Self-Managed Home Care Packages Explained

By Mable – HomeMade

What are the benefits?

It’s no secret that most older Australians want to continue living at home, as independently as they can, as they grow older. It’s been the finding of every survey, investigation and report on aged care services for decades and it’s been a major driver of government policy on aged care. Home Care Packages are designed to help support people in need live independently at home.

The Home Care Package (HCP) program, which provides four different levels of support at home with different levels of funding attached, is the fastest growing component of the Australian homecare services. In the 10 years between 30 June 2010 and 30 June 2020, the number of people receiving Government subsidised home care packages, tripled (from 47,684 people to 142,436 people, an increase of 199%)¹ and the Government expects more than 275,000 home care packages will be available by 2023.

It’s hardly surprising. We are living longer than ever before, despite often managing a few health challenges. Let’s face it: many of us are likely to need some form of support at home to help us continue to live well, independently, into our 70s, 80s and 90s. But that shouldn’t mean having to compromise choice and control over our adult lives. Right?

That’s where the concept of self-management of home care packages program comes in.

Changing expectations 

As the Home Care Package program has grown, it has also changed to meet evolving community expectations. Prior to the full introduction of the human rights-based policy of ‘consumer directed care’ in 2017, having a HCP tied you firmly to your home care package providers with sometimes quite limited choices. It meant working with their available support options rather than individually tailored approaches, accepting the service provider staff they sent you and fitting into their schedules and rosters. While people were often grateful of any assistance, the lack of flexibility and control over what were often quite intimate interactions with strangers, has been a persistent complaint. 

Indeed, a research study² commissioned by former Minister for Aged Care, Ken Wyatt, into the experience of people using home care package providers, found the most common complaint about home care providers was the high turnover of unqualified, inexperienced and untrained support workers coming into the person’s home and the lack of personal care. 

Changes from February 2017 saw HCP funding allocated to the individual, rather than to the aged care provider; and HCPs becoming fully portable. It meant that, armed with their funding allocation, people could really ‘shop around’ and, for the first time, they had the option to exercise ‘self-management’ of their package if they desired.  

Being in control

Self-management has a lot to recommend it.
For a start, you can choose and engage your own service providers and health professionals directly to suit your particular needs. You might want someone who lives nearby and knows your neighbourhood; someone who speaks your language; someone who shares your interests; who can meet your scheduling requirements or any other preferences you might have. 

A big positive for those who choose to self-manage their HCP is the potential substantial savings on administration fees. The high cost of fees charged by home care package providers – on average 35 per cent, but in some cases over 50 per cent for administration and case management³ – has been another consistent theme for complaints about home care package providers and one of the focuses of the Royal Commission into Aged Care Quality and Safety. 

People who choose self-management can make substantial savings on these fees which can be redirected into more hours of actual care and support.

The cost of care is generally another positive when choosing self-management. Rather than pay a marked-up hourly rate to the provider – with only a fraction going to the actual person providing the care – you can negotiate rates of pay directly, knowing the full amount will go to the worker themselves and their associated costs.

The Home Care Package (HCP) program, which provides four different levels of support at home with different levels of funding attached, is the fastest growing component of the aged care system.

Horses for courses

While there is no doubt about the potential positives of self-management, it’s not an option that suits everyone; and some people will be very happy to have their package provider manage all or a large part of their home care packages with just some input and direction from them. 

With self-management, you need to consider the time and work involved for you or your family member to be in full control – finding, interviewing, engaging and managing people in your support team, including discussing and agreeing on pay rates and other arrangements.

There are some very good online marketplaces where you can easily find qualified and safety-checked allied health or service providers in your area but you’ll need to feel comfortable with online platforms and have reliable access to the internet. 

It also helps to have some understanding of the home care packages program, to be comfortable with understanding financial statements and managing budgets. For many older Australians and their representatives, none of these things are barriers – it’s what they might have done all their lives – but they are important factors to bear in mind when considering the self-management option.

Choosing self-management

If you’re ready to explore self-managing your HCP, there are two steps involved. The first step is choosing a provider that offers genuine self-management; and not all package providers do. Some only offer a diluted form of it. However, there are a growing number of approved HCP providers that specialise in self-management. Their administration fees vary between 12 and 17 per cent, which is substantially lower than most traditional package providers. You can find some reputable Australian homecare services in this issue of the Australian Carers Guide.

Once you have set up your self-managed package, the second step is finding the people who can provide the services you need; and building your care and support team. That’s where online marketplaces can help enormously.

At the end of the day, the rights of older people ‘to make decisions about their care and the quality of their lives’ – part of the UN Principles for Older Persons adopted by a UN General Assembly resolution in December 1991 – is what is most important. It can mean taking full control over all our decisions, which we can if we choose self-management; enabling others to make decisions on our behalf; or something in between – but it is always our choice. 

For more information please contact Mable