Let’s get real: Should clients self-manage their Home Care Package?

The appeal of self-management in the Home Care Packages Program is understandable. Older people have been looking after themselves and others for a long time, and most want to remain in the driver’s seat. 

Self-managed Home Care Package providers advertise that they offer more choice, more control, more hours and more freedom – all for a fixed cost of 13% of the budget. But is self-management all it’s cracked up to be?

The basics: What is self-management?

While it is often referred to as self-management, it’s important to remember that a truly self-managed Home Care Package doesn’t exist.

Why? Because according to legislation, a Home Care Package provider is still required to “hold” government-issued Home Care Package funding. Providers of self-managed Home Care Packages simply offer a basic management service and charge a rate of around 13% for “hosting” the Package.

While self-management differs between organisations, it generally means that clients are active in managing the practical tasks of their home care. They are responsible for:

• Undertaking their own recruitment and management of their support team, including scheduling appointments and times, covering leave, and ensuring services are delivered to their standard
• Sourcing, purchasing and/or being reimbursed for their products and services
• Ensuring all purchases are made in accordance with the policies of a provider and relevant Government legislation
• Managing their own clinical needs, including hiring nurses and allied health professionals
• Managing their Home Care Package budget

What are the risks of self-management?

Self-management poses a number of risks that need to be carefully considered by clients and their families. For example, what happens if:

• An unexpected health issue disrupts their ability to self-manage?
• They need to increase their support, but they don’t have the capacity to make those changes?
• They haven’t left enough money in their budget for support when their care needs increase?
• Their chosen carer calls in sick, requests long-term leave or quits unexpectedly?
• Their chosen carer is performing poorly and not meeting their care needs?
• They want to make a complaint about their chosen carer?
• Their chosen carer’s insurance, qualification(s) or criminal background check lapses without their knowledge?

Rather than directly assisting clients with these matters, most providers of self-managed Home Care Packages will direct them to written and digital resources, training and technologies.

Therefore, it’s important for clients to create their own risk management plan by assessing the likelihood of these scenarios, the risk they pose to their health and wellbeing, and the contingency plans they will have in place should those scenarios occur.

What is provider management?

In provider-managed care, the client is offered a full and comprehensive Home Care Package management service that, according to Government legislation, must be delivered according to Consumer Directed Care (CDC) principles – consumer choice and control, rights, respectful and balanced partnerships, participation, wellness and re-ablement, and transparency.

So, what does this mean for provider-managed care? It means that the provider takes care of the administrative duties, budgeting, staffing responsibilities and purchasing – all in accordance with the client’s personal needs, preferences and goals.

Provider management can help with the following:

• Pairing clients with a coordinator to oversee all aspects of a client’s care, including budgeting, staffing and purchasing on their behalf
• Providing directly employed, nationally screened, highly trained and compatible caregivers to deliver support services
• Replacing staff who do not meet a client’s standards or “click” with them
• Scheduling a client’s appointments and services on their behalf and according to their preferences
• Covering sick leave, long-term leave and resignations in a way that does not affect the delivery of a client’s care and support
• Screening service providers, from the gardener to the in-home hairdresser, to ensure they are qualified, appropriately insured and police checked

The cost for provider-managed Home Care Packages should be between 15-20% of the value of a Home Care Package. However, be aware as some providers can charge up to double or triple this amount in package management fees. 

Is self-management the way to go?

Self-managing a Home Care Package may be suitable for clients if:

• They have low care needs
• They are transferring from the Commonwealth Home Support Programme (CHSP) to a Level 1 Home Care Package
• They have the capacity, time and skills to manage people, budgets and technology, or are being regularly assisted by a capable family member or friend
• They would prefer to use their Home Care Package as a wallet for purchasing equipment and basic task support such as cleaning and gardening

If a client decides to give self-management a go, it’s important that they are encouraged to consider their risk scenarios and put contingency plans in place should those scenarios arise.

Lastly, it’s important for clients to remember that they have a lot of control when their Home Care Package is managed by a provider, too. With provider management, a client’s risks are managed according to their needs and preferences, which means they don’t have to worry about budgeting, purchasing, scheduling, performance managing, staff absenteeism and more.