❓ A WA parliamentary question addresses changes to Silver Chain's Home Discharge Support Program eligibility, specifically regarding private patients in both public and private hospitals, and the financial implications of these changes. The response clarifies the eligibility criteria before and after December 2018, the reasons for the changes, and alternative service options.
AnsweredQoN 4942Legislative Assembly
Asked
20 March 2019
Member
Portfolio
Deputy Premier; Minister for Health; Mental Health
QuestionView source ↗
I refer to the recent changes to the eligibility criteria for the Silver Chain’s Home Discharge Support Program and I ask: (a) What were the eligibility criteria for private patients in public hospitals to access the Home Discharge Support Program before 10 December 2018; (b) What were the eligibility criteria for private patients in private hospitals to access the Home Discharge Support Program before 10 December 2018; (c) What are the eligibility criteria for private patients in public hospitals to access the Home Discharge Support Program after 10 December 2018; (d) What are the eligibility criteria for private patients in private hospitals to access the Home Discharge Support Program after 10 December 2018; (e) Why have the eligibility criteria for access to the Home Discharge Support Program been changed; (f) What is the reasoning for excluding private patients being treated in private hospitals from access the program; (g) Did the Department of Health discuss the eligibility criteria changes with private hospitals prior to their implementation; (h) How were the eligibility criteria changes communicated to private hospitals; (i) How much has the Department of Health estimated it will save, per year, by excluding private patients in private hospitals from accessing the service; and (j) What other avenues do private patients in private hospitals have to access this or a similar service, and at what cost to the patient?
AnswerView source ↗
Answered
7 May 2019
Response time
8 days
I am advised:
(a)-(b) Patients must be in a hospital at the time of referral and consent to the referral.
Patients must be medically stable.
Patients must reside in an area where the Home Discharge Support (HDS) is provided (Metro Wide, South West and Great Southern).
A person may not be eligible if their care needs exceed the capability of HDS - this is determined through the screening process with Allied Health Liaison.
(c) Patients must be in a hospital at the time of referral and consent to the referral.
Patients must be medically stable.
Patients must reside in an area where the Home Discharge Support (HDS) is provided (Metro Wide, South West and Great Southern).
A person may not be eligible if their care needs exceed the capability of HDS. This is determined through the screening process.
Patients accepted into HDS must have a functional need (basic support in daily living) for activities which requires Personal Care as part of the service (previous eligibility will be applied).
Patients under 65 years, residing in a National Disability Insurance Scheme (NDIS) area who are ineligible for NDIS, can be referred to HDS for screening and may be eligible. Patients in receipt of a Home Care Package are not eligible (they may be able to receive an HDS service funded through their package or they may be able to access Allied Health Reablement services via the Commonwealth Home Support Program (CHSP).
(d) After 10 December 2018, private patients in private hospitals are not eligible for HDS funded through the Department of Health WA. Private patients in Private Hospitals are able to execute a Service Agreement for HDS-like services directly with Silver Chain, under a fee for service approach.
(e) Following the implementation of the CHSP, responsibility for basic home-based support services for older consumers moved from the State to the Federal Government. Prior to the launch of CHSP in July 2018, the Commonwealth determined that Silver Chain's Personal Enablement Program (PEP) which had been funded in WA under the Home and Community Care Program (HACC) would not be funded under CHSP.
(f) The State Government's priority and responsibility is to support the discharge process at WA Public Hospitals. The limited State Government funding for HDS, combined with the demand for this new service, led to the decision to direct funding to WA Public Hospitals.
(g) No. The Department of Health did not discuss the eligibility criteria changes with private hospitals prior to their implementation. It was agreed between the Department of Health and Silver Chain, that Silver Chain would discuss these changes directly with the private hospitals.
(h) By letter from the Department of Health WA dated 5 December 2018.
(i) It is not possible to estimate any potential savings due to the wide variety of the service provision.
(j) Silver Chain has offered HDS to Private Hospitals under a fee for service approach. In this model the cost is to be paid by the Private Hospital, not the Private Patient with the rates as follows:
(i) $138.50 (plus GST) per patient occasion of service in the Metro area.
(ii) $147.50 (plus GST) per patient occasion of service in Regional areas.
(a)-(b) Patients must be in a hospital at the time of referral and consent to the referral.
Patients must be medically stable.
Patients must reside in an area where the Home Discharge Support (HDS) is provided (Metro Wide, South West and Great Southern).
A person may not be eligible if their care needs exceed the capability of HDS - this is determined through the screening process with Allied Health Liaison.
(c) Patients must be in a hospital at the time of referral and consent to the referral.
Patients must be medically stable.
Patients must reside in an area where the Home Discharge Support (HDS) is provided (Metro Wide, South West and Great Southern).
A person may not be eligible if their care needs exceed the capability of HDS. This is determined through the screening process.
Patients accepted into HDS must have a functional need (basic support in daily living) for activities which requires Personal Care as part of the service (previous eligibility will be applied).
Patients under 65 years, residing in a National Disability Insurance Scheme (NDIS) area who are ineligible for NDIS, can be referred to HDS for screening and may be eligible. Patients in receipt of a Home Care Package are not eligible (they may be able to receive an HDS service funded through their package or they may be able to access Allied Health Reablement services via the Commonwealth Home Support Program (CHSP).
(d) After 10 December 2018, private patients in private hospitals are not eligible for HDS funded through the Department of Health WA. Private patients in Private Hospitals are able to execute a Service Agreement for HDS-like services directly with Silver Chain, under a fee for service approach.
(e) Following the implementation of the CHSP, responsibility for basic home-based support services for older consumers moved from the State to the Federal Government. Prior to the launch of CHSP in July 2018, the Commonwealth determined that Silver Chain's Personal Enablement Program (PEP) which had been funded in WA under the Home and Community Care Program (HACC) would not be funded under CHSP.
(f) The State Government's priority and responsibility is to support the discharge process at WA Public Hospitals. The limited State Government funding for HDS, combined with the demand for this new service, led to the decision to direct funding to WA Public Hospitals.
(g) No. The Department of Health did not discuss the eligibility criteria changes with private hospitals prior to their implementation. It was agreed between the Department of Health and Silver Chain, that Silver Chain would discuss these changes directly with the private hospitals.
(h) By letter from the Department of Health WA dated 5 December 2018.
(i) It is not possible to estimate any potential savings due to the wide variety of the service provision.
(j) Silver Chain has offered HDS to Private Hospitals under a fee for service approach. In this model the cost is to be paid by the Private Hospital, not the Private Patient with the rates as follows:
(i) $138.50 (plus GST) per patient occasion of service in the Metro area.
(ii) $147.50 (plus GST) per patient occasion of service in Regional areas.
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