This is probably the question we get asked the most! What can and cannot be included in the home care package would benefit from a lot more direction than is currently available. Let’s face it, there is more grey than there is black or white.

So let’s start with what we know, the legislative intent of the Home Care Package (HCP) Program is to deliver care and services that help older Australians to live independently in their homes for as long as it is safe to do so.

The care and services provided need to meet the care needs set out in their My Aged Care support plan and care plan.  These are based on the needs identified during the ACAT or RAS assessment when first entering the HCP program.

What is known?

One of the common misconceptions around package funding is that it is ‘my money to spend how I want’. Although there is much uncertainty, the Department of Health and Aging is very clear on stating that HCP funding:

  • Is not a source of extra income to be used for everyday items and costs
  • Is only for expenditure directly linked to aging (for example, expenditure related to a Chronic Disease is not allowable)
  • Is not for expenses that all Australians have
  • Must be considered an acceptable use of a government subsidy that is funded through taxpayers’ money
  • Saving up for items at the expense of the delivery of care and services is not allowed

In addition all HCP spending:

  • Must be within the limits of the budget and the scope of the Program
  • Must only benefit the care recipient directly, funds cannot be spent on or seen to be benefiting the carers or family members
  • Cannot be for expenditure that is already covered by another government scheme
  • Must be documented in both the care plan and the budget
  • Must be agreed upon in advance of making the expenditure

What can be included?

Below are the categories of services that are allowable. You can find out more detailed information by visiting the allowable expenditure section of our website or by viewing Operational Manual for Home Care Package consumers

  • Allied health and therapy services      
  • Personal services
  • Nutrition, hydration, meal preparation and diet       
  • Nursing
  • Continence management
  •  Mobility and dexterity         
  • Transport and personal assistance
  • Management of skin integrity
  • Support for cognitive impairment
  • Cleaning and household tasks                                                                           
  • Home maintenance
  • Light gardening
  • In-home respite
  • Activities of daily living

Why is my expenditure rejected when I know other providers approve it?

Allowable expenditure is one of the biggest minefields for approved providers. There is always new information and clarifications on inclusions/exclusions being released. Different providers adhere to the expectations to varying degrees, meaning that there are discrepancies between what clients have approved with different providers. Even with the same provider an item that was approved in the past, may no longer be approved.

How do I know if expenditure is approved?

It is hard enough for providers to stay current on what is allowable, so it is unreasonable to expect clients to be experts. All items need to be in the care plan and budget prior to committing any funds, this is the opportunity to discuss the expenditure with your care advisor. If there is additional information needed or specialist recommendations required, this will be communicated to you. Providing a detailed description will assist in assessing if the expenditure is allowable.

In most cases any aids or equipment will need a recommendation from the appropriately qualified allied health professional, this is generally an Occupational Therapist, but might be a Physio or Registered Nurse depending on the equipment.

How are decisions made?

When making decisions about approvals or rejections, we take time to consider the Decision Making Process, which covers considerations such as:

  • Does it relate to aging?                                                                 
  • If it is in scope for the package?                                                 
  • Is it a reasonable use of taxpayers funds?                            
  • Is it evidence-based?                                                                      
  • Is it a capital improvement or a major work? 
  • Is it an expense all Australians have?
  • Does it impact the provision of care and services?
  • Are funds available?
  • Has it been self-prescribed?
  • Is there a safety risk?

If we haven’t come across an expenditure before and have some uncertainty, we will also seek an opinion from the Department of Health and Aged Care.

What happens if an expenditure is rejected?

If we determine that the expenditure is not in scope for the package we will discuss the reason why with you. We can provide you with a written explanation as to why the item was rejected.

If you are not satisfied with this outcome you may wish to seek assistance for dispute resolution from an independent advocacy service. The Aged Care Advocacy Service accepts enquiries at www.opan.com.au  or 1800 700 600

Should you wish to appeal the decision or to make a complaint, you can contact the Aged Care Quality and Safety Commission:  https://www.agedcarequality.gov.au/ . The Commission’s telephone number is: 1800 951 822. 

What else do I need to know?

Despite there being many items that can’t be included in the package, there are still plenty of opportunities for clients to fully utilise their package funding. If you need assistance with ideas, visit the Allowable Expenditure (Inclusions) section of our site. Alternatively contact your Care Advisor who can work through your needs to see what else can be included.