Transitioning your home care packages to consumer-directed care

If you have not transitioned all your Home Care consumers to Consumer Directed Care and provided them with a new Home Care Agreement, Care Plan & Individualised Budget, you need to continue working towards this. Hopefully the government’s one off funding will assist you with this undertaking.

Remember, you also have to provide monthly statements reflecting the consumer’s spending and package balance.

Analysing your costings

The Administration Fee you charge out as part of the consumer’s budget would be based on your Head Office and Home Care departments’ costs as part of your 2015/2016 Budget. This will include the following costs:

Have you undertaken an analysis of your costings and priced your services to ensure cost recovery plus a margin?

  • Insurance & government reporting
  • Ongoing research & service improvement
  • Capital costs – eg. additional IT requirements/equipment for staff
  • CDC administrative overheads including staff and IT (excluding direct service staff & their associated costs)
  • Developing statements and other consumer communication
  • Establishing contracts with sub contracted providers – this would be an ongoing additional resource required
  • Setting up and cancelling appointments

Therefore, it is just a matter of working out the distribution to each consumer’s budget, ensuring you have these costs covered.

Remember to exclude all direct service staffing & related equipment such as car & IT in the Home Care department’s overhead charge, as these costs would be charged out as part of the Case Management fee.

Your Case Management charging options will be based on the amount of time the case manager needs to spend with the client, including all follow up work. (Note, your administration staff should do most of this to keep the costs down). This would include the following costs:

  • Set up costs for new consumers
  • Initial Care Planning
  • Initial Service Schedule (determining required services/products based on care plan)
  • Formal package review or re-assessment bi-annually
  • Case co-ordination – organising initial services/products
  • Some initial support provided to consumers who elect to manage their own package

You have to estimate the time you would spend on each consumer, taking into account the above tasks and the level of assistance they require. To cost each category of staffing, take into account their hourly rate, on-costs and any associated equipment such as car and IT.

Implementing your system

Have you got the right systems in place as this is crucial to efficient workflows? I recommend using three systems to cover the CDC process unless you have found a system that does everything:

First system – a mobile software solution, such as Care Collaborator, that the Case Manager/Care Advisor can use to collect the consumer’s personal & financial data in order to generate the required documentation including the Home Care Agreement, Care Plan & Individualised Budget

Second system – Client Management System used to track actual income and expenditure against consumer’s budget and generate the monthly consumer statements

Third system – Finance System used to report on income and expenditure in the Profit & Loss and unspent consumer funds on the Balance Sheet. You also need to generate consumer statements of account showing their amounts owing.

Integrating your data

Have you set up data integrations between your systems as this makes the process more efficient & less prone to error by not having to re-key data?

The following data collected in your first system can be used in your Client Management System (second system): consumer’s personal and budget details. The following data collected in your Client Management System (second system) can be used in your Finance System (third system): Consumer’s personal details for billing purposes and actual income and expenditure. You can also use the consolidated budget information for your annual budgeting process.

Providing the required documentation

Are you using a Home Care Agreement produced in accordance with the Department of Social Services’ Home Care Packages Programme Guidelines? This needs to include the Care Plan, an Individualised Budget and your Complaints Policy.

Providing staff with a safe working environment

Are you asking the consumer some basic questions regarding the environment they live in prior to your staff visiting their home?

You can have a list of pre-set questions to be discussed with the consumer during the initial phone conversation. You might also include some compulsory risk assessment on the consumer’s property such as electrical and gas. This will form part of the consumer’s induction to the program which will be included in your administration charge to the consumer or charged as a one-off fee.

Your financial governence

Are you correctly allocating income and expenditure to the Profit & Loss and Balance Sheet?

I would recommend that you allocate your income initially to the Balance Sheet, then transfer to the Profit & Loss at month end based on the total consumer spending including the Administration & Case Management charges. By doing this, you are less likely to overstate your income.

Evaluating your competition

Have you compared your pricing to your competitors, ensuring that you aren’t pricing yourself out of the market?

You should be comparing your pricing to what other Home Care Providers are charging. Remember to compare apples with apples as some providers may offer a very low administration charge and offset this with higher case management options. Or they may include a mark-up on their service provision, both internal & external


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