3. Consumers’ 9 New Rights Under Consumer Directed Care (CDC)
Consumer Directed Care (CDC) reforms began in the aged care in home care industry on 1 July 2015 and became fully operational on 27 February 2017, and have given elderly Australians 9 really powerful new rights.
In our clients’ experience, Consumers have to be very knowledgeable of their rights and assertive to actually receive true Consumer Directed Care (CDC) because many Old School Approved Providers are still dishing out “Provider Directed Care”, not Consumer Directed Care.
Here are your 9 New Rights:
Elders have 9 NEW RIGHTS under Consumer Directed Care being the right to:
1. Choose your Approved Provider
2. Choose the type of care you need
3. Choose when you have your care
4. Choose who supplies the care
5. Approved Providers operate with financial transparency and accountability
6. Choose the level of management of your Home Care Package that you want to exercise
7. Receive care focused on your goals
8. Receive care focused on wellness and re-enablement
9. Be treated as an equal partner with no retribution
1) From 27 February 2017, you have the right to choose WHICH Approved Provider will receive and manage your Government funded Home Care Package.
You now have ultimate control over the Government Funding.
It’s your money, not the Approved Provider’s money.
If you feel that your Current Approved Provider is not giving you good service or good value… then do your research and transfer your Government funding to an Approved Provider who does… like Daughterly Care Community Services.
Due to our 4 specialisations Daughterly Care Community Services provides fantastic service and value for 4 groups of elders:
1. private paying, self-funded elders;
2. with high care needs i.e. Level 3 or 4 ACAT Assessments;
3. living with a form of dementia; or
4. needing 24 hour care or Live in Care.
2) To choose what TYPE of care you need.
Most seniors and elders just need a little bit of assistance to start with and so only being offered care by the hour is fine. However, your aged care needs can increase… and decrease over time so you need a Home Care Provider who provides a complete range of in home care services such as Registered Nurses, overnight care, 24 hour care, Live in Care and Palliative care to avoid unnecessary hospitalisation and premature nursing home placement. And you’ll want a Home Care Provider who is flexible and focuses on what’s important to you. An organisation who LISTENS to you and answers the phone.
As your care needs increase and you reach that “tipping point” where you need around the clock care, you’ll want a Home Care Provider who provides overnight care, 24 hour care or Live in Care, such as Daughterly Care so you don’t have to go to a nursing home.
3) To choose WHEN you need your care, i.e. what day, what time? No longer do you need to accept services at times that don’t suit you. No longer do you need to wait for help showering.
4) To choose WHO supplies your care. (Now you can choose a premium private care Home Care Provider such as Daughterly Care) and if your Current Old School Approved Provider makes this difficult by saying they are not on our “Preferred Panel” or charges unfair additional, often secret fees – you can just transfer your Government funding to Daughterly Care Community Services as we are a new breed of Consumer Directed Care Approved Provider.
5) To have financial transparency and accountability via a proposed budget and monthly statements sent to you. This new right is a GAME CHANGER.
In the past ‘care recipients’ of Government Subsidised In Home Care Package didn’t know how much the Government was paying for their care or how that money was being spent so The Productivity Commission recommended that change.
The new transparency comes via:
- the proposed budget and
- the monthly statement which shines a spotlight on how your money is being spent so you can check you are receiving sufficient value and negotiate better outcomes.
If you feel that you are not receiving value, you have the right to negotiate better value or just change to an Approved Provider like Daughterly Care Community Services who offers better value in the first place.
The introduction of financial transparency is a massive and welcome reform.
The Proposed Budget and Monthly statements show:
HOME CARE PACKAGE INCOME
- The subsidy amount paid by the Government. The Government funding for the 4 different Home Care Package levels are on this page. Don’t forget to come back!
- Supplements paid by the Government e.g. 10% supplement for dementia
- The Basic Daily Care Fee set by the Government (paid by the consumer)
- The Income Tested Care Fee (set by the Government) based on the Consumer’s Income Test and determined by the Human Services Department.
- The Voluntary Top Up Fees (private care paid by the consumer, NOT a Government requirement)
MINUS FEES CHARGED TO THE CONSUMER BY THE APPROVED PROVIDER:
(Please note: Daughterly Care Community Services does not charge most of these fees, but this is what I have seen charged when auditing hundreds of statements over the last 2 years)
1. Intensive Support Home Care Package Set Up Fee
2. Administration fees
3. Core Advisory fees
4. Case Management fees
5. Third party supplier fees (commonly 10% added onto the cost of a third party supplier of care or other services)
6. 10% GST incorrectly charged
7. Quarterly Review Fee
8. Annual Review Fee
9. Registered Nurse Case Management or review fees
10. Contingency fee
11. Exit Fee
EQUALS MONEY LEFT TO PAY FOR DIRECT CARE.
What matters is how much of the Government funding or Home Care Package income is left for your in home care support and assistance.
Costs are explained in more detail section 4
And all this disclosed financial information means you can ask your Case Manager … “How can I get better value? How can I get more hours of care to maximise my Mum’s / Dad’s chance of staying at home for life?”
Consumers with high care needs, i.e. receiving level 3 and 4 Home Care Packages who don’t want to go into a nursing home have the greatest need to reduce fees to a fair level and at the same time increase the quality of their in home care as this will improve your chances of staying at home for life. And when an elder reaches that tipping point of needing 24 hour care, around the clock they will want the option of Live in Care because it’s less than half the price of 24 hour care.
6) The right to choose what level of management the consumer (or their representative, Enduring Guardian or family) would like.
In theory, the higher your level of management of the Home Care Package you choose, the less fees the Approved Provider should charge you and the more you can spend on actual hours of care needs. That’s the theory and when I was negotiating for clients in 2015 with their Current Approved Providers… the switched on Approved Providers realised where the value lay and agreed to total fees of 10% pa… others got very clever and said, yes we offer the self-managed option and it’s 1.5% cheaper than the fully case managed option.
TIP: If you are one of the many consumers, who wasn’t asked how involved you wanted to be in the management of your Home Care Package then re-contact your Approved Provider and ask to discuss this. Here is a PDF from the Government Guidelines stating you must be asked how involved you want to be. We have negotiated reductions and refunds of Case Management Fees where Approved Providers failed to ask this question, because it is a breach of the guidelines.
Negotiation tips to gain your rights
Prior to 27 February 2017, our clients’ experience had been very “hit and miss”. Some Approved Providers are absolutely brilliant and really “get” Consumer Directed Care and are a total joy to deal with. Other Approved Providers, based on my clients’ experiences, well they act in ways that are the complete opposite to Consumer Directed Care and you wonder how they will stay in business now that the Home Care Packages are not allocated directly to them by the Government… now that the consumer chooses their Approved Provider based on service and value.
Here’s just some of what we have seen that was not Consumer Directed Care:
- They don’t offer choice of Care Provider.
- They flat out deny clients of their choice of Care Provider.
- They charged a whole year’s case management fees to a 96 year old client in the first 3 months of his home care package, during which time he received no care!! That’s not ethical or caring.
- They lie to clients telling them they “have to pay a contingency” fee. No you don’t, the Government Guidelines say “the contingency fee is not required”.
- They triple charge for the same service such that you end up paying 49% pa of all your Government funding and consumer contributions to them in fees before one dollar of care is bought. One Rogue Approved Provider charged an Annual Case Management Fee plus an Annual Core Advisory Fee plus charged by the hour for “case managing the client”. Plus charged for Registered Nurse visits that didn’t occur. Plus charged a quarterly review fee plus an annual review fee!!!
- They MISQUOTE the Home Care Packages Guidelines to the elderly consumer. They were written by the Government for the Approved Providers to abide by… so we have to help clients quote the actual rules back to the Rogue Approved Provider.
- They systematically over charge clients, charging for GST, when in home care, personal care, respite care is GST exempt.
- They don’t disclose all the fees they charge in breach of the Guidelines.
- They embed their own “secret undisclosed fee” into the care provider’s fee. This artificially inflates / overstates the care provider’s fee. Daughterly Care has discovered 10 Approved Providers who inflate the cost of care by artificially increasing our fee by their own undisclosed handling fee. One faith-based, not-for-profit increased our fee by $100 per day, another increased our fee by 10% pa. Another increased our fee by 5% pa and another increased fee by 20% pa. This serves the purpose of artificially and falsely increasing our fee making us look less competitive than we are. It also makes the Rogue Approved Provider look cheaper than they are. Their fees should be in their “Expenses” section on the statement, not hidden in the supplier’s fee.
7) The right for care to focus on your goals.
The Consumer Directed Care Home Care Package guidelines made it compulsory to ask elders what’s important to you? What goal are you wanting to achieve with your Government funded care? And this is documented in your Care Plan which is unique to you and your goals.
8) The right to focus on wellness.
In home care isn’t just about doing tasks for elderly Australians, it’s about re-enabling elders after a health crisis and supporting them back to their previous good health. It’s also about enabling elders to be healthier and happier. Dr Maria Montessori, Italy’s first female doctor famously said, “what we do for people we steal from them.” So when we talk to you about the goals for your care… one of our questions will be “how can we work together to improve your wellness?”
9) Equal Partners. No retribution.
Many elders and their families are afraid to speak up for their rights when receiving Government Funded Home Care Package services. You don’t have to be afraid, you cannot be discriminated against just because you stand up for your rights and for what is rightfully yours. From 27th February 2017, it’s your money (not the Approved Provider’s money) it’s your care, to live your life, your way and you control the money now. All power to you!
Click here to discover what the costs of Consumer Directed Care (CDC) are.