The hidden costs for rural & regional older Australians when accessing Home Care packages

There are a number of people in the Clarence Valley who are hesitant to apply for Home Care packages - often because the houshold budget maths just don't add up when it comes to what is now essentially privatised and very expensive assistance for older people in their own home.

Here is yet another example......

The Daily Examiner, 21 October 2019, p.3:

Clarence Community Transport CEO Warwick Foster said there were misconceptions surrounding how government funding works with Commonwealth Home Support, NDIS and Home Care Package clients.

“People don’t have the correct information about how the system actually works, and that’s understandable because it’s a confusing system,” he said.

Mr Foster said Clarence Community Transport was primarily a home support program, designed to provide subsidised transport to eligible clients.

“When it comes to clients who transition to a Home Care Package, regardless of the level, then they technically become ineligible to access Commonwealth Home Support Programme services,” he said.

“I think where the problem comes in is that there’s not enough education for the clients about what it means when they accept a Home Care Package.

“Unfortunately clients who had been using community transport to get to appointments go from paying one fee then having to pay another fee because we’re no longer able to provide subsidised transport. That’s why it’s such a shock.

“Three days a week we transport clients to Brisbane and the Gold Coast, and to get them up and back for a subsidised client is $80, but that fee goes up to $780 once someone accesses a Home Care Package.

“We get notified by the government, who tell us when a client is in receipt of a Home Care Package, that they’re no longer eligible for CHSP services.”.....

“We’re a not-for-profit but that doesn’t mean we’re here to provide free transport.

“We are required under our contracts to recoup some costs of the transport service from our clients.”

Waiting for home care in Australia in 2018

There are now 108,000 older Australians on the waiting list for Home Care Packages.

On this list are individuals who have:

* not yet been approved for home care;

* been previously assessed and approved, but who have not yet been assigned a home care package; or

 * are receiving care at an interim level awaiting assignment of a home care package at their approved level.

Waiting time is calculated from the date of a home care package approval and this is not a an ideal situation, given package approval times range from est. 27 to 98 days and the time taken to approve high level home care packages is now than twelve months - with actual delivery dates occurring at least 12 months later on average.

Labor’s Shadow Minister for Ageing and Mental Health issued a statement which pointed out that “With the waiting list growing by almost 4,000 older Australians in just three months, the 3,500 new home care packages a year committed in the Budget won’t come close to keeping pace with demand”.

With more than half the applications for permanent entry into residential aged care taking more than 3 and up to 8 months to be met, this is not going to be a go-to first option in any solution for this lengthy home care waiting list - even if enough older people could be persuaded to give up the last of their independnce and autonomy.

By June 2017 New South Wales had the largest number of persons on the home care waiting lis at 30,685.

Given the high number of residents over 60 years of age in regional areas like the the Northern Rivers, this waiting list gives pause for thought.

Then there is this side effect of the waiting list and home care start dates identified by Leading Age Care Services Australia (LAGSA):

Consumers with unmet needs and unspent funds

LASA has undertaken an extensive review of the disparity that exists in the current release of HCP assignments, noting that there are substantial numbers of consumers on HCPs with either unmet needs or unspent funds . This bimodal distribution of home care package assignments reflects a mismatch between consumer package assignment and a consumer’s current care needs. The mismatch appears to be a function of the extended lapse of time that exists between approval assessments and package assignments. Until this dynamic is sufficiently addressed by Government, LASA expects that providers will be faced with a unique set challenges in 2018 when providing care to HCP consumers. This is likely to increase the need for regular care plan reviews in the context of unmet needs and unspent funds. This dynamic could be considered more closely within the context of developing a single assessment workforce.

Thus far Australian Minister for Aged Care and Liberal MP for Hasluck  Ken Wyatt is offering no insight into federal government thinking on this issue.

Sources:

https://gen-agedcaredata.gov.au/Topics/Admissions-into-aged-care

https://www.aihw.gov.au/reports-statistics/health-welfare-services/aged-care/overview

https://agedcare.health.gov.au/sites/g/files/net1426/f/documents/09_2017/assessor_fact_sheet_-_home_care_package_wait_times_v1.0_0.pdf

https://gen-agedcaredata.gov.au/Resources/Home-care-packages-program-data-report-2017

https://lasa.asn.au/wp-content/uploads/2018/02/270218-Consumer-directed-care-in-home-care-packages.pdf