Outcome 4: Aged Care and Population Ageing > Part 1 Outcome Performance Report

Major Achievements

• Development of residential aged care funding reforms to meet future demand.
• Increased ratio of operational aged care places to 109.3 places for every 1,000 people aged 70 or over.
• Continued access to home and community care services following the successful negotiation of a new agreement with the states and territories.
• Strengthened protection of accommodation bonds paid by residents to approved providers through the implementation of prudential requirements.
• Amendments to the Aged Care Act 1997 to establish a new Complaints Investigation Scheme and an independent Aged Care Commissioner, to require police checks for certain aged care staff and volunteers, and to implement compulsory reporting of sexual and serious physical assault in residential aged care and protections for staff and approved providers who make these reports.

Challenges

• Deferred commencement of the Aged Care Funding Instrument to allow software providers sufficient time to develop new products and change existing computer systems used by aged care homes.

• Delay in the development and implementation of the National Continence Management Strategy’s communication strategy as additional time was required to incorporate research findings from the first two phases of the National Continence Management Strategy into a new, long-term awareness raising strategy.

Key Strategic Directions for 2006–07

Reform of the Aged Care Sector

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Securing the Future of Aged Care for Australians Package

During 2006–07, the Department provided advice to the Government on options for further reform of the aged care sector. This advice informed the Securing the Future of Aged Care for Australians package, which was the Government’s final response to Professor Warren Hogan’s 2004 report on aged care services, the Review of Pricing Arrangements in Residential Aged Care.

Announced in February 2007, the reforms focus on increasing the number of community care places to help people remain in their homes and ensuring people entering residential care receive appropriate care at a fair price. The package also encourages investment in quality residential aged care facilities and adjusts the balance of provision more towards high level care. The Department has started implementing these reforms. Further discussion will be available in the 2007–08 annual report.

Aged Care Funding Instrument

Also in response to Professor Hogan’s report, the Department continued the development of a new arrangement for allocating care subsidies to residential aged care providers. The new Aged Care Funding Instrument will reduce the number of funding levels from seven to three and provide two new supplements for the care of residents with complex health and nursing needs, including palliative care, and for residents who have mental or behavioural conditions such as dementia. The commencement date of the funding instrument was deferred from 1 July 2007 to 20 March 2008 at the request of the aged care industry. This allows software providers more lead time to develop new products and incorporate changes into the computer systems used by aged care homes.

Protection of Accommodation Bonds

Strengthening the protection of residents’ accommodation bonds was a key priority. To achieve this, the Department developed enhanced prudential requirements to assist approved providers to improve their financial management practices and reduce the risk of default on the refund of accommodation bonds. The Department issued guidance material and worked with industry bodies to promote awareness of the Prudential Standards, which came into effect from 1 July 2006. The Department also implemented appropriate compliance action, and worked with a number of approved providers to improve their accommodation bond management, following the receipt and review of the 2005–06 Annual Prudential Compliance Statements in October 2006. This work complemented the Accommodation Bond Guarantee Scheme introduced in 2005–06.

Complaints Investigation Scheme

Amendments to the Aged Care Act 1997, to provide greater protection to aged care recipients accelerated the Department’s efforts to drive improvements in standards of care and services in aged care during the year.

The Department established a new Complaints Investigation Scheme in May 2007. The scheme allows the Department greater capacity to investigate potential breaches of an approved provider’s responsibilities under the Aged Care Act 1997. The scheme also makes it easier for people to lodge complaints, ensures more timely resolution and allows for greater feedback to parties. By 30 June 2007, the Department had taken action on 1,170 cases reported to the scheme. During the course of investigating these cases, the scheme conducted 434 site visits and issued 50 Notices of Required Action, requiring the approved provider to remedy a breach of their responsibilities under the Aged Care Act 1997. The Aged Care Complaints Resolution Scheme continued to operate until 30 April 2007 under the previous dispute resolution model. Under this model, the scheme handled 1,229 complaints and 4,403 information calls between 1 July 2006 and 30 April 2007.

The Department also established a new and independent Aged Care Commissioner to hear complaints about action taken by the Department in relation to investigations or about the conduct of the Aged Care Standards and Accreditation Agency. In addition, preparations were made for the introduction of compulsory reporting from 1 July 2007 of incidents or allegations of sexual or serious physical assault in residential aged care, and the protection for approved providers and staff who make these reports.

The requirement for certain staff and volunteers in aged care services to undergo a national criminal police history check progressively from 1 March 2007 was also implemented by the Department.

Community Aged Care

Continued reform in community aged care, particularly in streamlined access and consistency in assessment and referral, as outlined in A New Strategy for Community Care – The Way Forward was another priority for the Department in 2006–07. Significant progress was made toward nationally consistent access to community care through a consistent approach to eligibility and assessment. The Department developed and tested the Australian Community Care Needs Assessment and the Carer’s Eligibility and Needs Assessment tools, in partnership with the states and territories.

The Department also commenced a review of subsidies and services in Government-funded community aged care programs in September 2006. To be finalised in 2008, the review is identifying areas for refinement in current arrangements and improvements in service delivery. The Department aims to use the findings to develop a more integrated set of aged care programs that support frail older people in their own homes as their needs change. During the year, the Department received over 50 submissions from community sector stakeholders wishing to provide input.

To help residents of retirement villages gain improved access to community care programs, the Department also implemented the Community Aged Care Services in Retirement Villages Initiative. This involved encouraging retirement village operators through the 2007 Aged Care Approvals Round to apply for community care places, and where relevant, the related approved provider status.

On 30 April 2007, the Department successfully concluded negotiations for a new Home and Community Care Agreement with all State and Territory governments. This new Review Agreement details the management arrangements for the Home and Community Care Program and recognises the commitment of both the Commonwealth, and State and Territory governments to work together to achieve better outcomes for people who are eligible to receive the program’s services.

The new agreement, effective from 1 July 2007, commits states and territories to extending A New Strategy for Community Care – The Way Forward reforms to the Home and Community Care Initiative. The new agreement also includes a move to triennial planning in home and community care, which will support longer term strategic planning and give greater certainty to communities and service providers.

Supporting Older Australians to have Healthy, Independent and Active Lives

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Support through Consumer Awareness

Providing older Australians with information on health related issues and support services can help them to lead healthy, independent and active lives. Under Phase 3 of the National Continence Management Strategy, the Department provided funding to the Continence Foundation of Australia to increase continence awareness and improve information and support services through the Continence Awareness and Support project. The need to increase awareness was identified through a number of research activities.

The Department provided a range of stakeholder information for older Australians and the aged care industry, through print and other media including the Aged Care Information Line (1800 500 853) and a talking book version of the Australian Government Directory of Services for Older People for the vision impaired. It also managed two key consumer websites, the Seniors Portal as a single point of access to information and services to older Australians, accessible at www.seniors.gov.au; and the aged care consumer website for comprehensive information about aged care accommodation, community care services, support for carers and important health matters, accessible at www.agedcareaustralia.gov.au.

Dementia

During the year, the Department was focused on improving services for people with dementia, their families and carers and improving training for the aged care and community workforce. Three Dementia Collaborative Research Centres and four Dementia Training Study Centres were funded, and research projects under the first round of the National Health and Medical Research Council Dementia Research Grants program were supported. Dementia Behaviour Management Advisory Services have been established in New South Wales, South Australia, Western Australia, Tasmania, the Northern Territory, the Australian Capital Territory, and in September 2007 in Queensland. Funding agreements are being negotiated with potential service providers in Victoria.

Strengthening the Residential Aged Care Workforce

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The Department administered a number of initiatives to strengthen the aged care workforce during 2006–07. These included offers of over 11,000 training places to personal care workers in rural and remote areas and over 3,000 certificate level training places to personal care workers working in residential aged care facilities. Over 1,000 training places were offered to enrolled nurses for training in medication management and over 2,600 training places in accredited dementia specific training provided to aged care workers in residential and community aged care.

The Department also provided funding to the Royal College of Nursing to provide 250 undergraduate scholarships and 183 continuing education or postgraduate scholarships under the More Aged Care Nurses Initiative.

Improved Aged Care Services in Rural and Remote Areas

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During 2006–07, the Department worked towards an equitable distribution of new aged care places to reflect where people choose to live, with around 40 per cent of places in the 2006 Aged Care Approvals Round allocated to regional, rural and remote areas. There was also an increase in the number of Multipurpose Services. As at 30 June 2007 there were 101 operational Multipurpose Services delivering 2,492 flexible aged care places to rural and remote areas. This is an increase of seven services over the past financial year and an increase of over 10 per cent in operational flexible aged care places.

The Department worked with Medicare Australia to implement a viability supplement for rural and remote community care services, the objective being to support quality service provision and equitable access to services for people in rural and remote areas.The location of service recipients determine payments to providers, thereby providing an incentive for providers to deliver care services beyond town boundaries. Payment of the viability supplement to eligible providers of Community Aged Care Packages, Extended Aged Care at Home and Extended Aged Care at Home Dementia commenced from 23 June 2007 with a date of effect from 1 January 2007. Eligible Multipurpose Services and Aboriginal and Torres Strait Islander Flexible Care Services received payments in the first quarter of 2007.

Table 4.1: Allocated and Operational Aged Care Places Per 1,000 Persons Aged 70 and Over At 30 June 2007¹

	Ratio of Allocated Places				Ratio of Operational Places
	Residential Care	Community Care	Transition Care	Total	Residential Care	Community Care	Transition Care	Total
New South Wales	99.1	21.2	1.0	121.4	86.4	21.2	0.8	108.5
Victoria	99.1	21.7	1.0	121.8	87.4	21.5	0.8	109.8
Queensland	96.4	20.9	1.0	118.4	85.7	20.8	0.7	107.3
South Australia	98.6	21.4	1.0	121.0	93.4	21.4	0.8	115.7
Western Australia	96.8	22.0	0.9	119.7	83.8	21.6	0.6	106.0
Tasmania	96.0	22.4	1.1	119.5	86.4	22.1	1.0	109.6
Northern Territory	103.9	128.3	2.8	235.0	97.0	128.3	1.4	226.7
Australian Capital Territory	106.1	26.8	1.6	134.5	72.5	26.8	1.6	100.9
AUSTRALIA	98.4	21.8	1.0	121.2	86.8	21.7	0.8	109.3

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¹ The places in Table 4.1 include flexible care places. The higher levels of provision in the Northern Territory address the care needs of Aboriginal people aged 50 years and over. In this table, community care places include Community Aged Care Packages and Extended Aged Care at Home packages.

The ratios in Table 4.1 are based on population projections derived from the 2006 Census. Population projections using 2006 Census data are not yet available down to the regional level. As a result, the following regional ratios (with the exception of the Australian Capital Territory) have been calculated using population projections derived from 2001 Census results. Population projections based on Census 2001 data are now thought by the Australian Bureau of Statistics to overestimate the population of people aged 70 or over by about 29,000. The ratios shown in Table 4.2 are consequently likely to underestimate the actual number of aged care places available for every 1,000 people aged 70 or over.

Table 4.2: Allocated and Operational Aged Care Places By Region Per 1,000 Persons Aged 70 and Over At 30 June 2007²

	Ratio of Allocated Places				Ratio of Operational Places
Aged Care Planning Region	Residential Care	Community Care	Transition Care	Total	Residential Care	Community Care	Transition Care	Total
New South Wales			1.0				0.8
Central Coast	86.2	22.4		108.6	76.7	22.4		99.1
Central West	94.3	20.4		114.7	92.6	19.9		112.5
Far North Coast	92.3	20.3		112.7	80.9	20.3		101.2
Hunter	94.2	20.1		114.4	84.4	20.1		104.5
Illawarra	96.7	23.2		119.9	69.2	23.2		92.4
Inner West	118.8	19.6		138.4	110.3	19.6		129.9
Mid North Coast	96.5	21.8		118.3	76.0	21.8		97.9
Nepean	100.6	21.2		121.8	91.5	20.5		112.0
New England	96.0	21.7		117.7	84.2	21.7		105.9
Northern Sydney	105.8	19.4		125.2	100.0	19.4		119.4
Orana Far West	94.5	25.4		119.9	90.1	25.3		115.4
Riverina/Murray	95.0	20.0		115.0	82.1	20.0		102.1
South East Sydney	90.6	20.7		111.3	76.2	20.7		96.8
South West Sydney	95.0	20.9		115.8	79.5	20.9		100.4
Southern Highlands	97.4	19.6		117.0	77.9	19.6		97.5
Western Sydney	94.1	19.2		113.3	84.0	19.2		103.2
Victoria			1.0				0.8
Barwon-South Western	96.6	21.6		118.3	89.4	21.2		110.5
Eastern Metropolitan	96.9	21.0		117.8	85.7	21.0		106.7
Gippsland	94.0	22.2		116.2	82.0	21.2		103.1
Grampians	96.1	22.5		118.6	86.4	21.5		107.9
Hume	99.7	22.1		121.9	92.5	22.1		114.6
Loddon-Mallee	94.5	21.5		116.0	88.1	21.5		109.6
Northern Metropolitan	97.9	22.5		120.4	83.5	22.5		106.0
Southern Metropolitan	98.9	20.5		119.4	86.7	20.5		107.1
Western Metropolitan	100.9	21.2		122.1	84.6	20.9		105.5
Queensland			1.0				0.7
Brisbane North	101.9	18.6		120.5	96.2	18.6		114.9
Brisbane South	98.0	20.4		118.4	88.8	20.1		108.9
Cabool	95.2	20.8		115.9	81.5	20.8		102.2
Central West	124.0	65.0		189.0	124.0	65.0		189.0
Darling Downs	99.8	19.0		118.8	92.3	18.9		111.1
Far North	86.9	24.7		111.6	81.4	24.2		105.6
Fitzroy	94.3	21.9		116.1	91.7	21.9		113.6
Logan River Valley	99.9	19.7		119.6	74.4	19.7		94.0
Mackay	85.0	21.3		106.4	83.3	21.3		104.7
North West	80.2	62.8		143.0	80.2	62.8		143.0
Northern	97.9	20.6		118.4	96.0	20.6		116.6
South Coast	93.6	19.4		113.0	77.6	19.4		97.0
South West	111.2	47.1		158.3	109.2	47.1		156.3
Sunshine Coast	93.1	20.5		113.6	78.7	20.4		99.1
West Moreton	93.7	19.5		113.3	86.7	19.5		106.2
Wide Bay	94.5	21.7		116.2	76.5	21.7		98.2
South Australia			1.0				0.8
Eyre Peninsula	86.3	24.4		110.8	86.3	24.4		110.8
Hills, Mallee and Southern	93.5	25.0		118.5	84.5	25.0		109.5
Metropolitan East	116.2	16.6		132.8	115.4	16.6		132.0
Metropolitan North	105.3	19.8		125.1	92.9	19.8		112.7
Metropolitan South	92.7	21.4		114.1	84.0	21.4		105.5
Metropolitan West	85.7	21.1		106.7	84.6	21.1		105.7
Mid North	84.0	24.1		108.1	80.1	24.1		104.2
Riverland	81.9	25.2		107.0	81.9	25.2		107.0
South East	84.8	21.4		106.2	84.8	21.4		106.2
Whyalla, Flinders and Far North	91.9	40.4		132.3	82.5	39.1		121.7
Yorke, Lower North and Barossa	94.2	23.5		117.7	94.2	23.5		117.7
Western Australia			0.9				0.6
Goldfields	101.0	30.3		131.3	101.0	30.3		131.3
Great Southern	90.4	25.3		115.8	88.7	25.3		114.0
Kimberley	132.8	55.6		188.4	107.9	55.6		163.5
Metropolitan East	102.2	19.2		121.4	90.7	18.5		109.2
Metropolitan North	94.4	21.6		116.1	77.5	21.2		98.7
Metropolitan South East	108.7	20.1		128.8	100.2	20.1		120.3
Metropolitan South West	87.4	19.7		107.1	72.6	19.7		92.3
Mid West	91.5	29.9		121.5	73.3	29.9		103.2
Pilbara	111.3	69.5		180.8	90.4	69.5		159.9
South West	97.5	22.5		120.0	82.7	22.5		105.3
Wheatbelt	69.5	27.9		97.4	65.7	24.6		90.3
Tasmania			1.1				1.0
North Western	89.2	21.6		110.8	79.4	20.3		99.8
Northern	94.3	23.3		117.6	87.3	23.3		110.6
Southern	98.6	22.0		120.6	87.9	21.9		109.7
Northern Territory			2.8				1.4
Alice Springs	167.7	203.0		370.7	167.7	203.0		370.7
Barkly	157.0	347.1		504.1	157.0	347.1		504.1
Darwin	89.0	91.5		180.5	79.4	91.5		170.8
East Arnhem	93.8	450.0		543.8	68.8	450.0		518.8
Katherine	164.7	200.5		365.2	164.7	200.5		365.2
Australian Capital Territory	106.1	26.8	1.6	134.5	72.5	26.8	1.6	100.9

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² The ratios in Table 4.2 are based on estimates of the population aged 70 years or over as at 30 June 2007 from small area projections prepared by the Australian Bureau of Statistics and based upon the bureau’s Population Projections, Australia (3,222.0), series B. The places in Table 4.2 include flexible care places. The higher levels of provision in the Northern Territory address the care needs of Aboriginal people aged 50 years and over. In this table, community care places include Community Aged Care Packages and Extended Aged Care at Home Packages.