Program assurance of the Home Care Packages Program

Program assurance reviews help confirm value for money for older people in Australia receiving Home Care Packages.

About the program assurance reviews and activities

We are responsible for good program governance and integrity. This includes ensuring that funds are spent efficiently and effectively and for approved purposes.

Older people in Australia are increasingly choosing to remain in their own homes. There is rising demand for Home Care Packages to support this choice.

We want to make sure that the maximum amount of funding for Home Care Packages supports older people to remain in their own homes for as long as possible.

To achieve this, we conduct assurance reviews and activities that are ongoing and risk-based to:

  • assure value for money for care recipients
  • check unfair costs are out of the system
  • assure providers use funds for approved purposes only
  • increase providers' program knowledge to support improvement and delivery of the program requirements
  • prevent fraud by identifying deliberate non-compliance
  • support better services for our older people.

Risks we focus on

Program assurance reviews/activities focus on 4 risks:

  1. Care recipients cannot exercise adequate choice due to provider processes or a lack of transparency or accuracy in pricing information/agreements.
  2. The program does not achieve value for money for Australian taxpayers and/or care recipients.
  3. Program funds are inappropriately or inadvertently used by a provider or care recipient.
  4. Program funds are fraudulently used by a provider or care recipient.

Activity and review benefits

  1. Greater value for money for care recipients and taxpayers through enhanced program integrity
  2. Better informed providers through education and capability uplift, including though the Community of Practice 
  3. Improved community confidence in the sector
  4. Ongoing improvements to the program benefitting providers and care recipients.

The Home Care Packages Program Assurance Framework and the Assurance Plan support these activities.

The review process

Risk-based assurance reviews and activities are guided by the Assurance Plan.

We also conduct reviews and activities outside of the planned reviews based on urgency and risk. Activities are mainly desktop-based.

For assurance reviews, selected providers (that are corporations) will receive a legally binding notice, which will explain:

  • the scope of the review
  • what the provider needs to do
  • what documents to provide.

Review officers work with selected providers throughout the review process. This could be through entry and exit meetings, and ongoing communication as needed to clarify requirements and support providers.

At the end of the review process, providers usually receive individual review reports. These include any recommended actions and areas for improvement identified during the review.

A program assurance review compliance team follows up with relevant providers where a review report recommends actions for the provider and these are not completed within the given timeframe.

A summary report of review findings is also usually published at the end of the review. We then conduct a webinar to present key learnings and outcomes from the review and to allow webinar participants to ask questions. To support the sector to benefit from such reviews, we share findings and learnings through the online Community of Practice. 

Reviews

We have completed 3 reviews of the program and issued the below summary reports for each review:

  1. Review 1 – Indirect and Care Management Charges
  2. Review 2 – Unspent Funds (Commonwealth Portion)
  3. Review 3 – Pricing Transparency on My Aged Care.

Webinars were held to discuss the findings of the reviews. Recordings of our webinars, along with the slides, transcripts and answers to questions can be found on our webinar page.

Current review – Excluded items

The current assurance review began in September 2023 and is looking at excluded items. Previous assurance activities and stakeholders have identified that in some instances program subsidies were spent on excluded items. 

This impacts the ability of care recipients to make informed choices about their care, affects value for money for the program, and could mean program funds are at risk of misuse.  

The review seeks to answer:

  • Is the program subsidy being spent on excluded items?
  • If so, how widespread the practice is?

Where instances are found of the subsidy being spent on excluded items, the review seeks to gain insights into why this occurred. 

A public summary report is expected to be released in the second half of 2024.

Provider engagement – Community of Practice

We have created an online Community of Practice to support all providers (not just those subject to a program assurance review or activity). The Community of Practice offers a safe space for providers to talk with us and each other on program assurance reviews and related matters.

As a registered member of the Community of Practice, providers can directly engage with the program assurance review team.

They can also:

  • understand review findings
  • uplift their program knowledge
  • improve care for older people in Australia.

They can also hear from the department about lessons learnt from program assurance reviews and gain information about completing the requirements for reviews. Providers can also give feedback on reviews.

The Community of Practice also offers providers the opportunity to leverage this platform to:

  • develop and discuss new ideas
  • share resources
  • build a sense of community with other providers.

Examples of Community of Practice activities include:

  • holding live-chat sessions
  • responding to questions from providers on program assurance matters
  • sharing posts on topics of interest
  • seeking feedback from users on whether the Community of Practice site is easy to use and navigate through.

We encourage providers to join the Community of Practice.

Tools for care recipients

We have prepared some tools to help care recipients compare provider charges. These are available on the My Aged Care website.

fact sheet is available to help care recipients understand how to get the best value for money from their package. It also provides instructions on how to use My Aged Care to compare providers.

Based on the findings of each review, we consider how to best support care recipients and program improvements.

Key legislation

The Aged Care and Other Legislation Amendment (Royal Commission Response No. 1) Act 2021 came into effect on 1 July 2021. This allows us to compel providers to participate in program assurance reviews when invited and supports the publishing of review findings. See Part 6.8 of the Act.

Key resources

Home Care Packages Program Assurance Plan 2023–25

The Home Care Packages Program Assurance Plan 2023–25 protects the integrity of the Home Care Packages (HCP) Program funding through evidence-based assurance of the HCP Program’s design, delivery and administration.

After the release of the report, we hosted a webinar to share the key learnings and outcomes from the review.

After the release of the report, we hosted a webinar to share the key learnings and outcomes from the review.

After the release of the report, we hosted a webinar to share the key learnings and outcomes from the review.

Contact

Home Care Packages Program assurance reviews contact

Contact us for more information about Home Care Packages Program assurance.
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