SELF-MANAGE YOUR HOME CARE PACKAGE

TOOLKIT

Level 4, 530 Little Collins Street.

Melbourne VIC 3000

Phone: 1300 899 288

Email: selfmanagement@cota.org.au

Website: www.cota.org.au

Welcome to COTA Australia’s Self-management in Home Care project trial.

Take your time reading through this document. Your participation is all about testing this comprehensive guide for yourself, and

importantly, on behalf of future self-managing people. You don’t have to do everything all at once - there are things you can come back to

later or skip over altogether if they don’t apply to you right now.

The COTA Australia project team have developed this document in collaboration with a number of valued contributors.

We’d like to extend our thanks to our key contributors and acknowledge their valuable input.

Home Care Consumer Working Party MembersHome Care Provider Working Party Members

Home Care Expert ReviewersOver 400 people who participated in our initial

surveys and consultations.

For those participants who have been self-managing their package in different ways already, we’d like to know how useful this Toolkit

would have been to you when you first started.

You are receiving this Toolkit because you are a participant in COTA Australia’s trial for ‘Increasing Self-management in Home Care’. This Toolkit was preceded by the Welcome Pack. It is helpful for you to have both documents handy during the trial.

The Welcome Pack was designed to introduce you to the concepts of self-management and our model, so this document won’t repeat any previous information. The information included in this Toolkit will provide you with more practical Tools and information to navigate through this 6-month trial and to effectively self-manage your home care package. The Toolkit is laid out in sections relating to the different elements of our Self-management model.

As you work your way through the document you will see some pages have a grey box on the top, right-hand side of the page with the word ‘TOOL’. The practical Tools are designed to be interactive activities to help you with aspects of self-managing your home care. You do not have to complete them but they are there if you want to work through them. You can type directly into the digital version or you can write on the hard copy. The remaining pages in this document are for information only.

“Taking ownership of your life brings many rewards!”

Working party member

IMPORTANT INFORMATION

Not all project partner Providers in this trial are identical. By their request, our providers are testing variations of the financial management options and staff management options. This means that some of the features you read about may or may not be fully relevant to you. Your Provider will communicate which options will apply to you.

CONTENTS Contents

Home Care ObjectivesSelf-management ModelMy Care And SupportSelf-Assessment ToolPrioritising Needs ToolMeeting My NeedsCare Plan Review ToolCarer Case Study: MariaFinancial ControlLoad ‘n’ Go AccountBankWest AccountRecord Keeping ToolFlexible SpendingFlexible Spending ToolCase Study: Li JingCase Study: GeorgeCase Study: Ray and NormaQuality and ComplianceTask Allocation ToolHelp If I Need ItIf Things Go WrongPreparation ToolFAQs

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HOME CARE OBJECTIVESThe Australian Government objectives of home care are a good reference point throughout your home care journey. These objectives are; 1. to assist people to remain living at home; and 2. to enable consumers to have choice and flexibility in the way that care

and support is provided at home

Australian Home Care Packages are delivered using a consumer directed care (CDC) model. The principles of CDC are;1. consumer choice and control 2. older person’s rights3. respectful and balanced partnerships4. participation 5. wellness and reablement6. transparency

For more information there are numerous sources online including the Australian Government Department of Health and Home Care Today websites.

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FINANCIAL CONTROL

HELP IF I NEED IT

You will have direct access to your home care package budget and statement online. You will have more autonomy over spending decisions.

FLEXIBLE SPENDING

MY CARE & SUPPORT

You can purchase services and products online and in-store using a debit card connected to your home care budget.

You can be more involved in your care planning, as well as your staff selection, rostering and daily communications.

You will have access to a range of helpful resources as well as access to our self- management consultant to help you stay on track with self- management tasks and activities.

SELF-MANAGEMENT MODEL

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You will note that each of the four elements of this model are colour coded. These colour themes are repeated throughout the document to indicate which element is being explored. You can learn about each section simply by matching the colours in the banner on each page.

MY CARE AND SUPPORT

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During this trial, COTA Australia and your approved provider encourage you to play a more active role in your care planning and arrangements with your support workers. On the following pages you will find information and several practical Tools which will help you with understanding and reviewing your home care and support.

Providers are only required to review your care plan annually, which means it can quickly become outdated. Your care plan should reflect your current needs and wishes; the spending of package resources should be tied to your care plan and to the outcomes you are trying to achieve.

Your unique qualities, characteristics and life experiences are what makes you who you are today, so your care plan and package spending should reflect your identity and what is important to you. The Government auditing process also uses your care plan to judge the appropriateness of the services delivered to you.

These Tools can help you decide what your most essential or urgent needs are. We recommend that you have a copy of your care plan on hand as you work your way through these Tools.

SELF-ASSESSMENT TOOL● PAGE 5

This Tool will help you to self-assess your care needs in the different domains of your life. You may identify areas that you need more help with. There are a series of prompting questions to help structure this activity. You will notice that these questions may be different from other assessments you have had.

PRIORITISING CARE NEEDS TOOL● PAGE 8

This Tool will help you identify the needs which are highest priority for your unique circumstances. This Tool may help you decide what your most urgent and essential care needs are. Knowing this can assist with designing your tailored care plan.

CARE PLAN REVIEW TOOL: ● PAGE 11

After going through the the Care and Support Tools as described in this table, you may wish to review your care plan. This Tool will help you to structure your changes to your care plan. There is no requirement for you to change your care plan. These Tools are provided as a prompt to consider your options and how you go about meeting your needs overall.

MY CARE AND SUPPORT

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Your provider is the host of your home care package, however, the provider will be able to form agreements with your preferred workers to enable more flexible staff arrangements. Before making changes to your arrangements we highly recommend that you thoroughly explore your community and different services available in your area.

You can select your support workers from several sources: 1. from your approved provider (if applicable to your specific provider)2. from service provider organisations in your area3. people from the general community as independent contractors

If you want to choose, manage and roster your own independent workers, there are two pathways in this trial which may vary depending on your provider:

PLEASE NOTE: You are not required to make any changes to your current arrangements with your support workers. This is an option for you to consider and explore only if you wish to do so.

BETTER CARING WEBSITE● Please refer to the separate brochure

for more details.

This is a safeguarded website for choosing and scheduling independent support workers according to your needs and preferences. You can search, post a job and/or bring people you already know in your community on to the website.

FLEXIBLE STAFF MANAGEMENT BOOKLET● Please refer to the separate brochure

for more details.

This is a booklet which describes the process for you to find your own workers from your community and bring them in as contractors with your approved provider.

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PROMPTING QUESTIONS YOUR NOTES

CULTURE & TRADITIONS

What are the important parts of your own family traditions and/or culture that you want to maintain? Are there things that you used to do in this regard that you are not able to do anymore? Do you want to find a way to make this happen again?

HEARING AND VISION

Does your hearing or vision interfere with you doing things you want to do?

SOCIAL NEEDS

What social activities have you enjoyed in the past? What is stopping you from doing these activities these days? What do you miss?

FINANCIAL/LEGAL MANAGEMENT

Do you make most of the decisions for yourself these days? Who assists you? Are you happy with this or would you like to change it?

HEALTH PROFILE

Who do see when you have a health concern? Which of your health issues impacts your daily life the most?

SELF-ASSESSMENT TOOL

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MEDICATION

Do you manage your own medication?Do you, or do others in your life, have any concerns about medication management?

PAIN

Does pain interfere with your everyday life? In what way? Would you be able to do more for yourself and do more activities if you did not have pain?

COGNITIVE HEALTH

Do you experience problems with memory or thinking? Does this stop you doing things you want to do?

EMOTIONAL WELLBEING

Do you experience times when you persistently feel worried or upset about things? In what way does this affect your life (sleep, energy, appetite)? Would you be more involved in other activities if your sense of wellbeing was improved?

MOBILITY

Is your mobility limiting things you want to do with your everyday life? In what way? Would you be able to do more for yourself and do more activities if your mobility was improved?

SELF-ASSESSMENT TOOL

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PERSONAL CARE

What are the main personal care areas you need assistance with (dressing, washing, grooming, drying, transfers)? What are the sorts of things that prevent you from being more independent with your personal care? Do problems with continence cause you to change your normal routine or have you stopped doing things you enjoy because of it?

NUTRITION AND HYDRATION

Do you have any problems eating or preparing meals (swallowing difficulties, weight loss, and reduced appetite)? Do you drink enough water ie. 8 glasses per day?

SELF-ASSESSMENT TOOL

FALLS AND BALANCE

Do you limit the things you do in life because of the risk of having a fall? What would make you feel more confident? Would you be able to do more for yourself and do more activities if your balance was improved?

DOMESTIC ACTIVITIES

What is preventing you from doing more around the house and garden nowadays? Is there something that could assist you to participate more in household or garden maintenance?

PRIORITISING NEEDS TOOL

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I need help to: Examples of care and services Prioritise from 1 to 8

look and feel my best by managing my personal care

• showering and grooming • continence management • allied healthcare (eg, podiatry, occupational therapy and physiotherapy) • other clinical health care and nursing

stay safe at home, reducing risks, keeping me safe and well with people that I know and trust

• personal alarm • monitoring and welfare visits • home safety assessment • sensor lighting, ramps and rails • key safe • aids and equipment

stay connected with my family, friends, culture and community and get out and about

• social and creative activities • healthy exercise • visiting family/friends • attending important events • keeping me connected to culture and country

look after my health with nutrition, medication management, medical issues

• meal preparation • medication prompts• healthy diet • pharmacy packed dose administration aids

manage my home and garden

• domestic home care • garden and home maintenance • de-cluttering and sorting

manage tasks such as paying bills, shopping, banking etc.

• care worker to help me with day-to-day errands • taxi or fuel vouchers

use technology, aids and equipment, or improve my mobility (lease or purchase)

• mobility equipment (ie. 4-wheel walker) • electric recliner, hospital bed • assistance setting up direct debit and online payments• online shopping

support my carer • respite care, counselling, linking to other services

Even though you already have a home care package, there may be other ways to get some of the care and support you need. Not every need or issue you identify for yourself will require a formal service response.

Look at the list on the following pages. Think about which resources are available to you and how they can work together as part of a network of support for you.

● FAMILY, FRIENDS AND NEIGHBOURS:

At times, over the course of our lives, we all need the support and input of others – so we should not hesitate to ask for a hand when we need it the most. It might be as simple as help to put the bins out or pick up a few things at the shops, or it might be a bigger job like mowing the lawn or giving you a lift somewhere. Having people do some jobs for you makes you both feel good and usually doesn’t cost you anything.

● YOUR LOCAL COMMUNITY:

If you have been living in the same place for a long time, you probably feel comfortable and familiar with the local area. Your community is often a great source of information, support and services.

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MEETING MY NEEDS

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● YOURSELF AND YOUR OWN INGENUITY:

Nobody knows you better than you do! Use your imagination and draw on your years of experience solving problems for yourself. Some needs can be met by others lending a hand, some with formal support services, and others by putting some money towards them if you can. You might like to contribute some of your own personal funds to boost the services you receive. If you have been saving money for a rainy day, investing in yourself and your wellbeing may well be the rainy day you have been saving for!

● OTHER GOVERNMENT PROGRAMS:

Depending on your needs and circumstances, you may be eligible for other free or inexpensive programs and services. Sometimes you can be eligible for more than one program at a time.

These might include: ● Commonwealth Home Support Program● Veterans’ Home Care● Carer programs ● Continence Aids Payment Scheme ● Aids and Equipment Program● Discount price taxi card● Exercise and health programs ● Falls and balance programs ● Allied health programs (such as podiatry, physiotherapy or occupational

therapy) ● Chronic Disease Management Plan via your GP● Support programs for people with specific health and medical problems ● Community Visitors Scheme.

MEETING MY NEEDS

CARE PLAN REVIEW TOOL

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KEEP What parts of your current care plan do you want to keep? What’s working well?

ADD What do you want to add to your care plan to stay up-to-date with your current care needs?

REMOVE What in your care plan is no longer relevant to your needs?

After going through the Tools in this section, you may wish to compare your answers to your current care and spending plan. You may have decided that your care plan needs updating or that some of your needs can be met in other ways. You can use this structure to help you make appropriate changes.

You will need to notify your provider once you make any changes to your care plan.

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Greta, was assigned a level 4 home care package when she required higher levels of support due to the fast progression of her Alzheimer’s disease. Her daughter, Maria, found a provider who not only offers a self-management option and a competitive administrative fee but also allows flexibility in how the home care funding is directed.

Maria has personally screened all the support workers to ensure they understand Greta’s needs, interests and personality. Maria and the support workers communicate directly with each other rather than going through a third party provider and manage their own rosters between themselves. A privately negotiated hourly rate allows for many more hours of care than Greta’s package could purchase via more traditional service providers. Maria engaged some of the support workers directly through a safeguarded online employment platform, where support workers are thoroughly screened and fully insured. Maria had already knew several care workers whom her mother had liked in the past. At Maria’s suggestion, they agreed to register themselves on the online employment platform so that Maria could directly engage them. Maria is very confident with self-managing her mum’s package and appreciates the flexibility, autonomy and control it gives her to respond to her mum’s complex needs.

CARER CASE STUDY: MARIA

FINANCIAL CONTROL

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Participants and providers will have a different financial arrangement to usual during this trial. For the purposes of the research trial, you are encouraged to think creatively and take the lead when it comes to making decisions about what products and services you feel you need to support the life you want to live.

You will have acquired your home care debit card by this time. Some providers are using the Australia Post Load‘n’Go card while others have used a more traditional bank debit card. Contact your provider if you are unsure about your card or if you have not yet got a card.

Depending on your personal preference and your arrangement with your provider, you have the choice of processing payments in the following ways. You may have a different process for different types of purchases. ● pay using your home care debit card● pay by approving the invoice and authorising your provider to transfer funds on your

behalf● pay by approving the invoice and authorising Capital Guardians to transfer funds on

your behalf● set up direct debit payments for commonly occurring expenses

RECORD KEEPING TOOL● PAGE 16

This Tool will help you to structure your record keeping. We recommend that you keep track of the services and products delivered to you to ensure that it aligns with your spending.

You will already have been advised by your provider if they are using the Capital Guardians financial services company to manage the finances and some administration of your home care package funds during the COTA trial.

If your provider is working with Capital Guardians, you will have received an additional Fact Sheet outlining the features that will assist you to manage invoices and payments.

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AusPost LOAD’N’GO ACCOUNT

The home care debit card is a major part of this trial.

● Using a card has a number of benefits, particularly the control you have in directly using your funding.

● You have direct access to view your current funds. If you know how much funding you have, you can make more timely purchases.

● You can make purchases online, or at the point of sale.● Your online account, and mobile phone App, linked to your

card helps you keep track of your budget (in real time).

Most project providers are using the AusPost Load’n’Go re-loadable VISA card for this trial. Avivo (WA) is the exception.

Your Load‘n’Go card will come with instructions to register your account online or on your smartphone. Your online statement will look like this one shown here. You will see a $0.09 fee applies for each transaction but this charge is capped at a total of $1.00 per month.

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BANKWEST ACCOUNT

AVIVO (WA) PARTICIPANTS ONLY:

The home care debit card is a major part of this trial.

● Using a card has a number of benefits, particularly the control you have in directly using your funding.

● You have direct access to view your current funds. If you know how much funding you have, you can make more timely purchases.

● You can make payments via online banking, via the mobile phone App, or at the point of sale.

● Your online account and mobile phone App linked to your card helps you keep track of everyday your budget (in real time).

● BankWest will issue their monthly statement and send it to Avivo as they are the primary owner of the account. Avivo can send the monthly statement to you together with your regular Avivo statement, but you can view it all online at your convenience.

RECORD KEEPING TOOL

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Keeping a record of your purchases is very important when using your home care package funding. It is a requirement by law that home care funding is spent on care, services and products that align with your care needs. Particularly for this trial, any purchases made using your home care debit card must be appropriately recorded. We have gathered suggestions from consumers that currently self-manage their home care and we are recommending for you to follow a similar method.

We suggest the following; ● Keep your receipts and invoices in a dedicated folder as a physical or digital copy, e.g.

take a photo using your mobile phone, or scan a copy. ● Send these to your provider on a regular basis. This could be weekly, fortnightly or

monthly. ● Keep a diary of your services and purchases, particularly recording details of any

services to your home. You may wish to use a dedicated notebook for record keeping.

DATE SERVICE ORGANISATION

WORKER NAME

SERVICE/PRODUCT DESCRIPTION

TIME IN

TIME OUT

SIGNATURE

08/07/2018 McM Cleaning Mel Smith

Cleaning 2pm 3pm <Mel’s signature>

FLEXIBLE SPENDING

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Take a moment to look over the last few pages of the Welcome Pack which contains an excerpt from the ‘Included and Excluded’ items from the Department of Health. As you already have an existing care plan, you will most likely have a number of regular service expenses. You are not required to change any of these services, though this Flexible Spending section may prompt you to consider other types of services or additional purchases, particularly if you have unspent funds.

There are times when an item or service does not fit neatly into the Included Items list. We are fortunate that the Australian Government is not overly prescriptive with approved spending, so you are not locked into a one-size-fits-all, black and white approach to meeting your individual needs.

The development of our Flexible Spending Tool aims to answer these important questions: ● how do we consistently and objectively manage home care package spending that

seems to be in the ‘grey’ area? ● how do providers and consumers stay collectively accountable for spending taxpayer

dollars in a fair and reasonable way?

Start by asking yourself some questions that help you to make decisions that are aligned with the Government objectives of home care, promote independence and wellbeing, improve quality of life, and may assist you to remain living at home longer. The Flexible Spending Tool on the following pages provides some guidance.

FLEXIBLE SPENDING TOOL● PAGE 19

This Tool is designed to help you with your purchase choices. Use this Tool when a spending request does not fit easily into the Government criteria. This should help you to think more creatively about your home care purchases.

FLEXIBLE SPENDING

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For this trial, we want the decision-making process to begin with you, the participant. This means, before you pick up the phone and call your provider to ask them what they think, first spend some time thinking through the process for yourself.

USING THE TOOL

● The questions in Section 1 are very important. Your care goals and/or your care plan must support your package spending. If the request doesn’t fit your care goals, then you must first update this in order to proceed.

● The questions in Section 2 may or may not be relevant to each request, but they are there to stimulate thought and discussion.

● Please refer to the Case Studies to see how others have used their package in flexible and creative ways to meet their needs.

INTERACTING WITH YOUR PROVIDER

● Once you are confident that your request meets the objective criteria, advise your provider/case manager and show them how you worked through the questions in the Tool. Even in self-management, there is an expectation that you communicate with your provider about budgets and spending.

● If your proposed spending request is already part of your care plan or care goals, then you can be confident that the spending is okay.

● If your approved provider does not agree with your considered assessment, it is up to them to show evidence why this is not approved spending.

EXAMPLE:Peter’s wife, Anne, is experiencing changes in managing her continence. Peter wants to arrange an assessment with a Continence Nurse to give some advice. Peter can arrange this assessment with confidence, because Anne’s care goals include Continence Management and she already uses her package to purchase continence products. Peter knows that there is enough money in the budget, so he can go ahead with booking the assessment and simply advise his provider about the plan.

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How will this help me to build/maintain my independence?

How will it help me to self-manage my home care package?

How will this help me to stay at home for longer?

How will this help to improve my quality of life?

How will this help me stay connected socially?

How will this improve my health and wellbeing?

How will this help me to build/ maintain my connection with my family, culture or community?

FLEXIBLE SPENDING TOOL

Most Important: Does this item/activity align with my current care goals or care plan?

If no or unsure, is this purchase urgent enough to bypass a care plan review?

Would this spending compromise my essential care needs? (check Prioritising Needs Tool, page 8)

Is this item on the Excluded list (Department of Health - page 19 of Welcome Pack)

Is there enough money in my budget right now?

Is there another way it could be paid for?

Section 1: Answer Yes / No / Unsure

Section 2: Ask yourself these questions and provide details where applicable

CASE STUDY: LI JINGLi Jing, aged 76, is proud of her Chinese heritage and sees herself as the family matriarch. She had been managing most things herself but was limited by arthritis and mobility problems. This was affecting Li Jing’s ability to cook – an activity that was central to her self-worth and family role. Her hearing loss meant she often didn’t hear her doorbell or phone ringing.

LI JING’S LEVEL 1 PACKAGELi Jing took up a level 1 package with a Chinese-specific provider. Knowing their budget limitations, Li Jing and her Case Manager, Mo Yee, designed a care plan that matched her package funds with her care needs in a very practical and efficient way. Li Jing’s family offered to take care of the home cleaning chores that Li Jing couldn’t manage anymore, but she still could slowly get through most day-to-day tasks for herself. Li Jing and Mo Yee also came to an arrangement where she would only purchase occasional case management from Mo Yee when needed rather than a traditional, on-going case management arrangement.

Li Jing’s detailed care plan included a home visit consultation with an Occupational Therapist specialising in assistive equipment. Li Jing’s package then purchased new lightweight and specialised pots, pans and utensils, and leased an adjustable-height chair for taking a rest in the kitchen. Li Jing didn’t need delivered meals now that she was cooking for herself again.

Later, following the recommendations of the Occupational Therapist, Li Jing’s package purchased a new doorbell with a ringer in all main rooms; sensor lighting in the hallway; and strong external lighting for safety whilst outside. She is now saving her package funds to replace her old hard-to-turn taps with mixer taps and easy-open door handles throughout the entire house. Li Jing’s package is purchasing or leasing aids and equipment and funding basic home modifications instead of providing actual ‘hours’ of care.

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CASE STUDY: GEORGEGeorge lives alone in rural NSW. As the secretary for many local committees over the years, he has a bit of computer knowledge and enjoys researching on the internet. George’s severe rheumatoid arthritis and some vision problems are quite debilitating but his positive attitude and willingness to try new things help him maintain the independence he values so much. George’s son, Andrew, lives in Sydney, though he is very involved in his care – albeit at a distance.

GEORGE´S LEVEL 3 HOME CARE PACKAGEGeorge is self-managing his home care package. George communicates with his Sydney-based package provider by email, Skype or telephone.

George needs assistance every morning with his personal care routine. Other than that, he prefers not to be tied to a particular day and time to do other things, George has contracted local people to provide his care. He is happy knowing he is having his needs met whilst providing valuable employment in a small town. George knows his package budget in detail so he and his staff manage the roster between themselves. George simply submits their timesheets to his provider for payment every week. George’s flexible package pays for his annual hydro-pool membership which supports his physical wellness and mobility. The package also helps him to stay online, covering a modified keyboard and enlarged computer monitor as well as half his ongoing internet connection costs. These are all essential tools for self-management and for staying in touch with his provider and other service providers. George also likes to keep himself informed of the medical and pharmaceutical advances in treating his health conditions by subscribing to various online publications and forums.

George’s most useful self-management tool is his Home Care Debit Card. Each week, his provider transfers $400 into this account, which George uses to pay for services and products in his care plan including a therapeutic masseuse for weekly in-home massages for joint and pain relief, plus occasional taxi fares to the doctor, and extra continence supplies from the pharmacy if he needs them. Once a month, George gathers up and scans the receipts, tallies it up against the online debit card statement, and sends the whole lot to his provider.

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CASE STUDY: RAY & NORMA

Ray and Norma recently celebrated their golden wedding anniversary. Ray has advancing Alzheimer’s Disease, but is otherwise fit and healthy. With their family living overseas, they’ve had to make some significant adjustments to their previously busy life. Ray is often anxious and tends to follow Norma around like a shadow. Norma loves Ray, but she feels alone and at times finds his behaviour very difficult to deal with.

RAY´S LEVEL 4 HOME CARE PACKAGENorma is self-managing Ray’s home care package and plays a major role in care planning to best meet Ray’s needs and her needs as his carer. Four times a week, a male care worker helps Ray shower and shave. Afterwards, they take a long walk together. Norma arranged a consultation with a dementia behaviour specialist to better understand Ray’s disease. The consultant gave her useful tips on how to respond to his behaviour and provided information about the free Dementia Behaviour Management Advisory Service. The dementia specialist recommended that Ray’s package purchase an iPad which the care worker uses to take photos of things that interest Ray whilst out on his walks. In the afternoons, Norma settles Ray by using the iPad to play his favourite music, and together they flick through the photos he has taken.

Following home visits from an Occupational Therapist and a Continence Nurse Advisor, Norma arranged for the package to lease an electric recliner chair, purchase a new four-wheel walker and a range of continence aids and products for Ray. Ray goes to a Day Centre once a week, which means Norma has valuable time to visit friends, go shopping, or just have some time at home. As a former nurse, Norma likes to keep informed about dementia research and treatments, so Ray’s package is paying for her to attend a Dementia workshop in the city. Norma can learn new information and then share this with her Carer Support Group.

Norma is not able to get additional in-home respite care funding because of Ray’s level 4 package, so she banks a few hours from Ray’s package wherever possible to plan a special day out with friends. To help support Norma with her changing role from ‘wife’ to ‘carer’, her GP arranged six free sessions with a counselling psychologist to explore the many emotions she is feeling. Norma is also part of a monthly Carer Support group where she has met others who are living in similar situations as herself.

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QUALITY AND COMPLIANCE

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This model of self-management operates within the current legal framework for aged care in Australia. In your Welcome Pack, and on separate pages in the project folder, you will find information on the roles and responsibilities in relation to self-managing your home care. The purpose of these documents is to to help all parties understand their obligations in this trial. It also helps to clarify which tasks and activities are optional. We recommend you sign the document to show your understanding and acceptance of the requirements.

You will also find a helpful Tool which helps to tease out the optional elements of self-management and structure your delegation of these jobs.

TASK ALLOCATION TOOL● PAGE 24

This Tool will help you identify the tasks you wish to take on in this self-management trial, as well as delegate to other parties involved in your care. This is not a binding part of your agreement.

Using the checkboxes place a tick to indicate your choices. You may wish to work through this form with your family and other people involved.

You are welcome to change and adapt your answers throughout the trial. You may even want to add in another responsibility that is not currently listed.

TASK ALLOCATION TOOL

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SELF-MANAGEMENT TASKS

YOUR RESPONSIBILITY

YOUR APPROVED PROVIDER

YOUR CARE WORKER/S

Choosing care workers

Deciding on appropriate services

Keeping record of services delivered

Arranging times for services to occur

Adjusting changes in schedule

Negotiating rates with workers

Submitting timesheets

Making decisions about purchases

Using home care debit card to make purchases

Keeping receipts from all purchases

Sending receipts and invoices to Provider

Approving invoices/payments

Payment of invoices

HELP IF I NEED IT

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Historically, home care packages and case management were synonymous. It was the main feature that supported consumers through the complex care system. These days, things have changed and more people want to reduce their costs and manage their care and support for themselves. However, even the most independent self-managing consumers and carers may need help at some point. Often, this help is most needed during times of challenges and difficulties.

In this trial we have several resources in place for you to access:

○ Angus Kerr, COTA Australia’s independent self-management Consultant○ Resources including: Toolkit, Welcome Pack and supporting fact sheets ○ Access to the COTA Australia project team

“Sometimes asking for help is the most

meaningful example of self reliance.”

Anonymous

PREPARATION TOOL● PAGE 28

This Tool will help you to identify ways to prepare for challenges and issues with your home care that may arise.

HELP IF I NEED IT

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It is our intention that our written resources will provide the guidance and help you might need. However, for the purposes of this trial we have a self-management Consultant available to you should you need additional guidance. Angus Kerr is an independent professional with extensive experience in home care and case management. We anticipate that some participants will need this support more than others.

You can contact Angus, via the COTA Australia details below for questions relating to self-managing your home care. ● Project email address: selfmanagement@cota.org.au

● Project phone number: 1300 899 288

Theresa from the COTA project team will be in contact with you to organise two personal consultations with Angus during the trial. These consultations will involve discussions about your experiences on the trial, to provide guidance and to support your progress with self-management. Angus is not a replacement for your usual case management arrangements, which can continue during the trial.

“Asking for help does not mean that we are weak or incompetent. It usually indicates an advanced level of

honesty and intelligence.”Anne Wilson Schaef

IF THINGS GO WRONGThere may be times when self-managing your home care can become overwhelming, or a crisis may arise unexpectedly. How we prepare for these problems can hugely affect how much our lives are impacted by them.

SAFEGUARDS:

● We recommend you fill out the Preparation Tool on page 28 and have a copy of this information on hand at home.

● Identify a case manager or someone within your home care package provider who you can reach out to for additional support when required. Engaging a case manager periodically can be a great resource and provide value to your care plan, especially in times of crisis or when you require assistance in navigating unfamiliar situations.

● Consider keeping aside some of your home care funds as your contingency plan; we recommend having around $350 available. This is enough for approximately 3-4 hours of professional advisory support which may be just enough to get you back on track again.

● If you are managing your own staff, ensure you have contact details of one or two other willing workers that can be a replacement if something goes wrong with your usual worker/s.

● If you are a carer, consider identifying a preferred respite service or other reliable supports, and have their contact details handy, just in case.

● Maintain regular contact with your next of kin, friends and/or neighbours if you can. Let them know you may call on them for help from time to time and have their contact details handy.

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HELPFUL CONTACT PLEASE FILL IN THIS COLUMN

Back up workers and/or back up approved agencies

Name: Phone number:

Name: Phone number:

Name: Phone number:

Next of kin or equivalent Name: Phone number:

Name: Phone number:

Trusted friends, neighbours or other connections

Name: Phone number:

Name: Phone number:

Preferred case manager or contact within your home care package provider

Name: Phone number:

Name: Phone number:

Preferred respite services Name: Phone number:

Name:Phone number:

Enduring Power of Attorney Name:Phone number:

PREPARATION TOOL

FAQs

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Do I need to ask permission from my approved provider each time I want to buy a product or engage a service?

● For the purposes of the research trial, you are encouraged to think creatively and take the lead when it comes to making decisions about what products and services you feel you need to support the life you want to live.

● To assist with decision making, you may need to complete the Flexible Spending Tool on page 19 of your Toolkit.

How do I find out what products and services I can purchase with my Home Care funding?

● Refer to the Government spending guidelines in the Welcome Pack on Page 19 to 21.

● Consider examples of how others have used their package to support their care needs by reviewing the case studies.

● If still unsure ask your provider or COTA Australia’s self-management consultant contact details on page 29.

Is there any flexibility to choose products and services outside the Government guideline?

● There are a number of products and services listed in the Government guidelines; these are only some examples and not the only purchases allowable.

● We encourage you to use the ‘Flexible Spending Tool’ on Page 19 to work through the same decision-making process that providers use to determine whether the package can fund your request.

Is there anything that Home Care funding can't be used for?

● Some things are excluded. These are also detailed in the Welcome Pack on page 19 to 21.

What happens if my choice of products/ equipment or services is not agreed to by my provider?

● The Flexible Spending Tool (Page 19) is a helpful resource to assist your thought process behind your choice/s and be useful in talking through your choice/s with your provider.

● If you have completed the Flexible Spending Tool, but your provider does not agree with your choice, then your provider should demonstrate why your request does not meet the criteria. The onus is on you both to be objective and responsible when it comes to allocating Government funds towards any spending request.

● If you feel that your provider’s perspective is unfair, and you have exhausted all discussion with your provider, you can call your state advocacy helpline for further advice.

FAQs

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What if I find that self-managing my Home Care is becoming too much for me?

● You can contact the COTA self-management consultant via selfmanagement@cota.org.au or 1300 899 288 to discuss your concerns.

● At any time, you can choose to opt out of self-managing, or reduce the amount of self-management, and add more case management support as needed. This may require a review of the self-management agreement you have with your Home Care provider.

What is a care plan and how does it relate to self-management, choice and my Home Care budget?

● Your care plan is a clear and written blueprint or expression of your individual life goals, and the care and support needs which will help you achieve those goals. You can be involved in creating and reviewing your care plan as a self-managing participant.

● Your care plan forms part of the Agreement with your provider and is at the core of how your available funding will be allocated.

Can I create and review my own care plan?

● Absolutely. Turn to page 5 to 11 for thought starters about what you might like to include in your Home care plan to achieve your personal lifestyle, health and well-being goals.

● Share your care plan ideas with your provider/case manager.

What if I don’t currently have a written Home care plan?

● You will need to discuss this with your provider as it is essential to have an agreed care plan.

● You can begin the process of creating a care plan using the Tools in My Care and Support section from page 5 to 11. You can liaise with your provider on finalising your care plan.

Can I continue to self-manage my Home Care package in the same way after the trial period is over?

● The arrangements that are in place are for the duration of the project trial.

● We hope that your provider will continue with the trial arrangements that you have enjoyed, however, the decision will be between you and your provider.

What are the benefits for me of directly choosing and managing my own care staff?

● You have direct control over what support services are delivered, by whom, and when and where those support services are delivered.

● You negotiate the times and rates directly with chosen support workers.

● You can potentially increase the number of hours of support possible within your package budget because you are engaging support workers directly rather than through an agency.

FAQs

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Who is ultimately responsible for how my Home Care funding is spent?

● Whilst you are encouraged in the trial to choose how, where and when your Home Care funding is spent, these decisions must be consistent with your care plan and budget.

● Whilst your provider is accountable to the Department of Health, we encourage you to share equal obligation with your provider for how your funding is spent.

In self-managing part or all of my Home Care, will this mean that the administrative and case management fees which currently apply will be reduced?

● Existing administrative and/or case management charges will remain in place at the commencement of the self-management trial.

● We acknowledge that as part of this trial, you will be doing more of the administrative tasks for yourself. The decision to reduce the administration fees charged to your package is a matter for each provider organisation, and COTA Australia has no influence in this regard.

● However, it will be a topic that is discussed by the Project Steering Committee and any changes will be communicated with you directly by your provider.

What happens if there are changes during the self-management trial due to a hospital admission, respite care, transition care or a holiday

● You will need to advise:

a) Your support workers and/or other booked service providers.b) Your Home Care Package provider, as this will affect the

payment of your Home Care Package subsidy.

What rules apply to the use of my Home Care Debit Card?

● You will organise with your approved provider on the way you wish to use your debit card. This will be different depending on your unique circumstances, and the procedures your provider has in place.

How much value will be loaded onto the Home Care Debit Card?

● This will depend on the agreement made with your provider, based on your total Home Care budget and agreed budget allocations.

● You can negotiate additional unspent funds being added as needed

FAQs

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How do I use my Home Care Debit Card for purchases?

* See note below

You can use the card just like any other debit card:● at the point of purchase as a tap-and-go or enter your pin,● for online ordering and payment where card number details can be

entered, and● for purchases made over the phone where card number details are

given.

Do I need to keep receipts from Home Care Debit Card payments and copies of invoices for goods and services purchased?

● Yes, you should keep your receipts and copies of invoices as proof of purchase and card usage.

● This is very important as you and your provider must keep an auditable record of spending.

What happens to any funds left unspent against my Home Care budget at the end of each month?

● Any unspent funds roll over indefinitely and will be shown on your provider monthly statements.

*NOTE: The AusPost Load’n’Go card does not allow you to use a ‘Pay Anyone” facility i.e. direct transfer to a nominated bank account.

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Disclaimer: This Toolkit provides general practical advice and is not intended as legal or financial advice. This publication should not be the only source of information for consumers and providers of home care. COTA Australia encourages anyone who has questions about home care to get the relevant professional advice to discuss their own or their organisation’s particular situation. COTA Australia makes no representations or warranties of any kind with respect to the contents of the information. To the maximum permitted by the law, COTA Australia disclaims any such representations or warranties as to the completeness, accuracy, merchantability or fitness for purpose of the information.

PROJECT CONTACT DETAILS

Anna Millicer Jacqui StoreyProject Manager Project CoordinatorCOTA Australia COTA Australia

Phone: 1300 899 288Email: selfmanagement@cota.org.au

Level 4, 530 Little Collins Street.

Melbourne VIC 3000

Phone: 1300 899 288

Email: selfmanagement@cota.org.au

Website: www.cota.org.au