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Home care system troubles ‘compounding’, says peak

Industry peak body Leading Age Services Australia is calling on the Federal Government to address a series of significant implementation issues arising from the latest home care reforms.

The peak body has written to the ministers for aged care, human services and the prime minister with a list of 38 recommendations to resolve key outstanding problems facing the sector.

Major concerns raised by providers include the ongoing reduced uptake of home care packages by consumers under the new system, assessment delays, a lack of access to high-level home care packages and persistent subsidy payment issues.

LASA said seven months into the new national system for assigning packages to consumers, home care providers are continuing to report a “significant downturn” in active packages.

The Department of Health has assigned over 65,000 packages to consumers through My Aged Care, however official data has not yet been released on the number of consumers that have taken up their assigned package.

Some providers have also reported a reduction in available staffing hours and increased workforce turn over due to a drop in package take-up, LASA said in its report handed to government.

LASA repeated its call for the government to increase the support and information available to consumers who are struggling to activate their package under the new system.

Delays in accessing an aged care assessment – reported to be up to six months in some regions – also impacted timely access to care and support for consumers and required urgent attention, said LASA.

The peak urged the Department of Health to review the resourcing of ACATs to ensure timely assessments can take place and consider tendering out the work of underperforming ACATs to other groups such as Primary Health Networks.

Unmet demand for home care draining CHSP resources

LASA also expressed concern over the impact of unmet demand for home care packages on Commonwealth Home Support Program resources.

The peak body said it held concerns over the sustainability of redirecting consumers requiring home care packages to the CHSP as an interim strategy.

Some CHSP providers were reporting staffing and program outputs were now exceeding their block-funded grant agreements due to an increase in referrals from clients with high-level care needs, LASA said.

It said it was concerned CHSP providers would not have sufficient funds to respond to demand for CHSP services in the second half of the financial year.

Unpaid subsidies

Providers are also continuing to report payment system problems resulting in the accumulation of significant unpaid subsidies. One provider has reported close to $125,000 in unpaid subsidies since February, LASA said.

Incorrect home care package withdrawals, which has been an ongoing issue since February, have also resulted in unpaid subsidies to providers, it said.

CHSP assessment

The peak also called for the government to release the formal evaluation of the Regional Assessment Service for the CHSP submitted to the department in June and to review RAS referral patterns to ensure the impartiality of home support assessment and referral.

Read the full paper here.

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3 Responses to Home care system troubles ‘compounding’, says peak

  1. Christine Mifsud September 8, 2017 at 4:31 pm #

    I hope LASA also raised these issues in a response to the recent DOH Consultation Paper on an Integrated Care at Home Program. Either way, the issues raised by LASA are a real concern to providers. Seems many of us are singing from the same song sheet, let’s hope the adept hears us!

  2. Margaret Many September 11, 2017 at 9:57 am #

    Clients are either dying or going into care before packages at high levels reach them especially in rural areas .
    Clients and carers and case managers are all very stressed and disappointed with the wait time for upgrades to high care packages they are not coming through
    The old system we where able to find a vacant package quicker even if it was with another provider .
    Older people and family’s are so stressed and unable to understand the system the miles of paper work the numbers what to do… the clients sit their and if they have a package its gone back on the system because they don’t understand they have been assigned a package .
    On the other hand they think when they are ACAT assessed and told they are whatever level that they are that this is their Package ready to go no then they have to understand you now wait and wait and wait to be assigned.
    It is a crisis and good people are leaving jobs good skilled people because of the dissatisfaction of being able to do your job properly and assist the most vulnerable people ,case loads are to high to complex to juggle due to no release of packages in rural areas.
    Transport is full cost recovery for Packages which takes up the entire amount given if you are living in the rural areas leaves nothing for P/C med checks ect the list grows.
    There has to be some recognition of the fact their are grave and serious issues in this new system and people and families are suffering greatly or just not getting any services at all .
    People don’t have extra money on their pensions to pay anything at all its really awful for the clients and their families and those of us saying we have no answer to these issues .

  3. Angus Kerr September 11, 2017 at 10:07 am #

    It will be interesting to see the data relating to the number of Home Care Packages that have been assigned since Feb 27 (47,000) but have not been taken up within the 56 days allocated and have been returned to the national queue?

    The LASA report identified that…

    “it is acknowledged that there are multiple factors contributing to consumer delays in activating assigned HCPs. Improved provisions and infrastructure are required to not only support consumers in researching HCP providers, but also to facilitate active follow-up to ensure consumers promptly activate their HCP in the 56-day assignment-activation period.”

    How many instances have consumers been allocated a Home Care Package but have not had the resources or capability to choose a suitable provider to administer the package (think of those who English is their second language, have cognitive decline and/or little or no family support)? How many cases have consumers failed to act on the allocation of a Home Care Package at all? Suggestions of a Consumer Support Platform by National Aged Care Alliance would no doubt improve consumers ability to choose a home care provider and inturn reduce waiting times for others. Putting this responsibility of supporting ‘vulnerable’ consumers back onto ACAT’s will only further blow out waiting times for assessments.

    LASA reported “Recent anecdotal reports by HCP providers in Victoria suggest that wait times for an ACAT assessment can range between 12-16 weeks while in QLD wait times for ACAT assessments are suggested in some regions as ranging between 6-8 weeks and in other regions 24 weeks. Such variations have significant implications for equitable access for placement in the national queue to access a HCP. It also raises concerns about the ability of ACATs to provide an urgent response to vulnerable consumers.”

    For those identified by ACAT’s as being ‘vulnerable’, access to some form of Independent Facilitation would be a start. It would not only support link participants to providers and ensure the committed supports are accessed but it would support consumers in exploring what is possible through their Home Care Package and provide them with clear expectations of what a Home Care provider can and indeed will provide. In turn this would allow packages to be taken up or withdrawn in a shorter amount of time and would allow the national queue to function more efficiently.

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