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Aged Care Essentials - Edition 2, 2011

The 2nd edition for 2011 of the Aged Care Essentials is designed for approved providers and the staff of Australian Government-subsidised residential aged care services.

In this section:

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An Update on HACC Reform

Under the national health reforms agreed to by the Council of Australian Governments on 13 February 2011, the Australian Government will take full policy and funding responsibility for Home and Community Care (HACC) aged care services from 1 July 2011 and full operational responsibility from 1 July 2012.

The Victorian and Western Australian governments have not agreed to changes in responsibilities in relation to the HACC Program, so existing arrangements will continue in these states.

In 2011-12, it will be business as usual for HACC service providers. They will continue to receive funding from the relevant state or territory government, and continue to deliver services to the full range of HACC clients they currently service.

From 1 July 2012, most providers will enter into new agreements directly with the Australian Government for the provision of basic community care services to people 65 years and over (50 years and over for Indigenous Australians). They will also continue to receive funding from their state or territory government for services provided to people under these ages.

The Australian Government is committed to working with key stakeholders in the aged care sector to ensure the future arrangements for community care build on the strengths of the existing infrastructure, the experience of the workforce and the needs of local communities.

Consultations in capital cities and Alice Springs occurred throughout November and December 2010 on the new ‘front end’ to aged care, as well as the transition of basic community aged care services to the Australian Government. The second phase of consultations in regional Australia was held during March 2011.

Further consultations planned for later in 2011 are intended to inform the sector of the new program framework and funding arrangements as they are developed.

Information on upcoming consultations will be advertised on www.yourhealth.gov.au. The department’s e-mail and fax distribution service will also be used.

Factsheets for service providers and HACC clients, carers and families are available on the website www.yourhealth.gov.au. If you would like any further information on the transition of the HACC Program, you can e-mail HACC.Reform@health.gov.au.
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Aged Care Education and Training Incentive Program

Get paid to develop your skills in aged care...

If you commenced study after 1 July 2010 and have not applied, you should apply now...

The Australian Government is providing incentive payments to aged care workers who undertake further studies to enhance their career as a personal care worker, an enrolled nurse or a registered nurse.

An eligible aged care worker who successfully completes an eligible training course will receive two incentive payments: a commencement payment and a completion payment. Payments range from $500 to $3 000 and are dependent on the level of study.

To qualify for the incentive payments, aged care workers must be employed in an eligible aged care service and commence training between 1 July 2010 and 30 June 2014.

A package containing application forms and Guidelines for Applicants can be forwarded on request. For further information please visit www.health.gov.au under the path of: Home>For Health Professionals>AgedCare>Working in Aged Care, or telephone the Medicare Australia Aged Care Information Line on 1800 195 206.

Medicare Australia’s Aged Care Approved Provider Statement is changing

In response to your feedback, Medicare Australia is changing the Aged Care Approved Provider Statement (provider statement) process.

If you are registered for Medicare Australia’s Aged Care Online Claiming, the last time you need to complete the provider statement is 2011. The terms and conditions for Aged Care Online Claiming have been amended to include the provider statement’s terms and conditions. These are now available from www.medicareaustralia.gov.au/aged

Note: you do not need to re-sign a new Registration for Aged Care Online Claiming form (authorisation form) as the terms and conditions in your original application remain valid.

If you are not registered for Aged Care Online Claiming, you will continue to submit the provider statement but instead of submitting it annually it will need to be submitted every three years. The 2011 statement will be for the period 1 July 2011 to 30 June 2014.

All providers, no matter what the current claiming method, must complete the 2011 provider statement by 30 June 2011. It will be sent to you in April 2011.

For more information go to www.medicareaustralia.gov.au/aged or call Medicare Australia on 1800 195 206*.
*Call charges apply from mobile or pay phones only.
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Strengthening the Aged Care Complaints Scheme

In the previous issue of Aged Care Essentials, we provided an overview of the role of the Aged Care Complaints Scheme (the Scheme) and the reforms being implemented in response to Associate Professor Merrilyn Walton’s 2009 review.

The goal of the reforms is to build a more responsive and customer focused aged care complaints system. Underpinning the system is a national approach that affords natural justice to all parties; focuses on clear and timely communication; and seeks to educate approved providers and consumers about their rights, responsibilities, the Scheme and options to resolve concerns.

Approved providers should already be starting to see positive changes, such as:
  • greater consistency and quality of decisions due to revised national procedures, comprehensive staff training, an ongoing focus on applying natural justice principles, and using feedback to continuously test and review procedures;
  • reduction in the number of ‘long wait’ cases; and
  • improved communication with approved providers and complainants, including early identification of the issues being examined.
A significant part of the reforms is strengthening the complaints management framework and increasing the options available to resolve concerns. The proposed framework aims to:
  • encourage complainants to raise their concerns directly with the approved provider in the first instance, where possible and appropriate;
  • expand the ‘pathways’ for resolving a complaint to include supported resolution, conciliation, mediation and investigation;
  • enable the Scheme to manage a complaint in the way that will achieve a quality outcome for the care recipient and approved provider; and
  • allow the Scheme to appropriately escalate complaints based on risk.
More improvements are planned for the coming months, including:
  • publishing the Scheme’s procedures, performance measures and strategic plan;
  • developing resources to support approved providers to manage complaints effectively;
  • revising the Scheme’s Service Charter;
  • improving information for approved providers, care recipients and complainants about their options, rights and responsibilities;
  • establishing a Clinical Unit to support Scheme staff to make effective and evidence based decisions involving clinical issues;
  • releasing reports to the industry on complaints topics, trends and risks; and
  • providing opportunities for approved providers, consumers and stakeholders to help shape the development of new communication materials such as fact sheets, posters and other resources.

Name change for the Scheme

With the revision of the complaints management framework, the name of the Scheme will also change. It will no longer be called the ‘Complaints Investigation Scheme’ or the ‘CIS’. The Scheme will be known as the Aged Care Complaints Scheme, to better reflect the pathways available to resolve concerns.

More information

For more information about the reforms, please call the Communication and Stakeholder Management section on 02 6289 1760 or e-mail agedcomplaintscomms@health.gov.au.
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Assistance for Remote and Aboriginal and Torres Strait Islander services

Aged Care — Service Development Assistance Panel (SDAP)

The SDAP is a service available to Australian Government funded aged care organisations providing care to Aboriginal and Torres Strait Islander people1, and/or organisations operating in remote areas2. This service lets you choose from a panel of experts who will work with you to improve key areas of your business, from meeting your reporting and regulatory requirements through to delivering better care.

There are five key functional areas of business where you can get hands on help. These are:
  1. Care delivery – improving care for clients of your aged care facility.
  2. Governance and management – guidance for staff and managers about how they work.
  3. Financial management – using your money more effectively and better reporting.
  4. Quality delivery – setting and meeting the required industry standards.
  5. Locum relief – getting temporary staff to fill in when key people are unexpectedly away.

Eligible aged care providers who can access the SDAP

The SDAP covers:
  • the 28 services funded under the National Aboriginal and Torres Strait Islander Flexible Aged Care program;
  • the 33 aged care services which predominantly provide residential care for Aboriginal and Torres Strait Islander people under the Aged Care Act 1997, which deliver culturally appropriate aged care, close to home and country, mainly in rural, remote and very remote areas;
  • aged care services anywhere in Australia that have more than 20 per cent Aboriginal and Torres Strait Islander clients, which provide residential aged care, Community Aged Care (CACP), Extended Aged Care at Home (EACH), EACH Dementia (EACHD), flexibly funded care or respite care (these services are not eligible for locum support); and
  • aged care services in remote and very remote areas, which provide residential aged care, CACP, EACH, EACHD, flexibly funded care or respite care (these services are not eligible for locum support).

What are the benefits of using the SDAP?

There are many benefits in accessing the SDAP. You can:
  • access expert guidance and advice across a range of five key functional areas;
  • select from a Panel of government-appointed professionals assessed as being culturally aware and sensitive;
  • receive aid, assistance and solutions while dealing with the difficulties and needs of providing services in remote and very remote areas;
  • improve the standard of your service without incurring a cost; and
  • enhance the overall quality of your aged care.
Note that limits to assistance apply and applications will be prioritised.

Further information on the SDAP

There are a number of ways to find out more about the SDAP.
You can:
  • view the SDAP website for information, benefits, eligibility etc at www.health.gov.au
  • e-mail any queries or concerns directly to the department on SDAP@health.gov.au and
  • call the department on 1800 850 744 or fax the department on 02 6289 3184.

1 Based on the department’s National Approved Provider System (NAPS).
2 The remoteness of a community/service is classified using the Australian Bureau of Statistics Australian Standard Geographical Classification.

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Prudential and Approved Provider Regulation Client Service Charter 2011

The Office of Aged Care Quality and Compliance has responsibility for the prudential regulation of approved providers charging accommodation bonds and for the approval of providers of aged care.

A Client Service Charter (the Charter) has been developed for prudential and approved provider
regulation. The Charter sets out the standards of service that approved providers of aged care and aged care consumers can expect to receive with regard to prudential regulation and the regulation of approved providers.

The Charter is available on the department’s website at http://www.health.gov.au/internet/main/publishing.nsf/Content/ageing-quality-client-service-charter

Hard copies of the Charter can be ordered from the National Mailing and Marketing by e-mailing health@nationalmailing.com.au.

For other enquiries regarding the Charter, contact the Aged Care Information Line on telephone 1800 500 853.

Community Care Common Standards

From 1 March 2011 all community aged care service providers receiving funding under the Home and Community Care (HACC) program, Community Aged Care Packages (CACPs), Extended Aged Care at Home (EACH), Extended Aged Care at Home Dementia (EACHD), and the National Respite for Carers Program (NRCP) will need to meet the requirements of the Community Care Common Standards.

The Community Care Common Standards are expected to reduce the administrative burden for service providers through a single set of standards and reporting tools for these programs; joint reviews where possible for providers receiving both HACC and Australian Government only funded programs; and nationally consistent processes for quality reviews. Greater clarity and detail around expectations under the Standards should also assist in ensuring quality in the provision of services to service users.

Service providers who receive notification of their quality reviews after 1 March 2011 will be participating in the quality review processes that are part of the Community Care Common Standards framework.

Further detailed information about the Community Care Common Standards and how they will be used in quality reviews of community aged care service providers can be found in the Community Care Common Standards Guide (the Guide). Hard copies of the Guide may be obtained from National Mailing and Marketing on 02 6269 1060 or by e-mail: health@nationalmailing.com.au

The Guide is also available electronically at the following websites: Top of page

Improving information, intake and assessment for aged care

The Australian Government is developing a new ‘front end’ for aged care to make it easier for older Australians, their families, and carers to navigate and access aged care services.

The Hon Mark Butler MP, Minister for Mental Health and Ageing, announced on 5 April 2011, the first step in a phased implementation of a new ‘front end’ to improve information, intake and assessment for aged care commencing from 1 July 2011.

Mr Butler has agreed that from 1 July 2011, this first step will focus on improving access to information through:
  • a new single national phone number for accessing aged care information; and
  • improving the aged care website to ensure more comprehensive and up to date information is available.
Over the next three years, the Australian Government will continue to improve entry to the aged care system using a phased approach. This will allow the Australian Government an opportunity to respond to the Productivity Commission’s final report, which will be released in June 2011.

In late 2010, consultations were held in each capital city (with the exception of Perth) and Alice Springs. Across the 12 consultations sessions there were over 800 participants, including representation from nongovernment organisations, peak bodies, local, state and territory governments.

Participants embraced the opportunity to share their views, assist in system change, highlight the strengths of the current system and raise issues for consideration.

The feedback from the sessions was positive and this information is being used to help refine the delivery of the new ‘front end’ for aged care.

Some common themes noted at the consultations, included that consideration be given to:
  • ensuring that local networks are sustained;
  • there should be independent, fair and equitable service allocation;
  • consumer choices should be a key feature;
  • that access for Aboriginal and Torres Strait Islander, and Culturally and Linguistically Diverse people mustbe considered;
  • there should be an appropriate national assessment tool;
  • access to clinicians is vital;
  • the ‘front end’ workforce needs to be sufficiently skilled to ensure the client’s journey is directed appropriately;
  • while the workforce is dedicated, service integration for clients remains patchy;
  • integrated IT and shared client information essential;
  • the terms new ‘front end’ or ‘one stop shop’ are distracting;
  • consistent flexible funding and fee structures should be considered; and
  • the reforms are a tremendous opportunity to redesign and streamline the system.
An online survey seeking feedback on the aged care reforms was available on the yourhealth website throughout December 2010 and January 2011. The survey enabled stakeholders to share their views and contribute to the development of the new ‘front end’ for aged care. The final results showed 513 people completed the survey, with the majority of respondents from Home and Community Care service providers (29 per cent) followed by Community Aged Care Service Providers (21 per cent).

The survey results also highlighted that the top five elements that should feature as part of the new ‘front-end’ for aged care, are:
  • clear referral pathways;
  • supported entry into, and navigation of, the aged care system;
  • multiple ways to access the new ‘front-end’ for aged care, for example, face-to-face, telephone, Internet;
  • knowledge of the local system; and
  • nationally consistent support and assessment.
A series of regional consultations is underway and will continue throughout 2011. The consultation schedule is available at www.yourhealth.gov.au and continues to be updated as further dates and locations are confirmed.

For further information about the ongoing consultation process, please call the Aged Care Consultation Information Line on 1800 057 616, or e-mail agedcareconsultations@health.gov.au

Also look out for the Implementation Update newsletter which will be available on www.yourhealth.gov.au. The yourhealth website is regularly updated with information about the planning and progress of the new ‘front end’ for aged care.
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Ensuring the correct details for admission of residents

It is important that Medicare Australia is advised of resident admissions as soon as possible. This assists the Department of Health and Ageing to provide early advice to aged care providers about subsidies and the fees that residents may be asked to pay.

Some residents are not being identified correctly on admission due to inaccurate information supplied on the Resident Entry Record for Permanent Care (RER). This causes delays in the Department of Health and Ageing advising residents and aged care providers of the correct fees the resident may be asked to pay.

Date of Entry/Pre-Entry

If the resident utilises pre-entry leave, the Leave Details section of the RER must be completed.

Resident Details

To identify residents quickly the Resident Details and Pensioner Identification Numbers should be taken from the resident’s Centrelink or DVA Pensioner Concession Card, their Health Care Card, or related correspondence, if this is available.

Each card shows the resident’s legal name, an Entitlement or SSR/CRN number and the name of the department that issued the card. It is important that the details provided on the RER are identical to the details on these cards (see for example, as circled on the Centrelink card image at right).

Note: The DVA cards are in different colours depending on the resident’s DVA entitlements. Copy the resident’s name and file number exactly as shown on the card.

Image of a sample of the front of the Centrelink Pensioner Concession Card. Image of a sample of the back of the Centrelink Pensioner
Image of Repatriation Health Card for all conditions within Australia Image of Repatriation Health Card for Totally and Permanently Incapacitated.
Image of the Repatriation Pharmaceutical Benefits Card. Image of Repatriation Health Card for Specific Conditions

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Aged Care Funding Instrument VALIDATIONS: Clarification of common reasons for downgrades

Following an analysis of information related to outcomes of the Aged Care Funding Instrument (ACFI) validation program, the department would like to share some findings to assist the aged care industry correctly appraise residents.

Two questions which have a high downgrade rate are ACFI Question 5 (Continence) and ACFI Question 11
(Medication) and some common reasons for these downgrades are discussed below.

Please consider the information presented below in conjunction with the ACFI User Guide, (December
2009, pages 22, 23 and 24 for ACFI 5,Continence, and pages 34 and 35 for ACFI 11, Medication).

ACFI 5 Continence

Claims are downgraded under the following circumstances:
  • urinary and bowel records contain Codes 4 and 7 with no evidence to support that the resident was incontinent of urine or faeces.
  • there is misinterpretation of the term ‘scheduled toileting’ and claims are being made in ACFI 5 when a resident recognises the urge to void or have bowel activity and requests staff assistance to use a toilet. Claims to assist a resident who recognises the need to use a toilet, can be made in ACFI 4 (Toileting), rather than ACFI 5.
  • colostomy — claims can be made in ACFI 4 (Toileting) and ACFI 12 item 15 (Management of ongoing stoma care), rather than in ACFI 5.
  • leaking urinary catheters — claims may be made in ACFI 4 (Toileting) for emptying drainage bags, and ACFI 12 item 8 (Catheter care) if the requirements are met.

ACFI 11 Medication

Excessive timing for medication administration is often claimed in the absence of an assessed need. Methods of validation in this instance may include interviewing staff or observing a medication round if the documentary evidence does not satisfy the higher rating claimed by the appraiser.

It should be noted that the following activities are not included in medication administration timing and do not apply to ACFI 11:
  • time taken to apply pressure to the lacrimal duct to prevent systemic absorption of all eye drops in the absence of an assessed need.
  • waiting one minute between the applications of eye drops in the absence of an assessed need or an instruction for this additional measure.
  • eye washes prior to administration of eye drops.
  • applying standardised timing of ‘one minute’ for each tablet (oral medication) administered to all residents.
  • cleaning and maintaining equipment such as inhalers.
  • looking for/or finding a resident or sitting a resident up to administer their medication.
  • removal of a resident’s clothing to enable the application of creams or patches.
  • standing by and waiting for full absorption of creams once applied.
  • reading and signing medication charts.
For further information on ACFI appraisal or claiming issues please refer to the ‘Frequently Asked
Questions’ at: http://www.health.gov.au/internet/main/publishing.nsf/Content/ageing-acfi-faq.htm

Please note the e-mail address scaleaccountability@health.gov.au is now closed and all queries about interpretation or validation of ACFI should be sent to the ACFI inbox at acfi@health.gov.au
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Dates for Quarterly Reviews of Income Tested Fees

The quarterly reviews of income tested fees will be conducted on the following dates:
  • 28 May 2011 – the review is effective from 1 July 2011
  • 17 September 2011 – the review is effective from 20 September 2011
  • 17 December 2011 – the review is effective from 1 January 2012.
Residents and aged care providers should receive fee advice letters as follows:
  • 1 July 2011 review – fee advice should be received late June 2011
  • 20 September 2011 review – fee advice should be received early October 2011
  • 1 January 2012 review – fee advice should be received January 2012.

Subscribe to receive Aged Care Essentials Electronically

Aged Care Essentials is distributed as electronic copy only.

If you would like to receive Aged Care Essentials through e-mail, please e-mail: agedcare_essentials@health.gov.au

Current and back issues of Aged Care Essentials can be found on the Department of Health and Ageing website at: www.health.gov.au/internet/main/publishing.nsf/Content/ageing-rescare-payessdx.htm

Aged Care Subsidies, Supplements, Fees and Charges

Aged care subsidies and supplements can be found on the Department of Health and Ageing website at:
www.health.gov.au/internet/main/publishing.nsf/Content/ageing-subs-supp-current.htm

The schedule of resident fees and charges can be found on the Department of Health and Ageing website at: www.health.gov.au/feesandcharges

Previous schedules of fees and charges can be found on the Department of Health and Ageing website at: www.health.gov.au/internet/main/publishing.nsf/Content/ageing-finance-resfees.htm
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