News regarding Home Care Packages (HCP) and reports of concerns by the community was widely circulated.

Was the Government’s response around concerns relating to what a Home Care Package (HCP) can be used for adequate?

In April 2023 there was a Webinar with a panel which included Julia Atkinson (Acting Assistant Secretary of the Home Care and Assessments Branch, Department of Health and Aged Care) relating to Home Care Packages and the updated program’s operational manual. Concerns relating to what you can spend the package funding for was discussed. 

Julia Atkinson’s response included the following:

So, the manual update that we did in January, we published on the website. This was an update to the manual itself, and the purpose of that update was to improve the clarity and transparency around what you can and can't use your Home Care Package funds for.

So I wanna stress this and I know it's been a point of misunderstanding through this process. This wasn't a change in policy, it's actually a clarification and further communication of extended policy. So these have always been the rules. As the government, we do need to administer our programmes judiciously, and part of that is to speak within the legislative framework. And so what money can and can't be spent on is an important part of that. The reason why we've updated the manual was because over several months and years, we were hearing that there was a lot of confusion, that the previous manual and the legislation were quite high level, and there was a lot of misinterpretation and confusion between providers and care recipients around what is and isn't an acceptable expense under our Home Care Package. And what we've heard is that that's really created a lot of tension. It's damaging to the relationship between the provider and the care recipient, and it also creates a situation where care recipients aren't empowered to know what is and isn't okay. So, that's not great. So our intent in making that update to the manual is to put a lot more clarity into how we've explained what can and can't be purchased with a Home Care Package. Now, what we've heard since January, since we put out the manual, is that we could have done a better job at how we communicated that update.

We've found that the use of funding for things that were excluded is probably a bit more prevalent than what we had previously understood.

And we've heard a lot of people have found that use of funding for those items is now being withdrawn as providers are realising this is actually not okay. And so in the process of getting that feedback, we've realized we need to be much more open and communicative, spend more time with groups like OPAN about talking to you about what and why these updates have been made so that everybody has a joint understanding of what's okay to spend that funding on.

Source: OPAN Webinar (Home care packages: what’s changed?) Transcript

Was the Government truly open about all this?

They mentioned that there wasn't a change in policy but a clarification. However, the following may indicate inconsistencies.

The Home Care Packages Program Operational Manual: A Guide for Home Care Providers includes a specified inclusion and exclusion list clarifying what the HCP can be used for. Even though this is helpful the Government Department should be honest if they blundered and led to misunderstandings or confusion. The following example indicates this.

Exclusion of installation and/or maintenance of raised garden beds

On the My Aged Care website a story was added to give you some idea what can be included (see below). It clearly stated that raised garden beds were introduced to make the person’s garden safer and easier to maintain so they wouldn’t have to bend down etc.

However, the same story was later altered and now mentions that a short ramp was introduced so could get outside safely to enjoy the garden. It was likely revised in February 2023.

Barry's story

After suffering a stroke, 81-year-old Barry’s balance was badly affected, which made him lose his confidence. He stopped going out to meet friends, spending time at church, and looking after things at home.

Barry wanted to get stronger so he could do more around the house and garden. He also wanted to resume his social life and church activities. So he contacted My Aged Care to arrange an assessment for aged care services.

An assessor came to Barry’s house and developed a support plan to help him achieve his goals.

The plan included a home maintenance service provider, who suggested ways to make his garden safer and easier to maintain. They introduced raised garden beds so Barry wouldn’t have to bend down. This meant he could enjoy his garden while reducing his workload.

Revised: February 2023 to: They introduced a short ramp so Barry would have safe access outside his home.

Source: MyAgedCare web page - Barry's Story (revised)

The plan also included a physiotherapist to design some light exercises to follow at home. After following the physio’s exercise plan, Barry regained his balance, and was able to walk unaided at home. This gave him confidence to go out and meet his friends and get back to his church activities with his local community.

Source: MyAgedCare web page - Barry's Story

The Home Care Packages Program Operational Manual (A guide for home care providers) was published in January 2023 and the Home Care Packages Program Inclusions and Exclusions fact sheet was published in April 2023.

If the Acting Assistant Secretary for the Department of Health and Aged Care stated that there wasn't a change in policy, why did the department initially find that installation of raised garden beds was an acceptable expense under the Home Care Package, then alter their support for this later?

This can easily be interpreted as a change to HCP care or services.

The reasonable assumption would be that there wouldn’t be an alteration to that particular story if the case was that there was no change in policy or to the inclusions list.

This suggests that the department may have played a role in causing confusion among the users of the aged care packages and the providers. Did they miscomprehend the rules and got it wrong? It would be a scathing mess on their part!

Even MP Anika Wells tried to squash incorrect claims that there were rule changes. If this is the case then why did Barry’s Story above in regards to a service that was always supported change? The evidence is indicating that there is conflicting information and concerns are within good reason.

Again, at the time of this mess, the Acting Assistant Secretary of the Home Care and Assessments Branch said

“It's damaging to the relationship between the provider and the care recipient, and it also creates a situation where care recipients aren't empowered to know what is and isn't okay.”

Perhaps they should eat their own words?

Where is the acknowledgement and accountability FOR THEIR ACTIONS?

Ultimately integrity of information builds trust and credibilty.

Article by: Concerned Community Member Supporting Transparency and Accountability