Does home care need to come in levels?
HOME Care Packages come at four levels. The lowest level Package is subsidised at $9,000 a year, while the highest level (four) Package is subsidised at $52,400. Some care recipients contribute towards this cost.
However, dividing care recipients in just four categories does not reflect the reality on the ground. People’s care needs vary endlessly and so, therefore, do the levels of funding required.
A recent paper by accountancy firm Stewart Brown looked at the structural problems of home care packages.
The paper notes that the funding of HCP at the four package levels means that there is “a lack of alignment between funding and individual care needs, according to the paper”. In other words, as a result, some people have packages which don’t offer enough money and some people have packages which offer too much money.
Stewart Brown goes on to say that this has resulted in unspent funds that are not utilised by recipients. In other words, on balance the HCP program provides too much money.
Stewart Brown found that the aggregate unspent funds have increased from $539 million at 30 June 2018 to $1.3 billion at 30 June 2020.
That’s a massive amount. It’s close to 5 per cent of what the Government spends on all forms of aged care. It’s money sitting idle which should be working for people assessed as needing care.
Stewart Brown suggests that the solution is to have at least eight levels of funding, so as to “closely align the funding for individual care recipients”.
CPSA’s position is that the whole idea of having fixed funding levels, whether they be four, eight, sixteen or thirty-two levels, will never generally match people’s needs.
Needs change and typically increase. This happens without regard to care agreement start and finish dates or financial years.
Funding needs to be flexible to keep pace with the actual needs people have as they age at home.
The Commonwealth Home Support Program (CHSP) does just that. It is not driven by an ideological goal of ‘consumer-directed care’, but it does deliver without wasting money.
CHSP attracts few complaints and works well. Obviously, it should be the model for the reform of the Home Care Packages program.