Home Care Packages (HCP) Program Assurance Reviews – Unspent funds and pricing transparency on My Aged Care

This webinar is about the key learnings and outcomes of the Home Care Packages (HCP) Program Assurance Reviews on provider self-reported unspent amounts and pricing transparency on My Aged Care.

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50:33

Home Care Packages Program Assurance Reviews

Review 2 – Unspent Funds (Commonwealth Portion)
Review 3 – Pricing Transparency on My Agd Care

Thursday, 7 December 2023

Presented by:

mc:

Chamandeep Chehl

Assistant Secretary, Program Assurance Branch

Panellists:

Mark Rummans
Director, Program Assurance Branch

Lanfeng Davis
Director, Program Assurance Branch

Nicola Champion
Director, Program Assurance Branch

Jennifer Young
Assistant Director, Program Assurance Branch

[Opening visual of slide with text saying ‘Australian Government with Crest (logo)’, ‘Department of Health and Aged Care’, ‘Home Care Packages Program Assurance Reviews’, ‘Review 2 – Unspent Funds (Commonwealth portion)’, ‘Review 3 – Pricing Transparency on My Aged Care’, ‘Introduction:’, ‘Chamandeep Chehl’, ‘Assistant Secretary’, ‘Program Assurance Branch’, ‘agedcareengagement.health.gov.au’, ‘7 December 2023’]

[The visuals during this webinar are of each speaker presenting in turn via video, with reference to the content of a PowerPoint presentation being played on screen]

Chamandeep Chehl:

Good afternoon everyone. Thank you all for attending today’s webinar. I’m Chamandeep Chehl and I lead the Program Assurance Branch in the Quality and Assurance Division of the Department of Health and Aged Care. Today it is my pleasure and honour to host this event.

I would like to begin by acknowledging the Ngunnawal people as traditional custodians of the land we’re meeting on and recognise any other people and families with connection to the lands of the ACT and region. I wish to acknowledge and respect their continuing culture and the contribution they make to the life of this city and this region. I would also like to acknowledge and welcome other Aboriginal and Torres Strait Islander people who may be attending today’s event.

Thank you all for joining us today. This afternoon we’ve got an hour long webinar to discuss the two recent Home Care Packages Program Assurance Reviews done by my Branch. We will hold a question and answer session at the end of the webinar. You can send through your questions in the Slido box on the right hand side of your screen. We will attempt to respond to as many relevant questions as possible at the end of the webinar. Responses to questions and answers including ones that we may not get to today will be available after the webinar on our website. Relevant questions have also been submitted during the registration process and we have considered those for today’s question and answer session. So thank you to all those who have taken the time to send those questions through ahead of the webinar. Please do note there is no option for attendees to turn on their video or microphone however we will be recording today’s session and uploading it to our website along with the slides.

So I do want to start the webinar by talking about the Branch I look after. The Program Assurance Branch is around two years old and we are responsible for undertaking program assurance reviews and activities for the Home Care Packages Program. This program supports older people with complex needs to live at home and to access affordable and coordinated care services. Demand for Home Care Packages is growing. Approximately $7.7 billion was allocated to this program in this financial year, so the 23-24 financial year. By the end of March this year over 268,000 older people had access to Home Care Packages from 931 approved providers. We know care recipients and the public expect value for money for Home Care Packages and they want to know that funds are being used for approved purposes.

My team and I want to help ensure that the maximum amount of program funding is going towards direct care and services. To do this since October 2021 we have been conducting assurance reviews and activities. This slide that is sourced from our publicly available Program Assurance Framework shows the expected benefits from our work, enhanced value for money for Home Care Package care recipients and Australian taxpayers, supporting Home Care Package providers – this is really important to us – to uplift their program knowledge and also to share better practices and we facilitate this through various means but including a community of practice that one of my team will cover later in their presentation. Obviously all of this should help improve community confidence in the sector. And we also use our findings and learnings to support future development of home care policy and programs.

There are three key assurance principles that guide our review work. Continuous improvement to support providers but to support our own team as well, to improve how we do what we do. We do risk-based and evidence-based assurance activities. This helps minimise the burden on providers but also ensures very importantly that we ask and answer the right questions. We also look to build trust with providers through collaborative engagement.

The program assurance reviews and reporting process for providers is ultimately of course to hold them accountable for efficient, effective and justified use of program funds but we’re really mindful of doing this the right way. So for example offering natural justice during reviews. What does that look like? We offer entry and exit meetings. Usually these are voluntary but depending on the review topic we have the ability to mandate these. The opportunity for providers who are participating in a review to give a response to our reports before we issue them as final. And we also have an internal appeals process. This is outlined in our publicly available Program Assurance Framework and also in the legally binding notices we issue to providers who are corporations.

We do have a very strong inward facing continuous improvement culture. In fact the Branch and I take great pride in this. We do seek formal feedback from all participating providers after each review and this is in addition to feedback we receive before and during reviews from a Program Assurance Reference Group we have. It is made up of providers and peak bodies including consumer peaks.

So today my team will talk you through the review process and the findings of our most two recent reviews, the Home Care Packages Program Assurance Review into Unspent Funds, the Commonwealth portion, and the Home Care Packages Program Assurance Review into Pricing Transparency on My Aged Care. Reports for both the reviews are publicly available on our website and hopefully a link should be showing up in the chat function shortly.

Today joining us as co-panellists we have Mark Rummans and we have Lanfeng Davis. They are the Directors who led these reviews. So Mark led the Pricing Transparency Review and Lanfeng led the Unspent Funds Review. Lanfeng and Mark are also joined by two review officers Jennifer Young and Nicola Champion. Lanfeng, Jen, Mark and Nic are going to take you through the presentation today on our two reviews but before I hand over to them I do want to take this opportunity to publicly thank the 164 providers who have participated in these last two reviews we’re going to cover today. We really appreciate your good faith engagement.

As you go on the journey of these two reviews with us today I hope you can see the applied benefits of Home Care Packages Program Assurance Reviews for providers but ultimately and most importantly for care recipients and the public. I’m going to hand over to Lanfeng and Jen first who are going to take you through the Unspent Funds Review. Thanks.

Lanfeng Davis:

[Visual of slide with text saying ‘Review 2 – Unspent Funds Review’, ‘Presented by’, ‘Lanfeng Davis – Director, Program Assurance Reviews Section’, ‘Jen Young – Assistant Director, Program Assurance Reviews Section’]

Thank you Chamandeep. Good afternoon everyone. My name is Lanfeng Davis and I’m the Director that led the Unspent Funds Review. My colleague Jennifer Young and I will be presenting information on why and how we did the review and what difference the review made.

Here’s a brief background. Since the introduction of Improved Payment Arrangements or IPA the responsibility for Managing Commonwealth unspent funds moved from providers to Services Australia. From 1st September 2021 providers were paid in arrears for actual services delivered. Providers were required to self-report to Services Australia the total amount of unspent funds by 31st December 2021. Unspent funds are comprised of a Commonwealth and the care recipient portion. They are held by either the provider, split into the Commonwealth and care recipient portions, or by the Government in the Home Care Account managed by Services Australia. The review focused on the Commonwealth portion.

The Unspent Funds Review was undertaken to confirm the accuracy of this self-reporting. We also wanted to ensure that the providers had a financial capacity to repay Commonwealth unspent funds when necessary and pay for care and services needed by care recipients. The amount of unspent funds shown on this slide provides some perspective.

These are the two critical questions that we focused on. First if providers accurately reported unspent funds to Services Australia, and second if providers have the financial capacity to return the Commonwealth unspent funds if needed. So why is it important that the self-reporting is accurate and that the providers have the financial capacity to repay these funds if needed? It is important so that providers and care recipients have an accurate understanding of the funds available to pay for the care and the services when needed when care recipients exit the HCP Program or move to a different provider. In the event that providers cease to be an approved provider the unspent funds need to be returned to the Commonwealth or transferred.

Providers were selected using a risk-based approach if they satisfy either of two criteria. First providers held an average unspent funds amount of $15,000 or higher per care recipient or providers reported a zero balance of the Commonwealth unspent funds for a high proportion of exited care recipients. These criteria were chosen as having higher average unspent funds balance per care recipient was considered a better measure than examining the total unspent funds amount per provider. The high proportion of care recipients recording a zero balance raises questions about the accuracy of reporting and was considered a key risk indicator. Under section 95BA.5 of the Aged Care Act we issued legally binding notices seeking information from providers that are corporations or they risk receiving a fine or being publicly named. Government providers received letters of invitation. In total 44 providers were reviewed with 41 being corporations and three Government providers. I will now hand over to Jen to discuss the next part of how the review was done.

Jennifer Young:

Thanks Lanfeng. To answer question one we requested the following. The total balance of unspent funds across all care recipients for a provider, a written description of how unspent funds balances were calculated and monthly statements for selected care recipients over a six month period. During this process the review team examined monthly statements. By doing so we gained insights into the accuracy of the reporting by providers. This identified if variances existed between what was reported to the review and what was recorded by Services Australia. To answer question two we reviewed audited financial statements for the 2021-22 financial year or HCP financial records, and providers’ written explanations relating to the Commonwealth portion of unspent funds. In assessing these documents we determined if providers had the financial capacity to return the unspent funds where appropriate or required.

So what did the review find? At provider level initially we found 37 of 44 providers or 84% had variances in the amount of unspent funds reported to the review and what was recorded by Services Australia. This variance puts the care recipients of these providers at risk if the providers do not have the financial capacity to make funds available for care and services. A negative amount indicates that the providers reported less to the review than what was recorded by Services Australia. In other words if the variance is negative a provider may have more funds to spend and care recipients may be missing out on the care that they could have purchased. If the amount is positive the provider and/or care recipient may be purchasing services that they may not have the funds to pay for. Therefore a critical part of the work of the review team was to support these providers to identify and rectify issues to reduce these variances.

By the end of the review the number of providers with a variance in unspent funds had reduced by nearly half down to 20 providers or 45%. The volume and range of these variances was also reduced significantly. The results were also positive at the selected care recipient level. Initially there were 197 out of 815 or 24% of care recipient records with variances. However by the end of the review this had reduced to 113 out of 815 or 14% of care recipient records. From both the providers’ and care recipients’ perspectives having an accurate understanding of how much funds that are available to them allows for better planning of care and services.

All 44 providers gave the required assurance that they could return Commonwealth unspent funds if required. 43 of the 44 providers gave financial statements as evidence to support their claims. In reference to the graph on this slide the review team compared the cash available to the provider with the amount owing to the Commonwealth which is known as cash coverage ratio. It is a measure of a provider’s liquidity and ability to pay debts that they owe to the Commonwealth. The higher the ratio the easier it should be for a provider to repay debts. Ideally the ratio should be greater than one as this means the provider has more available funds than the debts they owe.

Four providers were initially found to have a cash coverage ratio of less than one. These four providers were responsible for managing HCP funds for 557 care recipients. The providers may not have had sufficient funds available and potentially be putting their care recipients’ service provision at risk. Because of the review process the providers took remedial actions and improved their liquidity by the end of the review. This is a positive outcome for these care recipients as well as the providers.

The review also made other observations. They are out of scope but were noted in the providers’ individual reports.

As you can see on the graph one of the key incidental findings was in relation to potentially excluded items. We are currently undertaking a review into excluded items.

So what did the review achieve? The review gained valuable insights into the accuracy of reported unspent funds at the provider and care recipient level. The review assisted the return of more than $240,000 of unspent funds to Services Australia. During the review the number of providers with variances in unspent funds reduced from 37 to 20 and the number of care recipients with variances in unspent funds reduced from 197 to 113. It has also provided the care recipients supported by these providers both assurance and protection to ensure continuation of their care and services. The review has supported continuous improvement of these 20 providers with 14 having addressed variances, five continuing to engage with Services Australia and one which has since exited the HCP Program. The review has also been able to assure providers’ capacity to return unspent funds if required.

Lastly throughout the course of the review those four providers that were at financial risk improved their financial capacity assuring better protection for their 557 care recipients. We will now put up a Slido poll for you to respond to. You will be able to see the results straight away. So please head over to the Slido on the right hand side of your screen and answer a simple question.

I will now hand over to Mark and Nicola to present the Pricing Transparency Review.

Mark Rummans:

[Visual of slide with text saying ‘Review 3 – Pricing Transparency on My Aged Care’, ‘Presented by’, ‘Mark Rummans – Director, Program Assurance Reviews Section’, ‘Nicola Champion – Assistant Director, Program Assurance Reviews Section’]

My name is Mark Rummans and I’m the Director who led the Pricing Transparency on My Aged Care Review. Today my colleague Nic and I will be presenting information on why we did the review and what difference was made.

So why was the review needed? Effective pricing transparency empowers older people, their families, their representatives to make informed decisions about their Home Care Packages. It allows them to exercise choice and control over the care they receive, understand providers’ fees and charges and enables them to compare prices and providers easily. Inaccurate or incomplete pricing information reduces the Department’s ability to make well informed policy decisions.

The first assurance review in direct care and management charges completed in August 2022 identified pricing transparency requirements were not being consistently met by providers. The purpose of this review was to assure providers’ pricing information on My Aged Care was complete, accurate, up to date and in line with the requirements of the User Rights Principles. This review was the first to be conducted predominantly using information already available to the Department. This approach reduced the administrative burden on providers.

The review was conducted in two phases. Phase one of the review included assessing all 839 Home Care Package providers on My Aged Care against their publicly available pricing information. Using a risk-based approach providers displaying potentially inaccurate information such as N/A, $0.01, $1 or with no data entered in one or more of the four pricing fields on My Aged Care listed on the slide were selected to participate in Phase 2 of the review. These fields were predominantly chosen as there should be an associated cost entered given that care management is a mandatory service and there is an expectation providers can deliver common services directly or through a third party.

713 of the 839 providers were not required to participate in Phase 2. These providers received an innovative self-assessment tool developed by the review team to support them to assess their pricing information against relevant requirements. They were reminded of their pricing transparency obligations including specific potential concerns for 189 providers and were encouraged to complete the tool. This cohort was rechecked again after final reports were issued to providers in Phase 2 and improvements were noted. In all, 126 providers were identified as having potentially inaccurate information as per the criteria and were included in Phase 2 of the review for further analysis. Six of these providers did not participate in Phase 2. The remaining 120 providers included a mix of providers ranging in size from one care recipient to more than 5,000 care recipients.

Review officers then conducted a deeper analysis of the published pricing information on My Aged Care for this group. I’ll now pass over to Nic.

Nicola Champion:

Thank you Mark. After the closer analysis Phase 2 providers were sent a notice under the Aged Care Act or letter of invitation to participate, a preliminary analysis document that outlined pricing transparency issues identified during the deeper analysis of Phase 2 providers and a pricing transparency self-assessment questionnaire which was developed by the review team as part of the notice that providers were required to complete and submit to the review team.

The questionnaire asked providers to answer yes or no to three questions in relation to each of the My Aged Care pricing fields. Providers were expected to undertake a self-assessment when completing this tool. Following return of the questionnaire review officers re-examined providers’ pricing information on My Aged Care.

Based on the findings after re-examining My Aged Care 103 of the 120 providers received a draft report as they were not meeting at least one pricing transparency requirement. Providers were offered the opportunity to respond to the draft report findings. Review officers then re-examined providers’ pricing information. The remaining 17 providers received letters as there were no pricing transparency issues identified. However these letters may have included observations made for the continuous improvement and/or incidental findings not related to pricing transparency.

A final report was issued to providers in March this year. Providers with remaining issues identified in their final report were given two weeks to correct their pricing information and respond to the Program Assurance Follow Up Team. The role of the Program Assurance Follow Up Team is discussed later in this presentation.

So what improvements have been made? The main issues identified in the review related to the full price list and pricing consistency across all published pricing information. There was a marked improvement in the total number of pricing transparency issues identified during the review. 57 of 120 providers had no issues when final reports were sent.

Pricing transparency issues reduced from 381 identified in the prelim analysis to 117 issues in final reports. This graph shows the improvements seen across the review. The darkest coloured column shows the issues at prelim analysis, the middle bar shows the issues identified in draft reports, and the light blue column shows the issues identified in final reports. There were a couple of exceptions. The review team took a closer look at staff travel and exit amounts at the draft report stage which as you can see from the graph resulted in a higher number of issues identified. The number of providers with staff travel issues declined at the final report stage. There were no exit amount issues identified at the final report stage as this field was removed from My Aged Care. This was due to the January 2023 legislative changes removing exit charges. During the review several providers commented that while exit amounts were still displayed on My Aged Care they had ceased charging them months earlier.

I will now take you through the three most common issues identified at the final report stage. The remaining issues identified in the review are described in detail in the public summary report available on the Department’s website.

The most common issue in the review related to the full price list. At final report stage 43% of providers were found to have issues. This was an improvement from the prelim analysis stage of 80%. Providers’ full price lists by legislation must be published as either a document like a PDF or Word document on My Aged Care, or a hyperlink to the provider’s pricing information on their website. The full price list must contain all charges not just prices for common services. Without this information older people cannot make well informed decisions and it may affect their choice of care and services.

Issues relating to the full price list included incomplete full price lists, for example missing prices for common services, care management and/or package management, providers having no full price list at all on My Aged Care, or the hyperlink entered by the provider on My Aged Care not opening directly to their pricing page on their website. For example in a number of cases it opened to their home page, not their pricing page.

Only one provider was identified as still having exit amount in their full price list at the time of final reports. This demonstrates one of the benefits of the review. Providers were reminded to remove redundant prices from their full price list.

Other benefits included providers including all charges and editing some descriptions on full price lists to make them clear. This resulted in full price lists that are more accurate and easier for care recipients to understand.

The second most common issue in the review related to pricing consistency. At final report stage 22% of providers were found to have issues. This was an improvement from the prelim analysis stage of 75%. Providers’ pricing information is available as a pricing schedule which are the fields on the provider’s My Aged Care costs page and as a full price list as described on the previous slide.

Inconsistent pricing information across these sources may be confusing and affect people’s ability to understand charges they could be expected to pay. Price inconsistency issues often stem from providers only updating one source of information, either the pricing schedule or the full price list but not both. The significant improvement in relation to consistency will enable care recipients to be assured that when they review a provider’s prices in whatever form they are accurate and up to date. This will enable care recipients to better understand what care and service will fit into their budget.

The third most common issue related to care management. At final report stage 12% of providers were found to have issues. This was an improvement from the prelim analysis stage of 39%. Care management is a mandatory service and must be provided to all care recipients including those who self-manage. Care management cannot be charged as an hourly rate and the advertised charged fortnightly care management price should be inclusive of all care management costs. The review team found most providers with issues identified under care management had misunderstood or not completed the relevant fields. It was common for providers to have issues in multiple care management fields. Issues included providers entering N/A or zero hours for all fully and self-managed package levels indicating care management was not being delivered, providers entering N/A, $0 or zero hours for some package levels indicating they did not deliver services for those package levels when information available to the Department demonstrated otherwise. Care management descriptions indicated that care management was being charged hourly or additional care management amounts charged above the fortnightly advertised charge.

The review team observed that while meeting program requirements several providers entered comparatively high approximate care management hours per fortnight, for example 24 hours. These providers were encouraged to review their hours for accuracy.

The review resulted in improved clarity and accuracy of care management information and the removal of additional care management charges. I will now hand back to Mark.

Mark Rummans:

Thanks Nic. Providers were also informed of incidental findings and observations that were noted by the review officers. This included opportunities for continuous improvement even where already meeting their obligations. Incidental findings included potentially excluded items. The most common potentially excluded item related to the absence of information indicating that care recipients were contributing to the costs of the [0:29:42] component of meals. Most providers responded to the review findings that care recipients were required to contribute. A number of providers updated their full price list to make this clear for care recipients.

Other observations included providers charging above the care and/or package management caps introduced on the 1st of January 2023. These providers were directed to review their pricing and reduce their charges to under the caps. Another observation included providers’ practice relating to minimum service hours and cancellation periods. These providers were sent links to the Department’s guidance on the social, community, home care and disability services or SCHADS industry award to assist them in considering whether these practices were reasonable. A number of providers stated that they updated their practices on reviewing the advice provided.

So how have the Program Assurance Reviews made a difference? Well this review has led to an evident improvement in the accuracy, currency, clarity and completeness of pricing information on My Aged Care for the participating providers. This benefits older people with improved access to correct and up to date pricing information that is easy to understand ultimately improving their ability to make informed decisions about service costs and choice. There has been positive feedback from the sector on the public summary report noting it offers providers information and instructions in a practical way to meet their pricing transparency requirements.

Opportunities for program and My Aged Care enhancements were also identified. This supports the Department’s commitment to continuous improvement through the assurance process. Noting the achievements the review of pricing transparency will be conducted annually. Providers are reminded meeting their pricing transparency obligations on My Aged Care supports true choice, control and transparency for older people. Detailed information regarding the benefits of this program assurance review may be considered further in the public summary report.

We will now put up a Slido poll for you to respond to. You will be able to see the results straight away. So please head over to Slido on the right hand side of your screen to answer a simple question.

Post-review follow up. At the post-review stage the Program Assurance Review Follow Up Team engaged with providers to establish and communicate clear expectations. The Follow Up Team were available to answer questions in relation to review findings and support providers to find relevant guidance material to answer their queries. This post-review engagement strengthens the way providers operate which improves their ability to meet program requirements. Providers’ posture and performance during the follow up process may be considered in selecting providers for subsequent reviews. Where appropriate review information may also be shared with the Aged Care Quality and Safety Commission.

In Review 2 all provider matters were closed, some on the understanding that these providers will continue to engage with Services Australia to rectify variances. In Review 3 almost all provider matters have been closed, some on the understanding that the providers will address the remaining issues and inform the Review Follow Up Team when complete. The Follow Up Team is monitoring that this occurs.

We also have a Home Care Packages Program Assurance Community of Practice. This is a website which we use to share findings and a space for providers to engage with the Department. Registration is open for all approved providers and peak bodies. 99 of the largest 100 providers according to the number of care recipients are registered. There are currently 3,180 registrations. We have 676 approved providers of home care which represents around 72% of all home care providers. There are also five peak bodies represented on the Community of Practice. To sign up just go to the website on the screen for a simple sign up process.

As presented on this slide providers and care recipients can email the above addresses with any program assurance or fraud related concerns. Chamandeep, Lanfeng and I will now address some of your questions.

Chamandeep Chehl:

Thanks Mark. Just before we get to that I just wanted to mention that during the registration process we did receive some questions about the operations of the Home Care Packages Program. While it’s understandable we get these questions they are out of scope for today’s session because we are really focusing on our actual two reviews. However please be assured we will liaise with the program area and we will post responses on our website together with any program assurance questions we don’t get to today. So we will get to them, just not today. But do check the website afterwards for FAQs etcetera.

In today’s Q&A session as I said we will cover what is directly relevant to reviews. And I think I can see some questions so just bear with me while I fiddle the technology a little bit and make sure I’ve got the right questions before me. So just looking at Slido.

I just want to make sure I’ve got – sorry. I’m just seeing the – there we go. Sorry. I was looking at the wrong screen. Okay. So we’ve got a question here.

Q:        The reviews sound beneficial from a care recipient perspective. Are you likely to do them again?

So I’ll spare my panellists on that one. I think I’ll take that one. So the short answer is absolutely yes. Basically as I mentioned in my bit of the presentation we are doing these to support enhanced transparency and accountability and of course value for money for care recipients. And overall essentially program integrity of the Home Care Packages Program is our focus so absolutely we will be continuing these reviews. In fact currently as was mentioned I think by Jennifer we’re doing the excluded items review and we deliberately waited for the release of the updated revised manual before we did that review. And generally how we do these reviews is we do take into account – and I think Mark touched on this a little bit – we do take into account findings from previous reviews, provider posture, other intelligence we have around the place, and we seriously consider annual planning. We are about to put out the annual plan for example for the next 18 months or so shortly. But absolutely. I hope it was evident from the presentation that there are real benefits from the work we do and it is something we absolutely are committed and passionate about. I’ll stop on that one.

There is a question here Lanfeng probably for you. Well not probably. Definitely for you.

Q:        Was there a certain type or size of provider that didn’t have financial capacity to return funds?

Lanfeng Davis:

Thank you Chamandeep. They were corporations. We did not really further specify which type of company that they were. I hope that answered your question.

Chamandeep Chehl:

Sorry Lanfeng. I was distracted by technologies because I’ve got so much going on. So sorry. Can you repeat that just so I make sure we have answered the question and if not I’m going to hassle you a bit more.

Lanfeng Davis:

My understanding of the question Chamandeep is whether or not we looked at the full providers, what type of companies they were. We do have that information but we did not publish them. Because there’s a lot of financial information that we looked at that are commercial in confidence so we did not publish them.

Chamandeep Chehl:

Yep. Okay. Next one.

Q:        Could you please clarify the status of observations as opposed to issues in individual pricing reports?

Mark that one’s for you. I think you briefly covered it but you might want to just expand on that a bit. Thanks.

Mark Rummans:

No problem. Thanks Chamandeep. So with the observations in principle these are opportunities for continuous improvement. It doesn’t necessarily mean that you’re not meeting your legislative obligations. Quite often and in most cases you were. It was just where we saw that there was opportunities for even further improvement on those. Whereas the incidental findings generally related to items that fell outside the scope of the review but were still items that the review team identified where you weren’t meeting your legislative requirements. Thanks Chamandeep.

Chamandeep Chehl:

Thanks Mark. I need four hands not just two.

Okay. We had a few questions asked previously through our registered questions so I might just pick up one of those. So one of them was around – if I recall correctly – what is being done to follow up with providers – sorry. I am going to read my notes here – who have purposefully flaunted the rules for quite some time? Is there any meaningful penalty or are they being rewarded for their behaviour?

Absolutely unquestionably the Department’s expectation is that Home Care Package Program funds are being used for approved purposes and that providers are not deliberately flaunting the rules. In fact that is why we’ve been undertaking program assurance reviews since October 2021. As I mentioned we do have reviews that are risk-based so we do take into account information before us whether it’s come through intelligence, anonymous tip offs and of course our own review findings, public concerns evident through reports for example, and program risks etcetera. So we do kind of keep all of that in mind. As mentioned our reviews are legally binding on corporations. So when we invite a provider to participate and they’re a corporation there are civil penalties if they do not engage with us. We can also name providers for not cooperating with the review process. We do issue providers draft reports and they have actions we expect the providers to undertake. And then as Mark mentioned we do have a team that follows up with providers who have not appropriately responded to our findings.

Where appropriate we do share our information with the Aged Care Quality and Safety Commission. The Commission is the national regulator for the aged care program. And therefore if anyone listening in or anyone who knows anyone who is concerned about something that is relevant to us – so we cover four risks. We cover essentially risk of a lack of transparency for care recipients, value for money, and also inadvertent or deliberate misuse of funds. So if any of those risks, you have information relevant to that, please send it through. We do have a mailbox. HCPassurancereviews@health.gov.au. Someone might post it in the chat. We also have a fraud line for the Department so if you don’t want to identify yourself but you do want to share information about a provider you’re concerned about please do send that information through. Those details should come up on our chat. If they don’t we’ll certainly post it in our FAQs. But it’s a 1800 telephone number. We also have an email directly for aged care fraud. And then we also have on the website a form that you can use to report suspected fraud.

So there’s definitely very serious intent behind what we are doing and we do work very closely with the Commission and our internal relevant areas such as the fraud area. So I hope that answers that question.

There is a related one so while I’ve got the floor I might also pick that one up. And I think it’s a valid question. We hear this all the time.

Q:        What is the difference          between what you do and what the Commission does?

So the Government’s very clearly committed to enhanced accountability and transparency of home care. The Commission is the national regulator for aged care and our reviews do not go into regulatory domain. However the Department is clearly responsible for good program governance and management and making sure that funds are being used for the purposes provided. It’s absolutely critical because this is responsible use of taxpayer funds and obviously we want to make sure that the maximum number of older people in Australia can benefit from Home Care Packages. So that’s why we’re doing Home Care Assurance Reviews but we do work closely with the Commission as appropriate.

All right. Let me just check where am I.

Is your organisation likely to review and ensure that – sorry. That is not a good look. That is the poll. Actually that reminds me. I don’t know what we’re doing about the results of the polls. Are they coming up? Because I haven’t noticed them sorry. People might be interested in the results.

I can’t see any other questions there. Lanfeng there is one here I have from previously asked ones.

Q:        Why did you only choose 44 providers?

Lanfeng Davis:

Thank you Chamandeep. As I presented in the presentation all reviews are risk-based. These 44 providers represented the highest risk based on those two criteria.

Chamandeep Chehl:

And Mark you can’t get off that easy. Another one for you.

Q:        Why can’t my hyperlink on My Aged Care just go to my home page?

This is in relation to pricing transparency on My Aged Care obviously.

Mark Rummans:

No problem. Thanks Chamandeep. Providers are required to have a full price list available on My Aged Care as either a document such as a PDF or Word document or as a hyperlink that opens directly to the provider’s pricing information. It’s important that the hyperlink opens directly to the pricing information as it’s often difficult for people to navigate and actually find the provider’s pricing information on their website which is why we require it to go directly to that page rather than just the home page. Thanks Chamandeep.

Chamandeep Chehl:

Q:        Will providers who participated receive individual reports and feedback from the reports?

The answer to that is yes. I think we’ve covered that haven’t we? So just to detail that a little bit more procedural fairness is really, really important to us. So the reason for that is that even though the fabulous review officers we have are engaging with providers all the way through the fieldwork stage as we call it and we’ve drafted findings on that basis but we do want to make sure that we offer providers a right of reply so to speak. And so that’s why we do have individual reports going to providers and the actions are there in the draft report stage for that reason.

We do also have a question here about:

Q:        Have the providers already been selected for the current review?

So I might respond to that one even though obviously the team’s doing the review. So this review is underway. We’re at fieldwork stage for the excluded items so the answer is yes we have selected the providers for the current review. And you should definitely know that by now if you’re in or not.

We got a comment from someone.

Q:        Thank you for holding this webinar. Very useful and interesting information.

Thank you for that feedback. Really appreciate that. We do put our hearts and souls into this. It is a lot of grunt work, takes us many, many months, but we really want to make sure it’s evidence‑based, it’s fair, and it’s done in a way where we work with providers to support continuous improvement. And Mark mentioned the Community of Practice and this webinar. They are two means of spreading the word much more broadly and widely because we’re all about helping the sector overall to learn from what we’re finding and in fact we are looking to post Community of Practice posts out of the review we’re currently undergoing. Not to pre-empt our findings but more in the spirit of pre-emptively sharing some I guess areas where we need to raise awareness with the sector. Why wait ‘til the end of a few more months to do that. So that’s sort of where it’s coming.

Let me just check. I’m obviously not very good at driving this but I think we’re going okay. I can’t see any others. We are at 2:52. I might wait just for a minute or so but if there’s no others – there we go.

Q:        Are providers able to volunteer for the next review?

Wow. Absolutely. We love it when that happens. We did have volunteers for our first review actually. I think there were five. Six volunteered and we had capacity to pick five because we like to spread kind of the range and types of providers where we can. But absolutely. Mark or Lanfeng did you want to just talk to how that can be facilitated in terms of volunteering?

Mark Rummans:

Sure Chamandeep. There is a program assurance mailbox that was displayed on the slide and we’re happy to put that back up in the chat field. So if people are keen to participate please email us and let us know.

Chamandeep Chehl:

Excellent. And we also have the reference group I mentioned and there’s also the Community of Practice. So there’s a few different ways to reach out to us when we start talking about the next review for example. The reference group would know. We certainly would welcome that. Obviously as I said if you’re a corporate provider then it is legally binding on you. If you’re a Government provider then we invite you and generally Government providers have engaged well with us. So keeping that in mind volunteering may not mean you don’t get a draft report and a final report so think carefully before you volunteer. But we always love volunteers.

Q:        Will the webinar be available after this session?

The answer is yes but I don’t know exactly how soon after. But the presentation will go up and the FAQs will go up as well on our website.

Just checking if there’s any more coming through.

Sorry. Just waiting on the team. There’s a bit of lag on the technology side. I think that might be it. So just to close us out I just want to kind of take the opportunity to say thank you to everybody for finding the time to participate. Really appreciate it. If you can just hang on a little bit longer and help us there is a survey for attendees which will automatically pop up once the webinar session ends. And really, really grateful. It literally takes a minute to answer the questions and we’d really appreciate it because it helps us improve our webinars.

So on that note thank you all for participating. Really appreciate your time.

 

Presentation slides

Presenters

  • Chamandeep Chehl – Assistant Secretary, Program Assurance Branch
  • Mark Rummans – Director, Program Assurance Branch
  • Lanfeng Davis – Director, Program Assurance Branch
  • Nicola Champion – Director, Program Assurance Branch
  • Jennifer Young – Assistant Director, Program Assurance Branch

About the webinar

We conduct Home Care Package (HCP) program assurance reviews to:

  • assure value for money for older people in Australia receiving Home Care Packages (HCP)
  • increase providers' knowledge to support improvement and delivery of the Home Care Packages (HCP) program
  • support better services for older people.

Following the completion of the inaugural review on HCP Indirect and Care Management Charges in 2022, we published the next two assurance review reports. 

This webinar to understand the findings and outcomes of the two reviews:

Learn more about the Program assurance of the Home Care Packages Program.

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