Choice and control to hit home support next

Limited data on the Commonwealth Home Support Program is hindering the sector’s understanding of the largest part of the aged care system, sector leaders have told a national aged care conference.

David Tune, the author of the Aged Care Legislated Review and chair of the Aged Care Sector Committee, told the LASA National Congress on Tuesday, that improved data collection on the $2.2 billion program would be necessary as the government embarked on further reform of the community aged care sector.

Lynda O’Grady, chair of the Aged Care Financing Authority, also told the congress of her frustration over ACFA’s attempts to analyse the program, which have been unsuccessful due to a lack of information.

She agreed better consumer and provider data needed to be captured, which would also provide further insights into demand for aged care.

“Due to it being a grant-based system, we do not have sufficient information about the profiles of the people who are accessing the home support program. We also don’t know what portion are being afforded care [equivalent to] home care packages,” she told the Gold Coast audience.

The home support program is the largest part of the aged care system – servicing close to 1 million people – yet the most poorly understood.

“It is really important to expose the black box, which is community home support,” Ms O’Grady said.

In 2015-2016, only 130 of the CHSP’s 812 providers also delivered home and residential care, she said. (Figures for WA and Victorian HACC are not available.)

LASA CEO Sean Rooney told the congress the extension of CHSP contracts until mid-2020 provided the federal government with an opportunity to include provisions for further data collection.

Mr Tune said in addition to a lack of data, the CHSP was also the least mature part of the aged care system.

While Mr Tune said his review did not examine the CHSP in detail, he did recommend that mandatory fees aligned with the income testing arrangements for home care be introduced into the program.

The shift to a more consumer-oriented system would require CHSP providers to also adjust to be responsive to the principles of consumer choice and control, he said.

Aged care funding debate ‘needs to mature’

Commenting on the Commonwealth government’s initial response to his report, Mr Tune said he was “disappointed” the government had chosen not to keep all of his recommendations on the table.

When releasing the report last month, the Coalition Government announced it did not support including the full value of the unoccupied home in the assets test for residential care or the removal of annual and lifetime caps on consumer contributions.

“I framed those recommendation in terms of not what needs to be done today or tomorrow even, but what needs to be done over a period of time into the future. It was my wish that the government at least left those things on the table for future consideration.”

He said only a very small percentage of consumers had reached the annual cap on means-tested care fees, so the immediate impact would be limited.

Long-term financing of aged care

Mr Tune said the current split between consumer and government contributions to the aged care system was incorrect and “an essential issue” that needed to be resolved.

By “closing the door” on increased consumer contributions for those with the capacity to pay, the government likely created “other problems down the road,” he said.

“I hope the debate becomes a bit more mature in due course.”

Andrea Coote, chair of the Aged Care Quality Advisory Council and former Liberal MP in Victoria, likened the current controversy around the inclusion of the family home in the assets test to vocal opposition to the proposal to charge bonds in high care a decade ago.

She said it was up to industry and consumer advocates to keep the issue “on the boil” and on the agendas of politicians.

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