Lets Talk Visit Minimums
If you are interested in the Client Directed Home Care Invoicing Program, its likely you have heard the term “Visit minimums”. A visit minimum refers to the shortest amount of time a caregiver can be scheduled for any one visit. For example, if an agency has a 3 hour visit minimum, the shortest shift you could book with a caregiver would be 3 hours in continuous length. Agencies that are part of the invoicing program in Alberta can range anywhere from 1 hour to 6 hours for minimum visit lengths.
You may be wondering why visit minimums exist. Its time to de-mystify visit minimums, let talk!
Labor Laws
Alberta has homecare worker specific legislation. This legislation requires that Caregivers be paid for a minimum of 2 hours of work for each period of employment throughout the day, even if the working time was less than 2 hours. (For a full review of the caregiver specific legislation click here)
All agencies are bound to this legislation and staff cannot choose to decline these minimums, nor can an agency choose to dismiss them.
Traditional Model
Clients who are part of the traditional model of home care are not subject to visit minimums, and this is due to the models design which bundles client care in geographical service areas. Agencies in the traditional model are able to assign workers to see many clients within a community guaranteeing that staff will meet this minimum with quantity of work. This benefit is incredible for clients with short care needs, but does come at the cost of choice and consistency.
When care is bundled this way, it means visit times cannot be specific, and choice of caregiver cannot be guaranteed. Bundling care means your visit time is tied to the visit times of other people. It means your caregiver is tied to multiple clients and care is prioritized by medical need. Your preferences just cannot be incorporated without disrupting care for others.
Lets look at this practically.
Imagine you have care scheduled daily from 0800-0830hrs (Homecare’s most requested time slot!) but the agency who has your care just got a new client from AHS that needs care at 0800hrs because they have a day program to attend and must leave on the DATS bus. Your coordinator is going to have to move your visit to 0830 to fit that new client into the schedule. But not just your care, your coordinator is now going to have to shift EVERY client in that caregivers schedule for the rest of the day, by 30 minutes. They may even have to re-assign you to a new worker if there are other visits that cannot be moved due to medical reasons. This happens frequently, and despite the best efforts of coordination and care teams at agencies, it can often feel like a loosing battle trying to provide consistent care in this model.
Another quirk of bundling care is that the care is task based. If caregivers have completed all the tasks on your care plan, they can move on to the next client and are not required to stay for the full shift length. However, they will still be paid for the visit as it was scheduled. In my experience this incentivizes rushing. Some agencies also practice overlapping visits, which means scheduling multiple clients for the same time slot. This practice makes scheduling easier for their Coordinators, but managing workload extraordinarily challenging for caregivers.
I would like to note that often caregivers in the traditional model feel they have no choice but to rush, as their schedules are sometimes so packed they are overlapping. It would not be fair to blame a field staff for something that is fundamentally a systemic issue of the model
Client Directed Model
In the client directed model, we do not bundle care. We work with families to recruit and retain a caregiver for them who meets their specific needs including their visit time preferences. We are able to accommodate families requests for changes in visit times because the caregiver you are have is not typically scheduled for back to back visits. Our model is also not entirely task based. While our care plans do include regular tasks, staff are able to take initiative to help with additional tasks, socialize with the client, and are not incentivized to rush. Unless you request it, staff do not leave prior to their visit end time.
At ember we have a two hour visit minimum for our clients because your caregiver(s) are your own. This model is really tailored towards quality rather than quantity, and a two hour visit minimum meets Alberta’s labor standard.
Visit minimums can certainly be a drawback for some families if they have short or frequent care needs, however it is important to understand the “why” when pondering their existence in the space. For those who want their caregivers hand selected, value connection and care that is on your schedule, we cannot bundle care.