Tuesday 31 March 2015

What's New for Those Give and Receive Personal Support Care at Home

In my last blog post, I described the problems that make working conditions for personal support workers very, very difficult.  I described the challenges for clients who need personal support services, as well.

The Problems:
  • ·      Low pay
  • ·      Clients need many hours of support over long periods, so can’t afford the care they need
  • ·      Personal Support Workers, or PSWs can’t afford to insure themselves privately
  • ·      PSWs have few opportunity for regular, full-time work


Carol and Rod MacDonald are Canadian social entrepreneurs based in Toronto.  Together, they created a web-based company to match PSWs with clients who need care.   Currently, myPSW is operating within Ontario only, but Carol and Rod have plans to expand into the rest of Canada and the USA.  I had an opportunity to ask Carol about the model and why it’s innovative.

Q:  Describe myPSW and tell us why it’s so innovative.

myPSW is a very innovative model in that the website enables consumers of personal support services to independently search for, locate, hire and manage their own Personal Support Worker who lives right within their local communities.  This is innovative because this technology puts the power and control in the hands of the consumer of care and/or their family to manage without going through an agency or third party.  The site not only acts an effective means to link people, but also facilitates all the transactions right through the site.  What is really interesting is that something as vast as the internet/world wide web is used to build small communities of care in every little nook and cranny across the province. This would not be possible without technology, innovation and forward thinking.

Q: What are the benefits for PSWs? 

·       Client’s loyalty is with the PSW.
·       PSW determines her own schedule.
·       Geographic assignment of files based on a territory of PSW’s choosing.
·       Net earnings are significantly higher than industry average.
·       Legitimacy and no paper work as all invoicing/billing is completed on behalf of the PSW.  So     no hassles on the administrative side of being self-employed.
·       No canvasing of clients. Referrals are provided directly.
·       No collections. Funds are transferred directly into your account.
·       No upfront fees to create a profile.

Q: What are the benefits for clients/families?

·       Choice – you get to choose your PSW.
·       The peace of mind to know that your PSW is part of your local community!
·       Efficacy – find a PSW within minutes of arriving on the site.
·       Qualified – all PSWs have at least 500 hours of training.
·       Checked – all PSWs have provided a “Police Check” and “Liability Insurance”.
·       Legitimacy – professional billing charged to your credit card.
·       Reconciliation – ability to view PSW time slips on line.
·       No upfront fees.
·       All PSWs charge $20 per hour.
·       Electronic records provided for possible reimbursement or tax refunds.
·       PSWs earn significantly more than private home care industry average.

Q:  What is your business plan?  How will myPSW sustain itself financially?  

 We charge 15% of the $20 so our charge is to the PSWs, not the clients.  The PSWs end up making close to $17 (we have to charge them Harmonized Sales Tax or HST, so they net $16.61) gross. 

Q:  Can MyPSW be used together with agency or government provided home care services?  

Yes, myPSW can be used in conjunction with agencies or the government funded health care services.  At the present moment, we are in conversation with a few home care agencies in order to solidify strategic partnerships.  By partnering with these agencies, myPSW and the existing industry are working together to provide consumers a continuum of care and a "basket" of unique options from which they can choose.  Our plan, on a larger scale, would be to engage the Ontario Ministry of Health and Long Term Care further to discuss how myPSW might be introduced into the current service delivery model of the provincial home health services entry point.  myPSW is an ideal tool to be used in conjunction with individualized funding in health care budgets and this is our dream for the future.  

Silver Chain has eight palliative care teams in the greater Perth (Australia) area.  Each inter-professional team consists of palliative medicine physicians, specialist nurses, family doctors, social workers, counsellors, psychologists, pharmacists, and physiotherapists, personal support workers, resident doctors and volunteers.  

This full service, lead agency model for palliative care provides full-time employment for the PSW within a supportive team environment in which everyone’s contribution is valued.  Diagnosis-specific, full-service lead agencies offer PSW job security and the potential of insurance plan and government funding because of their multi-disciplinary nature. 

The innovative organizational structure in the Green House model is based upon “the conviction that we need a new framework around which to organize the experience of those who protect, sustain, and nurture our elders.” The structure challenges the traditional nursing home hierarchy to create environments that empower elders and those who are closest to them.

The direct-care providers (PSWs) function within self-managed work teams to provide the day-to-day care for the elders and act as managers of the home. These individuals, called Shahbazim, partner with nurses and other clinical team members to create an empowered clinical care team of excellence. The Shahbazim report to a Guide, who is responsible for providing the team with the support, accountability and resources necessary for success in their role.  The PSW role, reinvented as Shahbazim, gives care workers responsibilities for carrying out all activities of home life for elders.  This means cooking, personal care, ordering of supplies and cleaning.  Shahbazim report very high job satisfaction. 


Some jurisdictions are experimenting with congregated care.  Service provider agencies that staff the needs of several clients within one residence are looking at new ways of bringing in a single PSW to serve several clients in the same building.   In my mother’s seniors’ residence, multiple PSWs from both private and government funded agencies come in to assist through a revolving door.  The travel time and lack of coordination amongst clients and staff in a single location must have a huge and unnecessary cost.  It’s encouraging to hear about models that make life easier for both clients and itinerant care staff.  The congregated care model offers greater job security for PSWs and has the potential of lowering costs for clients through group purchase of service.


There is another answer to full-time, fairly waged employment for PSWs that would also be affordable for those who need care – a long term care national insurance plan.  That’s the subject of my next post.

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