Changing Home Care Providers
The Australian Government is improving the way home care services are delivered to older Australians. These changes are important for a sustainable and quality aged care system that is more consumer driven, market based and less regulated.
When a client is assigned a home care package they are able to choose a provider that best meets their needs and goals. This gives clients more choice over their provider and the care and services they receive. Once in care, a client can change providers whether they are looking for a better fit to meet their needs or if they move to another area to live. If a client decides to make a change, their unspent home care package funds (less any exit amount) will move with them to their new provider.
When a client transfers to a new provider they must notify their existing provider that they no longer wish to receive care and agree on the date that services from the existing provider will cease. The new provider will receive a system message in the My Aged Care provider portal that confirms the client’s name and the date the referral was accepted.
Agreeing on a cessation day
If a client tells you that they wish to change providers, you should have a discussion about the client’s needs and mutually agree on a cessation day for the home care services you provide. You will need to continue providing care up until the cessation day.
The cessation day should be agreed with the client with consideration of the:
- Client’s situation and circumstances
- Terms of the Home Care Agreement
- Legislative requirements of home care
Claiming for home care subsidy
Reaching an agreed cessation day with the client is important to:
- Know the period you can claim home care subsidy for; and
- Allow you to reconcile the client’s home care package funds accurately and calculate any unspent funds.
The start date for the new provider must be on or after the cessation day for the existing provider. When a client is changing providers and there is no gap in care, the start day for the new provider should be the same date as the cessation day for the existing provider. This ensures there is no gap in payment of home care subsidy for the client.
When a client changes home care providers the existing provider is not paid a home care subsidy for the cessation day, while the new provider is paid home care subsidy for the start day. An example of how subsidies are paid to the existing provider and new provider when there is no gap in services to the client is outlined in the table below.
Example: Suzie is moving from Provider A to Provider B with no gap in services. The claiming and notification arrangements for both providers are outlined in the table below.
|25 June||26 June||27 June||28 June||29 June||30 June|
|Existing provider||Subsidy paid||Subsidy paid||Last day of services
|Subsidy paid||Subsidy paid|
Before providing home care services, the new service provider should confirm the cessation day with both the client and the existing provider to ensure there are no overlapping claims for home care subsidy.
Where two or more approved providers claim subsidy for the same client on the same day, payment will be made to the provider that first entered into a Home Care Agreement with the client. When the start day and the cessation day are the same date, this does not represent an overlapping claim as home care subsidy is not paid for the cessation day.
Notifying the cessation day and start date
The existing home care provider must advise the Commonwealth within 28 calendar days of a client starting home care. This occurs through submission of an Aged Care Entry Record or through the Aged Care online claiming system.
From the client’s cessation day the client has 56 calendar days to enter into a new Home Care Agreement with their new provider before their package is withdrawn. Accepting the client’s referral in My Aged Care and submitting the Aged Care Entry Record before 28 calendar days can help ensure that your client’s package is not withdrawn in error.
The existing provider is required to notify the Commonwealth within 31 calendar days of a client ceasing care. Providers must submit the client’s name and their cessation day through the aged care payment system (either the home care claim form or the Aged Care Online Services system).
Obligations for the existing service provider
1. Provide cessation information to DHS
Once a cessation day is agreed with the client, the existing provider must notify DHS within 31 calendar days of the client ceasing. It is important to remember that home care subsidy is not paid for the client's cessation day.
2. Notify the client of their unspent home care amounts and arrange payment
Calculate and notify the client of their unspent home care amount. Arrange payment of the transfer portion to the new provider. For information about unspent home care amounts, refer to the Unspent Home Care Amounts Fact Sheet.
3. Retain records
The existing provider must retain:
- Written notice of the client’s unspent home care amount
- Records relating to the payment of a client’s unspent home care amount to the new provider.
Obligations for the new service provider
1. Accept client referral in My Aged Care
Accepting the client referral in My Aged Care is an important step in committing the client to their home care package. Providers must accept the client’s referral in the provider portal before submitting entry information to the Department of Human Services.
2. Develop a Home Care Agreement with the client
The new provider should work in partnership with their new client to develop a Home Care Agreement, care plan and individualised budget based on the client’s needs. The Home Care Agreement sets out:
- What the package will provide
- How the package will be provided
- How much it will cost
3. Provide client entry information to DHS
The new service provider should confirm the cessation day with both the client and the existing provider and agree on a start day. The start date for the new provider must be on or after the agreed cessation day.
The new service provider must notify DHS within 28 calendar days of the client starting care, by submitting an Aged Care Entry Record (ACER).
Client rights, responsibilities and actions
Under the Charter of Care Recipients’ Rights and Responsibilities - Home Care clients have:
- The right to choose their provider and to change providers if they wish.
- A responsibility to tell providers and their staff of the day they intend to cease receiving home care services, before they change providers.
Client’s wishing to change providers need to:
- Notify their existing provider that they no longer wish to receive care.
- Agree on the date that services from the existing provider will cease.
- Identify and find a new provider to avoid any gaps in care.
- Reactivate their home care services referral code by contacting My Aged Care on 1800 200 422 or through the My Aged Care client portal.
- Notify their existing provider of the details of their new provider within 56 calendar days, so that the unspent home care amount (if any) can be transferred.
- Provide their consent to allow information to be transferred from the existing provider to the new provider.
Key points to remember
- It is a joint responsibility of the existing provider and client to agree upon a cessation day for home care services.
- The start day for the new provider must be on or after the cessation day with the existing provider.
- Home care subsidy is not paid for the client’s cessation day.
- When transferring between providers, a client will be required to enter into a Home Care Agreement with a new provider within 56 calendar days (or 84 calendar days with an extension) of ceasing care with their existing previous provider.
- The new service provider must notify DHS within 28 calendar days of the client starting care through the Aged Care Entry Record.
- Providers are required to keep copies of notices relating to unspent home care amounts and records relating to the payment of unspent home care amounts.
- When a client changes providers the existing provider is required to reconcile the unspent home care amount and issue a notice to the client (or their representative) within 56 calendar days after the cessation day.
- If the existing provider is notified within 56 calendar days of the client’s new provider, the existing provider is required to transfer the unspent home care amount and issue a copy of the written notice to the new provider within 70 calendar days of the cessation day.
- The existing service provider has 31 calendar days from the cessation day to notify DHS, through the aged care payments system, of the client’s name and cessation day.
Join our email list to receive regular e-newsletters and announcements to the aged care sector.
This fact sheet provides general guidance to support the Home Care Packages Program. It does not constitute legal advice, nor is it a substitute for responsibilities under the legislative framework.