Home page iconHOME |   Contents page iconCONTENTS |   User guide iconUSER GUIDE |  Search iconSEARCH |
Annual Report - Outcome Summary
Outcome Performance ReportMajor AchievementsOutcome SummaryPerformance IndicatorsFinancial Resources Summary

KEY STRATEGIC DIRECTIONS FOR 2004-05


Investing in Australia' s Aged Care: More Places, Better Care


The Department is responsible for the implementation of the $2.2 billion Investing in Australia' s Aged Care: More Places, Better Care package announced in the 2004-05 Budget, in response to the report of the Review of Pricing Arrangements in Residential Aged Care. The package builds on the existing aged care program to improve access of older Australians to aged care services, strengthen quality and promote efficiency and sustainability. Implementation of the package is substantially complete. Of the 31 new measures, 24 were implemented by the end of 2004-05 and three more commenced on 1 July 2005. Implementation of the remaining four measures is well advanced. A number of the measures are discussed below, and others are discussed elsewhere in this chapter.

During 2004-05, the Department implemented the first stage of the Transition Care Program on schedule, by allocating 599 new Transition Care places. In partnership with the States and Territories, Transition Care will provide older people who have completed a hospital stay with services to improve their physical, cognitive and psycho-social functioning, thereby improving their capacity for independent living. It also provides older people with time to make longer-term care arrangements. Transition care seeks to minimise inappropriate extended hospital stays and premature admission to residential aged care.

During 2004-05, the Department developed the eligibility criteria for the Conditional Adjustment Payment (CAP). Commencing 1 July 2004, CAP provides $877.8 million to approved providers over four years, subject to the conditions that providers give their staff information about training and opportunities for training, provide audited General Purpose Financial Reports annually, and participate in workforce censuses required by the Department. CAP will strengthen financial management and corporate governance arrangements in the aged care industry and assist approved providers to improve their services so that they can continue to provide high quality care to residents.

The 2004-05 Budget included a decision to introduce a new dependency-based funding system for residential aged care in 2006 which will, among other things, reduce the documentation burden on staff and allow them to spend more time on care. During 2004-05, the Department continued to manage development of this new funding instrument, called the Aged Care Funding Instrument (ACFI). Alternatives for a new funding model with a reduced number of categories and two new supplements were explored. A broad sample of residential aged care homes from each State and Territory is participating in the ACFI trial in 2005. The detailed structure of the new funding model will be informed by the data collected in the trial.

As part of the 2004-05 Budget measure, Investing in Australia's Aged Care - Streamlining Administration for Better Care, the Department is collaborating with aged care providers to introduce eBusiness to the aged care sector, thereby streamlining administration processes and increasing efficiency. The first stage of eBusiness was implemented in 2004-05 with a small number of aged care providers, to enable them to submit simple business transactions electronically. In 2005-06, more providers will be able to participate and the eBusinesss capability will be progressively extended to more complex transactions.

Early in 2005, the Department released the online Commonwealth Carelink Services directory which contains information about aged care homes and community care services. The Department also commenced development of a more extensive website, which will provide more comprehensive information for consumers as well as tools to help them better understand their needs and the services available to them. The site is planned for release in 2006.

The 2004-05 Budget Package foreshadowed development of a guarantee scheme to strengthen the protection of accommodation bonds paid by residents to approved providers of residential aged care. The Department undertook extensive consultations during 2004-05, including with the aged care sector, following which the Government decided to complement the guarantee scheme with new prudential arrangements, both to take effect from February 2006.

Quality Care and Support for Frail Older Australians


During 2004-05, the Department improved older Australians' access to care and support by increasing the number of residential and community places, which grows in line with Australia' s older population. Through the 2004 Aged Care Approvals Round, 11,825 new places were allocated. They comprised 8,905 residential aged care places (the largest ever single allocation of residential aged care places), 2,020 Community Aged Care Packages and 900 Extended Aged Care at Home packages. At 30 June 2005, there were 114.6 allocated aged care places and 102.4 operational places per 1,000 people aged 70 years and over, compared with 110.2 allocated places and 100.0 operational places at 30 June 2004. The number of operational places differs fom the number of allocated places primarily because of the time required to seek planning approvals (and resolve any appeals) once suitable locations have been identified. Of delays of more than two years in making places operational, nearly 75 per cent are due to planning delays and land availability. Table 3.1 shows the distribution of places across Aged Care Planning Regions within each State and Territory.

Top of page

Table 3.1: Allocated and Operational Aged Care Places per 1,000 Persons Aged 70 and Over
by Aged Care Planning Region, 30 June 2005


Aged Care
Ratio of Allocated Places
Ratio of Operational Places
Planning Region
Residential
care
Community
care
Transition
Care
Total
Residential
care
Community
care
Transition
care
Total
New South Wales
Central Coast
91.7
18.0
-
109.7
72.4
18.0
-
90.3
Central West
99.0
16.7
-
115.7
95.3
16.0
-
111.3
Far North Coast
90.1
17.2
-
107.4
77.4
17.1
-
94.5
Hunter
92.6
15.6
-
108.3
81.9
15.6
-
97.5
Illawarra
89.8
18.2
-
108.0
68.6
18.2
-
86.7
Inner West
120.4
19.4
-
139.7
111.7
18.4
-
130.1
Mid North Coast
91.9
17.6
-
109.5
74.0
17.6
-
91.6
Nepean
105.7
17.6
-
123.3
95.1
17.6
-
112.7
New England
96.1
18.1
-
114.2
87.3
18.1
-
105.3
Northern Sydney
107.8
14.2
-
122.0
102.1
14.2
-
116.3
Orana Far West
98.1
23.8
-
122.0
89.0
23.8
-
112.8
Riverina/Murray
90.5
17.3
-
107.7
80.1
17.3
-
97.4
South East Sydney
89.4
18.4
-
107.8
71.9
18.4
-
90.3
South West Sydney
91.4
17.2
-
108.6
80.7
17.2
-
97.9
Southern Highlands
95.0
15.7
-
110.7
80.0
15.7
-
95.7
Western Sydney
95.7
15.6
-
111.3
87.9
15.6
-
103.4
State Total
96.4
17.1
0.3
113.7
84.2
17.0
-
101.2
Victoria
Barwon-South Western
98.7
18.7
-
117.5
86.1
18.7
-
104.8
Eastern Metropolitan
98.6
15.4
-
114.0
85.4
15.4
-
100.8
Gippsland
96.3
17.3
-
113.7
80.7
17.3
-
98.1
Grampians
96.0
19.3
-
115.4
87.7
19.3
-
107.0
Hume
99.9
19.2
-
119.1
87.6
17.9
-
105.5
Loddon-Mallee
94.6
17.7
-
112.4
87.1
17.7
-
104.8
Northern Metropolitan
99.7
18.6
-
118.3
83.2
18.6
-
101.8
Southern Metropolitan
99.4
16.3
-
115.7
83.8
16.2
-
100.1
Western Metropolitan
101.8
19.0
-
120.8
81.4
19.0
-
100.4
State Total
98.8
17.4
0.3
116.5
84.4
17.3
-
101.7
Queensland
Brisbane North
105.4
14.7
-
120.1
98.5
14.7
-
113.2
Brisbane South
100.4
13.9
-
114.3
91.5
13.9
-
105.5
Cabool
93.2
12.7
-
105.8
82.1
12.7
-
94.8
Central West
113.2
61.7
-
174.9
113.2
61.7
-
174.9
Darling Downs
96.3
17.2
-
113.6
93.3
16.8
-
110.0
Far North
88.2
24.6
-
112.8
85.5
24.3
-
109.8
Fitzroy
100.7
20.2
-
120.9
90.0
19.1
-
109.1
Logan River Valley
92.4
18.9
-
111.3
63.0
16.9
-
79.9
Mackay
92.1
19.7
-
111.8
85.0
19.7
-
104.7
North West
91.8
66.4
-
158.2
83.1
63.0
-
146.1
Northern
101.3
16.8
-
118.1
95.6
16.8
-
112.4
South Coast
88.3
13.1
-
101.4
73.9
12.7
-
86.6
South West
109.4
47.6
-
156.9
108.4
47.6
-
156.0
Sunshine Coast
85.5
13.3
-
98.8
73.8
12.8
-
86.6
West Moreton
95.8
14.1
-
109.9
91.6
13.3
-
104.9
Wide Bay
88.7
15.9
-
104.6
79.4
15.1
-
94.5
State Total
94.9
16.0
0.3
111.2
85.2
15.6
-
100.8
South Australia
Eyre Peninsula
83.8
23.7
-
107.5
82.1
23.7
-
105.8
Hills, Mallee and Southern
93.8
18.6
-
112.4
83.5
18.6
-
102.1
Metropolitan East
119.7
13.3
-
133.0
118.8
13.3
-
132.1
Metropolitan North
100.7
15.7
-
116.4
87.2
15.7
-
103.0
Metropolitan South
89.9
17.9
-
107.8
82.9
17.9
-
100.8
Metropolitan West
87.2
18.3
-
105.4
82.2
18.3
-
100.5
Mid North
84.1
19.0
-
103.2
79.3
19.0
-
98.4
Riverland
84.1
18.2
-
102.2
84.1
18.2
-
102.2
South East
88.2
16.8
-
105.0
76.4
16.8
-
93.2
Whyalla, Flinders and Far North
89.3
33.5
-
122.8
85.9
33.5
-
119.4
Yorke, Lower North and Barossa
95.9
22.1
-
117.9
93.9
22.1
-
116.0
State Total
97.2
17.5
0.5
115.2
91.2
17.5
-
108.7
Western Australia
Goldfields
115.0
24.5
-
139.4
105.2
24.5
-
129.6
Great Southern
97.5
19.7
-
117.3
87.5
17.9
-
105.4
Kimberley
148.8
55.8
-
204.7
128.4
49.3
-
177.7
Metropolitan East
103.3
17.7
-
121.1
98.2
17.5
-
115.7
Metropolitan North
95.4
15.7
-
111.1
78.8
15.2
-
94.1
Metropolitan South East
110.9
18.0
-
128.9
103.3
17.8
-
121.1
Metropolitan South West
86.4
13.3
-
99.7
72.7
13.2
-
85.8
Mid West
76.4
21.1
-
97.5
72.9
21.1
-
94.0
Pilbara
135.0
81.3
-
216.3
81.3
81.3
-
162.6
South West
97.1
15.7
-
112.8
83.3
15.7
-
99.0
Wheatbelt
70.7
22.6
-
93.3
60.9
16.5
-
77.4
State Total
96.9
17.0
0.3
114.2
85.2
16.5
-
101.7
Tasmania
North Western
90.1
17.3
-
107.4
82.6
17.3
-
99.9
Northern
97.2
21.6
-
118.8
88.4
21.6
-
109.9
Southern
98.8
18.3
-
117.1
89.1
18.3
-
107.4
State Total
96.3
19.0
0.4
115.8
87.4
19.0
-
106.4
Northern Territory
Alice Springs
173.1
196.0
-
369.1
162.7
190.8
-
353.5
Barkly
163.8
327.6
-
491.4
163.8
327.6
-
491.4
Darwin
96.7
82.2
-
178.9
84.6
82.2
-
166.8
East Arnhem
80.3
525.5
-
605.8
80.3
474.5
-
554.7
Katherine
169.6
187.0
-
356.6
157.1
137.2
-
294.3
Territory Total
118.7
131.0
-
249.7
107.5
124.5
-
232.0
Australian Capital Territory
Australian Capital Territory
94.6
21.6
-
116.2
72.1
21.6
-
93.7
Territory Total
94.6
21.6
-
116.2
72.1
21.6
-
93.7
Australia
96.9
17.4
0.3
114.6
85.1
17.2
-
102.4



The ratios in Table 3.1 are based on estimates of the population aged 70 years or over as at 30 June 2005 from small area projections prepared by the Australian Bureau of Statistics (ABS) and based upon ABS Population Projections, Australia (3,222.0), series B. The places in Table 3.1 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.



Since the introduction of the Aged Care Act 1997, places allocated for low level care may be used for high level care to enable residents to age in place. Table 3.2 provides information on the utilisation of residential places for low level care and high level care.

Top of page

Table 3.2: Utilisation of Operational Residential Aged Care Places by State and Territory, 30 June 2005

 
Proportion of all operational residential places utilised for high care

Proportion of operational places allocated as low care and utilised for high care

New South Wales
64.1%
27.7%
Victoria
58.8%
28.1%
Queensland
64.6%
38.8%
Western Australia
58.9%
27.6%
South Australia
68.5%
41.4%
Tasmania
67.5%
40.1%
Northern Territory
70.5%
36.7%
Australian Capital Territory
65.1%
41,9%
Australia
62.9%
31.7%


The Community Partners Program was announced in the 2004-05 Budget and commenced on 1 January 2005. Following a competitive process, the Department selected 40 organisations to facilitate increased access to aged care by culturally and linguistically diverse communities. Communities that have large numbers of people aged 70 years and older who are assisted by the program are the Italian, Greek, Vietnamese, Polish, German, Spanish, Arabic, Turkish, Dutch, Chinese, and Cambodian communities. Other culturally and linguistically diverse communities are also assisted.

Support Aged Care Industry Workforce Quality and Professional Input


The Department assisted the Aged Care Workforce Committee, which represents the industry, to produce the National Aged Care Workforce Strategy, released in 2004-05. The strategy provides a framework for the aged care sector to plan and develop best practice workplace models. It supports the aged care workforce in sustaining the flexibility, skills mix and numbers essential for effective care.

The Department continued a partnership with the Royal College of Nursing Australia that provides undergraduate, postgraduate and continuing professional development scholarships to people from rural and regional areas who are committed to caring for older Australians. Budgeted at $26.3 million over four years from 2002-03, the scholarships are offered by the college to candidates selected in accordance with guidelines approved by the Department. During 2004-05, 300 undergraduate scholarships, 94 continuing professional development scholarships and 10 honours scholarships were offered. A total of 626 undergraduate scholarships, 329 continuing professional development scholarships and 17 honours scholarships has been offered since the Scheme commenced in 2003. The Department also administers funds to the college and the University of Tasmania for programs to support the scholarship recipients. The scholarships are increasing the availability of professionally qualified aged care staff.

Through the Support for Aged Care Workers Training Program, the Department manages training of care staff in smaller, less viable, aged care homes to upgrade their skills. Budgeted at $21.2 million over four years from 2002-03, the program frees registered nurses to concentrate on clinical care. In 2004-05, this program reached 1,216 staff through 33 training programs in 73 aged care homes. In the three years since its establishment, it has benefited more than 5,700 staff through 70 training programs in over 470 aged care homes throughout Australia.

The Department successfully implemented medication management training for enrolled nurses and vocational education and training for personal care workers under the Investing in Care-Better Skills for Better Care component of the 2004 Budget package. Eighty eight approved providers and 72 training organisations have been contracted for training of staff to enhance the quality of care provided to frail older Australians.

Continued Improvement of Care and Accommodation Standards (Capacity to Measure and Evaluate Improvements in Aged Care Services)


The quality assurance system for residential care requires homes to be accredited to be eligible for Australian Government subsidy. The Aged Care Standards and Accreditation Agency Ltd (the Agency) monitors compliance with the Accreditation Standards, which cover management systems, staffing and organisational development, health and personal care, resident lifestyle, and physical environment and safe systems. The Agency has found that most homes meet all the standards and undertake continuous improvement. At 30 June 2005, 2,935 homes were accredited by the Agency, of which 92 per cent have been awarded three years accreditation and almost 99 per cent of homes were compliant with all 44 Accreditation Standard outcomes.

The Department is responsible for ensuring that approved providers of aged care meet all their obligations under the Aged Care Act 1997 and imposition of sanctions when approved providers breach their responsibilities or fail to implement improvements, including those required by the Agency. During 2004-05, the Department took regulatory action against 129 approved providers, including the issuing of 12 Notices of Decision to Impose Sanctions and 208 Notices of Non-Compliance.

The Department developed a quality reporting system which, from 1 July 2005, will provide a common reporting process and standardised reports on quality for providers of Community Aged Care Packages (CACP), Extended Aged Care at Home (EACH), and services under the National Respite for Carers Program (NRCP). This quality reporting will benefit older people who receive care in their own homes by encouraging providers to look at the systems they have in place for delivering services and how these systems might be improved. The aim of quality reporting is to continuously improve the quality of community care services at the individual outlet level and for community care overall. Quality reporting is an important part of the strategy for strengthening community care and supporting the continued growth of the sector. The Department will work with providers to review the standard of service delivery and develop measures aimed at continuous quality improvement.

Top of page

Strengthened Continuity of Care and the Community Care Review


To improve the ways in which clients move between aged care and other services, the Department is conducting a number of pilot projects in partnership with the States and Territories. The Aged Care Innovative Pool pilots the provision of aged care services in community and residential settings in new ways and through new models of partnership. In 2004-05, to assist younger people with disabilities in aged care homes to access more appropriate specialist disability accommodation, the Aged Care Innovative Pool focused on services at the interface between aged care and disability services. The Innovative Pool also focused on services for people with high levels of need, in areas where the provision of aged care has proven difficult. As at 30 June 2005, 1,428 places had been allocated in the Aged Care Innovative Pool, of which 77 were allocated in 2004-05.

In response to the Community Care Review, A New Strategy for Community Care-The Way Forward was launched by the Minister in August 2004. The Department has established a number of working groups with the States and Territories to help implement The Way Forward. Work has been underway in five broad action areas: addressing gaps and overlaps in service delivery; providing easier access to services; enhancing service management; streamlining Australian Government programs; and adopting a partnership approach. Significant progress was made on renegotiation with State and Territory governments of a new Home and Community Care (HACC) agreement, underpinned by the adoption of common arrangements in areas such as eligibility, assessment, common entry points and accountability in order to simplify access to services by clients and their carers.

In 2004-05, the Department undertook an open competitive process to achieve streamlining and improved service delivery across a number of programs, including the NRCP, the Commonwealth Carelink Program, the Carer Information and Support Program and the Continence Aids Assistance Scheme. This was in line with the directions set out in The Way Forward. New funding agreements and contracts will generally be for three years from 1 July 2005, with transitional arrangements until 30 September 2005. This will result in reduced duplication between services, streamlined administration and a more flexible mix of services for carers.


Produced by the Portfolio Strategies Division, Australian Government Department of Health and Ageing.
URL: http://www.health.gov.au/internet/annrpt/publishing.nsf/Content/outcome-summary-3
If you would like to know more or give us your comments contact: annrep@health.gov.au