Evaluation of the consumer - directed care initiative - Final Report

4.3 Profile of supports and expenditure - CDC

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Breakdown of package expenditure

Package expenditure can be classified into three broad categories:

• Administration – the fee charged by the CDC provider for administering the package.
• Care planning and management – the fee charged by the CDC provider for care planning and support coordination and management.
• Supports – expenditure on supports that a participant chose to access, including in-house (CDC provider) supports and brokered or purchased supports.

The figure below illustrates the breakdown of package expenditure for each of these three categories for each care level (for the April-June 2011 and July-September 2011 quarters). The figure shows that:

• administration accounted for between 12 per cent and 17 per cent of a CDC package, on average (using July-September quarter figures)
• care planning and management accounted for a further 8-14 per cent of package
• administration and care planning and management accounted for a larger proportion of a CDCL package (31 per cent combined in the July-September quarter) than for CDCH and CDCHD packages.

Figure 5: Breakdown of CDC package expenditure

Source: 1^st and 2^nd CDC provider data collections (April-June and July-Sept 2011)

Scope of brokered supports

CDC participants can choose the providers of their supports, and many chose their CDC provider as their main support provider (and some their only support provider) – preferring one provider to deliver all or most of their supports.

The figure below illustrates the extent to which supports (excluding administration and care planning and management) were provided in-house by the CDC provider, versus brokered or purchased from other support providers on behalf of the CDC participant – based on reported expenditure on in-house and brokered services. As the figure illustrates, the majority of supports were provided in-house – 63 per cent of services in the April-June 2011 quarter, and 55 per cent in the July-September 2011 quarter.

There was a higher degree of in-house support provision for CDCL package recipients than for CDCH or CDCHD package recipients.
Interestingly, the proportion of in-house supports decreased between the two quarters, which indicates that participants were changing their support arrangements and choosing alternative providers after a period of ‘settling in’ to their package.

Figure 6: Proportion of CDC package expenditure – in-house vs. brokered supports

Excludes administration and care planning and management.
Source: 1^st and 2^nd CDC provider data collections (April-June and July-Sept 2011)

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Supports accessed

The tables below outline the most common types of supports accessed by CDC participants – by the number of participants accessing each type of support, and the level of package expenditure on each type of support.

The tables illustrate that:

• 64 per cent of CDCL participants accessed domestic assistance, which accounted for 29 per cent of CDCL package expenditure, on average. Other common supports accessed included support with activities of daily living (personal care) and social support.
• 75 per cent of CDCH participants accessed support with activities of daily living, and more than half accessed domestic assistance. Social support and nursing care were also common support types accessed.
• Support for with activities of daily living was also the most common support type accessed by CDCHD participants, and relatively high numbers of participants accessed nursing care and clinical care. A relatively high proportion of CDCHD package expenditure was also spent on leisure, interests and activities (11 per cent).

Table 3: Top 5 types of support accessed by CDC participants, by proportion participants accessing these supports

	CDCL	% part	CDCH	% part	CDCHD	% part
1	Domestic assistance	64%	Activities of daily living	75%	Activities of daily living	52%
2	Activities of daily living	45%	Domestic assistance	52%	Domestic assistance	22%
3	Social support	30%	Social support	39%	Nursing care	22%
4	Nutrition, hydration and meal preparation	23%	Nursing care	31%	Social support	20%
5	Emotional support	18%	Nutrition, hydration and meal preparation	29%	Clinical care	20%

Excludes administration and care planning and management.
Source: 1^st and 2^nd CDC provider data collections (April-June and July-Sept 2011)

Table 4: Top 5 types of support accessed by CDC participants, by proportion of total package expenditure

	CDCL	% exp	CDCH	% exp	CDCHD	% exp
1	Domestic assistance	29%	Activities of daily living	36%	Activities of daily living	32%
2	Activities of daily living	25%	Social support	13%	Support for care recipients with cognitive impairment	17%
3	Social support	12%	Domestic assistance	11%	Social support	13%
4	Nutrition, hydration & meal preparation	7%	Nutrition, hydration & meal preparation	7%	Leisure, interests and activities	11%
5	Home maintenance	5%	Nursing care	4%	Domestic assistance	7%

Excludes administration and care planning and management.
Source: 1^st and 2^nd CDC provider data collections (April-June and July-Sept 2011)

Appendix B contains further detail on the supports accessed by participants and expenditure on those supports, including data from the April-June 2011 quarter which has not been presented in this chapter.

Note that no comparable data was available to compare supports accessed by CDC participants and standard packaged care recipients.
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