Étiquette : DirectEmployment
Choosing how to organize home care is the first structural decision and, paradoxically, the most anxiety-inducing one for families
Choosing how to organize home care is the first structural decision and, paradoxically, the most anxiety-inducing one for families. The ecosystem is marked by three models: the Provider (Prestataire), the Agency (Mandataire), and the Direct Employment (Gré à Gré). My role, as Christophe Delong, former Physical and Rehabilitation Medicine (PRM) Doctor and Autonomy Coordinator, is…
The funding of human assistance primarily relies on two allowances
The organization of social aid in France is decentralized, giving Departmental Councils the responsibility for setting the amounts and coverage rates for the APA and PCH. This local management has a direct consequence: significant territorial inequity. For the same level of need, the budget allocated to human assistance can vary considerably from one department to…
The organization of social aid in France is decentralized
The organization of social aid in France is decentralized, giving Departmental Councils the responsibility for setting the amounts and coverage rates for the APA and PCH. This local management has a direct consequence: significant territorial inequity. For the same level of need, the budget allocated to human assistance can vary considerably from one department to…
The Provider model is a heavy system that includes significant Structural Costs
One of the greatest sources of dismay for families is discovering that the bulk of their care budget does not reach the person providing the service. The Provider model is a heavy system that includes significant Structural Costs (Margin, Logistics, Marketing, Administration), which can represent 25 to 35% of the total hourly cost. This money…
Transparency is the foundation of trust.
Transparency is the foundation of trust. When we compare a provider billing €25 per hour and a total employer cost in Direct Employment (Gré à Gré) of €18 per hour, the €7 difference is not insignificant. It is the cost of management and margin, which does not contribute to the quality of the service. Simplified…
Team stability is non-negotiable.
The turnover crisis and the lack of attractiveness of the caregiver profession are the scourges of the sector. An underpaid caregiver in a rigid structure is a risk to the continuity and quality of care. As a former PRM doctor and Autonomy Coordinator, I know that people are at the heart of a successful life…
The main psychological barrier to Direct Employment (Gré à Gré)
The main psychological barrier to Direct Employment (Gré à Gré) is the idea of becoming an employer and managing HR administration. There is a fear of the complexities of the Labor Code, the risks of litigation, and the mountain of paperwork. However, the Universal Employment Service Cheque (CESU) Declarative system is the institutional tool designed…
The Durand family, beneficiaries of 80 hours/month of PCH human assistance
Nothing is more telling than a concrete example of budgetary transformation. The Durand family, beneficiaries of 80 hours/month of PCH human assistance, faced a recurring out-of-pocket expense of €560 per month through a provider billing €25/h. This cost was unsustainable and threatened the continuity of care. The solution: switching to Direct Employment (Gré à Gré),…
My experience as a former PRM doctor
The Disability Compensation Benefit (PCH) aims to fund personalized assistance to compensate for disability. My experience as a former PRM doctor has taught me that for people with disabilities (especially those with complex rehabilitation and autonomy maintenance needs), the assistance must be flexible, stable, and highly qualified, capable of integrating with care protocols. The provider…
The main objection that prevents families from opting for Direct Employment (Gré à Gré)
The main objection that prevents families from opting for Direct Employment (Gré à Gré) (the most economical and qualitative model) is the fear of the workload and responsibilities associated with the status of a private employer. The fear of having to manage payslips, Urssaf declarations, leave, and potential disputes is legitimate. My service is the…
