This week Carrie and Kell discuss how to support the process of good decision making when consumers request something that falls outside the expected scope for a home care package.

Whilst in the majority of cases it will be clear whether a requested service or item is appropriate or meets the guidelines – or not, there will be instances where the request falls into the ‘grey’ areas.

Information on the Home Care Package operations manual, which includes the guidelines of excluded items can be found on the Department of Health website.

Any discussion needs to emphasise that the Home Care Package funds are for the care and support of the individual, they are not discretionary funds that can be used in the same way that a person would spend their pension money.

Although you do not need a formal decision-making tool, having one can support you in arguing for or against an expenditure and maintain a documented account of your process.

Some of the questions you might want to include in a formal decision-making tool are:

  • Is the item or service something that an individual would normally purchase themselves? For example, a standard mattress would be something that is normally purchased out of personal funds, however, if the individual required a special mattress or topper this might be an acceptable use of package funds.
  • Is the consumer the only person who intends using the item or service? For example, an air conditioner in a shared space would be considered differently to one in their personal bedroom.
  • Is the item a one off or are there ongoing expenses related to the purchase? For example, if a water filter was requested the maintenance of this item may result in additional regular charges.
  • Are there adequate funds available to cover the purchase without adversely impacting on the consumer’s current assessed support needs? If not the case manager may need to work with the consumer to identify other ways to fund the purchase.
  • Does the funding of this purchase set a precedent that will impact on the funding of other consumers? For example, on a remote Aboriginal community there is often an openness between consumers due to the social structure. People know what each other has received from the aged care service. If there is a chance that the item or service is borderline, consider other options for the purchase.
  • Does the item or service assist the individual to meet their assessed needs and goals? All purchases should be linked to assessed need and goals.
  • Does it support the person to live safely and independently and will it improve their quality of life? For example, there is no sense in purchasing an item that will adversely impact on the long-term goals and wellbeing of the individual, someone might like a scooter to get around the community but is it necessarily the best thing for them?

Note: It is important to consult with allied health specialists before purchasing any health related items such as wheelchairs, scooters and rails.

Thanks to the case managers from Alpine Health in Victoria, for sharing their draft decision-making tool with us.

This episode is part of a series, that aims to prepare and equip organisations for the reforms around Home Care Packages to be introduced on the 27th February 2017. Here are the links to the other topics in the series:

CD005 Increasing Choice in Home Care Reforms

CD006 Increasing Choices in Home Care – Debunking the Myths

CD007 Bringing your Team Along – HCP Reforms 2017

CD008 Supporting Transient HCP Consumers

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Carrie and Kell

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