Why one home care program works and the other home care program doesn’t
IN a post a couple of weeks ago, we argued that the very successful Commonwealth Home Support Program (CHSP) should not be merged into the very unsuccessful Home Care Packages program (HCP). The merger should be the other way around.
It’s disappointing that these things have to be argued.
One of the reasons that HCP is so unsuccessful is that it assumes (1) people needing care know just as much about aged care as the providers do, (2) know just as much as the providers about how their care needs can be met, and (3) are able to interact with HCP providers as though they are equals.
This may be true for a minority of people needing care, but not for the majority. Many are frail and too distracted by their physical or mental condition to be able to deal with providers in this way.
The assumption people needing care are at the same level as care providers has led to all sorts of instances where people are not getting what they need.
In a perfect world, where care providers are all honest operators who put the wellbeing of their clients first, the HCP program would be wonderful.
But the world is far from perfect.
Here’s why HCP doesn’t work well.
Each of the four levels of HCP attracts a set amount in subsidies, but not everyone needs all of that money. So, providers have an incentive to provide services that are not needed.
Because the regulator is pretty slack in checking up on whether or not providers provide safe and good quality care, predatory providers charge as much as they can in administration and case management fees and skimp on the care services they provide, even on the care services that are needed.
These are all problems that don’t occur in the CHSP, the home care we all know of old. The reason for this is that CHSP providers are block-funded. They have an incentive to provide as many needed care services for an overall subsidy they receive to cover all of their operations.
When they report about services provided in the year just past, they are effectively also applying for next year’s funding. They have an incentive to have spent everything on services people have actually asked for.
The CHSP funding system is not perfect, but it’s a sight better than the HCP funding system. CHSP certainly gets rid of the shonks and the predators that abound in the HCP program.
Why do we still have HCP?
Why are we moving CHSP into HCP?