Reforms to the aged care system have brought about new freedoms and more choice for consumers, but they have also opened the way for potential abuses, an aged care reform conference has heard.
The head of the nation’s largest independent home care provider told the Criterion Aged Care Reform After the Budget conference he was concerned the ability of family members to shop around for providers in a portable funding environment could leave older people vulnerable to financial and even physical abuse.
Care Connect CEO Paul Ostrowski said he had anecdotal evidence of family members using ‘provider shopping’ to misspend home care package funds and even potentially get away with elder abuse.
In one case, a family member attempted to use home care funds to increase the future value of a parents’ home rather than spend them on care. In another, a son dumped a provider who had reported him to police for physical abuse.
“You start to realise that if that behavior is out there they will simply keep on shopping for a provider until they find one, or if you raise objections as a provider they will move their package where they get fewer objections,” he told the conference last Thursday.
“(Under) the previous framework was there was always a group of individuals, case managers or carers, going into a home who were observing what was going on. If there was a challenge then the potential abuser couldn’t just throw them out and find another provider.
“We have to be careful we don’t construct a system that allows what I hope is a very small proportion of bad behaviour to remain under the radar and continue.”
Mr Ostrowski said some of the protections that had existed under the old model were no longer there and new safeguards were needed.
For example, the new safety and quality commission set to come into force next year should be funded to investigate abuses within the home as well as just providing a forum for complaints against providers, he told Community Care Review after the conference.
But a new framework mustn’t undercut the benefits of portability, which remained a positive development, he said.
“We can’t say ‘no we don’t want to go down this path because there are some bad people out there’. We don’t want to create a situation where choice is disabled.”
A new dilemma for service providers
Aged Care Guild CEO Matthew Richter admitted the consumer model had opened up new dilemmas for providers, especially in regard to the use of taxpayer money.
“We’ve got to be honest, boundaries are absolutely pushed,” he said.
“As a provider you’re saying, how do we remain viable? You need a certain number of consumers to remain viable, and if you take a firm line on the guidelines and provider B says ‘oh no I’ll enable that’ … the consumer’s gone.
“The very rapid increase in the number of providers that have been approved has made it even more difficult.
“If you’re going to have freedoms you’ve got to strengthen the frameworks that makes sure those freedoms aren’t abused”.
Nick Loudon, managing director of Seasons Aged Care, said it was the responsibility of aged care providers to learn about their responsibilities and available avenues for action.
“It is actually our responsibility to take action and have (an) Enduring Power of Attorney expunged if necessary, even if it’s in the home care environment.
“It’s not just a matter of saying, they’ve decided they’re not using you as a provider anymore and they’re going to go somewhere else.”