The Federal Government’s national evaluation of consumer directed care has recommended trialling new approaches in home care for some special needs groups and strengthening the program’s focus on wellness and reablement.

The evaluation, which was completed by KPMG in April, was released by the government yesterday afternoon, three months after the full implementation of CDC.

The report urged the government to consider developing alternative models of CDC for indigenous clients, which may include options for some communal use of package funds.

Interviews with stakeholders suggested the inflexibility of program guidelines was contributing to the relatively low take-up of home care packages by indigenous communities, the report said.

Limited progress has also been made towards the use of CDC to support community participation for older people, and wellness and reablement approaches, the report found, and providers could benefit from sharing examples of best practice.

To strengthen the implementation and systemic support of CDC in home care, KPMG also advised increasing the knowledge and training on CDC available to Aged Care Assessment Teams, aged care advocacy services, Aged Care Complaints Scheme and quality agency staff.

Admin costs

For the first time, the evaluation has made public data on average charges for administration and case management.

A survey of 77 home care providers showed that on average providers were taking 27 per cent of a consumer’s subsidy in administration and case management fees. Average figures ranged from 29 per cent for a Level 1 and 3 package, to 21 per cent for a Level 4 package.

Approximately half of the providers interviewed by KPMG reported having undertaken some form of detailed cost modelling to develop their cost structures; whilst others (usually those charging at the lower end) set the fees based on what they thought was ‘fair’, the report said.

Providers reported that they experienced considerable administrative costs associated with the implementation of CDC, such as additional staff time and brokerage costs, which were being passed on to consumers.

Consumers who took on a significant degree of self-management but saw little reduction in the fees charged felt most dissatisfied with the costs.

The evaluation said there was still some work to be done around the transparency of administration and case management pricing.

Variable implementation among providers

While the evaluation noted there was a small number of early adopters of CDC, as well as a small group of resistant organisations, most fell somewhere in between these two extremes.

While steps have been made towards increasing consumer choice and control, individualised care and support, and respectful partnerships, the report said this varied across providers.

The evaluation was conducted between April 2014 and February 2015 and involved interviews with home care providers, consumers and carers, sector stakeholders, an online survey of providers and provider service data collection.

Related coverage: Providers vary significantly in CDC implementation

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