National Prioritisation System
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.
On 27 February 2017 a consistent national process for prioritising access to home care commenced. The national prioritisation system allows for the fairer allocation of packages to clients, based on their individual needs and circumstances, regardless of where they live. The national prioritisation system is necessary to address significant variations in waiting periods across Australia. While the total number of packages will continue to increase each year, overall the number of packages at each level will continue to be capped.
The national prioritisation process is made up of the:
- National package queue, which determines the order in which eligible consumers are assigned a home care package; and
- Package release process, which determines the number and type of packages that can be assigned to clients on the queue at a point in time.
Home care approval
Eligibility for home care services is determined by an Aged Care Assessment Team (ACAT) through a comprehensive assessment using the National Screening and Assessment Form. If approved, the client will receive a letter informing them of the assessment decision. This letter informs the client of the outcome of their assessment and is not assigning them a home care package. A client is not eligible to receive subsidised aged care services until they have been assigned a package.
How are consumers prioritised?
Clients approved for a home care package following their comprehensive assessment and who have indicated they are actively seeking care are placed onto the national queue. The national queue takes into account two factors:
- The client’s priority for home care services as determined by the ACAT during their comprehensive assessment; and
- The date they were approved for home care at a specific package level.
The package release process
The Department releases home care packages regularly to clients who have reached the top of the national queue. The number of packages released at each level takes into account the number of new packages that are available, as well as the number of packages that other clients have left or not accepted in previous weeks.
Projected wait times for a home care package are expected to be available in the client portal in late 2017. However, a client’s position in the queue will not be available due to the queue’s dynamic nature.
A client will receive a letter from My Aged Care when they are assigned a home care package. The letter includes their referral code and the timeframe to enter into a Home Care Agreement to prevent their package being withdrawn.
Timeframe for entering into a Home Care Agreement
Clients have 56 calendar days from the date their package was assigned to enter into a Home Care Agreement with an approved provider that best meets their needs. If the client needs more time to find a suitable provider, they can contact the My Aged Care Contact Centre and request a 28 day extension, giving them a total of 84 calendar days to enter into a Home Care Agreement.
If a client has not entered into a Home Care Agreement within 35 calendar days of the package being assigned, they will receive a reminder letter from My Aged Care outlining:
- The date they need to enter into a Home Care Agreement by;
- Their referral code;
- How to seek an extension if more time is required; and
- The need to seek a formal income assessment from DHS.
If the client has not entered into a Home Care Agreement within 56 calendar days (or 84 with the extension) the package will be withdrawn. This means the home care package will no longer be assigned to them. The client will receive a letter to inform them that their package has been withdrawn and what action to take, if any. Once a package is withdrawn approved providers are not able to claim subsidy.
If a client’s package is withdrawn and the client later decides they want to receive home care services the client will need to re-join the national queue by calling My Aged Care. Clients who re-join the queue are not disadvantaged, as their time waited is counted to the date they were originally approved for home care at a specific package level.
Interim package assignment
Clients have the option to indicate if they are willing to accept a package at a lower level than their approved level, as an interim arrangement while waiting for their approved package level. If a client is willing to receive an interim level package it does not mean they will wait longer to receive a package at their approved level and has no impact on their wait time for their approved level package. An interim level package simply allows the client to access care and services while they remain on the queue for their approved package level. Clients can call My Aged Care at any time to indicate that they are willing to accept a package at a lower level as an interim arrangement, if they have not already made their preference known.
Once a package becomes available at a higher package level, the package will be assigned to the client and accepted automatically. The client’s provider will receive a notification in the provider portal advising them of the client’s new package level. The client will also receive a letter advising them of the change.
This automatic upgrade process has been streamlined to minimise administrative processes and ensure clients receive additional home care services in a timely and efficient way. Once a higher level package has been assigned it is unable to be ‘downgraded’ as care recipients are independently assessed and approved for a specific home care package level based on their needs. Clients who decide they are happy with an interim lower level package must opt-out of the national prioritisation system by calling the My Aged Care contact centre. However, they must do this before they are assigned a higher package level, as after it is assigned it cannot be declined in favour of the interim package.
It is up to the provider and client to work out how they would like to manage their new package. This can be done through a discussion and update to the client’s care plan and any adjustments that may be required to the clients care plan and/or Home Care Agreement to deliver care and services accordingly.
Key Points to Remember
- The national prioritisation process allows for the fairer allocation of packages to clients, regardless of where they live.
- Clients approved for home care and actively seeking services are placed into the national queue to be assigned a home care package.
- A client’s position in the national queue is determined by their priority for home care services and the time they have waited for care.
- Projected wait times are expected to be available in late 2017. A client’s position in the queue will not be available due to the queue’s dynamic nature.
- Clients have 56 calendar days from the date their package was assigned to enter into a Home Care Agreement with an approved provider. Clients can request an additional 28 day extension by calling My Aged Care.
- If a client has not entered into a Home Care Agreement within 56 calendar days (or 84 with the extension) the package will be withdrawn. If a client’s package is withdrawn, the client can re-join the national queue by calling My Aged Care.
- If a client did not initially opt for a lower level package while waiting for their approved package level, they can contact My Aged Care at any time to indicate that they willing to accept a lower level package as an interim arrangement.
- If a client is receiving an interim package and a higher level package becomes available it will be assigned and accepted automatically. Once a higher level package has been assigned, it cannot be declined in favour of the interim package.
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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.