Department outlines vision for next wave of home care reform

From February 2017 home care packages will be assigned to consumers by My Aged Care from a national pool of available packages, and while overall numbers will continue to be capped, additional packages will be released regularly to ensure “a more even distribution of packages to consumers,” according to government proposals for a more market-based home care system.

In a discussion paper released late last week, the Department of Social Services set out the proposed implementation of the removal of the Aged Care Approvals Round in home care and the allocation of packages direct to consumers, which was first announced in the federal budget in May.

It is proposed that consumers will be prioritised for access to care by the gateway according to a set of nationally consistent criteria, suggested by the department to be the time spent waiting for a package, urgency of need, availability of other supports and risk of no longer being able to remain safely at home.

Move to national approach

The department said a national approach for making packages available to consumers based on individual needs would provide an opportunity “to monitor and address differences in waiting periods and access to home care across Australia.”

Packages will no longer be allocated in relation to a specific geographic area and would be portable between approved providers.

Under the government’s plans, Aged Care Assessment Teams would determine the eligibility of people seeking home care at a specific package level (1-4), which would end the process of ‘broadbanded’ referrals across lower (1 or 2) or higher level (3 or 4) packages.

The government is also proposing to remove specific conditions of allocation currently attached to some home care packages, which give priority access to special needs groups or target services to a particular location. The department said sector feedback indicated the existing system of conditions of allocation was “not effective”, as it was not transparent and could not be monitored effectively.

Providers would be better able to market their services through My Aged Care, including to people from special needs groups and those requiring specialised care, such as dementia care, DSS said.

Streamlining ‘approved provider’ process

The discussion paper, which is open for consultation until 27 October, proposed streamlining the process for becoming an approved provider to facilitate more choice and competition among providers, and to allow existing residential or flexible care providers  to ‘opt in’ to also deliver home care packages.

“Organisations that are not currently approved to provide care under the legislation may apply to become an approved provider in home care, and they will be assessed against the streamlined legislative criteria,” the department said.

The government’s discussion paper also flagged in the longer term the possibility that consumers would be able to direct the funding for their home care package to more than one provider as part of an integrated community care system.

‘A seismic shift’

Louise Greene, director of business improvement at The Ideal Consultancy, said the challenge for providers in the new system would be to demonstrate value and capacity to meet consumer needs. For consumers, the difficulty will be having information and support to make informed choices in a market-based system, she said.

“The transition to an open marketplace in which consumers choose their provider and, where able, are required to contribute to the cost of care is a seismic shift,” she told Community Care Review.

“Those who have put the hard work into developing a consumer-focused responsive model and can communicate and demonstrate value will be rewarded. Sadly for some within a short space of time their business viability will be challenged.”

Ms Greene said she believed the nationally consistent criteria for allocating packages to consumers would prioritise consumers in most need of care, including marginalised and disadvantaged consumers.

Written submissions from the sector close 27 October, 2015. For more information on the consultation process and stakeholder briefings, visit the department’s website.

The government plans to introduce amending legislation into Parliament in early 2016 to implement these reforms.

Key features of February 2017 changes

• Home care packages will no longer be allocated to providers through ACAR but directly to consumers through My Aged Care.
• A nationally consistent system will prioritise older people’s access to subsidised home care based on agreed criteria.
• Consumers can receive home care services from any approved provider, and packages will no longer be allocated in respect of a specific geographic area, for example, an aged care planning region.
• Packages will be portable, making it easier for consumers to change providers should they wish to. This means the package, including any unspent funds, will move with the consumer to their new provider.

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