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What's the difference between CHSP and HCP?
Episode 22 • 17th September 2024 • Your Aged Care Compass • Coral Wilkinson & Michelle Brown
00:00:00 00:30:25

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The Commonwealth Home Support Program (CHSP) and the Home Care Packages program (HCP) are two different programs of support for older people living in their own homes.

CHSP is considered “entry level” and HCP is generally for people with higher or more complex needs.

Understand what each program offers and how to access this support.

In this episode:

  • The Commonwealth Home Support Program (CHSP)
  • Home Care Packages (HCP)
  • The assessment teams
  • How does the funding work?
  • How to apply for these programs
  • Types of approvals for entry level services
  • Different providers deliver different CHSP services (fragmented)
  • Capacity to deliver services can be an issue for providers
  • Getting services through a HCP
  • Cost of services
  • Can a person stay on CHSP and not take up a HCP?
  • Changing service provision
  • Some upcoming changes to aged care programs

 Resources mentioned:

Related Episodes:


Connect with Coral Wilkinson: 

  

More about Your Aged Care Compass podcast: 

Are you supporting an older loved one at home and ready to give up because it’s just too hard? Your Aged Care Compass is aimed at anyone who is caring for an older loved one who still lives at home and is wondering what support is available to them.


We're Coral and Michelle, the sisters behind our business, See Me Aged Care Navigators.


Coral is a registered nurse with over 30 years’ experience in both health and aged care. A former assessor with the aged care assessment team, an advocate and author, there’s not much Coral doesn’t know about Australia’s aged care system.


Michelle is a former pharmacist with over 30 years in the public health and private sectors of pharmacy. Michelle is now client care manager for our business. 


Our story started as one of supporting our parents to remain in their own home, to be as independent as possible and remain connected to their community. We reached a point however, of needing extra support and we achieved this because we know Australia’s aged care system so well, we knew what programs could assist us and our parents.


This podcast, Your Aged Care Compass, brings together not only our personal experience in supporting our own ageing parents but also our vast professional experience in supporting other families to keep their loved ones at home. 


We will help you makes sense of Australia’s aged care system, from your first contact with My Aged Care through to the different funding streams and assessment workforces, management options for home care packages and extra funding that people might be eligible for.


There's so much more. Topics relating to dementia and legal and financial considerations will be covered, as well as real life stories of where it went wrong for people and how we guided them to get it right.

 

Your Aged Care Compass will guide you clearly and compassionately to the right support at the right time for your ageing parents and loved ones. 


Like what you hear? Please leave us a Rating and Review. We’d love you to share this podcast with any friends or family who have older loved ones.

Transcripts

Michelle:

Hi listeners, it's Michelle here.

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It's great to have you back for our

next episode of Your Aged Care Compass.

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Today, we're talking about the difference

between CHISP and Home Care Packages,

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two different aged care programs.

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There's a bit of jargon in there.

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Coral, would you like to tell our

listeners what CHISP stands for?

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Coral: Sure, Shell.

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It's the Commonwealth

Home Support Program.

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, it is a bit of a mouthful.

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So, throughout today's discussion, we

might be interchanging between CHISP

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and the Commonwealth Home Support

Program, but it's the same thing.

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Michelle: So what's the difference between

CHISP and the Home Care Packages program?

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Coral: So both of these programs come

under the broader aged care program, and

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they're both accessed via My Aged Care.

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So the Commonwealth Home Support

Program is the entry level in home

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support that people who have been

assessed by a regional assessment

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service, or a RAS, can access.

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shortened and home care packages are the

coordinated service provision that are

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the next step up and are assessed by an

aged care assessment team or the TISP

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services are fragmented, meaning there

can be any number of providers delivering

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the approved services, whereas home care

packages are coordinated, meaning that

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one provider coordinates all the services

and support that you need at home.

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Providers of CHISP services hold the

funding for the services, whereas

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with home care packages, the funding

is allocated to the person, not the

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provider, though the funding still

needs to be channeled via a provider.

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Michelle: Okay.

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Bye bye.

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So how do people get access

to CHISP funded support?

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Coral: They access to the funded

support the services via My Aged Care.

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So that's the, that's otherwise known

as the gateway to aged care services.

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So they would call My Aged Care and they

need to demonstrate that they cannot do

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tasks for themselves that they used to do.

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That's actually the eligibility criteria.

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Plus of course the age criteria.

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Being 65 years of age and older, or

for people who identify as Aboriginal

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and Torres Strait Islander people,

that's 50 years of age and older.

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So needing help to do those

daily tasks that they could

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previously do for themselves.

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When the person calls My Aged

Care, they're going to be screened.

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By my aged care, the call

center staff around these tasks.

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So my aged care asks the person

a whole lot of questions, you

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know, can you cook for yourself?

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Can you still drive?

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Can you still shower yourself?

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A whole range of questions.

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Then my aged care, if so, if the person

is presenting at entry level that their

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needs are not high and not complex.

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My Aged Care will then forward

that referral to the local regional

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assessment service, who will then

take over and contact the person

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to complete their assessment.

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Michelle: And , how do people

get a home care package?

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Coral: Home care packages are

allocated via a similar process.

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So again, going through the gateway,

being My Aged Care, and then being

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assessed by the Aged Care Assessment Team.

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If a person has previously been assessed

by the Regional Assessment Service, they

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would go back via The RAS, the Regional

Assessment Service, for a brief review.

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And if the RAS Assessor is satisfied

of the person's needs that they're

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more than what entry level services

can provide, the Regional Assessment

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Service Assessor, or the RAS Assessor,

will forward the referral onto the ACAT

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then for them to complete an assessment.

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Now people can be referred straight to

the ACAT in the first instance as well.

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So first time that they call My Aged Care

and register, if their needs are high

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and complex and there's a risk to the

older person that if that higher level of

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care is not provided, Sooner rather than

later that the older person may end up

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in hospital or prematurely admitted to an

aged care facility, then the person can

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actually get an ACAT assessment first up.

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And what's likely to happen here is.

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You know, the ACAT being the top tier of

assessment workforce, they can generate

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those entry level referral codes as well.

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So what they might do is they

will do their assessment.

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They might generate a whole

lot of referral codes, which

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are also the approvals.

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So referral codes are approvals.

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And they may give a person a whole

bunch of referral codes Potentially

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get some services in under that entry

level funding, but they'll also get

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approved for a home care package and

they'll go into the queue to wait

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for that package to be assigned.

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But that takes that

takes quite a few months.

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So some people may benefit from getting

some of those entry level type services

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started, you know, sooner until they

get their home care package assigned.

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Michelle: Okay.

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And Coral, do people get the same

services and the same level of

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services from each different program?

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Coral: Yes, , the services that people

receive you know, from the CHIS funded

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services and home care packages.

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Yes, it can actually be the

same type of service, but

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generally it's less frequently.

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So CHISP services tend to offer

domestic assistance fortnightly

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and lawn maintenance about

every two to three weeks.

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Whereas under a home care package,

people tend to receive weekly domestic

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assistance and potentially weekly

lawn maintenance should they need it.

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Meals, transportation, social

support, home maintenance.

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These are also services that are

offered under the Commonwealth

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Home Support Program or CHIS.

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But a person may also have these type

of services included in their home care

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package too, should they want that.

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Some people I've seen on CHIS

services are getting much more

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support than people on a level level.

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For home care package, believe it or not

and a level one home care package, that's

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the lowest level of home care package.

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It's like the next step up from

entry level, doesn't provide

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that much support in reality.

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It's kind of similar to , , the amount of

support that you might get under CHISP.

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So the same level is possible, but by and

large, it's rare to see someone receiving

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such a high level of support on CHISP.

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It tends to be, it's

designed to be basic needs.

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Entry level, you know, just a couple,

maybe a few services at entry level.

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But as people progress up to the next

level, their needs tend to be, you

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know, a little more complex, or there

might be a greater need, or , they

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might be better to have coordinated

services rather than those fragmented

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CHISP services at entry level.

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Michelle: Right.

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How do people get their CHISP services?

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Coral: How do they get

their CHISP service as well?

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As I've already said, you know, the,

the screening happens with My Aged

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Care, and then they go on to have

an assessment with ARRAS Assessor,

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the Regional Assessment Service.

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And from that assessment, they

will be given, you know, a bunch

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of referral codes or approvals.

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Now, in any given location, not all

providers deliver CHISP services.

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There are only a certain amount

of providers who deliver these

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services under this kind of funding.

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It's different to home care packages.

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So, you'll get these referral codes.

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Now you can't, you know, you

can't just go to any provider.

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You have to have a provider who's got the

CHISP funding, accept those referral codes

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and then begin delivering those services.

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Michelle: Right.

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Coral: The, the other point to note

here when those referral codes or

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those approvals are accepted by a

provider the provider, you know,

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they may or may not actually have

capacity to deliver the services.

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And we hear this all the time where a

person has had an assessment at entry

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level and they've received , a bunch

of referral codes, but they can't

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actually get the services attached

to those referral codes because, you

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know, the provider just doesn't have

the staff to deliver those services.

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So it's really important that people

are aware that just because they

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receive referral codes or approvals

at entry level in a perfect world,

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yes, they should get those services.

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But if no one has called the

older person for weeks, there's

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probably a good indicator there that

there's an issue that the provider.

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Can't deliver those services, and

it's really important for the older

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person or their representative to

follow up and contact the provider

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and ask them that question.

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You know, can, can you

deliver these services?

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If my, my mum's been approved for domestic

assistance, can you actually deliver that?

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Is she going to get domestic assistance?

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Michelle: Yeah, because we know the

system's very oversubscribed, don't we?

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Coral: Yeah, absolutely.

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Look, there are, there are, So many

tens of thousands of people vying for

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those CHISP services in any location.

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So, , it's a difficult sector to

work in with staffing and staff

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come and go, and that's kind of

out of the control of the provider.

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So it fluctuates.

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So at, you know, at one time a provider

might be able to deliver those Those that

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CHISPs funded domestic assistance and

they might lose some staff and, you know,

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the next month they might not be able to.

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So certainly an important

point for people to be aware of

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just because they're approved.

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Ideally, it would, you know, they should

get those services, but they may not.

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Michelle: And what about when

someone gets a home care package,

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how do they get their services?

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Coral: So the home care package,

it's, you know, being someone's

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had an ACAT assessment, they've

been approved for one of the four

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different levels of home care packages.

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If, when the person is approved

by the ACAT, that approval enters

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the national priority system,

otherwise known as the queue.

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And the person waits with all those

many thousands of other people in

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that queue, moving ahead, you know,

every week, every month, until

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they get to the front of the queue.

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And then their home care

package is assigned to them.

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So at this point in time, this

can take anywhere from about three

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months to 12 months, depending

on the level of home care package

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that the person is approved for.

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The higher level home care packages

currently have a wait time 12 months.

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So the three and fours.

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Yeah, considerable time to wait and, and

just going back to those CHISP services,

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this is where a person might be receiving

CHISP services to essentially tide them

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over until they're assigned, you know,

nine months later, their level three home

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care package, or what can also happen

during the ACAT assessment is, You know,

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the ACATs are very well aware of the

wait times of the home care packages.

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And if they're going to approve someone at

a level three home care package, knowing

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that that's going to be a nine to 12

month wait, they could ask the person,

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would you be happy to accept an interim?

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Home care package.

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Now, this comes from the same bucket of

funding as the home care package program.

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It's not a separate program.

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It's not something different.

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What it means is that the ACAT

will like effectively tick a

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little box and say that Mrs.

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Smith is happy to receive a level two

home care package should one become

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available before her level three

home care package is assigned to her.

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So potentially.

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You know, someone might

get CHISP services for.

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I don't know, maybe two

months, two and a half months.

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And then at that three month,

perhaps four month point, Mrs.

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Smith might be offered a level

two Home Care package, but she's

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still moving ahead in the queue

to get her level three package.

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So then again, another six

months later, her level three

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package will become available.

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It will be assigned to her, and then.

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She will accept that when a person's

assigned their home care package.

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This is when they need

to choose a provider.

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So, again, with home care packages,

the funding is assigned to the person.

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So the person has complete control and

choice over who their provider is going

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to be for their home care package.

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They may decide to stay with their

CHISP provider if they've come via

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entry level, but they're not obliged to.

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They can choose any home

care provider that they like.

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So they would do some research,

they would shortlist some providers.

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We always suggest three providers,

call them up, have a chat with them,

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potentially get them to come around to

your home, talk about what they're doing.

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what the older person's needs are, have

a look at what funding is allocated,

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you know, within a level three home

care package and talk about, you know,

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how far that, that funding would go.

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Then based on those conversations, the

person would choose their preferred

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provider and they enter into an agreement,

a service agreement with the provider,

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which is essentially a contract.

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Once that agreement is signed by the

provider and the older person themselves.

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The provider will then develop a care

plan in conjunction with the older person,

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noting all their needs and their goals.

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And then from that point is where

the service provision can begin.

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Michelle: Okay.

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So given these two different

funding programs, can you request

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from My Aged Care, which type

of fund services you want?

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Coral: No, you can't.

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The system won't let you do that.

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You know, when you contact My

Aged Care, it's at the discretion

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of My Aged Care where they're

going to forward your referral.

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So based on the answers that you give

My Aged Care during that screening

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process, they will work out if

You know, if going to entry level

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services is the most appropriate for

you, or do you need to go straight

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to the ACAT and have an assessment

with, with the ACAT, the aged care

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assessment team for home care package.

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You can't just ring up and

say, I want to have, an ACAT

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assessment for home care package.

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It comes back to you demonstrating

the need and getting that information

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across when you're speaking with My

Aged Care when you make that contact.

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Michelle: Okay.

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Really good to know.

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So as far as paying for services,

do Does the person need to pay extra

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for the services they get, either

through the Commonwealth Home Support

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Program or through a Home Care Package?

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Coral: Kind of depends Shell.

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So it's acknowledged that at entry

level, those CHISP funded services,

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they generally attract a small

fee because they've already been

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heavily subsidized by the government.

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at entry level.

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So for transport, domestic assistance,

you know, we hear anywhere from

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9, 10 for a service, domestic

assistance up to 20 or maybe 30.

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It's again, it's determined

by the provider, but it's,

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it's heavily subsidized.

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So it's not going to be like a full

Full rate to have, you know, domestic

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assistance might incur 10 per episode.

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Whereas if you get that kind of service

in your home care package, it's going to

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cost a lot more with home care packages.

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It does depend on your income.

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So, you know, you may or

may not have to contribute.

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And this is essentially it's people

who are deemed to have to pay for.

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their services within Home Care Package

will have been assessed by Centrelink

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or Services Australia and being deemed

to have to pay the income tested fee.

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So this is, this is like case

by case, individual basis.

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Essentially people who are on a

full age pension will not have

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to pay an income tested fee.

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But typically people who are self

funded retirees and might have some

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income may have to contribute towards

the cost of their home care package.

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And that's known as the income tested fee.

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And it's outside of the scope

of the home care package.

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So it's not another fee

that the package provider is

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putting on top of their income.

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care management and

package management fees.

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This is this is entirely separate.

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So it's no use arguing with your

home care package provider that

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you have to contribute this.

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This is a decision that's

made by Services Australia.

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Michelle: And that's a

non negotiable, isn't it?

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Coral: It's absolutely non negotiable.

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Yeah.

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Michelle: So Coral, what, what

would be the benefit of a Home

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Care Package over CHISP services?

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Coral: It kind of depends on the

individual, but you know, essentially

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a home care package ensures that

the services can be provided as

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the funding sits with the person,

doesn't sit with the provider.

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So the funding sits with you.

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So when you're choosing your

provider, you're making sure that

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the provider actually has the

staff, has a pool of staff support

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workers that can support you.

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Whereas with CHIS.

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When the provider holds the funding,

we know that, you know, delivering

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those services is, is dependent

on that CHIS provider having the

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staff there to deliver the services.

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So look, it is, it is more of an assurance

having a home care package that you will

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actually get the services that you need.

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Home care packages are also coordinated.

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So the difference again, at entry level,

the provider holding the funding, If

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you receive, let's say, four referral

codes or approvals at entry level, you

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could have four different providers.

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Providing those services.

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So we call this fragmented,

whereas with the home care

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package, you have the one provider.

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So you know, all those services

that you receive are coordinated

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by that home care package provider.

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So you have a better chance of having

continuity of care and you know,

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with a home care package at the

highest level, being a level four.

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It provides reasonable funding and

at the moment a level four home care

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package is just over 61, 440 a year.

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It's, it's reasonable funding,

so you're not going to get that

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level of service provision.

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So the benefit of a home care package

is certainly for people who have

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higher needs or more complex needs that

need that higher service provision.

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The funding attached to those

higher level home care packages is

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what's going to make that a reality.

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Michelle: okay.

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Coral, could I decide to stay on the

CHISP program, even if I get assessed

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by the ACAT for a Home Care Package?

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Coral: Yeah, you can.

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And we see people consider this when

they have particularly an attachment

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to their longstanding support worker

or their worker who provides their

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domestic assistance at entry level.

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Or, you know, if you're one of those

lucky people who are receiving lots of

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CHISP services, then, you might decide to.

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Continue with your CHISP services

and not accept a home care package.

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But you look, this is going

to change in the future.

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I'm not going to get into that

now because that's a whole other

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discussion and, possibly we might

touch on it a little bit before we go.

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But also consider that if a person

is on receiving CHISP services, And

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then they get an ACAT assessment

or the aged care assessment team.

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There's been a need identified for that

person to actually get to the ACAT and

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be approved for a home care package.

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So it's certainly a choice

that needs consideration.

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You know, if you've gotten to the ACAT

and the ACATs approved you for a level

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one home care package, it's quite possible

that you might already be receiving.

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More services under the CHIS

program than you would get with

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the level one home care package.

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It may not be worth your while

in this instance accepting

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the Level 1 Home Care Package.

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But you know, if you, if you've got

potentially a Level 2 or certainly those

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Level 3 and Level 4 Home Care Packages,

it would be my recommendation, you

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know, to give some serious thought to

accepting that kind of Home Care Package.

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Because for all the reasons we've

discussed, the continuity of care,

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the coordination of care, you know,

we know that people that are getting

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approvals for higher level packages

have more complex needs and they're

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typically related to their, you know,

their health conditions as well.

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So staying on to in those circumstances,

probably not a great idea.

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Take the home care package.

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Michelle: And if I'm receiving services,

so this is either under the Commonwealth

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Home Support Program or under a home care

package, can I change who provides my

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:

services if I would prefer someone else?

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Coral: You certainly can at

entry level or at the next level.

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So at entry level CHIS funded service

provision, it is more difficult

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to find another CHIS provider.

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Remembering that I touched on that point

that not all providers have CHIS funding.

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So if you're dissatisfied with your

current provider of entry level

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:

services, you can certainly go

looking for another provider that

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holds the CHIS funding that delivers.

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:

that same kind of service.

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:

So, not all CHIS providers deliver

domestic assistance and they don't

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:

all deliver you know, lawn maintenance

and they don't all provide transport.

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So you need to be very clear that if

you're not happy with your provider at

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:

entry level for your domestic assistance

and you want to move to another CHIS

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:

provider, you need to make sure that

that next CHIS provider Actually

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:

offers domestic assistance, because

if you, you know, if you reactivate

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:

that referral code, and you think

you're going to move to a different

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:

provider, and then you found that, oops.

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:

You know, the next provider doesn't

provide domestic assistance.

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You're in a bit of a pickle.

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:

So yeah, it is possible.

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You know, most, I would say

on the whole, it's uncommon.

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We don't tend to see people

changing between CHISP providers.

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:

But at the next level up with

a home care package, you can

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:

certainly change providers.

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:

And this is a fairly

straightforward process now.

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And it's a lot more people are a lot

more aware that if they're not happy with

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:

their current provider of their home care

package, that they can find their own.

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:

a new provider.

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And there's so many providers out

there in the marketplace now that

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people do have a lot of choice.

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:

The other thing that's good to be

aware of, and I, and I actually, I

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:

get surprised when people are not

aware of this, but people, providers

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:

can't charge exit fees anymore.

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:

You know, when people want to move

from one provider to the next and,

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:

and when those exit fees did exist,

that served as like a disincentive.

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:

So people, you know, there were some

providers out there and, and I, and

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:

I know one in my local area that was

holding onto 2, 000 of the person's

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:

package funding and told this person

that if they move providers, that the

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:

exit fee would be Would cost them 2,

000, which is absolutely outrageous,

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:

but they can't do that anymore.

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:

No provider can charge an exit fee.

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:

So it makes it a lot easier.

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:

for people if they're not happy

with their provider of the home care

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:

package, do their research, choose

a new provider, and they can move to

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:

that new provider knowing that they're

not going to be charged an exit fee.

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:

Michelle: Excellent.

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:

Coral, I know there are changes

to the aged care programs coming

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:

due to the aged care reforms.

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:

Are these two programs that

we've discussed likely to

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:

change in the near future?

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:

Coral: That's the question, Shell.

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:

Yes and no.

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:

And this has been going on since the

final report from the Royal Commission.

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:

So, The, you know, there were 148

recommendations for reform from the Royal

401

:

Commission and one of them was the merging

of the CHISP and the Home Care Package

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:

Program initially slated for July 2023.

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:

A huge task, so not surprisingly was

delayed until July this year, July 24 and

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:

kind of not surprisingly again, it's, it's

en delayed further until July:

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:

So, CHISP and home care packages

are not going to merge until July.

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:

Possibly July 2027.

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:

What is changing is the merging of

the Home Care Package Program and

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:

another program that's assessed and

approved by the ACATS, which is the

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:

Short Term Restorative Care Program.

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:

So those two programs, in accordance

with the recommendations from

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:

the Royal Commission, Are being

merged and this new program is

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:

going to be called support at home.

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:

And that's going to be introduced

of from July next year, July 25.

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:

Michelle: Well, we've had a good

discussion about the differences between

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:

the Commonwealth Home Support Program

and the Home Care Packages Program.

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Both programs are accessed via

a referral to My Aged Care.

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:

Keeping in mind, you can't request

which program or assessment

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:

team will receive your referral.

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:

Which program is right for

you really comes down to how

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:

much support you need at home.

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:

We've also written a

blog about this topic.

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:

It's one of our most widely read

blogs, so you can pop over to our

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:

blogs page and check that out too.

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:

The link to the blog will

be in our show notes.

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Listeners, if you're enjoying what

you're hearing, we'd love you to rate

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:

and review the podcast, and please tell

your family and friends about it too.

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:

Remember also that we've just introduced

our monthly Ask Me Anything episodes, so

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if this topic has prompted some questions,

Drop us an email via admin at seemeacn.

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com.

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au.

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:

Until next week, take care.

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