Support at Home care management: Where does the 10% go?
Learn how the 10% Support at Home care management allocation works, where the funding goes, what providers can claim and what care management includes.
If you receive ongoing services through Support at Home, 10% of your quarterly budget is set aside for care management.
But what does that actually mean?
Does the provider automatically receive the full 10%? Is it an extra fee? What happens if the money is not used?
The short answer is: the 10% is not an additional charge on top of your Support at Home budget, and it does not simply go straight to your provider.
It follows a specific funding and claiming process managed through Services Australia.
Watch: how the 10% care management allocation flows
The video above follows the funding from your quarterly Support at Home budget through to the care management support you receive.
Here is a closer look at each step.
Step 1: Your Support at Home quarterly budget is allocated
People receiving ongoing Support at Home services are assigned one of eight funding classifications based on their assessed needs.
That classification determines the amount of funding available each quarter.
The published quarterly funding amounts already include the care management allocation.
Step 2: 10% is set aside for care management
For ongoing Support at Home services, Services Australia deducts 10% of the participant’s quarterly budget for care management. Take note: this is not an extra fee added to your care.
Instead, it is a portion of your existing quarterly funding that is specifically reserved for eligible care management activities.
For example, if a quarterly budget were $10,000, $1,000 would be allocated to care management and the remaining funding would be available for approved ongoing services.
Step 3: The funding goes into a pooled care management account
The 10% allocated for each participant is pooled with care management funding from other participants connected to the same service delivery branch.
This pooled approach allows providers to respond more flexibly when one participant needs more care management support at a particular time, for example after a change in health, hospital stay or change to their care arrangements.
So the 10% is not held as an individual pot that can only ever be spent on one participant.
Step 4: Care management support is actually delivered
Before a provider can claim care management funding, eligible care management work needs to take place.
Care management can include:
- developing and reviewing your care plan
- planning and coordinating services
- monitoring how your supports are working
- reviewing your needs when circumstances change
- helping you understand and manage your care
- providing support and education
- monitoring your budget and services
Support at Home providers must deliver at least one direct care management activity each month to people receiving ongoing services. This might be a conversation or meeting with the participant or their registered supporter.
Not every administrative activity can be claimed as care management. For example, general rostering, staff training, compliance activities and human resources work are not eligible care management activities.
Step 5: The provider claims for the care management delivered
Once eligible care management support has been provided, the provider submits a claim. Services Australia then deducts the cost of that care management service from the provider’s care management account and pays the approved claim.
This is an important distinction:
The provider does not simply receive 10% of your quarterly budget as an automatic payment.
The funding sits within the care management account and eligible care management services must be delivered and claimed.
What happens to care management funding that is not used?
Unspent care management funding can carry forward between quarters within the same financial year.
There are limits on how much can move into the next financial year. Under current Support at Home rules, the maximum generally carried into a new financial year is equivalent to the amount of care management funding allocated for the April to June quarter.
Because the funding is pooled at service delivery branch level, this works differently from the unspent funding rules that apply to an individual participant’s quarterly service budget.
Do I pay a contribution for care management?
No. Care management is treated as a Clinical Support for contribution purposes, which means it is fully government-funded.
Participants cannot be asked to make a contribution towards eligible care management activities.
What if I self-manage my Support at Home services?
The 10% care management allocation still applies.
Choosing to self-manage some parts of your Support at Home services does not remove the provider’s care management responsibilities.
Even where a participant arranges some of their own workers, schedules or services, their registered provider must still provide care management and oversee areas such as the care plan, quality, safety and compliance.
Does the 10% rule apply to every Support at Home pathway?
Not exactly. The 10% allocation applies to ongoing Support at Home services.
For people receiving the Restorative Care Pathway or End-of-Life Pathway, care management is instead claimed directly from the funding allocated to that pathway. The Assistive Technology and Home Modifications scheme also has different funding arrangements.
What does care management look like with Leora?
At Leora Healthcare, your Care Partner helps connect the funding side of Support at Home with what is actually happening in your day-to-day care.
That can include reviewing your care plan, monitoring your budget, checking in with you, coordinating services and responding when your needs or circumstances change.
Care management is not simply an amount removed from your budget. It is the ongoing work behind your support that helps make sure your services continue to reflect your needs, goals and preferences.
If you have questions about your care management allocation, quarterly budget or how your funding is being used, speak with one of our Care Partners today!