Older people, advocates, carers and families have worked so hard for so long to make increased choice and control in Home Care Packages a reality. The challenge now is to make sure we continue to break down the barriers that inhibit choice and control and ensure that all consumers and families can really make the most of the opportunities this reform presents.
How can we make it easier for consumers to exercise choice and control in choosing a Home Care Provider and at the same time increase the responsiveness of My Aged Care with regard to the assignment of Home Care Packages?
In a recent submission response to the Federal Government discussion paper Future Reform- an integrated care at home program to support older Australians, LiveWell Care provided recommendations on how people with diverse needs can access services, make informed choices and exercise control over their care.
Recommendation: Development of a Consumer Support Platform – Providing Specialised Independent Facilitation Support, focused on ‘Access to Services’ for those who require or want support in choosing and accessing a Home Care Package provider.
Research shows that for people who know a service area well, more choice is better than less. This is great for consumers and their families who know the Aged Care System well and are eager to make the most of the opportunities available to them. For those without this insight, however, facilitation support is a critical piece of the puzzle that makes choice and control possible.
Face-to-face delivery of information and support as well as hard copy documents rather than online-only information will provide improvements to the quality and delivery of information and support given to consumers to help them better understand and exercise choice and control in aged care.
In many instances consumers are allocated a Home Care Package but do not have the resources or capability to choose a suitable provider to administer the package and in some cases consumers fail to act on the allocation of a Home Care Package at all. Independent Facilitation Support is so much more than merely linking participants to providers and ensuring the committed supports are accessed. At its best, Independent Facilitation support engages participants in exploring what is possible through their Home Care Package and provides them with clear expectations of what a Home Care provider can and indeed will provide. It reduces the administrative burden of choice and control and supports the consumer (with the chosen Home Care Provider) to put together a package of supports that genuinely facilitates progress towards their goals and wishes.
Recommendation: Ensure that the Aged Care System can easily identify vulnerable people who may require support to access and choose a suitable Home Care Package provider.
Currently Aged Care Assessment Teams (ACATs) determine eligibility for Home Care Packages by undertaking an assessment in the consumers home. ACATs are able to identify vulnerable clients who may require extra assistance to enter into home care services. The decision whether a client is ‘vulnerable’ is made based on the clinical judgment and reasoning of the assessor who has an allied health background. By identifying a vulnerable client, an assessor will receive a notification whenever a client receives a letter advising of the assignment of a home care package. ACATs can nominate themselves or someone else from their outlet to be contacted when a vulnerable client is assigned a package.
LiveWell Care has questioned if ACATs are the appropriate body to be notified and in turn support consumers to choose a Home Care provider once a package has been allocated. Recently, concerns have been raised over wait times for ACAT assessments with Australian Ageing Agenda reporting that assessment teams in only two States are meeting their targets for “high priority” referrals (Australian Ageing Agenda 03/03/17). To then ask these assessment teams to support identified vulnerable consumers to choose a provider would put added strain on ACATs and further blow out wait times for assessments.
LiveWell Care has suggested that the development of a Consumer Support Platform would enable a referral to a specialised independent facilitator when a package has been assigned to a ‘vulnerable person’. This facilitation role would ensure that consumers have a trusted and independent ‘system navigator’ to walk alongside them and support the formulation of goals and identify suitable Home Care Package providers. It would ensure that consumers are able to access the services they need and would also improve the functionality and responsiveness of the national prioritisation process and reduce waiting times for a Home Care Package. Currently, when a Home Care package is assigned to a consumer, they have 56 days (plus a 28 day extension if required) to enter into a home care agreement with a Home Care Package provider. If an assigned package is not taken up (for whatever reason) then it can take up to 86 days for that package to be reassigned to another consumer on the national queue.
Where consumers have not have been identified by assessors as ‘vulnerable’ but My Aged Care has been notified that they require more time or support to access or choose a Home Care provider, LiveWell Care has recommended that a referral should also be made to a specialised independent facilitator to support consumers to access their assigned package. Alternatively, should a Home Care Package Agreement not be entered into within an identified time frame, say 43 days post allocation (half the time allowed to enter into an agreement) then My Aged Care could contact the consumer to enquire if they would like support from an independent facilitator.
LiveWell Care believes that these recommendations will help ensure that progress and empowerment of consumers delivers benefits in practice not simply promised in theory. With these additional safeguards in place we will hopefully be able to celebrate a system that removes inhibition of choice and provides greater control to consumers.