Evaluation of the Home Care Packages Programme and Consumer Directed Care
The Home Care Packages Programme commenced on 1 August 2013 as part of the aged care reforms. The first tranche of 5,835 Home Care places were allocated through the 2012-13 Aged Care Approvals Round (ACAR). Further Home Care places will be released through future ACARs.
New Home Care places, which included all of the places allocated to providers in the
2012-13 ACAR, along with those allocated in subsequent ACARs, must be offered to care recipients on a Consumer Directed Care (CDC) basis.
CDC allows older people and their carers to make choices about the types of care services they receive and the delivery of those services, including who will deliver the services and when. CDC models of care were trialled through a pilot program conducted between 2010 and 2012.
The former Community Aged Care Packages (CACPs), Extended Aged Care at Home (EACH) Packages and Extended Aged Care at Home Dementia (EACHD) Packages were transitioned into the new Programme, however these are not required to be delivered on a CDC basis.
The new Home Care Packages Programme, including CDC will be evaluated prior to the requirement for all Home Care places to be delivered on a CDC basis from 1 July 2015.
In April 2014, KPMG was engaged by the Department of Social Services (the Department) to conduct an evaluation of the implementation of the Home Care Packages Programme, including the introduction of the CDC model of aged care service delivery.
The evaluation will identify any operational issues that may be considered by the Department to support the successful conversion of all Home Care places to the CDC arrangements before 1 July 2015, and may identify areas requiring future policy consideration.
In addition, KPMG will perform initial research into the applicability of CDC principles in residential aged care as a separate component of the evaluation project.
Objectives of the evaluation
The primary objective of the evaluation is to review and assess the implementation of the Home Care Packages Programme arrangements including CDC. This includes consideration of:
- consumer experience and outcomes, including people from special needs groups and people with dementia;
- the ability of the Programme and particularly the new CDC arrangements to meet consumers’ needs;
- experience of/impact on carers and family members;
- an outline of the different CDC models being used, including models used in rural, remote and regional areas;
- provider operations;
- assessment processes, including the impact on Aged Care Assessment Teams (ACATs);
- the interface between the Programme and other elements of the aged care system, such as the Commonwealth Home and Community Care (HACC) programme and residential aged care;
- the effectiveness of the new arrangements in delivering a graduated continuum of care, inc0luding re-ablement and wellness for consumers;
- the effectiveness of the new arrangements in delivering choice and flexibility for consumers;
- the range of supports used by older people;
- whether CDC has supported increased access to digital technology by consumers and providers;
- any recommended operational improvements (such as lessons learned) that will enable adjustments to the Programme ahead of the full implementation of CDC in all places from 1 July 2015; and
- advice on any areas that may require further policy consideration.
The secondary objective is to review existing approaches and identify potential approaches to incorporating CDC principles into the delivery of residential aged care services in Australia.
The research into the applicability of CDC principles in residential aged care will be conducted from April 2014 to June 2014. A report on this component of the project is expected to be received by the Department in June 2014.
The evaluation of Home Care will be conducted from April 2014 to April 2015. A final report is expected to be received by the Department in April 2015.
Data collection and stakeholder participation for Home Care
A three-tiered process has been developed for data collection in Home Care, which involves various stakeholder participation, this includes:
Template report by all Home Care providers delivering CDC
Covering a 12-month period (where available) this will collect details of care and services delivered for CDC based Home Care places, care fees charged, use of top up arrangements, use of contingency and unspent funds, use of brokered services, and use of digital technology. The template will be an Excel sheet and will be accompanied by written instructions and a telephone helpline for providers managed by KPMG. There will be only one collection, which is planned to occur in September 2014.
Online survey for all Home Care providers
The survey will explore provider experiences, views and insights with the Programme implementation, including transition to the new care levels and supplements, ACAT assessments, interface with other aged care services, and implementation of CDC (for those providers delivering CDC places). This is planned to occur between August to
Sample regions analysis
This involves a more in-depth review in a representative sample of Aged Care Planning Regions. The sample regions will be selected to ensure a mix of characteristics of interest. Characteristics of interest include a mix of different types of providers, different types of regions and jurisdictions, and different mixes of consumers (including special needs groups and those with dementia).
There are five methods in this data collection tier:
- Review of documentation from selected providers;
- Interviews with selected providers;
- Interviews with ACATs;
- Interviews with consumers and carers/families; and
- Review of de-identified Departmental correspondence.
The sample regional analysis will occur between August and November 2014, with the interviews being conducted in September to October 2014.
Targeted supplementary stakeholder consultations
The final tier involves conducting interviews with a targeted sample of other key stakeholders. This will occur in November 2014.
KPMG will work with the Department to identify participants.
Applicability of CDC in residential aged care
There are two components for this aspect of the project:
- Conduct a literature review, and
- Conduct consultations with selected stakeholders.
KPMG will develop and conduct a literature review of CDC in residential care and up to 15 stakeholders will be interviewed. The consultation will include semi-structured interview questions informed by the literature review findings. The consultations will occur in
The results of the literature review and the consultations will be synthesised into a report, which will assess the applicability of CDC principles to residential aged care and consider possible options for trialling CDC in residential aged care settings.
KPMG will work with the Department to identify the participants.
Consultation with the sector is important to the Department and it continues to work with the expert advisory group, the National Aged Care Alliance Home Care Packages Working Group and interested parties to ensure the Programme meets the needs of consumers.
If you want to participate, provide feedback or have a question about the evaluation or the Home Care Packages Programme please email the Department via firstname.lastname@example.org.