In-home care: it’s your choice

The introduction of consumer directed care nationally will allow older people to self-manage their home care packages, choosing the provider and services they want instead of what a provider is prepared to offer.

Home care packages help people to live independently either in a family home, caravan park, retirement community, granny flat or other living arrangement. The number of packages is expected to increase to about 100,000 by 2018.

At present home care package funding is “owned” by care providers who assess applications and tell clients what services are available to them, whether those services suit their individual needs or not.

The system has led to allegations of providers charging huge fees (sometimes 50 per cent of the package), discrimination against people who can’t afford private services, and problems for people who have to relinquish their package and apply again if they move to another area.

Under the new system, the home care package will be allocated to the package recipient, who will be able to choose their home care provider, change providers at any time (although a fee may be payable) and will be able to take their package anywhere in the country.

Anyone currently on a home care package does not need to do anything on February 27. Their service will continue without change, unless they are unhappy with their provider, in which case they can talk to their provider about their problems or if necessary change provider.

Any unused money in their account will move with them to a new provider and no exit fee is payable if not included in writing in their existing contract.

Reasons for wanting to change may include unfulfilled care needs or an elderly person’s wish to have a carer who speaks a certain language or understands their cultural background.

Council on the Ageing chief executive Ian Yates said benefits of the new system included greater competition, which would encourage providers to offer better value for money, and more service providers moving into the industry who would be able to provide an increased range of services.

“I’m very confident that providers who until now have not been able to move into new areas will be able to,” he said.

Mr Yates urged people to shop around for the best quality of service and price. “There will be some cheapies out there but discerning people will be able to make the right choice.”

He said COTA planned to approach the government to introduce a cap on exit fees but also encouraged consumers to read the contract carefully. Companies are required to disclose fees including exit fees in the contract.

Mr Yates said COTA also wanted to see the introduction of outreach services, peer support, peer education and advocacy services to assist elderly people who might not have anyone to help them with the application and selection process.

HOME care providers can charge exit fees on any new arrangements made with home care package recipients after February 27.

The exit fee must be agreed with the care recipient in advance, clearly disclosed in the arrangement documents and must be published on the My Aged Care website.

Care providers do not have to charge an exit fee and new care recipients and those wanting to change can “shop around” or negotiate a fee they think is fair.

The fee charged cannot be more than the balance of funds in the recipient’s care account.

Providers cannot charge an exit fee before or after February 27 if the care recipient is already in an arrangement that does not have an exit fee component.

Prior to February 27, care recipients changing providers forfeit any funds in their balance, but after February 27 the balance of funds will travel with them to a new provider.

COTA chief executive Ian Yates said even if a care recipient does not have a contract an exit fee cannot be charged.

He said anyone with an existing arrangement should decline to sign if presented with a new contract, which includes an exit fee, to apply from February 27.

Under the consumer-directed care system, new home care packages will be allocated after an assessment by an Aged Care Assessment Team (ACAT).

There are four levels:

Some people will have to contribute a fee towards their care costs, which will be taken off the government contribution, based on the income test for the age pension.

Full pensioners pay no income-tested fee while part-pensioners and self-funded retirees whose income exceeds $25,792 a year (single), $20,025 per person (couple) will be charged 50 cents for every dollar above the thresholds.

The maximum annual income-tested care fee is $5208.20 a year for part-pensioners and $10,416.42 a year for self-funded retirees. The lifetime cap is $62,498.66. These caps are subject to indexation.

Providers may also charge a daily basic fee, which is added to the care recipient’s budget and boosts what can be spent on care.

Different providers charge different basic daily fees. Some have no fee and some use a sliding scale.

The maximum that can be charged is $139.58, which is equal to 17.5 per cent of the full age pension and is negotiable.

Administration fees can be charged and will be taken out of the care recipient’s budget. These can also be negotiated.

The government’s My Aged Care department will assign packages and once assigned a recipient has 56 days to select a provider.

Services that can be provided include personal (bathing, dressing etc), support (home duties and transport), and clinical care (nursing and allied health services).

Current care recipients who have been assessed for a higher level service than their provider can give them because of lack of funding will now go into a national wait-list pool that may enable them to receive the increased level of service sooner.

COTA has developed the Home Care Today website to assist people with home care packages – homecaretoday.org.au

My Aged Care provides information on consumer directed care and home care packages as well as help finding service providers – 1800-200-422, www.myagedcare.gov.au