A Guide to Home Care Packages in Australia

A 2020 survey of over 10,500 people ordered by the Aged Care Royal Commission found that many older Australians were concerned about going into residential aged care, with a majority saying they would prefer to receive care at home. So, how can older Australians get assistance to remain living in their own home?

In August 2013, the Australian Government introduced the Home Care Packages Program (replacing the existing Community Aged Care Program) to help eligible older Aussies access affordable care services at home – from assistance with everyday tasks to more complex or intensive support.

The government-subsidised program is aimed at helping older people with complex care needs to live independently in their own homes for longer. According to the government, a home care package (HCP) may be suitable for people with “more complex care needs” than what the Commonwealth Home Support Programme could provide. But what services are available under an HCP, who is eligible for the program and how much does it cost?

To help break down the ins and outs of HCPs, we have enlisted the help of Ann Hopper, a Home Care Manager at Lutheran Services. Lutheran Services is one of the approved home care package providers in Australia.

In the following article, we cover:

 

Budget 2020 update (7 October, 2020): The Australian Government has announced that it will spend $1.6 billion to fund an additional 23,000 home care packages over the next four years. These packages will start to be released from November, 2020. The additional funding for these home care packages comes in response to the Interim Report of the Royal Commission into Aged Care, which recommended the government act urgently to reduce long waiting times for older Australians who have applied for in-home support.

What is a home care package?

A home care package is a coordinated mix of services that can help support older people with various needs in their home, such as assisting with household tasks (e.g. cleaning and gardening), organising transport, providing personal care (e.g. bathing and dressing), supplying equipment (e.g. walking frames) or helping with clinical care (e.g. nursing services), according to the Department of Health.

home care services
Source: DGLimages (Shutterstock)

Who provides home care packages?

Home care package services are provided by a variety of aged care organisations in Australia, according to the government’s My Aged Care website. The Department of Health reported 922 approved home care providers with a home care service as of 31 March, 2020.

You can use the My Aged Care provider tool to find an approved Home Care Package provider near you.

What are the eligibility requirements for a home care package?

Eligibility for an HCP is based on your care needs, which are determined through an online and face-to-face assessment that can be arranged through the My Aged Care website, Ms Hopper told Canstar. In addition to completing the assessment, the My Aged Care website said in order to qualify for an HCP you must also be:

  • An older person who needs coordinated services to help stay at home, or
  • A younger person with a disability, dementia or other care needs not met through specialist services

My Aged Care said your financial situation will not affect your eligibility, but you will need to undergo a financial assessment to work out how much you may be asked to contribute towards your home care.

What types of home care packages are available?

Ms Hopper told Canstar that once your eligibility has been assessed and approved, My Aged Care will notify you of what level of HCP you have been assigned.

The government will then pay your chosen provider a subsidy or ‘contribution’, depending on your level of HCP, to organise and provide this package for you to suit your needs.

“There are four levels of HCPs with different funding amounts for each that go towards tailored care services,” Ms Hopper said.

“While the same care services are available at every package level, the amount available to spend on the care is different.”

The amounts the Australian Government contributes to various HCP care levels are as follows:

Package level Level of care needs
Level 1 Basic care needs – approximately $9,000 a year
Level 2 Low care needs – approximately $15,750 a year
Level 3 Intermediate care needs – approximately $34,250 a year
Level 4 High care needs – approximately $52,000 a year
Source: My Aged Care. Figures rounded. Rates applicable from 1 July, 2020 to 30 June, 2021.

According to the Department of Health, HCP providers must make sure you:

  • have enough funding to cover the cost of the planned services set out in your care plan; and
  • get the full benefits of your HCP

What services are on offer with home care packages?

An HCP could help provide assistance with a range of different services, depending on the level of care you require.

According to the My Aged Care website, the services available fall into three main categories:

1. Services to keep you well and independent

Including personal care (e.g. showering and toileting), nursing services (e.g. wound care, help with taking medication and conducting health assessments), allied health and therapy services (e.g. speech therapy, podiatry and physiotherapy), food and nutrition (e.g. help with feeding and meal prep), and specialised support (e.g. dementia advisory services or vision and hearing services).

2. Services to keep you safe in your home

Including cleaning, home maintenance and modifications (e.g. installing grab rails) and assistive technology (e.g. providing walking aids, pressure-relieving mattresses).

3. Services to keep you connected to your community

Including transport and social support services (e.g. arranging social activities and visitors to the home, helping set up phone or internet communications).

home care transport
Source: Photographee.eu (Shutterstock)

The Department of Health said providers of HCPs must give people choice, flexibility and control over the types of home care services they receive, as well as how and when they are provided. Providers must also have ongoing care discussions with clients to make sure services are meeting their needs and to be transparent about how much funding they receive and where it’s going.

What services are not on offer?

My Aged Care outlines the following services that a provider must not use HCP funds for:

  • items that would normally be purchased out of general income (e.g. household bills such as electricity or gas)
  • buying food, except as part of enteral feeding requirements (e.g. tube feeding)
  • payment for permanent accommodation, including assistance with home purchasing, mortgage payments or rent
  • payment of home care fees that are owed to your chosen provider (e.g. daily fee or income-tested fee as detailed below)
  • payment of fees or charges for other types of care funded or jointly funded by the Australian Government (e.g. transition care fees, short-term restorative care fees)
  • home modifications or assets that are not related to your care needs
  • travel and accommodation for holidays
  • cost of entertainment activities, such as club memberships and tickets to sporting events
  • gambling activities
  • payment for services and items covered by the Medicare Benefits Schedule (e.g. GP visits) or the Pharmaceutical Benefits Scheme (e.g. prescription medication).

If you’re unsure about whether a service will be covered under your HCP, contact your service provider.

→Related article: What does Medicare cover and how does it work?

How much does it cost?

My Aged Care said the cost of an HCP is made up of:

  • the Australian Government contribution (the subsidy as detailed above), and
  • your contribution (the fees you may be asked to pay)

Together these funds cover your care services, as well as the package management costs from your provider. Service providers must list their costs online through the My Aged Care find a provider tool.

Your contributions towards the cost of your HCP could be made up of three types of fees:

1. Basic daily fee

Your provider may charge this daily fee based on your HCP level.

From 20 March 2020, the basic daily fees by HCP level are:

Package level  Percentage of basic age pension (single person) Daily fee Fortnightly fee
Level 1 15.68 $9.63 $134.82
Level 2 16.58 $10.19 $142.66
Level 3 17.05 $10.48 $146.72
Level 4 17.50 $10.75 $150.50
Source: My Aged Care, accessed 10 September 2020.

Ms Hopper said some providers may waive the basic daily fee, unless the client chooses to arrange extra hours in a fee-for-service arrangement. Otherwise, anyone receiving an HCP may be asked to pay the basic daily fee, according to My Aged Care.

2. Income-tested care fee

My Aged Care said you may also need to pay an income-tested care fee. The income test, conducted through Services Australia, determines whether the government provides the full subsidy amount towards this fee or reduces it for you to contribute the rest toward the cost of your services, according to Ms Hopper.

“Full age pensioners would usually not be required to pay an income-tested fee,” Ms Hopper said.

If you do need to pay for some of this fee, the amount you pay will depend on your yearly income, including your pension, according to My Aged Care.

You could pay up to $15.43 per day, if you:

  • Are a single earning over $27,840.80
  • Are a member of a couple living together, earning over $21,606.00 combined
  • Are a member of a couple living apart due to illness, earning over $27,320.80 combined

If you earn below the above amounts as a single or as a member of a couple, you generally won’t pay this fee.

You could pay between $15.43 to $30.86 per day if you:

  • Are single earning over $53,731.60
  • Are a member of a couple living together earning over $41,121.60 combined
  • Are a member of a couple living apart due to illness earning over $53,211.60 combined

My Aged Care said there are annual and lifetime limits on how much you can be made to pay for this income-tested fee.

3. Additional fees

These fees may be charged if you agree to receive extra care and services that are not otherwise covered by your HCP.

To get an estimate of what your home care fees may be, you can use the My Aged Care home care fee estimator.

When do I pay these fees?

My Aged Care said the basic daily fee and the income-tested care fee are paid for every single day that package funds are assigned to you, whether you receive the service that day or not. You may be asked to pay your home care fees on a fortnightly or monthly basis to your provider. Speak with your provider to find out when you should make these payments.

→Related article: What are the costs of aged care?

Is there a waiting period for home care packages?

How long it takes to get an HCP depends on what package level you are eligible for and how urgently you need services, according to My Aged Care.

The expected wait time for approved HCP levels to become available is:

Package level Approximate wait time
Level 1 3 – 6 months
Level 2 12+ months
Level 3 12+ months
Level 4 12+ months
Source: My Aged Care. Last revised 30 June, 2020

The Department of Health said it determines an individual’s priority for an HCP using the national priority system.

As of 31 March 2020, there were 59,071 people seeking a home care package at their approved level, according to a Department of Health report.

A person can choose to be assigned an interim package while they wait for a package at their approved level, the Department of Health said. This means they can start receiving some services at a lower level sooner and will be automatically upgraded to their package level when it becomes available.

If you have been approved for an HCP, you can find out your expected wait time by either contacting My Aged Care or by logging into your online client record on the myGov website.

Are there any alternatives to using an HCP?

If you are not eligible for an HCP or think you only need a low level of support, you may be more suited for help at home through the Commonwealth Home Support Programme (CHSP).

Ms Hopper said the CHSP is an entry-level program for people who need basic help with everyday care and support.

“The CHSP is not income-tested and is often used by people recovering from an illness who require some help with basic domestic tasks like shopping or cleaning,” she said.

On the other end of the spectrum is residential aged care, which Ms Hopper said is usually considered when a client finds they can no longer live at home independently, even with the assistance of an HCP.

nursing home
Source: Jacob Lund (Shutterstock)

Ms Hopper said those who do not want to apply for an HCP may also be able to choose a fee-for-service arrangement through an aged care provider.

“This type of service is charged out at a set hourly rate and delivered in exactly the same way as a home care package, with an exception that it is a private arrangement between you and your chosen provider,” she said.

For more information on the HCP Program you can visit the My Aged Care website or read the Department of Health’s HCP Manual.

This article was reviewed by our Sub-editor Tom Letts and Senior Finance Journalist Shay Waraker before it was published as part of our fact-checking process.Cover image source: Photographee.eu (Shutterstock)

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