Somehow, this simple idea that in theory makes convincing sense has turned into a nightmare and sometimes even a scam in practice.
A home care package includes different levels of care ranging from low to high needs. After being assessed as eligible, the recipient registers with a registered “provider” who is responsible for delivering the services and who, in turn, collects a fee each month. Administration and management fees are entirely separate from what is charged for the actual provision of the necessary service.
From personal experience, the process has become the tyranny of paperwork. Even the initial application process is tedious and intrusive. It requires disclosing highly personal medical information to a stranger, as well as full financial disclosure, which makes many seniors suspicious and anxious. There must be an easier way to separate those who need help from those who have money to support themselves.
From the most complex issue to the simplest request to access your own money in the plan account, requests are met with a deluge of paperwork. Even the most obvious and indisputable request for access to funds is stuck in a maze of regulations.
A simple replacement, for example, of a broken appliance – in my experience the stove in our parents’ nonagenarian home – was met by the request that we provide an occupational therapist’s report and a lengthy written assessment before approval for the purchase and installation of the most basic model of new stove has been granted. When I found out that the wait time and delay to get a report was two to three months and that redundant report (mentioning only the obvious bleeding) would cost almost as much as the stove, I confess to myself somewhat upset.
How can anyone even argue that two nonagenarians need just a working stove to stay in their homes? Needless to say.
Not for a moment is this acceptable, but imagine how much more difficult – if not impossible – it would be for a family less experienced, less confident, less familiar with the world of bureaucracy, trying to navigate so many pitfalls? What about families with limited literacy or language skills? Those who came to this country from a culture where the government is not your friend and officials should be viewed with suspicion and hostility?
What happens to them? Do they just give up?
Cost control is crucial to ensure the sustainability of these “care” programs. No one can argue for a blank check, and there is no appetite for unlimited resources to tap into. There are so many competing demands on taxpayers’ funds that we need to be careful and careful in allocating the money and ensuring it is well spent.
Whether analyzing care for people with disabilities, older people or people with mental illness, the approach should be the same – quality of care is non-negotiable. The challenge is to find the right balance between quality and cost. This model has clearly failed.
Unless the rent seekers and commercial vultures are kicked out, none of the changes essential to restoring client-centered care can be made.
Jon Faine is a regular columnist and former broadcaster for ABC Radio Melbourne.
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