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IN MY PLACE SA

A Guide to Understanding In-Home Care

ACAT ASSESSMENTS, CHSP SERVICES AND HOME CARE PACKAGES

Let me start by saying that the fact that we have access to Government-subsidised home care is amazing – we truly are in a lucky country when it comes to support to keep people in their homes as they age. But also, that these types of care are currently not the fix-all solution for all people. I often hear health professionals and clients alike stating that someone is ‘on the waiting list’ for a home care package like this is the answer to all the problems and the job is done. But they don’t often truly understand what a home care package is, what help it can or cannot provide, or if they can afford it.

This article is going to run through the basics and some of the things you may not be told at the start that are probably good to know as soon as you begin to need help.

home assessment ACAT

Let’s start with the ACAT Assessment – you or a loved one have identified that you need some help at home, or you have been in hospital and been referred for an assessment as part of your discharge.

A referral is made to My Aged Care. This is the organisation that basically manages referrals to ACAT, the records of what services you are approved for and the waitlist for home care packages.

THE ACAT ASSESSMENT

There are actually two types of assessment at this stage – when the person at My Aged Care takes the referral and gets background information they will decide which type of assessment you get based on your responses. This is basically divided into whether you need low level care or a higher level of care.

If you only need low level care, you will be told to await a phone call from a RAS assessor.

If you are assessed as needing a higher level of care you will be told to await a call from the ACAT team for an in-home assessment.

Wait times for these assessments can be up to 3 months in some areas.

If you need care in the meantime, you will need to find it outside of this program – there are quite a few subsidised or affordable options available elsewhere and In My Place SA can assist you to get these in place while you wait.

NEED TO KNOW – These assessments will be based on CURRENT LEVEL of care ONLY. So, if you have been diagnosed with a degenerative or rapidly progressing illness, the level of care you will be assessed as needing will be in line with what you need ON THE DAY OF ASSESSMENT only – future needs are not considered as part of this assessment.

If you had a phone call with a RAS assessor they will most likely only be approving you for lower level care via the Commonwealth Home Support Program (commonly called CHSP)

If you have had a home visit for an ACAT Assessment you will most likely be approved for CHSP services, and perhaps also approved for a home care package.

NOTE: Approval for a Home Care Package at this point does not mean you have one – you are simply put onto the waiting list at this stage.

Wait times for home care packages (unless urgent) are approximately 6-12 months from date of assessment.

If you need help at this time you will need to utilise the CHSP services you have been approved for while you wait.

CHSP SERVICES

There are two main ways in which you can be referred for CHSP services.

You can be provided with a list of codes after the assessment, which you can then use to find a provider (they take the code from you and access funding using those codes to provide a lower cost subsidised service)

Or My Aged Care can look into their portal and send them to providers who show ‘green’ – meaning they should have capacity to take the referrals.

The issue can be that providers do not always action the referrals, or do not actually have capacity. You may not be provided with the list of where the referrals have gone. So you will need to chase this up with My Aged Care to ensure you know who ‘holds the codes’.

Also, if you require numerous different services, they can all end up at multiple providers. This means that you will have multiple bills to keep track of and pay, as well as keeping track of all the different companies that are providing and coordinating your care visits.

If you are having services through a CHSP provider, and these services cease or are not meeting your expectations, you need to ‘retrieve’ the code from that service provider in order to go to another provider. You will then need to recommence the search process.

CHSP services are NOT INCOME TESTED. The provider sets a subsidised fee for the services, and then is able to claim back the gap from the Government.

There are supposed to be limits on the amount of CHSP services that can be claimed – this is an ‘entry level’ program with a focus on reablement. However, it usually doesn’t work this way in practicality.

The benefit of CHSP in some cases, is that CHSP providers do not cross reference how much is being provided by other companies – so you can build up quite a lot of subsidised services between multiple companies. The downside to this is that it is not managed or coordinated – so you will need to be on top of it to keep track of bills and service provision times.

This can also be a problem when you get your home care package and realise that you cannot fit all the assistance you have been getting into a home care package budget.

Which brings us to….

HOME CARE PACKAGES

You have served your wait time and you get a letter stating the your home care package has been ASSIGNED

NOTE: Approved = wait list Assigned = you now have access to the package

The first indication you may get that it is coming is that you start getting calls from the providers of your CHSP services – they can monitor your wait time and would now like to get you ‘on board’ for your impending home care package.

Things you need to know about Home Care Packages:

COSTS

How much does a home care package cost?

There are a couple of factors to take into consideration when we talk about this issue of costs for a home care package.

INCOME-TESTING

This is an income tested method of getting in-home care.

The daily fee varies from $0 for full pensioners to $33.59 per day for self-funded retirees. This income-tested fee may be quoted as ‘per day’ but what this actually means is that this applies for every day that you hold the package – not just on the days you have services. So, the maximum fee payable by a self-funded retiree is $235.13 per week. It is payable regardless of the level of home care package. The Government actually reduced its contribution per year by the amount you are required to pay. So, when they say that a Level 2 home care package is worth ‘up to’ $16000 per year, it means that for a self- funded retiree paying full fees, the retiree pays $12260 and the Government will pay the remaining $3740.

You can put in an income-tested fee assessment request at any time when preparing to receive in-home care. If you already have dealings with Centrelink you can contact them on the dedicated number 1800 227 475 and request an ‘income tested fee assessment for a home care package’. If you have never submitted information to Centrelink (Services SA) and wish to have your home care fees assessed you will need to complete this form and may need assistance from your accountant –  Home Care Package Calculation of your cost of care form (SA456) – Services Australia

OTHER COSTS

THE BASIC DAILY FEE

There is also a requested (but not required) co-payment fee of $10.49-$11.71 per day (depending on home care package level) The co-payment of this amount adds to the total funds available within the home care package to be spent on services. So, for a Level 2 home care package the Government puts in up to $16000 per year, and the expectation is that the recipient puts in $4047 per year.

Most providers will give you the option to waive this fee. What they may not tell you is that this also reduces the level of service that you may be able to put in the home care package – it usually provides 1-1.5 hours less of care per week to waive the fee.

In addition, if your needs change and you require another ACAT to get an increased home care package level approved, the ACAT team will not consider your home care package ‘fully allocated’ until the basic daily contribution has been included and utilised. You cannot request a re-assessment if you are not contributing this amount and then say the package is not meeting your needs. They will state that there is $4047 not being spent currently. You will then need to start paying the fee and then show that the package still does not meet your needs before the request for a re-assessment will be accepted.

In regards to a re-assessment of needs the ACAT team will look at how you are spending your funds. They will expect services such as ‘excessive’ cleaning and gardening to be cut in favour of higher level services such as medication management or personal care. You will need to show that the current funding does not cover your basic safety and health needs first and probably cut ‘low impact’ services prior to being accepted for re-assessment.

OTHER HOME CARE INFORMATION

After we take into account the costs, we need to look at ‘what can I get?’

This is where it can get complicated. Or not. It depends on what you need, what you know is available to you and how much of your chosen assistance can fit within the allocated funds of the home care package.

Ultimately the home care package is a completely flexible pool of money to spend on services, equipment and whatever is required to keep you safe, happy and healthy in your home environment. You have a fair amount of freedom in putting together a package that best meets your needs and you have choice. You do not have to take into account the needs or requirements of the provider.

You can choose a managed, or self-managed home care package. There are specific pros and cons to each and what works best for you needs to be taken into account. A managed package will include a ‘package management fee’ (which can no longer exceed 15% of HCP funds) and both types will include a ‘care management fee’ (which can be up to 20% of HCP funds and is now compulsory in all home care packages)

There are certain legislated items you cannot include within the package, such as items that carry a Medicare rebate, rent or accommodation, home care package fees etc.

Figuring out how best to fit your needs into a budget can be quite a process, and can take some negotiation and creativity – this is where In My Place SA has the experience in helping you to put together the best suite of services, equipment and home modifications to make staying in your own home as easy and stress-free as possible.

There is much more to take into consideration, but I hope that this can clear up some of the questions you might have.

WE CAN HELP

In My Place SA is Adelaide’s only fully independent, specialised home care navigation and ageing in place consultancy.

If you would like more information on the nitty gritty of subsidised home care, need help to get assessed or to get it in place, or you think we can help in any other way – get in touch. We are happy to chat.

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