Making the case for your services
Customer service, consumer education are goals
Love em or hate em, consumer-directed care programs are here to stay. The private duty industry is no stranger to the independent-care providers these initiatives promote. Consumers have privately employed neighbors, friends, relatives, and even strangers for years. At the same time, private duty agencies — exposed firsthand to problems and abuses that accompany such arrangements — marvelled at people’s persistence of directly hiring workers.
Both the lower up-front cost and ignorance about potential problems influence consumers to use individual providers, sources say.
"Who can afford quality care, but who wants lousy care?" asks Nancy Turner, RN, president of Professional Nursing Services in Valley Forge, PA. "People just don’t think about insurance or licensure issues."
They also don’t want to think about income and Social Security taxes, according to Jane W. Sullivan, president and chief executive officer of Always Caring, a private duty company in Chicago. "Some people are blatant about not paying taxes."
Client-employers are not the only ones disinterested in tax and Social Security issues, Sullivan notes. "The workers’ mentality is, I need every penny,’ and they are living for the moment and not contributing to Social Security."
Also, clients do not think beyond the convenience, cost-savings, and comfort of employing those they know and love. "It all sounds like a great idea to get your brother to provide care for you, but it’s hard enough to control what an employee does," says Bill Mahon, president of St. Charles, MO-based Preferred Health Care.
Initially, few people recognize the potentially disastrous mixture of emotional attachment and financial remuneration that results from employing relatives, Sullivan adds. After getting into a caregiving relationship, the caregiver may realize he lacks appropriate skills, is no longer interested, or is simply overwhelmed with his relative-employer’s care needs. Yet the patient may still insist, "I don’t want anyone else to take care of me."
Winning business tips
Despite the problems that can potentially result from directly employing caregivers, it’s the choice of many consumers. Some have few resources and are counting every dime, whereas others want to preserve resources. While private duty providers may simply be unable to woo such consumers, there are steps you can take to win business from those considering directly employing caregivers, according to sources:
• Educate consumers.
If you can get callers (whose usual immediate reaction upon learning your rates to say, "I can’t afford it") to hang on the line, educate them about what your charges cover and what others with lower prices may not.
"Educate them that agencies take out taxes," Mahon recommends.
"Let them know you offer complete peace of mind, that they don’t have to worry about taxes or if someone falls down a flight of stairs at their home," Sullivan agrees.
Some clients are not only ignorant about taxation and liability issues, but the different types of available in-home care. Professional Nursing Services mails inquirers a pamphlet, "How to Choose the Right Home Health Care Service." It outlines 15 actions and questions consumers can use to help find the best provider. (See sample, p. 5.)
Also, emphasize your care management capabilities, Sullivan suggests. Tell clients you can work with them to conserve resources as their care needs change. For example, someone whose use of hourly services is increasing may benefit from lower cost live-in services instead, she explains.
• Educate employees.
After working as a caregiver, some personal care providers believe they can make more money on their own. Educating employees about what they can receive in addition to their hourly wages may encourage them to not to jump ship and assist them to help clients understand what’s involved, says Colleen Sanders, RN, program development manager of paraprofessional staff development at Interim HealthCare in Fort Lauderdale, FL. Explain that while "you’re getting a dollar or two more an hour, you’re losing workers’ comp protection, direct tax payments, and every day things like personal protective equipment we provide free of charge," she explains.
• Promote your reputation, longevity, and licensure.
"We have a long-standing reputation in the community, and a reliance factor," says Marc Catalano, president of Catalano’s Nurses Registry in Hialeah, FL. "When potential clients call, they know caregivers’ background and licensure have been checked. People expect a certain amount of front work to be done when they call a company."
• Take the high road.
Some individual care providers and employees press the boundaries of their licensure and practice constraints, according to Glendine Barley, RN, BSN, director of VNA Personal Services in Bellingham, WA.
"Some people advertise everything up to and including brain surgery," she says "It’s very difficult to counteract their homespun, caring atmosphere, but we try to take the high road and follow the letter of the law and not allow folks to do what their license won’t allow them to do."
• Service, service, service.
Providing top quality service may also win potential clients over. "People can call [here] 24 hours a day, seven days a week and get services. If they get a call at 1 a.m. that their caregiver can’t come in, they know I’ll back them up," says Catalano.
"Look for ways to add value," Sullivan advises. "We have to do what’s right for people, care about them, and let them know that someone is coming behind [caregivers] to check the quality of work and care provided."
• Participate in your community.
To build your reputation, service commitment, and keep your company’s names before potential clients, look for ways to increase your community visibility, sources recommend.
At various forums, VNA Personal Services staff have health fair booths educating consumers about selecting nursing services, according to Barley. Sullivan writes a local newspaper column on elder care and speaks at community meetings.
Such activities may not make your rates any more affordable, but they will help potential clients think of your organization when they need services, possibly giving you the crucial opportunity to explain what you have to offer.
Vigorous competition and total customer service orientation are the best ways to convince potential clients that your organization is a better overall value than a lower-cost provider, sources advise.
"If consumer-directed care is the wave of the future, home care providers will have to position themselves as competitively as possible and market themselves as consumer-oriented services," says Linda Velgouse, deputy director of Independent Choices, a Robert Wood Johnson Foundation grant project, and director of consumer-directed services at the National Council on Aging in Washington, DC.
Catalano agrees. "You have to be competitive and offer services at a price that the consumer can afford; provide a service they want; and be better than your competitors. I love the competition. I feel strongly that if you give me the opportunity to compete, even if I charge a little more, I’ll do it!"
Sources
• Glendine Barley, RN, BSN, director, VNA Personal Services, 600 Birchwood Ave., Bellingham, WA 98225-1757. Telephone: (360) 734-9210.
• Marc Catalano, president, Catalano’s Nurses Registry, 419 W. 49th St., Suite 200, Hialeah, FL 33012. Telephone: (305) 821-7064.
• Jerry Crosby, president, Professional Registry of Nursing, 19033 W. Valley Highway, Suite D105, Kent, WA 98032. Telephone: (425) 656-9031.
• John Gilliland, attorney, 2670 Chancellor Drive, Suite 290, Crestview Hills, KY 41017. Telephone: (606) 344-8515.
• Bill Mahon, president, Preferred Health Care, 15 Centre Pointe Drive, St. Charles, MO 63304. Telephone: (314) 939-3925.
• Al Quattromani, associate director, Division of Developmental Disabilities, Department of Mental Health, Retardation, and Hospitals, 600 New London Ave., Cranston, RI 02920.
• Charles Sabatino, JD, assistant director, Commission on Legal Problems of the Elderly, American Bar Association, 740 15th St. N.W., Washington, DC 20005. Telephone: (202) 662-1000.Telephone: (401) 462-3234.
• Colleen Sanders, RN, program development manager of Paraprofessional Staff Development, 2050 Spectrum Blvd., Fort Lauderdale, FL 33309-3008. Telephone: (954) 958-4706.
• Mary Schantz, executive director, Missouri Alliance for Home Care, 2420 Hyde Park Road, Suite A, Jefferson City, MO 65109. Telephone: (573) 634-7772.
• Jane M. Sullivan, president and CEO, Always Caring, 2650 W. Albion Ave., Chicago, IL 60645-5031. Telephone: (773) 764-1313.
• Nancy Turner, RN, president, Professional Nursing Services, P.O. Box 911, Valley Forge, PA 19482. Telephone: (610) 933-9483.
• Linda Velgouse, deputy director of Independent Choices, Robert Wood Johnson Foundation, and Director of Consumer-directed Services, National Council on Aging, 409 Third St. S.W., Washington, DC 20024. Telephone: (202) 479-6604.
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