Provider readiness for landmark home care change in focus as report finds some lag behind

With just weeks to go before deregulation is introduced into home care, the Department of Health has released the findings of key research into the readiness of providers for the landmark reforms.

With just weeks to go before deregulation is introduced into home care, the Department of Health has released the findings of key research into the readiness of providers for the landmark reforms.

The report, which was completed by research agency Taylor Nelson Sofres in September, was based on in-depth interviews with 52 home care providers, representing approximately 10 per cent of the industry.

Its release on 23 January came after Community Care Review put questions to the department in December regarding the release of the report and subsequently lodged a Freedom of Information application requesting the report earlier this month.

The interviews, undertaken between June and August last year, showed enthusiasm for the reforms was highest among larger and for-profit providers, while rural organisations and small not-for-profits were the least prepared for the change.

Government efforts to assist providers with the transition to a competitive marketplace from 27 February should focus on not-for-profit providers, which may lack the resources and business acumen to make the necessary adjustments, the report said.

Resistance to change and limited understanding of the policy also contributed to concern and apprehension among some providers, the research found.

Despite some concerns, overall around 70 per cent of providers expressed high levels of confidence their organisation would be ready to compete in the new marketplace by February.

Support for sector delivered: department

When asked how it had responded to the report’s findings, the department told CCR that it had supported providers and consumers with the transition through webinars, fact sheets, consumer materials and funding of peak body organisations including Aged & Community Services Australia, Leading Age Services Australia, the National Aboriginal Community Controlled Health Organisation and the Federation of Ethnic Communities’ Councils of Australia.

In recognition of the issues facing rural and remote providers, the department said it had held group forums and “one-on-one education targeted at remote and very remote services” and provided assistance to providers through the Service Development Assistance Panel.

ACSA chief Pat Sparrow said that while helpful education and information resources had been provided, financial support to the industry to assist with the transition had been lacking.

“While we acknowledge the government has provided some financial support to the industry to prepare for reform, when compared to the government’s investment in the NDIS, which saw a similarly major industry restructure, it is minimal,” she told CCR.

Ms Sparrow said further detail about the precise implementation of the reforms was also needed.

LASA chief Sean Rooney said his peak’s members were still seeking further operational detail, particularly in relation to the claiming processes managed by the Department of Human Services.

“It will be important for the Department of Human Services to ensure it has structured processes in place that have been thoroughly tested to prevent a further escalation of the payment system issues that are already occurring.”

Consumer interviews: Few consumers say they are likely to change providers

The report also raised questions about the extent to which consumers would exercise their power to switch providers in a competitive marketplace.

In the study, which was based on 62 interviews with consumers and carers, only one in five consumers said they would be likely to change providers once they had the choice. The perceived stress of changing providers, customer loyalty and a dislike of change were some of the key reasons identified.

The research found that the reform is likely to have the greatest resonance with carers of high needs consumers, while clients with low needs and older clients appeared the least likely to exercise their power to move elsewhere.

“Carers were more likely to be critical of their current service, and more interested in ‘shopping around’ for a better option,” the report said.

Many consumers placed a high value on consistency of care and care relationships, in some cases, over and above service quality, the report said, which is also a finding of international models of CDC.

For some consumers a cheaper priced service would be an incentive to switch providers.

The report said older people may need support to change providers through face-to-face advice and guidance, particularly for those with high level needs and limited informal support networks.

RELATED COVERAGE: Support from families and providers critical to driving engagement with CDC: report

Subscribe to Community Care Review’s weekly newsletter and quarterly magazine

Tags: acsa, cdc, department-of-health, february-2017, home-care-packages, lasa,

5 thoughts on “Provider readiness for landmark home care change in focus as report finds some lag behind

  1. The attempt by some “Not For Profit” Providers to slug their Clients with a massive “Exit Amount” (i.e. an Exit Fee) if they swap to another service will, for sure, generate headlines at some point. Existing Clients of at least two major Providers are receiving letters requesting a retrospective change to their Home Care Agreement so that their Provider can charge an extraordinarily large and wholly unjustifiable exit fee. They request the Client to “sign and return this letter” – with a relatively obscure explanation that it will form an amendment to their Home Care Agreement. Clients are not being told that they have choice in this matter. The Providers know that a Client does not have to agree to such a change, but they are not letting their Client know that. This deceptive and misleading practice is an attempt to claw back as much of the “unspent funds” as possible. We have seen amounts of over $870 quoted to “cover the Administrative costs” of transferring a Level 3 Package. That really is an unreasonably high charge.
    It is evident that some of the existing Providers simply do not understand CDC or basic principles of customer service, courtesy and professional ethics. Until they transform their approach, those Providers will lose market share – slowly at first, then rapidly as their Clients gain better information on their rights, and the additional value possible under a Home Care Package truly delivered according to CDC principles.

  2. Absolutely agree. And in Residential Aged Care where you often need to fully refurbish a room after a resident leaves you cannot charge any form of exit fee. Why should there be an exit fee in home care and not one in residential care? The administrative requirements are the same in both types of care.

  3. Well articulated David. The Exit Fee impost is going to be the final attempt by existing providers to lay their unsubstantiated claim on unspent funds which they are so used to ingratiating themselves with for so long.

  4. Thanks Max and Stephen

    When a Provider seeks to charge an Exit Fee of 700 or 800 dollars it’s an admission that their Competitors offer a better and more cost effective service and they expect their Clients to walk away.

    By setting an outrageously high Exit Fee they hope to bully their Clients into staying with them.

    In a worst case scenario, if the Client leaves anyway the Provider gets to keep a large slab of the unspent funds which should never, by any ethical argument, be regarded as theirs to keep.

    This is exactly why Alzheimer’s Australia requested the Commonwealth to impose a cap on Exit Fees. Such a pity the Department did not listen.

    Personal opinion here – but a Provider which has taken 30% – 38% of the total Package value for “Admin” and “Case Management” – month after month after month – should be able to wind up the Package and transfer the unspent funds without bilking the Client for the minimal cost of doing that.

    And yes – let’s call it what it really is – an Exit FEE. The term being used is “Exit Amount” – but that’s a weasel word if ever I heard one – introduced by the Department and embraced by the big “NFP” Providers because they hope to avoid the political and market embarrassment of being seen to exploit long suffering Home Care Package Clients one last time before the gravy train ends….

  5. Thanks Max and David
    I own and operate two aged care facilities and spend my working week split between the two of them. When a resident leaves it costs us an average of $3,000 to refurbish the room (paint and freshen up). Residents leave hole sin walls, gouges in doorways and leave hooks and wall hangings in walls. Frequently their family “donates” their clothes and old possessions to us and we have to dispose of them. But we cannot charge any fee. We have to take it on the chin.
    I agree about the bullying ethos of some home care providers but sadly do not think this will change

Leave a Reply

Your email address will not be published. Required fields are marked *