Evaluation of the consumer - directed care initiative - Final Report

5.2 Provider motivations for participating in the initiative

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The motivations of CDC providers and CDRC providers for participating in the initiative differed. For CDC providers, there were a number of reasons which influenced their decision to participate, including their commitment to person-centred approaches, their desire to respond to anticipated future consumer demand for increased choice and control, or their desire to access additional community aged care packages. Motivations were sometimes a combination of these factors.

For CDRC providers, the motivation to participate in the initiative was strongly linked to their identification of limitations in the traditional respite approach for some carers. CDRC providers saw the initiative as an opportunity to offer a more planned approach and secure additional funding for carers with ongoing, unmet respite needs. CDRC providers universally saw the initiative as an entirely new approach from traditional responses.

Consumer-directed care providers

There were a number of reasons why providers chose to participate in the initiative.

Providers already had a strong commitment to person-centred approaches and saw CDC as consistent with their organisation’s values and culture

These providers spoke about consumer empowerment, choice and control being part of their organisational values and underlying approach to service delivery, and spoke of goals-focussed, strengths-based or enabling approaches to care planning and service delivery.

Several had prior experience with consumer-directed approaches in the disability field, and were already considering options for more consumer-directed approaches in their delivery of community aged care prior to the current initiative. They saw CDC as being significantly different from the standard packaged care approach because of its focus on the individual, its potential for more innovative use of funds to respond to individual goals, and the shift of control from provider to consumer.

Some were already trying to increase accountability and flexibility for existing clients within their standard packaged care approach prior to the CDC initiative, often in response to previous client complaints or frustration. Some already brokered a significant proportion of services as part of their standard care packages.

“We saw CDC as a chance to free people from the constraints of having a pre-determined plan of pre-determined services. Having scope for more flexible use of funds would suit different types of people.”

CDC provider

Providers saw CDC as an opportunity to do things differently, and wanted to be involved early in the testing and development of the approach

Generally, these providers recognised emerging demands for more choice and control from consumers and carers, and in particular from the ‘baby boomer’ generation. Their motivation for participating in the CDC initiative was more about being involved in this approach from the beginning and having the opportunity to shape and influence a new way of doing things.

While these providers typically had some understanding of CDC, they generally did not have any prior experience of CDC approaches prior to the initiative, nor did they have a strong consumer-directed or person-centred culture or approach in place in their organisation.
Providers tended to be relatively conventional in their approach to CDC, and the differences between CDC and standard packaged care varied widely among providers.

“There is going to be more demand for control by the baby boomers. We wanted to get in on the ground floor for that with this pilot.”

CDC provider

Providers saw the initiative as an opportunity to access additional packages

Some providers saw the initiative merely as a way to secure more funding for their organisation and to access more packages – to better meet demand for packaged care. These providers typically viewed CDC as another kind of packaged care, and generally provided CDC in more or less the same way as standard packaged care.

Consumer-directed respite care providers

All of the interviewed CDRC providers had identified significant limitations in the way current programs supported carers, including the inadequacy of providing only a short-term and emergency response to carers who had an ongoing need for respite, the limited availability of formal respite and other supports and an inability to meet some carers’ needs through the standard respite response (including carers in special needs groups and rural and remote locations).

Providers saw CDRC as an important and significant opportunity to take a more planned approach to supporting carers, and to secure additional funding for carers – which together would enable them to access the respites and other supports they needed, contribute to reducing carer stress, improving carer resilience and avoiding crises such as use of emergency respite, unplanned hospital admissions, and unplanned entry to residential care.

Providers also recognised the potential benefits of using a coordinated ‘case management’ approach for a number of carers (though recognising that the CDRC operational manual did not envisage an ongoing case management role in the CDRC model).

Unlike CDC providers, who tended to frame CDC in the context of and in comparison to standard packaged care, CDRC providers saw it as an entirely new approach. Importantly, they did not have preconceptions about how the model would operate or how the funds could be used, other than that they should be used to support carers in their caring role, and providers were open to exploring traditional and non-traditional support options.
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