Changes to HACC from July 2015
Major national policy and funding changes to aged services and disability services were announced in 2012 and are being progressively implemented. In 2015, sole funding responsibility for HACC for people in Victoria aged 65 and over will be assumed by the Commonwealth, which already has responsibility in all other states except WA.
The current HACC program for people aged 65 and older will be merged with some smaller programs and renamed as the Home Support Programme from July 2015. Current local government providers in Victoria will be offered a Commonwealth service contract that maintains existing funding arrangements for three years from July 2015. Subsequently services funded by the Commonwealth might be subject to competitive tender, as is already the case in other states.
Negotiations between the tiers of government on transition arrangements in Victoria are continuing.
Commonwealth Home Support Programme
The Commonwealth released a discussion paper in May 2014: Key directions for the Commonwealth Home Support Programme. This outlines many aspects of the new arrangements to be put in place nationally but lacks specific detail, particularly on arrangements for transition in Victoria. Major changes are being made to the point of entry to the system for people seeking services. This will be through the Commonwealth MyAgedCare website and telephone service for both home-based and residential aged care services. Face to face assessment of client needs, where needed to supplement basic telephone registration and screening, will be undertaken on a regional basis using national tools and processes, with record keeping coordinated through MyAgedCare.
In a major change for Victoria, where councils are both the main assessment body and main service providers, assessment of client needs will be separated from service delivery.
The HACC services for which Councils are currently funded will be reconfigured and consolidated into service groupings. For example domestic assistance, personal care and home maintenance which are currently funded as separate programs will be combined into one service group. Changes are also proposed in client fees to create uniform national fee structures.
Some elements of Commonwealth Home Support services will be subject to competitive tender in other states and territories, except for Western Australia and Victoria from July 2015, as the Commonwealth has been responsible for managing HACC services in those areas since 2013. If competitive tendering is introduced in Victoria in 2018, this would mean Councils would have to tender against private and not-for-profit service providers for government grants to provide the services it is currently contracted to provide.
The Commonwealth is also considering moving to a system after 2018, in which entitlements would be provided to individuals to procure services from a provider of their choice, rather than directly funding organisations to provide services.
Home Care Packages
In addition to the Home Support Programme that replaces HACC, the Commonwealth will continue to fund Home Care Packages, a significantly expanded program that replaces the previous Community Aged Care Packages. Home Care Packages offer health and support services coordinated by a case manager when services available through HACC are no longer sufficient to help aged people continue living in thecommunity. The packages are available only for people who are assessed as eligible for residential care but who can continue to live at home with sufficient support. There are four levels of package available. Home Care Level 1 and 2 packages are available to people who would otherwise require low level residential care, Home Care Level 3 and 4 are available to people with complex needs, who would otherwise require high level care.
The Commonwealth is increasing the number of home care packages available nationally from 60,000 in 2012-13 to 100,000 in 2016-17, with a further increase of 40,000 by 2021-22. At present some people choose to remain on HACC rather than transferring to a package, as the flat fee charged for a package, equivalent to 17 % of a an age pension, is significantly higher than HACC fees. It is anticipated that the increase in availability of packages combined with a proposed increase in client fees for HACC will see a significant number of clients with complex needs shifting from HACC to home care packages or privately funded services.