Consumer directed care welcomed

Consumer Directed Care (CDC) is a welcome change to community aged care

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Consumer Directed Care (CDC) is a welcome change to community aged care which sets the platform for sector wide change.  CDC is giving clients more control over how government funding is spent on their care and support. It’s also opening up service and care options to include more non-traditional options, such as smart technologies and wellness services.

With CDC the funding essentially goes to the client, with the aged care service provider being the custodian of the funding.  The provider negotiates a service fee and the client is in the driver’s seat as to how the rest of the money is spent on their care and support.

Clients will definitely be the winners with CDC, as the intention of the new program is for the use of the funding to be much more transparent.  The aged care service provider is to provide the client the budget funding, with the client choosing the services they wish, i.e. transport, social visits and programs, internet, equipment rental, alternative therapies, domestic and personal care. 

The client is then to be provided monthly statements, showing how much of their funding has been spent and how much of any unspent funds they can carry forward to add to the next month. A small provision for contingency funding (up to 10 per cent) can be put aside for unforeseen, short term increases in care and support (i.e. extra support required on return from hospital, etc.).

But is it truly consumer directed?

One issue with the new concept is the balancing act for providers.  The need to ensure the client has absolute discretion for their care must incorporate quality standards, funding guidelines and legislation. Providers need to ensure the basic care and services are in place, which will need to be a priority for providers and may eliminate total discretion by the client and their family.  But it is a start!  It will provide a much more flexible and transparent services for clients.

Feros Care is a big advocate for individual budgets for clients. Its goal never to say “no” to service possibilities and individual budgets allows for clients and their families and service providers to know what is possible within their allocated funding.

This is not new to Feros Care, which has been been optionally utilising individualised budgets for over six years, with clients having very broad and innovative service options, e.g. Telehealth, telecare, massage, therapies, internet for socialisation, accompanies outings to lunch, clubs, shows, sport exercise, equipment hire, short respite holidays, pet care and cooking classes. It absolutely supports the CDC concept as it will hopefully be the catalyst for many more aged care providers to broaden the scope and flexibility of care options to clients.


Timeframes

All new Home Care Package funding from the 1 August 2013 is to be provided on a CDC basis, with all existing funding and services needing to transition their current services to ensure they conform with the new guidelines and rules by the 1st July 2015. For community aged care providers, it is big switch and possibly expensive to change to current service models. Just for starters, new or existing IT systems will need to be adapted to integrate care and finance systems, to be able to record and produce detailed budgets and ongoing monthly statements of income and expenditure for each client in their care under a Home Care Package program. This is generally a new way of working for aged care providers. Professional firms such as laywers and accountants have been used to charging, in detail, time and services against clients for years – but for aged care – this is a new concept.

As mentioned above, there is also the issue, of working through the challenge of balancing duty of care and legal obligations of providers (which is what they will be audited against at government quality audits) against allowing the families to determine the services to be provided. There is also the issue of families potentially not agreeing with the client and/or aged care provider on what are the priority services and supports. For example, the provider may believe medication checks and assistance with meals are a priority (due to health /malnutrition) for a particular client, where the family may want to spend the funding money in other ways (e.g. home modifications, cleaning, etc). This leaves the provider in a difficult situation, as it is worried that the general health of the client is at risk and it has a duty of care to manage this. As a generalisation, there is mostly a consensus between families, providers and the client on priorities, but there will be situations such as these which occur that will challenge the intent of the CDC program.   



Contact

Feros Care Health Team services support healthy active ageing and can assist with understanding consumer directed care. For more information contact Feros Aged Care Advisory Service 1300 763 583 or visit Feros Care.






    COMMENTS

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    Jurassicgeek
    2nd Jan 2014
    7:39am
    this just sonds like the feds saving money at our expense...again...
    ekbg2002
    2nd Jan 2014
    10:06am
    Yes, this is a positive move but have heard the negative is that the client say needing modifications to bathroom would have to arrange it themselves, whereas this would currently be organised by service provider. How are elderly clients and young disabled clients expected to do this? I have heard this is true, but clarification would be appreciated.
    jaywalker
    6th Jan 2014
    12:30pm
    Having recently put my mother in a care home and prior to that oversaw home care for her for two years, I am highly suspicious of this new program. Providers even now often have difficulty in delivering basic care which is reliable and appropriate because the pay is so small and the responsibility so great. How are they going to deliver an even more diverse program?

    I did a bit of googling and the consensus seems to be that the US went this way and it turned out to be largely a money saver. And I can see the problem about some elderly people disagreeing with their families about their needs. That certainly happened in my mother's case.
    jaywalker
    6th Jan 2014
    12:40pm
    PS I am also cynical about having any power to get anything changed for the better. The food in my mother's care home is not good enough but if she moves homes now she will incur a financial loss. I did the right thing and wrote to the appropriate complaints authority who contacted me and listened but said all they could do was check it out when they did a regular or spot check of the home. I never heard another word from them and the food remains the same - a set menu with no choice apart from having sandwiches, fish and chips (frozen variety) every Friday, lamb chops every Thursday, tinned fruit and jelly and ice cream in winter, soggy toast every morning. She says she longs for something simple like baked beans or scrambled eggs on toast but can't have it.

    Of course, it's owned by a huge national company whose shareholder have to be constantly satisfied by greater profits which means cutting budgets. Privatisation is ridiculous in things like aged care, power, water etc where profit making for already well off shareholders is the driving force.