Evaluation of the consumer - directed care initiative - Final Report

5.3 Program implementation

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Guidance and support from the Department

CDC and CDRC providers consistently indicated that the level of guidance, communication and support offered by the Department during the implementation phase was less than optimal.

Timing

Several providers indicated that there was a gap between the allocation of places and the distribution of operating guidelines, and this in turn caused delays in the development of their own approach to CDC and the recruitment of participants.

A number of providers also noted that changes between the draft and final guidelines were not communicated in a timely way; many of them had already operationalised their places and put services in place by the time they were advised of changes to the guidelines. In some cases the changes required significant amendment to the processes and systems that providers had already put in place.

Level of direction

A number of providers appreciated the flexibility of the operating model, though the majority of those interviewed wanted more guidance and direction from the Department. Many CDC providers in particular identified a need for more definite guidance in some particular areas.⁸ A number of CDC providers also noted that the format, flow and terminology of the CDC guidelines⁹ were similar to standard packaged care guidelines,¹⁰ and that the CDC guidelines defer to the standard guidelines on several matters. This meant that the differences between CDC and standard packaged care were not always easy to see.¹¹ Providers also stated that it was not always clear where the standard guidelines should be consulted for additional information.

Ongoing support for providers

The Department provided ongoing support to providers through a telephone ‘helpdesk’, and produced a series of frequently asked questions which were published on the Department’s website.¹² However, it appeared that some providers were not aware of or did not utilise these supports.

Beyond the issues of timing and guidelines, CDC and CDRC providers also indicated that they would have preferred more proactive support from the Department during the implementation. Providers suggested that some initial training or face-to-face briefings by the Department would have been useful, as well as more regular information exchange and discussion with other providers and the Department focussing on building providers’ capability to be consumer-directed (rather than merely to disseminate information).

In lieu of formal, proactive support and training from the Department, providers relied on their own networks for support and information about CDC and CDRC, including discussions with other providers with more experience of CDC. While this proved a suitable form of support, some providers were concerned that the perceived lack of direction from the Department led to inconsistent application of CDC and CDRC across providers and jurisdictions, which in turn affected consumer experiences of CDC and CDRC.

“The Department just gave us the guidelines and the dollars and said ‘off you go’.”

CDC provider

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8. Examples included using packaged funding for ‘non-traditional’ supports, services, or goods; roll-over funding; use of surpluses when a participant exited.
9. Consumer Directed Care in Australian Government Packaged Care Programs 2010-2012 Operational Manual
10. The Community Packaged Care Guidelines 2011
11. Notably this was not raised as an issue by CDRC providers
12. http://www.health.gov.au/internet/main/publishing.nsf/Content/ageing-cpb-cdc-faq.htm, accessed January 2012.
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