For many older Australians, ageing independently at home is a priority. But changes in your health, mobility or capabilities could mean you need support to achieve that goal. Fortunately, you have options! In Australia, there are two aged care schemes that support for older Australians living at home: the Commonwealth Home Support Programme (CHSP) and Home Care Packages (HCP).
Both of these programs provide government funding for support services you might need to stay in your home for as long as possible. But there are important differences between the two schemes, and which one is right for you depends on the amount of services you need – and these differences aren’t always easily understood.
The types of services you can receive through CHSP and HCP are very similar. Both fund in-home services that enable you to live independently. The main difference is in the level of care you can receive with each program.
The Commonwealth Home Support Programme is intended for entry-level support for people who have been living independently. If you’re mostly able to care for yourself but you’ve recently noticed changes in your ability to perform daily life activities, then it’s likely you can qualify for CHSP support.
For example, perhaps you are mobile and enjoy walking to the grocery store, but your eyesight has been changing, which means it’s getting harder for you to read labels and prices in order to do your shopping. You are still able to plan and prepare meals but you need support with buying food. CHSP funds could help pay for a shopping assistant to accompany you to the store and help you shop.
(CHSP funding also can provide assistance with care and housing for people who are homeless or at risk of becoming homeless.)
HCPs, meanwhile, are for people who need more complex or extensive care. If you’ve recently been diagnosed with a medical condition that affects your ability to live independently, or if you’ve had a significant change in your mobility or ability to care for yourself, then you might qualify for a Home Care Package. You could also qualify for these funds if you’re already receiving CHSP funding and your needs have become more complex over time.
HCPs cover four different levels of needs, and each level provides a different amount of funding. All of them can include the same types of services – the only difference is the total amount of funding and thus care services you can receive. Some examples of the services you can receive through either CHSP or HCP include:
Generally, with the CHSP, however, you can only receive one or two types of services, and you’ll have to choose from a set menu of services. Because it’s intended for entry-level support, the CHSP is more restrictive in the types of care that each provider can offer. However, you can choose several different providers to offer your care. You can also receive more intensive short-term care for a temporary period, such as after a hospitalisation.
The type of care you can receive with a HCP is more broad and less specific, and each provider can offer a wider range of services. However, your HCP has to be administered by a single provider, so you’ll need to choose one approved provider who will manage all of your care. Your provider will work with you to create an individualised care plan that meets all of your needs. A HCP is intended for long-term care to meet ongoing needs.
The first step of applying for support with either program is the same. Both are managed through My Aged Care, and for either one, you’ll begin by applying for an assessment.
Based on the information you provide about your needs, a determination will be made about which type of assessment you need. If your needs are likely to be met by CHSP-level funding, then you’ll be contacted by an assessor from the Regional Assessment Service (RAS), which performs entry-level assessments for CHSP eligibility. If you need higher-level care, you’ll be contacted by an Aged Care Assessment Team (ACAT), which performs assessments for HCPs. The ACAT will determine which level of package you’re eligible for.
For both types of assessment, an assessor will come to your home to meet with you face-to-face. You’ll talk with them about your health and your need for support and they’ll determine what level of support you qualify for. During a RAS assessment for CHSP services, you’ll find out immediately whether you qualify and you can begin care as quickly as you can schedule services with an approved provider. Your assessor will tell you during your in-person assessment which services you can receive, and you can contact a provider to schedule services right away.
If you receive an ACAT assessment for a HCP, you won’t find out about your eligibility immediately. Instead, the ACAT assessor will meet with a team to evaluate your needs and determine which package level will best meet your needs. You’ll receive a letter telling you what level HCP you qualify for.
However, you probably won’t be able to receive services immediately; most HCPs have a waiting period. You’ll be placed on the national priority list depending on the severity of your needs and the date of your eligibility, and your letter will give you an estimate of how long you’ll wait before receiving your package. If you’re assigned a higher-level package, then you may be approved to use an interim lower-level package or CHSP funds until your assigned package becomes available.
With the CHSP, you qualify for services and the provider receives a government subsidy that helps make those services less expensive for you. However, the subsidy does not cover the entire cost of care; each type of service receives a set subsidy and you pay the rest of the hourly fee for care. The total cost for the service is determined by your provider, so it’s worth looking for the most cost-effective provider.
But although you’ll usually have to pay for CHSP services, you’ll only pay an hourly fee for the services you receive. There are never any daily fees, entrance fees, exit fees or contracts and can increase or reduce your services at any time.
In addition, if you are unable to contribute financially because of your income, you may be able to receive services for free. Each provider sets its own policies regarding financial need and ability to pay, and you are also able to negotiate your fees with providers.
With a HCP, instead of qualifying for specific services, you qualify for funding. Your package level provides you a specific amount of money that you can spend on any services you choose, as long as they’re an approved type of service and are included in your care plan.
The main limitation is that you have to receive all your care services through a single, approved provider who usually manages your HCP and coordinates your care. Different providers charge different administrative costs so, again, choosing a cost-effective provider is important because it means you can receive more hours of care for the same level of funding.
With a HCP, though, it’s possible for you to pay nothing out-of-pocket. But if your income is higher, then you may be required to make an income-tested contribution. In addition, some providers charge daily fees, which could come out of your package funding or out of your own income.
If you’re eligible for CHSP services, you’ll choose a provider for each service you receive. Normally, you’ll only receive one or two types of services but, as mentioned above, you can receive care from different providers. After your eligibility is approved, you can contact local providers directly and schedule the care you need.
If you’re eligible for a HCP, you’ll begin care by choosing a provider (I’ve previously written a step-by-step guide on how to do that using MyAgedCare’s home care search function) and meeting with them to create your care plan. Your care plan will explain exactly what care you need and how often you’ll receive services. Your provider is responsible for managing your HCP funds and for paying the carers who come to your home. You can then begin scheduling care appointments when your HCP funding becomes available.
With both programs, you’ll need to find an approved provider who can offer government-funded care.
Normally, the CHSP and HCP are two separate services, and you will use either one or the other (not both). But if you’ve been approved for a higher-level HCP with a long waiting period, then you may be able to use both a lower-level HCP combined with CHSP subsidies to receive care while you’re waiting for your approved package to become available.
You may also be able to use CHSP services temporarily if you’re receiving care through a HCP and you have additional short-term needs. For example, if you are approved for a Level 2 HCP and you’ve been using all of your budget for ongoing care but an unexpected illness means you temporarily need a higher level of care, you may be able to access CHSP funds to subsidise short-term care. MyAgedCare can advise you on how to do this.
This article originally appeared on The CareSide.