Consumer Directed Care
ADMINISTRATION fees eating into home care packages, clients being denied choice in their care and not provided with financial statements... welcome to consumer-directed care.
Advocates and lobby groups have been stunned by the number and gravity of complaints about the new system of organising and providing home care. Aged Care Minister Sussan Ley has been silent on the issues raised. The Senior has not been able to evoke a response from the minister, the task instead left to a department spokesman.
Surprisingly, provider peak bodies, which we would expect to be actively pursuing matters with members, most of whom are doing the right thing, have been unable to provide comment.
CASE STUDIES
Case study 1: ROBERT has been trying to sort out his home care package services for some time now. Under the new system he is paying more out of pocket – about $300 a month – for reduced services. Recently, he needed a week of additional support and was told he would have to pay extra, despite a significant portion of his package being set aside for use in case of emergency. The contingency fund now has $3900 unused, but he was not allowed to access it for extra care. He has been told if he leaves his provider, the money may not move with him, so he feels unable to look for alternative services.
Case study 2: FRANCESCA was advised by her home care provider that a staff member would visit to arrange for her to sign a new CDC Home Care Agreement last May. She had enjoyed a positive relationship with her provider and agreed, but explained she would like her son to be present. A few weeks later she received a call saying the visit would happen the following day. When her case manager arrived with the prepared agreement, many fields had been left blank. Francesca did not want to sign a contract that contained blank sections, so asked if she could keep it to show her son. Her request was refused, and she hasn’t been offered the opportunity to sign the contract since. She still receives services, but is worried about the consequences of not having a signed agreement. “I don’t want to make a complaint,” she said. “I just want to be communicated with and know what my parameters are so I can make my own decisions. “I don’t want to feel like a troublemaker when I need to call and ask for something.”
Case Study 3: JUDITH was recently upgraded from a Level 3 to a Level 4 package. She was told if she was assigned as Level 4 she needed a case manager, and the provider said it would also take care of paying her phone and internet bill. The provider charges about half of her package in administration and case management fees, which she has been told are mandatory. On top of that, her phone was once disconnected when the provider failed to pay her bill, and on another occasion the bill was overpaid by $700, which came out of her account.
Case Study 4: JOAN and Donald Brown both receive a Level 2 home care package. Both are very capable, but need help around the home to continue living the lifestyle they want. Although they want to be involved in their own care management, they each pay 45 per cent of their package on administration fees and co-ordination costs. They pay $1100 a month out of pocket towards fees that don’t go to direct care services. They have received very little information and support, and until they enquired about their budget had not received a single financial statement, despite CDC requiring providers to supply one each month. After inquiring, they were sent a consolidated statement covering the previous six months.
Case Study 5: MARGARET, 100, is legally blind and receives a Level 4 package to support her to continue to live independently in her private rental accommodation. She receives five hours of care each week through her provider – one hour a day and no help on weekends. When she called other providers to try to find a better deal, she found one that would offer her 12 hours of care under the same package – more than doubling her current support. However, there were 500 people on the waiting list for a Level 4 package with that provider “With the bigger package you end up getting less help because of the provider’s hourly charges,” she said. “I’ve often thought the administration was getting more out of the package than I was getting help.”
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