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Care at Home for Older Australian’s – The Home Care Package Program

Image 1

Conceptual Map of the Home Care Package Program

Overview

The Home Care Package Program is funded by the Australian Government to support older Australians to remain living at home and connected with their community (Department of Health, 2020). In accordance with the Aged Care Act 1997, the program is intended to provide coordinated, consumer directed care which meets the individual’s identified needs. My Aged Care was introduced by the Australian Government in 2013 to streamline the way consumers and their families accessed Aged Care, including assessment for a Home Care Package (Australian Government, 2022). The State and Territory governments deliver the Aged Care Assessment Program locally.

Each Aged Care Assessment Team is responsible for actioning referrals received via My Aged Care and completing assessments commonly known as the “ACAT” assessment (Department of Health, 2020). Once approved for a Home Care Package, individuals are added to the National Priority System. In March 2022, 58,282 people were reported to be on the National Priority System waiting to be assigned their HCP (Department of Health and Ageing, 2022). Image 1 demonstrates the complexity of the Home Care Package Program and the interplay between different elements within the system. Whilst the Royal Commission into Aged Care Quality and Safety identified major concerns with the current system (Commonwealth of Australia, 2021), this paper will briefly discuss three outcomes (depicted as oval shape in Image 1).

Identifying needs

The National Screening and Assessment Form (NSAF) is completed during the ACAT assessment. It identifies the specific activities a consumer requires support with, and how their needs would be best met. A personalised support plan is developed with the consumer, and their care givers where appropriate, and the relevant level of Home Care Package is recommended (Department of Health, 2020). Once assigned the Home Care Package, Service Providers have a legislative requirement to support consumers to use their funding in an appropriate manner which meets the needs and goals identified during the ACAT. Despite this requirement, HCP funds are at times misused to provide services which do not address identified needs or are in excess of what is considered reasonable presenting as a policy implantation error (Dixit et al., 2018).

Exceeding needs

Once approved for a Home Care Package, an individual cannot be reassessed as needing a lower-level package. This presents as a concern when an individual makes an unanticipated improvement in function, has a change in circumstances, or where the level of Home Care Package recommended during assessment is not appropriate. The consumer may then begin to accumulate unspent funds or continue to use funding to receive services which no longer address a need. It has been estimate that approximately 1.5 billion dollars of unspent funds had accumulated in 2021, while almost 60,000 people were waiting to receive support (Skatssoon, 2021).

Older adults with disabilities

Home Care Packages provide a set amount of funding per year, dependent on the level of package allocated, with no additional funding available for disability specific equipment. Older adults with disabilities are ineligible for the National Disability Insurance Scheme if they apply after 65 years of age and are significantly disadvantaged in comparison to their younger counterparts (Commonwealth of Australia, 2021). This inequity results in older Australians having to self-fund necessary equipment, forgo care identified in their support plan and in some instances, enter residential aged care prematurely.

References

Australian Government. (2022). My Aged Care. Retrieved 05/11/2022 from https://www.myagedcare.gov.au/about-us

Commonwealth of Australia. (2021). Royal Commission into Aged Care Quality and Safety. Retrieved from https://agedcare.royalcommission.gov.au/publications/final-report-volume-1

Department of Health. (2020). Home Care Packages Program Manual. Retrieved from https://www.myagedcare.gov.au/publications/home-care-packages-manual

Dixit, S. K., & Sambasivan, M. (2018). A review of the Australian healthcare system: A policy perspective. SAGE Open Medicine, 6, 205031211876921. https://doi.org/10.1177/2050312118769211

Skatssoon, J. (2021). Home care providers hold close to $1.5b in unspent funds. Community Care Reveiw. https://communitycarereview.com.au/2021/03/22/home-care-providers-hold-close-to-1-5b-in-unspent-funds/