Home-care package self-management:The Home-Care Packages Program (HCPP) and Commonwealth Home Support Program (CHSP) primary purposes are to allow elderly Australians supported by Federal Government funds to stay safely in their own homes for longer. CHCP is composed of targeted services to individuals from organisations funded by the Government.
Whereas, HCPP was mostly comprised of a budget - anywhere from $10,000 to $50,000 per year - for the individual person. They also allocated how the funds were to be distributed and come with an experienced provider who puts together a coordinated package of services tailored to meet their specific needs.
Significant deregulation in the industry has evolved the HCPP model to one more similar to CHCP. Organisations are now funded to support individuals to stay at home and age, without individual budgets or mandated consumer choice regarding how the care was delivered or what the care comprised.
Now those updates have been implemented, consumers are effectively free to spend HCPP monies how they like. The only restrictions on where the funds go are whether they are safely within the allowable types of expenditure.
The freedom now given to HCPP recipients is a welcome game-changer. The National Disability Insurance Service (NDIS), whilst still not offering quite as much independence, does have a similar program for disability.
Their model allows individuals to self-manage, with or without administrative support. With limited exceptions, NDIS has no mandatory requirement for a coordinating organisation.
So, what does a self-managed home-care package look like?
All the necessary regulatory attributes exist for HCCP to be completely consumer lead. The key elements exist and individuals with a home care package can currently choose:
- Their provider and whether they wish to change providers at any stage;
- How they want to spend the monies, in a manner significantly more flexible than NDIS, as the money is not allocated to specified areas;
- How much they pay and who they pay it to.
- Previous practice that providers bundle administration and case management services together;
- Legacy of many providers using their own staff for services
- The legislative duty of care put on providers of homecare packages and subsequent staffing and risk management overheads
- Lack of integrated technology options
Some providers are currently offering bare-bones homecare management services. The assumption being that the care recipients will not be requiring frequent support, and will largely manage the care delivery themselves within the agreed budgets. In return, the case management fees are significantly lower, than other clients who require higher levels of care.
Even the bare-bones homecare services still have management fees. These include administration and case management amounts that exceed 20% of the funding. However, this is still significantly below the industry average of 30% with some operators charging above the 50% mark.
Change to ‘pure’ self-management in the industry is no longer an ‘if’, rather a ‘when’. Updates in the industry are already visible with:
- New entrants. These new home-care providers aren’t necessarily following the industry script around administration and case management charges anymore. Many are simply costing in one management fee.
- Provider organisations cultures are changing. Many are making their case managers more independent to that of their direct care staff, to the benefit of the care recipient. They are becoming more flexible with the ability to use other organisations where there are benefits of service and price to in-house options.
- Home-care provider duty of care is increasingly being supported by advances in technology.
- Software is appearing that claims full integration of home care provider administration requirements.
What we will see in the near future will be similar to the deregulation of the superannuation industry. The superannuation services started providing bare bones superannuation services to be self-managed along with more premium offerings. Changes in super were also the result of government deregulation and technological advances.
It won't be long before providers appear in the marketplace with pure self-management options. They’ll allow care recipients to:
- Have a single low administration fee. For example a fee of 4% of the total package value.
- Manage with or without case management services.
- Select their own case manager, approved by the provider and most likely another provider who has demonstrable strengths in care and governance.
- Bundle up the offering with easy-to-use software and integrated care and financial management tool
- Get value added freedom with debit cards, and other similar types of cash out options.
The only question remaining is will it be months or years before these solutions are standard?Article appeared in the Community Care Review, Autumn 2018
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