Preparing for 2020: a how-to guide

To get ready for the home care changes ahead, the Aged Care Roadmap, future care at home discussion paper and recent review of aged care reforms, offer a good base for providers to start, writes Lorraine Poulos.

Providers of home care services, both private and not-for-profit, have been asking me what they can be doing to prepare themselves for the changes that are ahead in the sector.

Some are prepared and have done business case scenarios whilst others are playing a ‘wait and see’ game. The Aged Care Roadmap, the future care at home discussion paper and recent Legislated Review of Aged Care 2017 provide a good base for providers to commence planning for change and opportunities.

In the May budget, the government also announced changes to funding arrangements for the Commonwealth Home Support Program (CHSP). This included new funding conditions to provide a greater focus on activities that support independence and wellness and provide more choice for consumers.

The Aged Care Roadmap sets out a number of the future directions, including:

1. A seamless aged care system that is market based and consumer driven, with access based on assessed need
2. Seamless movement between home-based and residential care with true consumer choice of care and provider across the spectrum.
3. A system where supply is uncapped (this will be monitored by government to ensure funding allocation is adhered to)
4. Removing the distinction between care at home and residential care, creating a single aged care system – agnostic as to where care is received.

There are nine destinations outlined in the Aged Care Roadmap. I would like to focus on destination six – ‘Who Provides Care?’ as I think it is very important for CHSP providers to keep this in mind when considering their future. Recently the process for becoming an approved provider has been streamlined resulting in new entrants into the HCP market.

The number of CHSP providers is still controlled by government, and as we move to a combined CHSP/HCP program in 2020, it is not likely that any new providers will be given grants to provide CHSP leading up to this time.

The desired outcome when it comes to ‘Who provides care?’ according to the roadmap is:

• A single registration scheme
• A staged approach to registration depending on scope of practice
• Mutual recognition of similar registration and accreditation systems
• Multiple operators with the objective of driving competition, innovation and consumer responsiveness
• A desired goal is efficiency and value for money for the community

According to the Roadmap, providers need to be an incorporated entity to be registered with government to receive consumers’ government contributions. In a nutshell, all CHSP and home care providers will become ‘care at home’ registered providers. Some examples of registration types referred to in the Roadmap are:

• short-term restorative care
• care co-ordination/case management
• clinical and personal care
• services with an accommodation component; and
• financial services (holding payments in trust).

These are just examples and it is not clear what suite of services will be available for consumers to choose from, however it provides an opportunity for you to look at your service offerings and decide if you are able to change your model in any way.

In the recent Tune Review there a few recommendations that are well worth considering. These are recommendations 16, 23 and 29 which relate to the charging of mandatory consumer contributions in the CHSP, the introduction of a system navigator and outreach service and improved access to wellness and short-term reablement.

Preparation checklist

Ask yourself the following questions:

1. Imagine your service was a private business that was not reliant on government funding – what would need to change?
2. Have you undertaken business case scenarios – best case/worst case?
3. Who could you partner with to improve your chances of success?
4. How many of your CHSP consumers are self-funded retirees or part pensioners? Would they continue to pay for your services if they were charged on a full cost recovery basis?
5. What service types could you provide that you are not currently providing?
6. Would you consider the NDIS as a possibility to diversify your model?
7. What opportunities exist in the area of restorative care?
8. How can you better connect with the healthcare system?
9. How can you connect with your community? What local events can you be involved in? Do you know your market demographics?
10. At what point do you consider it may be time to exit or merge?

It is an exciting but challenging time for providers. Consumers have more say and are exercising choice, and this is a good outcome, however the smaller, locally connected services are struggling to survive. The next few decades will see many changes and I hope the sector continues to be supported and strengthened by our industry bodies and advocates.

Lorraine Poulos is a trainer and consultant with experience working with government and aged care providers. Contact admin@lorrainepoulos.com.au

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