Frequently Asked Questions

An approved provider of aged care is an organisation that has been approved to provide residential care, home care or flexible care under the Aged Care Act 1997 (the Act). To receive Australian Government aged care subsidies an organisation must be an approved provider.

An approved provider is responsible for the decisions about the delivery of care and financial management of subsidies and care recipient’s fees and payments. The approved provider has responsibilities and obligations to deliver the care in line with the standards that are specified in the Act and the Aged Care Principles.

All home care packages must be provided on a consumer directed care basis. Which means your provider will work with you to identify a home care package of care and services to meet your needs so you can live a more active and independent life.

Find information about different service providers’ charges for the care and services under a home care package from the service finder or by talking to providers.

Your service provider may ask you to pay:

1. a basic daily fee (which everyone can be asked to pay; usually 17.5% of the single person rate of the basic age pension)
2. an income-tested care fee (worked out by the Department of Human Services)
3. additional fees for additional care or services not covered by your home care package

You will need to discuss and agree to any fees with your service provider before you receive services.

The Home Care Packages Program provides older people who want to stay at home with access to a range of ongoing personal services, support services and clinical care that help them with their day-to-day activities.

You may be eligible for a home care package if you are:

• An older person who needs coordinated services to help you to stay in your home
• A younger person with a disability, dementia or other special care needs that are not met through other specialist services.

There are no minimum age requirements or residency restrictions but home care packages are not intended for visitors to Australia or people requiring temporary or short-term care.

To find out if you are eligible for a home care package or any other help at home services, call My Aged Care on 1800 200 422. The My Aged Care contact centre will ask you a series of questions to determine if you need an assessment by an Aged Care Assessment Team (ACAT).

During the assessment the ACAT will determine if you are eligible for a home care package and which package level best meets your care needs. There are four levels:

• Level 1 – basic care needs
• Level 2 – low-level care needs
• Level 3 – intermediate care needs
• Level 4 – high-level care needs.

You will be approved for one level of home care package. You will be prioritised for care based on your assessed need.

Each level of home care packages provides a different subsidy amount. This amount is paid to your selected approved home care provider. The subsidy contributes to the total cost of your services and care delivery. It is expected that you will contribute to the cost of your care where your personal circumstances allow.

Find information about different service providers’ charges for the care and services under a home care package from the service finder or by talking to providers.

Your service provider may ask you to pay:

1. a basic daily fee (which everyone can be asked to pay; usually 17.5% of the single person rate of the basic age pension)
2. an income-tested care fee (worked out by the Department of Human Services)
3. additional fees for additional care or services not covered by your home care package

You will need to discuss and agree to any fees with your service provider before you receive services.

The types of services you can access under a home care package include, but are not limited to:

• Personal services: assistance with personal activities such as bathing, showering, toileting, dressing and undressing, mobility and communication.
• Nutrition, hydration, meal preparation and diet: assistance with preparing meals, including special diets for health, religious, cultural or other reasons; assistance with using eating utensils and assistance with feeding.
• Continence management: assistance in using continence aids and appliances such as disposable pads and absorbent aids, commode chairs, bedpans and urinals, catheter and urinary drainage appliances, and enemas.
• Mobility and dexterity: providing crutches, quadruped walkers, walking frames, walking sticks, mechanical devices for lifting, bed rails, slide sheets, sheepskins, tri-pillows, pressure-relieving mattresses and assistance with the use of these aids.
• Nursing, allied health and other clinical services: speech therapy, podiatry, occupational or physiotherapy services, hearing and vision services. Home care level 1 and 2 packages are not intended to provide comprehensive clinical or health services. Home care level 3 and 4 packages have a greater emphasis on delivering complex care in the home, including more clinical care where needed.
• Transport and personal assistance: assistance with shopping, visiting health practitioners and attending social activities.
• Management of skin integrity: assistance with bandages, dressings and skin emollients.

A home care package may also be used to support the use of:

• Telehealth: video conferencing and digital technology (including remote monitoring) to increase access to timely and appropriate care.
• Assistive technology: aids and equipment (particularly those that assist a person to perform daily living tasks), as well as devices that assist mobility, communication and personal safety.
• Aids and equipment: some aids and equipment that are directly associated with your care needs can be purchased using funds from your package budget. Read more about aids and equipment.

There are care and services that you must not use home care package funds for:

• items that would normally be purchased out of general income
• buying food, except as part of enteral feeding requirements
• payment for permanent accommodation, including assistance with home purchase, mortgage payments or rent
• payment of home care fees
• payment of fees or charges for other types of care funded or jointly funded by the Australian Government
• home modifications or assets that are not related to your care needs
• travel and accommodation for holidays
• cost of entertainment activities, such as club memberships and tickets to sporting events
• gambling activities
• payment for services and items covered by the Medicare Benefits Schedule or the Pharmaceutical Benefits Scheme.

The Australian Government subsidy is paid directly to your chosen provider. The subsidy paid is different for each level of home care package. If you are eligible, you are expected to contribute to the cost of your care where your personal circumstances allow.

The maximum income tested care fee you are expected to pay will be determined by the Department of Human Services.

The Australian Government subsidises home care services. If you are eligible, you are expected to contribute to the cost of your care and services if you can afford to. Costs are different for care at home provided under the Commonwealth Home Support Programme and the Home Care Packages Program.

If you are being assessed for a home care package, you may follow these steps to work out your costs.

1. Estimate costs – If you are assessed as eligible for a home care package you can use the fee estimator to helpIf you are assessed as eligible for a home care package you can use the fee estimator to help calculate your costs.
2. Arrange for an income assessment
   Your income assessment will let you know if you need to pay:
   1. a basic daily fee (17.5% of the single person rate of the basic age pension)
   2. an income-tested care fee (if your income is over a certain amount).

If you are assessed as eligible for a home care package you will:

• Receive a letter of approval from My Aged Care that sets out the level of home care package you are approved to receive.
• Be placed in a national priority queue for home care packages and will be contacted when a suitable package becomes available for you.

If you don’t receive an approval letter explaining your assessment outcome, call My Aged Care and request a copy.

You are likely to wait between the time you are approved for care and the time you are assigned a home care package. The length of time you will need to wait will depend on the date you were approved for home care and your needs and circumstances, based on your assessment.

We currently expect the maximum wait to be more than 12 months for most people because of the demand for home care packages.

Depending on your individual situation you may receive a home care package sooner than this.
If you have been approved for a home care package, you can find out how long your wait is likely to be: log in to your client record using MyGov, OR call the My Aged Care contact centre on 1800 200 422.

Call My Aged Care if you need care while you are waiting to receive a home care package, or your care needs change. You may be eligible for other care and services.

If you need some help at home or are considering moving into an aged care home, you may first need a free assessment by an Aged Care Assessment Team (ACAT, or ACAS in Victoria). A member of an ACAT will talk to you about your current situation and work out if you are eligible to receive government-subsidised aged care services.

You will need an ACAT assessment and approval if you have complex aged care needs and want to:

• Access aged care services through any level of Home Care Package.
• Receive services through transition care.
• Receive respite care in an aged care home (sometimes known as nursing home).
• Move into an aged care home.

A member of your local ACAT, usually a nurse, social worker or other health care professional will make a time to come to your home (or the hospital, if you’re currently in hospital) and talk to you about how well you’re managing in your day-to-day life. You may like to ask a family member, friend or carer to be with you during the assessment for extra support.

The ACAT member may ask your permission to talk to your doctor to discuss your medical history before they meet with you. If you agree, your consent will be recorded by the ACAT member. The following steps briefly outline what you can expect to happen at an ACAT assessment.

The ACAT member will:

• Ask your permission to conduct the assessment.
• Ask you if you wish to apply for approval to receive certain aged care services. They will explain these service options to you and, if you do want to apply, they will ask you to sign an application form.
• Ask you questions about your day-to-day living activities and if you need help with all or some of them. They’ll also talk to you about your general state of health and specific health conditions; this will help them work out how much and what type of help you need.
• Talk to you about whether they think you need more support so you can keep living in your own home, or if they think you might be better supported in an aged care home.
• Give you information about all of the services that may be available in your local area.

After the assessment, the ACAT will write to you to let you know the outcome of your assessment. The letter will specify the services you are approved to receive, as well as the reasons why. You will also receive other information on your assessment.

You should keep a copy of these documents as it will make it easier for service providers to confirm that you are eligible to receive government-subsidised aged care services.

If you are not happy with your assessment outcome, the letter will also explain how to ask for a review of the ACAT decision.

If you cannot sign a Home Care Agreement because of any physical incapacity or mental impairment, another person representing you may enter the agreement on your behalf.

While the service provider must always offer and be prepared to enter into a Home Care Agreement, you can choose not to sign the agreement. If this happens, the service provider still needs to talk with you about how much involvement you would like to have in managing your home care package, as well as helping to design the type of care and services you need.

It is important that the service provider records the reasons for you not having a signed Home Care Agreement and the basis of the care that you are getting.

The service provider should always be able to provide proof that an ‘in-principle’ agreement is in place. This may include a copy of the agreement offered to you, a file note of the discussion with you about the basis of the agreement (including the date the discussion took place) and proof that you are receiving a home care package as described in the agreement.

Once you have signed a Home Care Agreement, your provider must continue to deliver your home care package services for as long as you need them. This is called ‘security of tenure’ and your Home Care Agreement should include detailed information about this.

If you wish to end your Home Care Agreement you must do so in line with the agreement you signed. This usually requires you to tell your provider in writing the day you wish to end the Home Care Agreement.

A home care provider may stop providing services if you do not meet your responsibilities within your control. This includes not paying your income-tested care fee.

Your home care provider will already have some information about your care needs recorded at your Aged Care Assessment Team (ACAT) assessment.

A Care Plan forms part of your Home Care Agreement. Your service provider must work with you to identify your goals and design a care plan to help you reach those goals:

• Your care plan cannot change without your agreement. Your service provider must give you a copy of any agreed changes to the care plan for your records.
• The care plan must be reviewed at least once every 12 months to make sure the care and services you receive through your home care package still meet your needs.
• You can ask for a review of your care plan at any time if your care needs change.

Personal goals are an important part of your care plan. Goals such as maintaining a healthy lifestyle or achieving independence in mobility can guide your choice of care and services.

Identified care needs are the areas of your daily living where you have been assessed as needing extra care and support. Care needs are identified by a member of the Aged Care Assessment Team (ACAT) and during the care planning process.

During the care planning process, your service provider will need to take into account any support you already have in place, such as carers, family members, local community and other services. Your home care package is intended to meet needs that are not already met by these other supports.

As a guide, your care plan may include:

• the exact types of services you will receive
• who will provide which services
• how much involvement you will have in managing and coordinating your services
• where your services are delivered
• when your services are delivered (for example, which day of the week)
• how much the care and services will cost.

You can discuss the possible list of care and services further with your service provider. If you identify a type of service that you feel would best meet your identified care needs, the service provider has to do what they can to assist you to access that care or service. This may include sub-contracting or brokering services from other service providers.

As this may increase the costs charged to your home care package, any additional costs should be made clear to you prior to you agreeing to the service.

You can have another person, such as a carer or family member, with you to help design your care plan. You also have the right to call an advocate that you choose to represent you when talking with a service provider.

An advocate can help you by:

• setting up or explaining the Home Care Agreement, care plan and individual budget
• talking and negotiating with your service provider about the fees to be charged to your home care package fund
• talking about any concerns you may have.

Your service provider must allow your advocate access to the home care service. If you need help, an advocate can be accessed through the National Aged Care Advocacy Programme by calling 1800 700 600.

Find out more about your rights and responsibilities in the Charter of Care Recipients’ Rights and Responsibilities – Home Care.

When a service provider offers you a home care package, they will need to work with you to develop an individual budget to fund your care plan:

• The individual budget sets out the total amount of funds available under your home care package and how those funds will be allocated and spent.
• Your service provider administers the home care package funds on your behalf.
• Your home care package budget is made up of:
  • Australian Government subsidy (and eligible supplements)
  • the basic daily care fee
  • your maximum income tested care fee (if you’ve entered into Home Care after 1 July 2014) which you may need to pay based on your personal circumstances
  • any other amount you’ve agreed to pay for extra care or services, not covered in your package.

All care and services provided to you through a home care package must be within your package budget, unless you make more contributions.
Any unspent funds must be rolled over from month to month and year to year for as long as you remain in the package.

Once you have entered into a Home Care Agreement, have developed your care plan and have received your individual budget your services can begin.

Your home care package starts on the day your Home Care Agreement is signed, not from the day that care is first given to you.

Care and services do not have to start on the same day the Home Care Agreement is entered into, but will be delivered according to the care plan.

The care plan must be reviewed periodically and in response to changes to your personal circumstances to make sure the care and services delivered under your home care package still meet your needs. You can ask for a review of your care plan at any time if your care needs change.

Your care plan cannot be changed without your agreement. Your service provider must give you a copy of any agreed changes to the care plan for your records.

If you need additional services and your home care package is fully allocated you may need to be assessed for a higher level package.

If you require a service that is not covered in your care plan and the service will help you meet your identified goals you can redesign the care plan with your provider or pay for this service privately.

Your provider must discuss with you any changes to the costs charged to your home care package.

You might find that your care needs change. Maybe your care needs have reduced or you have had a set back and your care needs have increased.

If your care needs change you should talk to your provider and ask for a review to your care plan.

Your provider may suggest to you that you need a review of your care plan.

You may need to be reassessed by the Aged Care Assessment Team for a higher (or lower) level home care package or other support services.

It is important to note that your provider must work with you to ensure your care meets your needs.

If you receive a home care package, you may be eligible for additional supplements for some specific care needs. You may need an assessment to find out if you are eligible.

Your provider must lodge an application and manage your supplement on your behalf. Your provider can also check if your supplement has been approved and if payment has started. All your supplements will be included in your individual budget.

Supplements available in home care are:

• dementia and cognition supplement
• veterans’ supplement
• oxygen supplement
• enteral feeding supplement
• viability supplement
• hardship supplement.

Ask your provider about whether you are eligible for a supplement or if your application has been approved.

Some supplements, such as the dementia and cognition supplement, will move with you if you change providers. You do not need to do anything. Other supplements, like the oxygen and enteral feeding supplements, will not move with you if you change providers, and your new provider may need to reapply. Check with your new provider.

From 27 February 2017, you can choose to change home care package providers. You can change providers if you move to another area, if you’re after a better fit or require particular services that your current provider doesn’t offer.

Before you make the decision to change providers you should check your Home Care Agreement so you know if there will be any conditions such as notice periods and exit amounts.

When you research new providers you should compare the provider’s fees with those of your current home care provider for items such as administration of the package and case management.

You can find a new home care package provider by using the service finder or you can call My Aged Care on 1800 200 422 and they will help you find a provider.

Once you have found a new provider you will need to contact My Aged Care on 1800 200 422 to re-activate your referral code. You need this referral code to give to your new provider before you can start receiving their services.

If you choose to move your home care package to another provider, any unspent funds in your home care package budget (after all expenses and fees have been paid) will move with you to your new home care provider.

Your old provider will give you a statement showing you the amount of unspent funds that will be transferred to your new provider:

• If your service provider has included an exit amount in your Home Care Agreement this amount will be deducted from the unspent funds to be transferred to your new provider.
• If you do not have any unspent funds, the old provider cannot charge you the exit amount.
• If your unspent funds amount is less than the agreed exit amount, the old provider can retain the unspent funds amount. The rest of the exit amount cannot be treated as a debt.

You and your Home Care Package provider have rights and responsibilities under the Charter of Care Recipients’ Rights and Responsibilities – Home Care.

Your provider must give you a copy of the Charter and deliver your services in a way that meets the Home Care Common Standards. You can ask your service provider for a copy of the Charter of Care Recipients’ Rights and Responsibilities – Home Care and the Home Care Common Standards. These documents list the Australian Government’s service delivery expectations for approved providers of home care.

If you have concerns about a service, try to talk to your service provider first. It may be something that can be easily resolved.

Your service provider should tell you how to make a complaint through their internal complaints handling process. You have the right to make a complaint without it affecting your care and services.
Sometimes, complaints can’t be resolved by the service provider, or you might not feel comfortable raising your concern with them.

If you’re unhappy with any aspect of the care or services you receive in your own home through a home care package or a Commonwealth Home Support Programme service, there are two ways you can make a complaint:
Speak to your service provider about your concerns.
Make a complaint to the Aged Care Complaints Commissioner.

Ref: https://www.myagedcare.gov.au/quality-and-complaints/how-make-complaint

The Commonwealth Ombudsman’s role is to review the actions and decisions of Australian Government agencies. The Ombudsman’s office handles complaints, conducts investigations, performs audits and inspections and carries out specialist oversight tasks to see if the actions and decisions of agencies are wrong, unjust, unlawful, discriminatory or unfair.

You can contact the Commonwealth Ombudsman through their website.