Minister agrees to case reviews

INSTANCES where home care clients are severely disadvantaged by loss of care hours under the new consumer-directed care system will be examined on a case-by-case basis.

Assistant Social Services Minister Mitch Fifield said the reviews will also look at whether some providers are charging excessive administration fees under the new system, which began on July 1.

The announcement followed claims that up to 12,000 older people could suffer care shortfalls as the system exposes problems that have existed for years.

Under the consumer-directed care model, clients who choose to be more involved in controlling their package work with providers to spend their allocated funds.

Under the previous system, some clients who were assessed as requiring high care – a level three or four package – often chose a provider who did not have that level of package available.

In those situations the provider sometimes put the person on a lower-level package until a higher-care option became available, and used funding from people who did not need their full allocation to top up the difference.

This “cross-subsidisation” will be impossible under the new system, leaving some people with high care needs on lower-care packages.

Their only options will be to seek a higher-care package elsewhere, pay for the extra services or go into residential aged care.

“Since the Home Care Program began there have not been enough high-level packages,” said Combined Pensioners and Superannuants Association senior advisor Charmaine Crowe.

“They are increasing the number of home care packages over the next few years, but it’s a slow process and it’s likely to still fall short.

“If people can’t get the care they need, they are going to go into a nursing home. It’s far cheaper for the government to provide home care than provide nursing home care.”

Senator Fifield said one of the reasons the previous government gave three years’ notice to aged care providers was so they could address the cross-subsidisation issue.

He said a team will work with those affected to check they are getting the full value of their package and to ensure providers are doing the right thing.

“I’ve heard of some examples where there are administration charges of up to 40 per cent, which strikes me as peculiar and not acceptable,” Senator Fifield said.

Packages would also be looked at to ensure someone who had been topped up from someone else’s package was on the correct level.

“That is the important other side of the equation: if someone is being topped up, they are being topped up at the expense of someone else.”

Senator Fifield said under the former system some people did not receive the full value of their packages, but funding was now more transparent.

While acknowledging the system remained “clunky” and “unsatisfactory for consumers”, he said this would change from February 2017, when funding was placed in the hands of individuals, who would then shop for a provider to handle their package.

Canberra historian Margot Harker, 68, is receiving home care after suffering a stroke four years ago.

A pensioner who has spent years in rehabilitation, she launched an online petition after she learned how much extra it would cost her to receive the same level of care once her package transitioned to consumer-directed care.

Margot is on a level four package because she only has use of her right hand, which has developed arthritis. She receives help for 90 minutes in the mornings and an hour every evening.

“I was really stunned,” she said. “I hadn’t had any warning about the magnitude of it all. “I have carers to help me with the very basic personal and household tasks I can’t do myself. That means I can live independently.”

Under consumer-directed care, her provider told her she would either have to cut her hours, pay $2185 a month to cover the extra hours, or move to a nursing home. The provider later offered to reduce those fees, but not to a level Margot could afford.

After she attracted 20,000 signatures on her Change.org petition, the Department of Social Services investigated the fees being charged by her provider, which make up more than 90 per cent of the amount she is being asked to pay after July 1.

Margot has spoken to a number of others in her situation, and is cautiously hopeful the reviews will resolve the problem. “I am pleased Senator Fifield genuinely appears to want this problem solved,” she said.

“However, I’m concerned that the review mechanism will take a while to set up, and the take-up may be very large.

“Until we can have our cases reviewed, many of us will either be trying to find the extra money or suffering the effects of reduced carer hours”.