HCP recipients, when to get reassessed.

Case 1: The 78-year-old Granny Sun, who lives in Melbourne accidentally fell at home and was unable to walk. She underwent rehabilitation treatment at home. Granny Sun’s demand for care services increased. Granny Sun’s daughter notified her Care Manager at Happy Living for the first time. The subsidy was upgraded from level 2 to level 3 after a reassessment.

Case 2: Last month, 84-year-old Uncle Wang, who lives in Sydney, suffered a sudden stroke and entered a nursing home. He wanted to get more care services to assist with his daily life after being discharged from the hospital. Uncle Wang’s subsidy has been upgraded from level 3 to level 4 after a reassessment.

The word “reassessment” appears in both cases, which is not fully understood by some older people. For example, we have heard:

“Reassessment, is very complicated, and also requires additional charges”

“During the epidemic, let alone assessment, we dare not do anything” and so on

So today we will introduce the reassessment of home care services to you.

 

Different types of Reassessments:

1. The first type of reassessment: care service upgrade assessment, also known as The Commonwealth Home Support Programme (CHSP), single service reassessment.

When many elderly people apply for home-based care services, in most cases, they will first receive a basic subsidy called CHSP, or otherwise called single-service program. As we have introduced in the previous article, this single service is a relatively basic subsidy, and its advantages are:

  1. The service can be started immediately,
  2. No income assessment required.

But this project also has obvious disadvantages:

  1. There is a fee charge for each service,
  2. Only approved service categories can be used and cannot be replaced,
  3. There are very few service providers with Chinese language and culture.

Therefore, many customers want to switch to the Home Care Package (HCP).

 

Requirements for upgrade from CHSP to HCP.

Requirement 1: The older Australian has been approved for CHSP and has held or used it for more than 6 months.

Requirement 2: The CHSP recipient’s care needs, health conditions, and family conditions have changed significantly.

Requirement 3: The care recipient understands the income tested fee (ITF) and is willing to pay the ITF.

Then, if the above three conditions are met, you can contact My Aged Care for a reassessment. The steps are very simple, call My Aged Care, (contact an interpreter if required) provide your AC number, and apply for a reassessment.

Of course, for more specific information, you can also call Happy Living, 1300 911 728 to speak with our consultants.

 

2.The second type of reassessment: the reassessment of the HCP level, which is often referred to as a HCP upgrade.

In the early stages of the HCP application, the assessment team (ACAT) will come to your home (or video call) to conduct an assessment with you. They will ask about your health, how you manage your daily life at home and whether you have support at home. Questions from this series of comprehensive assessments are recorded in the first assessment.

However, over time, if your health, family support and other factors change, which result in developments of your care needs, it is necessary to conduct a re-assessment. Therefore, many elderly people hope to receive a higher level of HCP.

 

What common Scenarios may lead to a reassessment:

According to the experiences of Happy Living, we have summarised 4 common Scenarios that can be applied for reassessment.

 

1.The cost of care services often exceeds the subsidy amount, resulting in frequent shortage of HCP.

The care needs of the elderly have changed, resulting in more types of services than before, and more hours of service than before. When elderly people find that subsidies are often insufficient to cover various types of care services, the government may consider upgrading their HCP level.

Types of services include:

Nursing care, nutritionists, physical therapists, speech therapists, podiatrists, etc.

Please note: the government may only consider upgrade according to care service and hours of service.

 

2. The care recipient’s physical or mental health conditions have changed, and their care needs have increased.

For example, the care recipient needs to be hospitalised for illness, brain functions such as memory and intelligence have decreased, and continence management has changed. Such changes in health status may lead to more care service and hours and they can be re-considered and apply for a HCP upgrade from the government. (Like Uncle Wang in Case 2, a sudden stroke led to changes to his health conditions and increased care needs.)

We know that the physical condition of older people is often changeable. An assessment done 2 years ago may now have expired and no longer be relevant. So a reassessment of the current actual level of care status is required. Reassessment is more common in these cases.

 

3. Family complexity changes or a care recipient loses support.

In the first assessment of the elderly, the assessor will consider the caregiver/guardian as one of the important factors in their decision.

If there is a change in the caregiver/guardian of the care recipient, so that no one is responsible for their care arrangements, the care becomes more complicated, and the they may have more difficulty handling everything. This is another situation where it may also be possible to apply for an upgrade.

For example, a son/daughter who goes to work or live overseas are no longer able to provide assistance. Or another example, a spouse suddenly becomes ill and can no longer help.

Some extreme cases, where caregivers could be committing elder abuse and can no longer provide care, could also result in a care recipient losing support.

In such extreme cases, an application for reassessment and upgrade may also be considered.

 

4. The care recipient is at increased risk.

The care recipient has recently fallen or suffered from a chronic disease.

This could include: an accidental fall, resulting in fractures, long-term bed rest; dangers from skin diseases, such as bedsores; dangers from nutritional deficiencies, gastrointestinal disorders, gout, osteoporosis, etc.; chronic diseases arthritis, asthma, cancer, chronic diseases obstructive pulmonary disease, etc. In any of these situations, an application for reassessment may also be considered.

 

If Happy Living members experience the above scenarios, can they get assistance from Happy Living?

Yes! No matter what kind of management model you have chosen, Happy Living will assist customers with reassessment. However, the following two requirements must be met:

  1. You have been with Happy Living for more than 3 months.
  2. You meet one or more of the 4 scenarios above.

 

Steps to have Happy Living assist you:

  1. Contact your Care Manager and inform them that you wish to be reassessed.
  2. Happy Living will conduct free reassessment applications for eligible senior members.
  3. If the assessment is successful and you get an upgrade, you will be notified by My Aged Care. Depending on the urgency of the your assessment, the waiting period for general upgrades varies from 1 month to 12 months.

 

Concern 1 ” Reassessment, must be very complicated, and also require additional charges”

We believe that care recipients who have this concern should not be a member of Happy Living.

We know that some providers charge a service coordination fee for a reassessment. Therefore, many seniors may have the idea of extra charges. In addition, some providers will also charge different fees based on their HCP level, such as one rate for level 1-2, and another rate for level 3-4. Therefore, the rate will also be adjusted after the upgrade. In general, it brings the care recipient a fear that if they go for a reassessment, they will have to pay for something.

In Happy Living, this situation never happens. Whether you have a level 1 or level 4, we have a fixed rate. In the self-management model, the average rate of 14% remains unchanged. This also includes the cost of assistance from our team if you are eligible for an upgrade.

 

Concern 2 “During the epidemic situation, let alone reassessment, we dare not do anything”

The current outbreak is indeed a peak period, so almost all reassessments will be done over the phone with seniors. Before the pandemic, seniors may have received a home assessment from the My Aged Care.

However, recently most assessment are done by phone with translation. So, we believe that the elderly can safely get reassessed from the comfort of their own home.

 

If you would like to know more about home care, the latest policies, and the benefits and allowance commonly used by the older Australians, please search for the “Happy Living Home Care Package” in Google Chrome or WeChat.

Please call 1300 911 728 (Mandarin, Cantonese, English)