Elderly migrants at risk of overcharging and reduced services under aged care overhaul

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Fears of reduced services and higher fees under Consumer Directed Care reforms.

There are fears of higher charges and reduced services for elderly Australians who get subsidized home care under a new national system.

The concerns are even greater for those from non-English speaking backgrounds.

After a three-year transition period, Consumer Directed Care (CDC) is now national. It's meant to give greater flexibility in the home care services bought, using a personal budget assigned according to client needs.

The packages range from an annual $7822 which buys around two hours of care per week for the lowest-need clients up to $47,566 a year - equating to up to 11 hours of care per week for those assessed at the highest Level 4.

Maria Jacubcyk, 82, from Sunshine in Melbourne has been on a Level 2 package since last year.

"I came home from hospital last month and needed a special chair to sit on. It's very good, I'm very very happy," she told SBS. 

Limitations

But the Federation of Ethnic Communities Councils has long pressed the Government about limitations in interpreting and translation services.

The Commonwealth provides free interpreters and translators to negotiate client agreements, and discuss financial statements. But ongoing needs must be met from the client's budget.

"We had a Polish consumer who wanted the agreement in Polish", said Ekram Awadallah from Melbourne support agency, Australian Multicultural Community Services. 

"And the quote for translation came back at $3000. That's about 40 per cent of a level one package subsidy. "

Penni Michael works with DutchCare, a not-for-profit community organization that helps with aged care services.

She says it's a complex system - especially for many from non-English speaking backgrounds.

"So under CDC, they're the ones who are meant to be able to direct the service. But they lack the skills, the system or the framework is unfamiliar. And I'm not quite sure which agency is meant to be educating, explaining, advocating and creating the access points."

At Fairfield Heights in western Sydney, Iranian-born Neema Nazari-Zaadeh has dementia, qualifying her for home care packages at the highest level 4.

Her daughter Najat said under CDC the number of care hours provided has fallen from 23 hours per week to ten.

"In ten hours you cannot include all the services, you know a level 4 package including all the services, like domestic, personal care, shopping, transport, physiotherapy; all of those including nurse (sic)," she told SBS World News.

"I need some hours to go out, at least once a week I need to go out. So I need some eight hours from those ten hours."

Costs

According to aged rights groups, hours have reduced because government funds go directly to the elderly person, not the service provider, which in the past could pool the money to subsidise higher-needs clients.

Providers do set the fees and may pass on administration and other charges.

And there's concern that, with no benchmarks for these costs, some providers are overcharging.

Support group NSW Aged Care Rights cites an extreme example of a client who was charged $80 an hour for help with showering. 

That's a surprise to other aged care providers.

Thomas Camporeale of Italian not-for-profit agency Co.As.It defends reasonable costs, while acknowledging their impact.

"Providers are forced to put very realistic unit costs on case management and personal care, for example, so they can recover the costs associated with running the business," he said.

"Yes, in some cases that has impacted on some consumers having to now reduce their hours, ironically, under a Consumer Directed Care environment."

Mr Camporeale also represents the Federation of Ethnic Communities Councils.

He told SBS there are cases of package providers imposing extra fees, to discourage clients from shopping around for services.

"The government's response to this is that, it's not their role to tell providers how to do their business. but we're finding it's an inequity, particularly for people who prefer to have a service delivered in their language," he said.

Assistant Social Services Minister Mitch Fifield declined to be interviewed by SBS World News for this story.

However in previous media releases SBS was referred to he admits that during the three year transition period changes made by some providers have had adverse impacts. he said providers are expected to keep their fees to a minimum.

He said people with concerns should first approach their service provider, then the CDC Transition Hotline 1800 138 225. 

Source SBS

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