Better health and ageing for all Australians

Living Longer. Living Better.

Better Health Care Connections: Models for Short Term, More Intensive Health Care for Aged Care Recipients Program - Grant Program Guidelines

October 2012



You can download this document in PDF format (GrantProgramGuidelines5-11-2012.pdf (PDF 341 KB))

Contents


1. Introduction

1.1 Purpose of this document

Welcome to the Better Health Care Connections: Models for Short Term, More Intensive Health Care for Aged Care Recipients Program Guidelines 2012 (the Guidelines). The Guidelines are designed to provide details of the Better Health Care Connections: Models for Short Term, More Intensive Health Care for Aged Care Recipients Program (the Program), including information about the seed grants available, who can apply, how to apply, how to get support with applications, how applications are assessed and what successful applicants need to do.

1.2 Background and policy context

The Australian Government is building a better, fairer and more nationally consistent aged care system. The Living Longer Living Better aged care reform package provides $3.7 billion over five years. It represents the commencement of a 10 year reform program to create a flexible and seamless system that provides older Australians with more choice, control and easier access to a full range of services, where they want it and when they want it. It also positions the aged care system to meet the social and economic challenges of the nation’s ageing population.

The reforms give priority to providing more support and care in the home, better access to residential care, more support for those with dementia and strengthening of the aged care workforce. They have been progressively implemented from 1 July 2012 to give early benefits to consumers and providers but also to ensure there is a smooth transition for consumers and providers and sufficient time to adapt and plan ahead for further reform.

The Government has undertaken significant reform to the health system to bolster primary care and preventative care services to keep people out of hospital, to help people stay well in their community and importantly to ensure the health and wellbeing of Australians as they age. As part of Better Health Care Connections in the aged care reform package, the Government has a strong focus on building links between aged care and the health and hospitals systems.

You can find more information about the Living Longer Living Better aged care reform package on the Department’s Living Longer Living Better website.


2. Overview of the Program

The Government is providing $25 million (including indexation) under the Program to support initiatives to encourage aged care providers to work with public and private health care providers and medical insurers to deliver short term, more intensive health care services. This will result in improved access to complex health care, including palliative and psycho- geriatric care. The Government is providing this funding over five years from 2012-13 to 2016-17 for seed grants to develop innovative models of health care services for aged care recipients.

2.1 Aim

The aim of the Program is to improve the quality of health care for aged care recipients.

2.2 Objectives

The Program’s objectives are to:
  • develop innovative models to build better health care connections between existing health and aged care services, that are cost effective and improve the way the aged care system works within the broader health system;
  • improve access to complex health care services for aged care recipients;
  • increase awareness and information on successful models amongst aged care and health care service providers; and
  • diversify the aged care sector to include more complex community and residential health care services for aged care recipients.

2.3 Outcomes

Program outcomes include:
  • cost effective innovation models of health care that demonstrate that aged care recipients have received high quality health care;
  • effective referral pathways between aged care and health care service providers that ensure that aged care recipients have improved access to health care;
  • reduction of unnecessary hospital admissions and shortening of length of hospital stays for aged care recipients;
  • improvement in the quality of health care services provided to aged care recipients; and
  • development of a more skilled and flexible aged care sector.

2.4 What activities will be funded?

It is intended that operational aged care providers will undertake a number of tasks including:
  • as a primary role, develop models to build partnerships and innovative ways of working to join up the range of short term, more intensive health care services within a local area/region from which aged care recipients may need assistance;
  • undertake all establishment phase activities and be ready to start accepting aged care recipients for the short term, more intensive health care services; and
  • develop promotional material to encourage the uptake of practice within the aged care sector in the long term.

Short term, more intensive health care services, such as palliative and psycho-geriatric care, may be provided to aged care recipients through:
  • in-reach subacute care services provided by accredited hospitals in residential and community settings; and
  • a broader range of more flexible and complex health care services provided in aged care homes and the community.

The health care services may range from hospital subacute services (those only provided by accredited hospitals) to a small number of simple interventions provided in aged care homes which potentially reduce unnecessary transfers to hospital.

As part of this arrangement operational aged care providers will continue to provide Specified Care and Services as required by the Aged Care Act 1997. Additional health care services will be provided by accredited hospitals, medical practitioners and other eligible health care providers using existing funding platforms (see Attachment A) and regulatory frameworks.

The provision of short term, more intensive health care in aged care homes will considerably enhance the flexibility of aged care delivery in residential settings and assist providers in delivering a wider range of such service offerings, and diversify their client and revenue base. For example, psychogeriatric services may include health care services for dementia and mild to moderate mental health, such as anxiety and depression.

It is important that additional health care services build on what older people can do rather than what they cannot do, such as enablement, re-ablement or restorative aged care. For example, better and more innovative connections can be made with directly related specific programs such as Transition Care and Day Therapy Centres and the palliative care innovative advisory services which provide access to specialist palliative care and advanced care planning expertise.

2.5 Integration with other health and aged care reforms

The Department will encourage operational aged care providers (see Attachment B) to form collaborations, consortia or partnerships to deliver projects, enabling Medicare Locals and Local Hospital Networks to actively participate in the Program. Joined-up or multi-regional approaches will be considered where appropriate. Successful seed grants should have demonstrated capacity to be integrated with other health and aged care reforms (for example Local Hospital Networks and Medicare Locals) and where possible effectively leverage off these reforms to deliver outcomes (see Attachment C).

2.6 How will Program funding be administered?

Program funding will be administered based on an open competitive selection process. Invitations To Apply will be released for each open competitive funding round conducted. Applicants will submit an application as per the instructions in the Invitation To Apply. The application is included in the Invitation To Apply at Part D.

Funding provided under the Program is intended to be broad in scope and flexible to support a wide range of activities that enable aged care providers to build relationships with public and private sector health care providers and medical insurers for the delivery of short term, more intensive health care services.

2.7 Evaluation

As part of a robust review, monitoring and evaluation framework, annual evaluations of the ongoing effectiveness of the Program will be conducted through an independent evaluation over four years from 2012-13.

Seed grant recipients will be required to:
  • provide information to assist, and to participate, in monitoring and evaluation activities for a period of time, as stipulated in the Standard Funding Agreement;
  • undertake monitoring and evaluation activities which will be used to inform the roll-out of the Program as it progresses; and
  • abide by any monitoring and reporting requirements and arrangements established to support this function (for example qualitative and quantitative data collection and reporting).

The evaluation will analyse annual formal evaluations (along with relevant progress reports) from seed grant recipients and report the results each year to the Commonwealth. Successful innovative models will be selected by the Department and their promotional materials will be disseminated by the Department to the aged care sector.

The Department will engage with stakeholders during the development of this Program through an Expert Reference Group. It will also work with the Expert Reference Group to disseminate promotional materials to the aged care sector. Timing of the distribution of promotional material will be dependent on the duration of individual seed grants.

Attachment D describes the development of the Program and the diversification of the aged care sector into a broader range of health care services.

2.8 Target group

Aged care recipients who require:
  • in-reach subacute care services provided by accredited hospitals in residential and community settings; and
  • a broader range of more flexible and complex health care services provided in aged care homes and the community.

2.9 Roles and responsibilities

The Grant Program Process Flowchart at Attachment E outlines the roles and responsibilities of each party.

The Department is responsible for the detailed administration of the Program, including all aspects of the application, appraisal and advice to the Funding Approver on the merits of each application, negotiating Standard Funding Agreements, payments, monitoring progress, and acquittal and evaluating processes.

The Funding Approver for the Program is the First Assistant Secretary, Ageing and Aged Care Division, Department of Health and Ageing. The Funding Approver makes a decision on each application and the Department advises the applicant of the decision.

The Minister for Mental Health and Ageing has responsibility for the Program.

As part of the application process, operational aged care providers submitting applications should ensure all information they provide is accurate. Providers applying for seed grants should be prepared to meet the costs associated with the development and lodgement of their application in response to an Invitation To Apply.

2.10 Anticipated key dates

The Program is a non-ongoing initiative from 1 July 2012. The Program ends on 30 June 2017.

Invitations To Apply will open for open competitive funding rounds under the Program in each year from 2012 to 2015. Timeframes for specific open competitive funding rounds may vary depending upon the funding process and the expected outcomes of the individual activities. Timeframes for activities associated with the open competitive funding rounds will be clearly specified in each Invitation To Apply.

You can find more information about the opening of Invitations To Apply on the Department’s website under Tenders and Grants. Potential applicants may check the site to learn when an open competitive funding round will be open/closed from 1 July each calendar year.

2.11 Monitoring of seed grants

Seed grants will be monitored under the Program and potential underspends identified. Consideration will be given to the use of any underspends, including through expansion or enhancement funding to new or existing projects to support implementation of the Program. For example, should such underspends be identified, applications received through the open competitive funding round assessed as being able to meet the Program’s aim and objectives but which did not receive funding, may be revisited and considered for future funding.

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3. Eligibility

3.1 Who is eligible to apply for funding?

The Department is seeking applications from interested operational aged care providers that have the capacity to best implement the Program.

To be eligible for seed grants, applicants must be an approved provider of residential or community aged care with at least one operational service. Applications will not be accepted from non-operational aged care providers.

Favourable consideration will be given to operational aged care providers who form collaborations, consortia or partnerships with public and private health care providers and/or other organisations as required or as necessary to meet the selection criteria and health care needs of specific aged care recipients.

Joined-up or multi-regional approaches with an operational aged care provider as the lead organisation will also be considered if it can be demonstrated that such an approach is a more effective and efficient way to deliver short term, more intensive health care services to aged care recipients.

Where the application is a joint application with one or more other organisations, an operational aged care provider with at least one operational service must be identified as the lead organisation and an authorised representative of the lead organisation must sign the application.

3.2 Applications considered for funding?

Program funding will be provided in support of applications for seed grants which:
  • are led by a suitably placed and experienced operational aged care provider; and
  • enable realistic achievement of the Program’s aim and objectives within a local area/region.

All requirements for applications will be set out in each Invitation To Apply, including matters such as:
  • project items that will be considered eligible;
  • any funding caps (minimum or maximum limits that may apply);
  • any restrictions on Start/End dates for activities (for example, all projects must be completed within the stated Financial Year/s); and
  • any restrictions on when funding must be expended.

Program funding will only be provided for new Program specific tasks to be undertaken by an operational aged care provider, even if the organisation engaged receives funding from another source to deliver programs and services other than those under this Program.

Retrospective items/activities will not be funded under the Program.


4. Probity

The Australian Government is committed to ensuring that the process for providing funding under the Program is transparent and in accordance with published Guidelines.

Note:
Guidelines may be varied from time-to-time by the Australian Government as the needs of the Program dictate. Amended Guidelines will be published on the Department’s website under Programs and Initiatives. The Guidelines will also be attached to each Invitation To Apply.


4.1 Conflict of interest

A conflict of interest may exist, for example, if the applicant or any of its personnel:
  • has a relationship (whether professional, commercial or personal) with a party who is able to influence the application assessment process, such as a Department staff member;
  • has a relationship with, or interest in, an organisation, which is likely to interfere with or restrict the applicant in carrying out the proposed activities fairly and independently; or
  • has a relationship with, or interest in, an organisation from which they will receive personal gain as a result of the granting of funding under the Program.

Each applicant will be required to declare as part of their application, existing conflicts of interest or that to the best of their knowledge there is no conflict of interest, including in relation to the examples above, that would impact on or prevent the applicant from proceeding with the project or any Standard Funding Agreement it may enter into with the Australian Government.

Where an applicant subsequently identifies that an actual, apparent, or potential conflict of interest exists or might arise in relation to their application for seed grants, the applicant must inform the Department in writing immediately.

4.2 Confidentiality and protection of personal information

Each applicant will be required to declare as part of their application, their ability to comply with the following Legislation/Clauses in the Standard Funding Agreement it may enter into with the Australian Government.

The Protection of Personal Information Clause requires the Participant to:
  • comply with the Privacy Act 1988 (‘the Privacy Act’), including the 11 Information Privacy Principles (IPPs), as if it were an agency under the Privacy Act, and the National Privacy Principles (NPPs);
  • refrain from engaging in direct marketing (s 16F of the Privacy Act), to the extent that the NPP and/or s 16F apply to the Participant; and
  • impose the same privacy obligations on any subcontractors it engages to assist with the Project.

The Confidentiality Clause imposes obligations on the Participant with respect to special categories of information collected, created or held under the Standard Funding Agreement. The Participant is required to seek the Commonwealth’s consent in writing before disclosing Confidential Information.

A template of the Standard Funding Agreement will be attached to each Invitation To Apply.


5. How to apply

5.1 Obtaining an application

Applicants may obtain an Invitation To Apply from the Department’s website under Tenders and Grants. The application is included in the Invitation To Apply at Section D.

5.2 Application requirements

Applications must be submitted to the Department by the date specified in the Invitation To Apply and should meet all the requirements outlined below.

Applications must contain information in relation to the:
  • proposed model;
  • project plan and budget;
  • project partners and other organisations;
  • communication strategy;
  • risk management; and
  • capability and capacity requirements.

5.2.1 Proposed model

Applications should include the following information:
  • name of the project;
  • project aim, objectives and outcomes;
  • identified geographical area and the target population for the project;
  • estimated number of aged care recipients to be assisted (if known);
  • a map of the health care services and other support systems in the local area/region;
  • how well the model meets the Program’s aim and objectives in the specified local area/region;
  • how the model will build partnerships and innovative ways of working to join up the range of short term, more intensive health care services within a local area/region from which aged care recipients may need assistance;
  • how the model will enable the provider to undertake all establishment phase activities and be ready to start accepting aged care recipients for the short term, more intensive health care services;
  • how the model’s promotional material will encourage the uptake of practice within the aged care sector in the long term;
  • how the model will address ebbs and flows in demand for the services and how referrals to the services that are not accepted will be appropriately managed;
  • how the model focuses on what older people can do rather than on what they cannot do, such as enablement, re-ablement or restorative care;
  • how the model links with other health and aged care reforms, for example Local Hospital Networks and Medicare Locals;
  • how the model will be viable and operational within the existing service system architecture operating in the local area/region;
  • what is the readiness of the local area/region to start effectively implementing the project; and
  • how does the model demonstrate capacity to be more broadly applied in the aged care industry.

5.2.2 Project plan and budget

Applications should include the following information:
  • who will be responsible for the management of the project;
  • how the project will be managed;
  • how the finances for the project will be managed;
  • a project plan that sets out the key dates, timeline and key milestones for the implementation of the proposed model within the local area/region;
  • what monitoring and reporting will be undertaken to manage the project;
  • clearly state when short term, more intensive health care services will be established, staffed and operational, ready to commence delivery of services to aged care recipients;
  • a detailed recurrent budget for the proposed model, identifying all associated costs in Australian dollars and identified as GST exclusive (these costs are to be itemised, where possible, according to the key stages and milestones in the project plan and cover the funding period); and
  • justification for budget costs should be provided and be limited to the costs of implementing the project within the local area/region (applicants should demonstrate that the budget is sufficient to meet the project’s aim, objectives and outcomes, and describe the intended benefits of the investment for the local area/region to demonstrate value for money).

5.2.3 Project partners and other organisations

Applications should include the following information:
  • for applications that are not from collaborations, consortia or partnerships, the following details should be provided in relation to other organisations:
    • an overview of how the Applicant will work with other organisations to support the successful implementation of the project within the local area/region; and
    • the roles/responsibilities the organisations will undertake, and the resources they will contribute (if any).
  • applications from collaborations, consortia or partnerships must include letters of support from any other key partners (for instance relevant state/territory government agencies and funded services, Local Hospital Networks or Medicare Locals); and
  • for collaborations, consortia or partnership applications, the following details should be provided in relation to non-lead organisations:
    • an overview of how the organisation will work with the lead organisation to support the successful implementation of the project within the local area/region;
    • an outline of the relevant experience and/or expertise the organisations will bring to the project team;
    • the roles/responsibilities the organisations will undertake, and the resources they will contribute (if any); and
    • details of a nominated management level contact officer for each organisation.

5.2.4 Communication strategy

Applications should include the following information:
  • a communication strategy outlining how the project will be appropriately marketed in the local area/region to encourage:
    • appropriate referrals (minimising the risk of high numbers of ineligible aged care recipient referrals);
    • awareness that the project is building better and stronger connections between existing health and aged care service providers;
    • engagement and support from all relevant sectors, services and supports within the local area/region; and
    • awareness about the initiative and how consumers, carers and families can benefit.

5.2.5 Risk management

Applications should include the following information:
  • applications should include details of factors/risks that will impact on the applicant’s ability to achieve the project objective and timelines; and
  • for each risk identified, details should be provided on the likelihood and the consequences of the identified risk, and what steps have been taken or will be taken to manage the risk.

5.2.6 Capability and capacity requirements

Applications should demonstrate:
  • experience in project management;
  • financial management experience when undertaking projects;
  • experience within and understanding of the health and aged care service and support systems;
  • experience and track record working with people who are aged care recipients;
  • expertise and knowledge to equip them to understand and form partnerships or working relationships with Commonwealth, state and territory health care services and supports;
  • expertise and knowledge to equip them to understand and form partnerships or working relationships with local health care services and supports;
  • capacity to engage with health care service providers, share experience and information, and analyse and formulate assessments/plans;
  • strong networking ability, and a high level of communication and negotiation skills;
  • an understanding of what services are in the local area/region and who needs to be connected with whom to successfully meet the aim and objectives of the project; and
  • an understanding of the local area’s/region’s demographics and the number of people within the project’s target group to be involved in the project.

Applications that do not completely satisfy all capability and capacity requirements listed under Clause 5.2.6, should describe how they will acquire these to successfully implement the project.

5.2.7 How to submit an application

Applications must be submitted on the official application in part D of the Invitation To Apply and must be lodged according to the instructions for submitting applications in the Invitation To Apply.

To assist with the appraisal of an application, clarifying information may be requested by the Department. Applicants will be notified by email or post where this is required.

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6. Assessment

6.1 Assessment process

Applications for seed grants under the Program will undergo a formal assessment process. Applications must be complete and meet all requirements outlined in Clause 5.2 above. Those applications which are incomplete and/or do not satisfy the Eligibility Criteria may not be considered.

Based on the information provided, an assessment panel convened by the Department will undertake an evaluation of eligible applications against the appraisal criteria outlined below. The assessment panel will consist of officers from the Policy and Evaluation Branch and the Program Funding and Procurement Services of the Department.

Any party involved in the assessment process of applications (for instance, assessment panel members, personnel providing independent advice, the Funding Approver) will be required to maintain the highest standards of probity and official conduct. As appropriate, such parties will be required to sign a Code of Ethics and/or a Deed of Confidentiality, which address conflicts of interest through requiring them to undertake certain actions in relation to any actual, potential, or apparent conflict of interest.

This includes making a declaration to an appropriate authority as soon as any actual, potential, or apparent conflict of interest arises, and to take such steps as the appropriate authority may reasonably require to resolve or to otherwise deal with the conflict. The appropriate course of action and management strategies determined by the appropriate authority may include considering whether the party can continue to participate in the assessment process, and if so, how the conflict will be managed.

6.2 Assessment criteria

Applications will be assessed against the following eligibility and assessment criteria.

6.2.1 Eligibility criteria

Eligibility criteria are the criteria that an application must satisfy in order to be considered for seed grants. This is expressed as “Mandatory Criteria” in the Invitation To Apply, which will involve the use of expressions such as “must”, “must not”, “will” or “will not”.

6.2.2 Assessment criteria

Assessment Criteria are the criteria against which all eligible, compliant applications will be assessed in order to determine their merits against the Program’s aim and objectives and, for competitive programs, other competing applications. Applications should address all of the following assessment criteria to be considered for seed grants. Seed grants will be provided on a competitive basis.

Assessment criteria:
  • how well the applicant’s proposed model meets the Program’s aim and objectives;
  • what the applicant’s ability is to implement the proposed model within budget and timeframes, as well as abide by and meet all accountability and audit requirements;
  • how well the applicant will work collaboratively with other organisations to support the successful implementation of the project;
  • how well the application’s proposed model will be appropriately marketed in the local area/region and communicated to all key stakeholders;
  • what the level and proposed management of risk is associated with the applicant’s proposed model;
  • what the relevance and strength of knowledge, skills, capabilities and experience of the applicant is in achieving the proposed model;
  • what the capacity of the applicant is to undertake all establishment phase activities and be ready to start accepting aged care recipients for short term, more intensive health care services; and
  • what the readiness of the local area/region is to start effectively implementing the proposed model.


7. Decisions

7.1 Approval of funding

Following an assessment of the applications by the assessment panel, advice will be provided by the Department to the Funding Approver on the quality, suitability, regional readiness and value for money of the application/s.

Applications will be ranked according to quality, suitability, regional readiness and value for money:
  • Highly suitable – application is of excellent quality, proposed a highly suitable model, is in a local area/region that is ready to implement the project, and demonstrates value for money. Contract negotiations should commence for immediate engagement.
  • Suitable – application is of good quality, proposes a suitable model, is in a local area/region that is ready to implement the project and demonstrates value for money. Contract negotiations should commence following clarification of issues to the Department’s satisfaction.
  • Further work required – application has some quality, or proposes a somewhat suitable model, the local area/region is building its readiness to implement the project, and/or there are concerns over value for money. Further work on the application is required to address concerns of viability and/or readiness. Applicant to rework application for further consideration.
  • Unsuitable – application is of marginal quality, proposes an unsuitable model, is in a local area/region that is not ready/does not have the capacity to implement the project, and/or does not represent value for money. The application will not be recommended for seed grants.

The Funding Approver will consider whether each of the highly suitable and suitable applications recommended for seed grants will make an efficient, effective and ethical and economical use of Commonwealth resources, as required by Commonwealth legislation, and whether any specific requirements will need to be imposed as a condition of funding.

Funding approval is at the discretion of the Funding Approver. Where the number of highly suitable applications exceeds the amount of funding available, the assessment committee will prioritise the recommended applications, as determined by applications with:
  • a proposed model described in a way that illustrates it as having the best chance of meeting the aim and objectives of the Program in the local area/region;
  • local area/regional need;
  • the strongest local area/regional readiness; and
  • state/territory government support for the project to be undertaken.

7.2 Advice to applicants

Applicants will be advised by letter of the outcome of their application. Letters to successful applicants will contain details of any specific conditions attached to the seed grants. Funding approvals will also be listed on the Department’s website.

The Department will notify all unsuccessful applicants, in writing, after execution of the Standard Funding Agreement/s with successful applicants. The Department is not able to provide feedback on applications prior to the Funding Approver’s decision.

7.3 Complaint handling

The Department’s Procurement and Funding Complaints Handling Policy applies to complaints that arise in relation to a procurement or funding process. It covers events that occur between the time the request documentation is released publicly and the date of contract execution, regardless of when the actual complaint is made. The Department requires that all complaints relating to procurement or funding process must be lodged in writing. Further details of the policy are available on the About Us page on the Department’s website at www.health.gov.au.

Any enquiries relating to funding decisions for this Program should be directed to:
    Program Manager
    Aged Care Interface Section
    Policy and Evaluation Branch
    Ageing and Aged Care Division
    Department of Health and Ageing
    Email: ACI@health.gov.au


8. Conditions of funding

8.1 Contracting arrangements

Successful applicants will be required to enter into a Standard Funding Agreement with the Commonwealth (represented by the Department).

A template of the Standard Funding Agreement will be attached to each Invitation To Apply.

The Department will work with successful applicants with the aim of having Standard Funding Agreements for those ranked “highly suitable” executed first. The remaining applicants will be engaged in subsequent stages. All organisations will need to be sufficiently staffed, networked and well established to undertake their projects as per their applications.

8.2 Intellectual Property

Successful applicants will be required to grant the Department with a broad licence to deal with and disseminate intellectual property created for a project, and note the Department’s intention is to release project material to third parties.

8.3 Specific conditions

There may be specific conditions attached to the seed grants approval required as a result of the appraisal process or imposed by the Funding Approver. These will be identified in the offer of funding or during Standard Funding Agreement negotiations.

8.4 Payment arrangements

Payments will be made on achievement of agreed milestones and on the Department’s acceptance of specified contract deliverables. Before any payment can be made, seed grant recipients will be required to provide:
  • a tax invoice for the amount of the payment;
  • evidence of meeting the obligations of the Standard Funding Agreement, including achievement of milestones; and
  • contract deliverables and have them accepted by the Department as per the Standard Funding Agreement.

Where payments are linked to the achievements of specific milestones, payments will only be made after the Department is satisfied that those milestones and associated obligations of the Standard Funding Agreement have been met.

8.5 Reporting requirements

Seed grant recipients will be required to provide progress reports on the agreed milestones and a final report at the end of the project. The timing of progress reports will be negotiated as part of the Standard Funding Agreement. The format and framework for providing progress reports will take into account the size, cost and relative risks of the project being under taken by seed grant recipients. The expected frequency of reporting is approximately three times per year.

Progress reports will include:
  • a description of actual performance against the Guidelines and standards for performance of the project as specified in the Standard Funding Agreement;
  • information on whether the aim of the project is being achieved and if not, why not:
  • a version of the project material produced to the date of the progress report, if requested by the Commonwealth;
  • a statement of the balance of the project funds in the bank account;
  • a statement of how much the operational aged care provider needs to meet current liabilities under legal commitments entered into by the operational aged care provider for the performance of the Standard Funding Agreement; and
  • any other requirements specified in the Standard Funding Agreement.

The final report will include:
  • a comprehensive report on actual performance against the Guidelines and standards for performance of the project as specified in the Standard Funding Agreement and the aim of the project and whether the aim of the project was achieved and, if not, why not;
  • an audited detailed statement of receipts and expenditure in respect of the funds prepared by an approved auditor in compliance with the Australian Auditing Standards which must include a definitive statement as to whether the financial accounts are complete and accurate, and a statement of the balance of the project funds in the bank account;
  • a statement of how much (if any) the operational aged care provider needs from the final payment to meet current liabilities under legal commitments entered into by the operational aged care provider for the performance of the Standard Funding Agreement;
  • a certificate provided by the Chief Executive Officer or Chief Financial Officer of the operational aged care provider, or a person authorised by the operational aged care provider to execute documents and legally bind it by their execution, confirming that:
    • the funds and other contributions received were spent for the purpose of the project and in accordance with the Standard Funding Agreement and that the operational aged care provider has complied with these requirements;
    • salaries and allowances paid to persons involved in the project are in accordance with any applicable award or agreement in force under any law on industrial or workplace relations; and
    • at the time the final report is provided to the Commonwealth, the operational aged care provider is able to pay all its debts when they fall due.
  • any other requirements specified in the Standard Funding Agreement.

8.6 Monitoring

The seed grant recipient will be required to actively manage the delivery of the project. The Department will monitor progress against the Standard Funding Agreement through assessment of progress reports and by conducting site visits as necessary.

8.7 Evaluation

The Department will assess the ongoing effectiveness of the Program over four years from 2012-13 through an independent evaluation. Seed grant recipients will be required to provide information to assist in this evaluation for a period of time, as stipulated in the Standard Funding Agreement.

Procurement processes will be conducted independently of any grant process.

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9. Glossary of terms

Activities of daily living
Activities of daily living are a core set of self-care or personal care activities that include bathing and washing, dressing, feeding, and getting in and out of bed, getting to and from the toilet and continence management.

Aged care
A range of services required by older persons (generally 65 years and over (or 50 years and over for Indigenous Australians)) with a reduced degree of functional capacity (physical or cognitive) and who are consequently dependent for an extended period of time on help with basic activities of daily living. Aged care is frequently provided in combination with basic medical services (such as help with wound dressing, pain management, medication, health monitoring), prevention, reablement or palliative care services.

Aged care recipient
People receiving aged care services in institutions or at home.

Approved provider
Approved providers are organisations approved by the Australian Government, to receive subsidies for the provision of aged care services and accommodation to residents within an aged care home, or for the provision of care and services to people in the community.

Assessment panel
An assessment panel is a committee of officers from the Department who assess the merits of applications submitted in response to an Invitation To Apply.

Carer
A carer is a person who has a caring role for an older person. They could be family, friends or staff and be paid or unpaid. The role of the carer is not necessarily static or permanent, and may vary over time according to the needs of the consumer and carer.

Community care
Is provided to people with functional restrictions who mainly reside in their own home. It also applies to the use of institutions on a temporary basis to support continued living at home – such as community care centres and respite. Community care also includes specifically designed, “assisted or adapted living arrangements” for people who require help on a regular basis while guaranteeing a high degree of autonomy and self-control.

Consultant
A consultant is an entity, whether an individual, a partnership or a corporation, engaged to provide professional independent and expert advice and services.
Expert Reference Group
An advisory group which is an external non-statutory departmental committee.

Local Hospital Network
An organisation established in accordance with Schedule D of the National Health Reform Agreement which provides public hospital services.

Medicare Locals
Organisations funded by the Commonwealth to be the General Practice and primary health care partners of Local Hospital Networks in accordance with Schedule D of the National Health Reform Agreement.

Operational aged care provider
Operational aged care providers are approved providers of residential or community aged care with at least one operational service.

Palliative care
Care provided for people of all ages who have a life-limiting illness, with little or no prospect of cure and for whom the primary treatment goal is quality of life. It focuses on living well until death.

Reablement
Intensive and generally time limited programs aimed at restoring function. Services included as part of a reablement approach can include physiotherapy, psychosocial and other education programs, environmental modification and linkages to social activities.

Residential aged care
Refers to facilities (other than hospitals) which provide accommodation and aged care as a package to people requiring on-going health and nursing care due to chronic impairments and a reduced degree of independence in activities of daily living. These facilities provide residential aged care combined with either nursing, supervision or other types of personal care required by the residents. Aged care institutions include specifically designed institutions where the predominant service component is long term care and services are provided to people with moderate to severe functional restrictions.

Subacute care services
May include rehabilitation, geriatric evaluation and care management. Some subacute care services are colloquially referred to as “low dependency” or “step up” or “step down” care, meaning that it can either precede (and potentially avoid) a hospital admission or follow an acute hospital admission. Most subacute services can be provided on either an inpatient or ambulatory basis.

Transition care
Short-term care that seeks to optimise the functioning and independence of older people after a hospital stay. It seeks to enable more people to return home after a hospital stay rather than enter a residential aged care facility.



Attachment A - Existing funding platforms

Successful innovative models will utilise existing funding platforms to fund the provision of short term, more intensive health care services for aged care recipients:
  • Commonwealth, state and territory funding for in-reach subacute care services provided by accredited hospitals;
  • the Aged Care Funding Instrument for residential aged care; and
  • packaged care subsidies for community aged care.

Funding for in-reach subacute care services

The Commonwealth’s present funding for subacute care is paid to states and territories through National Partnership Agreements for particular purposes related to hospital services and through the Commonwealth’s general subsidisation of public hospitals. The Commonwealth, states and territories jointly fund subacute care under National Health Reform. The Commonwealth is providing up to $1.6 billion in capital and recurrent funding from 2010-11 to 2013-14 to states and territories under the National Partnership Agreement on Improving Public Hospital Services to provide over 1,300 new subacute care beds and bed equivalent services. These will be provided nationally in hospitals and in the community and will ensure patients are cared for in the most appropriate setting with access to the services they need.

This work will be undertaken in consideration of the work completed and started under the National Partnership Agreement on Hospital and Health Workforce Reform to enhance the level of subacute care services by five per cent per annum or twenty per cent over the period 2009-10 to 2012-13.

Under the National Health Reform Agreement, Activity Based Funding will be introduced nationally to improve efficiency, as well as making transparent the funding contributions of the Commonwealth and state and territory governments for each Local Hospital Network across Australia. To achieve this the Independent Hospital Pricing Authority is required to determine the national efficient price that will be used to calculate Commonwealth payments for public hospital services that are funded on an activity basis.

Under the National Health Reform National Partnership Agreement on Improving Public Hospital Services, the Commonwealth and states and territories are working together in alliance with Local Hospital Networks to improve outcomes in the delivery of public hospital services.

Local Hospital Networks are obliged to work with local primary health care providers and aged care providers to ensure that locally responsive and tailored care extends beyond hospitals. Through the initiation of new, or expansion of current, relationships between aged care providers and Local Hospital Networks, the capacity for a delivery method of new models to provide subacute care in-reach public hospital services to residential and community settings would be enabled.

The Productivity Commission Final Report, Caring for Older Australians, indicated the benefits of improved coordination between the health and aged care systems are likely to be significant. For example, HammondCare stated that an acute hospital bed in NSW cost $1,223 per day compared with a HammondCare sub-acute hospital bed between $650 and $900 and an aged care bed around $160.

Funding for residential aged care

The Aged Care Funding Instrument (ACFI) is a resource allocation instrument that focuses on the activities of daily living, behaviour and health care that discriminate care needs among residents to determine the average cost of care in longer stay environments. While based on the differential resource requirements of individual persons, the ACFI is primarily intended to deliver funding to the financial entity providing the care environment. This entity for most practical purposes is the residential aged care home. When completed on all residents in the facility the ACFI provides sufficient precision to determine the overall relative care needs profile and the subsequent funding.

Three components of residential care subsidy are determined by the ACFI. These are:
  • Activities of Daily Living;
  • Behaviour Supplement; and
  • Complex Health Care Supplement.

Around 52 per cent of all aged care residents have some form of dementia. During 2012-13 the Australian Government will make changes to the ACFI under aged care reform, to set care subsidies in residential aged care to better match funding levels to the care needs of residents. To improve the quality of care in aged care homes for residents who have severe behavioural and psychological symptoms of dementia a new Very High Level of funding will be added to the Behaviour Domain of the ACFI. This new supplement will fund the provision of psycho-geriatric care services in aged care homes. This measure will better match funding levels to the care needs of residents in aged care homes and it is anticipated that there will be a significant increase in the number of people eligible for this additional assistance.

The Government will give providers an additional $5,789 per year, on top of normal subsidies to support people with severe dementia. Staff will receive improved training, and guidelines and procedures will be developed to ensure best practice by aged care providers.

Package care subsidies for community aged care

The Government currently funds more than 58,000 Home Care packages. Under the Living Longer Living Better aged care package the Government will more than double the number of Home Care packages available across Australia over the next 10 years – more than 80,000 new packaged by 2021-22. The Government is committing $880.1 million over the next five years to expand care in the home, reducing the emphasis on residential care.

Individuals with severe behavioural and psychological symptoms of dementia often find difficulty in getting access to appropriate services. The Government is providing $123.3 million for a new Dementia Supplement for eligible Home Care package recipients that will increase funding by 10 per cent to recognise the higher costs of caring for people with dementia.


Attachment B - Operational aged care providers

The Program involves operational aged care providers with at least one operational residential or community aged care service.

In 2010-11 there were 287 operational aged care providers operating 784 services other than mainstream residential services as follows:
  • 74 Extended Aged Care at Home Dementia packages
  • 133 Extended Aged Care at Home packages
  • 5 Innovative Pool services
  • 12 Innovative Pool – Client Directed Care High Care services
  • 5 Innovative Pool – Client Directed Care High Care Dementia services
  • 14 Innovative Pool – Client Directed Care Low Care services
  • 59 Multi-Purpose Services
  • 26 National Aboriginal and Torres Strait Islander Aged Care Program services
  • 34 Transition Care Program services
  • 422 Community Care services.

In June 2012, there were 1089 operational residential aged care providers operating the following services:
  • 2,273 residential services
  • 786 community services
  • 396 Extended Aged Care Home packages
  • 272 Extended Aged Care Home Dementia packages
  • 5 Innovative Pool services
  • 79 Multi-Purpose Services
  • 65 Transition Care Program services
  • 1 Australian and Torres Strait Islander Flexi service.


Attachment C - Integration with National Health Reform and aged care reform

National Health Reform

Under National Health Reform responsibility for hospital management is being devolved to Local Hospital Networks, giving local communities and clinicians greater say in how their hospitals are run. Local Hospital Networks will work closely with Medicare Locals and the aged care system to deliver better integration and smoother transitions for patients across the entire health and aged care systems.

Medicare Locals will improve linkages between aged care and GPs, nursing and other health professionals and hospitals; and identifying gaps in delivering primary care to residential and community aged care at the local level. The networks will help Australians by improving access to better coordinated health care and promoting more efficient use of resources and navigation between service providers and health services.

Further information on National Health Reform is available on the Department’s YourHealth website.

Aged care reform

The Living Longer Living Better aged care reform package provides $3.7 billion over five years. It represents the commencement of a 10 year reform package to create a flexible and seamless system that provides older Australians with more choice, control and easier access to a full range of services, where they want it and when they need it. It also positions the aged care system to meet the social and economic challenges of the nation’s ageing population. More information on aged care reform is available on the Department’s Living Longer Living Better website.


Attachment D - Diversification into a broader range of community and residential health care services




Text description of Attachment D - Diversification into a broader range of community and residential health care services over five years

Attachment D describes the development of the Program and the diversification of the aged care sector into a broader range of health care services.

An arrow pointing from left to right across the top of the page is labelled Diversification into a broader range of community and residential health care services over five years. This indicates the program aims over the five year funding program

The Program process commences with grants of seed funding to develop innovative models of health care services for aged care recipients. Annual evaluation reports inform the rollout of the program.

Grant recipients will be required to create promotional materials to ensure uptake of practice by the sector.

Operational aged care providers will make relationships and develop innovative models by working with Local Hospital Networks and/or Medicare Locals.

Aged care providers can work with Local Hospital Networks to establish subacute care in reach public hospital services in residential and community settings. Commonwealth and state and territories provide the subacute care funding for these services.

Providers can also work with Medicare Locals to establish a broader range of more flexible and complex healthcare services provided in aged homes and the community. Aged care subsidies available for these services include the Aged Care Funding Instrument (including the new Very High Level Behavioural Supplement) and packaged care subsidies (including the new Dementia Supplement).

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Attachment E - Grant Program Process Flowchart

  1. Application
    • Applicant completes an application
  2. Submit an application
    • Applicant submits an application
  3. Appraisal
    • The application is accepted. The application is assessed against eligibility and appraisal criteria
  4. Advice to approver
    • Advice provided to the Funding Approver* on the merits of each application against the Program Guidelines (*First Assistant Secretary, Ageing and Aged Care Division, Department of Health and Ageing)
  5. Decision/Notification
    • The Approver makes a decision on the application and the successful applicant is advised of the decision. Unsuccessful applicants are notified after the execution of Standard Funding Agreements with successful applicants.
  6. Contract/Funding
    • A Standard Funding Agreement is negotiated and signed by the applicant and the Department.
  7. Do/Complete/Acquit
    • Applicant undertakes funding activity, completes milestones, provides reports and acquits funds against expenditure.
    • Department makes payments and monitors progress
  8. Evaluation
    • Department evaluates the outcomes of the program.
    • Applicant provides information to assist this evaluation.


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