industry & reform
Unpacking packages
Making sense of the mindboggling world
of home care packages.
Braam Lowies and Rob Whait interviewed by Conor Burke
R
evelations from a leaked report commissioned by Aged
Care Minister Ken Wyatt show that providers are charging
“obscene” fees for home care packages.
The Nine Publishing newspapers revealed that in some
instances, providers are charging half of their fees in admin costs
or case management.
The research, conducted by Dr Sarah Russell, found that in one
example a provider charged over $600 in case management and
admin fees for one service valued at $130.22.
The study also found large differentials in the hourly rates
for support workers – between $39 and $61 – and that when a
provider took a bigger chunk of the home care package funds,
“some participants received less than 10 hours of personal/
domestic support on a Level 4 home care package”.
The minister responded to the claims that the home care
system lacked transparency. He told the newspapers that nearly a
third of providers do not publish their pricing online, as is the legal
requirement.
Russell’s report also highlighted the problem people have in
understanding the current system. One research participant told
her that: “We didn’t understand the statement. Nobody explained.
We asked the case manager to explain. She couldn’t understand it
either. Our granddaughters who are studying at university couldn’t
even understand. It was very confusing.”
Researchers at the University of South Australia, Dr Braam
Lowies and Dr Rob Whait, found similar problems in their study
12 agedcareinsite.com.au
of the ability of over-65s to navigate the financials of the home
care system.
“Our research found that older people felt insecure about their
capacity to manage home care packages to their best advantage
and we wanted to understand why,” Lowies said.
“We found a host of problems, from a general lack of
confidence and knowledge of the system among older people,
to overly complicated communications, high staff turnover and
inadequately trained staff providing in-home care, inconsistencies
in package administration, confusing fee structures and even
inaccurate billing processes.”
Aged Care Insite spoke with Lowies and Whait to find out why
home care is so complicated.
ACI: A recent government-sponsored report found that home
care packages have many problems, such as over-charging,
mismanagement of funds and high management fees. Did your
research find similar things?
RW: Yes. Our research focused on the financial capability of older
people in selecting and managing their home care packages. This
was also through the older person’s perspective, so we’re talking
to them about their perceptions and experiences. Along the
way, we came across perceived inconsistencies in billing, over-
charging, unfair charges, double-charging and unclear invoices.
It must be also stressed that older people aren’t a homogenous
group: they’re quite varied in their outlooks in life. So, some people
want to have significant ownership over their home care package.
They want to have much greater control over where the money’s
spent, what it’s spent on and who provides the services. But they’re
stifled in that, in general terms, by the administrative arrangements
from the provider. Sometimes the provider is probably hindered in
the way they can administer the package as well.
This system, whether that be through government or providers,
stifles those who want to manage their package. At the same
time, those older people who are happy to have the provider look
after their package for them aren’t really encouraged to have any
greater input.
BL: Also, it was clear from the people that we spoke to that the
high staff turnover in the aged care services industry is really an
issue. A lot of them were exposed to 1–4 case managers at a time.
That in itself presents a problem, because you can’t really establish