CDC Home Care Changing Home Care Providers

October 20, 2016

From 27 February 2017, home care package funds will follow the consumer. Clients will be able to choose a provider who best meets their goals and needs, and to change their provider if they wish, for example if they move to another area to live. If a client decides to make a change, their unspent home care package funds (less any exit amount) will move with them to their new provider. These changes give consumers more choice over their provider and the care and services they receive.

What happens when a client changes provider?

Finding out the client wishes to change providers

Once a client tells you that they wish to change to another service provider, you should have a discussion about the client’s needs and mutually agree on a cessation day for home care services. You will need to continue providing care up until the cessation day.

Consumers have a responsibility (under the Charter of Care Recipients’ Rights and Responsibilities - Home Care) to tell providers and their staff of the day they intend to cease receiving home care services, before they change providers.

The My Aged Care system will also alert you when a client is seeking to change to another provider. When a client initiates a transfer to a new home care service in My Aged Care, a system message will notify you of the client’s name and the date the referral was accepted.

Agreeing on a cessation day

The cessation day should be agreed with the client in consideration of the circumstances, the terms of the home care agreement, and the legislative rules governing home care.

Consumers have a right (under the Charter of Care Recipients’ Rights and Responsibilities - Home Care) to choose their provider and to have flexibility to change their provider if they wish.

Reaching a mutually agreed cessation day is important because it will provide you with certainty of the period you can claim home care subsidy. It will also allow you to accurately reconcile the client’s home care package and calculate any unspent funds.

Obligations for the existing service provider

1. Provide cessation information to DHS

Approved providers are required to notify the Department of Human Services (DHS) within 31 days of a client ceasing care through a home care service. Providers must provide the client’s name and their cessation day through the aged care payment system (i.e. the home care claim form or the Aged Care Online Services system).

2. Notify the client of their unspent funds and arrange disbursement of funds

For information about the calculation and management of unspent funds, refer to the separate Fact Sheet on Unspent Funds.

3. Retain records

Existing providers must retain:

  • the written notice of the client’s unspent funds; and

  • records relating to the payment of a client’s unspent funds to another provider; and

  • notices of exit amounts given to the Department for publication on My Aged Care.

Obligations for the new service provider

The new service provider will need to accept the consumer referral for home care service in My Aged Care and develop a Home Care Agreement with their new client.

The new service provider is also required to notify DHS within 28 days of the consumer starting care, by submitting an Aged Care Entry Record.

The start date for the new provider must be after the cessation day for the existing provider. Before providing home care services, the new service provider should confirm the cessation day with both the client and the existing provider to ensure there are no overlapping claims for home care subsidy. Where two or more approved providers claim subsidy for the same client on the same day, payment will be made to the provider that first entered into a Home Care Agreement with the client.

What is the client’s role?

The client (or their carer or representative) must notify their existing service provider that they no longer wish to receive care and agree the date on which services from the existing provider will cease. To avoid any gaps in their care, it is recommended that clients wishing to change providers do some research to identify a new provider first. They should then contact the new provider to ensure the services they offer will meet their needs, and agree the date on which services from the new provider will begin. The start date for the new provider must be after the cessation day for the existing provider.

Clients wishing to change providers will need to get their referral code for home care services reactivated by contacting My Aged Care on 1800 200 422, or through the client portal in My Aged Care. The new provider will need to accept the referral code to access the client’s record. The client must also provide their consent before any of their client information can be transferred from the old provider to the new one.

Key points to remember

  • It is a joint responsibility to agree with the client upon a cessation day for home care services.

  • You have 31 days from the cessation day to notify the Department of Human Services, through the aged care payments system, of the client’s name and their cessation day.

  • The new service provider must notify the Department of Human Services within 28 days of the consumer starting care, by submitting an Aged Care Entry Record. The start date for the new provider must be after the cessation day for the existing provider.

Read more at https://agedcare.health.gov.au/programs/home-care/changing-home-care-providers

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