Miriam Allred (00:00.92)
Hello and welcome to the Home Care Strategy Lab. I'm your host, Miriam Allred. It's great to be back with everyone today. Today in the lab, I'm joined by the lovely Debbie Miller, who is the CEO of Senior Helpers in Franklin, Tennessee, and also the founder and CEO of 52 Weeks Marketing. Debbie, thanks for being here today.

Debbie Miller (00:22.277)
Thank you, Miriam. It's so good to be with you.

Miriam Allred (00:25.376)
You and I have spent a lot of time together, but it's been a couple of months and you are busy and thriving and running several businesses. And so I thought we've got to catch up and hear about kind of the latest and greatest for your businesses. So before we jump into the topic, some, some listeners may not know you as well as others. So I love to have you share your background about what you were up to pre-home care and then starting your own home care business.

and then the following businesses that have kind stemmed off of your own experience. So let's start there.

Debbie Miller (00:59.845)
Sure, well thanks very much for having me. am always...

I love getting together and having a chat with you and certainly sharing some experiences that I've had in home care. Prior to home care, and first and foremost, I am an agency owner, started Senior Helpers in 2008, started from scratch. I think we opened the doors with 10 caregivers and we now have almost 500 caregivers. But before that, I worked as a product director for a big pharmaceutical company. So worked in big pharma.

supported, gosh, hundreds of reps across the country. I worked on huge brand launches like Celebrex, of you are probably aware of, lines of home women's health care and arthritis medications. So what was awesome about that experience though is I really learned about how to target and how important targeting is and reach and frequency. So reaching the right people, seeing them often enough and

influencing them in a way that kept our phone ringing, right? In that case it was for our drug being prescribed in the home care space, it's our phone ringing for our services. So I was able to apply a lot of that experience to the home care business. When I started I was out there pounding the pavement like many of you myself for the first two years before I hired my first marketer. But during that time I was able to create the 52

52 weeks methodology and system and to this day we use it, my team uses it and now many many other home care owners across the country are using 52 weeks as well. So it's been quite a journey and as you said I've been able to parlay a lot of that experience from my home care agency into businesses like 52 weeks and we'll talk a little bit about Helper Heroes as well which is our latest endeavor, very exciting.

Debbie Miller (03:05.107)
because as we are supporting agency owners across the country, we start to see what their pain points are, the same pain points as we've had. So as I've resolved some of these issues, then we're able to bring new solutions to folks out there experiencing the same kinds of things.

Miriam Allred (03:24.364)
You and I are always drawn to each other because we're both educators. You and I both take a very education first approach and you are just incredible at sharing firsthand experience, the good, the bad, the ugly of your own business with other owners, which I think is so powerful. And traditionally, I think most of the times that I've interviewed you or we talk, we're talking about the boots on the ground sales. That is your bread and butter. You've done it yourself. You've trained your team. You're helping hundreds of other home care businesses implement that methodology.

But today we're going to shift gears a little bit. You yourself have introduced virtual assistants, VAs, to your home care business over the last year or so. And I'm fascinated by that. I see a lot of companies kind of tinkering. I see a lot of VA companies coming on the scene. It's kind of up and coming right now. And you told me that you currently have seven virtual assistants in your own office. And I thought, let's dig into that. I want to hear the good, the bad, the ugly of implementing this inside of your own

business. So that's what we're going to focus on again, which is kind of a different topic for you, but also very top of mind and very relevant. So let's get into it. I want to just start by setting the stage and share with everyone how many office staff you have without the VA's and then about how many weekly billable hours your home care business is doing.

Debbie Miller (04:26.833)
Thank

Debbie Miller (04:44.323)
Right. And I will correct you on something, Miriam. I've been using offshore workers or virtual assistants for about three years now. So I've had a lot of experience, the good, the bad and the ugly, which we'll talk about. So just wanted to correct that. But I am billing about 8,000 hours a week.

Currently, have about 25 full time employees in our office to part time and then seven virtual assistants. we've gosh, you know, bolstering our infrastructure at a much reduced rate has been such an incredible opportunity where we've been able to take so much of the weight off some of the shoulders of our of our staff with on call, which will

talk through. But it's been, it's been where we are now is we're in a very good place. We're in a very stable place. But it was a little bit of a walk rocky road to get there. So I'll share some of the things that we've learned for sure along the way.

Miriam Allred (05:52.48)
Yeah, let's talk a little bit about three years ago, what was the initial thinking? Were you exposed to VAs via some other business or some other industry or did someone on the team say, hey, we should try this? What was the initial starting point for you all looking into VAs?

Debbie Miller (06:12.017)
I actually, I think we got cold called.

by an agency that did the staffing for virtual assistants. And I just, I loved the concept because of the cost savings more than anything, but also at that time, which was just after COVID, we had a very hard time getting a solid team and that actually wanted to work in the office because we had so many people that kind of got used to

working from home and when you want really we started to reel people back in it was really hard we had a lot of turnover in our operational staff and it caused a lot of issues of course you know it's really hard to when you don't have a consistent staff your clients are upset your service goes down caregivers aren't happy you know the recruiting was a whole other situation which the VA's really helped us with

that as well. anyway, so my main issue was the wage inflation that we were dealing with.

every time we lost somebody when we went to rehire, they're wanting five, seven, ten thousand dollars more a year, just in a matter of months. So it just became so unaffordable to really build the infrastructure that we needed for our size. So we needed to do something and so started working with the first agency and we had, know, there's as much training that goes into on

Debbie Miller (07:54.692)
onboarding a virtual assistant as it does if you're hiring somebody in your office. So we would invest all of this training and then we were seeing as much turnover with our virtual assistants as we did in the office, which was really frustrating and it defeated the purpose, which was why we offshored in the first place. So we had to really resolve that. and so we had, again, just a lot of ups and downs. We,

invest all this time. We would fall in love with this person. They become, you know, really part of the team. And the next thing you know, they've got another opportunity.

And so when I really got to the bottom of what was going on with the agencies and then we started working with some other agencies, that particular one that we started with was sourcing talent from Columbia. And then we started working with folks that were sourcing from Africa. And we've also worked with people that are sourcing from India. And so we kind of ran into the same kinds of issues.

with a lot of turnover. We had some issues with people not very happy with accents, that kind of thing, because it's an adjustment, right, for people to...

in this space in particular, where we're just, it's not a common thing, it's getting more common obviously, but it wasn't a common thing to have somebody that wasn't there in the office answering the phone and dealing with issues and things like that. So those were some of the things that we were dealing with.

Miriam Allred (09:36.19)
Okay, a lot to unpack here. And I love how honest and upfront you're being because we're going to talk about language and country and culture. Like those are huge factors in this equation. And so we're going to talk a lot about each of those. Let's talk about your seven VAs. I want to actually start here because I'm so curious exactly what each of them do. But first, just answer like who, what was your first VA?

hired to do? Was it scheduling, billing, after hours on call? What was your first VA hire and what were they doing?

Debbie Miller (10:10.961)
We actually hired, we hired two right out of the gate recruiters.

And why we did that was because it was, and by the way, before we hired the two VAs, we had four people working in HR. So we streamlined our whole process and worked with, we implemented an engagement platform that had less human touch points using technology, which streamlined the whole process to begin with. So there was a combination of

technology as well as offshore workers. So what we did is and as a result, we were able to go from four full time people to two virtual assistants. So you can imagine the significant savings, wage savings there. But also what happened was when you have folks that are just focused on these tasks, not being pulled into these other areas, putting out a fire over

here or that, but they're where they are, they're working from where they are and they are just solely focused on interviews. would, we do back to back, every 15 minutes we're doing interviews and they're able to do that because the minute they start, they get on the phone, they hit the phone and it's a go versus when your staff comes in, they talk to somebody, they get a coffee, they do this, they, you know, then there's some sort of fire over here and everybody starts

brainstorming on how to fix this and then what happens two hours go by and we haven't been recruiting. So that completely changed where we now are using a technology we start interacting with applicants and then this whole calendar is filled up and somebody's got to be managing those and so we have two people that are just doing that and so that that went well the accent was a problem.

Debbie Miller (12:14.993)
We live in Tennessee. We have a lot of southern folks and they really struggled with understanding that at that time our recruiters were Colombians with very heavy Spanish accents. And so what we did is we over time we moved to sourcing from the Philippines and the accents of the folks not only that they were

they were able to really problem solve. The task of a recruiter is a real sales position. Now you're selling them into your company. You're trying to recruit them. They may be working for several other agencies. So it's sales position. And the Filipinos, they were a little bit more strategic. They could kind of read between the lines because they're very Americanized.

TV, they know our idioms, were able to think on their feet. And I would say they're literally like, they think like we do.

That's my only way of trying to articulate it. Where other cultures are very different. They maybe wouldn't push the envelope a little bit like Americans will. Like, well, you know, we'll kind of not be pushy, but take it to the next step. Like, you know, try to really lure them into, no, hey, you sound like the perfect candidate for our organization and be able to do that versus just reading a script.

Miriam Allred (13:57.795)
Mm.

Debbie Miller (13:58.374)
which is what we had in the first round. So we have the two recruiters and we still have them to this day. And then we hired the schedulers. So we hired a team of schedulers since we were really struggling with keeping schedulers in our office.

And so that was, you know, and we just had some ups and downs with that. Again, you know, not not being able to retain them. Obviously, we all know how challenging scheduling is. Some could really grasp it. And so it's it's a, know, you've got to find the right person. And if it's not the right person, let them go quickly and move on.

So even though you may have invested, like what we would do is do a trial run and you really test the person out. Have them hear a couple of calls, answer a couple of calls. Make sure that that was a good fit for us. But where we really struggled and what we really did, when I did some analysis and did some digging, the reason that we weren't able to retain the folks was because of the wages that they're

by these agencies. They're paid very very low wages. Like I'm talking sometimes a hundred dollar fifty to two dollars and fifty cents. So anytime another opportunity came and they work across many different verticals, business verticals, so there's a lot of opportunities. There might be a bank, there might be a call center that is competing with us. There might have been, there were a lot of technology companies that were

grabbing these people and even maybe offering 25 cents more, 15 cents, 25 cents more. When you're less than two dollars or making two dollars an hour, that's a big deal. So when I discovered that and understood why, you can't blame them for going to another opportunity, right? But that really registered with me from a long-term standpoint, this is going to be an ongoing problem.

Miriam Allred (15:52.526)
Mm-hmm.

Debbie Miller (16:09.677)
So when we, when we'll talk about Helper Heroes we took a completely different approach and a completely different model so that the virtual assistants get most of the money. Most of the money is going to them so that they never want to lose their job. They want to stay with you and grow with you and be this longstanding employee. At the end of the day, they want to be with an American company. That's what we've learned, especially with the Filipinos. They love this. They think of themselves as quasi-American.

So to work with an American company is seen as a real privilege. And when they're able to make fair wages, wages that put them at the top of the wage bracket in that country, it changes lives.

So it's kind of a win-win. But it took us really understanding. that's something that I would recommend that if somebody is considering hiring an agency to staff a virtual assistant for them, what are you paying? What wages are you paying? They don't like to talk about it. But at the end of the day, it's something they'll answer if you really push them on it.

Miriam Allred (17:21.27)
Okay, let me ask a couple of questions. So you mentioned that the you started with recruiting, that was a function that you needed help on. You mentioned having standardized kind of your SOPs before bringing in the virtual assistants. That sounds important, like an important part here, because if you bring a virtual assistant into kind of a messy operation, where things are already a little all over the board, they're going to come into that chaos, and they're not necessarily going to be able to move the needle if things are kind of haywire. So it sounds like that's an important

prerequisite to bringing in a VA to be effective as you need to make sure that that area of the business at least is streamlined, organized, has like a very standard SOP that the VA can come into. I want to ask about the scheduling VAs specifically. So you said you brought in, I think, two VAs to help with scheduling. Were they supporting other schedulers that are in the office? Yes or no, it sounds like a yes.

And then are their roles the exact same or the VA schedulers supplementing some of the existing responsibilities of the in-office schedulers?

Debbie Miller (18:27.505)
Good questions. Our goal was to, I mean ultimately if it had worked out, my thought was we're gonna offshore all scheduling.

and then have client service managers in the office that could go out to different, know, go out to homes if they needed to. But my ultimate goal was to offshore at all. So we started with two, and what we did is we broke our business into two zones. So I have a pretty vast geography, and so we would have say two territories in one zone. Think about it that way.

office person was the lead over the zone and but they would work together as a team. So but my ultimate goal was we would probably get to the point where you know we would and we were always training somebody so so there was always this floater kind of thing and you know so we could plug plug another person in if we had to.

We didn't get there. We just couldn't get there. And so what we ended up doing was bringing in, we now have three full-time schedulers in our office. Now part of the reason that we couldn't keep a scheduler was because of the on-call portion of the job, which is in my case, because we're a large organization, it's a pretty big deal. Weekends are nonstop. And so what we ended up doing,

was we streamlined our whole approach to this. Had three full-time people. We still have our zones, but we have two now two scheduling coordinators that are answering the phones that are dealing with quick the call outs that are watching the dashboard and responding to any say late folks or no call no shows and things like that so that our schedulers can focus on scheduling our new cases, our clients service

Debbie Miller (20:30.739)
client and caregiver management. So they're kind of dealing with all the fires, the two folks that we have right now, and then our schedulers are managing the scheduling, the new clients and all of those kinds of things. What's really amazing is we have three people that handle all after hours and on call.

So our staff are absolutely off after when they leave at 4 30 they are off until the next morning and they don't have to do on call on the weekends. So how that that how we got to that place was first of all we trained everybody to be schedulers so everybody that's on call are really good schedulers. All right so they're trained they work as a very cohesive team with the daytime team and they've they're they're literally like

members. mean they feel like they're as part of the team as anybody in our organization as though they're sitting in the office next door. They are on our team meeting so what they do is between the three of them they will handle they start at 5 a.m. and they pass the baton to our scheduling team at 8 a.m. and they come back on at 430.

and there's straight through till 9 p.m. So this is really interesting. Well, what a lot of people do and what we did before.

when we had our on-call team and we struggled with this, like why can't we get this on-call team to be a solid team and to really take the pressure off our folks? They would be constantly calling because they couldn't deal with things. Well, what happened was when you're staffing 24-7, a lot of these agencies will have four people dedicated to you, working four, six, eight hour shifts. So they never really get to know the clients and the caregivers.

Miriam Allred (22:27.971)
Mm-hmm.

Debbie Miller (22:28.505)
right? Like somebody who is a true scheduler.

So what happened was instead of paying somebody 24 hours to man my phones, when I did the analysis, we never got calls. Our last shift ends at 7 p.m. So strategically when you're thinking about this, look at your phones. When do you really get your issues? They're gonna happen typically before that last shift. If there's a call off, you gotta deal with it. So our last shifts in our case end at 7.

Sometimes we have an 8 o'clock or whatever and we would probably change. We have a lot of 8 o'clock or 9 o'clock. We may have to change this, but we would stop our our on call goes off at 9. So we've got two hours in there. If anybody called off or any issues for that 7 o'clock shift, they're dealing with it. If somebody calls to call off for the next day, typically they'll call before 9 p.m.

So they end at nine and then we just for any kind of emergencies we have a phone answering system, service, like an answering service. Very, very reasonably priced versus paying somebody 24 hours a day.

It's not necessary when you really do the analysis. But they're dealing, they're getting on early enough at 5 a.m. so that those 7 a.m. shifts, any call-offs, they're dealing with them already, they've already got them staffed. So by the time your staff gets there in the morning,

Debbie Miller (23:58.958)
all of those things have been taken care of. They get a debrief and report of what happened and then the day staff go on with their day. So this happens during the week, after hours, and then on weekends as well. In my case, because of my volume, we have two full-time people on Saturday and Sunday. So that's how the hours work. between the three of them, they're doing after hours and weekend and they overlap. So somebody will get on at five,

and leave say at two, somebody else start at seven and leave at nine kind of thing. it's...

It's really looking strategically at where the issues are, even on the weekends. When are the bulk of the calls? You might need two people, maybe you have two part-time people on Saturday and Sunday. However that looks for you, that's the way to think about it. But our goal was to alleviate the pressure on our daytime staff, and since we've been doing this, we have had no turnover on our scheduling team.

They love it, they love their support team, and life is good. Life is a better place than scheduling now.

Miriam Allred (25:09.294)
I love how analytical this is, Debbie. This is why I love talking to you and people gravitate towards you is because you know how to look at the numbers. You know, I think a lot of businesses think we need someone in office during our working hours and then we'll just have that, that answering service for the remainder of the hours. But I love how you've broken this down to the next level of VA's in office, VA's and then answering service. It's like,

It sounds complex, but the way that you've broken it down makes a lot of sense and it sounds like everybody's happy. It's working really well.

Debbie Miller (25:39.826)
It's a lot, it's actually a lot less complex because you have fewer hands in the pot.

Miriam Allred (25:48.643)
Mm-hmm.

Debbie Miller (25:49.358)
and they know their on-call team. The caregivers get to know them. There are VA agencies that have a rotation. So you literally never know who you're gonna get. They might be sharing a virtual assistant with five, eight different agencies. So you don't get to know them and they don't get to know the caregivers and the clients. And that's been my experience firsthand. Our clients and our caregivers

do not know that the people answering the phone are not in our office. They have no idea.

Miriam Allred (26:24.046)
And you're you you're kind of citing this but you're alleviating so much stress of your in office team. I love that early morning VA shift that is already tackling issues already thinking ahead already being proactive before the day actually starts because I hear so much from office teams they come into the office and it is just like boom boom boom fire after fire and it's just like

Debbie Miller (26:35.942)
Yes.

Miriam Allred (26:51.028)
so hot and heavy for like the first several hours of the day, but I imagine those VA's alleviate a lot of that stress so the people coming into the office to start their day can breathe and kind of look at things and assess things before they really have to get into it.

Debbie Miller (27:05.683)
we've had schedulers to say, I can't even take a shower because the phone hasn't stopped ringing until the rest of their teammates get there. Then they shower and get in the car. Like they're literally stuck at home till 10 o'clock until we were able to get on top of it. That doesn't happen anymore. I mean, they come in, everybody's happy. It's a high five kind of environment versus a dread to go to work environment. And we don't want that for our people.

Miriam Allred (27:08.814)
Thank

Debbie Miller (27:34.051)
I mean, it's in burnout, high, burnout. And it's no wonder people don't stay.

Miriam Allred (27:40.362)
Yes, exactly. We both know there's so much burnout and so much turnover in that scheduler seat. And so we've got to find creative ways like having virtual assistants assist them so that they can feel confident and happy and be successful in that role and not burnout and be turning over in six months or a year. The last, the last I think bucket of VA's you do have some helping with billing, correct? You actually you do a lot of LTC and VA.

Debbie Miller (28:04.623)
Yes.

Miriam Allred (28:08.928)
And so you have designated VA's that help with billing. Can you talk a little bit more about that?

Debbie Miller (28:13.861)
Yeah, we actually have a full-time VA that does our long-term care billing. That's been a real focus for us and growth opportunity for our business. they do and it's getting more complex dealing with these carriers, these insurance carriers. They're getting so much more demanding. They're now, you know, they have each one of them has their own portal and their own way of for us to submit the documentation to them. And so it's a full-time.

job just trying to keep that all straight. And of course on the agency side we want to take a lot of that burden off our clients by providing that service where we're communicating with, whether we're doing an assignment of benefits or not, you certainly want to be submitting the paperwork and doing everything on your part so that your client gets paid in a timely manner. Well that's easier said than done.

it is one person's full-time job to be sure that we're submitting those time sheets, that everything aligns with the care plan and is in accordance with the way the policy is written. Otherwise, we could get some delays and our clients can get, the payments can be delayed. So it's really a great opportunity and it's, you know, with what we're able to pay them, it makes a lot of economic sense.

to have somebody dedicated to doing that versus either burdening your finance person or yourself. A lot of owners were doing this and this is like a big challenging job, especially as you grow in your number of insurance clients. again, VA, just a piece of the billing you can take off your billing people and they can handle it. So we're able to do all of that with one person.

Miriam Allred (30:06.84)
was gonna ask wow so I was gonna ask do you have a CFO and anybody else that's touching billing or what is your billing team look like

Debbie Miller (30:16.163)
Yeah, we do. We have one one person that that's doing everything else.

Miriam Allred (30:22.592)
Okay. So just two people, it's kind of the main and then the VA that is doing, sounds like kind of a lot of like the legwork, the manual paperwork claims, checking in on shifts. Okay. Yeah, this is.

Debbie Miller (30:27.333)
Yes. Exactly.

We have one other person that's in there that has to do with Medicaid that's very specific to Tennessee. It's actually changing in August. We're so excited. We had four managed care organizations, each with their own EVV system.

So it meant our caregiver signing in on say WellSky and having to know three other EVVs. So there was a lot of confusion. So we had one person dedicated to just monitoring all of those dashboards for our Medicaid piece of the business. And that goes away in August and we are so excited.

Miriam Allred (31:08.43)
I think a perfect topic to segue into is training these people because that is key. I'm thinking in my head, getting this VA up and running on LTC and VA, that is super intense and a lot of headaches for your even in-office people. So let's talk about training. What didn't maybe work so well that you tried at the beginning and then how has your training process evolved and what are you guys doing now that's working well?

Debbie Miller (31:15.205)
Yes.

Debbie Miller (31:38.116)
You said it earlier, it's a clearly defined process. and scheduling is tough to, you know.

for workflow, you're really documenting. And the more documented it is, where they can refer to a document, the better it is. Like, okay, I have a call off, check one, I've got to call the client and let them know. You know, and all the steps. you know, having all of those, that workflow in a document is very, very helpful. Clearly defining their role and articulating what you're

expectations of them are. I did a video when we first started with our VA's to tell them about who we are. I just like recorded it, some PowerPoints like who we are as an organization, what's important to us, what's important to clients when we're talking to them, what are the motivating factors that are working behind the scenes. Same with the family, totally different factors, right? They have different issues, different things are going to be important to them.

And then the caregiver as well. So what's important to your caregiver? What do you want to avoid saying? They're very non-confrontational. Like I would share with them the caregiver persona and then how to deal with that and how to talk to them in a way that's going to support them and not to alienate them. Just so they feel like they're, just the best communication skills as possible.

So all of those like things that we might take for granted are going to be really important to instill in them.

Debbie Miller (33:24.409)
So clearly defined process, helping them really understand the business, home care in general, and all the customers, the customers being your client, your family, and the caregiver. And then holding them accountable. When you set the clear expectations, be checking on them, like you really need somebody managing them and making sure that all of the, everything is being satisfied. But when it comes to the,

training piece. That's what we really had to learn, like virtual training. And we've gotten really good at it. In our operation, we use RingCentral. It's mainly like, it's just like Zoom, where we have them on the call just like today. And we're showing them and sharing screen, we would have them working alongside our schedulers, day in and day out for like a good couple of weeks so that they're just watching, listening,

Miriam Allred (33:59.342)
Mm-hmm.

Debbie Miller (34:24.419)
hearing how we handle because every day in scheduling is a different day in scheduling like You cannot share the scenarios on a document

It's like, it's just repetition, repetition until they, okay, yeah, I remember when that happened that time when, you know, the caregiver's car broke down and we had to schedule an Uber or whatever it was. I mean, every day is a new scenario that has to be problem solved and resolved. And so it takes time. And that would be a major recommendation that I would make to have really

have your expectations where you're going to invest like it for a scheduling role. It's a good month of investing in training at least.

So that's something that you want to factor in. That's going to be an additional cost as you're working in training them alongside you, your scheduler, or whatever it is. But to truly have somebody who can lift that burden off your folks, they've got to be able to rely on them and they've got to know as much as they possibly can. being prepared to do virtual training, record the training and then send them the recording.

very good at referring to recordings. That's a really good way for them to learn. if you could train, know, if you're say you're going to train them on your operations system, WellSky as an example, do little video clips and then then and you know create a library so that when you hire your next person you've got all that ready to go.

Debbie Miller (36:06.021)
and it'll save you time. So you only want to invest in training once, record everything so your next training is going to be so much easier.

Miriam Allred (36:14.316)
And it sounds like your existing team was the one doing these kind of ring central meetings with them. I'm curious, this was new to those team members. They probably hadn't trained VAs before. Was there any kind of grumblings or gripes or anyone that was kind of pushing back against it? And if so, how did you deal with that? Or was your team kind of excited to offload tasks? I'm just curious what your office team thought about this process.

Debbie Miller (36:43.853)
it was onerous for them. yeah, especially because we had so much turnover. And then it was like, my goodness, back to the drawing board, here I go again. So that's when we got smart about doing the recordings. And also we had higher level trainers get involved earlier.

So that by the time they got to the schedulers where it was really getting down to the everyday nitty gritty of doing the job, they had a much more basic understanding like they would do, we would do a well-skied training. And you know, we have a particular person in my organization that was really good at that, like is a really good trainer. Not all your schedulers are gonna be the best trainers. So you'll find over time who the good trainers are. Initially though, they're excited because they want the support. They want this person.

to be successful because they're going to be either their potential teammate or they're going to be covering for them when they're not on. they become their advocate and they'll want to invest in that because at the end of the day it's going to help them. So helping them see that is going to be helpful too. You don't want them to see it as a threat. That's important.

So that's something to articulate look I you know I'm investing in this person to support you You you may even if they're a good manager type You know you'll be managing them they they will like they that's kind of music to some people's ears other people not good managers So you you got to know that hey is this person going to be a good manager? because You don't want to

You don't want it to impact the virtual assistant in a negative way either, especially if you find somebody that's fantastic you want to To in to you know make them as excited about being part of your team as you are having them so So that's something to think about you and be be watching how the training is going I mean as an owner if you have the time, it's great if you can do that Know who your trainers are within your organization may take you

Debbie Miller (38:53.095)
It may take you a minute. We've got it so fine tuned now that and again the recordings have really really helped us

Miriam Allred (39:01.334)
Are you doing a daily standup with the VAs and your office team? Or what does kind of like your meeting structure look like that includes them?

Debbie Miller (39:10.501)
Yes, and we have weekly meetings that they attend. Also, we have a dashboarding meeting that the scheduling coordinators will be part of. We have a business development meeting that we have on Mondays. We review all of our incoming clients, new clients, how are they going, they're involved in those. And then the morning pass off meetings. So we have two meetings a day. They're present during the morning meeting, the first morning meeting, and then the afternoon meeting. Again, they're passing the baton back.

to them. So it's sort of like a full loop. We close the loop with them, how the day went, what they need to know going into the evening. Maybe there's open shifts that still haven't been filled that they're going to continue to work on.

Miriam Allred (39:49.452)
Okay.

Miriam Allred (39:56.598)
Okay. And accountability is such a key factor here. It's important with people in office and virtual assistants, but keeping people accountable and giving them metrics that can be tracked and measured and then improved upon. Are you tracking like accountability metrics in WellSky or do you guys have a spreadsheet or a separate tool or how, does everyone keep track of kind of those accountability metrics?

Debbie Miller (40:20.517)
Well, we were...

One of the things is the calls. In Ring Central, you can monitor calls. You'll see, we know how long our call, anybody's waiting for a call. That's a key metric is, you we've got to get that call within three rings. that they were able to handle the call, right? If they weren't able to handle the call, what training do you need so that you don't have to pass that call? Because then that's taking time away from the scheduler. So anything that you weren't able

to handle, they'll document so that we can do further training and we were literally training them on things every single day in that first month. This came up, I didn't know, I didn't know really how to to deal with that or if a call came, if a transfer had to come to a scheduler, they were documenting that. We're documenting any canceled shifts, that's a big KPI. If you weren't able to staff a case, why? And you know, we're looking at that.

We're tracking anybody that, bonuses, if you have to give a bonus, we don't want to give a bonus. So, you know, do you need some skills in salesmanship? Those kinds of things. Even Uber, you how are you handling Uber? So, one of the things that we do is with RingCentral, again, every single call that comes into our office is recorded and we're reviewing the calls. And of course, we have our client services managers who are talking to our

If there are any issues, we hear about them and we deal with them.

Miriam Allred (41:59.308)
Yeah, so just training, training, training. And the theme that I'm picking up is you treat them as if they were in the office. It's as in depth, as thorough, as integrated as if they were a new hire. It's just that they're in another country. But it's literally like you treat them as if you were bringing them on full time in house.

Debbie Miller (42:05.007)
Yes.

Debbie Miller (42:17.505)
Exactly, exactly. The more you invest, the more you get out. What I love is they're very, very bright. They're college educated. They're strategic minded. And that's what you want.

you need problem solvers, need people that are self starters, they can take the initiative, they can make decisions. When we were working, particularly with the Colombians, they could not make a decision. They were so nervous, this is where I mean about culture. And so that's not helping if you have to call me. instead of me getting the call, you're calling me and not having to transfer a call. So that's not productive.

That's something that you really want to look for and hire for is folks and ask them to give you some examples of where they've had to make tough decisions. many of them are coming from other work verticals. A lot of what I like to look for are people that worked with new businesses, that were the owner's right-hand person.

There are a lot of people out there. It's really interesting. Different vertical, of course, but they wore a lot of hats. So, and of course, in our industry, especially with scheduling, it's very multitasking. You've got your call coming in, you've got to deal with this, you've got to call Mrs. Jones back and let her know, okay, so and so's coming in place of Mary, and you know, we've got to close the loop and then get on to the next thing. So it's, know, those are tasks that...

You've got to really hire for somebody that can handle a lot of that.

Miriam Allred (44:02.741)
Yeah, that's a really good point that you make. I'm thinking of like executive assistants, someone that's been kind of like a virtual assistant or an executive assistant to a CEO, meaning the CEO needs help and just wants to offload all of those other kind of manual tasks, calls, responsibilities. They would make really good home care VAs because that's the nature of home care. It's a lot of different tasks with kind of a fast pace that are just flexible and kind of all over the board. So that's a really good point that you make.

Debbie Miller (44:27.227)
Mm-hmm.

Miriam Allred (44:31.758)
I want to talk about pay. You referenced it earlier. You mentioned kind of the one to $2 an hour. To be totally honest, that's lower than I was anticipating, even just you saying those numbers. And you mentioned that you all will talk about Helper Heroes, but pay quite a bit more than that. Can you just talk a little bit about pay specifically? And you've worked with other agencies and so you know...

what you're paying them and you may or may not know what they're paying the VAs, but can you kind of break down some of those rates and explain why you all are doing the pay portion differently?

Debbie Miller (45:08.079)
Right, this is the biggest deal for sure. when we launched Helper Heroes, we...

created the model with this whole concept in mind that we wanted to have most of the pay go to the virtual assistants so that, you know, obviously you're going to be happier when you're making more. And if no one else is paying that, they're going to stay with us. yeah, when they're making $2 an hour. So our partner that we have in the Philippines, our business partner, Dylan and my business partner, her name is Selby.

for years, like I'm talking 10 years she was a virtual assistant with several different agencies. she was, the most she made was $2 an hour. The most she made, this woman is an engineer by trade. She is the most.

organized, process-driven, I mean she's fabulous for us as a partner, we're so blessed to have met her. And we met her because she was actually looking for opportunities privately because I think she just was tired of being taken advantage of this way. And she, I think, caught wind of what these folks were billing.

When she saw the you know tiny little fraction that that was coming to her I think she got frustrated and and did that so anyway, we connected with her and and so our model was we wanted to pay them a wage higher and we paid three to four times the the normal rate To where they're making the kind of money that you know high level professionals are making in the Philippines We sourced from the Philippines

Debbie Miller (47:02.803)
because of the things that I talked about, their accent is much more pleasing and more acceptable to our clients and our caregivers for whatever reason. think there's a sort of a sweetness to their voice. They're very, they sound really sweet and they're very helpful in nature. It kind of comes across in their voice for lack of a better way to describe it. again, because they are so Americanized, they just seem to

to gel much better with our culture and certainly my corporate culture. Seldie's culture that she's creating with the VAs in the Philippines is just like Dylan and mine.

You know, we're all about helping our clients. We want to be as involved as possible. In our case, we want them to be able to focus on growth and have the operations taken care of by a solid team that they can count on. And so the way that we thought to do that was let's pay them more. We make less.

We charge a flat fee, very, very affordable. It's not even any more than you'd pay for any other agency. We're just making less on the business side of things. Like these companies must be making billions of dollars when you think about what they're actually paying their poor VA. So it's worked out really well and what's amazing is people are flocking to us.

literally they're leaving other agencies and Selvi is non-stop interviewing and amazing talent.

Miriam Allred (48:42.08)
And I love that you call it Helper Heroes because if I, if I'm not mistaken, the hero component is you all are heroes to these individuals in the Philippines. You want them to have a high quality of life. You want them to make a livable wage. You don't want them making that bare minimum so that you're profiting here in the U S you want them to truly be.

sustained and happy and then it's a win-win. They're happy, you're happy and your business is thriving.

Debbie Miller (49:14.115)
It's a win-win for sure. They're your hero because they're helping you take off some of the load. But yeah, for sure. mean, we have stories every single week. I have goosebumps just as I'm talking about it of the lives that are changed.

through, you can imagine if you're going from $2 an hour to $8 an hour, what that means to somebody in that country. And every single day we have stories of people, we had a gal whose house was hit by a typhoon, something like five years ago, and they were just sort of piecemealing it back together over all those years. And in two months that she was with us, she was able to start literally re-

building her house. We have others where their kids are able to go to better schools. mean on and on. mean, and Seldie has weekly meetings with her team and she shares them and Dylan and I are just like, they were so excited.

Miriam Allred (50:15.062)
And we know the margins are tight here and the labor market is challenging. And so I just love the contrast of like our reality here that we're facing and we're dealing with and we're trying to figure out. And then this opportunity that exists for these individuals. Like, I just love the contrast and just the marrying of these two very different challenges coming together to kind of solve that together.

You know, on this show, I like to ask people for formulas, you know, like get prescriptive and tell us like why this is working for your business. And you have outlined kind of six things that will make successful strategic VA integration in your business. So I want to give you a couple of minutes to just after everything we've talked about, like what are the six key ingredients to make sure that you could be successful in integrating VA's into your business?

Debbie Miller (51:03.289)
Yes, the first one is clearly defined role.

as I said earlier, when we, with Helper Heroes, the first thing we do is a discovery call where we really help the owner tap into where your gaps are, what are your challenges, and then out of that, clearly define a role that we can now go and source talent for. sometimes I just was on a call with a gal earlier today who said, I want my team to do more strategic

tasks. So take off some of these menial tasks. But what I want to do first is highlight all the higher level tasks that they're going to take off my plate as the owner. I want to define that first and then what can I take off their plate so that they could do that and then that's the role. you know sometimes it'll be you know clearly it'll be a recruiter, it'll clearly be a schedule, it'll clearly be a bill, it might be more of an executive assistant, right? So whatever

that role is that needs to be really clearly defined that's the first step. Second one is having a robust training and onboarding process like we just talked about. Who is going to be the trainer? Alright can you afford to have them do that for the next two weeks? You know in our case you know it was we parceled it out to different people that have really good skills in particular area. would you know they might spend day one with

person, day two with this person. I've got a big team so we can do that. It might be you as an owner, well who's going to cover you while you're doing this? So but that's something that we really need to think about and have that process in place. The next thing is dedicated oversight. Who's going to manage this person? They love feedback. They're very good at taking feedback. It's amazing. They'll be like what can I do better? They're very very open and again because they're focused on keeping their job. They want to keep

Debbie Miller (53:06.387)
you're happy. So but having that dedicated oversight making sure that they are meeting the KPIs that they are you know the clients and caregivers are satisfied.

a reliable staffing partner. whoever is sourcing the talent for you, do they understand home care? Are they going to be able to give you talent that is going to be dedicated to you? And sometimes there are folks that are working for two or three different other companies. And that's...

We didn't want that. We wanted people that are going to be dedicated to this owner, grow with the owner. That's our whole motto. Consistent communication, that's important. Like there's a certain number of credentialing that they've got that you're going to have to put in place, whether it's the WellSky or the Access credentialing. They're going to need an email. They're going to need a phone. You know, you're going to have to have a phone system so that the phone number that they're calling from looks like a local phone number. So those things that you need to get in place.

but you want to have some clear communication that they can be successful in who they're having to communicate with caregivers and etc. And then finally the accountability which we've kind of talked about but accountability is key and touching base with them you know like asking them what what what do you need from me to be more successful having you know a weekly meeting with just a one-on-one you know what's been really cool for

us is getting when you get a fresh set of eyes who have a really good educated mind and strategic mind we've had a lot of ideas come from our VA's.

Debbie Miller (54:54.905)
Which, we didn't really expect that, but this time around with the Filipinos that we've got in place, they're so smart. And they've had a lot of great suggestions because they're in it with us, right? And they're attending the meetings and they have a voice. So giving them a voice is really key. And they may see some things that you're not seeing. By the way, a lot of them have had so much experience with other verticals that maybe had a really

good way of doing things that we haven't thought about because we're so myopic in this home care space. So they may have worked with an executive, you know, that maybe whatever they did, hey, I did PowerPoint, you know, have you ever thought about doing your training and orientation virtually? We did it this way, you know, that kind of thing. So those are the key things that I think are important for success.

Miriam Allred (55:50.304)
I love it. That was a perfect overview of how to set these people up for success in your own business. And I love that last point that you're making, that these people come from education and from varied backgrounds. And the other thought is they also are likely exposed to senior care in their own country in some shape, form. And so they just have these perspectives. They have this experience and they're going to come

and bring that to your business, which is so rich, which is just such a great opportunity to give them that voice and hear them out and hear what they bring to the table and what they bring to your operation. I want to ask you, Debbie, you have been in home care for what, 15, 18 years, a long time, but you are still so in it. And you're also likely thinking about the future of your business, the future of home care. And I want to hear your take on

Debbie Miller (56:32.533)
years.

Miriam Allred (56:44.734)
the future of VAs in home care. Again, I've seen it on the rise the last couple of years and I don't think it's slowing down, but I think the interesting element is also technology is speeding up and AI is coming on the scene. And some people may think that, AI is going to take over a lot of the mundane, the minutiae out of my business. And so I'm just curious if you're kind of honest take on like technology and VAs and what you see the future kind of looking like.

Debbie Miller (56:56.038)
Yes.

Debbie Miller (57:14.287)
I think they go hand in hand, honestly.

The technology takes as many of the human touches out. You're still going to have to have human touches. mean, think about senior care in general. don't know that AI is ever gonna resolve personal care. You're going to still have to have caregivers and doing that, and that, goodness for us, right? We still have a business. But streamlining the processes is key. Think about the day when maybe one scheduler

whether it's somebody in the office or an offshore person, because of AI, spooling up recommendations for caregivers for a call off, I mean, that's gonna be amazing. So I think we're looking, and it needs to happen because the wage inflation is such that the margins are getting lower and lower for our, home care owners. I mean, I'm billing more and making less.

than ever because of wage inflation and caregiver wages too, right? Seniors can only handle so much. Payor sources are only willing to pay so much. So our margins are tending to come down. So anywhere we can save money and where we can streamline processes to make it easier on the people that we have here in the office, along with virtual workers that can fit in a place

that you know that any of those gaps that make things more affordable and just more manageable. So I think there's a place for both. I'm very excited about AI. I think you know for us to not have to make a thousand calls for you know some somehow technology goes out and the caregiver says yeah I heard Mrs. Jones has got an opening I want it. Would be you know I'm sure we're not far from that.

Debbie Miller (59:14.689)
So I think it's, and again, profitability is key. We've got a lot of new owners, a lot of competition. so, I was saying to somebody the other day, when I started 18 years ago, I think it was easier. There was less competition and I don't know, just, because we work with so many new owners and it's just, you've got to find ways to

Differentiate yourself. That's why marketing is so important, right? You've got to be out there marketing. So the more you can be saving and building your infrastructure, I didn't have this opportunity to build my infrastructure this way. And it would have been, you know, I can't even imagine how many hundreds of thousands of dollars we would have saved. But...

For new owners, this is actually, I think, a really good way to begin to build your infrastructure. And we see one and two men shows here. So it's a really, really common thing. So if one person's out doing the marketing and you need to be because the competition is so fierce, then you've got to have some support there at the back office so that you can be fulfilling the care when you're growing it.

Miriam Allred (01:00:32.504)
So many, so many good thoughts, Debbie. And it's taking me back to one of your earlier comments of, I think it was your recruiter role. You had four recruiters, but then implemented kind of the caregiver rewards and recognition system. And that took a lot of, you know, that was technology gone right, where it could do a lot of those manual tasks. And then you whittled down to two recruiters. So that was a perfect example of going from four people to two people with the help of technology and VA's. And I think

That is the future is we, we use less people and technology gets better and you bring in people like virtual assistants that can supplement the technology. And that's kind of like the, the up and coming formula of what these operations look like. And I love how forward thinking you are, Debbie. You've been doing this for 18 years and you're always the person that I can count on to just be thinking ahead. What is technology? Which of our technologies is working well, which is not. And you know,

What should we be trying? What should we be looking into? VAs, know, maybe 10 years ago, you never would have thought you'd have employees in the Philippines, but now you do. Like, I just love how forward thinking you are and how innovative you are and how willing you are to try new things because home care is evolving. It's not the same as it was even five years ago, three years ago. It's so different now and we have to be evolving and you're a great example of that.

Debbie Miller (01:01:48.209)
It is.

Debbie Miller (01:01:55.43)
Yeah, well, look at just doing Zoom interviews. mean, there was a time, and there are still owners across the country that are having caregivers come into the office to do interviews. And they're not getting the numbers they need. Where if you're doing telephone and Zoom interviews, they'll show up for that. And through technology, we're able to do that now.

There are many people that are doing orientation and training through technology. So not even having to have them come into the office because every time they have to visit the office you cut down the numbers in half.

Right? if you needed to hire 10, you've got to have 25 basically show up for your orientation. You've got to be interviewing 50. You've got to be talking to 100 applicants. So technology helps streamline all of that and puts you in the best position to get as many caregivers as possible. you know, hopefully you can focus on marketing also so that you get as many clients as possible.

Miriam Allred (01:03:04.334)
Yeah, and you're being humble. We didn't even share all of your statistics, but in your office alone, you reduced recruiting time to hire by 40 % with these VAs. You reduced canceled shifts by 25 % with these VAs. Like your numbers speak for themselves at the impact that these people are having in your organization. I just want to give you a couple of minutes here at the very, very end to talk a little bit more about Helper Heroes. Like you said, you tried and tested all of this in your own operation.

and you are pretty well known and people just kind of have flocked to you of, you're doing it, like help us do the same. And so you've had a lot of organic growth. Is Help Our Heroes live and can people reach out to you and what's the best way for people to engage with you and the team?

Debbie Miller (01:03:48.72)
Yes, we are alive. We've got gosh, we've

probably have over 50 virtual assistants placed in agencies now. A lot of those folks are working with us on 52 weeks and we happen to see, oh wow, you're not able to get out, you're only able to get out once a week, hey, let's resolve this. And then it's just sort of snowballed from there. We have so many folks that are flocking to us in the Philippines that we're able to help people en masse.

huge team in the Philippines that in great infrastructure to help people and onboard people as soon as possible. can we can do a turnaround time in about two weeks. So that's from basically a discovery call to somebody placed in your office within two weeks. And it's $13 an hour. That's the flat rate. It's $13 an hour. We are flexible in terms of the schedules. So I think we're the only VA provider

that has a minimum of 20 hours. So we can staff part-time, which is great for new owners that are trying to build their infrastructure all the way up to as many hours as you need. We've got folks that started with 20 and we now have five VA's placed in their office. they just layer on as they have the success. so yeah, are able to schedule a discovery call, takes about

little less than an hour for us to really uncover exactly what your needs are and then we just go from there.

Miriam Allred (01:05:28.734)
Amazing. And is the website live, Help Her Heroes?

Debbie Miller (01:05:32.001)
It is. Yeah, it's a work in progress. But perhaps we've got a QR code to book to schedule a discovery call. I'm sure you'll be able to put that up on the screen. Yeah.

Miriam Allred (01:05:45.516)
Yes, absolutely. I just think this is amazing, Debbie. Again, we've talked about just the opportunity at hand here and the impact that these people can make. just what a great opportunity. That's the word that comes to mind, I think, for home care business is when the margins are tight.

Debbie Miller (01:06:00.166)
Yes, it's a win-win. I love the way you captured that. It's a win-win for everyone.

Miriam Allred (01:06:06.132)
It's a win-win for everyone. And what would you say to someone listening to this that, you know, maybe on the fence or thinking, you know, is it right for me? Is it not? Like you were in that seat once, like, I'm not sure, you know, skeptical of this whole kind of VA coming into your operation. What would you say to someone to just kind of break down that hesitation?

Debbie Miller (01:06:26.437)
Look how far you've come.

I mean, look at how many changes that we've experienced. We lived through COVID. So, you know, we had to adapt. And this is like the newest adaptation, I think, in streamlining our organizations and saving money, basically. I mean, in improving your margins. That's the really the key here. So, you know, the nice thing is, with us, you're not locked into a contract.

If it's something that doesn't work out for you, it's not a huge deal. lot of these agencies, they've got you. We put our money where our mouth is. If you're not happy, we don't want you to do this. give it a try, just like anything else that you do. You've started your business, you've done this. You've done lots of things that you didn't expect to do. This is one of those.

Miriam Allred (01:07:22.078)
So good, Debbie. Thank you so much for joining me in the lab. I really enjoyed this conversation. I may be one of those kind of skeptics. Again, I've seen this on the rise. I've heard about these virtual assistants, but when you quantify the impact that it's had on your organization and when you've shared all of these statistics and these numbers with me and you've lived and breathed it firsthand and you've worked out all the kinks over these years, I just think it's a great opportunity. And like you just said, people should try it and see if it works for your operation and see how your team responds to it and see the impact.

that it can have and it doesn't hurt to try. So Debbie, thanks for everything that you shared today and I'll look forward to connecting you with owners that reach out after this conversation.

Debbie Miller (01:08:02.937)
Awesome, Miriam. Bye for now.