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Aged Care Essentials - Edition 3, 2010

The 3rd edition for 2010 of Aged Care Essentials is designed for approved providers and the staff of Australian Government-subsidised residential aged care services. It carries news and announcements about residential aged care services, as well as information about current rates for subsidies, supplements and charges.

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AGED CARE—Preparing for the future

The Council of Australian Governments (COAG), with the exception of Western Australia, agreed that the Australian Government would have full policy and funding responsibility for aged care services, including a transfer to the Commonwealth of current resourcing for aged care services from the Home and Community Care (HACC) Program, except in Victoria. This is a significant step towards a system with nationally consistent services, support assessment, care and regulation.

The system will cover basic home care through to high level residential care.

Services will provide a continuity of care for clients that are responsive to their changing needs rather than being tied to program and funding criteria.

The overlap of services created by different programs run by different governments, will be removed with different cost structures and eligibility requirements.

Over the next two years the Commonwealth will work with all levels of government, older Australians, their families and carers to create an integrated aged care system. Important elements of these reforms are:

• seamless transition of care for clients, allowing people to move from one level of care to another as their needs change
• simple access to services for clients
• single level of government with funding and regulatory responsibility for aged care
• simplified accountability of governments to the community through clearer responsibility for policy and service provision.

There will be a network of one-stop shops for people needing information, assessment and access to aged care. Over time these shops may link with local hospital networks and primary health care organisations.

Other outcomes include:

• investment to increase the capacity of the aged care system
• an increase to primary care services provided to people in aged care
• strengthened consumer protection in aged care
• states and territories to work to release more land for aged care facilities and accelerate planning approval processes
• funding for older Australians eligible for aged care and staying in public hospitals.

COAG have agreed to work together so that the transition to the new aged care arrangements will not disrupt current recipients of these services.

The Australian Government will consult with stakeholders and the aged care sector during the reform process.

Further information on the Government’s reforms and its investment in aged care is provided in this newsletter’s feature article Building a National Aged Care System.

Better Oral Health—Training For Residential Care Staff

Training for better oral health in residential care has commenced and is coming soon to a region near you.Top of page

On 1 March 2009 the Minister for Ageing announced The Nursing Home Oral and Dental Health Plan to improve dental and oral care in aged care facilities. It will encompass initial ACAT assessment through to care planning and management.

One component of the plan—The Better Oral Health in Residential Care Training—has begun and will continue throughout 2010.

Training is being provided for two registered nurses/dedicated trainers in each:

• aged care home
• multi-purpose service
• Indigenous flexible care service.

Facilities and workers will receive practical training resources.

A self-learning package of tools and further resources will also be provided to nurses so they can undertake:

• oral health assessment
• oral health care planning
• appropriate dental referrals for residents.

It is important that the right staff attend the training as those who attend will be expected to deliver training in their own workplaces.

As one part of the training will focus on the self-learning package, it is essential that at least one staff member attending the training is a nurse.

If you have a dedicated trainer who is not a nurse, the trainer could attend with a nurse.

Registered training organisations (RTOs) have been selected to undertake the training. They are currently contacting homes to let them know of the training schedule.

For further information about training, contact the RTO listed for your area in the table below.

The Aged Care Channel nominated June 2010 as Oral Health Month. It broadcast three modules based on the face-to-face training on 2, 16 and 30 June 2010. The modules are a good refresher for anyone who has already attended training or a good introduction for anyone attending after June.

More information about the Better Oral Health in Residential Care training is available from: www.health.gov.au/betteroralhealthtraining

More information on the Aged Care Channel programs is available from: www.agedcarechannel.com.au/index.html

Table 1:Registered training organisations (RTOs) contact table

Region	RTO	Website	Phone
ACT	Health Skills Australia	www.healthskills.com.au	1300 306 886
NSW: major cities, inner and outer regional	Health Skills Australia	www.healthskills.com.au	1300 306 886
NSW: remote	TAFE NSW–New England	www.newengland.tafensw.edu.au	02 6768 2061
Queensland	Southern Queensland Institute of Technology	www.sqit.tafe.qld.gov.au/courses/course_areas/aged_care_oral_health_training.html	07 4694 1903
Northern Territory	Health Skills Australia	www.healthskills.com.au	1300 306 886
South Australia: major cities, inner and outer regional	Royal District Nursing Service (RDN S)	www.rdns.org.au/education/index.php	1300 364 264
South Australia: remote and very remote	Health Skills Australia	www.healthskills.com.au	1300 364 264
Tasmania	Tasmanian Skills Institute	www.skillsinstitute.com.au	03 6336 2764
Victoria	Health Skills Australia	www.healthskills.com.au	1300 306 886
Western Australia	Central Institute of Technology (formerly Central TAFE)	www.central.wa.edu.au	08 9427 3725

It ’s Time For Police Check Renewals

All staff and unsupervised volunteers who have access to care recipients at Australian Government funded aged care services must undergo a police check to determine their suitability to provide aged care.Top of page

This is a requirement under the Aged Care Act 1997.

Police checks must remain current and need to be renewed every three years, before they expire.

It has been three years since police check arrangements were implemented, and it is now time for approved providers to check:

• the expiry dates of police certificates for all staff and unsupervised volunteers
• that procedures for detecting upcoming expiry of police checks are working effectively
• that procedures allow time for checks to be undertaken and returned before the expiry date
• that storage, security and access policies are effective.

Police checks can be applied for through state or territory police services, the Australian Federal Police service, or CrimTrac accredited brokers at www.crimtrac.com.au

Process times may vary between agencies and the Department has been informed that in some cases police check renewals may take eight weeks or more. This should be factored in to renewal procedures.

On 16 April 2010 the Department sent advice to approved providers on what they need to consider during the renewal process. This advice can be found on the Electronic advices to the Aged Care Industry page of the Department of Health and Ageing’s website at www.health.gov.au

The Department can take compliance action against providers that don’t meet their obligations. The Aged Care Standards and Accreditation Agency also monitor approved provider compliance with the police check requirements.

Further information on police checks, including the Police Certificate Guidelines for Aged Care Providers and the Accountability Principles 1998, is on the Department of Health and Ageing’s website. Follow the links at www.health.gov.au/oacqc

For more information or to clarify police check matters please contact the Department of Health and Ageing through the Aged Care Information Line on 1800 500 853.

New guide lines for preventing falls in older people

The Australian Commission on Safety and Quality in Health Care has developed the Preventing Falls and Harm From Falls in Older People: Best Practice Guidelines for Australian Hospitals, Residential Aged Care Facilities and Community Care 2009.Top of page

The guidelines were endorsed by Australian health ministers in November 2009 and build on earlier work including the 2005 Falls Prevention Green Pack.

The guidelines are designed for clinical practice and to assist health professionals to develop practices that reduce the number of falls and consequent harm suffered by older people in various settings.

Three main care settings are addressed: the community, hospitals and residential aged care facilities.

The guidelines are extensive and thorough and include evidencebased intervention recommendations and cost-effectiveness evidence where available.

Several documents have been created from the new guidelines including:

• a shortened guidebook for each setting for front line health professionals—each gives essential information for providing care for older people at risk of falling
• an implementation guide for hospitals and residential aged care facilities—designed to assist implementation and containing a tested methodology and practical tips
• fact sheets providing the core messages from the guidelines for health professionals and others providing care
• fact sheets for patients and residents.

The guidebook and a CD containing the full guidelines, implementation guide and fact sheets will be sent by end June 2010 to all Australian Government funded residential aged care homes, community care approved providers and service providers for the National Respite for Carers Program.

All documents can be accessed online at www.safetyandquality.gov.au/internet/safety/publishing.nsf/Content/FallsGuidelines.

Transfer of concessional status

Under the pre 20 March 2008 rules a resident had to apply for a new assets assessment to be concessional in a new home because the concessional status was for a particular entry into care.Top of page

Under current arrangements—post 20 March 2008—a resident who was concessional in their first home as a result of a Centrelink or DVA determination automatically transfers this status to the new home.

However, a resident who has a provider concessional determination will still need to fill in a Request for an Assets Assessment form for assessment by Centrelink or the Department of Veterans’ Affairs.

Depending on what has happened to their assets over the time they have been in care they may, or may not, be eligible to retain their concessional status in the new home.

Varying the amount of an accommodation bond with an existing resident

If a provider and resident agree, the amount of an accommodation bond can be varied—but the revised amount cannot exceed the maximum that applied at the time of the person’s entry to care.

Any agreed increase should accompany an improvement in accommodation for the resident, for example moving from a shared to a single room.

This does not alter the requirement of the Act that if a person transfers between aged care services, the new service cannot charge a bond that is greater than the bond balance refund from the previous service either at the time of transfer or after.

For further information contactthe Aged Care Information Line on1800 500 853.

Reduced reporting requirements for aged care providers

The Government is cutting the regulatory burden on Australian Government-subsidised aged care providers.

The cuts will be immediate and follow key recommendations in the Productivity Commission’s Annual Review of Regulatory Burdens on Business: Social and Economic Infrastructure Services report. In particular:

• to be reduced is the reporting requirements for the Conditional Adjustment Payment (CAP)
• to be removed is the requirement to lodge an annual fire safety declaration.

This means that from 1 July 2010 approved providers:

• will no longer have to submit a separate notice confirming compliance with the financial reporting obligations
• will also only need to advise the Department about instances of non-compliance with relevant state, territory or local government authority fire standards.

The Department will write to each approved provider with more information about the changes to legislation and reporting requirements.

More information can also be found at www.health.gov.au

Building a National Aged Care System

The Australian Government will invest more than $900 million over four years to deliver more highly qualified aged care workers, more aged care places, more health care services and greater protections for older Australians.Top of page
This investment will support the integration of the aged care system with Local Hospital Networks through the Government’s National Health and Hospitals Network reforms to provide better health and better care for older Australians

Full funding and policy responsibility

$38.3 million will be used to establish a nationally consistent aged care system that covers basic care at home through to high level care in aged care homes. For the first time, one level of government will have full policy and funding responsibility for aged care services.

The Commonwealth will become the sole funder and regulator of aged care services, including Home and Community Care services (except in Victoria).

This will provide opportunities to improve the efficiency of aged care services delivery, reduce cost and improve services. Over time, the Commonwealth will build a national aged care system by delivering a consistent approach to service provision under the Home and Community Care (HACC) Program, community care packages and residential care.

One-stop shops

To help older Australians and their families access the information and services that best suit their needs, $36.8 million will go towards establishing one-stop shops throughout the country to provide information and assessment services.

When linked with Local Hospital Networks, these one-stop shops will ensure nationally consistent eligibility and a care coordination system that benefits clients and carers.

Building an aged care system for the future

In preparing for the challenges ahead the Productivity Commission will undertake a major inquiry into the aged care system.

To support the inquiry and assist aged care providers to improve their financial sustainability, the Government will provide $7.0 million for a benchmarking tool and business advisory services for aged care providers to compare and improve business practices.

All 1140 Australian residential aged care providers will be included in the benchmarking survey to ensure that every home can benefit from the analysis.

Each provider will then be able to compare its operations against best practice, and improve the quality and efficiency of its care delivery to residents.

They will also have access to business advisory services to help them interpret and apply the survey results to their own operations.

The Government will also undertake research on staffing levels, skills mix and resident care needs.

These initiatives will build a more sustainable aged care sector while establishing the information base needed for long-term reform.

Building the aged care workforce

Top of pageThe Government will commit more than $310 million to support the aged care workforce and to support workers while they undertake education and training.

The Government will shift the focus of its existing workforce programs ($211.2 million) to improving clinical care. This will include:

• Introducing Teaching Nursing Homes to strengthen the links between the aged care sector, research and training institutions
• financial incentives for providers to make available up to 400 nursing graduate placements
• up to 640 clinical training placements
• 40 aged care nurse practitioner scholarships
• undergraduate and postgraduate training and scholarships
• certificate level training for personal care workers.

New budget measures ($103 million) are to:

• encourage aged care workers to upskill by introducing an Aged Care Education and Training Incentive Payments scheme
• provide an extra 600 fully funded enrolled nurse training places and 300 undergraduate nursing scholarships
• establish different models of practice to utilise nurse practitioners in aged care.

In total the Government will fund more than 31 000 aged care training places and scholarships and more than 1000 clinical and graduate placements over the next four years.

More Zero Real Interest Loans

The Government introduced Zero Real Interest Loans to provide low cost finance to providers to support investments in areas of high need.

$145 million will go towards doubling the loans initiative. This will support investment in aged care by providing a further $300 million in loans to support 2500 more aged care places.

Loan repayment periods will also be extended from 12 to 22 years.

As well, aged care providers who have allocated places that are not yet operational will be able to apply for loans.

Increasing the community care viability supplement

$10.1 million will be provided to improve the viability of rural and regional community care providers by increasing the viability supplement for eligible providers.

Expanding the Multi- Purpose Service program

$122 million will support the construction of more than 280 sub-acute beds, or their equivalents, in new and existing Multi-Purpose Services. This will support up to 5400 people a year and will increase the availability of more appropriate care options for long stay older patients in rural and remote areas.

Financial assistance for Long Stay Older Patients

The Government will provide up to $280 million to assist state and territory governments meet the cost of Long Stay Older Patients in public hospitals.

It will also seek to increase the availability of aged care places by:

• working with states and territories to accelerate planning approvals and have more land released so services become available more quickly
• allowing transition care services to be provided in rural and remote hospitals, where appropriate— providing up to 500 additional places in rural and remote communities
• allowing multi-purpose services to be built in larger rural communities than currently—providing up to 300 extra aged care places in rural and remote communities.

Consumer Directed Care

Top of pageTo improve care recipients’ quality of life, independence and satisfaction, they will be given the opportunity to be more active in shaping their care. This will be through 1200 Consumer Directed Care packages in Commonwealth-funded community care programs.

Improving access to primary health care services

Too many older Australians are unnecessarily admitted to hospital when better care in the community and in aged care homes would have kept them healthy and out of hospital.

Aged care homes also report difficulties obtaining GP and primary care services.

$98.6 million will be provided to improve access to general practice and primary health care. This will benefit older people in aged care homes and seniors receiving aged care support in the community.

Building a Better Aged Care Complaints Investigation Scheme

An extra $50.6 million will better equip the Aged Care Complaints Investigation Scheme to improve the response to complaints from residents and family members.

The Government will also expand the means through which complaints can be resolved by working with the aged care sector to establish alternate methods of resolution, including mediation and conciliation.

The Government will work with the aged care sector, consumers and key stakeholders, including the Ageing Consultative Committee, to develop
and implement other quality improvements to strengthen the Scheme, including:

• more timely responses to complaints through early risk assessment and resolution
• greater access to clinical expertise
• improved processes, procedures and training for the Scheme
• a broader range of options to resolve complaints
• an enhanced communications strategy for the Scheme
• better access to seek an independent review of decisions and processes.

Protecting aged care residents’ savings

$21.8 million will be provided to better safeguard the more than $9 billion of residents’ life savings held by approved providers as accommodation bonds.

The reforms will increase the accountability of aged care providers for the way they use the life savings of their residents by:

• clearly articulating the permitted uses of bonds.
• improving reporting requirements.
• introducing criminal penalties for misuse of bond funds.
• putting in place a prudential regime consistent with proposed legislative changes, to apply to aged care providers who hold accommodation bonds.

The confidence of more than 60 000 residents who have paid accommodation bonds and their families will increase, knowing their life savings are secure and that funds are being used to improve aged care infrastructure.

Forgotten Australians—education package for service providers

A National Education Package will be developed in 2010 to improve the knowledge and awareness of service providers about Forgotten Australians. Forgotten Australians include former child migrants, care leavers and people from the Stolen Generations. These are people who have experienced childhood institutional care or out-of-home care, or were child migrants, in the 20th century. Some have reported neglect, exploitation, mistreatment, as well as physical and sexual assault. They were separated from their families and have felt a sense of abandonment, loss and grief.

In 2003–04 the Senate Community Affairs Reference Committee held an inquiry known as Children in Institutional Care. The inquiry report with 39 recommendations, Forgotten Australians— a report on Australians who experienced institutional or out of home care as children, was tabled in Parliament on 30 August 2004.

In 2009 the committee released its Report on the Progress with the Implementation of the Recommendations of the Lost Innocents and Forgotten Australians Reports, stating that more needed to be done.

Subsequently, on 16 November 2009, the then Prime Minister, Hon Kevin Rudd MP, formally apologised. Following the apology the Allocations Principles 1997 were amended to include ‘care leavers’ as a special needs group under aged care legislation.

In his apology the then Prime Minister outlined initiatives in support of Forgotten Australians and stated that ‘service providers need to act in an appropriate and responsive manner towards care leavers.’ One initiative is to develop a National Education Package for service providers.

The aim of the National Education Package is to help service providers understand the difficulties and needs of this group. The Package will be developed over the coming months following consultations with key service providers, peak organisations representing Forgotten Australians.

The apology can be found at the following website: www.pm.gov.au

For copies of the Allocations Amendments Principles 1997 and the Explanatory Statement, contact the Carers and Carelink mailbox at
commcarelink@health.gov.au

Update to the Residential Care Manual 2009, Edition 1

Top of pageThe Residential Care Manual was created assist approved providers to meet their responsibilities under the Aged Care Act 1997. It is also for staff of aged care services, to help them understand the current regulatory and funding arrangements for Australian Government-subsidised aged care.

In September 2009 the Residential Care Manual 2009, edition 1, was released.

Two copies were sent to all residential aged care services and multi-purpose services nationally. It was also made available on the Department’s website.

In June 2010, following legislative amendment, edition 1 (on-line version) was updated (Update 1). Advice on the update was issued to all approved providers. Users of the manual are now able to print the changed pages out and insert them into the relevant sections of their editions of the Manual.

For extra copies contact the Residential Care Manual contact officer on (02) 6289 5007 or the Aged Care Information Line on 1800 500 853.

For more information about the manual, including information on Update 1, go to the Department’s website at :
http://www.health.gov.au/internet/main/publishing.nsf/Content/ageing-manuals-rcm-rcmindx1.htm

$34 million for local palliative care grants program

Almost 200 organisations have so far benefited from Australian Government funding of over $34 million to the Local Palliative Care Grants Program (LPCGP).

The funding began in 2005 and runs until 2011.

Under the funding, organisations can improve care and support to people needing palliative care and their families.

Four funding rounds were held between 2005–2009 with allocations to 178 organisations for:

• fit-out of, and equipment for, premises for palliative patients
• pastoral care, counselling and support
• step-down and transition-to-home support
• care planning for patients living at home.

In 2010, 21 organisations are receiving. funding under the recently completed fifth round. The focus in this round is to improve palliative care for people
with a mental illness, Alzheimer’s disease or other dementias.

Many of the organisations are working in partnership with aged care facilities to implement projects. Some examples of round 5 projects include:

• introduction of the Namaste Care Program, which includes family conferencing, dementia/palliative education, and the development of a ‘decision-tree’ pathway for symptom management
• piloting advanced care planning and symptom management interventions for people living with advanced end stage dementia in residential aged care facilities
• addressing mental health issues for palliative patients through the innovative use of specialised staff with both mental health and palliative care skills.

Information on previous rounds and grant recipients can be found at www.health.gov.au/palliativecare

RCS saved rate subsidy payments will continue

Top of pageThere is apparently some confusion in the residential aged care sector about whether RCS saved rate subsidy payments will continue.

When ACFI began on 20 March 2008 the subsidy payment was introduced as a transitional arrangement for existing residents classified under the RCS. It was to ensure that no daily care subsidies would be paid at a lower rate under an ACFI classification.

There is no expiry date on which the RCS saved rate subsidy ceases to apply.

If a subsidy is being paid for a resident this will continue at the existing rate (plus indexation) until either:

• their care needs increase to the extent that an ACFI rate becomes payable or
• the resident is discharged from the aged care home.

The payment is based on the following rules.

• Once an ACFI appraisal has been completed for an existing resident, the rate of subsidy will be either the new ACFI rate or the person’s existing RCS rate.
• If the ACFI appraisal results in an increase in the daily subsidy of $15 or more, the ACFI based subsidy is payable.
• If the ACFI appraisal results in a rate that does not increase the daily subsidy by $15 or more, the RCS rate of subsidy continues to be paid.

Further information about the ACFI can be found at www.health.gov.au/acfi or by contacting the Aged Care Information Hotline on 1800 500 853.

Contacting Medicare Australia—even easier now

Medicare Australia aims to make things easier for you, which is why they want your calls to go to the right person.

Table 2:Contacting Medicare Australia.

To find out about paper-based claims processing, online claims processing and the Aged Care Funding Instrument	1800 195 206*	Option 1
If you have a question about online claiming registration,online claiming website enquiries, software vendor, technical enquiries and data synchronisation	1800 195 206*	Option 2
To speak to a business development officer (BDO) about aged care onsite service presentations, assistance with online claiming registration, start up queries, Public Key Infrastructure (PKI) certificates, administration and general support	1800 195 206*	Option 1
To find out about aged care fees, care recipients and their nominees	Call the Department of Health and Ageing on the Aged Care Information Line on 1800 500 853*
Call charges apply from mobile or pay phones only. You can contact Medicare Australia between 8.30 am and 5.00 pm, Monday to Friday.

Project update—electronic aged care client record

It is pleasing to report the continuing progress of the electronic Aged Care Client Record (eACCR) Project.Top of page

As at 8 June 2010, 74 Aged Care Assessment Teams (ACATs) had submitted over 116,854 eACCRs.

Queensland ACATS commenced and completed their rollout in April 2010.

New South Wales continues to move teams across to the electronic process, with 5 more expected to commence in the coming months.

Rollout planning continues in South Australia and the NorthernTerritory with teams also expected to commence in the coming months.

The Department continues to work with Medicare Australia on there quirements for expanding online access.

Under the current arrangements only residential and community aged care providers who have registered for online claiming with Medicare Australia can electronically access ACCR information via the Commonwealth Online Claiming System.

To access eACCRs online, aged care services must be registered for online claiming with Medicare Australia.

To register, complete the online authorisation form on Medicare Australia’s website at
www.medicareaustralia.gov.au/aged or phone the Medicare Australia helpdesk on 1800 195 206.

Table 3: Project update—electronic aged care client record

Supplement	NUMBER OF TEAMS	Total of eACCRs
NSW	19	18,872
WA	16	19,702
VIC	18	64,826
ACT	1	3,791
TAS	3	6,732
QLD	17	2,931
TOTAL	74	116,854

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Future editions Aged Care Essentials will be distributed in soft copy only. If you would like to receive Aged Care Essentials via email, please email agedcare_essentials@health.gov.au

Current and back issues of Aged Care Essentials are available at:www.health.gov.au/internet/main/publishing.nsf/Content/ageing-rescare-payessdx.htm

Aged Care Subsidies, Supplements, Fees and Charges

Current Aged Care Subsidies and Supplements can be found on the Ageingweb website at:www.health.gov.au/internet/main/publishing.nsf/Content/ageing-subs-supp-current.htm.

For rates for the 2001 and 1997 viability supplement schemes, see current subsidies and supplements on the Department’s website atCurrent Aged Care Subsidies and Supplements can be found on the Ageingweb website at: www.health.gov.au/internet/main/publishing.nsf/Content/ageing-mailfax-2009-1806a.htm

Current Schedule of Resident Fees and Charges can be found on the Ageingweb website at: www.health.gov.au/internet/main/publishing.nsf/Content/ageing-finance-resfees.htm

Previous Schedules of Fees and Charges can be found at: www.health.gov.au/internet/main/publishing.nsf/Content/ageing-archive-feesinfo-0109.htm

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