Aged Care Insite Issue 112 | Apr-May 2019 | Page 15

industry & reform a relationship with your aged care service provider and case manager because of the high churn you have in the industry. Secondly, the training and the skill set of aged care workers is an issue – from the staff older people contact for their home care package through to the person who does the gardening as part of the service. billing systems, and having more robust administrative systems. Other recommendations are ensuring there’s some sort of checking process that goes on so services aren’t double-dipped, as well as improving the training of not only individual care workers, but also case managers. So, providing training for services, managing packages, accounting and finance, so that people understand what they’re dealing with as far as the finances go in a package, and ensuring that some of these billing and administrative errors aren’t made. I’m sure a lot of these errors are made without intent. For example, on a public holiday the older person still gets invoiced for a service even though it wasn’t provided. Now that’s a systems issue that could be prevented. Hopefully, that would reduce costs, so the older person would be better off and charged less. Presumably the administrative charges reflect what it takes to administer a package, so we could reduce those costs by making the administration more efficient and communicating it to the older person. A lot of time is taken up with the older person ringing up the case manager or the provider and clarifying: “What’s this on the statement? What’s that? Why haven’t I seen this person today? Why am I getting different people every day?” If we can remove those sorts of repetitive phone calls and unnecessary communication, presumably it would be more cost effective to administer the package. Which means there’s more money in the hands of the older person to spend on their services. Getting back to the fee structure that we’ve advocated in the report, we’d like to see simplification of the fees and services, and to have clarity about what people are actually paying for. We also advocate for an independent third party, like an ombudsman, that the older person can go to when they’re having issues, rather than only being able to resolve these with the provider. In a competitive market, the fallback position is that if you don’t like your provider, you can always change. But when you’ve got an industry-wide issue, the report itself may bring about some change. ■ In your report, did you find any positives that came out of home care packages? RW: Many people are very happy with the care they receive. I don’t think I came across anybody who didn’t see having the package as important. Many people felt they couldn’t live without one – it was that important to them. It’s important to them for a number of reasons. They want to have physical and financial independence. They don’t want to rely on their family for the help they need. And the broader issue here is that people do have varying needs. The physical needs tended to be similar in the sense that they needed gardening, cleaning, help with food preparation and so forth, and they exist to a greater or lesser extent. Then some people focus more on social needs and activities that they really value. Overall, people were very grateful for the help that they did get. One particular gentleman we spoke to said: “If you don’t have a package, you’re history.” On the other side, people said: “That’s great, I like the package, it’s a fantastic system – however, it’s open to what you might call abuse or rorting.” Some people thought it was a bit of a gravy train and that it’s a source of income for providers, and they thought the money could be spent in a much more efficient manner. The next phase of the royal commission will look at home care packages, and there could be restructuring on the cards. If the government asked you how to improve home care packages, what would you recommend? 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