If you have been trying to work out how Government subsidised home care works and feel none the wiser as to what you are entitled to, or how to actually access services, then you are not alone.
We wanted to give you a brief breakdown of what Government subsidised services are all about and how you can determine if this is the right model of care for you.
Who can access help at home?
The short answer is that anyone can. If you are in a position to pay privately then you are free to access whatever home care you desire. You do not need any formal eligibility assessments. Your biggest challenges will be deciding on which agency to source your care staff from, and if will you self-manage and coordinate these services, or will you engage a private case manager to do this for you.
What if I cannot afford to pay private rates?
Then you may be eligible for a government funded program, currently known as Home Care Packages (HCP). Or you may be eligible for the low level/entry level Commonwealth Home Support Programme (CHSP).
Am I eligible for a CHSP?
You must be aged 65 and over (50 and over if you are Aboriginal or Torres Strait Islander) (50 and over if you are experiencing homelessness, at risk of homelessness, or are on a low income).
You must be living at home (unless homeless). And, you must need some assistance to continue living at home and to maintain your independence.
Contact My Aged Care and they will refer you to the Regional Assessment Service who will discuss your needs and goals with you, and f you are eligible for a CHSP then the assessor will help you source the services that best meet your needs.
You do not need an income assessment to be eligible to receive support via CHSP.
For CHSP the fee you pay towards your care services is determined by the provider of the services. This can vary from $0.00 – $12.00 p/hour, for example (this is just an example of some rates).
Am I eligible for a HCP?
There is no actual lower age limit other than you need to be an older Australian, living at home, wanting to stay living at home, and need help to coordinate /case manage services, and develop a care plan, in order to remain living at home.
People living with younger onset dementia or other disabilities may be eligible for HCP if their needs cannot be met through other channels.
How do I get assessed for a HCP?
You will need to be referred to the Aged Care Assessment Team (ACAT) by contacting My Aged Care. The ACAT will determine which funded package level best suits your needs.
How much funding do I receive towards my care needs on a HCP?
There are four levels of care within the HCP – Level 1, Level 2, Level 3 and Level 4.
The Government provide a different daily subsidy rate based on the level of care you are assessed as requiring. For example, a HCP Level 2 is equivalent to $40.09 per day subsidised by the Government. This daily amount covers the cost of your care services, the Administration fee and the Case Management fee determined by the Approved Provider who will hold the funding on your behalf.
Government subsidy rates are increased every financial year.
What fees do I have to pay?
For a HCP the fee you pay is known as a Client Co-contribution, or sometimes known as a Basic Daily Care Fee. This can be up to 17.5 % of the pension rate (approximately $10 p/day). If you are a self-funded retiree you may be asked to also pay a gap payment as you may not be eligible to receive the full Government Subsidy amount. If we look at the above example of a HCP Level 2, the Department of Human Services may advise that you are required to pay an income tested care fee of $10.00 per day towards your Level 2 package. This means that the Government only pay $30.09 per day (rather than the $40/09 per day) for your care needs, and you will be invoiced not only for your Client Co-contribution but also the $10.00 gap payment.
Your co-contribution payment may be increased every year.
Why do I have to Pay Fees?
Fees help your Approved Provider to run their business effectively so that they can provide you with the proper management and ensure that your needs are well met.
What Other Subsidies/Supplements Are Available?
You may also be eligible for a Dementia and Cognition supplement, Veterans supplement, an EACH D top up supplement (for those receiving EACH D funding since 2013), or Oxygen or Enteral Feeding supplements. The assessor from the Aged Care Assessment Team will determine if you are eligible to receive any of these.
Do I get to keep the Government Subsidy myself and organise my own care?
At this stage this is not possible. An Approved Provider organisation will manage the budget for you. They will issue you with an invoice each month for your co-contribution amount, and any income tested fee you are required to pay. They will also issue you with a monthly statement. This statement is similar to a bank statement – it shows you your opening and closing balance, all your transactions throughout the month including the cost of services, administration and case management fees, and incomes such as your co-contribution and the Government subsidy rate for your package level. This is often referred to as your Budget Statement. This is not an invoice but a statement showing you where your funding is being spent.
Do I get a Choice of Provider and Care Staff?
Yes, you can indeed request the Approved Provider of your choice, and also the agency who will provide the care. If your need is urgent, then you may be encouraged to accept the first Approved Provider organisation who have a vacancy to help you. You may at any time choose to swap Approved Providers. However, please be aware that some Approved Providers do charge an Exit Fee. It is a good idea to check this out before you sign on with anyone.
You can also choose the agency that will provide your actual care services. This may be the same organisation that manages your budget (your Approved Provider), or you can choose care staff from elsewhere. As care agencies charge different hourly rates, it is wise to investigate this before you get started.
What does Consumer Directed Care mean?
Consumer Directed Care (CDC) means that you – the consumer – has the choice about how your funding is spent and what type of services you want to receive, and who you want to engage to provide these services.
Do I have to pay the Case Management and Administration Fees to my Approved Provider?
This is best discussed with your Approved Provider as some organisations will not charge an ongoing Case Management fee if you or your family are able to provide this services yourselves (or engage a private case manager). However, most organisations will charge the ongoing Administration fee as this covers all the administrative duties they undertake on your behalf.
What happens if I need more hours of care service than my package allows?
If you are needing more care than there is money in your HCP budget, then you have the option of self-funding extra care, or asking your Approved Provider or Case Manager to arrange the Aged Care Assessment Team to come out and reassess you for a higher HCP level.
How do I find our more?
To find out more information, or to refer yourself, or a loved one, for a CHSP or a HCP please contact My Aged Care:
Phone: 1800 200 422