From 27 February 2017, the rules around home care services for older Australians have changed. The changes were originally announced as part of the 2015-16 Budget and aim to strengthen the quality of home care services by increasing competition and reducing red tape for providers. In this article, we explain the upcoming changes and how they can help you address the needs of your retiree clients.
Why do I need to know about home care services?
Home care is an important part of care services for older Australians. The number of home care recipients are growing, and so too the need for home care advice. At 30 June 2015, there were 72,702 home care packages, which were used by at least 83,838 eligible individuals. The Australian Government has a target to increase the number of home care packages available to 140,000 by the 2021-22 financial year, meaning advice opportunities in home care will grow significantly. By understanding the home care rules including the upcoming changes, advisers are better positioned to maintain current retiree client relationships.
What does home care involve?
The aim of home care is to provide eligible individuals who want to stay at home with a range of services to help them with their daily activities. These include:
- Personal services – showering/bathing, dressing and/or mobility
- Support services – help with housework, gardening, maintenance, transport etc
- Clinical care – nursing, physiotherapy, dietary, hearing and vision services.
What are the changes?
From 27 February 2017, changes have been made to improve the way home care services are delivered. The main changes relate to:
- Removal of approval ‘bands’.
- Assignment of home care packages.
- Portability of home care packages.
In the first stage, from February 27 2017, funding for Home Care Packages (government subsidized home care services) will follow the consumer. This means that a consumer will be able to choose a home care provider that suits their needs and direct their package funding to that provider. This first stage will also give consumers the opportunity to change home care providers if they wish – whether they move or no longer require care at home.
The second stage of these home care reforms will integrate the Home Care Packages Program and the Commonwealth Home Support Program into one single home care program. This will simplify the way that home care services are delivered and funded. At this stage, the new integrated home care package program will be introduced from July 2018.
Removal of approval ‘bands’
Currently, there are four levels of home care packages that fit into two different approval bands. To obtain a home care package, individuals must be assessed by ACAT to determine eligibility in one of these two bands, either Level 1-2 or Level 3-4.
From 27 February 2017, these bands will be removed and ACAT assessors will approve individuals for a home care package at one of the specific levels. The effect of this is, any of your ACAT assessed clients who were approved for a home care package band before 27 February 2017 will automatically be approved for the higher level of care in that band.
For example, individuals who have an ACAT approval for a Level 1 or 2 home care package will be automatically approved for a Level 2 package from 27 February 2017. In the event the care recipient is not sure of their current level of home care they can find out by contacting their provider or checking their Home Care Agreement.
Portability of Home Care Packages
- All consumers – both new and existing – will be able to change home care providers if they wish.
- Any unused funds will move with the consumer to the new home care provider.
- If a consumer leaves home care, any unused funds will be paid back to the Government and to the consumer – either directly to them or their estate. Exact amounts are determined on a case by case basis.
Prioritization of Consumers
- A consistent national system will be introduced to assign home care packages to eligible consumers.
- The prioritization process will consider the needs and circumstances of eligible consumers and the time spent waiting for care.
Home Care Package Assignment
From 27 February 2017, a national queue is established to assign home care packages to individuals through the My Aged Care service. An individual will be placed in the national queue when they have been approved for a home care package and have indicated that they want to start receiving home care services.
Previously, packages at each level were allocated to service providers, who then managed their assignment to individuals. This created waiting lists for some providers. In the new national queue, ACAT assessors will need to determine whether an individual should be assigned a high priority to gain faster access to a home care package. These changes will mean the allocation of packages will be more consistent across the country. Packages will be made available based on the relative needs and circumstances of individuals and the length of time they have been waiting, rather than on a regional basis.
When the individual reaches the top of the national queue, a letter will be sent informing them that a home care package has been assigned to them. The letter will include:
- The details of their home care package
- A unique referral code
- The date they need to enter a Home Care Agreement.
The individual will have 56 days from the date of the assignment letter to choose a service provider (they are also able to ask for an extension of 28 days) to avoid their package being withdrawn. For individuals who have already been ACAT assessed, transitional arrangements will apply to them based on their approval date and whether they are currently receiving a home care package.
What’s Not Changing
- There will be no changes to the current home care fee arrangements.
- Home Care Packages will continue to be delivered on a Consumer Directed Care basis but consumers will have greater choice regarding their home care provider.
- The total number of Home Care Packages available will continue to be capped in line with the aged care planning ratio set by the government.
- Funding will continue to be paid directly to an approved home care provider.
If you decide to change providers, the provider can charge you an exit fee to cover any administrative cost, which will be deducted from any unspent funds. Exit fees may vary between providers and the amount should be clearly stated in the Home Care Agreement between you and the provider of your choice.
All these changes have been put in place to give you more say, flexibility and transparency in the way your home care services are delivered
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