An insight into the future from Victoria

Jeremy McAuliffeGeneral Manager, Benetas Home Care2O March 2015

Aged & Community Services SA & NT Inc 2015 Community Care Forum

Overview –Hot Topics Regional assessment

services Wellness & reablement Fees policy Conversations with

clients (covering fees and reablement)

About Benetas Anglican Aged Care Services Group was

established in 1948 by volunteers from the Anglican Diocese of Melbourne.

Re-branded under the trading name of ‘Benetas’ in 2003 (which means ‘a good age of life’ in Latin).

Services provided across Melbourne and regional Victoria - home care packages, respite programs, residential aged care facilities, independent living units, retirement village.

We support clients with a continuum of care from housing and home care through to specialist residential care.

1,400 employees and 400 volunteers.

Setting the Scene When driving a car you

encounter various speed limit signs, but these have changed over time and drivers have had to adapt.

Drivers look for signs and adjust accordingly.

Aged care reform is changing the signs on our roadway.

Like a speed sign, if you don’t read it right there are consequences.

Aged Care Reform today Transitioning from traditional

Home Care Package service models to new reform responsive and CDC aligned service models, impacts program procedure, team and job roles, accounting process, and finance systems.

Getting ready for Commonwealth Home Support Program (CHSP), Screening and Assessment tools, Regional Assessment Service, Provider Portals, client matching.

Looking ahead - program integration, individual funding, provider ratings?

Assessment– current situation The Framework for assessment

in the HACC program in Victoria, 2007 – enter anywhere, no wrong door.

All providers conduct a service specific assessment for the HACC services they provide, short term need.

500 HACC providers, wide range of organisations.

Broad based, holistic assessments of client and carer need, Living at Home Assessments, longer term need.

100 HACC assessment services across Victoria, local government and health authorities.

Assessment– current practice No formally prescribed tool,

provider defined – organisational policy, professional judgement.

Focus is on practice - guidelines, resources, training etc. to support good practice.

Assessment has an active ageing approach, opportunities for improved functional capacity and social participation.

Care planning takes a person- centred, goal-oriented approach.

Assessment– future impacts No Regional Assessment Service

(RAS) in Victoria. Transitioning HACC assessment

and ACAS to an “integrated” assessment service at regional level.

Early implementation about to start, will provide some insight to Stage II age care reforms.

Has been heavily resourced by State government.

Wellness/Reablement– Active Service Model

Active Service Model assists people in the HACC target group to live in the community as independently and autonomously as possible.

Independence refers to the capacity of people to self-manage the activities of their daily life, including social and community participation.

Autonomy refers to making decisions about one’s life. Principles - i)people have the potential to improve their

capacity, ii) people’s needs should be viewed in an holistic way, iii) services should be organised around the person and their carer.

Elements of health promotion, and strengthening care relationships, family networks and social support.

Wellness/Reablement– Active Service Model ‘Wellness’ or ‘active ageing’ approach, optimal

physical and mental health. Capacity building, restorative care, improve social

participation. Holistic person-centred approach, active

participation in goal setting and decision making. Timely and flexible services, responding to recipient

and their carer’s needs. Collaborative relationships between providers.

Wellness/Reablement– ASM supports

State government support of ASM implementation has been significant.

HACC funded agencies are required to develop and submit individual ASM implementation plans.

Regional ASM consultants available to support providers to develop and implement ASM responses.

ASM implementation currently under review.

Wellness/Reablement–ASM supports

Research. Evaluation. Case studies http://www.health.vic.gov.au/

hacc/projects/asm_casestudies.htm

Videos http://www.health.vic.gov.au/hacc/projects/asm_gwa.htm

Fees – current situation Victorian HACC Fee Policy in

place since 2006. Policy sets parameters for HACC

fees – principles, charging procedure, recommended fees, grievance etc..

Fee levels aligned to capacity to pay- low, medium and high.

Fees are not prescribed, maximum set at each level.

Client declared income – self assessment.

Provider managed process – information, collection, administration.

Fees - current practice Fees are recommended

maximums so providers effectively set rates, typically lower, not consistent

Policy allows for full cost recovery if other funding is available, typically higher.

Client income level is self declared not formally assessed, provider “discretion” applied.

HACC fees have “informed’ fees for Commonwealth NRCP services, not consistent.

Fees – future impacts Moving from self declaration

to formal assessment of capacity to pay, some consumers may be unwilling to participate.

Moving from zero and low fees to higher prescribed fees, may compromise consumer acceptance of service.

Fee is additional to funding not “in lieu of”

Remains a provider managed process.

Client Conversation- Fees The client fee landscape is

different and so are conversations with clients about money.

Clients, whether old or new lack awareness and understanding of income assessment and co-contribution.

It takes time to explain co-contribution and income assessment, time that is unfunded and may delay or block commencement.

Client Conversation- Expectations

We set client expectations, often from the moment of first contact.

The expectation we set will influence the customer experience sought by the client.

Client expectation can force unsustainable and non-competitive practice.

CDC doesn’t mean that you should create an expectation that you cannot fulfill.

Client Conversation - Choice & Control

Choice has focused on client preference.

Now it is multi-layered – provider, service offer, flexibility.

Customer experience or range and flexibility services.

Duty of care or dignity of risk?

Advice or informed choice?

Client Conversation- Service Agreement

Traditional client agreements focused on compliance.

Client agreements should be more about obligations.

Consider service as a partnership with shared responsibilities.

What the provider will do, what the client will do; and the consequences of not doing.

An agreement brings everything together.

Questions

Thank you for your interest and attention.Contact me: jeremy.mcauliffe@benetas.com.auMore about Benetas: www.benetas.com.au