3. What can a Government Subsidised Home Care Package pay for?
Page 3 of 21
What can a Home Care Package pay for? Seeing as Home Care Packages are Consumer Directed you might think it can pay for anything you need or want; however that is NOT the case. Home Care Packages are funded by Tax Payers’ money, so they are “Consumer Directed within the Government’s Home Care Package Guidelines”. It is NOT as simple as, “if the item is on the list below, your Home Care Package can pay for it”. You need to get prior approval from your Care Manager and they will apply these tests:
- Does the service / item meet the Home Care Package Program Rule Guidelines? Here is a link to the Guidelines for Consumers produced by the Government. Be aware that we attend training to interpret the Guidelines, so our understanding is deeper than the Consumer Guidelines.
- Does the service / item meet an ASSESSED CARE NEED & GOAL which is documented in your Care Plan?
- Clinical CARE is always the top priority of a Home Care Package, then CARE, and then non-care services like lawn mowing, cleaning-only services etc.
- Is there sufficient Unspent Funds available to pay for the service / item?
- When there are insufficient funds to meet all goals / needs / wishes, clinical care trumps all other wishes. When care needs change your Home Care Package may need to cease paying for services that are non-care services so there is more budget to pay for clinical care and care services.
- The cost must represent value because tax payers are paying.
Please: Do not organise any third party services unless your Care Manager has approved these services in advance. If you are unsure talk to your Care Manager.
- Is the service being provided by a family member or friend? Your family cannot be paid by taxpayers to pay for your care. Family provides free care because they are family and they love you.
This brief list applies to all 4 levels of Home Care Packages.
|A. Care services||Care can include:|
|Personal care services||Personal care assistance, including individual attention, individual supervision, and physical assistance with:
|Activities of daily living||Personal assistance, including individual attention, individual supervision and physical assistance with:
|Nutrition, hydration, meal preparation and diet||Includes:
|Management of skin integrity||Includes:
|Mobility and dexterity||Includes:
|B. Support services||Support services can include:|
(^ Please note a Home Care Package cannot pay for capital modifications to your home such as a NEW kitchen, bathroom or roof.)
|Leisure, interests and activities||Includes:
(A Home Care Package cannot pay for tickets to the Opera / Football / entertainment but it can pay for transport to and stand-by-assistance during an event.)
|C. Care management||Can include:|
|D. Clinical services||Can include:|
|Access to other health and related services||Includes:
Excluded items that your Government Subsidised Home Care Package cannot pay for
The following services or items are outside the scope of the Home Care Packages Programme and must not be paid for by a Government Subsidised Home Care Package (by any of the four levels of the home care).
Clarification About Meals
*Meals – The government subsidy for a Home Care Package can be used to pay for the preparation and delivery of meals. This could be through the consumer’s home care provider, a CHSP service provider (for example, under a sub-contracting arrangement with the home care provider) or by a private service provider. However, the consumer is expected to pay for the cost of the food. Services such as Meals on Wheels ask the consumer to pay for the food and the consumer can ask for their Home Care Package to pay for the preparation and delivery, when it is itemised separately on the invoice.
Your Home Care Package can pay for a Caregiver to shop for ingredients and to prepare your meals, however the consumer must pay for the food from their own money.
Important Note About Clinical Care
If you need clinical care such as services provided by Registered Nurses or Allied Health staff (such as a Physio, Occupational Therapist, Dietician) the Government Guidelines are very clear that clinical care must be prioritised over less essential services such as gardening or cleaning.
GST and Home Care Packages
Every service or item your Home Care Package pays for is GST-free. We pay the whole bill inclusive of the GST but we only deduct the net GST-free amount from your Home Care Package. Our Handling Fee for paying Third Party Services is 10% (equivalent to the GST you would have paid).
Remember Private in Home Care has no limitations like the excluded items list above.
Here is a framework that you and your Care Manager can use to help you decide if your Home Care Package can pay for the item/service you would like.