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Aged Care Complaints

Protocol between the Aged Care Commissioner and the Department of Health and Ageing, in relation to the operation of the Aged Care Complaints Scheme

Purpose - This protocol outlines how the Aged Care Commissioner and the Department of Health and Ageing (the Department) will work with each other in relation to the operation of the Aged Care Complaints Scheme. Specifically, the protocol guides the processes and interactions between staff within the Office of the Aged Care Commissioner and the Department.

PDF printable version of the Protocol between the Aged Care Commissioner and the Department of Health and Ageing (PDF 274 KB)

Description of the offices

The Aged Care Commissioner (the Commissioner) is a statutory appointment under s 95A-1 of the Aged Care Act 1997 (the Act).

The Complaints Principles 2011 (the Complaints Principles) set out functions for the Commissioner and the Secretary of the Department of Health and Ageing (the Secretary) in relation to a person raising an issue or issues about an approved provider’s responsibilities under the Act or Principles made under s96-1 of the Act.

Both the Commissioner and the Secretary may formally delegate responsibilities under the Complaints Principles to nominated officers.

The Secretary has delegated her responsibilities under the Complaints Principles to the nominated officers within the Department’s Office of Aged Care Quality and Compliance (OACQC). OACQC manages the Aged Care Complaints Scheme (the Scheme), which carries out the Secretary's responsibilities under Parts 2 through 6 and s13A.22 of the Complaints Principles.

The use of ‘the Scheme’ in this document should be read as reflecting the Secretary’s delegation of her responsibilities to OACQC and has the same meaning as the Secretary or the Department, unless otherwise stated.

Communication

Nominated officers

The protocol is supported by regular communication between nominated officers, who each have primary responsibility for initial liaison under these protocols. These officers are:
Office of the Aged Care Commissioner:

• Director
• Investigations Manager

Department (case-related matters):

• Director, Complaints Assistance and Review, Aged Care Complaints Branch
• Assistant Director, Complaints Assistance and Review, Aged Care Complaints Branch
• Assistant Secretary, Aged Care Complaints Branch
• First Assistant Secretary, OACQC

Department (other matters related to the operation of the Scheme):

• Assistant Secretary, Aged Care Complaints Branch
• Director, Stakeholder Relations, Aged Care Complaints Branch
• Other areas of the Department as necessary.

Referring information

If either the Commissioner or the Department receives letters, documents and other exchanges of communication outside its jurisdiction but within the jurisdiction of the other, the information will be exchanged by each office by close of business that day by email or fax. The correspondent will be advised the matter has been referred to the relevant office.

Communicating with the public

Members of the public seeking to communicate with either the Commissioner or the Department will be provided with the following contact information:
Office of the Aged Care Commissioner
Phone: 1800 500 294
Fax: (03) 9663 7369
Website: http://www.agedcarecommissioner.net.au (includes an online complaint form)

Aged Care Complaints Scheme
Phone: 1800 550 552
Fax: As advised per jurisdiction
Website: http://agedcarecomplaints.govspace.gov.au (includes a link to an online complaint form)

Private numbers and email addresses will not be disclosed. Top of page

Examinable decisions

After receiving an application to examine a decision under the Complaints Principles, the Commissioner’s Office (OACC) will email the Department to request:

• information regarding the specific matter held on the IMS
• a printed copy of the file and
• a copy of Australia Post receipt(s) for the mailing of the Scheme’s decision to the complainant.

The OACC email will identify:

• that an application to examine an examinable decision has been lodged
• whether the application has been lodged by an approved provider or complainant and
• case ID (if known).

The Department will:

• provide IMS case information and printed copies of the file and relevant Australia Post receipt(s) within three working days
• advise if there has been an application for reconsideration of the relevant decision by the Department. If a valid reconsideration application is lodged after the Department has provided documents to the OACC, the Department will immediately notify the OACC of the application.

Once the Commissioner decides whether or not to accept an application, or decides to take no further action, the Director or Investigations Manager of the OACC will email the Director or Assistant Director of the Complaints Assistance and Review Section advising of this decision.

If the Commissioner decides to examine a decision, the OACC will provide a copy of the Commissioner's final report and recommendations to the relevant State or Territory Manager and a copy to the First Assistant Secretary (FAS) of OACQC.

If the Commissioner recommends the Scheme undertake a new resolution process, the Department will write to the Commissioner to advise the Scheme’s decision on the reconsidered matter.

The Commissioner may choose to write to the FAS of OACQC about general issues identified as part of the examination of one or more decisions.

Request for documents

Following its review of the Commissioner's statement of reasons and before coming to a decision, the Scheme may request particular documents on a case-by-case basis. The Director or Assistant Director of the Complaints Assistance and Review Section will email requests to the Director or Investigations Manager in the OACC.

The Commissioner will consider any reasonable request for copies of particular documents obtained during the course of examining an appeal, which existed at the time of reviewing an examinable decision and are material to the decision. Top of page

Complaints about process

Understanding

Straightforward complaints about process, particularly where the Department is continuing to deal with a complaint, may be dealt with by conciliation. Following resolution, the Commissioner will write to the relevant State or Territory Manager and the complainant outlining the actions taken and agreements reached.

Initial contact

After receiving a written complaint about the Scheme’s process for handling a matter under the Complaints Principles, the OACC will email the Complaints Assistance and Review Section to request information held on the IMS and a printed copy of the file.

The OACC email will identify:

• that the complaint relates to a complaint about the Scheme’s processes
• the nature and substance of the complaint
• case ID (if known).

The Scheme will provide IMS case information and hard copies within three working days.

Secondary contact

If the complaint is accepted, the Commissioner will advise the FAS of OACQC and the relevant State or Territory Manager in writing.

After establishing an investigation process, the OACC will email the relevant State or Territory Manager to advise:

• the nature and substance of the complaint received
• the names of Departmental officers the OACC wishes to interview
• a request to identify any other Departmental officer/s involved in the management of the complaint
• a request to nominate a suitable date and time for the interviews
• a fact sheet about the interview process to be provided to relevant Departmental officers.

Interviews

If an interview may give rise to any comment likely to adversely affect the reputation of a Departmental officer being interviewed or another individual, the OACC will provide a record of the interview to the Departmental officer (or in the case of another individual, a copy of that part of the record of interview that relates to them) before it is distributed to another party.

In accordance with the principles of natural justice, the Departmental officer or other individual concerned will be given an opportunity to respond to this record before it is included in a preliminary draft.

The Secretary and the Commissioner acknowledge the rights of any person being interviewed to be accompanied by a support person and agree this person is not a participant in the interview. The support person may, however, seek to arrange a separate interview if they have further advice that will assist the investigation process.

Report

The Commissioner will provide a draft of the preliminary findings and recommendations, inviting comment within a specified timeframe of no less than 14 days, to the FAS of OACQC, relevant State or Territory Manager and Director of the Complaints Assistance and Review Section.

If more time is needed for the response, the Director or Assistant Director of the Complaints Assistance and Review Section will contact the Director or Investigations Manager of the OACC and request an extension of time.

The Commissioner will consider any comments provided by the Department before the final report and recommendations are prepared and distributed.

The final report will not identify any Departmental officer by name or in such a way that their identity is apparent or can reasonably be ascertained by a person who is not already aware of the Departmental officer’s identity.

The final report will be provided to the FAS of OACQC, the relevant State or Territory Manager and the Director of the Complaints Assistance and Review Section.

The Department will respond to the Commissioner’s recommendations and advise any actions taken in response to the recommendations.Top of page

Own motion investigations

The Commissioner will advise the FAS of OACQC and the Assistant Secretary, Aged Care Complaints Branch and the Director of the Complaints Assistance and Review Section of the planned examination, including:

• the issue/s to be investigated
• estimated timeframes
• if any additional documents are required and the nature of those documents
• whether it will be necessary to interview Departmental officers.

After the Commissioner completes the formal examination, the Commissioner will provide a draft of the preliminary findings, inviting comment within a specified timeframe of no less than 14 days, to the FAS of OACQC, relevant State or Territory Manager and Director of the Complaints Assistance and Review Section.

If more time is needed for the response, the Director or Assistant Director of the Complaints Assistance and Review Section will contact the Director or Investigations Manager of the OACC and request an extension of time.

The Commissioner will consider any comments provided by the Department before the final report and recommendations are prepared and distributed.

The final report will be provided to the FAS of OACQC, the relevant State or Territory Manager and the Director of the Complaints Assistance and Review Section.

The Department will respond to the Commissioner’s recommendations and advise any actions taken in response to the recommendations.

Sharing data and information

The Department and the OACC will exchange a range of data and information on a quarterly basis.

The Commissioner will provide the following information to the Department:

• number of applications to examine a decision of the Scheme:
  • on hand at the start of the quarter
  • received
  • accepted
  • withdrawn prior to a final recommendation
  • finalised after investigation
  • finalised where a No Further Action decision has been made
  • still under consideration
• complaints about the Scheme’s complaint handling processes:
  • on hand at the start of the quarter
  • received
  • accepted
  • withdrawn prior to a final recommendation
  • finalised after investigation
  • still under consideration
• number of appeals that recommend to the Secretary to undertake a new resolution process
• number of own motion cases:
  • commenced
  • ongoing
  • finalised.
  The Department will provide the Commissioner with the following information held in relation to the Complaints Principles:
• Number of complaints received under s13.A5
• Number of complaints finalised including a breakdown of intake, assessment, and resolution
• Number of resolution processes commenced under s13A.6(c)
• Number of resolution processes finalised under s13A.13 excluding internal reconsiderations and ACC reconsiderations
• Total number of internal reconsideration applications received (including a breakdown of valid/invalid/withdrawn figures)
• Number of decisions made under s13.A.22
  • s13.A.22(1)(a) – to confirm the decision to take no further action or to end resolution
  • s13.A.22(1)(b) - decide to undertake a new resolution process
• Number of complaints for which a new resolution process was finalised under s13.A.22(1)(b)
• Number of complaints following a recommendation under s13.A26 to undertake a new resolution process (including a breakdown of new process commenced, new process finalised)
• The five most commonly reported issues Top of page

End of year reporting

To be well-prepared for end of year reporting, the OACC and the Department will informally exchange additional data quarterly, as follows:

• Two weeks following the end of each quarter, the Director from the OACC will email a spreadsheet containing year-to-date 'Appeals Finalised' and 'Complaints Scheme Complaints Finalised' for the previous quarter to the Complaints Assistance and Review Section
• The Complaints Assistance and Review Section will check the information against the Department’s records and note any differences
• A teleconference will be arranged to discuss any differences, and agreement sought on points of difference.

Input

The OACC will provide the Department, in accordance with Departmental deadlines, input for:

• Briefing notes
• Question Time briefs
• Ministerial correspondence
• Ministerial briefings
• Freedom of Information requests
• Any other requests received that require input (e.g. Annual Reports).

Consultation on reports and publications

The OACC and the Department will consult each other regarding input for the Department’s Annual Report, the Commissioner's Annual Report, the Report on the Operation of the Aged Care Act 1997 and other publications. This will be done during the drafting process to ensure data and information is accurate and consistent.

Conduct of Departmental officers

If the Commissioner, while conducting an investigation, believes the conduct of a Departmental officer involved in the Scheme’s handling of the complaint may be contrary to Australian law and/or the Australian Public Service Code of Conduct, the Commissioner will, as part of the investigation, notify in writing the:

• Assistant Secretary, Aged Care Complaints Branch (in relation to central office officers) or
• Relevant State or Territory Manager (in relation to state and territory officers).

Freedom of Information Requests

If the OACC or Department receive a request for information under the Freedom of Information Act 1982 which may relate to information held by the other office all communication between offices should be instigated through the Freedom of Information Co-ordinator in the Legal Services Branch of OACQC in the first instance. If deemed appropriate by the Freedom of Information Co-ordinator, the freedom of information request may be partially or wholly reallocated to the relevant office and a new action officer and decision-maker assigned accordingly.

Other issues

Related issues

From time to time, the Commissioner may choose to write to the FAS of OACQC regarding general issues identified as part of the examination of one or more decisions.

About the protocol

The Commissioner and the Department have reached the understandings set out in this protocol and have endorsed them.

The protocol recognises the independence of the Commissioner.

Nothing in the protocol should be read or taken to suggest or permit either the Commissioner or the Secretary to do other than discharge their statutory functions in a lawful, independent and impartial way.

The Department and the Commissioner agree:

• that any issues arising out of this protocol or their dealings with each other be resolved by negotiation in good faith, where possible
• that they and their officers will cooperate to ensure matters are dealt with in the most efficient and effective way, in accordance with the protocol and to the extent lawfully possible and appropriate
• to keep each other informed on anticipated or known media interest in cases or processes, particularly in relation to major and unforseen events
• to inform each other of any significant change in law, policy or administrative practice that may affect their roles and interactions. Where possible, they will consult each other in advance of any such change
• to make available to the other information about their processes and policies that may affect their roles and interactions
• to treat all information in accordance with relevant legislation pertaining to privacy, confidentiality, protected information and data storage.

                          
Rae Lamb                                          Rosemary Huxtable
Aged Care Commissioner                     Deputy Secretary
                                                        Department of Health and Ageing
12 June 2012                                     14 May 2012

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