THE shape of the new home care program has become clearer with the publication of a federal Department of Health discussion paper.
Gone will be the Home Care Package (HCP) program, the Commonwealth Home Support Program (CHSP) and the Short-term Restorative Care program, which is so small it never rated an acronym.
Instead, we will have the In-Home Aged Care program scheduled to start on 1 July 2024.
Combining the three home care programs into a single offering has been on the Department of Health’s to-do list for a long time. In fact, it’s been on there ever since home care became an aged care service provided, funded and managed entirely by the federal Department of Health in 2015.
The Aged Care Royal Commission also recommended the integration of these programs, so now it really can’t be put off any longer.
After many false starts, we now have another start date, 1 July 2024, which is also the expected date for a new Aged Care Act to take effect.
The In-Home Aged Care program will most closely resemble the current Home Care Package program, but without the Packages, which gave care recipients a fixed annual amount to spend on their care, regardless of their needs.
This was always not such a good idea, and it’s pleasing that the penny has now also dropped at the federal Department of Health.
Instead, each care recipient will have an independent assessment of their needs. A plan will be put together to meet those needs, and each time a service is delivered, a fee is payable.
Means-tested subsidies will continue, although it is unclear at this stage whether the system of personal contributions currently used in the HCP program will carry over unchanged.
What is certain is that personal contributions in the CHSP will change. They are likely to become substantially higher than they are now.
The current haphazard arrangements for care recipients to get the benefit of equipment and home modifications will be replaced with what for now the Department calls the Goods, Equipment and Assistive Technology and Home Modifications Scheme. This will put an end to HCP recipients having to ‘save up’ for, for example, the urgent acquisition of an electric wheelchair.
The ability to change provider will still exist, but if the Department sticks to the Aged Care Royal Commission’s recommendations, for those care recipients intent on ‘self-managing’ their care, they can expect some scrutiny.
They will be able to choose what the Royal Commission has called a ‘lead provider’. One of the jobs of this lead provider is to provide case management. This is to be done with respect for the care recipient’s wishes, but ultimately responsibility and therefore final decisions lie with the lead provider.
Perhaps the biggest shock will be felt by CHSP care recipients. Many of the providers currently delivering care to them will cease to exist because the system changes from one where care is the focus to one where paying-for-care is the focus.
Many CHSP providers, especially community- and volunteer-based providers, will find they are unable to cope with the new tech requirements of the system and the need to compete for business.
The City of Greater Bendigo, which is a CHSP provider, has already announced it will pull out by 1 July 2024. Bendigo is currently responsible for the delivery of basic aged care services to approximately 1,800 clients, which includes services such as domestic assistance, personal care, home maintenance and social support.
“The City currently has a partial monopoly on the local aged care market, however the changes that will be introduced will make it difficult to continue,” said the Bendigo Mayor, as quoted in The National Tribune.
“The [new] program intends to open up the market for aged care providers, making it more competitive and giving clients greater choice about who they access care from. This will effectively split our client base. There will also be changes to the payment structure from Federal Government to Local Government, making it difficult to budget to deliver the service.
“If the City was to continue providing aged care, it would have to expand its service delivery significantly, which would require an investment in new technology and the appointment of a skilled committee to ensure compliance with requirements of the new service.
“Critically, due to the expansion of the service into a competitive market, the City would not be able to continue to use ratepayer funds to help cover the costs of running the service, as these funds are not available to the private sector, and it would be unfair for councils to continue to use them.”
It really does look like the Department of Health is about to throw out the baby with the bathwater.