Aged Care Packages – what’s in the box?

I belong to a Facebook group that aims to help consumers and their families understand and navigate the aged care system.

Because let's face it, simply accessing aged care services can be confusing for many. The group is great: there are a lot of knowledgeable people involved, both those who are consumers or their families who have been through the process and industry professionals like myself. I see some well-considered answers to people's questions, and I'll add my two bob's worth where I can add value.

But one recurring theme I see is the confusion around where a person's funding comes from and what they are entitled to. And it's not only those who have just been assessed and approved, these are people who are already receiving services from a provider.

I thought I'd give a quick overview of the different programs a person might be on to help consumers and aged care staff understand these better.

Having different home care programs creates confusion for those accessing aged care services.

This is often exacerbated when well-meaning friends and family get involved and want to know why a person can't get more assistance through their package.

Now, for many of us in the industry, when we read a post from someone well-meaning like this in the Facebook group, it's clear that the person is not on a package at all but instead is on the Commonwealth Home Support Programme (CHSP), getting entry-level aged care services.

But if you're not in the know, it can be confusing. I see people talking about their ‘My Aged Care Package', or their ‘CHSP package' so let's unpack this for clarity.

The Process

All people wanting to access government-funded aged care support must go through My Aged Care. This is a website and phone service that acts as a funnel to put the person in touch with an assessor relevant to the person's needs. My Aged Care is not an actual program.

As an analogy, think of Centrelink; it acts as the portal to a pension or support payment, but it's not the pension itself.

Once the person is contacted by a My Aged Care phone operator, they will need to answer some questions to validate their identity, and then the operator will review the person's needs based on the call.

If it's a simple request, they may allocate a CHSP-level service. This happens if someone only needs basic services or support like help with housework, lawn mowing or basic home maintenance.

The screening questions will help the operator know whether to refer the person for a basic or comprehensive assessment. Generally, a basic assessment may result in allocating Commonwealth Home Support Programme (CHSP) level services, while a comprehensive assessment may lead to approval for a Home Care Package (HCP).

What is the difference between these programs?

The Commonwealth Home Care Programme is an entry-level program. It provides basic services to help an older person live independently at home. If a person is referred for CHSP, they will receive a code that they can take to any organisation that holds funding for the specific service type they have been approved for.

It's important to note that not all providers have funding for all service types. They may also be at capacity and have a waitlist. CHSP funding is more restrictive, and most people can only receive a couple of hours of service a week, even if they have been approved for and are waiting for an HCP.

The CHSP manual is useful for understanding the different service types available. Common service types are delivered meals, domestic assistance, social support (individual) such as supporting a person in visiting their doctor or shopping, social support (group) to minimise social isolation, personal care, and transport services.

There is a video on the CHSP program and different service types on our YouTube channel, so check that out if you want to understand more.

Home Care Packages are a different beast. They belong to the consumer, not the provider, although the person must choose a provider to oversee the package even if you choose to ‘self-manage'. This is because of the reporting and legislative requirements that must be met to support the safety, well-being and hopefully positive outcomes.

A home care package has more flexibility than CHSP funding; however, it is not an extension of a person's pension. It is a package of care and services aimed at supporting independence, well-being and health.

You can refer to the HCP manual to understand what the HCP can cover. There is a separate manual for providers and one for consumers. As a general rule, though, anything that a person would normally pay for out of their pension is not funded through a package. This is why food, general bedding, furniture and holidays or movie tickets are excluded items. Even where specialised furniture is required, it needs to be assessed by an Occupational Therapist (OT) or Physio to ensure the correct item is purchased and doesn't harm or lead to deterioration of the person.

I have seen incorrect items purchased by well-meaning providers that have led to harm or have been the incorrect size for the person, placing them at risk. Even the simple lift armchairs that people often request can contribute to the person's deterioration due to loss of leg strength. Everything needs to be considered against the health and well-being goals of the individual.

There is a full HCP video that you can watch on our YouTube channel.

Several other ‘packages' are out there and managed by designated providers.

One of these is the Transition Care Program. This program is aimed at helping seniors who have experienced a health setback and ended up in hospital. This could be a stroke, a hip fracture or some major surgery. It is generally a 12-week program that includes support from an allied health team and is aimed at preventing a ‘bounce back' to the hospital by providing intensive support and services as well as any necessary aids and equipment to improve the person's safety as they recover. State and Territory Governments manage TCP through contracted service providers.

The TCP can be delivered in the person's home or a residential setting if their home is unsuitable. My mother was able to access this program after a fall resulted in a hip fracture. Once she was discharged, she went to a residential rehabilitation care centre for a week or two and then came to stay with us for the remainder of her time. The allied health team visited regularly to monitor her recovery and take her through exercises designed to speed her recovery.

Another similar program is the Short-Term Restorative Care Program (STRC). This helps people who may have experienced a minor health setback or lost capacity. Sometimes, it's something like a life partner dying or family support that is no longer available, and the person needs to learn some new life skills. This program, like the TCP, has very specific eligibility criteria. People are not eligible if they are on a Home Care Package, but if they receive CHSP services, they may be able to access STRC as a form of extra support, so long as services are different and complement each other.

More information on these two programs is available on the My Aged Care website. There are manuals for consumers and their families and more detailed provider manuals.

I'd also encourage providers and their staff to take the time to help consumers and their families understand the different programs and leave written information packs on the relevant program for the person and their support network. Many of the complaints in the Facebook group I belong to relate to the lack of communication from their provider. Make it a priority to follow up and check on every consumer who receives support from your organisation. Consumers will be happier, and you'll receive fewer complaints!