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Elderly retirees may come to a point where they need support to live at home. They can sometimes rely on friends, family and volunteer services to help. Getting assistance from your nearest and dearest is definitely the cheapest option but can’t always be relied on, especially over the long term. So, what are the alternatives?
Home care packages – what are they?
A home care package is a co-ordinated package of services delivered using a budget allocated to an individual, which is tailored to meet a person’s more complex care needs. Services may include help with personal care such as showering or support services for cleaning, and even equipment where necessary – for example walkers for mobility.
Four package levels
The packages are offered at four different levels to help meet the different levels of care needs which are determined by the outcome of an aged care assessment (ACAT).
The packages are provided by a range of not for profit and commercial organisations using money allocated to an individual by the government.
The chosen provider hosts the package and for a fee (which comes out of the package) will manage it for you – working with you to select the services and carers based on what you need to stay in your own home.
A monthly budget, which is prepared by the provider allows you to see how much funding is available and where it’s being spent. This can help to determine how to tailor the services to meet your own needs.
The annual budgets for packages are:
- Level 1 package, considered to be for basic needs: $12,118 per year
- Level 2: $18,892 per year
- Level 3: $36,923 per year
- Level 4: $54,133 per year
As well as paying for the selected services, the budget has to cover the administration and case management fees, which could be as high as 40%.
Depending on the case management and admin fees and the hourly rate charged by the provider, the number of hours generally works out at about:
- 2 hours per week for a level 1 package,
- 2-4 hours per week for a level 2 package
- 7-10 hours per week for a level 3 package
- 10-14 hours per week for a level 4 package
Not surprisingly, the higher-level packages are the ones in highest demand and generally offer the best value for money. However, there are some other factors to consider when applying for a home care package.
Package delivery isn’t entirely free
A person may be asked to pay a basic daily fee which, from 1 July, ranges from $9.44 for a level one package to $10.54 for a level 4 package.
Income tested fees may also apply where annual income exceeds $27,284 for a single person and $21,158 a year for a member of a couple, with caps of $5,506 or $11,013 applying depending on an individual’s income.
Some providers will waive the basic daily fee if Centrelink determines there’s an income tested fee.
Funding can take time
High demand for a government subsidised home care package means it’s now common for anyone with approval for one to wait at least 12 months before receiving any funding.
According to the latest Home Care Packages Report there are 93,331 older Australians using home packages, with about 75,739 people waiting for one at their approved level.
This raises the question of what to do about getting help in the interim. And, even if you do get a package, what if it isn’t sufficient to deliver the level of care you need to remain in your own home?
Finding other help
You may be offered a package at a lower level than you are approved for, or most people are offered support through another government subsidised scheme, the Commonwealth Home Support Program (CHSP).
Here services are delivered at a highly subsidised rate on an ad hoc basis by a range of providers. While it can be cheaper to use this option, it doesn’t always have the security of a home care package and generally covers basic services such as cleaning.
For many people the year long wait for a package or finding sufficient help, means using their own income and assets to pay privately for the care they need, which can be very expensive. Estimates from one nursing agency show full time care at home can cost about $250,000 a year, although the overall figure may vary depending on whether the care workers are enrolled nurses or care support and whether they’re required 24/7.
Private care rates vary
Rates for private care through a reputable provider vary from between $50 and $80 per hour. Care that requires a registered nurse is more expensive. A growing alternative is to recruit carers directly, such as through online platforms like mable.com.au.
Those needing care can choose and self-schedule workers based on their needs and preferences, including the timing of home visits. You may also be able to negotiate the rate of pay, which generally starts well below those charged by an approved provider or agency.
While employing someone directly may work out cheaper than going to a provider, it can also be more work for the family particularly where rosters or replacing a worker who calls in sick come into play.
If help is needed and you can afford it, then the surest way of remaining in your own home is to pay privately for the services you need until the package is allocated.
It will be a bit like a bonus when the package eventually does come through and you get more hours that you don’t have to pay for.
Bina Brown is a journalist and director of aged care solutions company Third Age Matters.