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Home care providers accused of resisting change


The home care sector has been “patchy” in adapting to the shift towards greater consumer control and many providers are resisting it, the head of Australia’s peak advocacy body for older Australians says.

COTA Australia chief executive Ian Yates will emphasise the need for consumers to strengthen their role in the growing home care market when he addresses a key aged care conference in Sydney next week.

“I think essentially providers who knew how to do (consumer directed care) have adapted well, but many providers are essentially resisting it,” he told Community Care Review.

Ian Yates

“It is quite common to get stories from consumers who say that they don’t really have much choice.”

But he is confident the situation will “evolve” as providers respond to consumers becoming more informed about their rights.

Requiring providers to be more transparent about services and prices by providing comparisons will also help bring change, he said.

Mr Yates said COTA is standing firm on its insistence that legislation for an Aged Care Quality and Safety Commission includes a consumer commissioner to protect and promote consumer rights, as proposed in the 2017 Carnell-Paterson review.

The government has indicated it won’t accept the proposal for a separate consumer commissioner but COTA is prepared to take the fight to the Senate, where the government doesn’t hold a majority, if the provision isn’t included.

“We will pursue that point in the senate. We will pursue amendments to the bill if it’s not in there,” he said.

Addressing the home packages gap

Mr Yates will also talk about moving forward on the shortage of home packages at the conference.

The budget allocated an extra 14,000 high-level home care packages over four years to address the increasing demand for home care, however that falls short of meeting the needs of the 82,000 older people currently waiting in the national queue for a Level 3 or 4 package.

Other thorny issues that still need to be resolved include decisions about combining CHSP and home care packages and what to do about unspent funds. But there’s also room for some optimism.

“We have inadequately addressed the home care package shortage but a big step was taken in abolishing the distinction of funding pools for residential and home care,” he said.

“By the time that we finish these forward estimates we’ll have 152,000 home care packages out there … a decade ago we hardly had any packages, it’s a really big shift.”

Fixing up financing

Another issue not addressed in the budget, he says, is the unsustainable and inconsistent approach to financing home care.

“Both government and opposition have to address it,” he said. “You can’t get a sustainable sector without sorting that out. We have an incoherent set of means testing arrangements across the whole.

“We talk about aged care being a continuous spectrum, but the most discontinuous thing about it is what you might be charged in any point in time, which is why you get people who refuse to move off CHSP onto a lower package because there’s a different charging regime.

“We have to sort out the relationship between the two and we need to have a fair and sensible, but also robust, user-charges regime, so the people with more capacity pay more.”

Mr Yates will also focus on the single quality framework in home care.

“While there’s been a lot of media focus on residential care, we are going to find that there are significant issues in home care,” he told Community Care Review.

The Aged Care Reform after the 2018 Federal Budget conference will be held on 25-26 July at the Hilton in Sydney and speakers will include Treasurer Scott Morrison, aged care minister Ken Wyatt and health economics expert Professor Michael Woods.

Australian Ageing Agenda is a media partner of the conference.

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6 Responses to Home care providers accused of resisting change

  1. Kate Lambert, CEO Daughterly Care July 19, 2018 at 3:05 pm #

    Finally someone in a Senior position speaking the truth for Older Australians. From my audits of hundreds of Home Care Statements what I have seen is “Old School Approved Providers” actively working against true choice for consumers, not to mention taking advantage of elderly people via undisclosed secret fees, overcharging etc

  2. Richard July 19, 2018 at 7:02 pm #

    I only just published about CDC this morning! It needs to be said as we need the shift!
    I think it is not through bad faith of any Home Care Provider but lack of govt support to teach them and the package holder. Poor roll out of CDC really and without any outcome measures and a few other things that are lacking from such a big spend by the govt. How do we determine if an agency is delivering value for money to the consumer and govt?

  3. Shalla Thomas July 20, 2018 at 11:18 am #

    Home Care Package Provider would like things to stay the same as many grew very quickly and employed their own staff and so to keep this staff they need to keep the status quo, still not a lot of choice and the conversations with older people who have never been asked what their goals and aspirations may be need to have a different type of conversation than the old this is what we offer and how many hours of that can we afford for you to have after we have taken out a large chunk in admin and hidden fees

  4. Julie Howard July 23, 2018 at 11:36 am #

    Its not so much that people are not given a choice. What about when they want to spend all their package on weekly lawn mowing and social outings, heat pumps, new bathrooms and other home modifications and they are not having things like twice daily medication prompting (despite needing it) or their other personal care needs met? There is not enough funding for everything – sometimes the provider has to make a call and say no, the package cannot fund it.

    Regarding the program – the waiting list is not just about waiting for a package, its waiting for other necessary allied health services also! e.g. Occupational Therapy assessment and implementation of recommendations is important to facilitate self care and independence. The limitations of funding in terms of aids and home modifications further impede this process. I know people who have been waiting 10 months to have an OT assessment. The whole MAC process impedes prompt implementation of these basic services.

  5. Jikan July 23, 2018 at 3:27 pm #

    I really wonder exactly whose interests COTA represent on this issue. Both my experience with multiple immediate family members and friends, and exposure to organisations and seniors groups suggest that whilst they welcome ability to have say in the care that is provided, they do not support the added complexity of the system, the additional user pay charges (separate fees for each component, exit fees etc), the burden of having to deal with providers that are increasingly morphing into call centers, and the increasingly impersonal and cold quality of care that is flooding the market. In short, the elderly I know who are in need of a home care package, simply want consistent quality care, not increased charges, and the burden of staying on top of a transactional market based system. I don’t see hordes of package holders and those waiting for high end packages such as my parents calling for more user pays. Perhaps we shouldn’t be surprised to see some Provider CEOs and COTA sing from the same hyman sheet.

  6. Javnika Patel July 28, 2018 at 7:19 am #

    It’s nice to see people are talking about real issues in Home Care Industries and having single quality framework across the aged care industry. From my experience, I have seen some really good home care services provider who provides consistent quality care and are client oriented but they are few and far between. Its time that all service provider are transparent about services, prices and explain the consumer rights to aged community.

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