Aged And Community Care Victoria Annual State Congress Melbourne Park Function Centre 20 June 2008
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Good morning ladies and gentlemen.
Firstly, I’d like to thank Aged and Community Care Victoria for the invitation to be here today to speak about the Government’s plans for the future of aged care in Australia.
Events such as this not only draw the aged care sector together, but the input and feedback you provide is essential to helping the Government plan for future of aged care in this country.
Could I just start by going over a few figures and facts by way of background – some of which I’m sure people here today are familiar with.
By 2051, people aged 65 years will represent more than a quarter of our population.
That is a major change, as today they make up around 13 per cent of the population.
In terms of sheer numbers, there are now more than 2 million Australians over 70 and this will double to 4 million in the next 20 years.
In Australia and other more developed nations, the number of elderly people has already overtaken the number of younger people aged 14 or less.
A phenomenon I find particularly interesting is that the Australian Bureau of Statistics has predicted the number of people over 100 years of age will increase from 2,860 people today to 78,000 people by 2055.
These few background points are indicative of the demographic challenge before us all. But I believe it’s one that we should welcome as an opportunity.
Here in Victoria, there are three quarters of a million people aged 65 years and over, which has risen by almost 90,000 in the past five years. The median age of Victorians is now 37 years of age, and will continue to rise in the coming decades.
While the population is ageing, we can expect that the quality of life for older Australians will continue to improve thanks to advances in medicine and improvements in health and aged care.
Because our elderly population is an opportunity to draw on the wisdom, knowledge and experience of older Australians.
But we must also adopt policies that reflect the needs and desires of this ageing population.
Meeting these challenges and opportunities is something that we have to do together and at all levels of government.
On that point – it’s interesting to note that the State of Victoria has a higher proportion of residential services under State Government control than any other jurisdiction.
In this state 25 per cent of aged care homes are run by the State Government – more than twice the proportion of any other jurisdiction.
Cooperative relationships between the different levels of government are vital. To that end I will be joining my Victorian counterpart Lisa Neville later today to make an announcement regarding improved services in community care.
More funding to aged and community care
Over the next four years, funding for aged and community care will reach record levels of more than $40 billion – with $28.6 billion of that on residential aged care alone.
Over the next five years total subsidy payments to Victoria will be about $8.8 billion.
In the 2008-09 year, Victorian aged care providers will receive about $1.7 billion – which represents an increase of more than 8 per cent in the subsidy per resident at the same level of frailty compared to 2007-08.
In response to the concerns expressed by the sector, we have increased the level of the Conditional Adjustment Payment (CAP) by 1.75 per cent from 7.0 per cent to 8.75 per cent of the basic aged care subsidy.
This will give an additional $407.6 million over four years for investment in the aged care sector, and brings total CAP payments over the next four years to $2 billion.
The Government will review the CAP by the end of October this year and of course we will be working closely with the industry during the review.
Aged care providers and their representatives will be invited to make written submissions in July 2008.
Aged Care Funding Instrument
The new Aged Care Funding Instrument, which was introduced in March 2008, determines the level of care payments for residents in aged care homes,
It is simpler, with fewer basic funding categories, and two new supplements will ensure funding is better matched to people with dementia and complex health care needs.
It also aimed at reducing the time spent by aged care homes in assessing residents for the purposes of funding.
No existing resident will receive less funding due to the introduction of the Aged Care Funding Instrument.
It is estimated that government expenditure on care payments will increase by more than $380 million over four years with the introduction of the Aged Care Funding Instrument.
The Department of Health and Ageing is working with several large organisations that have undertaken their own trial Aged Care Funding Instrument assessments to ensure that there are no unanticipated effects.
And the department has been working with approved providers in many states to assess samples of existing residents. This has been done with the assistance of peak state aged care associations, including Aged and Community Care in Victoria.
Because the changes will be progressively phased in, it will take more than a year before even half of all residents are funded according to the Aged Care Funding Instrument.
Let me assure you, the department is monitoring the Aged Care Funding Instrument closely and is continuing to work with the Aged Care Funding Instrument Reference Group on its progress.
The Government has committed to reviewing the impact of the Aged Care Funding Instrument after 18 months.
Overall the increase in accommodation payments and care payments will deliver estimated additional revenue of $1.13 billion to residential aged care providers over four years, rising to more than $350 million per year after that, from both government and resident payments.
To ensure aged care providers are being correctly funded to meet the needs of their residents, the Government will temporarily increase the number of reviews of funding claims made by aged care providers, achieving expected net savings of $18.1 million over two years.
Better planning and coordination
The future of aged care planning and coordination will benefit from better data collection which will focus on tracking population shifts and changing patterns of use for aged care services.
We will do this in a number of ways:
- by regularly reviewing aged care planning ratios to determine the number of aged care places available for older Australians;
- by consulting with the industry on methods to improve the allocation of places through the Aged Care Approvals Rounds and reduce the time it takes between the allocation of new aged care places being allocated and for them to become operational;
- by working with the states and territories to initiate, develop and monitor policy reform. This includes the recently established Ministerial Conference on Ageing which has been developed through the Council of Australian Governments. The conference will help to improve the efficiency and sustainability of the aged care sector; and
- by better using all the data available to us, such as the second National Aged Care Census and Survey. Conducted this year, the survey will give a comprehensive profile of our aged care workforce, their skills, training gaps, types of employment, career paths and levels of job satisfaction. With this information we can address the future needs of the aged care workforce.
In its 2020 Summit submission, Aged and Community Care Victoria raised the issue of the ability of the aged care sector to continue to attract and retain a skilled workforce.
It’s a concern that this Government shares.
We are committed to ensuring the aged care sector is properly staffed, and that the aged care workforce has better access to training. This will ensure staff have a clear career path and encourage them to stay in the sector long-term.
There is a general shortage of qualified nurses across Australia, and internationally, but unlike our predecessors, the Rudd Government has committed to solving the problem.
The Bringing Nurses Back into the Workforce Program is a $39.4 million measure to bring 8,750 extra nurses into the Australian health workforce within five years. This plan includes $6.9 million to bring one thousand nurses into residential aged care.
There are approximately 30,000 qualified nurses in Australia who are currently outside the nursing workforce, including thousands of aged care nurses.
The program will provide a cash bonus to nurses who are returning to the profession after an absence of more than 12 months. The cash bonus of $6,000 will be paid in two instalments of $3,000. The first payment will be made after six months of employment and the second after 18 months.
Aged care homes employing these nurses will be paid $1,000 per nurse to assist with retraining costs.
Training is a key factor to attracting and retaining staff and giving them options to develop a career path in the industry. To this end, the Rudd Government will invest in up to 50,000 additional health vocational training places.
We will also be creating 90 new Commonwealth-supported places in nursing in the second semester of 2008, with a further 1,170 places in 2009.
More aged care places in areas of need – zero interest loans
We also recognise – and are currently addressing – the need for aged care beds in areas of high demand.
To this end, the Australian Government recently called for applications and released the timetable for Stage One of its election commitment to provide $300 million zero in real interest loans to build or expand aged care homes in areas that need them the most.
The plan is expected to create 2,500 permanent residential aged care places in regional and undersupplied areas.
Applications closed on June 6 – and I’m pleased to announce that 115 applications were submitted.
The announcement of loans and places will take place in early August.
After this round we will review the first stage to see what improvements can be made to the next round.
Further expansion of community care
We all aspire to remain as independent as possible as we grow older, and we want to stay connected to our families and our community.
This is when community care becomes so important.
Currently, around 600,000 older Australians and their carers receive community aged care services through a mix of programs funded by Commonwealth and state and territory governments.
Announced in the Budget, Australian Government funding for community care services will total $2.2 billion in 2008-09, an increase of $260 million compared to 2007-08.
HACC will receive over $1.7 billion in funding from the Commonwealth, state and territory governments for 2008-09, with the Australian Government providing 60 per cent – or just over $1 billion – in total program funding.
This is an increase of over 7 per cent from the previous year.
While the growth of the community care sector means that it is able to meet the needs of more people, it has also resulted in a system that is unnecessarily complex and somewhat fragmented.
Our goal is for a simpler and fairer community care system that is even better able to meet the needs of frail older Australians.
As you know, the Commonwealth, state and territory governments have been working to improve cross-program administrative arrangements.
We have seen the establishment of Access Point demonstration sites across Australia, designed to streamline entry into the system for clients and their carers, and ensure a consistent approach to assessment.
And we are working in partnership with the states and territories through the Council of Australian Governments.
The work plan for the Council of Australian Government’s Health and Ageing Working Group includes a focus on increasing and reforming community-based care, focusing on opportunities for more seamless delivery, and the intersection between aged care funding, HACC and disability funding.
Continued improvements to protections for older/frail Australians
The standards of care for older Australians in aged care homes will continue to be improved in consultation with the industry.
While the overwhelming majority of aged care providers are giving top quality care to older Australians, there are some areas where improvements can be made.
One way of doing this is by encouraging providers to adopt evidence-based best practice.
Residential aged care facilities across Australia will benefit from a new funding round worth more than $8.7 million to encourage homes to use improved best practice clinical care.
This round is part of the Australian Government’s $21.6 million-over-four-years Encouraging Best Practice in Residential Aged Care (EBPRAC) program.
New developments in treatment, care and research are happening all the time and it’s important aged care providers are across these so they can provide the best possible practice of care.
I commend the program to you all.
During the next financial year, the Aged Care Standards and Accreditation Agency will be making 7,000 announced and unannounced visits to aged care homes across the nation.
Other measures we have introduced include:
- expanding the requirement for staff to undergo police checks;
- strengthening the powers of the Aged Care Standards and Accreditation Agency; and
- requiring departmental clinical staff to check on residents as part of their investigations.
More flexibility in care - Transition Care Program
The future of aged care will require a more flexible approach to the needs of individuals.
Let’s consider the Transition Care Program, which assists older people leaving hospital for home rather than prematurely entering permanent residential care.
The Transition Care Program is a unique blend of traditional care, physical therapy and community care that individualises the support patients receive, and provides a direct transition between the hospital and aged care sectors.
As part of this program, older people leaving hospital can transfer to transitional care which is provided in their homes or in a ‘live-in’ setting. It has assisted older people develop their own personal goals that help them to improve their mobility, strength and independence. In other words, it works with the patient on their needs, and doesn’t just provide a single static service.
We have received some wonderful anecdotes from this program. Let me share a couple with you.
After suffering a stroke, a lady went into transition care to improve her physical functioning through the therapy and support services provided by the program. When she filled in the feedback form at the end of the transition care period, she proudly reported that she could do her own laundry again and clean the house.
In another case, a 90-year old lady in a NSW transition care service made it her personal goal to visit her relatives in America. With the help of the program, she achieved the goal and sent a postcard to staff at the transition care service to prove it.
The Government will provide $293.2 million over four years to double the size of the Transition Care Program from 2,000 to 4,000 places nationally. This will help up to 30,000 older Australians leaving hospital each year.
The Transition Care Program demonstrates where aged care is heading – a system that is flexible to the needs of patients that works with them, and that can actually help them to recover some of their lost abilities so they can continue to lead meaningful lives.
Status shift – Ambassador for Ageing
Lastly, I’d like to say that the status of older Australians is undergoing a meaningful transformation, and the Government recognises that older Australians need better representation.
That’s why we have appointed the esteemed Noeline Brown as Australia’s first Ambassador for Ageing.
Noeline will be involved in a range of activities and events that promote positive and active ageing within the community, and will be a spokesperson on respecting and recognising the continuing contribution made to the Australian community by older people.
In conclusion, the future is bright for aged care in Australia.
The sector will be better staffed, regulated, more flexible, staff will have better access to training and clearer career paths, and there will be more aged care places where they are needed the most.
But none of this will be possible without the continued help and support of the wonderful aged care providers and staff, like the people who are here today.
I would particularly like to take this opportunity to commend the dedication and commitment of the staff in nursing homes, who I meet around Australia. I have seen first hand the great work that they do, many working in the industry for 10, 15, 20 years.
Once again, I thank you for the invitation to join you today and I look forward to working with you to make the future aged care even more productive and fulfilling.
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