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Honor lands $20 million for senior in-home care agency

Assisting an elderly person with activities of daily living — bathing, dressing and eating, for instance — is as low-tech and hands-on as it gets. But a San Francisco startup hopes to use technology to rewire in-home care for seniors.

Honor (www.joinhonor.com) begins service Thursday with $20 million in funding from the likes of Andreessen Horowitz (Marc Andreessen is on its board), Kapor Capital, PayPal co-founder Max Levchin, Sen. Bob Kerrey, Yelp CEO Jeremy Stoppelman, actress Jessica Alba and producer Cash Warren, among others. It will start off with a test in Contra Costa County this month and then spread to the rest of the Bay Area.

At its core, Honor is an agency to provide home aides, but it says that some high-tech overlays and its systematic approach will result in better care with more transparency and flexibility.

“Our mission is to help seniors stay in their homes as long as they want to by providing excellent care,” said CEO and co-founder Seth Sternberg. He co-founded instant-messaging pioneer Meebo, which was acquired by Google. The idea for Honor arose when he visited his mother in Connecticut and realized her driving skills had deteriorated. “I looked at current solutions (for helping her) and they’re very bad,” he said. “I’d have to fly to Connecticut, interview 20 people, randomly pick one, fly back to California and be completely in the dark about the care she was getting.”

Instead, he imagines a nationwide network of care providers who would be matched with assignments by a smartphone app. A senior’s family would also have an app to help them monitor when an aide visited their relative at home. Honor would provide touchscreen-tablet devices in the seniors’ homes to notify them when an aide was on the way and let them rate the care they received, Sternberg said.

“Our technology will connect all three parties — the caregivers, the families and the seniors — and give visibility into the care your mom is getting,” he said.

The technology also will help Honor verify that aides visited homes at the agreed-upon times, didn’t check Facebook or make social calls, and, for instance, were walking around if they were supposed to be cooking a meal, not sitting down. “We actively monitor to ensure they do what they should,” Sternberg said.

Honor does in-depth screening of aides, Sternberg said, and pays its independent contractors a higher hourly rate than other services, offering $17 an hour in the Bay Area and a $15 average nationwide, compared to an industry average of around $10. Honor will also charge a higher rate than other companies, around $30 an hour in the Bay Area. (Its services would all be privately paid by families.) That is somewhat mitigated by extra flexibility; it will let families request as little as one hour of care at a time, compared with the three-hour minimum that many agencies require.

Leah Eskenazi, director of operations at the Family Caregiver Alliance, a nonprofit that helps families manage care for disabled adult relatives, said Honor’s concept sounded positive, although ultimately the personnel will be key.

“Families are looking for reliable, dependable, affordable people that they can trust to come into their homes,” she said. “The other things, like the technology connections, are a bonus, but it is not the essence of what people need.”

Still, she sees an interest in being able to monitor a loved one’s care from work, such as receiving an alert that an aide has arrived. Many companies now offer all sorts of tech solutions for seniors, ranging from devices reminding them to take medicine to full-scale monitoring systems with video cameras.

At $30 an hour (the price isn’t yet fixed), Honor would be on the high end for in-home care, although the Bay Area average is about $26 an hour, said Christina Irving, a social worker and family consultant with Family Caregiver Alliance. Most agencies have a graduated scale and charge higher rates for clients who need extra medical care or suffer from severe dementia, she said.

The flexibility to hire for just an hour is a plus, both Eskenazi and Irving said, as often a senior may need just an hour of help in the morning getting up and getting dressed, and then another hour in the evening to bathe and go to bed.

Although Sternberg said Honor seems unique, in fact, there are a lot of agencies that provide in-home senior care, including some nationwide, such as Home Instead Senior Care, which operates as franchises. Many such agencies are increasingly using technology to communicate with families, Eskenazi said.

And as many as half of all families that hire caregivers for senior relatives do so informally, relying on word of mouth or their own advertising rather than an agency, Irving said.

As the nation’s population ages, the need for senior care will continue to grow. Some 83.7 million Americans will be aged 65 or older by 2050, almost double their ranks in 2012. Right now, around 43.5 million families care for an older relative, and 14.9 million care for a relative with Alzheimer’s or dementia.

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Friday, April 17, 2015


In light of the recent news of UBER's driver being awarded the title of "employee" by the California court should be of note to Honor and other care-matching platforms. First things first, this work is steeped in history and the latest chapter will reveal that these aides are not likely to pass the test for being a true independent contractor. The DOL will easily see that HONOR and the hiring family are at best joint employers of the aide. Honor calls them "Care Pros," but a one hour visit sounds more like a "Care Ho"

There is a good reason for the minimum time requirements, but if Honor can find someone willing to take on the work for an hour, then they will have unearthed a new careforce of people who often demand a minimum of 2 hours. Nevertheless, I look forward to innovation in the care space.

It is really amazing that they want to get into this care space. It's really hard work running an agency of aides. It's not easy like UBER. There are so many layers of complexity that truly require some oversight. I think they need some home care mavens helping them because that level of expertise is essential.

First things first... better run this by the Department of Labor. The aides actually like the benefits of being an employee. They like the unemployment in down times and they like being able to be assigned new cases.

Welcome to the care space Honor. There's room for everyone... but with $20 million you're not dependent on sales like the rest of the agencies. Most agencies don't have that kind of financial backing. In fact, at this rate, Honor will have to deliver 1.34 million hours of service just to break even. That would break down to 3,652 cases a day. And that's just to break even. Geesh!


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