Consumer Directed Care: working in a new world of funding and client relationships

Many people would prefer to live independently at home as they get older. If someone is generally able to manage but just needs some help with daily tasks, there are support services available to assist, however access to these services is based on age.

Services for older people, people aged 65 and over and Aboriginal people aged 50 and over, are funded and managed by the Commonwealth Department of Health through the Commonwealth Home Support Programme (CHSP). These services include help with housework, personal care, meals, social support and group activities, nursing care, allied health and home maintenance.

Community care services, otherwise known as Home Care Packages, are provided either through a government funded package or private funded home care services.

Government funded Home Care Packages

Government funded Home Care Packages provide older people with the in-home support necessary to remain living independently in their own homes. There are four Commonwealth Government funded Home Care Packages available, depending on the level of assistance required:

  • Level 1 – Basic care and support needs
  • Level 2 – Low level care and support needs
  • Level 3 – Intermediate care and support needs
  • Level 4 – High level care and support needs

The following range of supplements are also available to people across all levels of Home Care Packages who meet the eligibility criteria in recognition of the additional costs associated with certain care and service requirements:

  • Dementia and Cognition Supplement and Veteran’s Supplement
  • Oxygen Supplement
  • Enteral Feeding Supplement
  • Viability Supplement
  • Top-up Supplement
  • Hardship Supplement

An overview of the government funded Home Care Package assessment process is as follows:

  • Assessment by an Aged Care Assessment Service (ACAS) Assessor using the National Screening and Assessment Form (NSAF)
  • The assessment is then entered into the My Aged Care system so that the correct level of service can be determined. The person applying for care will then be placed in a queue until a suitable package becomes available.
  • Once a package becomes available, the person nominates their chosen service provider and enters into a service agreement

If eligible for a government funded Home Care Package most costs are covered, however some costs may apply which are calculated based on the income of the person receiving the services.

What is Consumer Directed Care?

Consumer Directed Care (CDC) is a model of service delivery designed to give more choice and flexibility to consumers. The term “consumer” is used to refer to the person receiving care and services through a Home Care Package. The introduction of CDC is a significant change to the way that home care is delivered in Australia.

The principles of CDC are:

  • Consumer choice and control
  • Rights to individualised aged care services, support and budget
  • Respectful and balanced partnerships
  • Community and civic participation
  • Restorative or enablement framework to be as independent as practical
  • Transparency of costs, care and budget

The 2012-13 Aged Care Approvals Round (ACAR) saw the introduction of conditions of allocation requiring all new places to be delivered on a CDC basis. From 1 July 2015, all existing and new packages were required to be delivered on a CDC basis.

From February 2017, the Government changed the funding arrangements for government funded Home Care Packages to attach the package to the individual and not the home care provider. The term “home care provider” is generally used to refer to the corporation that has been approved by the Department of Social Services under Part 2.1 of the Aged Care Act 1997 as suitable to provide home care.

Prior to February 2017, aged care places were allocated across Australia to home care providers via an annual Aged Care Approvals Round (ACAR). The ACAR was a competitive application process that enabled prospective and existing approved providers of aged care to apply for a range of new Australian Government funded aged care places and financial assistance in the form of a capital grant.

Impact of Consumer Directed Care on the industry

Though the ACAR process did not restrict commercial organisations from entering the market, the majority of registered home care providers as at 30 June 2018 were faith based and/or not for profit organisations. With the removal of the ACAR allocation process and the portability of packages from February 2017, commercial organisations have recognised the opportunity and have started entering the sector in greater numbers.

Although CDC was phased in over a number of years, the faith based and not for profit sector has been slow in embracing the cultural change needed to survive in a commercially competitive environment.

There is a fundamental business risk that if these organisations don’t transform into a more commercial operating model with a strong sales culture, then as their customers no longer require community care there will be a huge financial gap, which will not be passively filled from ACAR as per previous arrangements.

How we can help

BMS Advisory can help your organisation integrate a consumer directed care based model into your services.

We offer a broad range of services that can be customised to meet the particular needs of your organisation in the following areas; customer journey mapping, sales strategy and pipeline management, CRM design and sales tools, phone system & IVR, webchat & email channels, customer loyalty and retention, customer satisfaction surveys, organisational structure and alignment as well as staff sales and customer management training.

Get in touch with us to discuss how we can customise our skill set to suit your needs.

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