THE promised "choice and control" utopia of consumer directed home care is developing into a nightmare for many older people and their families.
Huge exit fees - some as high as $4500 - "boilerplate" contracts with no opportunity for negotiation, pressure-selling, and confusing or inadequate information on the government's My Aged Care website have taken the gloss off the much-touted system, which came into effect on February 27.
And insufficient level four packages mean the most needy are being offered inferior level two packages, with no indication of when or if they will be upgraded,
Seniors' advocacy groups have been fielding calls from people desperately trying to navigate what was supposed to be a simple and straightforward system.
Before February 27 home care packages were "owned" by care providers, who used them to service clients in need of personal or domestic care. If a client chose to leave a provider, they could not take their package with them as they were not portable.
The new system places the choice of provider and how the care package can be spent with the consumer, with a requirement that all providers place their details on the My Aged Care website.
While providers have listed on the website, many have included no information about costs or services except for the exit fee they will charge if a client leaves them and goes to a different provider. These range from zero to many thousands of dollars.
Many providers have not included a website address.
This has left people with the onerous task of having to phone several different providers to compare services and costings, which can include hourly rates, evening, weekend and public holiday rates, different rates for domestic assistance and personal care, cost for attendance by a registered nurse, fees for administration and/or case management, and basic daily fee contributions.
Ellis Blaikie from the Combined Pensioners and Superannuants Association said people were confused - "Confused that the push to give consumers greater choice and control also included the introduction of uncapped exit fees, and confused about what the changes mean, because there has been next to no attempts from the department (Health) to explain the changes."
"There is little help available, unless you're in a position to fork out and pay a consultant. And that creates an issue in itself, when you've got one group of consumers who can afford to pay for the extra support needed to find a good home care provider, and another group who don't have that support and are more likely to take the first option that comes their way.
"You should be able to call My Aged Care and they should be able to give you a like-for-like comparison of the home care providers in your area."
Council on the Ageing chief executive Ian Yates said that to address the lack of level four packages, his organisation was pushing the government to take a more flexible approach.
"If they've got unused level twos in the system they should bundle them up to make more level fours," he said.
If high exit fees persisted, COTA would ask for them to be capped, while evidence of "boilerplate" or pressure-selling activities would be taken to the Australian Competition and Consumer Commission.
Aged and Community Service Australia chief executive Pat Sparrow said the vast majority of home care organisations provided affordable, quality services.
If consumers believed the fees were too high they could choose another provider.
"Consumers are only required to pay what is in the contract they have negotiated and agreed on with the provider," she said.
'Hitting our most vulnerable'
Meanwhile, a national survey commissioned by in-home care provider KinCare, which does not charge exit fees, showed that 75 per cent of those affected by the new scheme believe exit fees should be banned altogether.
"The introduction of exit fees is unfair and it's hitting our most vulnerable the hardest, at a time when they are supposed to have greater choice in selecting a care provider for the first time," said KinCare chief executive Brian Bissaker.
"The whole point of the government's consumer directed care scheme is to deliver increased choice and flexibility, not lock thousands of older people into care arrangements they might not be satisfied with.
"As an industry we have a huge opportunity to reshape the sector by improving the service offered to customers across Australia so they can live richer, more independent lives."