Is It Time To Freak Out Yet?

I get stressed out sometimes about the silliest things, things which should really not bother me at all, things which should not matter, do not matter, in the long run. Right now I am freaking out about "self-managed care", a different model for home care than I currently use. Basically self managed care is where the Alberta Health Services determines how many hours of care you truly need each week, then gives you funding for those hours based on an hourly rate they determine. Then you go out and hire your own care workers based on what you believe to be your needs. If you use less than the government funding, you give it back. If you use more than the government funding, you pay it out.

What this method does for government is lower their costs. They pay the person needing care less than they would pay a caregiving agency. Theoretically I don't have all the overhead of an agency, plus there is an expectation that some of the overhead would simply, and magically, vanish if the task of it all is given to me instead of an agency. What this does for me, or the other clients in my situation, is to provide control and consistency over caregiving. I decide when I want care, how much I want up to the government approved maximum, and I arrange care with my own, privately hired caregivers.

This is a thinly sliced sandwich, all depending on the amount of hours the occupational therapist from AHS Home Care decides I need each week. Remember too that this is a 7 day week, not a 5 day week. In theory I take that budget and see if I can get the care I need. These days I am considering a live-in care giver. This will entail me interviewing, selecting, hiring and training someone. There is no compensation from AHS for this process. It will also require forming a corporation to pay the person, or hiring an agency to do that work. I will hire an agency, a bookkeeping firm likely, and have them take care of all payroll issues. Of course that will cost money, money that must come out of the hours allotted to me each week.

The hours allotted to me will not necessarily be the same as those allotted under the Care Agency model, the way things currently work for me. They may be more. I don't see any way there could be fewer hours granted to me; my care needs are constantly increasing. Nonetheless, it all depends on my assessment, happening on February 23rd.

The rational me says "Don't worry. Make your decision once you know the numbers." Of course the irrational me, the one which wins most of my internal battles these days, says "There are so many things that could go wrong. What if they assess me for fewer hours than I need? What if they assess me for less than the cost of a live-in? What if, somehow, they decided I am already getting too much care and decide to reduce my care level from the agency?" And so on, and so on, and so on...

There are plenty of other things for me to worry about here, places where I can allow anxiety to take over, something happening more and more. The hiring process, arranging the payroll agency, hiring for coverage on days off for the live-in; the list goes on and on.

Back to the rational side. Live-in care will likely cost about $2,500 a month. Extra costs associated with that will likely cost another $300 to $500, more likely the $500 figure. Then there are the statutory and weekly days off. Home Care live-ins only get one day a week off, but they also get the typical statutory holidays, usually one day a month. So I need funding for another 6 days a month. Then there is a sick day allowance of another 2 days a month, although I don't know if that is required under provincial law. Bottom line is I likely need another 8 days a month of coverage. Each of those days is expected to be 12 hours, but with only 6 or so hours of support; this is a likely cost of $120 to $150 per day. So that means I need a minimum of $3,000 + $1,200 in funding.

Now take that $4,200 need and divide it by the mysterious AHS funding rate; let's assume, for shits and giggles, that the funding rate is $15 per hour, the current minimum wage in Alberta. That means I need to be approved for 280 hours a month, or about 9.3 hours per day. Right now I get about 4 hours per day. At that rate, it's not going to happen. On the other hand, if the funding rate is $18 per hour the hours per day become 7.7 hours. And so forth.

It all depends on three mysterious factors, as yet not fully explained. How many hours per week will be included in my assessment? That I will likely find out in a couple of weeks. How much an hour is the funding level? That I will also likely find out in a couple of weeks. And finally, how much will it cost, all in, to get live-in care plus appropriate coverage for days off? That remains to be seen.

So. All I get to do now is freak out, stress out, and generate anxiety over all this. I hate this fucking disease.