Home Care Reforms Information Series – Issue 5

Frequently Asked Questions

1. What is changing in Home Care?

The Federal Government announced the Home Care Programme – Increasing Consumer Choice initiative as part of the 2015-16 Budget, with reforms commencing on 27 February 2017. These changes will occur in three main areas:

  • Home care package funding will follow the consumer – Home care subsidy and supplements will continue to be paid to the approved provider, not directly to the client. The client will be able to change to another provider if they wish and the package, including any unspent amounts, will move with them.
  • A consistent national approach to prioritising access to home care packages – Home care packages will be assigned to eligible consumers from a national pool managed through My Aged Care. This national queue will be managed by My Aged Care and will include a National Package Inventory.
  • A streamlined process to become an Approved Provider under the Aged Care Act 1997 – Additional information is available on the Department of Health website.

2. What is not changing?

  • Packages will still need to be delivered under a Consumer Directed Care (CDC) model, as introduced to all packages in July 2015 and outlined in the User Rights Principles 2014.
  • There will be no change to the current fee and income testing arrangements and clients are still responsible for paying any basic daily fee and income tested care fee as specified in their Home Care Agreement.
  • The total number of home care packages will continue to be capped.
  • Claims and payments will still be made through the Department of Human Services Aged Care Payment System.
  • Approved providers must continue to meet relevant quality and accreditation standards.

Additional information is available from the Department of Health factsheet Introduction to home care changes and in Issue 2 of LASA’s Home Care reforms information series on Home Care Agreements.

3. What do I need to do to be ready?

The Department of Health has released a factsheet identifying key activities that providers should undertake prior to 27 February 2017. Some points to keep in mind include:

  • Determine whether your organisation would like to charge an exit amount. If so, you will need to complete the Notification of Home Care Maximum Exit Amount Form and return it to the Department by 5pm (AEDT) 24 February 2017. From 27 February onwards, providers will need to make changes to the identified exit amount via the My Aged Care provider portal.
  • Consider reviewing your Home Care Agreements to ensure that the reference material is still accurate and up to date. This should include reference to the revised Charter of Care Recipients’ Rights and Responsibilities – Home Care which will come into effect from 27 February. There are two new additions to the Charter:
    • Schedule 2, subclause 1(2)(f): [the care recipient has the right] to choose the approved provider that is to provide home care to him or her, and to have flexibility to change that approved provider if he or she wishes.
    • Schedule 2, subclause 2(3)(c): before the care recipient changes approved providers, [the care recipient has the responsibility] to tell the approved provider and their staff of the day the care recipient intends to cease to receive home care services from the approved provider.
  • Be aware of the new requirements for the reconciliation and transfer of unspent home care amounts if a consumer leaves your organisation. Additional information is available from the Department factsheet on changing home care providers and in Issue 3 of the LASA’s Home Care reforms information series on Unspent Home Care Amounts and Exit Amounts.
  • Update relevant organisational policy and procedures to reflect the requirements regarding reconciliation and transfer of unspent home care amounts, as identified under Section 7 of the Records Principles 2014.

4. Do I still need to notify the Department of Health if I don’t want to charge an exit amount?
Prior to 27 February 2017, if your organisation has decided not to charge an exit amount, you will not need to complete the notification of home care maximum exit amount form.

However, from 27 February 2017, you will be prompted to enter an exit amount (which can be $0.00) when logging into the My Aged Care provider portal. This is the only mandatory field that will change on the service finder. Once you have entered this figure into the relevant field, it will be published on My Aged Care. The inclusion of this information aims to improve transparency for potential clients.

Of note, the system generated receipt, as stated in the provider readiness checklist, will not be available until release 8 of My Aged Care. Therefore, providers should take a screen shot of the message with the amount and the time stamp for their records.

5. Do I still need to update my home care agreements if I don’t want to charge an exit amount?
This may be a good opportunity to review existing Agreements to ensure that the reference material is still accurate. Content that may need to be reviewed could include:

You may also wish to take the opportunity to include a notice period in which the client must provide notice (for instance, specific number of days) prior to the cessation day.

It is important that any variation to an existing Home Care Agreement includes evidence of mutual consent, this doesn’t mean that a new Home Care Agreement needs to be written. Instead, a provider can look at alternative options such as a letter of variation signed by the provider and the client and/or their representative.

6. What do I need to do if a Home Care client wants to transfer to my service?
There are five points to keep in mind if an existing home care client seeks to transfer to your service:

  • As currently occurs, you will need to accept the client referral in My Aged Care.
  • As currently occurs, you will need to work in partnership with the client to develop a Home Care Agreement and a care plan.
  • You should confirm the cessation day with both the client and the original provider to ensure that there is a continuity of service and no overlapping claims in home care subsidy. The consumer’s start day with their new provider should be on or after the agreed cessation day.
  • As currently occurs, within 28 days of services commencing, you must notify the Department of a new client via the Aged Care Entry Record.
  • Following receipt of any transfer portion (i.e. transferred unspent home care amount from the original provider), the next monthly statement must separately identify receipt of these funds.

Additional information is available from the Department of Health factsheet on changing home care providers and in Issue 3 of LASA’s Home Care reforms information series on Unspent Home Care Amounts and Exit Amounts.

7. Do I need to reconcile and notify the client if their unspent Home Care amount is zero?
You need to reconcile and notify clients (even if the amount is zero) when a client ceases receipt of services as follows:

  • Within 56 days of this cessation day you will need to provide a written notice of the unspent home care amount (even if the amount is nil) to the consumer or their estate. The specific details that you must include in that notification are available on the Department of Health factsheet on unspent home care amounts.
  • Within 70 days of the cessation day, you will need to notify the Department of the Commonwealth portion of unspent home care amounts (even if it is zero) via the Department of Human Services (DHS) claiming payment system.

Additional information is available from the Department of Health factsheets on changing home care providers and unspent home care amounts and in lssue 3 of LASA’s Home Care reforms information series on Unspent Home Care Amounts and Exit Amounts.

8. Will the DHS Claiming Processes change on 27 February?
There will be no changes to the claims process for either online or paper based claiming channels. With the introduction of the unspent home care amount requirements, the payment statement and the claim process will include the ability to record the Commonwealth portion of the unspent home care amount. As outlined in the above question, you will need to notify the Commonwealth of this amount, even if it is zero.

From 27 February, claims will no longer be blocked by over occupancy restrictions for care recipients receiving care and services from 27 February. It is important to note that existing occupancy rules will continue to apply up until 27 February.

Services will no longer need to submit a change in the level of care for a consumer from 27 February 2017 for the DHS to action. Instead, once a consumer has been approved (in relation to their changed level of care) and assigned a package, this information will now be sent to the DHS, as will any subsequent changes to a consumer’s assigned package level.

9. Will a new Operational Manual for the Home Care Packages Programme be released?
The Department will not be releasing a revised Operational Manual for the home care package programme and instead encourages providers to refer to the relevant Legislative Instruments, factsheets and webinars.

The home care changes will be introduced through the Aged Care Legislation Amendment (Increasing Consumer Choice) Act 2016 which will result in amendments to a number of existing Principles and Determinations and the introduction of four new Legislative Instruments:

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