Call to increase top level home care to $132k
Some older people will be forced into residential care while home care organisations may have to stop providing services without two key changes to Support at Home, says group in open letter to PM.
A group of 10 home care leaders have written to the Prime Minister and aged care ministers calling for top level home care under Support at Home to match residential funding levels and care management fees to remain the same as they are now.
Without these changes, some older people will be forced into residential aged care while home care organisations may have to stop providing services, they say in an open letter published online on Tuesday.
The authors – who include aged care consultant and former provider and peak body head Paul Sadler, Macquarie University academic Dr Michael Fine and several service provider chiefs – say their experience shows the incoming Support at Home program is inadequate to enable many older people with diverse or higher needs to remain at home.
“The current proposed lower levels of home-based funding will create the perverse incentive for older people to enter residential care to get their needs met,” says the group – who have been brought together by home care consultants Invox.
“The highest level of funding for individuals in the current proposals is just over half that the royal commission recommended. In addition, the new approach to funding for providers of care management falls significantly short of the actual costs incurred by a diverse range of organisations currently supporting older people at home.”
The proposed program will create a two-tiered system that disproportionately impacts older women with lower superannuation balances and disadvantaged groups, say the authors, who also made a last-minute submission last Friday to the Senate inquiry into the new Aged Care Act.
“Those who self-fund will be able to remain at home while older people with lower means will be forced into residential care.”
The group is calling on the government to:
- raise top level of Support at Home funding for individuals from $78,000 to $132,000
- retain the current variable approach to care management fees with a maximum of 20 per cent.
“If the government does not align Support at Home with residential care funding, many community organisations will either stop providing services to higher needs and disadvantaged older people, or close their doors altogether,” the authors say.
The other signatories include:
- Mary Patetsos, chair St John Ambulance
- Les MacDonald, CEO Meals on Wheels NSW
- Kate Fulton, CEO Avivo, Perth
- Michele Bell, CEO KNC Care, NSW
- Huda Ammar, CEO Everglow Community Care Links, Townsville
- Sharon Douglas, CEO Angels in Aprons, Milton
- Melissa Bastian, CEO Just Better Care, Gippsland
- Roland Naufal, director Invox.
Changes to save gov’t money, say group
Mr Sadler – a co-founder of Invox and spokesperson for the group – said increasing the funding available to individuals with higher needs was in line with the royal commission’s findings.
“The royal commission recommended that we should peg the highest rate in home care to the highest rate in residential aged care, and we’ve had a look at what the costs are,” Mr Sadler told Australian Ageing Agenda.
They have come to $132,000 by combining the highest AN-ACC classification funding of $93,000 with the residential base care tariff.
“We believe that to give people true choice, you need to provide them the same level of care in community care that they would attract should they be in [residential aged care]. It’ll still be cheaper for the government to provide that level of support to people living at home because you don’t attract the accommodation cost” or other funding elements such as everyday living and the hoteling supplement, he said.
Rather than asking for a delay to the start of Support at Home – like other stakeholders – Mr Sadler said the preference was to “get the system as right as we can before it starts in July next year” and use the May Federal budget to make any adjustments to Support at Home funding if required.
On the proposed changes to care management from 20 per cent under the current Home Care Packages program to 10 per cent under Support at Home, Mr Sadler said “many providers are concerned about the potential implication of that cut” including some people not getting the level of care management they actually need.
The proposed 10 per cent is a pooled funding arrangement so providers can use as needed across recipients. But current spending shows it’s not enough, he said.
“Currently, the number of hours spent on care management are 18 per cent of the total hours that a home care package provider offers to older people. We would say you need to retain flexibility so that you can increase the level of funding with the agreement of the older person or their supporter to a higher level [of care management as needed],” Mr Sadler said.
“You need to meet the needs of individuals here, and just putting a blanket 10 per cent on the amount of money is not the right way to go.”
The other issue is that the profit margin for home care package providers largely comes out of the care management fee.
“There’s a risk that services further operate in deficit rather than being able to sustain their service delivery,” Mr Sadler said. This will depend on the Support at Home pricing, which the Independent Health and Aged Care Pricing Authority is working on.
“And the other thing is the case management change is triggering many providers to consider whether they stay offering services,” Mr Sadler said.
Along with the letter and accompanying fact sheet, Invox has launched a campaign asking aged care providers to write to government and opposition ministers and their local elected members about what changes should be made to the Support at Home.
“We’re really encouraging all providers to get behind us in that ask,” said Mr Sadler.
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