Home care queue puts unspent subsidies in the spotlight

Industry peak bodies and service providers are calling for a government review of unspent funds in home care as new data shows surpluses continue to climb.

Industry peak bodies and service providers are calling for a government review of unspent funds in home care as new data shows surpluses continue to climb.

Aged and Community Services Australia and five not-for-profit provider groups are the latest to call for action on the issue among a series of recommendations to boost access to home care.

On Monday, ACSA, Anglicare Australia, National Presbyterian Aged Care Network, Baptist Care Australia, UnitingCare Australia and Lutheran Aged Care Albury jointly recommended steps be taken to maximise the use of available subsidies.

New benchmarking data from accounting firm StewartBrown published this month showed average unspent funds per client increased by 27 per cent to $5,400 in the six months to December.

A consumer attitude of saving for a ‘rainy day’, incorrect or outdated assessments and an increase in automatic upgrades from My Aged Care have all been cited as potential reasons for an accumulation of funds.

Based on a survey last year of 34 home care providers, industry peak body Leading Age Services Australia estimated unspent funds could be in excess of $200 million.

LASA’s analysis found almost 40 per cent of packages had unspent amounts over $5,000 and some providers reported consumers with surpluses over $20,000.

The national peak body has called for large amounts of unspent funds to be clawed back and redirected into the system.

In a recent paper addressing this issue, LASA said automatic upgrades via My Aged Care have contributed to an increase in unused funding since the introduction of the Increasing Choice in Home Care changes last year.

“It is suspected that many consumer upgrades are poorly matched to a consumer’s current care needs,” the report said.

Consumers may also be unready or reluctant to accept additional services, it said.

ACSA has argued that clients with large amounts of unspent funds that are not being saved for an agreed purpose should not be automatically upgraded to a higher-level package.

The extent of unused subsidises in the system has come into sharp focus considering the size of the national queue for home care and the urgent need for additional packages.

Government data shows nearly 105,000 people are waiting to receive a home care package at their assessed level of need.

The system also currently does not facilitate the downgrading of a client to a lower-level package, especially in the context of an reablement approach to care.

The sector is also calling for additional investment in home care to be delivered in the May budget.

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Tags: acsa, home-care-packages, lasa, unspent-funds,

12 thoughts on “Home care queue puts unspent subsidies in the spotlight

  1. This is to a simplistic report, many people myself included keep funds to one side for replacement and repairs of necessary equipment or modifications or unforseen circumstances which in the case of replacing a customised wheelchair is about $5,000.00 much higher for powered chairs which I have. Stop precaravating about funds not being used and do something about the aged especially those with profound disabilities are properly funded, There was supposed to be equity and no disadvantage between the NDIS & MAC there is and it is massive,why?

  2. David NDIS and MAC have nothing to do with each other. Aged Care Packaged funds are only to be used for certain purposes. Customised wheelchairs is not one of them. This article refers to those that are fortunate enough to have an indivialised budget with a package of care are not fully utilising the budget, going without services needlessly whilst others are still waiting to receive a package. The government is trying to ensure equity of access but if service providers are not doing the right thing, not keeping assessments and needs up to date and so forth, money is being wasted. As service providers we have had since July 2015 to ensure all our assessment systems are up to date and meet the contracted outputs and assessment criteria for each client. There is no excuse now for any service provider to not ensure all plans etc are up to date and that each client is using their budget efficiently.

  3. Hi Ted,
    Agree with most of your explanation however just wanted to clear up one comment you made that isn’t correct, that is you certainly can purchase a customised wheelchair for your client if they have a need for one and it is included in their care plan.

  4. Ted get your facts right, and you obviously have no idea about the distress MAC is causing, the government are totally incompetent on MAC, 110, 000 people waiting for assessed packages proves that, if you are a provider then you are doing a lousy job in advocating for your clients, so before you start pontificating check your facts, I have an excellent provider, but I do not back down from my comments about the inequity between NDIS and MAC, I have never known a more incompetent organisation so according to you it is ok to discriminate against Aged persons with disabilities, they don’t deserve the same level of care as the NDIS just because they are over 65, unreal

  5. This is a byproduct or an unintended consequence of government policy decisions about individualisation. However, if policy makers had reviewed the research and evidence from other countries in terms of individualisation of funding for older people, they might have considered investing in more capacity building initiatives to educate and inform and support older people and their carers about knowing how to make the system work for them.

  6. Does anyone remember the leadup to the individual home care packages and the number of clients who were benefiting from cross subsidisation? Doesn’t look so bad now, when we have clients who sit on high care packages with healthy surpluses (let’s not forget their right to CDC is paramount, so if they choose not to spend it now, we respect their choice) who in the old days were subsidising your over spenders. Now we have to cut down, negotiate and have clients top up privately. Now it’s all arguing about the cost of everything with individuals who have no concept to the true cost of aged care.

  7. It troubles me that we talk about unspent funds, but don’t identify the distinction between planned savings (for a major purchase or a 10% contingency fund) vs unplanned unspent funds. Any policy alternatives in this area must surely be predicated on this distinction and restricted to the unplanned unspent funds only if we are to enact the desired outcomes.

    Good idea from Carrie about the need for more capacity building initiatives to educate consumers on how to educate and inform and support themselves. A vital component of the much needed consumer support initiatives long been called for around system navigation and outreach programs.

  8. Mac not finding needed equipment or not designed to? What? Once a person is on mac how else are they supposed to find the funds?- they are now ineligible for grants, ineligible for caep… mac is designed to meet all care and equipment from a basic and essential standard to keep someone home. Long waits for ndis or ndia or what ever they are calling themselves now and mac are putting both parties at a disadvantage..

    There are unspent finds- it just needs to be clear if some are ear marked for expensive items..

  9. The issue is downstream at the time of assessment , some simply do not require the allocated level . MAC indicting that it must be activated irrespective of the clients flies in the face of the principles of the program. Clients do not wish and have the choice not to work towards goals requiring high level spending. The frugal mindset of some clients is no amount of excellence in case management can change this. I can see a recall coming where funds above x do not roll over and the money can be better used to open up the wait list and provide additional support. I am also at a loss how the interpretation of the guidelines is leading to spending on house painting , solar panel installation and a myriad of other purchases in the name of choice.

  10. I get really frustrated with FB posts about the ‘poor elderly people’ who don’t know about the aged care system and are being denied services, etc. Part of the problem of unspent funds it appears is that most older people have very narrow conception of their needs and ways that the funding could support them to continue living at home. Carrie is right – we need an investment in capacity building. I would argue that some providers’ staff, based on their experiences, do have this capacity to educate and inform and in fact do this already. I would also argue that older people on packages need to be reassessed with capacity to move at least one level down and the option to return to the original assessed level when needs change that demand higher levels of support. We currently have a static system of assessment.

  11. If a client has good mangement of their HCP and appropriate care coordination (information & advice, regular and timely contact, plan reviews, support to access reablement/wellness services and assistance to access community social services, etc), then I don’t think we would see so many surpluses but improved quality of life for our clients. I see very little surpluses accumulated across our 250+ HCP clients. But there are good reasons why some clients are accumulating surpluses, for example, a client preparing for additional home care services to support them after a planned operation or other treatment, as well as the equipment mentioned previously. I heartily agree with Carrie’s comment that much more should be done to support, educate and build the capacity of customers and their families to navigate the home support and care systems. About half of our clients are waiting for their approved package levels, and many struggle while they wait.

  12. It is a pity that the funds for the COTA peer education sessions were stopped. CDC packages were explained to consumers at group meetings so that they knew how to navigate the system, obtain services etc. The evaluation sheets handed in after each session showed the extent of the knowledge gained and the appreciation of the consumers for the advice. As the educators were all volunteers , the cost of the project should have been financially sustainable.

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