Legislation enacting the next wave of reforms giving older Australians more choice about their home care services passed the Senate yesterday.
Council on the Ageing (COTA) Australia said the new changes were “a very welcome improvement to our aged care system.”
From February 2017 home care packages will be assigned to consumers by My Aged Care from a national pool of available packages.
The new provisions would, for the first time, enable older people to choose their services and who provided them, rather than having services determined for them, said COTA chief executive Ian Yates.
The new legislation would allow people who were unhappy with the services they were receiving, or who needed to relocate out of the area, to change providers and keep their package.
The new laws were a big step forward in implementing Productivity Commission recommendations from 2011 for a system that gave more choice and control to the consumer, Mr Yates said.
A more competitive aged care environment would put the onus on aged care providers to prove their worth and improve the quality of care and services they, he added.
COTA congratulated the Federal Government and Minister for Aged Care Sussan Ley on the passage of the legislation and thanked Labor and the Greens for their bipartisan support and assistance in swift passage of the Bill, which Mr Yates said “would now allow ample time for implementation before the new arrangements start in February next year.”
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Whilst I applaud the Government’s next step in implementing aged care reform, there is still an annual cap of the amount of funding available. So this begs the question now that Coles and Woolworths are sniffing around the traps to become approved service providers, I am sure they will have the resources, as will most large providers to sweep in and grab every referral put through the gateway, quicker than lightning.
I manage a home care service, but I am also a family member of consumers. Recently my mother (aged 63) endured a 14 week wait to be approved to receive a carer’s pension to give up her part-time work as a book keeper to provide ongoing daily care to my grandmother (aged 95). During this time she was balancing trying to work (to pay the bills)and the competing needs of supporting my grandmothers frailty. Home Care is the only option for our family (our preference) up until this week she has juggled all of this with only 3hrs of CHSP a week. Mums pension has been assessed at just over $500 per fortnight and she intends to do about 7 hours of paid work a week from home when Nanna has her daily sleep. So lets do the sums here… $500 @ 26 fortnights is $13,000 and CHSP @ 3 hours per week for approx. $45 is $7,020 is $20,020 per annum. Nan would most likely need a Level 4 package if she did not reside with mum and have her for ongoing care… a saving to the Government of around $25K per annum. So why does it take Centrelink over 3 months to process a carers payment??? And why is the carers pension and the aged care pension for that matter $800 per fortnight. I certainly could not live on that unless I owned my home outright, had installed some significant solar panels, water tanks, grew my own vegies and lived in an urban setting with access to public transport.
Given that mum also wouldn’t be charging administration and coordination costs to look after Nan, I wonder if the reform implementation has looked at the range of living and family circumstances… yes, I know “paying” family members to care for their loved ones is fraught with danger, but if we are trying to truly look at a system that is consumer directed, is value for money and keeps people at home where they want to be… then the carers definitely need a voice and reviewing the carers pension would be a good start (not to mention Centrelink inefficiencies). I may be doing myself out of a job by supporting this notion, but my point here is about advocating for what is fair, right and in the best interests of a person with very individual circumstances and needs.
With less than 12 months until the “floodgates open”… the My Aged Care / RAS staff really need to improve their game in ensuring they provide thorough assessments and truly put client needs first, otherwise money will continue to be wasted and clients will continue to be very, very confused.
Certainly the reforms passed in the Bill on Friday will have a significant impact and I would like to encourage a system of Financial Best Practice among providers including financial bench-marking through perhaps Forms Administration.
Through such a system, there would exist financial transparency on the delivery of HCP and perhaps the Department could even consider a Gold, Silver and Bronze standard whereby a provider is actually rewarded if they can deliver high quality services to the consumer measured by the Financial Standards. An example would be:
Gold Standard – 70% of total subsidy is budgeted for direct client services
Silver Standard – 65%
Bronze Standard – 60%
This scenario does not include client contributions to services but is based on the subsidy alone.
Providers who attain the Gold Standard can retain unspent subsidies (designated to be returned to the Department) to reinvest in services; Silver can retain 50% and Bronze retain 25% as an example.
This would have to be measured against the service costings however to ensure that the consumer is receiving high quality service delivery at competitive rates.
Financial Standards need to be included in the Home Care Standards and should form part of the Quality Review process.
Subsidies are funded by the tax payer and whilst an open market system may generate more competition, the reality is that no real financial standards are in place to measure performance of the subsidies managed by the Approved Provider of Home Care Packages.
When for profit multi-national providers are pitted against small not-for profit community providers it is clear that there is no foresight from the Government or the Department as to what the long-term outcome of these reforms will be, or perhaps there is and, if that be the case, then instead of consumers being given more choice, the reality will be quite the contrary – a few very large, for profit providers setting the rates with very little competition whatsoever – a Woolworths vs Coles vs Aldi vs IGA so to speak.
My question is why some organisations are given these packages don’t have the staff to service them, so they contract the clients services out. Which in turn means clients are paying more in admin fees and get less hands on. A client with the lowest package only gets approx 4 to 4.5 hrs a week. This is not much when a variety of services are needed.
Consumer choice leads to market accountability. If you cant survive without government handouts then the market has decided you’re not viable.
NFP or multinational, the government’s only responsibility should be the monitoring of regulatory standards…not funding inefficient operators. If large players can provide a comprehensive and cost effective service, then all the better for the client.
But let’s get back to the consumer for a moment. Now that consumers have the freedom to choose their services, we need to consider their ability to make those choices. The typical consumer will be elderly and have little or no computer skills. The very nature of these products means that people will be accesing these services at a time when things aren’t going well for them; they’ll be stressed, confused and unwell.
The current aged care portal is a convoluted maze that would test even the most tech-savvy user; good luck with getting granny to find her way around.
We would better serve our clients by developing a range of simple accessiblity solutions rather than complaining about our bottom line