Transcript by Senator the Hon Mitch Fifield

Doorstop Interview, Benetas Customer Centre

Location: Benetas Customer Centre, Home Care Provider, Mitcham, Melbourne

E & OE

JOURNALIST: Michael this is obviously an important visit for you. Tell us a little bit about what this means?

MICHAEL SUKKAR (MP for Deakin): Well it’s wonderful to have Minister Fifield here at Benetas in Mitcham. Obviously the reforms to home care packages, making it simpler for consumers to go and choose the services they want rather than being locked into one particular provider or another I think is an outstanding change in the budget. So it’s great to be here today to hear from Benetas who are on the front line dealing with families and often people in difficult circumstances. So thank you Mitch for coming out to Benetas and thank you to the team at Benetas for hosting us here today. It is a very important service they provide to my electorate. And they do an outstanding job in serving the families of our elderly and hopefully this announcement in relation to home care packages will make Benetas’ life easier as well as ultimately the consumer.

JOURNALIST: Okay thank you very much. Minister I’m just going to ask the CEO a quick question here first. Obviously this is a time of enormous change in the industry here. How does an organisation like Benetas respond to that?

SANDRA HILLS (Chief Executive office, Benetas): We’ve been working on the changes, the aged care reform changes, for over three years, once the Government announced them. So our organisation allocated significant resources to actually put together a team and you’ve met some of those people today. We’ve been working on this for three years, we’ve really been focused on trying to provide quality services and we’re almost over the line. We’ve almost got all of our clients over to Consumer Directed Care. So come the 1st of July we’re really excited about that. I’m not saying that it hasn’t been without its challenges, it has been. And we know that come the 1st of July we won’t have got everything right, but we’re really excited about this time in aged care. We know that the Minister has made some announcements about individualised funding. And that announcement was made in the budget last week. We still know we have some work to do and we’re really excited by the opportunities that lie ahead for our service users.

MINISTER FIFIELD: It’s great to be in Deakin with Michael Sukkar, the local member. And thanks to Sandra and the team at Benetas for hosting us here, where we have the opportunity to talk about an important budget announcement. From February 2017 home care packages with attach to the individual, giving the individual the capacity to choose the service provider of their choice.

At the moment the arrangement is that aged care providers have to apply through an annual aged care approval round to have access to home care packages. Aged care providers aren’t necessarily sure why they were successful when they are successful. And when they are not successful, they’re not necessarily sure why that was the case. So the current arrangements aren’t satisfactory from the point of view of providers.

And from the point of view of consumers at the moment, once they’re assessed as being eligible for a home care package they have to, firstly, find a home care provider who has a home care package. And, secondly, they’ve got to find a home care provider who has a package at the level at which they’re assessed. And if someone, for whatever reason, would like to change providers, at the moment they’ve got to resign from their provider. They’ve got to resign from their package and go through the exercise again of trying to find a provider who has a package firstly, and secondly, who has one at the assessed level.

So from February 2017, the power will be in the hands of the consumer. And over four years about $7.4 billion worth of home care package funding will be directed to individual consumers rather than through providers. So the individual will be at the centre and in control.

JOURNALIST: So this is really an important companion to Consumer Directed Care because on the one hand you’re giving consumers the control to determine their own package as of 2017 it’s going to be much easier for them to shop around. Do you think maybe there is some frustration that that’s not easier to do now as of July 1st when everybody is on Consumer Directed Care packages?

MINISTER FIFIELD: I think there will be some frustration. It’s great that from the 1st of July there’ll be much greater transparency and much greater visibility for consumers in relation to home care packages. Really for the first time they’ll get a regular statement about what the various elements of their package are. The amounts that are being spent and the amounts that are unexpended. Also what the administration costs are. And with that visibility there is the opportunity for consumers to negotiate with their providers about the elements of their package. So that visibility is a great thing. But the real power for consumer comes in having the capacity to choose their service provider. CDC if you like, is a halfway house. The changes in February 2017 will complete the task of putting the consumer at the centre and in charge.

JOURNALIST: Now, as you can imagine with any change like this, there are people who are welcoming this change, they like the control, they like the feeling that they have more of a say in how their care is provided. As you will be aware and as I think you discovered this week in Brisbane on the air on Wednesday, there are a number of people who are concerned, particularly people who are on level three and four home care packages, that in the transition to CDC when it all comes out in the wash, they are being offered considerably less care than they receive now. And in fact as I pointed out in one of my reports earlier, there was some guidance from the Department of Social Services to providers that indicated that this may come up and they offered alternatives that people should discuss. Things like perhaps people could renegotiate their package, which I’m told is very rarely successful, or they could top it up with their own funds or consider residential care. Are you concerned that there is still this problem out there for a relatively high number of people that they are transitioning to CDC on level three or four packages and they are finding that they are getting significantly less care when they make that transition?

MINISTER FIFIELD: Well, one of the issues with the former arrangements was when an individual was looking for a provider and they find a provider who had a package, often they would find that the provider didn’t have a package at the level to which they were entitled. So you could have someone who needed a level four package, but the provider only had a level two package. So in some circumstances, the provider would offer that level two package and then top that up from the money from someone else’s package. Now the previous government, when they first started the initial CDC packages, gave providers three years notice to regularise arrangements. Given the average length of time a person is on a package is a bit under two years. That meant there was the opportunity for providers, and there was certainly the intention, that providers would transition over time as people left packages and came onto new packages, to make that adjustment without affecting individuals.

Now, what is becoming increasingly clear is that not all providers have done what they should have done over that period. Benetas is a terrific provider and has been a model in that regard. But not all providers have done what they should have. So that’s disappointing.

And what I will be putting in place is an arrangement so that if there are individuals who have higher needs, who are concerned that there may be a gap in terms of the level of care that we can, firstly, have a process in my Department that can look at whether they are getting the full value and benefit out of their package, and if there is still an issue we can look at whether we issue a higher level package to that provider to take account of that particular circumstance.

JOURNALIST: Alright, can you tell us a little more about how this is going to work? Is this essentially, within the Department, there is going to be an appeal bodies per se, sort of speak, rather that will look at people’s cases on an individual basis and see if perhaps there is some relief that can be provided?

MINISTER FIFIELD: There will be a team of staff who will work through, very closely with individuals, on a case-by-case basis to firstly, check that they are getting the full value of the package that has been allocated to them. Secondly, they will be looking to make sure that providers are doing the right thing. That for instance, there aren’t excessive administration charges. I’ve heard of some examples where there are administration charges of up to 40 per cent, which strikes me as peculiar and not acceptable. So that will be the second thing that is looked at. And the third thing that will be looked at is whether there is the need to issue a higher level package to someone, say, who has been on a level two package that had been topped up from someone else’s package. And that is the important other side of the equation. If someone is being topped up, they are being topped up at the expense of someone else. It means that there is someone else who wasn’t getting the full value of their own package.

So there was a period of notice of three years that the previous government gave that should have provided ample opportunity for providers to make adjustments over time without affecting individuals. But where individual consumers have concerns then we want to work through those with them.

JOURNALIST: We are essentially talking about what they call cross-subsidisation here where some people who, providers have lots of people, some were over serviced, and some of that money was being used to provide people who were underserviced. Do you think one of the unintended consequences of this policy was the impact of that issue was underestimated, the cross subsidisation was more prevalent in the level three and four packages than policy makers might have realised?

MINISTER FIFIELD: Well I think it is a combination of issues. I think that there are some unreasonable administration charges on the part of some providers. I also think that there are some providers who did not take the opportunity and did not adhere to the intention of government policy, policy initiated by the previous government, which was to use the three years to regularise arrangements so as not to impact on individuals.

JOURNALIST: Can you give us, I know you don’t have real details yet, but when will this procedure begin and how is it, the money going to materialise to pay for this, if there is extra cost involved, where is that going to come from?

MINISTER FIFIELD: In aged care, it is essentially a demand driven program, so there is the opportunity, where there is the need, to make adjustments through offering a higher level package in individual cases to do that.

JOURNALIST: Because as you know Aged and Community Services New South Wales and some other bodies have estimated the number of people affected could be anywhere from 15 to 20 per cent of people who are being transition to CDC packages, roughly 20 per cent of 60,000 if my maths is right, that is about 12,000 people, that is a lot of people who might be calling in for a reappraisal of the that they have been offered.

MINISTER FIFIELD: Well, I am not going to put a figure on the number of people because we really need to work through individual circumstances. We need to work out, if it is a case of someone not getting the full value of their package, not having had the opportunity to fully negotiate what is in their best interests. Whether it is a function of higher administration charges or if there is a case where a provider hasn’t taken the opportunity to make the transition over time.

JOURNALIST: Alright, Minister, thank you very much your time.