Home care faces existential threat, conference hears

 Home care is under direct threat from the government’s proposed overhaul, which will see the current system replaced by a new Support at Home Category, an aged care sector conference has been told.

Addressing delegates at the ACSA National Summit 2022, ACSA CEO Paul Sadler said the government had ignored the recommendations of the aged care royal commission and the advice of providers in drafting its proposed new model.

“We have a government that is claiming that it is doing something in response to what the royal commission said,” Mr Sadler told delegates.

“And when you read the detail, they are doing something that is contradictory to the whole thrust of the findings of the aged care royal commission.”

Lowering regulatory threshold

One example of this, Mr Sadler said, was the proposal to lower the regulatory threshold for new entrants into the home care market.

“It’s explicitly planned as part of the government’s reforms that they’re going to lower the regulatory threshold for organisations to enter into an expanded home care market,” he said.

“I challenge any of you to go and read the hundreds of pages of the royal commission report and find any sentence that said that was a good idea, let alone an actual recommendation to do it.”

He also accused the government about being disingenuous in its commitment to co-desiging the new system, saying consultation would only be on how to implement a system that had already been decided.

Community based services under threat

“The Support at Home Alliance position here is that this model directly threatens quality of care for older people,” Mr Sadler said.

“It threatens the existence of community-based services that have developed in the past 70 years for the support of people living at home. This is an existential threat.”

Other areas where the government model departed from the royal commission recommendations were in relation to funding models, inclusion of respite care in a single program, integrated assessment and case management, which the government has proposed would be a separate service delivered by a management agency or provider.

The Support at Home Alliance wants to see the new support at Home Program include  classification and funding system similar to AN-ACC in residential care, Mr Sadler said, and a system that would recognise the home and community sector as the bedrock of the aged care system.

“Our vision is that we’ll build on this local network of services to  provide real choice for older people,” he said.

More information on the alliance’s vision is available here.

Mr Sadler said ACSA was also calling for housing to be added as a sixth pillar to the government’s five pillars of aged care reform, because without secure retirement housing for older people “you’ve got a major problem” with home care.

Reform being ‘rushed’

Meanwhile, aged care benchmarking expert Grant Corderoy said he thought the home care reform agenda was being rushed and cast doubt on whether the new system, planned to be in place by July 2023, would be delivered on time.

“I think it might be delayed because there are significant issues that still have to be addressed,” Mr Corderoy said. These included questions about travel time and the new SCHADS award.

Mr Corderoy said future red flags for the sector included a decline in home care operating results, unspent funds – which had now reached $9,900 per person  and $1.7 billion in total – and an increase in case management as a percentage of revenue.

“If we’re looking at charging care management as a separate service line, which is what the current proposal is, that’s going to be evaporated,” he said.

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