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Urgent calls to tackle home care wait list

Providers, sector peaks and academics have expressed concern over the 89,000-long wait list for home care and urged the Federal Government to take further action to address the long-running problem.

Data released by the Department of Health last week revealed there were just as many people in home care each year as on the national queue.

Based on the 53,000 people currently without access to any home care packages services, the system would need to increase the number of available packages by more than 50 per cent.

The national wait list for home care far exceeds the median wait time of four months for hip surgery, where five per cent of people wait more than a year for a total hip replacement in Australian public hospitals.

According to the latest figures from the Australian Institute of Health and Welfare, nationally two per cent of patients waited more than a year for elective surgery in public hospitals and the median wait time was 37 days.

Ian Yates

COTA Australia chief Ian Yates said the volume of people waiting for a home care package in Australia was “an unacceptable problem.”

“There are a lot of people who aren’t getting a package at all. Some people are receiving Commonwealth Home Support Program services or services through the allied health system, but a lot of them are just being looked after by a partner or family and friends and that is a real worry.”

He said there were hidden costs to residential care and the health system while unmet demand for home care packages continued.

While he, like many in the sector, applauded the Coalition Government for introducing transparency into the system for the first time and announcing additional high care places, he said the government must continue to address the problem in the Mid-Year Economic and Fiscal Outlook and in the next budget.

“The scale of the problem is so great that the government really faces no alternative but an injection over the next couple of years of new money into high care packages, while they look at the longer-term Tune recommendations around the balance between residential and home care places,” said Mr Yates.

Pat Sparrow

ACSA CEO Pat Sparrow said transparency of the queue data was an important step forward for understanding consumer wait times and the level of unmet demand was a clear indication there was a need for increased investment in home care.

Ms Sparrow said it was also important the government moved to integrate the Commonwealth Home Support Program and home care packages as soon as possible to ensure that community aged care resources were being used most effectively.

“The data is reinforcing that people want to age at home and we need to look at the system overall in a way that ensures people can get residential care when they need it, but that the majority of people want to age at home, and they are supported to do so.”

Lee-Fay Low

Lee-Fay Low, an associate professor in ageing and health from the University of Sydney, said the data showed the home care system was significantly underservicing older people and many were missing out on care services altogether.

Without access to adequate support the health of people waiting on the queue could decline faster resulting in the need for residential care or increased hospital admissions, she said.

The impact on carer burden could also be significant, which had wider health and productivity costs from family carers leaving the workforce and experiencing high levels of stress, she said.

“What worries me is that there’s a whole lot of people who could be living at home with good quality of life and they are not.”

Average waiting times for high priority cases was not yet available from the public reporting.

She said another key issue was how effectively the system was reassessing older people’s changing needs while they waited, in some cases more than 12 months, for a package.

Associate Professor Low agreed there needed to be a discussion about what is the correct balance between home care places and residential aged care beds in Australia.

Providers react

Richard Hearn

Resthaven CEO Richard Hearn urged the government to do everything it can to expedite access to services to people at their assessed level of need.

To address the extent of unmet demand, Mr Hearn called for the government to commit to uncapping the supply of home care packages and to introduce a Level 5 home care package, as recommended by the Tune Review.

As an initial step to uncapping supply, Mr Hearn said the aged care ratio should be adjusted to further increase the home care ratio from 45 to 50 packages per 1,000 people over 70 and reduce residential care places to 70.

Sandra Hills

Sandra Hills, CEO of Victorian provider Benetas, said unmet demand for packages has been a persistent problem in the home care sector and the report revealed the extent to which older people can’t access care that adequately meets their needs.

“We still need to understand the full extent of wait times across the program. People should be allowed to know when they could expect to receive services,” she said.

“If consumers know how long the wait time is, they can make interim arrangements, such as accessing private funded services. “

Ms Hills said more information was also needed on the take-up of assigned packages by consumers, including the number of package withdrawals.

“There is evidence that many consumers remain confused about the process and what they are being asked to do.”

Paul Sadler

Paul Sadler, CEO of Presbyterian Aged Care, said an undersupply of home care packages has been a significant and well-known problem in the industry and underscored the need for greater investment in home care.

However, to develop a fuller picture of the interim arrangements in place, Mr Sadler said it was necessary for the government to report on how many people waiting on the national queue were also receiving Commonwealth-funded home support services.

Mr Sadler said the Tune Review’s proposal to temporarily reallocate residential places to home care was a good idea in principle, but the practicalities of implementing the measure needed further consideration.

Rebalancing the residential and home care places as part of the aged care planning ratio was also a debate the sector needed to have, he said.

David Martin, the general manager of HammondCare at Home, said to help people in urgent need his organisation has been offering “early commencement of care” to people on the national queue who have not yet been assigned a package.

“It is a risk that we are prepared to take to help those, particularly with high needs, who are at risk,” he said.

Related coverage: Home care data reveals 90,000 package shortfall

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6 Responses to Urgent calls to tackle home care wait list

  1. Angus Kerr September 21, 2017 at 3:57 pm #

    Hammond Care at Home offering “early commencement of care” to those who have HCP approval but are waiting on the national queue?!? Does this fit the old adage of “if it sounds to good to be true it often is” or “don’t expect anything for free”? My first inclination is that there must be a catch and it is another creative piece of marketing encouraging consumers to engage in fee-for service products while waiting?

    Wanting to know more I checked the Hammond Care at Home website, it advised that “terms and conditions apply” with regards to this offer- I could find no link to these terms and conditions. So as a potential consumer I was none the wiser.

    As someone who supports individuals and families navigate the community aged care sector, I continue to come across some interesting marketing tactics to engage current and future HCP consumers and their subsidies. Yes there are now more HCP provider options and yes choice is great thing, but without transparent information to help consumers understand their options it is just confusing or at worst misleading!

    Hammond Care at Home may indeed be taking on the risk of providing Home Care Packages to consumers who have not received a subsidy yet- with the hope they remain Hammond Care at Home consumers when that subsidy finally arrives. If so, a credit to them but with My Aged Care now advising of a maximum wait time of more than 12 months for all HCP levels, I hope this is sustainable and does not cause consumers who take up this off to become dependent on these unfunded services.

    More information on this offer please otherwise buyer beware.

  2. Jo September 22, 2017 at 8:02 am #

    If level one packages were withdrawn, level two and three merged – level two packages have lost enormous purchasing power over last 15 years – to create a medium and high level, you would not have so many people on level 2 waiting for higher packages, which has blown out both the level 4 wait list and the assessment wait times. Many people on level 2 cannot be cared for on that level so are being referred for review. If level two was upgraded, most of them would not need review as they don’t need level 4, just more than level 2!

  3. At the coalface September 22, 2017 at 11:22 am #

    I agree with Angus Kerr, I applaud Hammond Care for their bold move, but definitely concerned about how they plan on reconciling once the subsidy is finally received. I am experiencing it with a level 2 client and only have a few months’ worth of delays – eventually this will be squared off – but we do a lot of work to reassure the client we still provide services and support them regardless of the fact MAC and DHS Medicare seem hellbent on confusing the hell out of my client during an already distressing time. PS This is 1 client – and we are a big organisation, so can wear the costs.
    Hammond Care appear keen to jump ahead of the competition, however this is not the same industry as a typical market based system where companies have the capital to innovate and consumers have the money to spend… Where will they get that money from with 12 month+ waitlists for level 4 funding? And trying to budget and cost services based on estimates is already a nightmare…

  4. Drew Dwyer September 22, 2017 at 1:18 pm #

    So what is the plan?….Hold back the services and packages that forces consumers into residential care homes? Hardly a choice left.

    Too many families are hanging by a thread on this and the transparency is identifying the issues.

    This doesn’t meet the original sales pitching on LLLB and Choice and Voice. Consumer still has no control and is loosing confidence in the system.

    We can do better than this by using the CDM in medicare at least.

  5. Jo September 23, 2017 at 8:20 am #

    The 12 months + wait is misleading. We need to know the real wait times. We have many clients waiting for higher level packages and wait times are more like 2-3 years. However, wait times for residential, at least in our area is zero. So much much for the notion that community care is govt preferred option!

  6. Can't Do Care October 2, 2017 at 3:53 pm #

    Since these reforms (Feb 17) the general waiting time for packages has sky rocketed, 10 weeks for an Assessment, 10 weeks to get a package-and that’s for the lucky ones on high priority (most are not high priority). I have seen examples of some where it is now 5 months since my referrals and the person still yet to be assessed.

    This is by no means providers fault. The government already clawed back funds to return to government after packages ceased unlike the previous 10 years, so organisations are running now on shoe strings as it is-some are not keeping up with natural attrition of client exits, transfers and withdrawals. To then go out and make organisations provided unfunded services is ridiculous. What is the plan? Ask the government, they dug this hole themselves!

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