Australian Government response to Senate Standing Committee on Finance and Public Administration Report: Residential and Community Aged Care in Australia
Response to Recommendations 21 to 31
Recommendation 21
The committee recommends that the Department of Health and Ageing consider further initiatives to attract culturally-appropriate staff in consultation with involved stakeholders including Indigenous clients.Response
The Australian Government supports in principle Recommendation 21 of the Committee.
The Australian Government has introduced new aged care workforce programs and restructured existing programs to deliver more flexible training initiatives focussed on improving clinical care, assisting recruitment and retention and creating career paths. This includes investment in training from vocational places through to undergraduate and postgraduate nursing qualifications, support for clinical and graduate placements, and financial incentives to encourage aged care workers to undertake study and remain in the workforce. An unqualified personal care worker will be able to progress through the vocational education system onto undergraduate nursing studies and postgraduate study.
The recent reforms announced in the 2010-11 Budget will benefit all aged care workers. In rolling out these reforms, the Department of Health and Ageing will ensure that appropriate strategies are in place to effectively target and provide training support for Aboriginal and Torres Strait Islander aged care staff. Additional support for workers in financially less viable facilities in rural and remote services will continue and this includes travel, accommodation and some backfilling costs for staff attending training.
The Specialised Training Project currently provides funding for up to 2,000 training places over four years to
up-skill community aged care workers from a culturally and linguistically diverse (CALD) and an Aboriginal and Torres Strait Islander (ATSI) background to attain accredited community aged care related competencies and/or qualifications.
Since July 2007, four separate initiatives have been implemented to create over 700 permanent part-time positions for Aboriginal and Torres Strait Islander people in aged care services nationally. These initiatives stem from changes to Community Development Employment Projects (CDEP) processes.
To date, approximately 81 part-time positions in Home and Community Care (HACC) and Aboriginal Flexible services have been implemented nationally in urban and regional locations under Building an Indigenous Workforce in Community Care. A further 349 permanent part-time employment positions have been funded under the Northern Territory Emergency Response Welfare Reform Agenda. Of these, 304 are in the HACC program and 45 part-time positions in Aboriginal Flexible and residential aged care services. Under the Cape York Welfare Reform Trial, 12 part-time positions have been created in four communities in Cape York in the HACC program and in residential and aged care services.
In 2009, under the National Partnership for Indigenous Economic Particpation, approximately 260 part-time positions were funded in HACC, Flexible and residential aged care services from further changes to CDEP processes.
In 2010, the extension of the National Partnership for Indigenous Economic Partnership into the Torres Strait Islands will see up to 50 permanent part-time positions being funded for Torres Strait Islander workers in their own communities.
All of these initiatives include funding for training and other workforce supports aimed at improving retention rates of local Aboriginal and Torres Strait Islander workers in aged care services. This is currently being implemented in the Northern Territory and Cape York, and will roll out nationally in 2010.
In 2010, the Department is also implementing 80 business administration traineeships in remote regions for Aboriginal and Torres Strait Islander workers in aged care services under the Indigenous Remote Service Delivery initiative.
Recommendation 22
The committee recommends that the Australian Government implement the recommendation of the 2007 National Review of Aged Care Assessment Teams and review the legislative requirement for re-assessment of those residents:- moving from low to high care within an aged care complex where the low and high care facilities have separate provider numbers; and
- entering an aged care facility with a low care approval but who require high care.
The Australian Government supports Recommendation 22 in part, with further consideration occurring as part of the Review of the Aged Care Funding Instrument.
While an Aged Care Assessment Team approval is required to enable classification of a resident as high care when they first enter an aged care home, current arrangements do allow residents to move from low to high care as their needs change without reassessment by an Aged Care Assessment Team. This applies whether they are ‘ageing in place’ in the same complex or transferring to another facility.
Issues around the relationship between Aged Care Assessment Team assessments and the Aged Care Funding Instrument are being considered as part of the Review of the Aged Care Funding Instrument.
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Recommendation 23
In the light of disparities in information regarding the Aged Care Assessment Team (ACAT) assessments and re-assessments between the Department of Health and Ageing and involved providers, the committee recommends that the department launch an information campaign on recent reforms to the ACAT.Response
The Australian Government supports in principle Recommendation 23 of the Committee.
A communication strategy was developed and actioned to implement the legislation changes. The Department of Health and Ageing has produced the following materials:
- Guide to changes to the Regulatory Framework for Aged Care
- Fact sheet on the Legislative Changes relevant to the Aged Care Assessment Teams
- Guide for Aged Care Assessment Team reassessment requirements effective from 1 July 2009
- Frequently Asked Questions on the Aged Care Amendment (2008 Measures No. 2) Act 2008
- Advice sheet for Medicare Australia
- Guide for ACATs to answer consumer queries
- Advice sheet for Commonwealth Respite and Carelink Centres
The Department has also written to people who have been approved for high level residential care, residential respite care, EACH or EACH D packages on or after 1 July 2008 who have not yet entered care and whose approvals were not time limited so that they expired before 1 July 2009, to inform them that the approval will no longer automatically lapse after twelve months and that the person will continue to be eligible for these types of care.
Recommendation 24
The committee recommends that the Department of Health and Ageing review methods directed to affirming the ACAT as a single nationally consistent program which genuinely serves as a single entry point to aged care services. The review should entail dialogue with aged care clients and providers as well as liaison with state and territory health departments.Response
The Australian Government does not support Recommendation 24 of the Committee.
It is not appropriate that the ACAT be the single entry point to aged care services.
Through the National Health and Hospitals Network — Aged care — one stop shops measure in the 2010-11 Budget, the Australian Government will provide $36.8 million over four years (including $20.0 million in capital in 2010-11) to enable older Australians and their families to more easily access information and assessment for aged care services, through establishing one stop shops across the country. The Australian Government will fund a national, integrated aged care system offering information and assessment through telephone and web based technology, which will assist older Australians to access services in the place that best suits their care needs. This measure will also enable older Australians to be linked to assessment services, including through the one stop shops purchasing more complex aged care assessment services. This will enable one stop shops to better refer older people to appropriate assessment and care services.
Recommendation 25
The committee recommends that the Department of Health and Ageing conduct a national education campaign directed at new and potential aged care clients to raise awareness of the aged care services available to them including the role of ACAT and of their rights and entitlements in relation to such services.Response
The Australian Government supports in principle Recommendation 25 of the Committee.
The Australian Government already provides information and advice to new, potential and existing aged care clients on the services available to them through a variety of outlets, including:
- the Commonwealth Respite and Carelink Centres network operates through 54 centres and around 65 ‘shopfronts’ around Australia;
- the Aged Care Information Line – a national freecall service to provide information about aged care services; and
- Australian Government web based information services for older people, namely:
The Australian Government will fund a national, integrated aged care system offering information and assessment through telephone and web based technology, which will assist older Australians to access services in the place that best suits their care needs. This measure will also enable older Australians to be linked to assessment services, including through the one stop shops purchasing more complex aged care assessment services. This will enable one stop shops to better refer older people to appropriate assessment and care services.
Recommendation 26
The committee recommends that the Department of Health and Ageing analyse decoupling of residential care and accommodation. Such a review should consider and assess the views, concerns and recommendations of involved stakeholders including the Productivity Commission.Response
The Australian Government supports in principle Recommendation 26 of the Committee.
The Australian Government has commissioned the Productivity Commission to conduct a public inquiry into Australia’s aged care needs over the coming decades. In undertaking the inquiry, the Commission will develop options for further structural reform of the aged care system so it can meet the challenges facing it in coming decades. In particular, the Commission will develop regulatory and funding options for residential and community aged care. The Commission is due to report by the end of June 2011.
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Recommendation 27
The committee recommends that the Australian Government expand community aged care funding and services to meet growing demand and expected quality service provision outcomes.Response
The Australian Government agrees to consider further Recommendation 27 of the Committee.
The Australian Government’s planning framework for aged care services aims to achieve and maintain a national provision level of 113 operational residential places and community care places per 1000 of the population, aged 70 years and over, by June 2011. This framework was designed to keep the growth in the number of Australian Government subsidised aged care places in line with the growth in the aged population. In addition, funding for the Home and Community Care Program is increased each year in recognition of the growing demand for community aged care services.
The Australian Government has commissioned the Productivity Commission to conduct a public inquiry into Australia’s aged care needs over the coming decades. In undertaking the inquiry, the Commission will develop options for further structural reform of the aged care system so it can meet the challenges facing it in coming decades. In particular, the Commission will develop regulatory and funding options for residential and community aged care. The Commission is due to report by the end of June 2011.
Recommendation 28
The committee recommends that the all-encompassing review of the residential and community aged care sector take a client-based approach in order to ensure that its findings are client focused.Response
The Australian Government supports in principle Recommendation 28 of the Committee.
The Australian Government has commissioned the Productivity Commission to conduct a public inquiry into Australia’s aged care needs over the coming decades. In undertaking the inquiry, the Commission will develop options for further structural reform of the aged care system so it can meet the challenges facing it in coming decades. In particular, the Commission will develop regulatory and funding options for residential and community aged care that are based on business models that reflect the forms of care that older people need and want, minimise the complexity of the aged care system for clients and allow smooth transitions for clients between different types and levels of aged care and between aged, primary, acute, sub-acute, disability services and palliative care services, as need determines. The Commission is due to report by the end of June 2011.
Recommendation 29
The committee recommends that the all-encompassing review of the aged care sector consider options to enable greater flexibility in relation to payments and services directed at providing a client-centred aged care system for Australia.Response
The Australian Government supports in principle Recommendation 29 of the Committee.
The Australian Government has commissioned the Productivity Commission to conduct a public inquiry into Australia’s aged care needs over the coming decades. In undertaking the inquiry, the Commission will develop options for further structural reform of the aged care system so it can meet the challenges facing it in coming decades. In particular, the Commission will develop regulatory and funding options for residential and community aged care that are based on business models that reflect the forms of care that older people need and want, minimise the complexity of the aged care system for clients and allow smooth transitions for clients between different types and levels of aged care and between aged, primary, acute, sub-acute, disability services and palliative care services, as need determines. The Commission is due to report by the end of June 2011.
Recommendation 30
The committee recommends that the suggested taskforce undertake a review of the current planning ratio for community, high- and low-care places. Drawing on all available demographic and social information, the review is an opportunity to assess the planning ratio in light of growing and diverse demand on aged care services.Response
The Australian Government supports in principle Recommendation 30 of the Committee.
The Australian Government has commissioned the Productivity Commission to conduct a public inquiry into Australia’s aged care needs over the coming decades. In undertaking the inquiry, the Commission will develop options for further structural reform of the aged care system so it can meet the challenges facing it in coming decades. In particular, the Commission will develop regulatory and funding options for residential and community aged care that are based on business models that reflect the forms of care that older people need and want, minimise the complexity of the aged care system for clients and allow smooth transitions for clients between different types and levels of aged care and between aged, primary, acute, sub-acute, disability services and palliative care services, as need determines. The Commission is due to report by the end of June 2011.
Recommendation 31
The committee recommends that the suggested taskforce review continuity of care as a potential long term solution for the aged care sector.Response
The Australian Government supports in principle Recommendation 31 of the Committee.
The Australian Government has commissioned the Productivity Commission to conduct a public inquiry into Australia’s aged care needs over the coming decades. In undertaking the inquiry, the Commission will develop options for further structural reform of the aged care system so it can meet the challenges facing it in coming decades. In particular, the Commission will develop regulatory and funding options for residential and community aged care that are based on business models that reflect the forms of care that older people need and want, minimise the complexity of the aged care system for clients and allow smooth transitions for clients between different types and levels of aged care and between aged, primary, acute, sub-acute, disability services and palliative care services, as need determines. The Commission is due to report by the end of June 2011. Top of Page