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Home care providers pilot ‘radical’ self-management model


Seven home care providers and more than 100 clients are piloting a new self-management model which includes direct online access to financial information, hands-on involvement in sourcing care staff, the use of a home care debit card and access to a self-management consultant.

Carmel Laragy

Dr Carmel Laragy

COTA is working with RMIT University to design a CDC-based model specifically tailored for Australian home care, which it says will strengthen the capacity of the aged care sector to respond to ongoing challenges of aged care reforms.

The two year federally-funded Increasing Consumer Self-management in Home Care Project is set to finish in March when outcomes will be reviewed.

The research team says the project comes in response to demand from consumers for autonomy and self-determination, as well as feedback from providers who say they are keen for a package of fit-for-purpose self-management resources.

Power to the consumer

Research leader Dr Carmel Laragy form Centre for Applied Social Research (CASR) at RMIT University says the new model departs from the existing system in that “the person themselves makes changes instead of a case manager or a coordinator.”

“It is quite radical,” she says.

Dr Laragy says making sure people know how much money they’ve been allotted and giving them control over how the money is spent within the parameters of their plan is at the heart of model.

It is specifically tailored to the Australian system where “everything in Australia is about ‘lets set up a plan, let’s itemise what you’re going to spend’,  and then there are reviews and checks that the money was spent according to the plan,” she told Community Care Review.

The seven providers involved in the study also have flexibility within the model to come up with their own unique “flavour” of self-management, which will be compared at the end of the pilot period.

Paricipants were surveyed at the beginning of the trial and the cohort will be evaluated again when it ends to see if the trial lived to their expectations, and to find out what worked and what didn’t.

Interest from providers

Anna Millicer

Anna Millicer

Project leader Anna Millicer said while self-management is valued and encouraged in other areas, such as superannuation or the NDIS, there’s a tendency to reduce the options in aged care.

“Our participants tell us that they value having access to information and resources that assist them to maintain their autonomy and sense of purpose as they age,” she told Community Care Review.

She said  50 per cent of providers indicated on the My Aged Care Service Finder that they offered self-management, but were unable to describe what this actually involved.

“Many providers have contacted us to express their interest in our model and our resources,” she said.

“They are keen to offer self-management, but with reduced profit margins for some, they say they cannot afford to create their own resources and instead want a package of resources that are fit-for-purpose that they can simply integrate into their existing service model.”

What the model involves

  • Direct, real time access to home care budget and statement providing more authority over spending decisions
  • Access to an independent or in-house self-management consultant
  • Ability to directly hire and manage staff and suppliers including planning rostering and daily communication
  • Availability of a home care debit card

What consumers want

  • Maintain autonomy
  • Tools and information to increase knowledge
  • Clear parameters around decision making
  • Ability to make informed choices about spending subsidies
  • A safety net if they want to return to provider-managed care

Self management expectations and hopes

  • A third thought self management would result in positive changes in their relationship with their provider
  • The majority (41 per cent) didn’t expect self-management to lead to more stress, although a quarter thought it would. The remainder were neutral
  • Almost half (44 per cent) said they weren’t worried about poor outcomes
  • Most joined the trial because of hassles with previous providers

Anyone interested in receiving project updates can register by emailing selfmanagement@cota.org.au

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