Consumer Directed Care (CDC) in Home Care Packages

Consumer Directed Care (CDC) in home care packages

Part 3: Information for home care package providers

This is part 3of a seriesof fact sheets on the implementation of CDC for home care providers.

CDC: Working with consumers

The introduction of CDC to all home care packages on 1 July 2015 changes the way you provide your aged care services.

CDC is both a philosophy and an orientation to service delivery. It is a way of delivering aged care services that gives consumers greater control over their own lives by allowing them to make choices about the types of care and services they access and how those services are delivered.

CDC enablesyouas a care facilitatorto work in partnership withconsumers to co-produce their individualised budget and care plan.

This means youneedto empower your consumers to make decisionsabout their care, including their needs and goals and determining the amount of control they want to exercise in relation to their package.

It is your responsibility to ensure the consumer understands their rights in relation to their home care agreement and individualised budget. This includes informing the consumer of their right to choose alternative organisations to deliver their services.

What does co-production mean for my organisation?

Fully implementing CDC within your organisation means working in partnership with your consumer. Understanding what the consumer wants and aspires to achieve is the key to developing and delivering services that will work best for them.

You should talk to consumers about what their care and service needs are, and how these can be delivered. The consumer’s choices should not be limited to a list of services or service providers. It is important that consumers are not made to feel pressured to agree to services determined by the provider, noting that flexibility and choice are the foundations of CDC.

It is important to recognise that some consumers may feel more comfortable having an advocate or family member there during discussions with you and this should be offered.

During your discussion with the consumer, you need to discuss the level of involvement the consumer would like to have in managing their package. Some consumers may want you to continue to fully manage their package, while others may want more involvement.

Once you have worked through the care and services the consumer requires, and the agreed level of involvement they would like to have in managing their package, this information will need to be recorded in the consumer’s care plan and individualised budget.

It is important that the care and services identified in the care plan fit within the available budget for the package level. If not, further negotiations will be required between the provider and the consumer to find a solution. Any fee for services charged over and above the package level should be discussed with the consumer and made clear that this is not part of the home care package budget.

Developing their care plan

CDC places the consumer at the very centre of their health and wellbeing. The care planning process must be driven by the consumer.

The care plan should clearly outline:

•the consumer’s goals, needs and preferences – what the consumer would like to achieve through their package;

•the care and services to be provided to support the consumer’s care needs and identified goals;

•who will provide the care and services;

•when care and services will be provided, including the frequency of services and days/times when regular services are expected to be provided;

•the level of involvement and control the consumer will exercise over the management of the package;

•case management arrangements, including how ongoing monitoring and informal reviews will be managed; and

•the frequency of formal reassessments.

Transitioning ‘high cost’ consumers to CDC

Home care providers should reassure their consumers that the Government has not reduced the value of any home care packages. In fact, all home care packages were increased by an extra 2.4% on top of regular indexation on 1 July 2014.

The Government is committed to ensuring that consumers can access services to the full value of their package to achieve their goals.

With the introduction of CDC, a consumer’s Home Care Agreement includes a care plan and an individualised budget, which clearly records all home care package income, including the Government subsidy and supplements and fees and contributions collected from the consumer.

This means that providers are no longer able to redirect funds to ‘top up’ the care of a more complex consumer with funding from another consumer’s package.Although this was not illegal, it was not in the spirit of the Aged Care Act 1997.

For some consumers, this will mean that they will now receive all the funds they are entitled to and will have more funds to get the support they need to achieve their goals.

CDC delivers services with a consumer led focus, allowing consumers to set their goals in a restorative and re-enablement framework. Each consumer has a right to access services to the full value of their package to achieve these goals.

What should home care providers do?

Some providers may find that transitioning ‘high cost’ consumers to CDC will involve some difficult conversations about what they are currently receiving.

There is an opportunity for providers to reorient their services delivery and find more innovative ways of delivering care to high need consumers.CDC provides much greater flexibility around how package funding can be used, and there may be creative options that meet people’s needs at a lower cost than their current services.

One of these options could be to compliment a consumer’s home care package with another programme, such as the Community Visitors Scheme (CVS). CVS is a national programme that provides companionship to socially or culturally isolated people receiving home care or living in Australian Government-subsidised aged care homes.

You may also find that grouping services at differing times of the day may be more cost effective for your organisation and provide more costed options for consumers to consider.

How to access an advocate

During your conversations with your consumers, they may feel they need the support of an advocate.

Your consumers are able to access Government funded advocacy services under the National Aged Care Advocacy Programme.

These services provide free, confidential and independent information to consumers about their rights and responsibilities when accessing aged care services.

If your consumer would like to have an advocate, they can contact the National Aged Care Advocacy Line on freecall 1800 700 600.

You are also able to organise an advocate on your consumer’s behalf.

Assistance for consumers impacted by cross-subsidisation

If you have been cross-subsidising services and now have a consumer that is being impacted by this action, you should, in the first instance:

•have a discussion with your consumer about reconfiguring their care plan to provide continuity of care for them, within the scope of the home care package funding; and

•ensure that the full amount possible, including relevant supplements, is being claimed and applied to the consumer’s home care package budget.

If a consumer still has concerns after these discussions, they can contact the Department of Social Services’ (the Department) CDC Transition Hotline to discuss their situation and seek a review of the way their current home care package is being delivered.

Consumers can contact the CDC Transition Hotline on 1800 138 225 (Monday to Friday, 9am to 5pm) or send an enquiry to .

The Department will work with these consumers and your organisation to understand what actions have already occurred and what further options are available to maintain the consumer’s current level of care.

During the Department’s review of a consumer’s current care and services, it will also review what process the organisation has put in place to transition consumers to CDC.

A consumer requesting a review will not be precluded either initially or during the review process from lodging a formal complaint with the Aged Care Complaints Scheme, if they wish to do so.

Monitoring the implementation of CDC

The Department will continue to monitor the implementation of CDC through established mechanisms that engage directly with providers and consumers, such as the My Aged Care portal, the Aged Care Complaints Scheme and the Australian Aged Care Quality Agency.

If a consumer feels that their home care provider is not meeting all its responsibilities, they are being encouraged to discuss this issue with their provider in the first instance. However, consumers are able to make a complaint if:

•they feel they were not given the opportunity to decide how their package is delivered;

•theyfeel they were pressured into the Home Care Agreement; or

•they feel they were not appropriately informed before entering into a CDC agreement.

If the Department is concerned that a provider is not CDC ready, or may not be meeting the requirements, the Department will work with the provider. This gives the provider the opportunity to explain the situation and, where possible, address the Department’s concerns without the need for further action.

The Department will work with providers to ensure that they meet the requirements for CDC through:

•education and information;

•monitoring compliance;

•engaging with the provider to explore any concerns or queries the Department may have regarding compliance; and

•responding to identified non-compliance through administrative resolution, where necessary.

Home Care Today Resources

The Home Care Today websiteat has some useful resources for implementing CDC in your home care packages.

The website has been developed byCOTA Australia and is planned in partnership with aged care peak bodies Aged & Community Services Australia and Leading Age Services Australia.

Home Care Today Newsletter

One way to keep up to date on the implementation of CDC is to receive the Home Care Today newsletter,which provides a range of CDC resources.

To sign up, visit the Contact Us page on the Home Care Today website at

Further information

More information about the Home Care Packages Programme is available in the Home Care Packages Programme Guidelineson the Department of Social Services website at dss.gov.au/homecarepackages, and theGuide to Aged Care Law at

More information for consumers is available by:

•calling the national contact centre on 1800 200 422; or

•visiting the My Aged Care website at