How long is the queue for home care packages, how fast will it move, who is in it, where are they based and what services do they need are just some of the questions that home care providers hope will be answered soon.
While the Department of Health pre-empted the systems failures on My Aged Care that did eventuate on Monday in its correspondence to providers last week (remember #censusfail?), far bigger problems remain for service providers trying to prepare 2017/18 budgets.
“Last week I could say to someone, ‘we don’t have a vacant package right now but there’s a reasonable chance in the next four to six weeks we’ll have something for you’,” Jeremy McAuliffe, General Manager of Benetas, told Inside Ageing this week.
“Now there’s no way I can give any vague sense of when someone might reach the top of queue.”
“We don’t know how many people are in the queue, whether they are in our local area or where an individual is positioned in the queue,” he said.
“Consumers get hooked into My Aged Care easily, their assessment is done reasonably quickly but then they have no idea when their package will commence because no one can tell them.”
“As a provider, I want to maintain my business. I know that worst-case scenario the queue needs to deliver what I might lose over attrition. Maybe it will deliver more. But nobody knows the machinations. How do you plan your business around that?”
“What we do know is that we have to find a way to work with the prioritisation queue – but we can’t see it.”
In the lead up to the February 27 changes, much of the public discussion about the Increasing Choices reforms focused positively on consumer empowerment.
It was anticipated that consumers who are dissatisfied with their current service provider will give notice and take their package elsewhere – assuming of course that there is an alternate option within a reasonable distance of where they live.
Information disseminated by the industry peaks largely focused on the new processes for transferring clients, managing exit fees and how to onboard new clients – assuming they come.
The true business implications have been somewhat glossed over.
“It will be fascinating to see where we are at in six months time. There are parts of what is happening that no one is going to know what the outcome looks like for a period of time,” said Mr McAuliffe, who has worked in senior management roles within aged care for more than 13 years.
“Today I have 918 packages of a mix of levels one to four. We have a service offer that gives consumer at any level a number of options with a total of 12 possible variations. I might have 300 level four packages today but what is that spread going to look like in a week, a month, three months, a year?”
“I want to do a budget for 17-18 financial year. What on earth is that going to look like?”
“The government has no capacity to know what my package mix will look like. So we need to ask what are the things that could be visible to us that can help us to plan.”
Issues around unspent funds remain problematic for both current providers and those that clients seek to transfer to, with new rules that don’t take into account the ongoing delays and backlogs already in existence.
“For consumers who want to transfer to your services, you have no way of knowing what their surplus is,” Mr McAuliffe said.
Under the changes, providers have 56 days to calculate unspent funds including the breakdown of the commonwealth portion, home care subsidy and supplements, the consumer portion, and transfer portion.
Yet it is understood the Department of Human Services is sitting on a backlog of at least three months worth of payment statements for some providers.
It remains unclear how providers are supposed to accurately calculate the unspent funds, determine whether they can charge an exit fee – which is only possible if the client has surplus funds – and then transfer the balance within 70 days to the new provider.
There is also the possibility that the original provider might choose to retain unspent funds in their own bank account for the full 70 days, Mr McAuliffe points out.
The other business impact that has largely been ignored is the impact on your staffing levels.
“Is this [Increasing Choices reforms] going to change how we manage our workforce? Most definitely,” Mr McAuliffe said.
“I’d love to know that in the next 3-6 months we are going to have more demand and be able to manage staffing accordingly. But I don’t. I should be able to, and if we had visibility of who is in the queue then I could.”
“Most organisations know they have staff working who are also employed either casually or part time by other providers.”
“The challenge for us in this more uber-style world is the need to engage more people on our terms, but in a manner that doesn’t see them leave us.”
While there may be more questions than answers for providers over the coming weeks, one thing is certain: it will be awhile before anyone really knows what the impact of this will be and it’s vital that providers raise any problems they encourage with the industry associations and the Departments.
“To be fair, the Department of Health has been more active over the last three to four months in its engagement with the sector than it has for quite some time. They’re trying to get it right and that’s what’s important,” Mr McAuliffe said.