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Changes to home care and moving to CDC – Compliance top 10

By Julie McStay25 Sep 2013

The change from the former CACP, EACH and EACHD packages to new Home Care Packages took effect when the Aged Care (Living Longer Living Better) Act 2013 and the relevant subordinate legislation commenced on 1 August 2013. On that date, all existing community care packages transitioned to home care packages as follows:

  • CACP package – Home Care Level 2
  • EACH package – Home Care Level 4
  • EACHD package – Home Care Level 4

New level 1 (basic care and services) and level 3 packages (intermediate care and services) were also introduced. We have identified the top ten items we suggest home care providers focus on when considering how they will comply with changes to home care requirements and moving to CDC.

1.     Review DOHA’s home care guidelines

The guidelines released in July 2013 are an excellent starting point for providers who have existing home care packages or are considering applying for packages in future approval rounds. The guidelines are not intended as a substitute for legal advice but they do provide a good source of information about the manner in which the Department of Health and Ageing (DOHA) can be expected to apply the new provisions.

2.     Come to grips with the new assessment process

Under the new home care arrangements care recipients will undergo an Aged Care Assessment Team (ACAT) assessment to determine whether they need home care at a level equivalent to low care residential care (a level 1 or 2 package) or high care residential care (a level 3 or 4 package). The ACAT does not need to determine a person’s care needs at a particular level within each band. This process is called “broad banding” and is expected to continue until at least July 2015.

If a care recipient has been assessed as eligible for a particular level of package, but none is available, they can be offered a lower level package, as an interim measure, until a higher level package is available. However, if the care needs of a person who has an ACAT assessment for a 1 or 2 package increase, a new ACAT assessment is necessary before the provider can offer a level 3 or 4 package.

3.      Review entitlements to ensure access all available subsidies and supplements

Importantly:

  • An ACAT approval to receive a home care package takes effect from the day the approval is given, but a subsidy is not payable until the consumer has been offered and accepted a package by the provider and a home care agreement is entered into. Processes should be implemented to ensure care agreements are entered into before commencement of the delivery of care.
  • A Dementia and Cognition Supplement is available to all home care providers that provide care to consumers who meet the eligibility criteria across any of the four levels of packages. There is also a Veterans’ Supplement for veterans with an accepted mental health condition.
  • The onus is on eligible providers to make application for subsidies and supplements.

4.     Proactively manage the transition to CDC

All packages allocated in the 2012- 2013 ACAR must be delivered on a CDC basis and all existing home care packages must be delivered on a CDC basis from 1 July 2015. Providers can transition their packages to CDC earlier but they must notify DOHA of the intended date of transition and after transition they must comply with the CDC requirements.

Providers should decide when they wish to transition their existing home care packages to CDC and review the following to ensure they are compliant with CDC requirements with respect to:

  • care planning;
  • financial planning; and
  • their care agreements.

5.     Review your brokerage arrangements

The provider to whom places have been allocated retains principal responsibility for ensuring care is delivered in a way that complies with the legislation. Providers should review brokerage agreements to ensure they comply with the new home care requirements (and the CDC requirements if you are offering care on a CDC basis or are transitioning your packages to CDC prior to 1 July 2015) and to manage your organization’s risk.

6.     Review your home care agreements

DOHA has indicated that it does not require home care providers to transition existing care recipients to new agreements. However as existing care recipients are replaced by new care recipients, providers will need to ensure their care agreements comply with the new home care arrangements. There are additional requirements for agreements to deliver care on a CDC basis.

The User Rights Principles 1997 (Cth) set out the matters that must be included in a home care agreement regardless of how the care is delivered i.e. CDC or non CDC.

Simply Legal (documents by Hynes Legal) has a range of compliant home care agreements (CDC and non-CDC). Click here to visit Simply Legal.

7.     Home care services

Providers should review their services in light of the new common list of care and services that apply across all four package levels that are set out in the Quality of Care Principles. There is also a single list of excluded items that applies across all four package levels. The main difference between the home care levels is the amount of care and services that can be provided to the consumer, rather than the type of care at each package level. If required, a care recipient can now access nursing and clinical services across any of the 4 packages.

Care and services must be provided by the home care provider in a way that meets the Home Care Common Standards – the old Community Care Standards under a new name.

8.     Police checks and other requirements

Provider should ensure they are compliant with the new requirements with respect to:

  • key personnel; and
  • staff, volunteers and contractors.

9.     Financial reporting to DOHA

The current Financial Accountability Report and Statement of Compliance process will continue to apply for the 2012-13 financial year and possibly for 2013-14. The Financial Report for the 2013 financial year must be provided to DOHA by 31 October 2013.

The Aged Care Financing Authority has been asked to provide advice to the Minister on whether there should be changes to the reporting process. If there are any changes they are likely to apply from 1 July 2014.

10.   The Coalition

The recommendations made in this article are made on the basis of the changes as implemented on 1 August 2013. The Coalition’s Policy on Ageing released as at the date of preparation of this article has no specific proposals that indicate any plans to unravel the changes made under Living Longer Living Better reforms with respect to home care.

If you need assistance with any of the matters raised in this article please contact Julie McStay, director and head of Aged Care and Retirement Living, Hynes Legal.