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Episode 44

From Zero to 42 Franchises: Bien Chez Soi’s Blueprint for Rapid Homecare Growth

00;00;01;10 – 00;00;10;20

Jeff Howell

Welcome to Home Health 360, a podcast presented by AlayaCare. I’m your host, Jeff Howell. And this. Is the show about learning from the best in home.

00;00;10;20 – 00;00;14;07

Jeff Howell

Health care from around the globe.

00;00;16;19 – 00;00;49;01

Jeff Howell

Good day, listeners, and welcome to another electrifying edition of the podcast that has leaders from home care and Home health from across the globe. Today we are speaking with Alison Green, the CEO of Bien Chez Soi, which translates to well at home. If I have my numbers correct, BMJ Soir has gone from 52 850 caregivers over the past five years and are now at 42 locations, making it the largest homecare franchise in Quebec.

00;00;49;15 – 00;01;10;20

Jeff Howell

Now, to put that into perspective, Quebec has a population of about eight and a half million, so it puts it on par with the state of Virginia and in Virginia. Even the most brand name of agencies only have maybe 3 to 5 locations at the max. So, Alison, thank you for being here today.

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Alison Green

Thank you for inviting me, Jeff.

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Jeff Howell

So give us some personal background and what led you into home care. And I do want to also talk a little bit more about just how much you guys dominate the Quebec market because, of course, 42 locations divided by the population. I was so impressed.

00;01;31;15 – 00;01;58;03

Alison Green

Thank you. Yeah. So it actually really started as a family need. I started my business when I was 23 years old, coming right out of school, not really knowing what I wanted to do with my life. And my grandfather had been hospitalized for two years. So for him to be able to come back at home at that time, 15 years ago, there was just no home care options in the province of Quebec.

00;01;58;25 – 00;02;38;20

Alison Green

So I hired my first two employees so that we could we call them people who died in Quebec, so home care workers to bring them home. And that’s how the company started very, very quickly. Within about one year, I knew that I wanted to convert my idea into a franchise model. So quickly I put things in place. I was 24 years old at that time, and I had given myself an objective that at 30 years old I could start selling franchises confidence to being a woman and a man’s business world.

00;02;38;20 – 00;03;20;17

Alison Green

Anyway, that’s what I thought in my head, knowing as well that the market in terms of the baby boomers coming onto the market at three my age, that the 30 year mark would be the moment that I needed to leave the market very, very quickly, and that a franchise model would be the the tool that would permit me to, within five years completely dominate the market without losing on the quality of the service, having, you know, exponential amount of entrepreneur franchisees in each of the local regions being able to make a difference in their community.

00;03;21;23 – 00;03;25;10

Jeff Howell

So I started in 2008. When did you sign your first franchisee?

00;03;27;01 – 00;03;29;04

Alison Green

So six years ago now.

00;03;30;02 – 00;03;52;27

Jeff Howell

Okay. Yeah. So. So you spent. I’m interested because you’re 24 years old and you gave yourself six years at that time. Yeah. To become the solopreneur and build a stable enough business so that you could. I’m. I’m rather surprised that the maturity and patience that you exhibited at that age.

00;03;53;18 – 00;04;29;08

Alison Green

Yeah, I really. I understood that I had five years to dominate the market, so I had to make sure. And that’s a very quick growth. You know, having went from 0 to 42 franchises in five years in one region. So I really wanted to make sure that my recipe was, you know, nothing’s perfect in life, but it’s perfectly possible so that I could live that hypergrowth without needing to build any of the tools necessary during those five years and only be able to support the growth of the company.

00;04;29;29 – 00;04;41;13

Jeff Howell

And so about how big was your business then? Like how many caregivers and how many clients did you have when you said, okay, now we’re going to offer franchise opportunities?

00;04;41;20 – 00;04;52;18

Alison Green

So I had about 70 caregivers, and I would say that in the reaching to a market were about two caregivers per one client. Okay, is about our ratio.

00;04;53;01 – 00;05;05;20

Jeff Howell

Okay. And then in those six years, were you researching how to become a franchise or I’m curious, like you had no background yet and I’m wondering, like, so for the people that are out, the study didn’t help.

00;05;06;06 – 00;05;57;23

Alison Green

So really, no background franchising business, anything. So I actually read an enormous amount of frontline contracts that I would purchase online. Lots of them be from like the really big brands in the United States and really learning from those agreements, writing my own agreement, obviously with lawyers as well, but knowing what I wanted to do, I went also through a lot of pieces and cut back of franchise doors for whatever reason, not related all to home care, to kind of learn what didn’t work, why to be able to really build that company, foundation and and culture and code development that was so essential to us being able to grow and have, you know, happy, fulfilled

00;05;57;23 – 00;06;02;14

Alison Green

and powered franchisees.

00;06;02;14 – 00;06;09;18

Jeff Howell

How is home care administered and paid for in Quebec? I shockingly know very little how it all works.

00;06;10;07 – 00;06;43;27

Alison Green

Yeah, nobody knows very much about how it works, unfortunately. So if I look at Vichy, why about 60% is really like private. Private and about 40% will be paid by the government. Even within the government. Unfortunately, you know, there’s 16 different administrative regions and each of those regions managed completely differently. Either budget allocations and other ways of working.

00;06;43;28 – 00;07;15;12

Alison Green

So it’s a very difficult market, unfortunately, to undertake. And from a government perspective, I’ve been able to speak with a lot of different home care organizations around the world and unfortunately in Quebec, it’s one of the least organized in terms of being able to work directly with the government. The government has a very strong lead in agency structure.

00;07;15;20 – 00;08;04;16

Alison Green

Mm hmm. So the difference between the two being that the Quebec government wants you with our employees of or employees of placement agencies to fill the schedules. But of which the government is in total control of the information of the client. Whereas in most regions in the world where home care works best and is actually helping the client, at the end of the day, it’s more of a structure of, you know, the homecare agency, your company, you know, taking whatever control of the client and managing the employees and having a complete care plan and then billing the government and and giving reports to the government on how it’s going, but still having a direct contact

00;08;04;16 – 00;08;12;09

Alison Green

with that client. So that’s one of the big differences in Quebec compared to other places, especially in North America.

00;08;13;19 – 00;08;46;12

Jeff Howell

Okay, so. Mm hmm. I’ll give you. So, in other words, are they not? Because I would have just assumed that they would just refer clients and they would do it on a pro-rata share of the market. So it being a sua in a in one of the six regions has 20% market share of in-home occupational therapy. And then the fifth patient comes along that that referral goes to the shuswap.

00;08;46;13 – 00;08;55;07

Jeff Howell

But you’re saying that this placement structure, they’re still like the government is doing the scheduling of the home care and taking care of the care plan.

00;08;55;14 – 00;09;27;23

Alison Green

Yep. Which is totally dysfunctional. So from a lobbying perspective, we’re fighting very hard to change that structure. We’re working in collaboration with the AlayaCare to try and and have, you know, the the structure put in place so we can change that and really work on a referral basis instead of an employee scheduling management nightmare. But yeah, we’re not we’re not quite there yet.

00;09;28;15 – 00;09;37;08

Jeff Howell

Got it. Okay. And then I noticed on your web, your website’s very helpful, by the way, and I noticed that you have a.

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Alison Green

Family of my relative.

00;09;40;17 – 00;10;14;02

Jeff Howell

The colors are really good, too. I felt like I’m on Instagram. Thank you. And with the family and members section on your Web site, a drove me to think with self-directed care being such a a booming sort of niche within our industry. I’m curious, what if Quebec is taking any steps towards helping solve the staffing crisis with compensated family caregivers that are already providing care?

00;10;15;05 – 00;10;43;07

Alison Green

Yeah. So in Quebec, we call that that plus a done is the terminology. And yes, more and more, with every year that passes, there are more and more programs and subsidies to help the families take care of their family and take care of their loved ones. But I mean, in Quebec, I think one third right now of the population that is 18 and over is apostate.

00;10;43;07 – 00;10;54;20

Alison Green

That which is definitely not, you know, is not equal to the amount of money for sure that’s going in and helping these families.

00;10;55;09 – 00;11;07;16

Jeff Howell

Got it. And I noticed there’s quite a bit of information on tax credits for child care on your website as well, I’m assuming. Is that a big way that the government operates is with tax credits?

00;11;08;00 – 00;11;40;17

Alison Green

Yeah, exactly. So whether it be the elderly population or nanny services for younger families, the government does a lot of tax credits. So anybody who’s 75 and over automatically gets a 35% tax credit of which will increase by 1% every year to 40% over the next five years. And same thing for nanny services for young families. It’s based on the person or the family’s income, but will have an amount between 25 and 75% that will be reimbursed.

00;11;42;13 – 00;12;13;13

Jeff Howell

So in Ontario, the trend has been to be fewer health authorities. So I think when they were called community care access centers, I think there were 29 of them and this which was somewhere around 2017 where they moved to, I think, 14 Lynn’s local health integration networks. And then and now we’ve moved to five Ontario health teams. So someone’s going to be fact checking all this out there.

00;12;13;13 – 00;12;14;14

Alison Green

Calling you out on it.

00;12;14;27 – 00;12;27;17

Jeff Howell

Yeah. And so I actually thought that Quebec had 22 local health authorities. So you said that they’re 16. Do you see a trend of them moving this number down like Ontario?

00;12;29;06 – 00;13;22;17

Alison Green

No, I don’t think there will ever be a change in the administrative region. However, what’s changing in the politics of the health care system in general is a non abolition of the I don’t know what CEO is in English. The governing boards of these different organizations that are all working in silos and the government working on abolishing them all and having one entity that all of these purport to, to make sure that one of the goals being the collaboration between public and private, being much easier to manage and needing to have different ways of working, which is really not helping anyone and even creating competition in terms of budget between them.

00;13;23;07 – 00;13;27;05

Alison Green

So that’s a big change that will be over the next maybe 2 to 4 years.

00;13;28;27 – 00;13;51;28

Jeff Howell

And I know that you’ve been busy. You’ve presented a memoir to the Parliament of Quebec on the issues affecting home care. Yeah. How big is the lobby group in in Quebec and how effective are they? I know that with in the States, with HCA and NAC, there’s a there’s a watch. I watch a lot. A march on Washington.

00;13;51;28 – 00;14;02;05

Jeff Howell

And I’m just curious if for home care it’s really you know the the leaders within the space that like are you regularly going to parliament or how does all that work.

00;14;02;27 – 00;14;36;27

Alison Green

Yeah so regularly where we are doing lobbying, not necessarily directly at Parliament there’s very little physically done in Quebec City where our parliament is. But yes, Thursday at the time from the society, there’s an appetite from the government and from politics for change and innovation. Quebec is far behind. So we’re seeing more and more, even just in the last few months, what we call in French these gaps in the EPA.

00;14;36;27 – 00;15;13;22

Alison Green

And so the government opening discussions with all entities related to whatever sphere on collecting new innovative ideas on how to constructively build home care in a positive way. So in terms of the memoir, I work too, I’m the founder and vice president of the Home Care Association of Quebec. So we built a memoir together with all the different private home care entities in Quebec on how we think the home care sphere should evolve over time.

00;15;14;00 – 00;15;45;23

Alison Green

And the principle of that is really creating a referral structure where the government is able to refer clients and be able to provide obviously the care, but also the the the information that the data behind how this is done. Because a report actually came out from the government in the last few weeks that said that there was basically no collection of data on the performance of home care in the government at this time.

00;15;46;11 – 00;16;01;20

Jeff Howell

Got it. Yeah. And I think even the industry in general, probably about one third of agencies don’t do any reporting. There’s still a lot of small agencies that are are labor and you can’t improve or you don’t measure.

00;16;02;06 – 00;16;04;29

Alison Green

Yeah of course. Yeah.

00;16;05;07 – 00;16;13;07

Jeff Howell

What about how has life been through COVID, do you think? How do you feel that the province handled the pandemic and how did agencies get along.

00;16;14;08 – 00;16;43;05

Alison Green

So in terms of home care, it went really well. We were very lucky. It was a huge eye opening event for Quebec. Quebec is one of the places in North America that pushes the most anything. My words are all in French, but the advantage of that So putting people in homes that are subsidized by the government, so the place in North America that pushes that type of elderly care the most.

00;16;43;16 – 00;17;08;16

Alison Green

So like in Quebec, like anywhere in the world, obviously the pandemic hit very hard in that type of setting because in in any type of elderly home, there is a much higher possibility of contamination, especially the government working in a very placement agency way. Well, they had caregivers that were going from one home to the next and, you know, propagating the disease on a very, very high level.

00;17;09;20 – 00;17;42;02

Alison Green

In Quebec, there was almost a two year shutdown for people that were in homes, were not allowed to see their family members, were not allowed out of the home. The health care system was not able to support the influx of people needing help. So luckily, home care and the possibility, you know, all the positive that comes with home care was really put in like there were very little negative, you know, patients that came out.

00;17;42;02 – 00;18;09;06

Alison Green

And this is what directly related to our company. There were zero zero negative propagation between houses or caregivers. There were really no negative stories or anything negative that happened around COVID and home care. So it was only positive for our for our industry and even for the government and for society to see the importance of home care through COVID.

00;18;10;04 – 00;18;19;26

Jeff Howell

Yeah, there’s definitely a light shine shining on home care that you don’t see prior to the pandemic. What changes do you see happening in home care over the next few years.

00;18;21;15 – 00;18;52;24

Alison Green

When it comes to come back specifically? And it’ll be huge. They’re calling this a revised market both planned and used in the fall. There’s going to be really like a a massive turning in terms of budget, in terms of structure for towards home care. So in terms of the Quebec market, it’s going to be enormous, really a referral, like I said, a referral based structure that will really help home care companies emerge and innovate.

00;18;53;18 – 00;19;31;03

Alison Green

In terms of the market in general, I think that the collaboration between, you know, competitors and markets is something that I have never seen before, and I think we’re so lucky to have the possibility to really make a difference in people’s lives that people want wanting that to happen. And the really, you know, difficult position that we’re going to be over the 30 years is really creating beautiful, innovative hubs in Quebec and elsewhere where people really want to help.

00;19;31;03 – 00;19;54;26

Alison Green

So I’m really hopeful for the future in terms of data plan where we will be bringing our company. I think that we need to see home care in a in a really to rethink. If you if someone wants to stay in their home, it’s not just home care in itself. That is the deciding factor for them being able to stay in their home.

00;19;55;08 – 00;20;22;14

Alison Green

There’s, you know, the household maintenance, food, is the house appropriately adapted to the needs of that person. So creating solutions that have a3d view and keeping someone in their house, I think for the future of home care, of which DC Span has developed a new product that’s called me and my deputy that will really be that xc60 service that someone needs to stay in their home.

00;20;24;10 – 00;20;30;22

Jeff Howell

Yeah, and almost 100% of people want to do that. Age at age in place.

00;20;31;06 – 00;20;33;02

Alison Green

Yeah, absolutely. Yeah.

00;20;33;23 – 00;20;39;06

Jeff Howell

Well, do you have any secrets on how to recruit and retain caregivers?

00;20;40;07 – 00;21;03;00

Alison Green

I don’t think I have any secrets. But what really works and being shaped by the culture, I think everything has to do with culture. Culture, culture. Employees just want to feel, especially caregivers. They just want to feel recognized. They want to feel important. They want to feel like they’re part of something bigger. So our strategy is really just tweaking the time every month.

00;21;03;00 – 00;21;40;20

Alison Green

You know, we have an employee of the month, the caregiver of the month. We can called our caregivers the day they got home with that, with a capital B that really empowers them and feeling that they’re making a difference, not just doing, you know, technical, medical, whatever work. We have an annual party every single year where all of the 850 caregivers across Quebec are reunited together and and really take the time to make sure that each one of them recognizes themselves in a movement that is larger and that they’re a part of.

00;21;40;29 – 00;21;50;10

Alison Green

So I think that’s really just recognition. And culture is really the key to keeping caregivers and making them feel to feel well.

00;21;51;01 – 00;22;12;21

Jeff Howell

Yeah, we did. We did a study of over a billion home care visits and and we looked at the utilization and that’s obviously a big one is is that they have to get hours and make a paycheck as soon as possible. And the exiting caregivers, the number one thing that they would cite is lack of communication from the office.

00;22;12;21 – 00;22;19;14

Jeff Howell

So they both were not getting the hours that they needed. And they really did feel disconnected from the company as well.

00;22;19;29 – 00;22;46;22

Alison Green

Yeah, it’s hard. You’re working in someone’s home every day. How do you create that connection? So we were really lucky. We actually were one of the first AlayaCare clients, so we’ve really used AlayaCare to help us create that communication with our employees by using, you know, the most amount of tools possible to make sure that we stay connected to people, that we’re not physically connected with because they’re in people’s homes.

00;22;47;04 – 00;22;57;25

Alison Green

So I think it’s just thinking out of the box about how do I stay connected to people that I don’t physically see. And really, like I said, making them feel recognized for what they’re doing.

00;22;59;16 – 00;23;14;22

Jeff Howell

So let’s talk your expansion plans. With 42 locations and already really covering the market. How much more runway would you have for Quebec? And then do you have any expansion plans beyond the province?

00;23;15;02 – 00;23;44;14

Alison Green

Yeah, so definitely Dublin. So we’re going to be at about 90 locations in about five years. So we’re going to double about exactly the same rate that we’ve grown so far. In terms of my franchisees growth as well. We are growing. We’re doubling almost every single year in terms of amount of people that we’re helping. Not including the addition of new franchises so that the market is is changing.

00;23;44;14 – 00;24;10;28

Alison Green

In Quebec, the government is giving more and more leeway and wants to collaborate more and more with the private. So in terms of growth of the auto franchise, this is my franchises growth. We’re on a really, really good track. I have no intention of leaving the province of Quebec. I think that there’s so much more that we can do to help someone in their home, or if we’re thinking of a Frisco View, what we can do to help.

00;24;11;06 – 00;24;36;22

Alison Green

And really, now that I, you know, more or less an expert in franchising, I think that the growth of B.C. style will be in creating different home care affiliate through franchising of different types of services that we can offer to make sure that we’re really offering that 350 plan to people that want to stay in their homes.

00;24;37;00 – 00;24;48;21

Jeff Howell

Well, we’re just about bumping up on our time here. So, Alison, I’ll give you get you out of here on this last question. Give us a reason to be optimistic about care delivered in the place that the clients call home.

00;24;49;18 – 00;25;17;15

Alison Green

For me, I think it’s really collaboration. We have this beautiful industry. We want to go into home care or health naturally, because we want to make a difference in people’s lives and we want to help people and do better inspiration and people wanting to help each other. It’s just so, so inspiring, I think, for the future of home care and the people that want to stay in their homes.

00;25;18;02 – 00;25;33;11

Alison Green

So I would really say that, you know, it’s really each human in the home care industry that exponentially wants to make a difference that is going to enable people to stay in their homes as long as possible.

00;25;35;01 – 00;25;59;08

Jeff Howell

Well, I’m certainly inspired. I feel like I have gotten the 360 view of home care in Quebec today. And your growth has been incredible. And I’m already amazed that you have 42 locations with a population of a half million. And I have no doubt that you’re going to get to the 90 locations. So I’m excited to follow so far.

00;25;59;18 – 00;26;00;28

Jeff Howell

And thank you for being on.

00;26;01;21 – 00;26;04;11

Alison Green

Thank you, Jeff.

00;26;05;19 – 00;26;06;25

Jeff Howell

Home Health 360.

00;26;06;26 – 00;26;08;07

Jeff Howell

Is presented by AlayaCare.

00;26;08;20 – 00;26;34;25

Jeff Howell

First off, I want to thank our amazing guests and listeners. To get more episodes, you can go to alayacare.com/homehealth360 that’s spelled Home Health 360 or Search Home Health three Second, Any of your favorite podcasting platforms? The easiest way to stay up to date on our new shows is to subscribe on Apple podcasts, Spotify or wherever you get your podcasts.

00;26;35;12 – 00;26;58;09

Jeff Howell

We also have a newsletter you can sign up for on alayacare.com/homehealth360 to get alerts for new shows and more valuable content from Lion Care right into your inbox. Thanks for listening and we’ll see you next time.

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Home Health 360 - Episode 44

Episode Description

Prepare for an electrifying episode as host Jeff Howell dives into an inspiring conversation with Alison Green, CEO of Bien Chez Soi, Quebec’s largest homecare franchise. Discover Alison’s inspiring journey as she grew from 50 to 850 caregivers while achieving an incredible 42 franchise locations in just five years. Listen to gain valuable insights and practical advice on rapid growth and how to become a franchisee, her secrets on how to recruit and retain caregivers. and how she presented a memoir to the Parliament of Quebec on issues affecting home care.

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