1996-1997
5.1: Policy and Planning
The 1996-97 Portfolio Budget Statements, informs Senators and Members of Parliament of the proposed allocation of resources to portfolios outcomes and their objectives and targets including the agencies within the Health and Family Services portfolio.
Objective
- To plan equitable distribution of accessible and cost-effective forms of care and support for older people appropriate to their needs, and to research and develop policy options for the Programme that are appropriate to the long-term future of aged care.
Goals
- Distribution of and access to aged care services in line with identified needs in the community.
- Framework for the implementation of the 'Structural Reform of Residential Aged Care' measure in place.
- National Aged Care Strategy agreed as basis for exploring bilateral agreements on the transfer of Aged Care to the States and Territories.
- A National health promotion approach to maintain and improve the health and well-being of older Australians, developed in conjunction with State and Territory governments, older people, other programmes and sectors.
Strategies
- Develop a Structural Reform Package for Residential Aged Care that includes:
- an accreditation based system of quality assurance;
- capital investment in improved building quality;
- a single resident classification system for residential care;
- dementia funding;
- aligned funding and charging system for nursing homes and hostels;
- expanded Exempt Scheme encompassing nursing homes and hostels; and
- reduced regulatory requirement on industry.
- Approve new services within government target ratios of 40 nursing home, 50 hostel and 10 care package places per 1000 people aged 70 and over according to projections.
- Examine the scope for increasing flexibility for planning ratios across regions between residential, and community care, to better reflect the regional variations in population profiles, the overall need and demand for services and the need for dementia-specific services.
- Help providers to deliver services appropriate to the needs of rural and remote communities, Aboriginal and Torres Strait Islanders, ethnic aged people and veterans.
- Help providers to develop innovative care models that encourage linkages between accommodation and care options to meet the aged care needs of clients whose need for secure accommodation is as great as their need for care.
- Improve the capacity of aged care and other services to care for people with dementia through training; demonstration of best practice; and improving partnerships and linkages between the general and mental health systems and aged care.
- Develop a National Aged Care Strategy as a basis for bilateral agreements in line with the work plans and consultation strategy agreed by Commonwealth and State Health and Community Services Ministers.
- Develop and implement a national approach for maintaining and improving the health of older Australians, in conjunction with State and Territory governments, and in consultation with current and prospective users of aged care services.
Performance Indicators and Targets
Top of pageEffectiveness
- Common classification and funding scale for nursing homes and hostels in place by July 1997, reflecting the range of resident care needs.
Target: New scale provides continuum of funding across nursing homes and hostels and allows increased funding to be directed to clients with dementia. - Specific reductions in existing regulatory requirements in nursing homes and hostels.
Target: Elimination of unnecessary layers of accountability. - National Aged Care Strategy developed.
Target: Multi-lateral Agreement and number of Bilateral Agreements signed before the end of 1996-97. - Waiting period for clients entering residential care.
Target: Reduction on previous year.
Efficiency
- Average cost to Commonwealth per place by State and service type.
Quality
- Number of managers and staff of aged care services trained in dementia care.
Target: 50 per cent trained by end of 1996-97. - Client satisfaction with consultation as measured by ad hoc evaluation studies.
Equity
- Level of service use by, and level of specifically targeted service provision for, older people with dementia, older ethnic people, older indigenous people and older people in rural and remote areas as compared with levels in the whole aged population.
Target: Provision appropriate to proportion in population. - Nursing home, hostel and care packages places and units of residential respite care service provision per 1,000 persons aged 70 and over, by planning region.
Target: Equitable distribution in line with national benchmark of 40 nursing home places, 50 hostel places and 10 care packages (including two respite places) per 1,000 persons aged 70 and over by 2011.
Budget Measures
Election Commitments
Pilot Projects to Implement the Healthy Seniors Initiative
Top of pageFinancial Implications
1996-97 $m | 1997-98 $m | 1998-99 $m | 1999-00 $m |
0.5 | 0.5 | 0.5 | - |
Purpose of Measure
To promote good health for senior Australians, enabling people to remain in their own homes for as long as possible, maintaining health and reducing social isolation and recognising the special circumstances of carers and older women.Expected Implementation Strategies for Measure
The measure will fund projects which facilitate good practice and a sustainable infrastructure for achieving good health and well-being for older people. This will include:- community based leisure and participation programmes;
- tailored exercise regimes suitable for frailer people;
- assistance to older people to cope with grief and loss; and
- enhancement of the quality of life and social networks for older women.
Intended Impacts of Measure
Some of the benefits planned for this programme include: removing the barriers that stop some older people from participating in physical, recreational and community activity; decreasing social isolation and improving the health outcomes and well-being of older people. Other benefits include: strengthening inter-generational linkages, disseminating good practice models, improving health and well-being data for planning and evaluation; and developing a strategic research framework.Savings
Structural Reform of Residential Aged Care
Financial Implications
1996-97 $m | 1997-98 $m | 1998-99 $m | 1999-00 $m |
-13.8 | -52.8 | -79.4 | -98.7 |
The savings from this measure increase over four years as current capital commitments are paid out and the number of exempt nursing homes and hostels grows.
Purpose of Measure
To address major structural problems with the existing residential aged care system in order to make it more sustainable and to make the system more responsive to the needs of frail older people.Top of page
Expected Implementation Strategies for Measure
The changes will take effect on 1 July 1997 and include:- unifying the nursing home and hostel systems as a single residential aged care system;
- implementing a single resident classification mechanism to assess dependency and allocate funding across the system;
- in doing so, developing a completely new mechanism to ensure that residents at all levels of dependency are appropriately funded, paying particular attention to the needs of residents with severe dementia;
- reducing red tape and paperwork by providing simple, non-acquitted recurrent subsidies across the board and eliminating the need for nursing homes to justify their expenditure and be audited;
- income testing recurrent subsidies (at 25% in the dollar above the pension income test "free area");
- providing incentive and access to financing for all providers to invest in building quality by allowing them to charge resident entry contributions as already occurs with aged care hostels, market driven but subject to meeting minimum building and other standards and with appropriate protections. A targeted capital programme will be retained to meet the needs of rural, remote and other identified communities;
- providing a higher rate of recurrent funding for low income earners to protect their access to care and compensate for their inability to pay entry contributions;
- establishing (from 1 January 1998) a new quality assurance system in partnership with the industry and consumers to ensure excellence and high quality resident care through accreditation and standards review under the supervision of a National Aged Care Standards Agency; and
- expanding the Exempt Nursing Home scheme to encompass (ex-) hostels, improving choice for consumers who want, and can afford, higher quality accommodation and services.
Intended Impacts of Measure
Aligning nursing homes and hostels, which have historically been funded and regulated quite differently, will help them to better meet the changing needs of their residents. Reform of the funding and classification systems will better match funding to care needs at all levels and, in particular, bring significant improvement to funding for dementia care. It will also allow providers more flexibility in meeting local needs. Consumers will have a wider range of choice with the expansion of exempt facilities.Income testing recurrent subsidies will ensure that wealthier residents make a fair and reasonable contribution to the cost of their care. Giving nursing homes the same capacity to raise entry contributions as hostels, subject to building quality accreditation, will lead to much needed improvements in the nursing home building stock. Access for those unable to pay entry contributions will be protected through a higher rate of recurrent funding.
An accreditation based quality assurance system will allow the Government to work in partnership with industry and consumers in regulating standards. It will give the industry more of a stake in the provision of high quality care and enhance incentives for quality, innovation and excellence.
Deregulating financial accountability will facilitate enterprise bargaining and workforce adjustment, and will substantially reduce the regulatory burden on nursing home small businesses.
The reform package will improve the overall sustainability of the system in the long term. Broadbanding nursing homes and hostel funding will lay the groundwork for transferring administrative responsibility for such a sustainable system to the States.
Top of page
Application of Efficiency Dividend to Commonwealth Own Purpose Outlays and Specific Purpose Payments of a Running Costs Nature
1996-97 $m | 1997-98 $m | 1998-99 $m | 1999-00 $m |
-1.1 | -1.2 | -1.7 | -2.1 |
Across-the-Board Reduction of 2% in Running Costs
1996-97 $m | 1997-98 $m | 1998-99 $m | 1999-00 $m |
-0.3 | -0.3 | -0.3 | -0.3 |
