So you have been approved for a Federal Government funded Home Care Package or HCP – Now what? It is important to consider the following so that you are able to get the most benefit from your package of funds to assist you to live at home.
- Shop around for a suitable Home Care Package Provider
From 27 February 2017 a major change is occurring to the Home Care Packages Program. Home care package funding will follow the consumer, replacing the current system where home care places are allocated to an approved provider through the Aged Care Approval Round (ACAR). These changes have been made to give consumers greater choice and control over their care.
Package recipients still need to have an approved Provider holding their package and all Home Care Packages are required by law to have a Home Care Agreement between the provider and the consumer. The Care Agreement contains a number of key elements about how the Home Care Package will be delivered.
Given the importance of the Home Care Agreement, you should ensure that you fully understand all the terms of the agreement. It is important that you have a good relationship with your Service Provider and that they understand your requirements. You can access a list of Approved Home Care Providers at www.myagedcare.gov.au.
- Understand the costs that may be payable by YOU
Although the Federal Government subsidises the cost of providing a Home Care Package, they do expect individuals to contribute to the cost of their care where individuals can afford to do so.
Home Care Packages recipients can be asked to pay an income-tested care fee if your income is over a certain amount.
Depending on your income and assets, you may be asked to contribute more to the cost of your Home Care Package. This fee is called the “Income-tested Fee”. The Income-tested Fee is calculated by the Department of Human Services following an assessment of your financial situation. This fee is non-negotiable and may impact your decision to accept a Home Care Package.
The Department of Social Services’ website www.myagedcare.gov.au has a fee estimator which can assist individuals to estimate the fees and payments they may be asked to pay for a Home Care Package.
- Know what your package of funds can and can’t be used for
Home Care Packages are designed to assist individuals to remain living in their residence for as long as they wish. The Quality of Care principals 2004 guide what services can be paid for by this funding. The range of care and services available for any Home Care Package includes the following:
- Care services (Activities of daily living, Personal services, Nutrition, hydration, meal preparation and diet, Continence, Mobility and dexterity, Management of skin integrity)
- Support services (Cleaning, personal laundry services and gardening, leisure, interests and activities)
- Clinical services (Nursing, allied health, podiatry, physiotherapy services; and other clinical services such as hearing and vision services. Access to other health and related services.
The following items cannot be included in a Home Care Package:
- Items that would normally be purchased out of general income;
- Purchase of food, except as part of enteral feeding requirements;
- Payment for permanent accommodation, including assistance with home purchase, mortgage payments or rent;
- Payment of home care fees ;
- Payment of fees or charges for other types of care funded or jointly funded by the Government;
- Home modifications or capital items that are not related to a consumer’s care needs
- Travel and accommodation for holidays;
- Cost of entertainment activities, such as club memberships and tickets to sporting events;
- Gambling activities; and
- Payment for services and items covered by the Medicare Benefits Schedule or the Pharmaceutical Benefits Scheme.
- Understand Consumer Directed Care and Consumer Flexibility
Consumer Directed Care or CDC is a new approach to how people receive their care. It focuses on choice and flexibility for the recipients of home care packages. In a CDC approach consumers decide on the level of involvement they have in managing their package. This could range from involvement in all aspects of the package, including coordination of care and services, to a less active role in decision-making and management of the package. In addition, the CDC approach also asks providers to explore opportunities for their clients that may be outside the boundaries of services previously provided. This may include building networks and community connections so that the client has additional support to remain in their home for as long as they wish.
The CDC approach starts by finding out about a person’s life and goals for the future. What they would like to keep doing for themselves and where they may need assistance to continue living independently in their home environment. The CDC approach focuses on giving individuals the flexibility to plan and make their own decisions about their support.
You should not be limited by a standard menu of services or service providers. If you identify a type of service that you feel would best meet your care needs, your service provider must do what they can to help you to get that care or service.
- Be knowledgeable about the supplements available in addition to your funding
In addition to funding allocated in a Government funded home care package (HCP) there are also extra supplements that can be applied for by the Service Provider on a client’s behalf. With the supplement (benefit) going straight to the pool of funds utilised by the client for their care.
Below you will find information relating to the enteral feeding supplement, oxygen supplement and the financial hardship supplement:
Enteral Feeding Supplement – Enteral feeding is an alternative method of providing nutrients, including water, through a tube placed in the nose, the stomach, or the small intestine. Enteral feeding is administered to people who have conditions which hamper their ability to absorb nutrients via the gastrointestinal tract, or who are unable to swallow food. Your service provider can assist you to apply for this supplement.
Oxygen Supplement – This is a primary supplement paid to aged care providers of residential care (including respite) and home care for care recipients with a specified medical need for the continual administration of oxygen. There are two levels of Oxygen Supplement – a standard supplement and a higher supplement.
Hardship Supplement – For care recipients who are in genuine financial hardship there is a supplement available on top of their Home Care Package to help pay the costs of care incurred due to circumstances beyond their control. Each case is assessed on an individual basis, taking into consideration a range of issues which may be unique to the home care recipient.
- Understand your individual budget
Every Home Care Package, no matter which level requires an individual budget to be prepared. This budget should be prepared in consultation with you and reflect what is in your Care Plan.
An individualised budget for a Home Care Package must be prepared having regard to:
- Your goals, assessed needs and preferences;
- The funds which will made available for the Home Care Package
- The services selected by you and set out in the care plan.
- The case management costs associated with the delivery of the Home Care Package
- The administrative costs of the provider which covers a range of overhead or operational costs, such as insurance, workers compensation, care co-ordination and travel costs.
The individualised budget for the Home Care Package should be amended whenever the care plan or costs change.
The individualised budget should clearly identify the total funds available to you, which is made up of:
- Government subsidy
- Any eligible supplements
- Income-tested care fee, when applicable
Providers must review and, if necessary, revise the individualised budget for you if:
- There is a change to the care and services to be provided
- The costs of providing the care and services change; and
- If you request them to do so.
- Understand your Leave provisions
Consumers of Home Care Packages are permitted to take temporary leave from their home care package for any reason, such as for a hospital stay that may be followed by transition care, to receive respite care, or social leave.
Your service provider can provide information on leave provisions.
- Make sure you are receiving a monthly statement
After a Home Care Package commences, you should receive a monthly statement from your Service Provider that details funds received during the month such as Home Care Package subsidy and any contributions from yourself, how those funds have been spent and the balance of any unspent funds. This must be delivered to the consumer as soon as practical, after the provider has all the necessary information to complete it.
The User Rights Principles 2014, specifies that the following details must be included on the monthly statement:
- the amount of home care subsidy paid or payable to the provider (including eligible supplements);
- the total amount of home care fees paid or payable by you;
- the total amount paid or payable by the provider in respect of the home care provided;
- an itemised list of the care and services provided to you and the total amount for each kind of care or service;
- the total of any unspent funds received from any previous month; and
- The balance of unspent fees at the end of the month.
There is no legislation which regulates how the statement must look. The provider and you need to agree on the level of detail in, and the format of, the statement. The means by which the statement is provided to the consumer, e.g. hardcopy, email or web-based, can be negotiated between the provider and the consumer.
- Make sure you discuss any concerns you have with your package provider
Having a Care Manager means that you have a point of contact to review your package and discuss any changes you would like to make or concerns you have. This is an important relationship and you should ensure that you are comfortable with your Care Manager and are able to contact them easily to discuss your care and any lifestyle changes that may impact the services you require.
- Keep abreast of any changes to the package program going forward
The Changes taking place to the Home Care package program in 2017 mark a significant change to the Aged Care System. The best resource for monitoring changes is the My Aged Care website.