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Backup Caregiver Services Help Keep Workers on the Job

June 24, 2005
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Related Topics: Work/Life Balance, Benefit Design and Communication, Attendance, Featured Article, Compensation
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Snow days, sick kids, babysitters with the flu, elderly parents who unexpectedly need some short-term assistance: It’s not really a secret that situations like these lead to more than a few missed days of work.

    Yet there are cost-effective steps that employers can take to reduce missed days of work, increase productivity and give a big boost to employee morale all at the same time, say proponents of employer-subsidized in-home backup care.

    Both employers and employees like the flexibility of in-home backup care, which can met the needs of any dependent, whether infant, teenager or elderly parent. Mildly ill children or elders can be cared for and the hours covered are unlimited, including overnight and weekends.

    This is a benefit that balances business needs with employee needs, says Carol Sladek, a work/life consultant with Hewitt Associates in Lincolnshire, Illinois. It is especially useful for health care providers or those in other industries where it is important that workers be on site in order to be productive, she notes.

    Blue Cross/Blue Shield of Massachusetts recently decided to offer in-home backup care as a benefit because "we really like the combination if child care and elder care," says Catherine Devlin, director of associate relations for the Boston-based company.

    "As we looked at how our demographics are changing and what we need now and what we’ll need five years down the road, we saw a significant increase in the number of employees with elder care responsibilities," says Devlin. BC/BS of Massachusetts began contracting with Brookline, Massachusetts-based Parents in a Pinch about three months ago to help meet those needs.

    PIP has provided backup care services since 1984. "From the moment we opened our doors, we knew there would always be a demand for our services," says Barbara Marcus, the company’s CEO. "Despite the reluctance to let a stranger into our homes--and I understand that reluctance very well--the issue for us has always been keeping up with the supply (of caregivers)," Marcus says.

    An employer pays PIP an annual fee ranging from $5,000 to $100,000, depending on the number of its employees, which entitles each employee to use the service 20 times a year. For their part, employees pay the caregivers the going hourly rate in their part of the country, ranging from $11 to $16 an hour. Some employers also choose to subsidize employee costs in part or in full, and PIP will tailor the program to the employer’s specifications, says Lynne Satlof-Karas, director of PIP’s corporate services.

    When employees need backup care, they contact the PIP call-in center, which is open from 7 a.m. to 7 p.m. Monday through Saturday and from 5 p.m. to 7 p.m. on Sunday. PIP can typically have a caregiver at the house within two hours of receiving a call, says Marcus.

    A key part of PIP’s service is its provider screening and vetting process. After caregivers have passed the interview process and background check, they have a short interactive computer-training course on safety and discipline and are taught how to handle choking emergencies. CPR classes are offered twice a month for any interested caregiver, Marcus says. After every placement, PIP follows up with users to make sure they were completely satisfied with the caregiver, culling any caregiver who receives even a mediocre report.

    This prescreening makes it easier for employees to take the leap and allow "strangers" to care for their dependents, Marcus says.

    Dr. Diane Greer, medical director of mental health/social services at MGH Chelsea HealthCare Center in Chelsea, Massachusetts, used the service for the first time after her regular sitter caught the flu. "As a physician, I absolutely have to be at work. I was absolutely panicked," Greer says. "I really did not want to use them, but I did call them and they were so responsive and flexible. I’ve used them four times now and will definitely use them again. I don’t have a need for it that often, but when I do, it is indispensable."

    PIP is one of the benefits offered by Cambridge, Massachusetts-based Harvard University, and "it allows me to run my organization more effectively," says Tiziana Dearing, executive director of the Hauser Center for Nonprofit Organization at Harvard.

    "I consider this to be a true benefit. Not only does it allow my staff to be at work, but it allows them to be fully at work mentally. People are not forced to make bad choices between home and work," says Dearing, who has used the service herself several times.

    PIP is not the only vendor offering backup dependent care. Wilmington, Delaware-based Just in Time Care has also found a niche in the marketplace, using a slightly different model than PIP does.

    Just in Time Care is the corporate service of the Family & Workplace Connection. A nonprofit dependent care resource and referral organization.

    Just in Time Care was founded after a particularly bad winter in 1994. "The roads were so icy and snowy that schools were closed days on end," recalls Gerri Weagraff, business development director of Just in Time Care.

    Wilmington-based E.I. DuPont de Nemours & Co. "was one of the companies that was seeing what was happening, which was that parents were staying home with their children or bringing them to work, where they were roaming the halls. Or they were leaving children and dependent elders at home, then coming to work and worrying about them. Absenteeism and distractions were up, and productivity was down," Weagraff says.

    DuPont, which helped fund Just in Time Care’s startup and was one of its initial clients, envisioned a comprehensive service "that would allow employees to choose backup care that they preferred for their own scenarios, whether that be school closing, business travel, children sick, elders just out of the hospital--every possible scenario where care would be unavailable and there would be gap time," Weagraff says.

    At first, Just in Time Care referred employees to the typical daycare providers for out-of-home placements for children and elders, as well as to nanny and home health agencies for in-home placements for children and elders, as well as to nanny and home health agencies for in-home placements. But in 1998, the organization evolved at the request of Citigroup, which was using the service for its employees in the New York City area.

    "Citigroup knows that many of its employees used family and friends for backup care and wanted to be supportive of those arrangements," Weagraff says.

    "Much of this care is a day here and a day there," Weagraff says. "People want care they are familiar with." She says that people find it easier to ask a neighbor or even their own family members to help them if they can tell them that their company will pay them for their services. Now all Just in Time Care clients offer this option to their employees, and 75 percent of the care arranged by Just in Time Care is provided by friends and family members.

    In its first year of operation, Just in Time Care arranged 1,473 days of backup care. In 2004, it arranged more than 28,000 days of backup care, according to Weagraff.

    In 2004, Just in Time Care reported that it saved 19,861 workdays for the approximately 100,000 employees eligible to receive its services.

    Employees are urged to enroll in the program "before they realize they need care" and to think through their potential backup care needs, Weagraff says. Just in Time Care helps them identify providers that meet their needs and urges employees to check them out ahead of time. Although Just in Time Care used to prescreen the providers that it recommended, it no longer offers that option, she says. Employees can use the program even if they haven’t pre-enrolled by calling the Just in Time Care hotline, which operates 365 days a year from 5 a.m. to 10 p.m. In addition, an answering service will beep a customer service representative during the night when needed.

    Employees choose from the options that Just in Time Care identifies for them and fill out an invoice form so that Just in Time Care can reimburse the provider for the company portion of the care.

    All of Just in Time Care’s clients choose to subsidize at least 80 percent of the cost of care, typically up to a per-employee cap of $300 a year.

    Employers contracting with Just in Time Care pay an annual fee based on total employee population. This fee covers enrollment, employee publicity materials, the cost of referrals and comprehensive extensive monthly usage reports, Weagraff says. By multiplying the number of workdays saved by the cost of a missed employee workday, employers can determine their return on investment, which Weagraff says ranges from 2-to-1 to 4-to-1.

    PIP’s Marcus concurs, noting that "the expense of providing backup care is minimal, and the return on investment is almost immediate." She added that in-home backup care fills many gaps in a way that is "more responsive, more flexible and much less expensive" than on-site backup care centers.

    Ceridian, based in Minneapolis, soon will offer a more do-it-yourself approach to locating backup dependent care. Customers of Ceridian’s employee assistance programs and work/life services will have access early next year to an online service that can identify caregivers resources across the country.

    Employees will be able to access the data in the Backup Care Locator at any time, says Jean Holbrook, director of product management for Ceridian in Boston.

    The database includes more than 20,000 entries nationwide, and, although it is "more robust in some areas than others, it is a pretty comprehensive service," Holbrook says.

    Employers will pay no additional fees for the Backup Care Locator, which is integrated into Ceridian’s EAP. Subscribers to Ceridian’s EAP or to its work/life services pay an annual per-employee fee that ranges from about $8 to $32, depending on the size of the organization and the scope of services being provided, Holbrook says.

    In addition to the Backup Care Locator, Ceridian offers another service called Just in Case, which reimburses employees for their backup care. "The locator ties into the Just in Case service very nicely," says Holbrook. Just in Case is not included in the standard EAP package and does have a small management fee, she says.

    Cerdian worked with Just in Time Care to develop the locator. "Just in Time Care owns the data; we own the Web platform that provides the access to the data," Holbrook says.

    The American Business Collaboration funded the program, which is already available to its member companies. The ABC works together to invest in dependent care programs and services and includes Abbott Laboratories, Deloitte & Touche US, Exxon Mobil, General Electric, IBM, Johnson & Johnson, PricewaterhouseCoopers and Texas Instruments.

    The Backup Care Locator currently is available to the funding companies. Starting in January 2006, it will be available to all Ceridian EAP and work/life customers.

From the June 20, 2005, issue of  Business Insurance. Written by Sara Harty.

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