From the 27th February 2017 consumers can choose and change the service provider that provides their home care package, meaning they can choose a provider that better suits their needs, has better customer service, or is better value.
While added choice puts people (and their families) in a stronger position to negotiate with the current provider, not everyone can easily exercise this choice.
So how do people choose the right package for them or a family member? And what are the barriers to getting the right services?
Firstly, what is a home care package?
A home care package is an allocation of funding that can be used to tailor suite of services, subsidised to a set amount by federal funding, to help older people live in the community.
The federal government funds a set number of home care packages. In 2016 there were almost 80,000 packages funded at a cost of A$1.49 billion.
Home care packages are consumer directed. This means people choose the services that make up their package rather than being told what services they are going to be given. Some people may prioritise having a clean home or taking their medication, others want help to exercise and socialise. Home Care Packages should be flexible in meeting your needs.
Pre February 27 2017, the government allocated home care packages to approved service providers. Once signed up with an approved provider, it was difficult to change providers.
What changes?
From 27 February 2017, after approval by the Aged Care Assessment Team, individuals are placed on a national queue managed by My Aged Care. The new system will allow home care packages to be assigned to consumers according to:
- their relative needs
- how long they have been waiting for care.
The department has started releasing home care packages through the new system, with approximately 11,300 packages scheduled for release throughout March 2017. As at 21 March 2017 approximately 1,200 have been released with an additional 10,100 to be released over the coming week. From next month, packages will be released on a regular basis, likely to be weekly.
Newly approved applicants then choose a service provider from the outset, while those already with a service provider can change providers.
How to choose?
So, how do you choose a new provider? Here are seven points to consider when initially choosing a provider or if you want to switch providers.
Think about what would support you at home and make a list.
List the things you think would support you at home. Can the Home Care Provider meet these needs? These may relate to Case Management and direct care staff (gender, language, culture, consistency), their availability (day, weekend or evening service), or range of services provided (personal care, home care, physiotherapy, occupational therapy, gardening). Some providers only provide certain in house services. Are they willing to outsource services they don’t provide in house?
Find out what’s available nearby
Identify alternative providers in your area by calling My Aged Care on 1800 200 422 or by using the improved search function on its website. Providers are no longer restricted to geographical areas but locally based providers often have established links to community services in your area .
Do your homework
When interviewing and comparing providers, ask about:
- fees: how much the provider charges for administration and case management fees (these can vary widely); the hourly rates for direct care services such as cleaning, personal care, allied health visits etc; average percentage of government subsidy available for clients to spend on direct care services; ask for an example of a monthly statement to see how clear it is and how it shows accrual of spent and unspent funds
- staff: whether service providers employ their own staff or use agency staff; the level of training of their case managers (some have university degrees, others might have minimal training); the level of training of their care staff (some require certificate III or certificate IV, others might have specialty training in dementia)
- communication and relationships: how often will case managers visit and speak with clients; how regularly care plans are reviewed; how service providers ensure you will get consistent care workers. What can you expect?
- self-managed packages: are there opportunities to self manage your package? This may allow you to allocate more resources to purchase of services.
Beware exit fees
Understand if the provider charges exit fees before signing any home care agreement. Exit fees can range from $0 to $4000.
Negotiate, negotiate
When you’ve chosen a new provider, or if you’re going to stay with your existing provider, don’t be afraid to negotiate your home care agreement. You can negotiate your daily fee contribution. Providers are not required to charge this fee and can only charge up to 17.5% of the Age Pension (any income tested fee is determined by the Department of Human Services- Centrelink and is not negotiable). Likewise the percentage taken from the package subsidy by the provider for case management and administration can also be negotiated.
The clock is ticking
From the time you are allocated a Home Care package you have 56 days to choose a provider and enter into a home care agreement. This can be extended by a further 28 days by contacting My Age Care. If you do not choose a provider and enter into a home care agreement within this time the package will be returned to the national que.
Set a date to switch
If you are not happy with your provider, contact My Age Care on 1800 200 422 and advise of your intention to look for a new provider. They will give you a unique referral code which can be provided to the new provider of choice. Agree on a date to switch to your new provider and notify your old provider of the date from which you will no longer be using its services. Your current provider will be required to transfer any unspent funds to your new provider.
Yes, the system is confusing!
There is not much consumer-friendly information about Home Care Packages. This makes it difficult to make good choices. Some providers are more consumer-focused than others; some have been having trouble shifting from the traditional “list of services” model to a more individualised, flexible and innovative approach.
Some providers may not have had to sell their services directly to consumers before. They might not have the information you want easily available online, like their fees. They may have also not had to administer stopping a client or starting a new one before. So, expect teething issues.
Particular challenges
Some groups will find it particularly difficult to exercise this choice.
People from culturally and linguistically diverse backgrounds have been able to use the government’s translating and interpreting service to set up their home care agreement, care plan and budget, as well as to discuss their budget each month. But translating and interpreting costs during care delivery are paid for from their package. Under the new scheme, it is not clear who will bear the costs associated with investigating and negotiating a new service.
People living in remote areas may also have fewer choices of a service provider.
People with dementia who are no longer able to make complex decisions often need a family member or friend to advocate their needs.
Giving consumers choice is meant to create market forces that drive innovation and enhance service quality. However, until older people become aware that they have choice, are given information to help make choices, and start acting on their choices, we might not see much change in the standard of home care.
Angus Kerr established LiveWell Care in 2012 in response to his recognition of changing consumer needs in relation to aged care services options. LiveWell Care is an independent consultancy service supporting older people and their families navigate the community aged care sector. Angus holds and Bachelor of Social Work degree from RMIT and a Diploma of Frontline Management from Swinburne University. With 17 years’ experience working in the community aged care sector across and number of management and case management roles, Angus has an in-depth understanding of the operational needs of Home Care Package Providers as well as great insight into the decision making process of consumers who are wanting to engage aged care services. Angus is on the steering committee of The Association of Age Service Professionals