 Outta your pocket Yep. Going into that. And, and they, they include in almost every state, and they all have a little different swings as to what's included and what's not off of that. That's why you should use an attorney for this folks. Yeah. Um, you know, they're gonna look five years backwards, by the way. So like you're planning out, just like he said that, boy, long term term care insurance seems to be insanely important for our age group right now. Um, but on the other side, if you haven't started planning, and if you know that you're, you're likely to li wind up in, in a long-term care need off of that start thinking of, and you're gonna be in that, that kind of in between area of life from that, which honestly is probably less than three quarters of a million dollars, $750,000 in less to pretty much wipe out.
Speaker 0 00:40:11 Oh, you can look quick if you, if you get sick enough, fast enough, you'll wipe through, uh, you'll wipe out, uh, 750,000 in less than two years. Yeah.
Speaker 3 00:40:22 Yeah. So,
Speaker 0 00:40:22 So,
Speaker 3 00:40:22 And that is, that's, those are real things, peeves. So real things, think about that. Know that, that you need to be, think if you wanna, you know, mom's gonna give this and you're gonna give this away and these things are gonna go, you are not talking about now what the conversation is not is inheritance and a work against that. This is a different conversation and the two collide, and they're very complicated, but
Speaker 0 00:40:46 Very important and absolutely need a professional.
Speaker 3 00:40:48 You do, you've gotta get this right. This is one absolutely one to get right. And by the way, you could probably get two different answers if you are going to an attorney who's working to protect you for how those assets passed down from one to the next and one who's there to ensure that you're getting the Medicare spending that you're going to need Yes. Or whatever that assistant looks like while they're still alive. So, right. You're gonna have to balance that out, uh, and work
Speaker 0 00:41:14 Through. Yeah. You need a specialist. Yeah. You do not an estate planner, a specialist law or geriatric attorney. Uh, yeah. They, they have to know what they're doing. So, but the next thing that is common when it comes to this is Medicare. People always end up in the skilled nursing facility or the hospital. Oh, no, I'm not worried about it. Medicare will take care of it. The, the short answer is no. All right. Yeah. Medicare, if, if you spent enough time in a skilled nursing facility or had a se serious enough injury or illness, they that you qualify, you're gonna get an average of one to three hours per shift. One to three times per week for a cap of about 120 hours a year, depending on which advantage plan you have. All right? And it's very limited and you don't really get a lot of say in what happens.
Speaker 0 00:42:06 Okay. It's, it's under a doctor's order and that's that. So if you're banking on that, please start rethinking your strategy. Yeah. Next, uh, we're gonna move into the long-term care. I'll mention that again, you know, cause I, I'm a huge fan of that. If you're watching this and you're between 45 and 55 years old, look into a long-term care policy for yourself when, when you need it and you gotta crack it open. There's a lot of things to understand. There's the, there's, uh, elimination periods, there's, you know, which is a deductible. There's a whole lot of stuff going on there. Go find one, it'll, you'll, you'll thank me for it when you're 75 <laugh>. Alright. So,
Speaker 3 00:42:52 And your kids, your kids are gonna write love letters like
Speaker 0 00:42:55 This, <laugh>? Yes. Yes. Oh, your kids, your kids will build a statue in my honor when they see that, you know, how much money they're saving by having that policy, but you being smart enough to have that policy in place. Yeah. You know, um, it, it's, it's a lifesaver because it acts as cash. Okay. That's the big thing about it. It acts as cash. And the younger you are, when you start, I'll say this again, is that cheaper? It comes out after a certain age. You can't even get written for one of those policies. So if, if you wait till you're 65, oh, I'm about to retire, that policy is gonna cost you a small fortune. Okay? Yeah. And it's not gonna give you much coverage cause you waited too long. The ideal time is, you know, under 55. That's, that's, uh, find whoever it is that you deal with for insurance and let them explain to that.
Speaker 0 00:43:44 And then finally, we have cash. You know, cash is the final way. And I'm sure if you look through this podcast, there's a bunch of people that can explain alternative funding methods for senior care. So, moving on, now that we understand the paying how you're gonna pay for this, uh, in a very short way, let's talk about what makes a good home care agency. Now, this is regardless, I don't care if you're looking for a hospice agency. I don't care if you're looking for home health because you need skilled care. I don't care if you're looking for a Medicaid agency or a private pay agency that's billing themselves. That's top of the line. Couple of things to keep in mind. There is absolutely zero difference between a franchise or a locally operated, uh, agency. That's number one. Because franchises are independently owned and operated, and you are still dealing with a human being that may or may not have any experience in this industry whatsoever.
Speaker 0 00:44:39 And with franchises, having been a franchising consultant for many years before I went into independent consulting, um, I, I gotta tell you, half these people have are they clueless. And the training that they receive on average is three to seven days. That's it. They get three to seven days training on how to operate a home care agency before they start the process to open their business. So it's, you're not getting anything necessarily better or worse. Some franchises are more reputable, but when it comes down to, is these specific things, number one, do a Google search. We live in an era where you have all of the information known to man on a device that fits in the palm of your hand. <laugh>, okay? Including something called social proof. Back when, you know, back when, uh, me and Tony were young when we needed to know if, you know, the pizza place down the street was any good.
Speaker 0 00:45:40 Yeah. We would ask our buddies, Hey, did you ever eat at Domino's? Yeah. You know, their pizza's okay, but blah, blah, blah. Okay, great. And if you got enough people telling you that the pizza was good, you went and ate there. You know, if you wanted to find a good auto mechanic again, you figured out whose car did they mess up? All right? Yeah. Yeah. All right. And that's how businesses grew or fell by word of mouth. Today, especially in the post covid world, that information is much, much faster to get your hands on. You very literally type in the business name into Google and you can look at their reviews. This is important. There's two specific places you wanna look for when it comes to home care. Number one is the Google reviews. What are other people saying about that business? Now there's people naysayers out there that'll tell me, oh, yeah, yeah, people can make those up.
Speaker 0 00:46:32 Yes, they absolutely can. But here's the difference. If the agency has been open for five years down the street and you see that they only have one or two Google reviews, that doesn't necessarily mean that they're a bad agency. But I would much rather trust the agency that's been open for five years with 50 Google reviews. At least I could see what people are legitimately saying about how they conduct their business. The second place, and this is one that most people don't think of, go to Indeed, okay, what are employees saying about working for that particular agency? How an agency treats their employees is going to matter dramatically on the level of care and concern that they're gonna have on how those employees behave in your home. Okay? Make sure that they're nurturing quality caregivers, that they're nurturing, you know, um, that they're, that they're actually concerned about the behavior that people, you know, that if you see a group of angry caregivers and you see that they're saying, oh, this agency, they're unfair and unreasonable, and you see that the agency's responding, we were unreasonable, but you did no call, no show five times.
Speaker 0 00:47:44 That means they are concerned about their product, their service. Here is something that, you know, I, I go through a lot with my clients. I call it the 1% rule. If you go into any given area, and let's say, let's just say for example, Hackensack, New Jersey, just for argument's sake, if I were to type in home care in Hackensack, New Jersey, I'm gonna find about 150 agencies. Okay? That's a lot. Here's the beauty of it. There's only a limited amount of caregivers. New Jersey is a highly regulated state. So that means out of 10 agencies I will call, I will probably get the same caregiver at least four times. Okay? Every agency is gonna tell me that they have a nurse on staff. You know what? It is regulated. They are mandated by state law to do that. So of course they're gonna have a nurse on hand, you know, they go above and beyond, which is one of the statements I hate more than anything else, because nobody ever explains what that means.
Speaker 0 00:48:45 Yeah. Ok. Yeah. So that tells me that 99% of these agencies in that local market do the exact same thing. They all are competitively priced. They all, they're so it means they're all within one to $2 of each other. Yeah. They all are hiring from the same pool caregivers. They're all going to the same facilities, and they all have relationships with the same referral partners. So ask yourself this, what makes them different? What makes them different? And what you should always look at is how they're going to respond when something goes bad. This is why, we'll go back to the first part. Social proof, word of mouth. What's going on? Ask to meet them. They were, especially in a post covid world, they're all gonna push, oh, we can meet through Zoom, we can meet on the phone because they don't wanna leave <laugh>. Okay?
Speaker 0 00:49:36 Yeah. Get that personal touch. What is it that you are getting for the money? Because look, it's no different than if I were to tell you, Hey Tony, you know what? Go outside your door right now and I've got a brand new Mercedes SL 500 that you can have for the low, low price of $500. You're gonna look at me like I'm crazy, and ask yourself, what's wrong with that car? Okay, because of the price, does it really matter the price and the car? The car's gonna still get you from point A to point B. The home care agency is gonna provide a caregiver. What is it that's, that's gonna differentiate? It is the quality. Now, if I were to tell you the same thing, and I would say, Hey Tony, you know what? I got a uh, Toyota, uh, Toyota Corolla, Outback for you cheap, only 125,000.
Speaker 0 00:50:23 Again, you're gonna look at me like I'm crazy. You know, because it's overpriced. And that's what, that's what you have to look at when you're shopping around for a home care agency. Doesn't matter to me. Again, Medicaid, Medicare, it doesn't matter who's paying for it. Look at the quality of the product. The product is not the caregiver. The qu the product is the quality of care that you are receiving. How much concern will they have? Are they actually gonna make an earnest effort when that caregiver calls out to find your replacement that day? Yeah. Yeah. And, and this is where the whole thing comes in. For example, Medicaid agencies have a higher client turnaround rate. You're looking at probably, you know, on any given time, 15, 20% of clients will bounce. One client might run through five or six agencies depending on the market. You know, um, I've seen clients run through as many as 15 or 20 agencies, you know, um, depending on how, how strict the state is with changing agencies under Medicaid, private pay, it's a little bit different.
Speaker 0 00:51:29 It's a higher level of service. Your average family will only change agencies maybe once. Okay. Um, uh, the service usually has to be pretty bad because the caregivers are, tend to get very attached to the family. And it's not as easy to take service with the caregiver with you in private pay as it is in Medicaid. You know, the, the rules are much more strict on what you can do as an employer. So that is the biggest thing to look for. If you see that the, if you call the agency and you start services on the very first day, somebody from the office did not at least communicate with you to start the case. And if it's private pay, I, I always say if, if a physical body from the office did not come with that caregiver to start that case, that's a red flag that that's a red flag to see the quality of the care that you're getting.
Speaker 0 00:52:24 Yeah. You know, high touch, high contact usually means to better results. You know, how often as time goes on, how often is this, um, agency communicating with you? Are they trying to build a legitimate relationship with your family? Again, regardless of private payer or Medicaid, are they trying to get to know you and how does, how to provide the care that you legitimately need? Yeah. Or are you just a number to them, you know, when you call, do they sound like interested in speaking to you? You know, if cuz if they're not interested with you before you sign up, what makes you think they're gonna care when something goes wrong?
Speaker 3 00:53:02 Well, you know, those are, that something goes wrong is the crux of a parent project. I mean, those are the, these things are, they're, especially because in a lot of parent projects and, and what we look to do is to help families be able to do more for themselves as long as possible. Which means things are gonna, there's gonna be bumps, right? There's gonna be more bumps in that. This is something that we as human beings do, maybe two to four times at the most in our life, right? If you're handling your parents and your spouse's parents, you're not gonna be awesome at this. You're just no. Like, things are gonna go wrong. Mm-hmm. When you, when you're jump, when you're talking with organizations, you having an organization that can be nimble with you, that can Yes. Respond, that responsiveness. It is great. I don't expect perfect reviews when I look and we do verification of these vendors, and when we look for that, we do not look for a perfect review off of that.
Speaker 3 00:53:50 Right. We're looking for that four star, at least as somebody who can maintain that four star. And when we're looking for those comments against reputation management at Parapros, we're looking for that responsiveness to that and get posted. Did the company respond against that? Did they make an earnest effort to try to deal with that, figure out what was, what was going down? There are, there are some families who are their own grief is just gonna put 'em where they're going to be. Right. Right. Right. And, and that's if, if a rational person could look at this un look at the situation from both sides and go like, these people just can't agree this wasn't a good match against this. Right. That, that is, that is what that is. And I think most will give that leniency or will give that grace to the situation. But when you're, when you are screening those organizations, those are the things that think I I I love that you're bringing that up. I love bringing up the, or I love the idea too, of asking 'em questions in those meetings about what, what's your policies look like if somebody calls out Yes. What happens if my caregiver, uh, tests positive for covid and can't show up, or, you know, is sick or what you
Speaker 0 00:54:48 Ask them to provide a, the background check. You legally, in most states, you can just tell the agency, I wanna see the background check and they have to provide it. Yeah. You know, you wanna know, you wanna know who you're bringing into your home. Yeah. But now, uh, uh, just to, again, to jump on the back of what you're saying, everybody makes mistakes. It's how you handle it that makes you a good agency or a bad agency. Yeah. And on the same note with the, I I just want to clarify something on the Google reviews, some people are very experienced and very knowledgeable, but they're just new at the agency. Ask the owner or the people in charge, or whoever it is that's coming, ask them about their experience in caregiving. So, you know, if I go to do the in-home and close the sale and sign up the client, don't be afraid to ask me, Hey, what's your background?
Speaker 0 00:55:39 Like, how, how long have you been doing this? You know, I'm, I'm concerned. What happens if a caregiver doesn't show up and doesn't call? You know, what, will I still get coverage that day, even if it's late? Yeah. Ask them these things. Yeah. If you have, if you need to go be at work by nine and you have to leave your house by eight, what happens when it's eight 30 and the caregiver didn't show up? You know, what is the company's policy or, or protocol for handling things like that. Yeah. You know, so these are all things you wanna make sure that, that you ask and that, you know, to give you the better experience.
Speaker 3 00:56:14 Will those things. Mm-hmm. <affirmative>, oh, I'm sorry. I'm sorry. I was gonna say, will, will, will things like that be something that will be documented in, uh, in their and what they give you or the, their policies, procedures or something? No. Okay.
Speaker 0 00:56:27 Yes. They're, they every, uh, every state requires for li that every state that has licensing requires an agency to have policies and procedures. And there's, you can actually go to your state website. Uh, it's either under board of nursing or the Department of Health or Department of Aging, depending on what state you're in. And you can actually look up what are the policy requirements to open a home care agency in your area and look 'em up and what whatever policy is there, you need to ask them for it. And if you are concerned about something and you don't see the policy as being state mandated, ask them if they have a policy or, so basically they just check the boxes so that they can get licensed, or are they legitimately trying to run a business that's gonna be for the betterment of the client.
Speaker 3 00:57:17 Yeah. Great. Excellent. Excellent, man. Um, okay. Those are, that is just sound. That is great. Mm-hmm. <affirmative> sound advice. I think, like you said, you and I could go with this, we could talk about this all day long, but mm-hmm. <affirmative>, uh, but I think that is a, a, a good chunk drinking out of the fire hose for those of you that continue to fall and work with us. These podcasts is gonna be broken up. It'll be chapter down below, so check that out in the comments. By the way, if you don't subscribe to us, you know, subs, hit that, subscribe, that like button, it does help us in the algorithms continues to keep this content relevant for everybody out there. Uh, Julio, tell us how can, uh, people get more information from you or talk with you about, about what you do ESP or if they're a company even, that maybe they, they're in home healthcare, they've got a company out there and they wanna work with you guys as well. How, how do people find you?
Speaker 0 00:58:07 Well, the easiest way is to go to my website, and that's www.thebrionigroup.com. All right. Yeah, there it is. All right. So you can just go on there and if you're a home care agency or home health or assisted living or anything looking for strategic support or strategic planning help, by all means book a discovery call with me. And if you just interested in what I said and you want to run through a few things, look, I open stuff up. Just shoot me an email. There's, my email is right on my website, and I'll happily answer any questions to help guide you along the way. Uh, it's, it's about from making sure that no other family went through what my family went through, and that's why I do this. You know, it's it for me, like I said, it's a passion project. I, I don't, you know, I, I love what I do, and I do believe firmly in that better, better quality service gives much better outcomes.
Speaker 3 00:59:03 Yeah. Well, I think you've, you've just laid that out really well. I think anybody else can see that in you, man, and I commend you. I appreciate the time that you've spent with us and for sharing your time, talents, and treasures with us. Julio, thanks so much for joining us.
Speaker 0 00:59:17 Thank you for having me.
Speaker 2 00:59:23 Well, that's it for the team this week, and thanks for joining us. If you've enjoyed the content, remember to subscribe and to share this episode on the app that you're using right now. Your reviews and your comments, they really help us expand our reach as well as our perspectives. So if you have time, also drop us a note. Let us know how we're doing for tips and tools to clarify your parent project, simplify communication with your stakeholders, and verify the professionals that you choose. You can find us on YouTube, follow us on Instagram and Facebook. Thanks again for trusting us. Until our next episode, behold and be held.
Speaker 8 00:59:55 Thank you for listening to this Parent Projects podcast production. To access our show notes, resources, or forums, join us on your favorite social media platform or go to parent projects.com. This show is for informational and educational purposes only. Before making any decisions can consult a professional credential in your local area. This show is copyrighted by Family Media and Technology Group, incorporated and parent projects l l c. Written permissions must be granted before syndication or rebroadcast.
