1996-1997
5.4: Quality Assurance and Accountability
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 optimise the quality of care, quality of life and respect for the dignity of consumers of aged care services, and to ensure funding is spent on its designated purposes.
Goals
- Quality assurance of care standards and financial accountability achieved in a cost-effective manner.
- Adequate and useful information and procedures available to clients to help them exercise their rights as users of services.
- Payments of benefits and subsidies are accurate and on time and are properly accounted for.
Strategies
- Review outcome standards as part of the move to accreditation based quality assurance system developed in partnership with the residential care industry, including consumers.
- Develop a single classification instrument in partnership with the residential care industry, including consumers.
- Encourage and monitor nursing homes, hostels and providers of community aged care packages to provide a quality of life and quality of care that reflects the needs and wishes of residents.
- Target quality assurance and classification monitoring resources through a risk management approach to outcome standards and financial auditing that ensures timely and decisive response to cases of poor performance.
- Continue to educate residential services in the use of appropriate documentation for care planning and accountability.
- Finalise all validations of nursing home expenditure to end of financial year 1993-94.
- Ensure an effective complaints and advocacy service operates in each State and Territory to give a range of assistance to older people to promote their quality of life and care outcomes.
- Ensure that useful information about the types and quality of care available in nursing homes, hostels and through community care packages is readily available to the public including users and potential users of the services.
- Enhance and maintain computer payments systems in accordance with relevant policy and legislation.
Performance Indicators and Targets
Effectiveness
- Dependency levels of residents in nursing homes and hostels as measured by RCI and PCAI classifications approximating estimates.
Target: Distribution continues trends established in previous years. - Length of time taken to meet outcome standards once non-compliance is identified.
Target: A reduction on previous years.
Efficiency
- Progress in meeting activity targets by State for RCI and PCAI reviews and for Validations and Outcome Standards Visits.
Target: In line with established targets. - Proportion of late or inaccurate payments.
Target: A reduction on previous years.
Quality
- Average compliance with outcome standards and in nursing homes and hostels, and compliance with financial accountability requirements in nursing homes.
Target: Increase on previous years. - The number of proven complaints by residents of nursing homes and hostels.
- Development of new Accreditation Scheme.
Target: On schedule for December 1997.
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.
Budget Measures
Spending
Replace Rent Assistance with Higher Residential Aged Care Subsidies
Financial Implications
1996-97 $m | 1997-98 $m | 1998-99 $m | 1999-00 $m |
- | 224.4 | 227.5 | 230.8 |
Purpose of Measure
To improve the transparency and accountability of residential aged care funding.Expected Implementation Strategies for Measure
Currently the resident contribution in an aged care facility is set as a % of the pension plus rent assistance (87.5% in a nursing home and 85% in a hostel). From 1 July 1997 payment of rent assistance for DSS and DVA pensioners in nursing homes and hostels will be rationalised so that:- the subsidy to the service provider will be increased by an equivalent amount for these pensioner residents; and
- the minimum resident contribution will be standardised in both nursing homes and hostels at 85% of the single pension. This will ensure that no pensioners are worse off as a result of the change.
Intended Impacts of Measure
This measure will improve the transparency and accountability of residential aged care funding by consolidating all funding for residential aged care accommodation in the one appropriation. It will also better mesh with the reforms of health and community services in the medium term.Setting the standard resident contribution for pensioner residents at 85% of the single rate of pension will ensure that no pensioner suffers a reduction in disposable income as a result of the change. Non-pensioner residents will not be affected.
Savings
Structural Reform of Residential Aged Care
Financial Implications
1996-97 $m | 1997-98 $m | 1998-99 $m | 1999-00 $m |
9.7 | -72.2 | -85.1 | -95.8 |
The savings in this sub-programme reflect a progressive reduction in nursing home benefit and hostel subsidies consequent on the introduction of income testing. The expenditure in the first year is the cost of aligning the nursing home and hostel payment cycles which is a necessary precursor to aligning the funding and classification systems.
Additional Funding for State Government Nursing Homes in NSW and Queensland
Financial Implications
1996-97 $m | 1997-98 $m | 1998-99 $m | 1999-00 $m |
3.5 | -0.4 | -1.1 | - |
Reversal of Additional Funding for State Government Nursing Homes in NSW and Queensland
Financial Implications
1996-97 $m | 1997-98 $m | 1998-99 $m | 1999-00 $m |
-1.3 | 0.2 | 0.6 | - |
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Purpose of the measure
The original decision would have bought forward the conversion of State Government Nursing Homes in New South Wales and Queensland to standard Commonwealth nursing home funding. Offsetting savings were provided from elsewhere in the programme and portfolio. However, only the conversion of State Government Nursing Homes in New South Wales was implemented before the election.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 |
-0.2 | -0.3 | -0.4 | -0.5 |
Across-the-Board Reduction of 2% in Running Costs - Department
1996-97 $m | 1997-98 $m | 1998-99 $m | 1999-00 $m |
-0.6 | -0.6 | -0.6 | -0.7 |
