The Department of Social Services says it has no plans to change income-tested care fee arrangements or package levels as part of the February 2017 home care reforms.

As reported by Community Care Review, there have been ongoing and widespread concerns in the sector about the effectiveness of existing means testing arrangements for consumer care co-contributions and their impact on the occupancy rates of subsidised home care.

The Federal Government’s commissioned evaluation of home care packages recommended addressing the perceived financial disincentive for eligible consumers to take up a lower home care level package as soon as possible, and to monitor occupancy for Level 1 places over time.

However, the director of home care reforms with the Department of Social Services, David Braggett, confirmed on Tuesday there would be no change to the current fee arrangements in home care in 2017.

“We know there has been a lot of talk and a lot of debate as to the appropriateness of the income testing arrangements that were introduced in 2014…This is an area that is really not up for grabs in 2017. It will come back onto the table for 2018 [in the merger of CHSP and home care packages],” he told the ACS NSW & ACT community forum.

He said there would also be no immediate change to the four levels of packages currently in place.

Steve Teulan, director of UnitingCare Ageing, told the forum that as a result of income tested co-contributions, 40 per cent of eligible clients have rejected a home care package because they are seen as being unaffordable and representing poor value for money.

“That has reduced the occupancy for many service providers and increased competitiveness significantly. We also know it has reduced the fees that clients pay because of that competitive environment,” he said.

Sector consultation on 2017 home care reforms

Mr Braggett said the department had received 101 submissions in response to its discussion paper setting out the proposed arrangements for allocating home care places direct to consumers from February 2017. Some 50 per cent of submissions had come from service providers.

Overall, stakeholders supported the policy objectives of the reform but highlighted the importance of effective and targeted stakeholder communication and adequate support for consumers to exercise choice, he told the forum.

“A number of providers have highlighted the importance of having transition activities – potentially funding in place – to assist businesses to adapt to the change. There were different views as to what the government’s role should be in this area, as we move to a more market-based system,” Mr Braggett said.

Stakeholders had told the department that Aged Care Assessment Teams needed to be well supported in the transition and My Aged Care had to be operating effectively before additional functionalities and roles were added.

He said the department had begun working with ACATs on how the National Screening and Assessment Framework (NSAF) could assist a national approach to prioritising access to care.

Sector feedback also recommended government closely monitor the impact on consumers from special needs groups and rural and remote areas.

Mr Braggett said the department intended to publish a summary of sector feedback to the discussion paper before the end of the year, and would continue to consult on key details of the policy, such as criteria for national prioritisation of access and arrangements for unspent funds.

The government planned to introduce legislative amendments to the Aged Care Act into parliament in February 2016 with the expectation that legislation would be passed by June, Mr Braggett said. He conceded the government’s timetable for reform was “challenging”.

‘Cashing out’ to consumers

In response to an audience question as to why the government has not considered “cashing out” home care subsidies to consumers in 2017, Mr Braggett said it was the government’s intention to move in that direction, but the timing and readiness of the sector and systems had to be right.

He said direct payments to consumers or allowing consumers to allocate funds to multiple providers would be considered as part of the integration of home care programs from July 2018.

The balance between individualised and block funding, funding instruments, approved provider status and approach to fees and income testing were some of the big issues that would need to be worked out in consultation with the sector to develop the single home care system. Consultations on the next phase of reform would commence early next year, Mr Braggett said.

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1 Comment

  1. I believe the point being missed by both the government and the sector in the the debate of how services should be funded and to whether funds should go to the consumer instead of block funding or funding the provider misses some key points:

    1) Will a stable service industry exist? While consumers holding the funds and having the choice of the providers sounds great, will there be providers who can afford to remain as providers without any assurance that customers will be there to choose them?
    2) Job security effect on employees – if the providers don’t have the assurance of customers, how can they have a guaranteed pool of staff?
    3) Consumers acceptance that they is a huge component of care they will need to fund or contribute themselves due to the income testing.
    4) Impact on Quality? Consumers might go for the provider that offers the cheapest service, but will quality always be maintained. Also if you have a market where employees sign up as casual staff with multiple providers – which provider or employer ensures their education and skills meets the requirements of the service standards or for their roles.

    Whilst I support greater consumer control and choice, I believe there needs to be serious consideration as to the impact on providers and the quality of the service, let alone the potentials for elder abuse.

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