Care managers must play a central role in the new, redesigned home care system, a forum on aged care reform has heard.

The federal government has agreed to implement a new single aged care program in line with the recommendations of the aged care royal commission.

That raised questions about the role of care managers in the new system, LASA’s Roadmap to Reform online forum heard last week

Care management at the centre

During a panel session on home care reform, ECH CEO David Panter said experience with the NDIS has shown that care management isn’t highly valued.

But he said active management is crucial to empower clients to stay independent, and it’s important it doesn’t get lumped in with administration.

Martin Warner at LASA’s Roadmap to Reform forum

Home Instead’s CEO Martin Warner said his organisation recognised the importance of care managers and is currently focused on attracting the right people to the role.

It’s important care managers are appropriately funded in the future, he said.

“I think the role of care manager is going to be really central to how we run our organisations. It’s a vital connection with clients and highly important role.”

Kincare CEO Jason Howie said under the current system a lot is being asked of customer care managers, and there’s an industry-wide need for upskilling.

Care managers were required to have health skills, financial skills and relationship management skills, Mr Howie said.

“We’re still skilling up that cohort of staff across the industry,” he told the panel.

“We haven’t got to the point yet where we have a cohort that is as skilled as they ultimately will be, or that as an industry we’re to communicate the value that people get from having a relationship with someone that’s overseeing their care with that breadth of skills.”

Reporting requirements

Community Vision CEO Michelle Jenkins said while care management would remain important in the higher end of home care, it was likely to become optional for lower levels, leaving clients with something resembling self-management.

That raised issues around reporting requirements, she said.

Michelle Jenkins at LASA’s Roadmap to Reform Forum

“It’s going to become interesting going back to the detail of how we’re going to be reporting,” she said.

“How do you create a wellness an reablement report if you’re not involved in that care management?

“Whatever this new scheme looks like I think there will probably be two options around care management and it’s going to be awkward for us as providers to provide the reporting the government is going to want.”

Devil in the detail

Panelists agreed the royal commission’s focus on home care, as well as the government’s response, was welcome. But they said the devil is in the detail.

The government has responded to the recommendations by releasing more home care packages and agreeing to create a single home care system combining CHSP with HCPs.

“The extra packages was a big announcement but there’s not a lot of detail about how the system will work,” Mr Howie said.

Jason Howie at the Roadmap to Reform forum

Uncertainty remained round workforce recruitment pricing, payments and how the CHSP and HCP programs would work together.

Mr Panter said it was important for home care providers to have a collective voice on future reform.

“We’ve often felt like the afterthought but going into the future home care is where most people want to be receiving services,” he said.

“We need to make sure we apply our expertise into the reform process.”

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  1. Over the last 10 years I have provided case management training to thousands of care managers, co-ordinators and support co-ordinators across many sectors. The case/care management role is a standout positive element of the home care program – every home care consumer at present is expected to have one. Having a care or case manager who is proactive and involved in supporting a consumer
    is vital in HCPs. Often the difference between great or poor outcomes for a consumer, is the
    quality of case management. Case management is a profession and it needs to be promoted and supported by government and the community as key to the success of older people remaining safe at home regardless of package level. Circumstances can change very rapidly for older people and that is where case/care management is so vitally important

  2. I couldn’t agree more Lorraine. Unfortunately we’ve allowed the false narrative of “care management = administration” to persist, joined by a parallel narrative of “care management = reduced consumer control”. Nothing could be further from the truth. Care management, done well, is at the heart of “understanding my needs and planning the right supports for me”, enablement and “living my best life at home”. The last few years of CDC and the NDIS have demonstrated this more strongly than ever.

  3. Recipients should be central to Home Care Packages. Providers have forgotten what they are there for. It’s all about profit. Ethical providers will make recipients the central point of their service.

  4. From my experience as a case manager I believe skilled case management to be an integral part of HCP’s. The level of case management is the essential consideration here, situations and needs are different for consumers. I recently spoke with a recipient of a level 3 who had a lot of unspent funds, this is perhaps an indicator of poor management from the service provider. There is also a place for self-management, again this depends on the consumer of the service. Skilled workers are a key ingredient to ensure quality and appropriate support that fit the consumer of the service.

  5. The administrative and compliance requirements of HCP’s needs to be revised and an efficient cohesive process developed, and led, to ensure consistency throughout the industry. The current administrative and compliance workloads, regulatory red tape, continuous improvement and reform have totally robbed HCP consumers of case management time and quality because case management (person to person) has become 5-10% of the role and “other admin” 90-95% .

    Through the Government, ACQAS and peak bodies working together with providers (who are delivering the services) and with technology companies, and efficiency experts, “The System” could set framework for policy, operational methodology, best practice, and could be consistently delivered through design and not leaving it to chance or compliance to correct or fix it up. This would level the playing field and ensure safe, effective services, efficient administrative processes, compliance and monitoring activity is delivered by HCP providers.

    Great care management (quality) would be the driving point of difference, and competitive edge, providers could focus on to complete and gain market share. The winners would be everyone: consumers, providers, and government alike. It is time for re-design, not to fix something very much broken or to use compliance to reform an industry.

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