Aged care reforms make i-home care too expensive for council

In a report to council's monthly meeting on Tuesday, shire community wellbeing director Wendy Gladman recommended council no longer be a service provider of Home Support Program (HSP) services; Home and Community Care Program for Younger People services (HACCPYP); and Veterans Home Care services.

At the moment, council receives funding from the Commonwealth for HSP (for over 65s) and from the state government for HACCPYP (those under the age of 65).

Reforms to the aged care service system will see Loddon Shire's funding agreement with the Commonwealth government to provide these services end on June 30, 2023.

The new service system will see the combining of a number of programs into the one In-Home Aged Care program, reforming all aspects of the delivery of in-home aged care.

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In her report to council, Ms Gladman indicated that on the information released so far regarding the changes, it would be too expensive for council to remain a service provider.

"Council would not be able to effectively operate under the new In-Home Aged Care program without significant investment in and changes to its operating model and reduction in operating costs," she said, criticising the cost shifting on to local government

"This report proposes that council does not enter a new service delivery contract with the Commonwealth government and transitions out of the service delivery function at the end of the current contract period on June 30, 2023."

She said any redundancies for shire staff as a result of the decision could be met within the existing council budget.

Ms Gladman said existing block funding arrangements were being replaced with a competitive marketing model.

This involves a "fee for service payments in arrears and full cost reflective pricing", or in other words, client contributions meeting the gap between government funding and the cost of the service.

"As a result, there is uncertainty of future funding levels for council, and as other providers enter the service system council's market share will likely reduce," Ms Gladman said.

"The introduction of competition and consumer directed care will likely increase the cost of future service delivery and reduce council's service user market share."

Ms Gladman said at the moment, council's delivery of the in-home care programs provides support for under four per cent of the shire's population per year.

"With 54 per cent of council's population aged over 50, council has the opportunity to consider a broader contribution to improving outcomes for older residents through positive ageing activities available to all older people in the municipality," she said.

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Ms Gladman said the Royal Commission into Aged Care Quality and Safety recommended service providers deliver a co-ordinated and integrated range of care and support across areas not currently covered by council.

This includes care management, clinical oversight, enabling and therapeutic care, nursing care, allied health, palliative and end of life care.

"Council is not well positioned to move into a clinical model of care, or to implement a broader staffing profile that includes nursing and other allied health disciplines," Ms Gladman said.

She said when the fully commercialised model is implemented on July 1, 2024, "there will be a degree of turbulence in the industry due to the introduction of many changes in the service system".

"It is recommended that council no longer be a service provider from June 30, 2023 to mitigate this risk," Ms Gladman said.

She said council could provide a transitional support role providing resources over a two-year period to help clients navigate the new aged care service system.

Council will discuss the report and vote on the recommendations at its meeting on Tuesday.

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