Those of us who work in the aged care sector often use a lot of acronyms.
Sometimes we describe the care and support we provide to clients by referencing a program, such as saying someone is receiving CHSP support or they’re on a Home Care Package, but we often don’t give a lot of thought to what this means to others who are not immersed in the industry.
I thought I’d start addressing this and first take a look at the Commonwealth Home Support Program. Let’s dive into the world of CHSP.
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Before we get into the nitty gritty, let’s take a short history lesson.
The Commonwealth Home Support Program, or CHSP, was introduced in 2015 and replaced the Home and Community Care Program. It also incorporated a couple of other programs, including the National Respite for Carers (or NRCP) program and the Assistance with Care and Housing program (commonly called ACHA). This is why you’ll come across variations in service types and age eligibility requirements.
For the purposes of this article, I’m mainly focussing on what we originally knew as the Home and Community Care, or HACC, program. In fact, you might still find this legacy name used by some service providers because the HACC program started in the mid-1980’s, which means it was around for a very long time and became synonymous with community-based aged care.
With the introduction of CHSP came the requirement – eventually – for people to be registered on My Aged Care and assessed by the Regional Assessment Service (RAS). Up until then, people had been approaching service providers directly if they needed help and they were also being assessed by the service provider.
While this might appear a practical approach in that it gets straight to the provider, it did lead to some inequality of service access and people missing out on some needed services. This was because people didn’t always know who to contact and service providers would usually only assess for services they were funded to provide. So this change did have merit.
Moving on to 2021, CHSP has pretty much stayed the same since it started in 2015, although we are starting to see a few small changes as we get ready for major program reforms planned for July 2023.
Now you know the history, let’s back up and take a look at what the aim of the program is and who it is aimed at.
CHSP was established to support older Australians to remain independent and living at home, as well as helping them to stay active and socially connected to their community by providing them with basic care and supports. The program has been designed to provide entry-level aged care help.
To access general CHSP support, people must be over the age of 65, or over the age of 50 for people from an Aboriginal or Torres Strait Islander background.
What sort of help can be accessed?
Many Australians say they want to remain living at home as they get older. If we want to help people live independently and age in their own home, then we need to recognise that sometimes they are going to need a small amount of assistance to get the essential things done.
Perhaps a person needs some help maintaining their yard or home, maybe they have lost their life partner who used to do these things or they have become frailer as they’ve got older and now they’re no longer able to easily and safely do these things. This is where the support provided through CHSP can help.
Also, people might want to participate in activities that help them to become more independent, like someone who wants to learn to cook meals that meet their dietary requirements or perhaps someone who is looking to regain physical capacity or strength after an adverse event like having a stroke or knee replacement surgery.
Gardening, house cleaning, learning to prepare and cook meals, working with Allied health professionals, attending group activities – these are all support types that people can access through CHSP, along with other well-known service types that you’ve probably heard of, like meals on wheels and transport.
But there are some limiting factors. Not everyone is able to access all the services they might need or want.
Firstly, people need to be eligible for the service. Because CHSP is all about promoting independence, if a person doesn’t need a service they are very unlikely to be offered it.
Secondly, not all providers are funded for all service types. Some providers are funded for one service type only, like meals on wheels or transport, while other organisations may be funded to provide a wider range of service types that include domestic assistance, centre-based activities support to do shopping and banking or get to appointments, day respite, nursing care, etc.
This is where the independent My Aged Care assessment comes into play. Once a person has been assessed as needing a service they can be referred to an organisation that offers that specific service type.
Thirdly, there are limits on services available. With an ageing population and capped funding grants, service providers will often use up popular service types really quickly, so people might need to go on a waitlist.
People also need to understand that CHSP is entry-level care and the expectation is that most people will only be receiving one or two types of services which would most likely add up to around 2-4 hours of care over a fortnight. If they need more help than this the person needs to be assessed for a Home Care Package – we’ll talk about those another time.
When a person is assessed for CHSP help, they will be approved for individual types of help, such as transport or perhaps domestic assistance.
If, as time goes by, they deteriorate further, the person will need to go back to My Aged Care and be re-assessed for any additional service types.
For example, let’s take a hypothetical client called ‘Tony.’ Tony might start out just needing some transport because he can’t get to the shops since giving up his licence. For a number of years, this suits him fine, but then he starts to become frailer and finds that he can no longer push the lawnmower around his yard, so he goes back to My Aged Care and asks for help with yard maintenance. He can only get this additional type of help once he has been re-assessed and approved for it.
People can also get temporary help through the program with short term referrals.
Perhaps our friend Tony has a bad winter. He comes down with pneumonia and is hospitalised for a short time. To help him get back on his feet, it is recommended by the discharge planner at the hospital that he gets Meals on Wheels for the next 6 weeks. She puts in a referral to My Aged Care, Tony gets assessed and approved by My Aged Care as a short term referral and when he goes home, a local meals on wheels provider brings him a meal every day over the next month and a half.
After the 6 weeks are up, Tony is feeling much better and can go back to cooking his own meals. This is the wellness and reablement aspect of CHSP.
It’s important that people understand that CHSP is not free, it is a subsidised service.
The Commonwealth Government contributes a significant amount towards the cost of delivering the services, however, those who can afford to are expected to contribute towards the cost of their care.
Additionally, anything that is considered a ‘consumer item’ needs to be paid for – for example, the ingredient cost of a meal is expected to be paid for by all people receiving that service, regardless of any other exemptions on fees. After all, if a person is getting meals on wheels then their grocery bill is going to be lower as a result.
CHSP funded services will always focus on working with a person rather than doing things for them because the more a person does themselves, the less dependent they are on a service provider and the slower any deterioration in ability will be. Staff delivering care under this program should always keep this in mind and understand they are a partner in helping their clients to remain independent.
As mentioned previously, CHSP will be changing in the near future, but as programs often build and improve on previous ones, I still think it is good to know about the CHSP program going forward. For more detailed information about the Commonwealth Home Support Program, go check out the Department’s CHSP Manual.
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