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Confusion reigns over new aged care queue


The Department of Health has said 22,000 home care packages have been released under the new system and it will release detailed data in July on how it’s performing.

Bonnie Carter says her 84-year-old mother has been waiting for a high-level home care package for more than 70 days.

Ms Carter says that since an Aged Care Assessment Team assessed her mother as needing the package, “nothing has happened.”

“There’s been no contact other than me calling My Aged Care several times to see where she is in the queue and how long she might have to wait,” Ms Carter says.

“Apparently no one can tell anyone anything about this mythical queue until the end of this year,” she adds.

Under the latest aged care reforms that came into force on 27 February, the Department of Health has created a new centralised process for allocating home care packages directly to consumers.

As part of the new system a “national prioritisation process” has been created: after a senior is assessed as needing a home care package they join a new national queue where they wait to be allocated a package.

How long a senior waits on the queue is based on various factors – such as their level of need, how long they’ve been waiting and how quickly a package at their level of need becomes available (the number of packages is increasing but remains capped by government).

It’s a complex new system and, in the absence of transparency around how it is working, confusion is mounting among providers and consumers.

System is working, says department

This week the department said that 22,000 home care packages have been allocated across the country since the changes – evidence, it said, that the new system “is working”.

But many providers report a significant drop in the volume of clients coming through to them. Where are the 22,000 seniors who have these packages, they ask.

Many point to the likely implications of the 56-day rule.

Under the new system, once a senior receives a letter from the department to say they’ve been assigned a home care package, the older person has 56 days to find a provider and start receiving services.

Within that period they also receive a reminder letter (after 35 days) if the system identifies they haven’t yet taken up their package.

Sector stakeholders are privately wondering if 56 days is too long. Some say they initially suggested to the department that letters wouldn’t cut it – the My Aged Care contact centre should be following up with calls, for example, to more actively manage the process.

Others believe seniors may be confused by the different letters they receive (one to say they’ve been approved for a package, the next to say they’ve been assigned a package) and argue government needs to spend more on consumer support.

The department itself says a lack of seniors coming through the system is likely more to do with the lengthy time they have to avail of a package, rather than issues with the new process.

“The expectation is the flow of clients through to providers should start to ramp up as we come through the 56 day period,” bureaucrats said in a webinar for providers this week.

Lack of data on packages, wait times

At the heart of the mounting disquiet in the sector is the department’s reluctance to release data on how the new system is performing.

The department has repeatedly said it cannot provide detailed data until “the second half of the year.”

Last week Australian Ageing Agenda emailed detailed questions to the department seeking data on the allocation and uptake of packages and wait times on the national queue.

We also asked: “If the department maintains that it cannot provide this data until ‘the second half of the year’ then can it explain why it is taking six months to gather this data.”

The department’s media adviser responded: “Oh dear – sorry you are so aggro – I’ll see what we can do.”

No further response was provided.

By stark contrast, the officials who appeared in this week’s webinar said they acknowledged the sector’s need for data and said quarterly reports would be provided from July.

They said the quarterly reports will include:

  • the number of approvals at each level
  • how many seniors are on the queue
  • how many are opting into services who had an older approval
  • how many are being assigned packages and what is their take-up behaviour
  • information on people leaving care
  • information on new providers coming into home care

The first report to be released in July will cover the period between 27 February and the end of June, the officials said.

While much of the focus has been on the new system for approving and assigning packages, some provider sources say assessment delays in some areas could also be a factor.

As AAA reported in March, assessment teams in just two states are meeting their targets for “high priority” referrals (read that story here).

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20 Responses to Confusion reigns over new aged care queue

  1. Jodeane Anderson May 19, 2017 at 12:26 pm #

    Great article! I hope the department read it!

  2. Kate Lambert, CEO Daughterly Care May 19, 2017 at 1:06 pm #

    Fair crack of the whip. Its totally over the top to say “Confusion Reigns over new aged care queue.

    I strongly agree Elders are confused by the 2 letters one saying they are “approved” and the second saying they are “assigned”. Many Elders and their Adult Children make the mistake of thinking they have their package when the first letter arrives telling them they are “approved”.

    “Approved” sounds like you are ready to go, but it just means you have been added to the Waiting List.

    In our experience, many Elders and their busy Adult Children are putting the letter aside and leaving the decision until the last week or days before the deadline.

    We often receive calls when they are less than a week away from the 56 expiry deadline, so we advise them to ring My Aged Care on 1800 200 422 and ask for an extension of 28 days, just to take the pressure off.

    One new client was a day past the expiry date and My Aged Care had resumed the package, but with a phone call, the Elder got it back.

    Some spouses and adult children are highly stressed by their carer role and don’t understand what the “assigned” letter is telling them.

    Most people are not familiar with the word “assigned”. It needs to be more direct and say “YOUR MONEY IS NOW AVAILABLE for your Home Care Package to start now”.

    We have to remember the 22,000 new packages issued since 27 February 2017 are spread all around Australia, including areas where the backlog might have been longer.

    Also existing Old-School Approved Providers who commonly charge 35%+pa are likely to be quieter than in the past because Elders and their Adult children are choosing a New-Breed of Approved Provider (like Daughterly Care Community Services) which offers a lower fee.

    Many new organisations now have Approved Provider status so there is wider choice available for Elders.

    Older people have never known how long it would take to get their Home Care Package – I feel more confident now that it is being managed centrally.

    Kate Lambert
    CEO
    Daughterly Care Community Services Ltd

  3. Greg May 19, 2017 at 1:25 pm #

    There are big problems with accessing home care services currently and it’s hard to get good information by ringing the My Aged Care number. There is also no clarity about what resources are available and when. These reforms have got a way to go before they deliver any worthwhile improvements and I fear people in the sector have placed too much neo liberal faith in them. Currently the ‘workaround’ is still king.

  4. Mike for his wife May 19, 2017 at 2:08 pm #

    Time waited to date
    231 days – queued from 29 September 2016

    Sydney NSW.

  5. M May 19, 2017 at 6:52 pm #

    Its not just about the 2 letters after approvals are given. The assessment process can be 2 stage-Home Support then comprehensive. Both those steps result in a letter and a copy of the support plan generated. Add in a trip to hospital and stint under TCP. Seniors are drowning in paperwork. None of which makes any sense to them. They end up with multiple people having visited them. God help you if english it not your first language. All this and they can end up with nothing for months on end.
    I work in local government service delivery in Victoria. We have 350 people on our wait list for support. No one wants to take up the Level 2 packages because of the fees. They ring in and say “I got this letter. I dont know what it means and what I’m supposed to do”. It’s extremely hard to explain why they should take a package.
    Dont even get me started on codes.

  6. Jo May 19, 2017 at 11:11 pm #

    I know people that have approvals from 2015 that still have no offer. They opted in, but it makes no difference. MAC need to acknowledge the reality – in our region the wait for assessment is up to 9 months! Then you join the queue- another 1-2 years! Hopeless.

  7. Priscilla May 20, 2017 at 8:35 am #

    My family is wondering how long is it ok to wait. 77 yr old dad with MND. Approved for high care package in Oct 2016. No package assigned yet (nearly 200 days). Major deterioration in interim. My Aged Care says they cannot give any information on how long. This is a terrible illness and the indignity of begging for a package that feels mythical adds to the burden. Reality is he may die before package is assigned – only blessing is that will be one less on the waiting list.
    Melbourne

  8. Frustrated May 22, 2017 at 1:00 pm #

    My dad received an ACAT assessment for a Level 4 HCP in March 2016. He was placed in the queue in December 2016. He is still waiting, despite numerous calls. Although he receives CHSP services, we have topped up with private services which is costing our family a lot of money.

  9. Karen May 23, 2017 at 8:16 am #

    Service providers are not receiving referrals even to keep status quo we had before the changes, let alone having potential to increase consumer numbers. Before the change if we had a vacancy for level 3 or 4 we were able to fill within hours , now it has been 3 weeks were 3 level 4 became vacant for us and we have not been referred or received requests for level 3 and 4 to fill them.

  10. Terri May 24, 2017 at 11:47 am #

    The National Priority Queue was only established on 27 February 2017.

    It clearly shows there is an issue with the system when people think that they have been in a queue since before this date.

    Up until that point a person with an assessment for a package had to source a provider with a package vacancy, join a provider’s waitlist, or even decide if they wanted to take up a package now that they are assessed.

    As a provider, we are seeing many referrals for multiple CHSP services, as people are clearly not being assigned a package.

  11. Adrienne May 24, 2017 at 2:03 pm #

    To Priscilla, – my recommendation is to contact the MND association in your state for equipment, they are likely able to help. And contact your local Aged Care Assessment Service (ACAS) to see whether the priority levels can change. That is awful, MND is unfortunately quite a quick and progressive disease.

  12. Gena Cavini May 24, 2017 at 4:31 pm #

    Yes, but the Delegate Letter that goes to the client from the Aged Care Assessment Service after an aged care assessment has been conducted, states the client has not only been approved for a Package but that they have been added to the National Queue and what to expect.

  13. Kate August 22, 2017 at 7:42 pm #

    The whole process is very lengthy . My mother who is 91 has been placed on the queue – no one can say how long for. If an elderly person was having to do this on their own they would give up. The letters are unclear and lengthy. It is clearly not easy for someone with a cognitive impairment at all. Why someone who is on a full aged pension then has to approach Dept Human Services to have an income assessment is beyond my comprehension but I’m told I must do it. Some of the management fees for the providers are high and why the hell should anyone have to pay exit fees.

  14. Julie August 23, 2017 at 3:36 pm #

    The Government had over two years to plan the reforms and get it right and once again they have have proven their utter incompetence! They couldn’t organise a chook raffle and its the vulnerable elderly who are the ones suffering because if it.

  15. Leanne October 29, 2017 at 5:27 pm #

    My 90 yr old mother had been receiving a number of services for many years while living in her own home. She has early stage dementia. She got sick ended up in hospital and long story short is now living with us. Relocating her to another state to live with us we now find that she never had a ‘package’ therefore is now in the queue which apparently has a 12+ mth waiting time. If we want to access any support services for her now then we pay full price. So used to get plenty of services but then had to relocate to live with family due to decline in health so back to the end of the queue you go. 12+ mth waiting time? That’s ok she’ll probably be dead by then so that’s another off the list, and that will probably be reported as ‘client declined package’!! , not ‘client died waiting’. What a joke!!

  16. Zac Wills April 19, 2018 at 2:08 pm #

    My 90 year old mother was recently diagnosed with dementia, mini strokes, lost her drivers license and had an extreme episode of delirium and psychotic behavior, probably partially contributed to the shock of loosing her licence and what she claims is her freedom of independence.

    While she has been waiting for nearly a year for her Level 3 Home Care Package, the strain to support her home care, dietary needs and transportation to medical, shopping and social appointments has been huge.

    Being so independent in the past, she is highly reluctant to use a taxi, two of her children live interstate putting added pressure on her local child who has to pick up and deal with all the pieces while trying to manage work and her own life.

    Though she gets council support with domestic work fortnightly, her reduced mobility increases her risks at home because she can not get weekly services to support her needs or has to go without social engagements because there is no transport services to assist.

    She is one of the lucky ones who does not need higher care needs, but the system has serious holes and more respect for our elders should be addressed.

    The Home Care Package is such a great opportunity, but equally too many clients are abusing and ripping off the system.

    Totally no applicant of the program should have a build up of Government Funds unspent unless there is 100% supported with an up to date Care Plan to support why funds are not being spend.

    Some Providers are truly creative with their terminology of the clients care plans and are not a true reflection of the clients needs, after all they get a kick back from their fees.

    Take funding away from those who feel it is their right to have Government money build up for no valid purpose and give it with those who really need it. NOW.

    Case Managers should be visiting their clients every 3 months to ensure their Care Plans are up to date and valid in order to justify the funding balance, if not, part of it should be withdrawn and only enough to cover existing services and then reassess for further funds for increased needs if it is not reflected correctly on their Care Plan.

    If the Government was really serious about knowing where taxpayers money goes, they should seriously investigate how the funds are being spend especially in the area of items purchased or funds reimbursed, I am sure the general public would be shocked to know how some well established, larger providers are spending Government/Tax payers funds.

    Shame, shame, shame.

  17. Deb Van Eldik July 13, 2018 at 11:17 pm #

    Zac
    I agree with you wholeheartedly, as we are in the same situation with our mother. She was given a Level 2 package in 2015 at which time we decided to save her & the Australian taxpayers money & do the jobs ourselves. Since that time our dad passed away and her health has deteriated considerably. She was reassessed by ACAT in December 2017 to a Level3 (medium level) with low respite care available. In May 2018 she had a fall, has cracked her lower back and has extreme difficulty in walking and completing simple home tasks.Today 13 July 2018 I requested she be asssessed yet again as her base level has again dropped. I had to beg the social worker in the hospital to organise this.I was told she would probably be discharged in three days- she can hardly walk, toilet herself ect ect.
    What has OUR COUNTRY come to in disregarding our seniors in such a disgusting fashion while giving billions of dollars to foreign aid?
    I have told the hospital she is not being discharged until we can get some suitable services in place and that she is fully able to look after herself as is their duty of care. We can only live in hope.

  18. Caroline Romeo July 17, 2018 at 8:42 pm #

    I can’t share the pain of the writers of the above 2 posts. However, I can state that the issues are real in terms of under-utilised subsidy to provide care and support to some older people. This is not often the fault of a provider. Rather, an older person will refuse services as they try to retain their ‘independence’ or worse still, a person is assessed incorrectly and allocated a far higher level than required. Some of the challenges of expending the subsidy is that people are not re-assessed as their needs change. Care plans need to work both ways : improvement and decline of function.

    Another real challenge I believe in the HCP environment is the notion of ‘my monies’ therefore it should be used for whatever the family (and/or older person) deems its direction. I am sure case managers find that the balance between compliance and consumer-directed care can be a real struggle.

    No one party is to blame. Education about HCPs is important (consumer) as is reassessment of a person (ACAT) and the courage of Government to move people between levels without having to wait in the queue. Something like substantive positions in Government agencies. Your substantive position is Level 4 but you haven’t used more than X% of funding. Your position now is Level 3 package. When your needs change considerably, you return to the substantive Level. I know this sounds simplistic but I do believe it will free unexpended funds and not force people to wastefully spend public monies.

  19. Gaynor Macdonald July 18, 2018 at 6:59 pm #

    Why isn’t anyone ‘to blame’? Why is no one held to account? Does anyone even care what happens to those on ‘waiting lists’? We’re on a waiting list for a Level 4 package – will my husband live another 18 months? Or is it the hope that he won’t – that will certainly save government money. And in the meantime?
    I blame people who avoid paying taxes which would better support all people in a caring society. I blame government for not allocating sufficient funds to cover the costs of aged care. I blame a society that condones ageism. The idea that we should be concerned with ‘wastefully spending government money’ comes across as uncaring and hypocritical. it would indeed be a luxury to have some to waste! It is abundantly clear to me that few people ‘managing’ this ‘industry’ actually feel the pain. It is a very broken system. Please don’t defend it – work to change it. It seems to be all about saving money or making money – not caring. We need a very different approach, not a propping up of this one.

  20. Jackie Boyce September 8, 2018 at 6:29 pm #

    My mum has waited 433 days she was approved for a Level 4 – she was just assigned for a level 3,
    to my surprise what that gives her is a total of 9 hours.

    She is also a self funded retiree – which means she will actually have to pay the max fee of $29.00 per day which equates to $15,000 a year.

    I find this appalling given she still pays tax, how is this fair. It is cheaper for her to just stick with the codes that were assigned. So I will double her outings which is still cheaper, and will still given me -her sole care the respite I need.

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