How the ‘Support At Home’ Program will impact Care/Case Managers.

The proposed change is designed to improve the quality of care to clients and reduce costs to consumers who do not need care management e.g. those who only access domestic assistance via a Home Care Package (HCP). It is hoped that clients on CHSP services will have access to care management which is currently not available due to the HCP waitlist. This transition will require providers to implement an integrated solution.

At LPA we have provided case management training to in excess of 4000 individuals over the last decade and have considered the pros and cons of the new model.

In the current Home Care model, Case/Care Managers are effectively ‘package administrators’ with the responsibility for budget and procurement, and in our experience there are weaknesses with this model. Case Managers are frustrated at being considered ‘fund approvers’ and this has eroded the reputation and value of their role. Case management or care management should not be a transactional model. Diverting Case/Care Managers to administrative tasks is uneconomical. Additionally, the sector has a critical shortage of staff, especially Registered Nurses. Ironically, an outcome of The Royal Commission into Aged Care Quality and Safety, will see a greater number of Registered Nurses in residential care, reducing the supply in home care.

Case/Care Managers working within their scope of practice, can safely be trained to deliver high-quality clinical oversight to cost-effectively bridge this gap. Health literacy is now a widely recognised concept and at LPA we work with highly skilled Care Managers who demonstrate a high level of skill in being able to identify health changes and implement robust referrals.

The days are numbered where care/case management is bundled into a package, regardless of needs. In the future, care/case management will only be for clients with complex care needs, not for those who may only require domestic assistance. The value of Case/Care Managers is that their skill-set is designed to support clients with complex care needs. However, regardless of any legislative, regulatory or program changes, this model makes sense from an economic, workforce and quality care perspective. So, there is no need to wait to implement it.

To prepare Case/Care Managers for the transformation of their role, service providers need to start upskilling these staff now and reevaluate their workforce around this model. Skills will be required in a number of areas. For instance, health literacy skills are essential. Educating Case/Care Managers about common geriatric conditions enables them to identify and refer to signs of deteriorating health. Early identification and referral to an appropriate health professional result in interventions that halt or minimise further deterioration. Health literacy skills also support continuity of care and multidisciplinary collaboration. This maximises the use of Registered Nurses and Case/Care Managers. These skills are also beneficial in ensuring clients are educated about their role in managing their health. Equipping clients with health literacy skills promotes independence and dignity as well as reduces the risk of unplanned hospitalisations, medical emergencies, and deterioration of health.

While the ‘Support At Home’ program may feel disruptive, service providers can maximise the benefits of this transition. The key is to become educated on new systems and ensure all employees including Case and Care Managers are adequately trained and upskilled to not only remain compliant to new protocols but also excel in giving the best possible care to customers. Lorraine Poulos and Associates (LPA) run public and customised courses that equip Care/Case Managers to transition to this role defined by the Support At Home program. LPA offers advice, resources and support to providers to establish and implement policies, systems, structures and protocols to enable a smooth transition.