Evaluation of the Home Care Packages Programme and Consumer Directed Care

On 1 August 2013, Home Care Packages replaced the former Community Aged Care Packages (CACPs), Extended Aged Care at Home (EACH) Packages and Extended Aged Care at Home Dementia (EACHD) Packages as part of the Aged Care Reforms. This has been a significant change to the way home care is delivered in Australia.

With the introduction of the Home Care Packages Programme, the first tranche of Home Care places required to be delivered on a Consumer Directed Care (CDC) basis were allocated through the 2012-13 Aged Care Approvals Round (ACAR).

On 1 July 2015, approximately 59,000 existing Home Care Places will convert to a CDC model of care. To ensure providers are able to transition, the Government is working with the sector to identify the support they need and the new practices they need to implement to achieve this.

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.

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.

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, including 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.

Timeframes

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:

Tier 1

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.  The data collection for this was finalised in December 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).

All home care providers were invited to participate in the voluntary online survey in late 2014, which closed on Friday 9 January 2015. Thank you to those who participated.

The results of the survey will be used to shape the next stage of the Home Care Packages Programme. All data from the survey will be presented in a de-identified format to the Department at the end of the Evaluation.

The Australian Government Statistical Clearing House Approval Number for this survey is 02408-01.

Tier 2

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 Aged Care Planning regions were selected by the Department in September 2014.  Interviews were conducted in November 2014 completed in January 2015.

Tier 3

Targeted supplementary stakeholder consultations

The final tier involves conducting interviews with a targeted sample of other key stakeholders.  This will occur in January 2015.

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