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Home care providers accused of resisting change

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The home care sector has been “patchy” in adapting to the shift towards greater consumer control and many providers are resisting it, the head of Australia’s peak advocacy body for older Australians says.

COTA Australia chief executive Ian Yates will emphasise the need for consumers to strengthen their role in the growing home care market when he addresses a key aged care conference in Sydney next week.

“I think essentially providers who knew how to do (consumer directed care) have adapted well, but many providers are essentially resisting it,” he told Community Care Review.

“It is quite common to get stories from consumers who say that they don’t really have much choice.”

But he is confident the situation will “evolve” as providers respond to consumers becoming more informed about their rights.

Requiring providers to be more transparent about services and prices by providing comparisons will also help bring change, he said.

Mr Yates said COTA is standing firm on its insistence that legislation for an Aged Care Quality and Safety Commission includes a consumer commissioner to protect and promote consumer rights, as proposed in the 2017 Carnell-Paterson review.

The government has indicated it won’t accept the proposal for a separate consumer commissioner but COTA is prepared to take the fight to the Senate, where the government doesn’t hold a majority, if the provision isn’t included.

“We will pursue that point in the senate. We will pursue amendments to the bill if it’s not in there,” he said.

Addressing the home packages gap

Mr Yates will also talk about moving forward on the shortage of home packages at the conference.

The budget allocated an extra 14,000 high-level home care packages over four years to address the increasing demand for home care, however that falls short of meeting the needs of the 82,000 older people currently waiting in the national queue for a Level 3 or 4 package.

Other thorny issues that still need to be resolved include decisions about combining CHSP and home care packages and what to do about unspent funds. But there’s also room for some optimism.

“We have inadequately addressed the home care package shortage but a big step was taken in abolishing the distinction of funding pools for residential and home care,” he said.

“By the time that we finish these forward estimates we’ll have 152,000 home care packages out there … a decade ago we hardly had any packages, it’s a really big shift.”

Fixing up financing

Another issue not addressed in the budget, he says, is the unsustainable and inconsistent approach to financing home care.

“Both government and opposition have to address it,” he said. “You can’t get a sustainable sector without sorting that out. We have an incoherent set of means testing arrangements across the whole.

“We talk about aged care being a continuous spectrum, but the most discontinuous thing about it is what you might be charged in any point in time, which is why you get peope who refuse to move off CHSP onto a lower package because there’s a different charging regime.

“We have to sort out the relationship between the two and we need to have a fair and sensible, but also robust, user-charges regime, so the people with more capacity pay more.”

Mr Yates will also press for a single quality framework in home care.

“While there’s been a lot of media focus on residential care, we are going to find that there are significant issues in home care,” he told Community Care Review.

The Aged Care Reform after the 2018 Federal Budget conference will be held on 25-26 July at the Hilton in Sydney and speakers will include Treasurer Scott Morrison, aged care minister Ken Wyatt and health economics expert Professor Michael Woods.


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