Feb 16, 2023

Government denies changes to home care exclusions list

Government denies changes to home care exclusions list

The Federal Government has rejected calls that it suddenly excluded key items and services from Home Care Packages (HCP), instead stating that a recent update only clarified what could not be claimed.

However, several HCP recipients have reported they can no longer access items or services through the Government-subsidised program because of the changes.

Last month an updated version of the Home Care Packages Program Manual was quietly released for both consumers and providers, outlining recent legislation changes such as the capping of HCP management fees and the extension of the Serious Incident Response Scheme (SIRS) to home care services.

But the Government also expanded the list of excluded items and services that cannot be claimed through HCPs, a list based on the Quality of Care Principles 2014.

The original list featured 10 dot points and explanations of items that could not be claimed as part of HCPs did not exceed one sentence.

Now there are nearly 100 individually listed items or services that are explicitly excluded, including heating and cooling costs, white goods and electrical appliances, ambulance cover, non-PBS medications, and gym memberships that are not monitored by a health professional.

Minister for Aged Care, Anika Wells, released a public statement addressing reports made by both the Daily Telegraph and The Guardian, denying the Government has changed any rules.

“Reports that the Albanese Government have changed the rules about what Home Care Package recipients can claim are incorrect and misleading,” said Minister Wells.

“In particular, mobility scooters have not been excluded.

“The Albanese Government knows most people want to stay in their homes for as long as possible, so it’s imperative reforms to in-home aged care bring genuine improvements for older Australians in the long and short-term.”

Minister Wells said they are committed to providing better value for money and access to appropriate services for HCP recipients.

The changes appear to have had the opposite effect on some of the 237,000 older people accessing HCPs, as Dot Waterhouse told the Daily Telegraph that her husband’s Parkinson’s non-PBS medications will now cost them over $800 per year due to the changes.

“It was absolutely overnight,” said Ms Waterhouse.

“People with Parkinson’s have huge problems with their gut health, it can be life and death. These were supplements that my husband must have and the specialists require him to take.

“The whole thing is just ridiculous, these are not people rorting the system, these are people who are elderly and sick trying to stay in their homes.”

In a statement provided to The Guardian, the Department of Health and Aged Care reinforced the need for medicinal exclusions, claiming HCPs are not a medicines scheme.

“It is accurate to say non-PBS medications are excluded, but it is inaccurate to say this is a change to policy,” the Department told The Guardian.

“The purpose of the home care packages program is to support older Australians with complex ageing related care needs to live independently in their own homes, to maintain the care recipient’s capabilities as they age.

“This may include assisting an older person to manage their medications but does not include subsidising the cost of the medicines themselves. It is not a medicines scheme.”

Minister Wells later said that several providers have reviewed their business practices following the changes to HCPs and identified services that were being offered but should not have been funded.

The Government said it is the providers’ responsibility to notify recipients of any support changes as they are the ones responsible for providing services that were not allowed.

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  1. I would like to have a comparison to the services that NDIS clients receive. Please compare against an elderly person against an older NDIS client/s The difference is massive! Why not have one system and make it fair!

    1. You are so correct. Some of the items being claimed by NDIS recipients are unbelievable like sex services. It is disgusting that non PBS has been removed from HCP as those of us who have a HCP have additional medical needs and non PBS medication. If we fall ill we have to be hospitalised which is terrible and the costs are large.

  2. it’s not the consumers ‘rorting’ the system, it’s the deliberate ambiguity of the program guidelines that allows flexible interpretation by HCP Providers and subsequent provision of goods and services that should never have been provided. This creates false expectations for consumers who get used to these subsidised goods and services that should NOT be covered in their HCP in the first place. That fact that the list of items not included has increased is due to now having to list every single item individually to be crystal CLEAR that people’s personal health insurance and dishwashers are not exactly costs that should be covered by aged care funding.. are they???!!! If you actually compare the previous guidelines with the new ones, the list really hasn’t changed… it’s just now been spelt out very C.L.E.A.R.L.Y.
    People don’t like it when loopholes get closed, so everyone needs to be prepared for the next 12 months because accountability may just keep on increasing for providers who have been basking in the land of loopholes..

    1. You obviously have no idea about the heartache this is causing people, your comments are really without any foundation This is a blatant attack on the vulnerable, and it will be challenged, the inequity between people over 65 and denied access to NDIA funding is a disgrace roll on our day in court it will make the current commision into robodebt value wise seem insignificant

  3. I wonder if you might like to look at the increase in falls risks for older Australians when spectacles can’t be purchased from packaged funds. Many frail aged people cannot afford single vision reading and single vision distance glasses and opt for bifocal or multifocal lenses. There is clear research that single vision lenses are a falls prevention strategy and falls and the injury incurred from falling is a significant risk for older people living independently.

    1. There is separate commonwealth funding for glasses and hearing aids. This is considered to be double dipping.

      1. No, you are in error. I am not considered in Commonwealth Schemes because we get $150 or so each extra a week in another US pension, while losing also as a married couple. Also, choice is currently limited.

  4. Non PBS has never been allowed. The government just didn’t stop organisations claiming – and the guidelines were taken advantage of- they were a bit wishy washy.

    1. Yes as the medications were already funded by the commonwealth under the PBS this is considered to be double dipping. Agencies yet again not following the rules.

      1. These drugs are not on PBS. They are prescribed by specialists to keep people out of care for the longest time possible. When the pension is 1400 / month and the pharmacy bills are 250-300 monthly where do you think the money will come from?

  5. people onwho apply for home care packages are excluded from the packages if assets / income exceed set limits, which results in people who get home care packages are not high income people more likely just the opposite and if home care packages are to help keep them at home the money allocated should be able to be used to help pay for medicine not pbs etc since without this ability to subsudise medicine, provide equipment ,apliances which contribute to persons ability to function at home, may prevent them from remaining at home etc that enable the to function at home eg replace to small fridge with one that can hold required to order frozen supplied meals,lift chair ,electric lift bed, etc ,not cheap items and often out of financial reach with out using money from package. No medicine etc = cannot stay at home =package does not meet desired outcome of stay at home .Stay at home=cost goverment signicantly less with people on even full level4 packages then th cost to goverment it would be having them having cared for at goverment aged care facility. /

  6. Keeping elderly people at home “longer” is fine in theory but the legislation no longer allows for a common sense approach in case management. Providers are not willing to work the system for the benefit of their clients for fear of reproach and non-compliance. This results in the client being disadvantaged and the case worker no longer able to be creative in the best interests of their clients.
    The changes to entitlements is generating fear and anxiety amongst the vulnerable client base.

  7. It just means the government can get more money back if and when we die or go into care They do not care if we have no heat in our homes,or the money to get our tablets , They give it too people who do not work or do any thing for this country but take .So take it from the people that have worked for this country for the last 40 or 50 years

    1. I agree how can we make this people with their head in the sand take notice ,its about time Aussies stood up to these idiots

      1. Politicians and their families are fine. Big salaries and allowances and huge pensions. They don’t care a damn.

  8. the minister who did this has probably has never seen a old person with needs.SHOULD BE ASHAMED OF HER SELF,how would she like to sit in a boiling hot 40deg.home because cant afford cooling,my wife also has a medication on prescription that costs $170.00 a pop .and to think i voted Labor ,does Albo. know about this ?

  9. Items related to wellness such as art/music/xraft therapy have been disallowed. I had been previously reimbursed for paint and boards but after buying and applying for reimbursement I was rejected for craft material such as felt and threads etc and I ended up being 300 dollars out of pocket because of the unexpected change in the manual. This is contrary yo the original contract and I was not warned in advance that this was about to change.
    It is obvious that when July 2024 rolls around any money left i participants accounts that has been unused will roll back to the Govt. coffers. This is no more than a cost saving exercise and denying heating and cooling to vulnerable seniors with the present climate change is going to decrease the numbers of elderly [eople claiming Support at Home by significant numbers as the elderly drop dead with heat exhaustion

  10. A couple of ridiculous comparisons, You can have your spouting cleaned out, but you can’t have your windows cleaned. You can have your carpet vacuumed but not cleaned. If you SPRAY the bugs, flies, and other creepy crawlies that get into your home, it is a good chance your much-loved companion pet could be allergic to that spray, “as mine is” get sick, and off to the very expensive Vet.
    So, what I am saying is not every regulation can fit all. Prior to the labor party and the 23rd of January 2023,
    If you were in a certain situation and your provider had a bad night last night, you could present your particular case to a sort of OPAN and have the decision reversed in your favor. Every negative result of an application by the aged and sick adds stress, anxiety, and mental health to those who need it least of all.

  11. The changes are nothing more than a money saving exercise, and no matter what the minister says this was done in underhanded way and is causing great distress to Aged Persons especially those with profound disabilities and because they can’t access NDIA level of funding or services this is now going to be challenged in court though Mitry Lawyers

  12. I am astonished to read some of the items that people expect from a HCP. Recently a very dear friend died who had been seriously ill living alone. She received 1 shower per week and 1 hour of house cleaning per fortnight. That is all. Because there isn’t enough resource for someone to receive palliative care at home. Whilst others expect everything on the list AND everything NOT on the list. Its called greed.

  13. This is not before time, the rorting that has occurred in this program has been there for years. I have worked with many different Agencies as a Case Manager with a Nursing background and Social Work for over 20 years. Some permanent roles in management and more recently on contracts mostly with Not For Profit Agencies. The rules were never prescriptive enough, I was often having disagreements with different staff in regard to what was allowed to be paid from the package.

    One of my big bugbears was the split for the prepared meals. As my first role in this community was as a Manager of a Meals on Wheels service, so I know the rules about the fact that people must purchase their own food. Commercial food producers make up their own rules and have a 30%/ 60% split. Most Agencies charge clients 30% which is meant to be the preparation and delivery fee, not the cost of the food component. The standard amount for a CHSP MOW meal is around $9.00 a meal, most agencies do not charge this cost to the client, they pay for the food from the package.

    As for all the standard double beds and expensive recliner chairs that have been purchased for clients this has needed to be rectified. I have seen these electric chairs prescribed to smokers and people who live in areas where they have had blackouts and been stuck in the chairs overnight. These chairs are prescribed to people who need to keep moving to stay fit. I have experienced many people’s fitness deteriorate in these chairs as they sit for hours and many times sleeping all night, in them.

    Scooters are another concern as many clients have had to stop driving due to their cognitive issues. Then they are allowed to have a scooter prescribed without the same considerations regarding their ability to drive on the road. I am aware of the people who are given the scooter and then drive them on the road in quieter areas. There appear to be no rules about checking a person’s capacity to drive a scooter. At one stage I know it was being considered by the authorities, but there seem to have been no changes in this area. Added to this there have been clients that I have been involved with who have not charged them correctly and have been caught in areas away from their homes.

    There are many other things that I could talk about but I believe this direction from the Commonwealth has been a good thing, as it will make the Agencies approve the correct items. With the way the funds are being reimbursed, they will be expected to have all the correct processes in place to prevent the rorting that has been allowed in the past. A lot of it was done innocently, as the directives were not clear enough. Added to this there are a lot of inexperienced staff working in this area, and they believe they are doing the right thing for their clients.

    1. I’ve been caring for my mother for over 15yrs now but I totally agree with the fact these staff needs extra training as some really had no idea..! Another point I wanted to make is regards to their fees. They have 2 seperate fees CARE MANAGEMENT FEE & PACKAGE MANAGEMENT FEE.
      Honestly, what do they do to justify these 2 fees? My mother is ob Level 3 and they take $900 in fees every month. For little they know and provide that’s a lot of money from one patient. Then there’s the transport fees which is $800 for 4 trips that’s about 40kms round trip and each trip is $200, Really?
      These providers are rorting not just the elders but the governments naivety.
      If they’re going to charge these ridiculously expensive fees then they should at least know their jobs and know what their patients can request and what not or what can be fought and argued for. I personally had to argue many occasions where they tried to say my mother couldn’t get this and couldn’t get that only for me to jump in my mums request and point out to these person who was in charge with my mums affairs that she was wrong. So many times then when something goes wrong she tried blaming my mum. We ended up making a complaint against her then we went to another provider. They’re lot better than our first provider but the fees are just the same. Very very expensive!

  14. This is a great incentive but starting with providers there needs to more which is government funded. At the moment these fees providers charge are ridiculously overpriced and those staff needs to be better trained. Another point I’d like to explain is, I thought the whole point of the Home package was to give our elders the option to stay at home as long as possible and making that possible is the whole purpose of this home package so then why are they excluding instead of adding? It’s so clear there’s so little options for them already so why would they exclude their option to have a hairdress to come and fix their hair? So is the government saying it doesn’t matter whether they try to keep themselves looking respectful and neat? Anything they can access from a aged care providers they should be able to receive them from their own home!

  15. Very unfair legislation and separation of hcp and ndis
    We are disable since many years but never knew about ndis and when applied we were misguided and they didn’t allowed ndis and now we are not eligible what a jokee ifu are ndis member before 65 u r eligible for many services but if you are djsable after 65 u cant even at age 66 similar person on agecare get more services and u donf g Ave to pay income tested fees and it is very unfair they should remove hcp and bring under one umbrella of ndis servicesand everyone should treated equally
    2014 rules were their rules only
    They given more revision to provided and every errors needs are diffrant if they plan their package within the limit of their money they get they should all as self managedto use money on hmany health related problems. And let them decide where the want to use if they contribute money let them decide where they wast to use their package under the guideline of previous year but they make rules more rorting by provider and in favour of provider so now alm saved money for particular services they removed it and bring ridiculous law for everything u pay to ot and their charges very high if physio do assessment their charges for hcp wilm increase
    Now they bring new strategy care worker should be qualified even for cleaning job and than regusted with provider and provider will finaly indirectly will not allowed our sw but wil be force fto here their se.and their charges are 3 times more than outsider and jt is sofistcated rorting of system or nedical compromjsd

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