HOME CARE PACKAGES
What is a Home Care Package?The Australian government has created the Home Care Packages Program to help older people to live at home for as long as possible. ‘Home care’ is a type of aged care service that has been created under the Aged Care Act 1997 (as amended 2013). Previously, home care was known as ‘community care’, or sometimes ‘Community Aged Care Package (CACP)’ or ‘Extended Aged Care at Home Package (EACH)’. If you want to stay in your own home as you get older, but need some assistance with things that may improve your health, wellbeing and independence, a Home Care Package may help you. For more information on Home Care Packages, please visit the My Aged Care website or call My Aged Care on 1800 200 422.
How do I find out if I am eligible for a Home Care Package?Depending on your personal situation and the level of assistance you require, you may be entitled to a Home Care Package. The first step is to call the Government's My Aged Care Team on 1800 200 422 or visit myagedcare.gov.au. They will register you over the phone and arrange an appointment for you to be assessed by the Aged Care Assessment Team for a Home Care Package. If eligible, you will receive approval of your Home Care Package and level from My Aged Care within 10 days. It can take between six to 12 months to be allocated a Home Care Package. During this time, if you need help, we can assist with Private Care, which is based on a fee for service. Our Private Care Services offer individually tailored, flexible care in your home. Services can be combined in any way that suits you. For more information, call us on 1300 993 591. While you are waiting for a Home Care Package allocation, contact Approved Providers in your area and short-list a Home Care Provider. My Aged Care will send you a letter of assignment of your Home Care Package, with a 10 digital Referral Code, that will be needed by your chosen Home Care Provider, so that they can connect the Home Care Package with My Aged Care and begin services on your behalf.
How do I find an Aged Care Assessment Team (ACAT)?The ACAT teams are located around Australia. Your GP or local health care provider can assist you on your search or you can do it yourself by accessing the My Aged Care website http://www.myagedcare.gov.au or by calling My Aged Care on 1800 200 422.
How can I prepare for my ACAT Assessment?During your ACAT assessment, your assessor will identify your needs and advise on the types of care services that may help you to stay at home. This is a time for you to speak up! Talk about what you are still able to do for yourself and what you may need assistance with to stay living at home with the lifestyle you choose. Your assessed needs will help to determine which level of Home Care Package you may be eligible for. You will also be asked about whether you want to use residential respite care in the future. You can have a friend, family member, partner, carer or advocate with you during the assessment. The National Aged Care Advocacy Programme (NACAP) is funded to promote your rights. To contact your local advocacy service phone 1800 700 600. In some instances, when staying at home is no longer possible, the ACAT/ACAS assessment can also help to determine your eligibility for care in a residential aged care service.
What questions should I ask when I get an ACAT assessment?If you have a preference for a particular Aged Care Provider to manage your package, you can ask the Assessor to specify which Care Provider/s you want to be wait-listed with.
What if I disagree with my ACAT/ACAS assessment?The ACAT/ ACAS assessor must provide you with information on how to appeal a decision. Remember you have a right to express your concerns. For more information go to http://www.myagedcare.gov.au/eligibility-and-assessment/acat- assessment
I have received my Letter of Approval from My Aged Care. What's next?Your Letter of Approval from My Aged Care means that you have been successful in your My Aged care assessment for home care assistance. You have been placed in a national priority queue for Home Care Packages, for when it becomes available. There may be a waiting period between the time you are approved for care and the time that you are assigned a Home Care Package. This waiting period is based on your needs and circumstances as well as the time you have already spent waiting for care. During this time, if you need help, we can assist with Private Care, which is based on a fee for service. Our Private Care Services offer individually tailored, flexible care in your home. Services can be combined in any way that suits you. For more information, call us on 1300 993 591. While you're waiting for a Home Care Package to be assigned to you, it's recommended that you research Home Care Providers in your local area. My Aged Care will send you a letter of assignment of your Home Care Package. This letter will provide a 10-digit Referral Code, that will be needed by the Home Care Provider. If you have decided that Oxley Home Care will be your Home Care Package Approved Provider, we can take care of the paperwork. Simply call us on 1300 993 591 and we will take care of the rest.
I have received my Letter of Assignment from My Aged Care. What's next?Your letter of assignment advises you of the level of Home Care Package that's been assigned to you. There are four levels of a Home Care Package - Level 1 is the lowest amount of funds and Level 4 is the highest. The letter will contain a 10 Digital unique Referral Code that you will need to supply to your chosen Home Care Provider. Contact your shortlisted Home Care Provider with your referral code, so that they can arrange to meet with you to discuss your care and services. You have 56 days to find a Home Care Provider and enter into a Home Care Agreement from the date of your assignment letter. Once you have a Home Care Agreement, a care plan and an individualised budget, your care and services can begin. If you have decided that Oxley Home Care will be your Home Care Package Approved Provider, we can take care of all of the paperwork. Simpy call us on 1300 993 591 and we will take care of the rest.
How long can I stay on my Home Care Package?You can stay on a Home Care Package as long as you need. If, however, you need to move residence, check whether your Aged Care Provider can support you in the new area. Home Care Packages are allocated for specific areas. If your provider cannot assist you in the new location, they can advise you about how to find another provider with a vacant package. If you move out of your area and make no arrangements to find another provider, you will be without services until you find another provider who can support you.
Can I put my Home Care Package ‘on hold’?You can take ‘leave’ from your Home Care Package if you need to go to hospital, or if you are taking ‘planned leave’ from your package, such as a holiday or respite care. You may be able to access necessary services whilst you are away on holidays in another location. Talk to your Aged Care Provider about making arrangements for putting your package on hold. On your return you can restart the services.
How do I estimate my fees for a Home Care Package?Although Home Care Packages are subsidised by the Australian Government, depending on your financial capacity, you may be required to contribute towards the cost of your care. Your financial capacity, will be assessed by Centrelink who may request that you contribute in one of the following ways:
- A basic fee of up to 17.5% of the single basic Age Pension
- An income-tested care fee, if your income is over a certain amount.
ELIGIBILITY AND ASSESSMENT FOR HOME CARE PACKAGES
What is the difference between Home Support and Home Care Packages?The Commonwealth Home Support Program provides basic support services to assist people to remain living at home. It was formerly known as Home and Community Care (HACC) services. Home Care Packages are different from Home Support in that they provide a co-ordinated package of services with the assistance of an advisor or case manager.
How do I know whether I need assistance from a Home Care Package or the Commonwealth Home Support Programme (or Home and Community Care in Victoria and Western Australia).You can call My Aged Care on 1800 200 422 and tell them about your situation and they can advise you on which services are best suited to your needs. They will then refer you either directly to the appropriate service in your area, to an ACAT (Aged Care Assessment Team) for Home Care Packages or the Regional Assessment Service (RAS) for Commonwealth Home Support Program services.
Does Oxley Home Care host Commonwealth Home Support?Oxley Home Care at present doesn't host the Commonwealth Home Support Program.
What services are typically included in a Home Care Package?The most common types of supports are:
- Personal Care - assistance with bathing, dressing, grooming
- Preparing meals
- Continence management
- Cleaning, laundry services
- Gardening, home maintenance
- Transport to attend medical appointments or social activities
- Nursing, allied health and therapy services.
CONSUMER DIRECTED CARE (CDC)
What is Consumer Directed Care?Consumer Directed Care (CDC) is a way of delivering services that allows you to have greater choice and flexibility in the services and supports you receive as part of your Home Care Package. In the CDC approach:
- you are encouraged to identify your goals which will be the basis of your care plan
- you decide how much involvement you want to have in managing your Home Care Package
- you are able to exercise choice in the way that services are delivered and by whom
- you will receive an individualised budget and a monthly statement of income and expenditure
- you can expect ongoing monitoring and review, and a formal re-assessment by the home care provider.
How is CDC different from Home Care Packages before 1 July 2015?The CDC approach encourages Aged Care Providers to explore options outside the boundaries of the formal services. That is, you can explore your community connections, family or informal networks, community and private resources to help achieve your goals. The CDC approach starts with finding out about your life and your goals, what you would like to keep doing for yourself, and the assistance you may need to continue to live the way you wish. For example, the family of Mrs. H may have sought home care support for their mother because they were concerned that she is losing weight and not eating well. While the initial response may have been to arrange delivered meals, a deeper exploration may lead to other responses. Why is Mrs. H not having nutritious meals? When did it start? What happened? Does Mrs. H like cooking? What kind of assistance would she prefer? Would she benefit from a dietitian referral? Would she like to be cooking for herself again? Is food important in her life? Would she prefer to have meals in a social context? By asking questions and exploring further the need for nutritious food, the provider learns more about the person and a very different support can be put in place. For example, Mrs. H’s need for nutrition can be satisfied with either delivered meals or she could have someone coming to help her to cook, someone to help with the shopping so that she can cook herself, she could have her family on a roster to bring her some meals, or she may join a group who has a meal out once or twice a week. The CDC approach focuses on giving you the flexibility to plan and make your own decisions about your support, helping you to live the life you always lived – planning, making your own decisions and living your life in full! That is, with CDC you can tell your Aged Care Provider what you want to do - you can set broader life goals. Aged Care Providers will help you within the limits of the package program. Providers will also look at how you might be able to regain your health and strength to be able to do more for yourself and be less reliant on people coming in to assist you. There is flexibility within the Home care Package program to allow for both of you to explore the options with a broader mindset. CDC also requires Home Care Package providers to give you a monthly statement of your income and expenses for your individual Home Care Package. Understanding the funds available and what your services are costing will assist you to make decision about your priorities for assistance.
How is my budget worked out?Your budget is based on the level of your Home Care Package and is allocated to the supports you need after discussing your goals and completing the care plan with your provider’s adviser / case manager. The budget includes the costs of services to be purchased for you, an optional ‘contingency’ fund and the core advisory costs and administrative overheads. You can read more about these cost items in your budget in the information sheet – Individualised Budget Items Costs The income component of your Home Care Package budget is made up of:
- Australian Government subsidy (and eligible supplements)
- the basic daily care fee which all consumers receiving a Home Care Package can be asked to pay
- your income tested care fee (if you’ve entered into Home Care after 1 July 2014) which you may need to pay depending on your assessable income
- any other amount you’ve agreed to with your service provider.To find out more about creating a budget for your package, please visit the My Aged Care website.
What if I don’t understand my Home Care Package statement?You have the right to ask questions about your statement. If you do not understand your statement, call your adviser/ case manager and ask questions about it. It is important that you know and understand how your package funds are spent. Providers are required to produce statements in a way that you can understand. To find out more about your individualised budget and income and expenses statement, please visit the My Aged Care website, or call My Aged Care on 1800 200 422.
Why has my budget for services or number of hours of service been reduced?Before the introduction of CDC, Home Care Package providers received funds for a number of Home Care Packages at different levels. Some providers chose to allocate additional funds to people with higher needs, which meant that other people were receiving less care than they were entitled to. Since the introduction of CDC, every person is allocated the budget according to the level of package they have been assessed as needing. This means that people who were previously receiving more than their funding entitlement may have the amount reduced, and those who were receiving less may have their amount increased. In some cases Home Care Package providers may have reviewed their service costings, resulting in a reduced budget for hours of service within individual packages. You might want to ask your provider to explain why your services have changed, including details about previous cross-subsidisation, and changes to their organisational cost structure. If you are concerned about the impact of moving to CDC on your package you can speak to your provider. If you are not happy with their response you can contact the CDC Transition Hotline at the Department of Social Services on 1800 138 225 and ask them to review your situation.
Is there any Government regulation of the amount that home care providers can charge in administration costs and core advisory and care management services?The government sets the amount of subsidy for a Home Care Package depending on the level that you have been assessed as needing (Level 1 to 4). You can find those amounts on the DSS website here: https://www.dss.gov.au/our-responsibilities/ageing-and-aged-care/aged-care- funding/aged-care-subsidies-and-supplements Within that amount, plus any relevant supplements and your contribution of the basic fee and income tested care fee, Home Care Package providers can determine how the budget is allocated to:
- core case management and advisory costs
How can I compare the charges of different providers?
Can I change Home Care Package providers?You can move to a new Home Care Package provider if that provider has a vacant package at the level you have been assessed as needing. This will be more likely if your package is a lower level (Level 1 or 2) than a higher level (Level 3 or 4). Fewer high level packages are allocated so the demand for them is greater. Before you consider changing Home Care Package providers you should speak with your provider about the aspects of your service that you are not happy with. If you still wish to change providers, you can go to the My Aged Care service finder at http://www.myagedcare.gov.au/service-finders or call them on 1800 200 422 to find out who provides home care services in your area. You will then need to contact them to see if they have any vacant packages.
What choices do I have about the supports I can purchase from my budget?Under the CDC approach, your adviser/case manager works with you to find out what is important to you and what you would like to achieve with the help and assistance that will be provided – providers often call this ‘goal setting’. The choices of supports depend on what your goals are. In short, the provider supports you either directly, by providing a service or indirectly by organising supports for you from other organisations or pointing you in the right direction. The Government has set some limits to purchasing arrangements. You have the right to ask and choose but keep in mind that the package cannot be used:
- as a source of general income
- to purchase food, except as part of enteral feeding requirements
- as payment for permanent accommodation, including assistance with home purchase, mortgage payments or rent
- to pay home care fees
- to pay fees or charges for other types of care funded or jointly funded by the Australian Government (this includes fees for residential respite care).
- for home modifications or capital items that are not related to your care needs
- for travel and accommodation for holidays
- for the cost of entertainment activities, such as club memberships and tickets to sporting events
- to pay for services and items covered by the Medicare Benefits Schedule or the Pharmaceutical Benefits Scheme
- for gambling or illegal activities.
What aspects of the organisation and management of my CDC package can I take on? How does this impact on the cost of my support?A key objective of CDC is to promote choice and decision making for consumers. You can manage as much as you want as long as it is agreed and stated on your care plan. You need to discuss this with your provider. The CDC model can change from provider to provider. What remains constant is the fact that you make all the decisions about your care and you choose what is right for you. You cannot be excluded from taking on an active role in these areas on the grounds of any lack of qualifications on your part. There are core advisory services that the Home Care Package provider must be responsible for in order to meet their legal and funding obligations. While you can have increased choice and flexibility with CDC, you are not able to receive the funds directly. The funds are allocated to the provider to plan the services in partnership with you. To find out more about CDC, please visit the My Aged Care website.
What if I want things in my plan my provider doesn’t deliver?You have the right to have your wishes for lifestyle and support respected. 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. This may include arrangements to source services from other service providers. As this may increase the cost of service to you, any additional costs should be made clear to you prior to you agreeing to the service. It is impractical to try to state everything that is an inclusion or an exclusion under Home Care Packages guidelines. Rather, there should be transparency around the decision-making process your Provider uses to determine whether your request can be accommodated. You should have the opportunity to state your case for budget expenditure where you believe your health and wellbeing will be enhanced as a consequence. To find out more about creating your care plan, please visit the My Aged Care website. For more information on the care and services you could receive from your Home Care Package, please visit the MyAgedCare website.
I want my family or friends to be paid to care for me. Is that possible?You can certainly express your wishes and desires. Your provider will work with you to address your requirements in the best way possible. Every provider has their own CDC approach. The support of your family and friends may be able to be included in your care plan in certain circumstances but you need to discuss this with the provider as they have responsibilities set out by the Aged Care Act 1997 that they still need to adhere to.
How will my Home Care Provider meet my language, cultural or diversity needs?The Department of Social Services expects that Home Care Package providers work with consumers to find the most suitable way of communicating both written and verbal information. The National Translating and Interpreting Service (TIS National) can be accessed free of charge when you and your provider are discussing the Home Care Agreement, care plan, budget and monthly statement. Any requirement for translation and interpreting relating to you communicating with services involved in delivering care and support, need to be met by the consumer’s Home Care Package budget. Some Home Care Package providers specialize in working with culturally diverse communities. You should ask your ACAT assessor when you first wish to access a Home Care Package which organisations might meet your specific requirements. You can request that these organisations are made aware of your desire to receive your Home Care Package through their service.
What does the term ‘special needs’ mean in the context of Home Care Packages?Under the Aged Care Act 1997, people with special needs include people who identify with or belong to one or more of the following groups1:
- people from Aboriginal and Torres Strait Islander communities;
- people from culturally and linguistically diverse backgrounds;
- people who live in rural and remote areas;
- people who are financially or socially disadvantaged;
- people who are homeless or at risk of becoming homeless;
- people who identify as lesbian, gay, bisexual, transgender or intersex;
- people who are care leavers; and
- parents separated from their children by forced adoption or removal.
- ‘National Ageing and Aged Care Strategy for People from Culturally and Linguistically Diverse (CALD) Backgrounds’; and
- ‘National Lesbian, Gay, Bisexual, Transgender and Intersex (LGBTI) Ageing and Aged Care Strategy’.
How many levels of Home Care Packages there are?There are four levels of Home Care Packages:
- Home Care Level 1 - to support people with basic care needs.
- Home Care Level 2 - to support people with low level care needs.
- Home Care Level 3 - to support people with intermediate care needs.
- Home Care Level 4 - to support people with high care needs.
FEES AND VALUE FOR MONEY
Do I need to contribute financially to my support under CDC? How much? Why?Under arrangements for home care prior to 1 July 2014, you may have been asked to pay a fee based on your ability to contribute to the cost of your care. For older people on the basic rate of single pension, a basic daily fee of up to 17.5% of the pension could be charged. Consumers on higher incomes could also be asked to pay additional fees, limited to 50% of any income above the basic Age Pension rate. If you were already on a package prior to 1 July 2014, your fee arrangements should not change. To find out more about this fee structure, please visit the My Aged Care website. Since 1 July 2014, the fee arrangements for Home Care Packages have changed. You should go to www.myagedcare.gov.au/financial-and-legal/help-home-costs-explained for more information. You can use the Home Care Fee Estimator to estimate the costs your provider may ask you to pay.
Can a Home Care Packages provider increase my fees from 1 July 2014 if I was already receiving a package prior to 1 July 2014?This depends on your Home Care Agreement, what fees have been included in your Agreement and whether the Agreement allows the provider to increase these fees. As long as you don’t end your Home Care Agreement and take longer than 28 days to enter into a new Home Care Agreement you will remain subject to the fees that were in place prior to 1 July 2014. Prior to 1 July 2014, there were two parts to the fees charged for Home Care Packages. The two types of fees are explained below. Basic fee: Everyone taking up a Home Care Package can be asked by their service provider to pay the basic fee. The basic fee has not changed as part of the new fee arrangements. It is indexed twice per year in line with changes to the age pension. Income-tested care fee: If you have a total assessable income above the single rate of the basic Age Pension, you could have been asked to pay an income-tested care fee. This fee can be up to 50% of your income above the Age Pension amount. To find out more about this fee structure, please visit the My Aged Care website.
How do I decide whether my Home Care Package is providing value for money?There are a number of aspects to consider when thinking about whether your package is providing value for money. In relation to your direct services or other goods or equipment provided, you could compare the costs with what you could purchase on the private market. You can ask your Provider for assistance to make this value-for-money comparison. You should also consider the benefits of having an Adviser/Case Manager to work with you on co-ordinating your support, assisting you to locate other support, and working with you to arrange the best possible support available. Home Care Packages have the benefit of Government oversight of your care and support through the monitoring of the Aged Care Quality Agency www.aacqa.gov.au. Another consideration is the annual and lifetime caps that apply to the income-tested care fee for Home Care Packages. Once these caps are reached, you cannot be asked by your service provider to pay any more income-tested care fees. The Australian Government will pay these fees for you after you have reached these caps. The amount of these annual and lifetime caps can be found at http://www.myagedcare.gov.au/financial-and-legal/home-care-package- income-tested-care-fee together with more information about these fee caps. Once the annual cap is reached, you cannot be asked to pay any more income-tested care fees until the next anniversary of the date you first began receiving aged care. Your service provider can still ask you to pay the basic fee. Lifetime cap: There is a maximum amount of income-tested care fees you may be asked to pay in your lifetime. Any means-tested care fees you pay in residential care will also be counted towards the lifetime cap. When you have reached this lifetime cap, you cannot be asked to pay any more in income-tested care fees. Your service provider can still ask you to pay the basic fee. If you are anticipating that you may need support in the longer term, the fact that your fees are capped when receiving government funded services may influence your choice between these services and buying services on a private basis.
GETTING MORE INFORMATION AND WHERE TO GO IF YOU ARE NOT HAPPY WITH YOUR ARRANGEMENTS
Isn’t the information I get from my provider too biased? How do I get the independent information I need to make choices about my support?There are a number of ways you can get information about home care:
- My Aged Care is a central point for aged care information. You can access the website http://www.myagedcare.gov.au or you can call My Aged Care on 1800 200 422.
- Home Care Today is a service that is here for you. We have been funded to provide you with information about CDC. A number of resources are available in the website under the Consumer banner.
- COTA is an organisation that represents the interests of older Australians. COTA is delivering free education sessions on CDC around Australia. The sessions are organised by your local State or Territory COTA. Please contact them to find out when the next session is.
- Independent advocacy services also are available to assist you with any difficulties relating to your home care supports. Advocacy Services are community based organisations funded by the Australian Government under the National Aged Care Advocacy Programme (NACAP) to provide free and confidential support to recipients of care and also to promote the rights of older people to aged care service providers http://www.myagedcare.gov.au/how-make-complaint/advocacy-services.
How do I work with my Home Care Package provider?Providers seek to develop a good relationship with consumers. Your key contact with the provider is your adviser/case manager. Developing a good relationship with your adviser/case manager will help you to address care concerns about your support. However, if you want to express concerns about your relationship with your adviser you can follow the organisation’s complaints processes. You may find this in the information package from your provider or contact your provider directly. If this is not possible you can access the Aged Care Complaints Scheme or call 1800 550 552.
What can I do if I don’t like the person who comes in to help me at home?You can ask the provider to change the staff who come into your home. You can speak to your adviser/case manager or the manager of the service about your concerns. You have the right to have your wishes respected. At times Home Care Package providers need to send different people to your home to cover for staff sick leave, holidays and other unforeseen circumstances. However, you have the right to ask to be notified if you have a regular person coming to your home and for some reason the arrangement changes.
What if I am really unhappy with the care I am receiving?You have the right to express your concerns. You can express your concern directly with the provider, or you can have the support of an advocate or by making a complaint to the Aged Care Complaints Scheme https://www.dss.gov.au/our-responsibilities/ageing-and-aged-care/programs-services/aged-care-complaints-scheme or call 1800 550 552. Another alternative is to discuss your concerns with a person who can advocate on your behalf. The National Aged Care Advocacy Programme (NACAP) is funded to promote your rights. To contact your local advocacy service phone 1800 700 600.
What are the roles and responsibilities of my service provider?It is the responsibility of your provider to:
- ensure that your rights are respected
- provide you with the information you need to make your own decisions
- allocate an adviser/case manager to liaise with you - this person will act as a facilitator and adviser
- be in contact with you to ensure your needs are met through regular service review.
- meet all the legal requirements and quality service standards.
What are my responsibilities?As a consumer of home care services it is your responsibility to:
- respect your home care workers
- give as much information as possible so your provider can develop a good care plan with you
- follow the Home Care agreement
- provide a safe environment for your care workers to come to your home as agreed in the plan
How can I make a complaint if I am not happy?You should first discuss your concerns with your Home Care Packages provider. It may be something that can be resolved easily, and your provider is in the best position to address your concerns. Should you have a complaint, your provider will tell you about their internal complaints process and how to make a complaint. You have the right to make a complaint without it affecting your care and services. Sometimes, complaints cannot be resolved by the service provider, or you might not feel comfortable raising your concern with them. In these situations, you have the right to an advocate in resolving this matter, the Government funds advocacy services under the National Aged Care Advocacy Programme (NACAP). Advocacy services provide information to consumers, their families and carers about their rights and responsibilities when accessing aged care services. Advocacy services are free, confidential and independent. The National Aged Care Advocacy Line can be contacted on a free call to 1800 700 600.