CEOs giving evidence at the aged care royal commission have backed a proposal for a new system of home care where specialised service categories would replace the current tiered package system.
The change would represent a radical overhaul of the way home care is provided.
Counsel Assisting’s draft outline for new home and community care service arrangements, which has been tendered to the commission, proposes that CHSP and HCP should be reconfigured into a single system with four categories of services, including home care.
The other three categories would be social support; assistive technology and home modifications; and respite.
“Waiting lists for care at home are not respectful, nor are they safe,” the proposal says.
“Getting a home care package is like winning a lottery, People currently have to make trade-offs between their physical, psychological, social needs and the needs of carers due to the limited funding available in their package.”
Meeting needs without trade-offs
It says the proposed new system would allow people to meet their needs without the need for trade-offs because it would assemble key services into categories that could be added together or taken individually in various combinations according to need.
All categories would be funded by grants except home care, which would receive individualised package funding and include domestic assistance, personal care, clinical care, end of life care and care management.
The social support would target social isolation and loneliness while AT and home modification would be focused on the capacity to live independently.
Respite care would target the needs of carers but should not diminish the money available for the provision of ongoing support and care for an older person, the proposal says.
Concern about care management
CEO of South Australian provider ECH, David Panter, said the proposed structure had “huge advantages” but he stressed that care management was important for all categories.
“Whilst (care management) is clearly articulated in the care at home element … I would want to ensure that there isn’t a complete separation between people embarking on a support journey in those other categories … that their journey needs care management from the beginning,” he said on Tuesday.
Martin Warner, CEO of Home Instead Senior Care, also said he supported the proposed new system and had always held the view that CHSP and Home Care Packages should be combined into one system, along with the addition of a level 5 home care package.
“All these aspects are exactly what we experience right now, in care at home … there are people who want social support, there are people who want personal care, there are people who need assistive technology and so on,” he said.
The proposal also recommends care finders, who would function as an initial point of contact with the aged cared system and screen, register and link an older person with assessment, and then connect them to care services.
A care finder would provide a personalised and knowledgeable service that the proposal says is missing from the current system.
“The care finder will build a relationship with the older person and understand their health, financial and housing circumstances,” it says.
“As part of their case management role, the care finder will connect up and integrate the older person so a holistic approach is taken in helping people to transition to aged care.”
The proposal notes that COTA has been piloting a navigator service and calls for the trial to be scaled up.
There should also be a single, scalable assessment process which would assess eligibility and number of hours of support a year across – social support, respite, enabling care and care at home, the proposal says.
Read what the CEOs told the Royal Commission about home care funding here.