Consumer Directed Care – Moyne Health Services

Assisting with client’s food preparation increases their health & wellbeing

The advent of Consumer Directed Care in-line with the Wellness and Re-enablement philosophy has seen the broadening of care parameters from the old style of 3 showers per week, 1 hour home care and the 3rd weekly lawn mowing scenario. Clients now also benefit from more obscure, complimentary types of goal orientated services.

The Case Manager as part of advocating for their client, strives to provide information enabling the client make a more informed decision to the types of goal orientated care services that are now being delivered.

The vast array of complimentary services are untapped and limitless At the present time they are known to include the list below. Currently these services are being provided from the clients’ unspent funds, then when established will be included in the clients Goals, Care Plan, Service Schedule and HCP Budget.

• Pool vouchers
• Carer support for clients to be able to participate in strength based exercise groups
• In-home massage therapy
• Deluxe comfort support mattresses. A good night’s sleep is the start to a good day
• Cancelling of carer support to access the laundry-mat and purchase of a washing machine to enable client to maintain their independence
• In home meal preparation assistance - a boon for the client’s health and wellbeing
• House spring clean, and window washing – always good for pre-Christmas
• Electricity connected to the shed for Pop to potter
• Higher reliance on carer assisted transport
• Taxi bookings to access social events
• Higher occurrence of evening assistance
• Some of the more obscure requests but also relating to a client’s level of wellness have been known to include;

Applying different methods for a task results in a better outcome

The farmer who was concerned about snakes and the advent of a grass fire saw him using a high percentage of his HCP funds for mowing to keep the grass surrounding his farm house and sheds, maintained.  A home visit and discussion with his Case Manager led to the purchase of an electric strand fence (installed and maintained by the farmer /client) and two goats at $25 each for lawn duty. The subsequent reduction in mowing costs allowed the client access to funds to provide personal care and regular transport to town for socialisation. “Win Win!!”

Wheel chair access via construction of footpath providing access to BBQ area and the simple and enjoyable ability to be able to access the letter box.

Pathway with access to the chicken coup and construction of raised planter beds to continue with daily chores and enjoyment in gardening.

Contact and consultation with a Case Manager who appreciates and understands these diverse services sees the client’s needs, requirements met which greatly enhances the client’s ability to achieve and maintain their goals.

In the first instance, we need to ensure the client is being provided with the necessary level of care to maintain their independence and not favour saving unspent funds to purchase equipment.

The Client Budget

The open and transparent client HCP budget and the provision of an accurate, easy to read and informative monthly financial statement has been a godsend for both the client and the Case Manager. These updates have proven to enable the client to have ownership and a higher level of understanding of the financial working of their HCP.  The monthly budget statement has also proven invaluable for the Case Manager and client to monitor a client’s level of spending, including one-off purchases and care services.

These monthly statements reconciled with the Providers Medicare Payment summary ensures accuracy of payment funds. Having at hand the amount of unspent funds available for a client has proven to be a huge advantage for the supportive Case Manager when a client enquires or requests access to funds for, complimentary services, equipment or an increase in short-term care to re-able them to regain their base level of Wellness.

Another aspect to ensure transparency on both sides of the coin is to ensure the client informs the Case Manager about their requests and not just purchase equipment or services and expect the Provider to pay the invoice. It is much easier for the client to source their desired item then allow the case manager to arrange a purchase order.

 The Need for Case Management

A supportive Case manager is key

The level of HCP Providers that allow their Case Managers to have the privilege of being able to provide person centred, in-person Case Management seems to be (or is) diminishing.  Some HCP Providers have adopted the perception that providing clients with a higher level of understanding and ownership of their HCP allows the Case Manager to take a step back – but is this equated with a Case Management fee reduction?

Current clients still want, need and do benefit from the supportive Case Manager. Can you envisage many of your clients being able to navigate the MyAgedCare system? This week I had a client who had to arrange 3 times for his POA daughter to give MyAgedCare consent to release his referral to his preferred Provider.

As time passes newer clients related to the baby boom may/will seek to have a higher level of involvement in their HCP. This may equate to less Case Management costs. The supportive Case Manager who is:

1. Readily contactable

2. Able to visit in-person

3. Is supportive and builds a good rapport

4. Actively monitors, reviews and consults with the client

Will remain a justifiable, viable and accepted component of a client’s HCP

The HCP Providers that work from a distance without the provision of face to face will lose the personal touch and may see themselves becoming more reliant on revenue gleaned from the initial setup fees, contractor monitoring, gap fee in service costs, and exit fees.

The key issue will be the quality of Case Management and genuine Consumer Directed Care.  

Kevan McNamara, Home Care Services Managers, Moyne Health Services