Yesterday, we wrote about Grant Corderoy’s data showing Level 4 Home Care Package recipients are receiving just 50% of the hours they were a decade ago. Today, providers tell us they are not cutting back on care – but the system needs an overhaul.
In his presentation to LASA’s Ten Days of Congress, Grant pointed to StewartBrown data which shows the lower care revenue being achieved by home care providers in recent years has led to a progressive reduction in care hours.
One provider disagreed that this was a result of less care being delivered by their organisation.
Clients opting for less care or spending money on goods
Instead, Sarah Newman, General Manager of BaptistCare at home, says their current cohort of clients are choosing fewer direct service delivery hours – and therefore accumulating large amounts of unspent funds – or choosing to use their funds for other goods or services.
“Providers are not reducing the number of hours we are offering – indeed we want to provide more direct service delivery hours, that is where we make our margin in order to remain financially viable,” she said.
Sarah attributes the reduced hours in the graph to a range of reasons, including:
- The large number of higher-level clients who have been over-assessed for the level of care and services they require.
“Because the initial assessment occurred so far before their actual package allocation, their needs now may be entirely different and there is no mechanism for ongoing assessment/re-assessment,” she pointed out.
“It is not unusual to find L4 clients who were assessed 18 months or 2 years ago for the L4, following an acute episode, but are now doing well and functioning quite independently. This is of course the goal of home care – to help reable people to be independent and live great lives. We have a significant number of L3 and L4 clients who actually only want/need minimal services. There is currently no mechanism for these consumers to be reduced to a more appropriate level, so the higher levels are accumulating these consumers, who skew the stats across the board.”
- Consumers increasingly opting to spend their funding on goods rather than services.
“In some instances, this flexibility is providing excellent outcomes and further enabling independence, in others it continues to be a challenging area with clients seeking to purchase inappropriate items,” Sarah said.
“We continue to encourage clients to take advantage of the opportunities for staff to provide a broader range of supports and assistance – outings, allied health provision, learning to use the internet, social groups etc. and remain concerned about the focus on the purchase of goods instead.”
- The impact of COVID on direct service delivery.
“Older community members have been urged to stay at home and limit visitors,” Sarah also noted.
“Many have reduced hours to only essential supports, and accompanied activities have also significantly reduced. For example, clients have opted for meals services rather than accompanied shopping and assistance with meal preparation, online shopping has replaced accompanied shopping, accompanied or assisted social activities have reduced and so on.”
Assessment system needs to be based on individual needs
Sarah concludes that the assessment system needs to be overhauled – because the more care that providers actually deliver, the stronger their ongoing financial viability.
What the graph makes clear is that providers are being denied this chance.
It is worth pointing out that the StewartBrown figures are an average.
So, some Level 4 package recipients are receiving less than eight hours of care a week while others would be receiving more.
What is troubling however is that the Government has allowed this situation to happen.
Government lacks data on use of Home Care Packages
Evidence to the Royal Commission from the Department of Health has shown that there is no data available on the demand for home care in the community or the provision of services once they have been approved.
With no information to guide their policy-making, the Government can’t fix the problem.
The result: those older Australians who genuinely need a Level 4 package are missing out.
Meanwhile, home care providers carry the cost of providing services and struggle to stay viable.
The politicians think the system is working because people are receiving services and providers are continuing on – while missing the real story.
What it tells us – once again – is that the Government really doesn’t understand what is happening in the sector.
The Royal Commission has picked up on this failure. The question is: what will the Commissioners recommend to change this?