Multi-Purpose Services Program (MPS) webinars

[The visuals during this webinar are of each speaker presenting in turn via video, with reference to the content of a PowerPoint presentation being played on screen]

Cathy Milfull:

All right. Hi all. Thank you for joining us for this next webinar in our MPS reform series. My name’s Cathy Milfull. Most of you have met me before I think now. I’m Acting Assistant Secretary of Thin Markets Branch at the Department of Health and Aged Care which has responsibility for the MPS Program. So it’s great to be with you again. I’d also like to introduce the fabulous Tanya Clancy and Roger Hunt who are joining me today on the panel and they’ll be helping me after my presentation with the Q&A part of this webinar.

So as usual we’ll go through a formal presentation first but then we’ll have questions and answer session at the end. So please make sure you take the opportunity to ask all those burning questions you always wanted to ask. We’ve got the Q&A function on the side. You should be able to ask a question at any time. You don’t have to wait until the end. And then the panel and I will do our best to get through as many questions and answers as we can. I do note that last time a few people had some issues with the Q&A functionality so hopefully that resolves. But if you have any issues let us know and I think my team have got a back up this time if we really need it. So hopefully I think that’s really it for the general housekeeping for today.

So we’ll bring up the presentation slides in a second and get started. But before we do I just wanted to acknowledge the traditional owners of the lands on which we are meeting today all across Australia, the lands where we live, learn and work. I would like to pay my respects to Elders past and present and recognise their resilience and strength and their rich contribution to Australian society. I’d also like to extend special respect to any Aboriginal and Torres Strait Islander peoples here with us today.

All right. So let’s get started. We’ll just get the slides up for you.

[Visual of slide with text saying ‘Multi-Purpose Service (MPS) Webinar 4:’, ‘Aged care reforms:’, ‘Impacts on the MPS program & providers’, ‘28 November 2024’, ‘Thin Markets Branch’, ‘Australian Government with Crest (logo)’, ‘Department of Health and Aged Care’, ‘www.health.gov.au’]

So the first slide that will come up in a second just outlines what we’re going to intend to cover today. As you can see I’ll be the presenter for the entire webinar this time. So sorry. You’re stuck with me. But we will have other panellists to help with the Q&A session. I do acknowledge that it’s been a big week for aged care with the Aged Care Bill finally being passed through Parliament. So I’m going to really provide you with some update about that first today. We will then update you on the related rules that are coming under the new Act as well as transitional arrangements for the new Act. I’ll then just give you an update on other MPS reforms and activities including the reform schedule, the recent allocations round for MPS and the second ACCAP round, and we’ll give you a bit of an update on the 24/7 registered nursing trial as well.

All right. So let’s kick on. The next slide, slide three, just outlines the future webinar topics. Sorry. I’ll just ask my team. I think we’re having a bit of trouble with the slides. Are we able to put it on slideshow? Sorry everyone. There’s always a technical issue. I’ll just keep talking while they get sorted. But just so you know effectively we’re going to take a bit of a webinar break in December but then we’ll pick up again in January 2025. The slide that will come up in a moment will just show you suggested topics for January to April and you’ll just see we’ve got a few new topics particularly relating to new MPS Funding Agreements to accompany the new Act. And this has actually pushed a few of the topics we had planned back a little. So that’s why that’s happened. I just wanted to flag also that we might need to adjust the timetable that we’ve displayed here to reflect consultation on the rules for the new Act.

But as always if you’ve got any other suggestions for subsequent webinars or if you think something is really needed to be discussed by the group more urgently please feel free to let my team know. Suggestions are really welcome.

All right. So we’ll move onto the next part of the webinar which is actually about the new Aged Care Act.

[Visual of slide with text saying ‘Update on the new Aged Care Act and related Rules’, ‘Cathy Milfull, Thin Markets Branch’]

So if we move onto slide five. The exciting news is that I can confirm officially that the Aged Care Bill has finally passed the Parliament. So this means that the Aged Care Act which addresses more than 60 outstanding recommendations of the Royal Commission will commence on 1 July 2025 unless another date is proclaimed earlier. I realise that some of you might have some mixed feelings about this as it does mean there’s a lot of change ahead for all of us. But I think it is important to take a step back and just consider what an important milestone this is for aged care in Australia. It really is the start of a new rights-based system that places older people at the centre and is designed really to achieve higher quality care for Australians.

I think it’s also important to note the Act does deliver for rural and remote Australia in the sense that it does allow block funding arrangements like we have for MPS to continue. It also allows us to support ongoing thin market initiatives aimed at improving access to services for older people living in regional, rural and remote Australia. 

Also just to mention I do think it’s important that the Statement of Principles which is at the front of the new Act really recognises that older people should be able to access quality and culturally safe care wherever they live. It also notes the importance of the aged care system building provider capacity and community connections that can support service continuity and access to integrated services like MPS which we know are just so critical in rural and remote Australia.

Just to note too that there’s now a list of draft Rules and when they will be released on our website. To date you would have seen that the service list and the Support at Home Subsidy Provision Rules have been released. The next to come – there’s another tranche to come in early January 2025 and that will include MPS Subsidy Fees and Payment Rules. So really encourage everyone to keep an eye out for that. And we will certainly discuss that at our first webinar next year in January.

So moving onto slide six. You can see that I’ve just given you a link here which you’ll be able to access when we distribute the slides. But for anyone that’s interested there were some amendments made to the Bill while it was passing through Parliament. So the Senate made several amendments and you can actually see those on the APH website if you need to. So it’s the Australian Parliament House website. I’m not going to go through all of those today but I did just want to flag a couple for you in case you want to go and have a look yourselves. So one is that there are a number of amendments to definitions. This includes changes to the definition of responsible person which I’ve flagged with the MPS Working Group previously. So what we’ve done is amend the definition just to ensure that it caters for Government entities and supports a risk appropriate approach to regulation.

And thanks team. I think we’ve got it. Great. So sorry everybody if you were getting seasick but I think we’ve sorted it now. So as I mentioned the definition of responsible person has been changed a little and that’s because we wanted to make sure that it reflected the situation for Government entities. So if we hadn’t changed it what it might have meant is those of you who work for larger state health organisations potentially would have had to list large – I guess many names from your organisation on your registration application. But we’ve fixed that so it won’t be the case and it will be a more risk proportionate approach to regulating your entities.

On the slide here I’ve also just included some information on exemptions, some changes that were made to the definition of high quality care to prioritise nursing services. And just noting that there’s an additional right that’s been added, so a change to the Statement of Rights as well.

The next slide just shows you some of the other areas of change. Look again I’m not going to go into the detail but there were some changes to reporting requirements and arrangements for supporters. There’s also a new note that’s been added to the Bill just to clarify that a person can make a complaint to the Complaints Commissioner about a registered provider acting in a way that is incompatible with the Statement of Rights. So I just thought that was an important reminder for everybody.

[Visual of slide with text saying ‘Update on transitional arrangements’, ‘Cathy Milfull, Thin Markets Branch’]

So that’s the main Bill. Moving on now to talk about the transitional arrangements. So here it’s important to remember that other legislation is also required to transition the sector from the current to the future aged care system. We’ve also had some progress in this space with the Consequential and Transitional Amendments Bill now also introduced to Parliament and it’s in fact already passed the House of Representatives. This Bill is really important as if passed the Bill and the Rules that will sit under it actually show how we can preserve the position of existing providers and clients under the new Aged Care Act. We can also develop rules to cover other matters such as maintaining places allocated to an MPS site. 

But the transitional legislation is one thing. There are also a lot of administrative processes that need to be put in place to ensure transition occurs without any problems. And that’s really what I’m keen to talk to you about today in more detail. So this slide, transitional arrangements for providers, firstly looks at transitional arrangements for you guys, ie for our MPS providers. As we’ve discussed previously existing approved MPS providers are intended to be deemed to be registered providers when the new Act commences. They will also need to be deemed to be registered in particular categories. So that’s the residential care category plus additional categories associated with different home care services.

You might remember that we had intended our regulatory strategy colleagues to write out to you to work out what categories each of the providers would like to be deemed to be registered in. But following a discussion with the MPS Working Group earlier this week I just wanted to flag here that a revised approach is now proposed which we look like we’re going to proceed with subject to some final conversations. So this will actually mean we kind of go the other way and that we’ll deem all providers to be registered in all categories. What’s going to happen then is in April next year we’ll be in contact with you and there will be a preview period. So the idea is that providers can actually log on to Departmental systems, have a look and see what it’s going to look like, see their details, and check their registration information. 

We’re thinking that this will offer you an opportunity to then opt out of any registration categories. We think it’s better we leave this decision ‘til then. It will give you guys some more time to think about it. You’ll also have a chance to review any additional rules that are published in the new year as well.

So look we’ll be in touch about this. Probably the other outstanding issue that impacts this is you might be aware that there’s some discussions underway with jurisdictions regarding at what level a Government entity will register in the new world. And so by that I mean is it going to be the state of Queensland for example or would each provider be representing more like a regional area, like a local health district. Certainly the latter would be our personal preference from an MPS policy perspective but we’re really keen to work with jurisdictions to understand what works best for them noting this decision is relevant not just to MPS but also to our other programs like transition care and even mainstream residential care.

So look I’ll leave provider transitionals there for now because I really want to talk to you about individuals today. But please feel free to lodge a question if you want me to expand on anything else in relation to providers.

So as per this slide we’ll now move on to talk about discussing transitional arrangements for individuals. So by that I mean the actual older people who are accessing services via your MPS. Look we talked about this last time and I have to admit we still don’t have absolutely everything worked out with transitional rules still to be drafted. But we do have some more information and we wanted to share that with you and get your feedback so we can all be as ready as possible for the work ahead.

So I just wanted to flag as outlined on this slide you’ll hear me talk about today probably using the term deemed approvals but essentially what I’m talking about is if we have a person, so for example fictional Francis who lives at delegate MPS, the aims of these arrangements are to ensure that Francis can continue to access residential care services on 1 July 2025 when the new Act starts and that she has all the approvals that are needed under legislation to allow her to do that. As you’ll see from this slide we’ve also decided now to go a bit wider so we cover individuals who you might not have commenced delivering services to but you have entered an agreement to do that very shortly. And we’re going to try and cover people that would commence accessing services at the MPS within three months. So we’ll explain a bit more as that goes but that means that you won’t have someone who you’ve actually signed an agreement with, the new Act starts and then you kind of have to retrospectively get them to go through a new application process.

All right. So next slide. What do we need from you all as MPS providers? So as we flagged last time we will need your help to ensure that my fictional Francis and indeed all our real life MPS clients can transition over to the new arrangements and continue to access residential care services or home care services or both. As outlined on this slide we’ll need to collect client level information from providers and/or jurisdictions centrally to ensure that this can actually happen in practice.

So what do we need from you? This first slide covers the logistics in terms of timeframes and when we will need the client information for your existing clients. Essentially we are proposing to send you a template where you can upload required information and provide those to us by the end of April. The idea is that we’ll then give you two additional opportunities to update or add to this client list before the transition day so we can make sure everyone in your MPS or who you’re delivering services to in the community as at 30 June 2025 is effectively covered.

All right. So the next slide. How much information about existing clients will we need? Well the next slides really go into more detail about what type and level of client data is required. As I just mentioned my team will be coming out to you with a formal request and templates but we want to provide you with as much notice as possible now regarding what information will be required. As noted here that’s actually going to depend on what sort of services the individual is accessing. So there could be different requirements if they’re accessing for example residential or home care. It will also depend on whether they’ve had an assessment or not. Existing clients will not be required to get a new formal assessment to transition over to accessing services under the new Act. So that’s probably the important message here. Sorry. Can we just go back one slide? As long as they consent for their data to be provided to the Department so that we can include them with the transitional arrangements and the provider confirms that they meet minimum requirements.

So just on that we will also be coming back with more information regarding outcomes for those who don’t consent or don’t meet minimum requirements but we want to ensure our MPS approach here aligns with that of other program areas.

So next slide. What sort of information will we need? This slide again just shows you what information we will need and it will be different depending on whether the person is a resident in your MPS or accessing home care. This slide shows you that the least information for example will be required for individuals accessing residential care who had an ACAT assessment already done. On the other hand the most information will be for people accessing home care who have never been assessed by the Department. And there will be a bit of a range in between which we’ll explain in a second.

So the next slide just shows you to try and make this easier we’ve basically tried to split what we think are the clients out there in MPS land into four cohorts. So in short the first cohort are individuals who are already accessing MPS services with a previous assessment. Then the second cohort is individuals already accessing services who haven’t had a previous assessment with the Department. The third one is individuals with an agreement to commence services within three months of the Act commencing who again had a previous assessment such as an ACAT. And the last cohort is people who have an agreement to commence services with an MPS but don’t have a previous assessment. So basically what we’re imagining here is that the template you get will be split into four and you can work out who fits into those cohorts and different levels of information will be required for each cohort.

I also just wanted to confirm one thing here which you can see down the bottom in red, because I know there’s a lot of sort of uncertainty around age requirements. So just to flag that in terms of the transitional arrangements we’re talking about today there’s no difference depending on whether the person is 65 or 45. Those cohorts and the same rules apply. So the age requirements in the new Act are really only going to impact our younger people who might have sought access to aged care after 1 July. They’re going to be impacted by new eligibility requirements but not existing MPS clients.

All right. So I’m not going to go into this in too much detail or everyone’s brains may explode. But I did just want to show what we’ve done is given you one slide for each of those cohorts and it basically shows you so you can get ready what sort of information we’re going to need for each of those cohorts. So the good news is if you look at the information required all clients column, that is information we will actually require for all the cohorts, so basic client bio data. Then for each cohort you can see a column for residential care and a column for home care. And that’s the additional information that we will need for each cohort. So you can see for cohort one if your client is accessing residential care we really don’t need to know a lot other than their basic bio data plus what services they’re accessing. Is it respite or permanent residential care? And then the date that they actually commenced service delivery with your MPS. So that’s cohort one.

If we now look at cohort two you can see that we will require some additional certifications for clients in this cohort. For example if you look at the residential care column you can see that we will need a bit more information because this person’s never had an ACAT assessment. So basically what we want is providers to indicate something – basically it’s pretty low level. It’s just that in your view the person has some kind of sickness and that can include frailty. That means you believe they need residential care including nursing on an ongoing basis. And we’re keen for you to just indicate on what basis you’ve made that certification. So did they have a GP referral? Have you got information on the client file? That kind of thing. We don’t need to know the details. We just want to know what is it that you’re basing your certification on. So that’s cohort two.

For cohort three again this one is really similar to cohort one in terms of what information we need. The only difference here is that the person hasn’t actually commenced accessing services when the new Act commences on 1 July. So we would just want some extra information from you on the agreement that you have in place to commence services within that first three months and what is the date of commencement of services. 

Next up is cohort four. So this really mirrors cohort two. Very similar. The person hasn’t had an IAT or an ACAT assessment. But again this time they just haven’t commenced services yet but they have an agreement with you to do so. Okay.

So they’re the four cohorts. So moving on. What happens from transition day? So getting back to practicalities if we get all that sorted the idea is our MPS clients can continue to access services. They will then be deemed to be approved to access services. They’ll also get at the same time all other delegate decisions that they’re required to have under the new Act. So you don’t have to worry about that too much. But for example they’ll have an eligibility determination, a priority category and a classification level. But for MPS purposes those things aren’t very relevant but from the client’s perspective they’re important in terms of aged care more broadly.

I did just want to flag that as in the current world if the person moves from an MPS service to a mainstream provider or requires new and additional services they are likely to need to undergo further assessments under the new Act. For example if they move from an MPS home to a mainstream home they will need a new AN-ACC classification assessment. But that’s actually no different to the current world anyway. If they move from home care to residential care they will also need a new aged care assessment. And I just wanted to flag that that’s the one possible cohort where existing under 65s might be impacted because there might be some additional requirements if they want to move into residential care after 1 July. And that’s because we’ve talked before about the Government’s targets to actually reduce the numbers of younger people in residential care given that the Royal Commission basically found that it’s not an appropriate environment for younger people and that where possible we want to find them services that are more appropriate to their needs.

So what do we still need to confirm? Just flagging here there are still some things we need to work out. We’re having a little look at what happens with someone who had a RAS instead of an ACAT or IAT assessment. So we’ll come back to you on that. The main thing apart from that we want to work out is really the logistics around client data being submitted, stored and managed and of course making sure that we’re all meeting all our relevant privacy requirements under legislation. So we need to have a think about how to manage clients who don’t consent to give their information to the Department and we want to make sure there’s clear information available on how the Department will use and manage this data. Because really we’re collecting it for a very specific purpose, to allow older people to transition without going to get a new assessment. So we’re hoping people will see that as a positive but we appreciate we’re going to need to explain that and make it really clear what happens with their data.

So I think that’s probably it with that one. Last slide on transitions is just to say that really as I said please don’t worry too much if you found that quite complicated. Ask questions if you have them. But we will certainly write out to you in January. We’ll probably touch base with your MPS Working Group representatives first and then we’ll write out to you with clear instructions and the template. But this session is really just to give you time to get ready and consider how you might manage collecting this information, how you can make sure no clients are overlooked, how you might talk to them about releasing their information to the Department, noting we will try and give you information to help you with that. And just a last reminder. We talked about it before but if you’ve got new residential care clients coming in between now and the new Act it might be worth getting them an IAT assessment. That just means they’ll fit then into that cohort one that we were talking about and so less information for you all to worry about collecting.

[Visual of slide with text saying ‘Update on other MPS reforms and activities’, ‘Cathy Milfull, Thin Markets Branch’]

All right. So that’s transitional. Sorry. I am taking a little bit longer than normal with the presentation but it is quite a complex area. So this next slide just really returns to giving you more of a general update around our MPS reforms. So we’ve updated our usual schedule just to reflect some recent developments. So the first is if you look in that yellow box for January that effectively – and sorry. That should actually say January 2025 – that basically we will have an increase to subsidy rates for 1 January but that’s actually only for our three private MPS providers. And that’s to reflect the most recent Fair Work Commission aged care decision. So there will be a 3.24% increase for 1 January. But that doesn’t affect our State Government providers. 

The other thing that’s going to happen hopefully in January, at least it’s imminent but possibly early 2025, is we really want to finish the MPS allocation rounds and notify relevant applicants of the outcome. So just a bit of apologies from me. This has taken a little bit longer than we had anticipated. But that’s because we actually got more applications than expected and those applications were asking for approximately 150 new MPS places. You might remember that the Minister actually allocated only 100. Sorry. Made available 100. So that’s why. But I’m actually really positive about it. I’m really glad that we’ve got that response and I think it shows that people are keen to work with us to expand the MPS program which is great. So hopefully we’ll have more to tell you about that very shortly.

The other thing that’s been keeping my branch a little bit busy too is the second round of the Aged Care Capital Assistance Program. So some of you might be interested to know that that round is very close to being finalised as well. In fact they’re ahead of the MPS one. So keep an eye out for announcements on that one and hopefully we’ll get some good outcomes for providers in terms of capital funding supports. 

The other thing that I’ve changed on this diagram but I won’t talk about now because I’m about to talk about it in more detail is just our milestones in terms of the 24/7 registered nursing trial. So as you might remember we’ve been doing a trial of the 24/7 registered nursing obligation for MPS. We’ve been doing that via a phased approach and I’m pleased to say we’re kind of at the end now of Phase 1. As you can see from this slide we had 60 sites participating and it’s great to see that almost all sites provided us with the required reports and also survey responses. So I did really want to make a shoutout to those providers to say thank you so much for participating, particularly also to the sites that were kind enough to host my team who did site visits between August and October. I really do think that the collaboration on this has been fantastic and I think it will make for a better outcome for the trial. So you can see here as well that the good news is that almost all the sites also confirmed that they met the 24/7 registered nursing requirement for those trial reporting periods. 

The next slide just gives you a graph which shows those results. So basically we had 86% compliance if you like recorded which is I think pretty fantastic for only Phase 1 of the trial. The other thing if you look at the next slide you can see is I actually think the results are probably better than we’ve actually recorded in that what we discovered were some sites potentially recorded themselves as not complying with the obligation but we think actually they may have taken a slightly I guess stricter if you like view of what we meant by on duty and on site. So the team are working to revise the advice in that space and so we actually think the compliance levels if you like for the next reporting period might actually be higher.

But the one thing we know we do need to address in Phase 2 is basically how to manage – the team did visit a number of sites that have a low acuity lodge or hostel that are not necessarily collocated with the main MPS site where there is a registered nurse available. So we just need to have a think about how that’s going to work in the new world, how do we want to present that off site location if you like under the new Act, and is that area able to meet the 24/7 requirement or is that a situation where we need to look at some kind of exemption, and in which case are the exemptions that are available to mainstream residential care facilities sufficient or do we actually need to come up with something more specific for MPS. So that’s what we’re hoping to look at via Phase 2 of the trial.

So last slide here just shows you I guess the next steps. And just to clarify some of you should be aware that basically all the MPS trial sites or representatives of are on this reform implementation sub-working group that we set up and really each phase of the trial we are discussing the outcomes with that sub-working group before we go back to our higher level MPS Working Group to decide the way forward. So again thanks everyone to participate in that group. And basically it was really pleasing to see that that group recommended that basically we could proceed to the next stage. So what we’re going to do is from 1 February 2025 we will proceed into Phase 2 but that will follow our first webinar next year in late January and we’ll also make sure we update our communication materials to make sure we’re even clearer about things like on site and on duty. That means then all sites will need to participate in the next phase and so there will be a reporting month in March and May when MPS sites will basically report back to us on whether or not they’ve complied. We’ll then come back to the sub-working group with those results and then we’ll see where we land in terms of actually rolling out the formal obligation to have a nurse 24/7 under legislation.

So just as you can see at the bottom there and on the next slide we’ve just adjusted the timeline for the trial as a result. So we’re now proposing that the formal obligation would not start any earlier than 1 October and only if we get agreement. So I just wanted to flag the reason why we’ve done that is just to give everyone a bit more time and breathing space but also obviously the new Act commences on 1 July 2025 at this stage so we just thought it would be good not to necessarily align those and give providers a bit more time to settle into the new Act first and the new rights-based system. And then if all goes well we can roll out 24/7 more formally in October. But we note that you’ll still be participating anyway in the trial so hopefully we’re getting those good quality assurance outcomes anyway.

All right. So I have taken a little bit longer than normal but we are at the question part of the show. So I’m not sure. I think team – I’m not sure if we’ve been having some issues with the questions again. But one question I can see is:

Q:         Do we know what the new actions will be for MPS under the new Quality Standards?

So I think it’s from Peter. So Peter in short I guess the new and robust Quality Standards will apply from 1 July and they will apply equally to all providers who are registered in categories four, five and six. So there’s sort of no exceptions for MPS to that particular obligation. So I guess I’d encourage you to have a look at the revised Quality Standards. They’re already on the website. They will then officially – probably you’ll see them in the form of actual rules in the new year. But to answer your question they will apply. And if that’s something people are particularly – if you haven’t been that involved in that consultation process around the Quality Standards I’m happy to get one of the relevant policy teams along in January to kind of sing out the key differences if that would be useful.

All right. Next question I have is:

Q:        Can I confirm that as client data will be sought will the transfer of information occur by a secure electronic file arrangement to comply with the legislation?

So look I might start but Roger feel free to jump in as well. But I think essentially yes, the team’s plan is to organise some secure electronic file arrangements. And as I mentioned we’re just working through all those privacy requirements. So we can come back to you all and make sure that we’ve met all our obligations and both yourselves and clients can feel comfortable in that. I don’t know Roger. Are you wanting to add anything there? Sorry. I can’t see.

Roger Hunt:

Thanks Cathy. No. Look I think you’ve covered it off. That’s right. So look we’re definitely wanting to be able to provide some further advice as soon as we’ve got it to hand but absolutely the intent is to ensure all the transfer and storage complies with all the relevant legislation. Absolutely.

Cathy Milfull:

Fantastic. And so really Roger will no doubt be contacting everyone early in the new year with those templates that we mentioned but it will also explain how they’d be submitted and how the data will be stored.

We had another question around transition I think.

Q:        So if a client transfers from one MPS site to another MPS site but will receive the same services will they need a reassessment?

So Roger can correct me if I’m wrong but my understanding is no. So effectively with our transitional arrangements basically they’ll get an approval to access the relevant services. They can effectively take that to any site. As I mentioned there’s just potentially some complexity if they move into the mainstream and that’s really because as some of you would be aware currently in HCP but coming in Support at Home they have classification levels that we don’t have in MPS. So they’ll actually need to know what that level is before a mainstream provider starts delivering services. But not a problem from an MPS to MPS perspective to my knowledge.

All right. Tanya I might throw you a question because everyone’s sick of my voice. 

Q:         Will 24/7 RN reporting look the same or different in the new world after the Act?

I must admit I’m not sure if the person here is asking about mainstream or ours but did you want to respond to that one?

Tanya Clancy:

Yeah sure. So the 24/7 RN reporting requirement will not change when the new Act comes into play so therefore the reporting for MPS also will not change. So the new Act won’t have any impact on the reports for 24/7. 

Cathy Milfull:

Thanks Tanya. And the other question was:

Q:         Is there a minimum bed requirement for a site to be exempt from reporting for 24/7 RN?

And I’m going to take that as meaning are we proposing that in the MPS context Tanya.

Tanya Clancy:

Yeah sure. So in mainstream sites can apply for an exemption if they’re in MMM 5-7 and have 30 or less beds. But that is something that we’re going to explore in Phase 2 of the trial to see what’s appropriate for MPS. So at this stage we haven’t landed on that one yet.

Cathy Milfull:

Thanks Tanya. Next question I think from Brett.

Q:        Is there likely to be interim funding arrangements to ensure sites are viable with changes while the actual MPS funding model is developed?

So I think it’s a good question from Brett. I think look Brett, in a sense there’s no specific funding committed, additional increase to funding for 1 July to MPS to cater for the implementation of the new Act. Of course all our subsidy rates often change on 1 July with indexation so that will happen. But then we will obviously be looking at the new funding model. If you go back and have a look at that reform schedule I showed you though we do have a couple of points where we will consider interim additional funding uplifts. I obviously can’t guarantee that. That’s a matter for Government. But we will be along this journey looking at whether we think that is necessary. And some of you might be aware that my team are actually starting a bit of a deep dive with certain sites once we get agreement from jurisdictions and that’s a way that we’re really hoping to look at and investigate how MPS sites are fairing at the moment and to what extent there is any gap between the costs of service delivery and what you’re being funded now.

We also as you know have already allocated additional funding for participating sites in our direct care minutes trial. So that’s additional funding that’s been added in. But nothing especially for new Act implementation.

All right. Have I got any other questions? I think a question from Megan.

Q:        Currently an IAT is not required for MPSs and may be required when the Act commences in July. You had mentioned for services to seek an IAT now for new clients. Can you please clarify?

Thanks Megan. That’s a great question. So basically when the new Act commences all our clients need to effectively go through the front door and do an IAT assessment. Although we will have alternative entry arrangements in place where you need to bring a person in urgently and there’s a delay in the assessment. So that’s not mandatory yet if you like. That only starts with the commencement of the new Act. But I guess we’d had some conversations with the Working Group. There’s nothing stopping you getting IAT assessments already now for your clients just like you did with ACAT. And so really at your discretion but as I said it might help with the transition to the new Act if you start doing that. But what we’re basically saying is please don’t feel like you have to go back and do that for existing clients because the arrangements we’ve discussed today for transitionals that Roger will be developing really removes the need for retrospective assessments if you like.

All right. Have I got any other questions that I have missed team?

I don’t think so.

Tanya Clancy:

It looks like we’ve answered them.

Cathy Milfull:

I think we’re good.

All right. Well look thanks everyone. And thanks for the really good questions. If you think of other things please don’t hesitate to drop us a line. Either my team can give you an answer or we can cover it too at the next webinar. I really do appreciate that there is a lot going on. It’s been a long year and a lot to get ready for next year. So look we really are keen to work with you to support you. And look we don’t have all the answers. We don’t necessarily know what’s going on at particular MPS sites. So if there is a particular challenge with the new Act or a particular new rule please sing out. The rules are out for consultation and it really is important that jurisdictions look at them carefully and let us know if we think there’s something that we haven’t identified that might have an unintended consequence for MPS providers or for your clients.

But if nothing else I will leave it there. And thank you very much everyone for attending and sorry about the technical problems. But it wouldn’t be a webinar without a few little hitches. So we really do appreciate your attendance and participation. Thanks everyone. Bye. 

[End of Transcript]

[The visuals during this webinar are of each speaker in turn via video, with reference to the content of a PowerPoint presentation being played on screen]
Cathy Milfull:
Hi everyone. Thank you for joining us for this next webinar in our MPS reform series. And sincere apologies for the need to delay this due to our building evacuation last time but we’re really pleased that you can join us today. So my name is Cathy Milfull and I’m still Acting Assistant Secretary of the Thin Markets Branch which has responsibility for the MPS program so I’ll be hosting today’s webinar. It’s great to hear from you again. I’m also pleased to introduce Katherine Koesasi who’s on screen as well who’ll be joining me. Katherine’s from the Aged Care Assessment Policy section and she’ll be with me on the panel today.
So just a bit of housekeeping first. As per the last webinar today will include a formal presentation as well as a Q&A session at the end. So you can submit questions and answers like last time in the Q&A panel on your right in Teams. And we’d really encourage you to do that throughout the presentation today to make sure today’s as useful and interactive as possible for you. You don’t need to wait until the end. You can do that any time. And then we’ll try and get to as many questions as we can during the Q&A session. So I think that’s pretty much it for the housekeeping today. So I’ll get my team to bring up the slides for today’s presentation and we’ll get started.
But just before I do I of course wanted to acknowledge the traditional owners of the lands on which we are all meeting today across Australia. I would like to pay my respects to Elders past, present and emerging. And I also want to extend that respect to any Aboriginal and Torres Strait Islander peoples here with us today.
[Visual of slide with text saying ‘Multi-Purpose Service (MPS) Webinar 4:’, ‘Aged care reforms: impacts on the MPS program & providers’, ‘9 October 2024’, ‘Thin Markets Branch’, ‘Australian Government with Crest (logo)’, ‘Department of Health and Aged Care’, ‘www.health.gov.au’]
So let’s get started. So this slide outlines what we’re going to cover for you today. I did want to start off by saying there is going to be quite a lot of information to go through today as it’s been quite a big few weeks for aged care as I’m sure you’re aware of. So apologies if the webinar is a little bit more dense today but we are going to try and summarise some key takeaways for you where we can.
So as per this slide the first section of the webinar we’re really going to focus on some of the recent aged care announcements by the Government. I’m then going to provide you with some key reminders about eligibility and assessment arrangements under the new Act, so what happens for new entrants to an MPS after the new Act commences. I’ll then hand over to Katherine who’s going to take you through some information about an important new project called the Assessment Experience Project which is related to that eligibility and assessment space. And finally then we will talk through transitional arrangements for the new Act followed by a few quick reform updates and reminders and then we’ll start the Q&A session.
All right. So just quickly this slide just gives you a bit of a notice of future webinar topics. Obviously sorry we’ve now shifted these back a month due to this webinar being delayed. So as you’d be aware up until now we’ve really been focusing on matters of how MPS providers will be regulated under the new Act. This webinar today really moves on to focus much more on MPS clients and impacts on client pathways and requirements under the new Act. And then next month we really want to turn our attention to funding under the MPS program including how subsidies work under the new Act as well as client fees and payments. But just wanted to flag we will keep updating this slide and our schedule to reflect consultations that are happening with the new Act so that as much as possible we can engage with you where you’ve actually been given an opportunity to comment on something and have the information to do so. As always too we always welcome your suggestions about future webinar topics so feel free to send these through to my team.
[Visual of slide with text saying ‘Recent aged care announcements:’, ‘impacts for MPS and next steps’, ‘Cathy Milfull, A/g Assistant Secretary, Thin Markets Branch’]
All right. So we’ll start off with the main topic for today. So I guess the really exciting news is that the Bill for the new Aged Care Act was finally introduced to Parliament on the 12th of September 2024. So it’s quite a hefty document as you can see. The Bill has not yet been passed as I note has incorrectly been reported in a few places but importantly it’s before the Parliament so it’s beginning its Parliamentary journey which is still an important and really massive milestone for aged care. 
As noted here on the slide if passed not only will the new Act address about 60 outstanding recommendations of the Royal Commission but it also responds to the more recent recommendations of the Aged Care Taskforce. 
I just want to say there’s probably a lot of focus you’ve seen in the media since the 12th on changes to client contributions for aged care services in response to the recommendations of the Taskforce which probably is not so relevant to MPS but I think it’s also important to recognise that the Bill will be the start of building a new rights-based aged care system that places older people who need care at its centre. It really aims to improve transparency, accountability and the way services are delivered to older people.
So what has changed in the Bill since the Exposure Draft? Look I won’t go into this slide in detail and some of you might have already seen it if you’ve dialled into one of the new Act’s webinars. But it really was just for your reference in case you were wondering what changed since the Exposure Draft in the Bill which was published back in December and the actual Bill that’s been introduced to Parliament. So just quickly really the differences are that the missing chapters have now been included obviously. So in particular you’ll note the additional chapter on the funding of aged care services. So that’s Chapter 4. But there have also been a couple of changes in response to feedback from the Exposure Draft. So for example as noted here the Bill’s been changed to include a positive requirement for providers to uphold the rights of older people. Criminal penalties for breaches of new statutory duties which had raised some significant concerns for the sector have also been removed.
So where can you find more information? Well I just wanted to flag there’s actually a lot of information out there already on the Bill and so we will make sure you get copies of this presentation where I’ve put links into relevant documents. But my team will probably also try and post some links in the Q&A as I go today for those eager beavers who are keen to have a look straight away. But yeah there is a lot out there but I appreciate it can be a bit hard to digest where there’s a lot of information out there so we really encourage you to sing out if you’ve got questions on how something impacts MPS specifically. We can take your questions into account as well when we’re progressing future webinars or as you all know we now have an MPS reforms web page so we’re really happy to put sort of more tailored information on that page if we’re noticing there’s some really common questions coming through from providers or jurisdictions.
So next up I just really wanted to flag that obviously you might have seen the Prime Minister announced that the Bill had been introduced but alongside that I think it’s important to recognise that the Government also announced a $5.6 billion aged care reform package. So that includes the funding reforms I’ve mentioned but also Support at Home which is also targeted to start on 1 July 2025. So through these webinars we’re obviously trying to focus on things that really impact MPS providers specifically but of course if there are other things that you’d like to know about in the broader reform package please give us that feedback and we can weave it into these webinars as well.
But in terms of thin market measures so there were actually some measures included in that reform package which were specifically relevant to the delivery of rural and remote aged care and indeed to MPS. So I’ve listed a few on these slides just for your awareness. So they include that an additional $300 million in infrastructure funding was committed to by the Government. So that will come through our ACCAP program, the Aged Care Capital Assistance Program, and it will mean that there will be the potential for more or expanded opportunities for grant funding for infrastructure upgrades.
Consistent with the recommendations of the Aged Care Taskforce the Department will also be reviewing the remoteness classification system for aged care which you often hear people talk about as the MMM review. So as part of this process which you’ll hear more about we really welcome your feedback regarding any identified issues with the MMM classification for your region. I think it’s important to recognise too that that review is not going to be done in isolation. We’ll also be doing a stocktake of other rural and remote policy levers and developments as well as looking at how this works across the broader care sector.
Another inclusion in the reform package was that the Independent Health and Aged Care Pricing Authority or IHACPA will be undertaking an assessment of how the MPS program is funded. This group’s probably aware that that’s been on the cards for quite a long time but that’s now been officially announced as well. And it’s important as this specialist advice will then inform the work of the Department who will develop a new MPS funding model addressing outstanding parts of recommendation 55 of the Royal Commission. So we’ll give you more details about all these projects in the coming weeks and particularly as scoping discussions move forward and we can confirm things about timeframes and when consultation etcetera will occur.
All right. So what’s next with the new Act? So just to clarify that the Bill has been referred to the Senate Committee Affairs Legislation Committee as you might be aware. Some of your jurisdictions may already have provided a submission. And that there’s planning to be a report by the Committee by the end of October. I just wanted to flag here that during this time the Department will be inviting feedback on some of the rules that sit under this law and indeed that’s already started to happen and that’s one of the things we wanted to talk to you about today. This consultation on the rules will then help inform a Parliamentary debate on the Bill. It’s also a really important process because as you might know the rules contain the details that it’s really important that we get right to ensure effective implementation of the new arrangements. So we’re really keen for you guys to get involved in this process and any feedback opportunities that arise which we will highlight through these webinars and our regular communications with providers and the jurisdictions.
All right. So speaking of the rules some of you might be aware that the first set of draft rules has actually been published for consultation. So that’s available on the Department’s website. And those rules cover what’s called the aged care services list which you would have heard me talk about before. So this is a really important pillar of the new aged care system. So this list will list all the aged care services for which funding will be payable to providers under the new Act. And importantly that includes the MPS program. So I’m not sure if anyone’s had a look yet but it is quite a long, lengthy and complex list because it really is one list to cover the whole aged care system. But essentially if you have a look you’ll see a list of services that are grouped into service types and also service groups.
If your MPS only delivers residential care it’s the residential care services group that will be of relevance to you, with providers as in the current world expected to deliver all the services within this group as needed by the residents in your care. If your MPS delivers services out in the home or community then the other services will also be relevant.
Okay. So what do we need from you? I guess I’m keen for everyone to have a look at the draft service list. Check the list. If there’s anything you think is obviously missing we’re obviously keen to know, or if you have any concerns about how the services are described. And you’ll note in some places there’s identified exclusions, so things that are not taken to be part of that service. So if you think there’s anything that’s at odds with how your MPS or your jurisdiction currently operates it would be great if you could provide us that feedback. I did want to mention though just that on the service list there is a lot of sort of complex language around means testing categories, things like efficient prices, unit prices, loading type. Please never worry about all that because they’re not actually relevant to MPS. That is more relevant to the new Support at Home program. So from an MPS perspective if you can just consider the services, their description and those exclusions that would be great.
All right. So that’s the service list which just to reiterate is already out for comment in October. We don’t actually have the full consultation schedule finalised for the rules but that is underway. But I did just want to flag that next up we expect that you will be able to take a look at the sections of the rules that relate to subsidies, fees and payments. So we’re going to discuss this in detail at the next webinar and welcome your further feedback. But just in case you see these in the interim I just wanted to flag not to worry too much I think about the subsidy rules given that they’re not expected to change much from the current arrangements. So effectively they’re very similar to the current world. They’re just put in the language of the new Act. On the other hand there will be some changes in terms of the fees and payments arrangements consistent with the Aged Care Taskforce report. So we’ll talk about those at the next webinar but just be aware that we are expecting to make some changes and that’s really to ensure that client fees for MPS do not exceed the limits that are imposed on mainstream aged care programs and that MPS providers who choose to charge accommodation payments as currently are required to meet standard requirements for these under the legislative framework.
So in terms of the new Act and the next steps just some key takeaways here as that was probably a lot to take in. So the main things to remember is the Bill is before Parliament. It’s subject to Parliamentary passage but the aim is still at this stage to commence on 1 July 2025 subject to Parliamentary passage. The rules that sit under this Bill have started to be released for consultation and we’ll discuss more of those rules as these webinars continue and as they’re released for consultation.
[Visual of slide with text saying ‘Eligibility and assessment arrangements under the new Act (new entrants to an MPS)’, ‘Cathy Milfull, A/g Assistant Secretary, Think Markets Branch’]
All right. Thanks everyone. So next topic we’re really looking at who will be able to access Commonwealth funded aged care services. So we’re moving onto questions of access and eligibility. So this slide you would have seen before is just a reminder of what we call the single entry arrangements that come into place with the new Act. So what this means is that older people seeking Commonwealth funded aged care services basically need to make an application. They’re going to then have their eligibility to proceed to an assessment determined by the delegate. If eligible they will then undergo an individual needs assessment with an approved needs assessor. The needs assessor will then make recommendations to a delegate who will make a legal decision on whether the person requires aged care services and what type of services they can access. This delegate may also make additional decisions including for example the level of services the person requires or the funding that they require and their priority, so what is the urgency in terms of them accessing those services.
So what does this then mean for MPS? So just to summarise because it can be a lot to take in, in short what we’re saying is that those arrangements that I just discussed will also apply to the MPS program. So that is different to the current Act. Subject to what will be known as the alternative entry arrangements which I’ll talk about more in a second to commence care via an MPS after the new Act commences an individual will need to go through those same single entry arrangements that I just discussed. MPS funding will also need to be used to deliver services to individuals consistent with their approval decision from the Department. So that’s services that are on the service list that we just talked about.
Those other decisions though that a delegate might make around funding levels and priorities don’t actually have any relevance for MPS and that’s because of our block funded arrangements. So you don’t need to worry about that but you will need to be cognisant of what services the person has been approved to access.
So are there any exceptions to this? So I think the main thing to note here is there will be transitional arrangements in place for individuals that are already accessing services through your MPS and we’ll talk more about those shortly. But there are also these alternative entry arrangements that I wanted to flag with you because we have talked about them previously but they weren’t in the Exposure Draft for the Bill. So you’ll now find them in section 71 of the Bill if you want to take a look. And effectively they are the mechanism through which we allow an individual to enter care immediately in certain circumstances with the application and assessment process we have just discussed to occur retrospectively. So to be clear they still need to go through that process but it can happen later.
When this occurs the older person will still need to make an application and at the moment they’ll need to do that within five days of you commencing service delivery unless we decide we actually need a longer period for MPS and we can actually prescribe that in the rules. So as per the slide here we’d really welcome feedback from providers and jurisdictions whether you think that five days is practical for MPS or because of some of the challenges in an MPS or in a rural and remote environment you think a longer timeframe would just be more appropriate for MPS. So please let us know if that happens.
All right. So I think I will give you a break from my voice for a second. Thank you very much for listening so far. And I’m going to hand over to Katherine who’s going to talk to you about the Assessment Experience Project.
Katherine Koesasi:
[Visual of slide with text saying ‘Assessment Experience Project’, ‘Katherine Koesasi, Aged Care Assessments Policy Section’]
Thank you so much Cathy and thanks for your time today. It’s lovely to meet you all and to provide a break for Cathy from speaking for most of the webinar as I’ve discovered seems to be her want. As Cathy mentioned earlier I’m the policy lead in the Aged Care Assessment Branch here at the Department and I’ve come to talk to you about one of the projects we’re undertaking at the moment which is future focused.
And so it’s called the Assessment Experience Project and what we’re doing is really thinking about what the experience will look like for clients and assessors after the new Act and Support at Home are introduced so that we get it right. So what we’re looking at is developing a clearer picture of the future state assessment process and one of the things we want to do through that is to identify gaps and issues in the future state assessment experience. And we’re also keen to develop some tools through this project to help us evaluate the impacts of future proposed changes to the assessment process. So even further ahead not just when the new Aged Care Act and Support at Home are introduced. So we’re looking forward in that sense.
In terms of how we’re undertaking the project we’ve got two phases and we’ve just completed phase one. So through phase one what we’re trying to do is get a high level view of the future state through getting a journey map that identifies the key touch points for clients and for assessors and then look up and investigate some key risks and considerations in phase two, so identify what we’re going to focus on. And the way that we’re doing it is through a mixture of bringing together existing resources and also targeted engagement. So that’s been happening and we’ve just pretty much finished phase one.
Phase two of the project is – can we go back to the previous slide? Sorry. Phase two is us getting up close and looking in detail at some of the things that we’ve identified through phase one and that’s where we’re hoping to get some of that really targeted, detailed mapping, some cohort profiles, scenarios and some resources to help us to evaluate the impact of particular changes to the assessment process in the future. So really useful, tangible things that we can use in the Department on a day to day basis to help us think about this change is going to happen to the assessment process. What will that mean? And so if you look to the right of this slide some of the project outcomes we’re looking for is to understand the cognitive load, emotional journey and time taken for clients and assessors and how that might change through some of the introduced changes through the Act and what not, to identify and prioritise risks and gaps, to identify risks in the transition to future state, and to help us evaluate requests. And one of the other things we’re trying to do is use the knowledge we’re gleaning from this project as we go to support the change management because we’re really conscious that there’s so much change happening in the assessment space at the moment.
Okay. I’m ready for the next slide thank you. And so we thought we would share with you an example of the high level, so the phase one high level journey map. It’s a work in progress live document. So this is literally a screenshot of it that the team took as we prepared for the ill fated session that got cancelled due to the evacuation the other week. And so I suppose one of the things that I’m interested in today is any particular concerns or questions that you might have about the assessment experience for clients or assessors under the MPS thinking about the future. And we know that there are unique challenges in rural and remote areas. So please if you do have any comments or questions pop them into the chat but obviously also happy to talk in the Q&A. But now that Cathy’s had a break and I’ve talked about the Assessment Experience Project I’ll hand back to her for the final section of the webinar.
Cathy Milfull:
[Visual of slide with text saying ‘Transitional arrangements for current individuals accessing the MPS program’, ‘Cathy Milfull, A/g Assistant Secretary, Thin Markets Branch’]
Thanks Katherine. And everyone I do encourage you to get those questions in while we’ve got Katherine with us because the Bill and the Act is one thing but we’re very conscious that it’s not all about the legislation. It’s really important that the practical process works and works well. So we really can’t emphasise enough I think that we want to hear from you. You will understand where those pain points are and what we can do to address it. So feel free to jump in or reach out to us separately as well.
So moving on. I just wanted to talk more about transitional arrangements. So up until now what Katherine and I have really been talking about is what happens with new clients who commence with MPS but also we need to talk about existing clients, so what happens to individuals who are already in your MPS for example when the new Act starts. So a separate Bill is being drafted which will allow us to make special transitional arrangements for existing clients and providers where we need to. Up until now we’ve been talking quite a bit about providers with the group in terms of deeming arrangements and what’s going to happen to make sure you as an existing MPS provider can be deemed over to be a registered provider on 1 July 2025. And now that the Bill is introduced we will be progressing those discussions with providers. But today the focus is really on older people themselves, so the people in your service. We really need to now work with you all to manage the care of these people when the Act commences and make sure there’s no issues. We want continuity of service for those individuals.
So as per this slide there are particular challenges here for MPS. So that’s why we’re really keen to start these discussions with you and make sure that we are able to identify the individuals in your care and the services they are accessing. We will then need to make sure that those people meet any legal requirements for transition under the new Act and that those people have their position under the new Act documented and explained to them.
So there’s quite a lot of work to do in terms of identifying these transitional cohorts. So we’ll be commencing preparations to engage with each of the jurisdictions to confirm the most efficient approach for doing this and we’ve already started these discussions at a high level with the MPS working group. But we’re really keen to get moving on this now so there’s not a last minute rush in 2025, or worse, older people are somehow negatively affected. So we really need your help to identify the relevant individuals and get their details recorded in our aged care systems.
So as I mentioned earlier we also need to get your help to ensure any transitional requirements are met. I would really like to say that I have all the details of these already but I don’t as the Bill is still being drafted and the transitional Bill will also have rules that sit under that Bill. But we really don’t want to wait any longer with this to progress discussions and we really want to work with providers and jurisdictions to identify any hurdles early. As noted on this slide it’s also expected that there’s going to be different requirements that need to be met by individuals who we want to continue to access residential care in an MPS as opposed to those individuals in your communities that you might be providing services to in their home or in the community.
So what are we likely to need to know. So this is a bit of a complex slide but just in short you can see it’s split on the one hand into residential care services and the other home or community. So if you have a person that’s in residential care while this is still being worked out as I mentioned what we think we’re going to need to know is we’re going to need to be able to identify who the person is. We’re going to want to know are they accessing respite or permanent residential care in your MPS. We think we’re going to need you to confirm that the person has some kind of infirmity, illness, disease, incapacity or disability. And we’re going to want you to advise us on what information your assessment is based. For example have they had an ACAT? Did a GP complete an assessment or is there medical information available on their file?
Look I’ve got to say we are still confirming what level of information and/or evidence will actually be required from a legal perspective and we suspect it might be different for individuals who had an ACAT already and those who haven’t. But we’re keen to share with you now as much as we can early on and to get your thoughts and ideas if there’s a problem. Our aim is certainly to avoid people requiring a further new IAT assessment where possible though we do note that after the Act commences if someone then moves from an MPS to for example a mainstream residential care service they may need further assessments. So that’s residential care.
On the home care side there will be similar processes in place but we will probably need slightly different information from you including the reasons why the person requires aged care services. But this is still being confirmed. But you can see on the slide there it gives you an example that we’d want some kind of advice from you that you’re providing services that support the person to live in the community and prevent their isolation and keep them at home and not in residential care or a hospital. So that’s where we’re at at the moment.
So things to remember. I think it’s just important to remember that July 2025 is the starting point for all this. The transitional arrangements are really about ensuring we don’t disrupt services for existing MPS clients where possible. But to do this we’re going to need your data and we’re going to need your help. So we would really encourage you to start reviewing what client records you have for your MPS clients and whether you’re in a position to provide these to us. For individuals that have never been recorded ever in the Commonwealth aged care systems at all, for example because they’ve never done an ACAT, we would also really encourage you to at least get their details recorded in My Aged Care as a first step. We will then come back to you with more details about what level of information we require and any additional processes required to transition them over as obviously we don’t want to put you all to extra effort for things we don’t need. So please don’t worry. We will confirm exactly what’s required.
All right. So I think that’s the Act for now and transitionals. Moving on just to the last topic of the day just before we move to Q&A. So we just wanted to give you a few small updates. So firstly here we’ve got our usual schedule of MPS reforms on the screen at the moment. Look this really hasn’t changed but you can see we’re now in that October space and that’s with the MPS allocation round. But apart from that no changes at the moment but just please be aware now that the Bill has been introduced we’ll continue to monitor the timeframes that are listed here for each of the projects and what makes sense depending on when the new Act passes and is implemented.
All right. So just a couple of other quick updates. In terms of the 24/7 and direct care trials, so that’s one of the reforms too that we’re keeping an eye out in terms of timeframes. You can see here that my team have been out visiting participating sites and we really thank all the sites for their participation in the trial so far and for welcoming my team and their open approach to discussing the issues with them. I know they’ve found it really helpful so far. So we’ve had the first 24/7 reporting period now completed and so far the arrangements seem to be working well. But that’s something that we will be discussing at the first proposed reform implementation sub working group which is being now scheduled for late October. So at that meeting we’ll also discuss the findings from those site visits and also recent surveys that participating sites have submitted to us to give their feedback not just for example on 24/7 but how they’ve found the reporting process and any ideas or suggestions for improvement.
All right. So just a couple of extra updates here. I mentioned the MPS allocations round. So just a reminder that that’s open at the moment with applications closing on the 25th of October. So that’s really the mechanism via which your MPS can get additional residential care places. The second ACCAP round has also now closed and just for your information we’re hoping decisions will be made before the end of – sorry. That should just be the calendar year. Hopefully definitely I think in December. And just a reminder that what we know as Rural LAP or the Rural Locum Assistance Program has also been extended up until 30 June 2025. So just a reminder that this program is available to assist with locum support where you’ve got staff needing to leave your MPS to do professional development or there’s high staff turnover. So it’s available for a range of positions as we’ve noted there and there’s also funding available for relocation and retention incentive payments. So just flagging that because my team did note when they were travelling around to various sites recently that some providers didn’t seem to be aware of this program. So please let us know if you need more information but it is really there to help rural and remote providers where they’ve got staffing challenges. So please do make yourself available to that program where you’re eligible to do so.
All right. Lastly just a final reminder before we go really to the Q&A session. Just wanted to say don’t forget that there are requirements for managing and preventing incidents that we know as SIRS which do apply to MPS providers when delivering home or residential care services. So this includes reporting, what’s known as reportable incidents, and specific obligations particularly under the Quality of Care Principles. So you need to have an incident management system in place. You need to use this data to drive quality improvement and there’s certain incidents that you need to notify the Aged Care Quality and Safety Commission of. So look I’m not going to go into too much detail here. There’s lots of resources on the Commission’s website and I understand they are actually going to look to reach out to providers soon just to give you some more information. And that was really just because some providers seemed to be unaware of these responsibilities recently so we want to make sure that everybody’s on the same page regarding their obligations here particularly because these obligations will continue to apply under the new Aged Care Act. So if you do need any extra assistance, training or explanation including around the use of restrictive practices it would be I think really useful to address that as soon as you can and reach out for additional assistance if you need it prior to the new Act coming into place.
So I think that’s really it from me team. But it looks like I’ve either stunned everyone into silence or they’re feeling shy today. So I don’t think we have any additional questions. Just checking with my team.
I think someone asked. We definitely will share the slides so don’t worry about that. And the team have put in lots of links in the Q&A as well. Okay. Well I might say going, going, gone all. No questions. So hopefully that all was really clear for you but please feel free to reach out as I said if you’ve got any other questions. Happy to give you a buzz. We really welcome your participation today. And Katherine I really wanted to say thank you to you as well for coming along. We really appreciate your time. But if that’s it for everyone we’ll leave it there. And we’ll see you next time for the November webinar. Thanks everyone. Take care. Bye.
[End of Transcript]

Cathy Milfull:

Okay. Thanks everyone for joining us for this third MPS reform webinar. My name’s Cathy Milfull and I’m still Acting Assistant Secretary of Thin Markets Branch which is responsible for the MPS Program. So I’ll be hosting the webinar again today. It’s great to be back with you. Also pleased to introduce Simon Christopher who you can see on the screen from our Regulatory Strategy area, and Tanya Clancy from my MPS team. And also our special guest star Margaret Banks from the Australian Commission on Quality and Safety in Health Care. So all joining me on the panel today.

As per the last webinar we’re going to do a formal presentation to start and then we’ll try and leave as much time as we can for a question and answer session at the end. I would like to point out that we have moved to MPS Teams this time so please be a little bit gentle with us. And apologies if there are a few hiccups today or somebody inevitably forgets to turn off their microphone or something of that nature. So unless technology defeats us today though we still want to make this as interactive as possible so just like last time you can certainly submit questions throughout the whole webinar and we’ll try and answer those at the panel session at the end. But just so everyone knows there’s a Q&A panel that you can open on your right and that’s where you put those questions in. So you don’t have to open a separate program anymore which is great.

We’ll try and get to as many questions as we can but don’t worry if we don’t. We’ll publish a list of questions and answers on our new MPS Reforms web page which I have talked about a couple of times before but I’m pleased to say should go live this week. So I’ll get the team to send around a link when that happens. And on that page then will be all our Q&As plus also links to these webinars which are recorded if you want to view them again and also to our slide packs. I did just want to say that we have disabled the chat function this time around but if you do have any problems today with the webinar if you just use that Q&A function we’ll still get the information that’s needed.

So look that’s probably the housekeeping for now so I’ll get my team to bring up the slides and we’ll get started with the formal presentation. But just before we do I just wanted to acknowledge the traditional owners of the lands on which we’re meeting today all across Australia. I would like to pay my respects to Elders past, present and emerging, and I also want to welcome any Aboriginal or Torres Strait Islander peoples here with us today.

[Visual of slide with text saying ‘Multi-Purpose Service (MPS) Webinar 3:’, ‘Aged care reforms:’, ‘impacts on the MPS program & providers’, ’29 July 2024’, ‘Thin Markets Branch’, ‘Australian Government with Crest (logo)’, ‘Department of Health and Aged Care’, ‘www.health.gov.au’]

All right. So just to get started this slide outlines what we’re going to cover today. As with previous webinars I’m going to start off myself just giving a few quick updates regarding recent reforms that are relevant to MPS. I’ll then hand over to Tanya who’s going to talk about our direct care trial. Margaret will then talk to the new MPS Module which is being developed to reflect the coming strengthened Aged Care Quality Standards. And lastly before opening up to Q&A Simon will continue the discussion that we’ve been having around expected provider obligations under the new Act and its rules, this time focusing on provider obligations more broadly as opposed to conditions on registration. And as flagged previously just a reminder that the rules for the new Act are still under development so this is preliminary information only and may change.

All right. So this next slide just tells you our future suggested schedule for next webinars. I just wanted to flag that to date we have been focusing very much on topics related to provider obligations and regulations and we’ll certainly return to this rather large topic in September. But as you can see for next month we do want to make a bit of a shift because we’re keen to look more at if you like the MPS client journey under the new Act, so what are the impacts on client pathways requirements. We’ll be talking about eligibility and assessment arrangements for new entrants to MPS but importantly we also want to talk about transitional arrangements for existing individuals who are already for example residents in your MPSs. 

So if there any particular really burning issues or questions you have in that space please feel free to shoot them through to my team in advance so we can make sure that we cover them at the August webinar. And as always the invitation is open for you to suggest additional topics for future webinars.

[Visual of slide with text saying ‘Quick updates’, ‘Cathy Milfull, A/g Assistant Secretary, Thin Markets Branch’]

All right. So we’ll move onto just our standard quick updates. This slide shows you an updated version of our MPS reforms schedule that we’ve been using. I’m pleased to say nothing’s really changed this time around in terms of upcoming reform items. We’ve just amended the slide to reflect the actions that have already been completed. So you can see that really our next focus is the expansion round for the MPS Program in September/October this year. And I just wanted to mention for your information that it’s been agreed with the MPS Working Group that this upcoming allocation round will be for residential care places only. If however it’s agreed to be needed we may consider a further round early next year that focus specifically on home care places.

All right. Next up. What’s next with the new Aged Care Act? Look I don’t have a lot of new things to say about the Act today. Just reaffirming that subject to Parliamentary processes we’re still tagging the 1st of July 2025 for a start date. But as you might have seen reported in the media there’s quite a lot of Parliamentary discussions underway at the moment around the Bill and the Government’s response to the Aged Care Taskforce report in particular. So as a result we await confirmation of a date for introduction into Parliament for the Bill. 

But it’s certainly not pens down in any sense and we’re making the most of this time to continue drafting the Rules so that we can share them during Parliamentary passage in priority groups. And we’re working on the transitional and consequential Bills which is now a focus. I just thought today it might just be worth clarifying for those who are not familiar with the terminology too, the transitional Bill is basically used to preserve the position of existing aged care clients and providers under the new Act. This is important as the existing Act and subordinate legislation will cease when the new one commences. So you sometimes hear people talk about grandfathering or grandparenting arrangements but I think this can sometimes be a little bit confusing. While transitional arrangements will certainly be used to preserve equivalent entitlements so people don’t if you like lose out, they do still need to be new provisions agreed to by Government and Parliament as the old provisions will not continue. So we really need to look at all the cohorts and scenarios that impact existing clients and providers.

On the other hand consequentials will cover changes required to other legislation. So there might be for example health legislation, tax legislation, disability support legislation, anything that references the current Aged Care Act we also need to review that and make appropriate amendments where necessary.

All right. Next update was just on the Integrated Assessment Tool or the IAT as it’s commonly known. So I’m sure many of you will be aware this has replaced what was known as the NSAF or the National Aged Care Screening and Assessment Form. So as of 1 July this is now the new tool used to assess the eligibility of older people for Commonwealth subsidised aged care. As the new Act is not in place yet such assessments are not mandatory from an MPS perspective. Nevertheless we would certainly encourage you to still get clients assessed where you can, noting that our previous reporting has shown that the majority of MPS clients have been having ACAT assessments even though it’s not mandatory. If you do this this will help with the transition of existing clients to the new Act.

I can also confirm that there are no changes to the services/programs that can be recommended in the IAT support plan and the support plan completed after the IAT still has the same look and feel. If you’re interested to see what type of questions are used in the new IAT there’s an offline form that’s available on the Department’s website.

So why the IAT? This slide highlights for you some key benefits of the IAT. Look I’m not going to go into too much detail today but just to reiterate that the tool is designed to achieve consistency. It’s designed to ensure proportionate assessments. And also really we want to ensure that older people are only required to tell their story once. Also just important to note that the IAT will become even more important with the new Act because that assessment will be required to support decisions made under the new Aged Care Act and that will include for MPS clients. So that’s why we’ll talk about this in a lot more detail at the August webinar.

Okay. Lastly just a couple more quick updates from me before I hand over to Tanya. Firstly on the 24/7 registered nursing trial. So my team’s been holding a lot of meetings with participating sites and really would thank everybody for all their engagement and feedback so far which I understand has been really positive. We’ll be having our first trial reporting period taking place in August which is pretty exciting and the team will soon get out a reminder email to participating sites with the reporting template for completion. 

Just wanted to clarify a few things though about this trial while I have everybody just in response to feedback. Firstly that the trial related documentation is in draft and that’s because it is intended to be improved as the trial continues. But we’ll certainly make sure we share the most up to date trial documentation on our new reform website so it’s easy for you to access and we’ll notify trial sites when there’s been a significant change. Also just wanted to clarify that there are no changes to mainstream 24/7 nursing requirements as a result of this trial. So those arrangements remain in place for now.

And lastly just want to say we are very happy to develop additional support material. So for those trial sites if there are other things that you think would be helpful, for example could improve the consistency of reporting, please just sing out to the team.

All right. So last two updates. Payments. Just quickly on payments, our first quarterly payments for 24-25 went out earlier this month as well as workbooks that explain those payment calculations which have been distributed. And the annual activity report. Just a reminder that we actually have two for the price of one this week. We have a second webinar that is being held on Wednesday that’s specifically on the MPS annual activity report. So we would encourage staff that are specifically involved in that process to dial in and get some advice from my team.

All right. I think that’s it from me so I will now hand over to Tanya who will talk to you about the direct care target trial.

Tanya Clancy:

[Visual of slide with text saying ‘Direct care targets trial’, ‘Tanya Clancy, Assistant Director, Rural & Remote Policy and MPS Section’]

Good afternoon everyone. Thank you Cathy. I’m going to speak to you today about the direct care target trial. So this initiative has been designed to identify an equivalent mechanism to the care minutes requirements for mainstream residential care so that we have assurance of the levels of direct care being provided to residents in MPS. We recognise that given the circumstances MPS are operating in and the absence of AN-ACC classifications for residents that a tailored approach to targets will be required for MPS. We also acknowledge that the environment in which MPS operate may also offer other methods for providing assurance that MPS residents are being provided with sufficient levels of direct care.

We have commenced a phased trial of direct care targets for MPS with a number of sites in South Australia, WA and Victoria and you can see on the map the locations of these sites. Participating sites in these jurisdictions have been nominated through their state and territory representatives on the MPS Working Group. As of the 26th of July we have 47 MPS sites participating with 11 from South Australia, 26 in Queensland, one in Western Australia and eight in Victoria. All MPS in participating jurisdictions would have received additional funding to support direct care target implementation in their first quarterly payment. This is to support improved care outcomes across the board and help everyone prepare for further phases of the trial. While at this stage only some sites are formally participating we are keen for all MPS sites in participating jurisdictions to get involved and support their trial sites as well.

So the implementation timeline. The trial is split into a number of phases. Phase 1 which runs from July to December will be with the nominated Phase 1 trial sites to develop and agree to a direct care target approach to be trialled in Phase 2. Subject to Phase 1 results and further discussion with the MPS Working Group Phase 2 will involve a trial of an agreed direct care target approach or approaches in nominated MPS sites from January ’25 to June ’25. That’s to test workability and the need for any further adjustments. Phase 3 will then involve a trial of an agreed direct care target approach in all MPS sites anticipated to commence 1 July 2025. Phase 4 will involve formal commencement of direct care requirements or equivalent at a date determined in agreement with states and territories. At each phase we intend to confirm the proposed timeline remains appropriate, taking into account issues identified and options for resolution found through previous phases.

So the purpose of the direct care target trial. What we want to do is develop an approach to direct care targets that best suits the circumstances of the MPS program while retaining our shared strong commitment to ensuring appropriate staffing time for residents. During Phase 1 of the trial we will be working collaboratively with MPS providers to undertake planning and design work with a view to determining how direct care targets can or should apply in an integrated health/aged care context including in the absence of AN-ACC assessments. We will also be considering whether there is a need for alternative reporting and assurance mechanisms, and also whether we should use alternative terminology when considering direct care target requirements for MPS. 

Though while we work this out you will see us talking about direct care targets rather than care minutes. We note that even for mainstream residential care this is the language actually used in legislation as well and will be in the new Act with care minutes the more common operational terminology that has been used.

The work undertaken in Phase 1 and the learnings from this work will be used to determine next steps for the Phase 2 trial where a direct care target approach or approaches will be actively trialled in nominated sites.

So next steps. So if you are a participating site in the direct care target trial you should have received an email with a fact sheet and a link to an online survey for completion by the end of August. If you are a participating site but haven’t yet received this email and link please reach out to the team at MPSreforms@health.gov.au and we can assist you.

Thank you very much. And I will now hand over to Margaret Banks to talk about the revised MPS module.

[Visual of slide with text saying ‘New Quality Standards and the MPS Module’, ‘Margaret Banks, Director, National Standards Program’, ‘Australian Commission on Safety and Quality in Health Care (ACSQHC)’]

Simon Christopher:

You might be on mute Margaret. Sorry.

Margaret Banks:

I apologise. Can I please note that I’m on the lands of the Gadigal people of the Eora nation from the office where I’m speaking today, pay my respects to the custodians, the Aboriginal and Torres Strait Islander custodians of the lands on which we all meet.

So since 2013 the MPS has been required to comply with the National Safety and Quality Health Service Standards and then since 2020 we’ve had in place a Multipurpose Service Aged Care Module. The Module has allowed MPSs to be assessed to two different sets of standards in one assessment process. This has reduced the compliance burden particularly in small services while giving the regulators and the community and funders assurance that the standards are being met.

The actions in the MPS module are ones that are unique to the Aged Care Standards and they cover areas that are really not addressed in the National Safety and Quality Standards. The Commission has been involved in the development of the Aged Care Quality Standards this time around and been responsible for the development of Standard 5 and quite a lot of the input around each of the other Standards. So you’ll see there’s a higher degree of consistency in the way that the Standards are being approached.

With the development of the new Standards, the new Aged Care Quality Standards, a new Module needs to be developed. And so the requirements of the two sets of Standards have been mapped and the aged care specific actions are again being identified and pulled out. The Module will be circulated to MPSs and other key stakeholders in part to identify the resources that you might need to particularly implement a Module. There is though a significant amount of work already underway and the Aged Care Commission as well as the Health Care Commission have developed a swathe of different resources that MPSs will be able to access. Maybe you could move onto the next slide please.

The Commission will provide a mapping document so that if you’re looking for resources that the Aged Care Commission has developed which they are providing by their action number, which will be different to the National Standards and the Module, you’ll be able to track it one to the other and be able to navigate between the two different sets of Standards. In addition the Commission has developed resources that are specific to the National Standards and will be resources developed for the Module.

In terms of assessment for MPSs nothing really substantial will change. You’ll still be assessed in line with the rules and the requirements of the National Safety and Quality Standards. So that’s short notice assessments on a three year accreditation cycle with 24 hours’ notice. You will however be assessed to both the National Standards and the Aged Care Module once the MPS Aged Care Module has been finalised. 

Now I’m happy to take questions. There’s still quite a lot of work to be done in relation to this Module. We’ve done all the preliminary mapping but we now need to restructure it and put it into actions that make sense in relation to the National Standards. At the moment it’s looking like ten instead of six actions but that’s still to be finalised. And certainly we’ll let you know and provide you with draft copies as soon as they’re available.

And so on that note if I could then hand over to Simon Christopher for further discussion on provider obligations and the new Act.

Simon Christopher:

[Visual of slide with text saying ‘Provider obligations under the new Act’, ‘(Part 2 – continued from previous webinar)’, ‘Simon Christopher, Director, Harmonisation and Regulatory Strategy Branch’]

Thanks very much Margaret and good afternoon everyone. It’s good to be talking with you again. Today we’ll go over a quick refresher of provider obligations under the new Act and we’ll highlight a couple of obligations specifically that might be new or varied for MPS providers.

First a quick reminder of what’s different in terms of provider obligations under the new Act. Revised provider obligations will be in place when the new Act commences. These will be presented as either conditions on registration which include compliance with the Quality Standards, specific obligations or new duties placed on providers. They will reflect obligations that already apply via Part 4 of the current Act, related principles and standards, as well as MPS agreements. They will be collocated and easier to understand and navigate. Obligations will apply to MPS providers where they are not specifically excluded from application in the rules. There will be some new obligations but most are similar or varied and streamlined where possible. Just move to the next slide if we can please.

Registration conditions are described in Chapter 3, Part 4, Division 2 of the Bill for the new Act. For some obligations significant additional details will be provided in the rules including the details of requirements to be met and the kinds of providers that must comply with them. Provider obligations as opposed to conditions often relate to matters that are relevant to the Department’s function as the aged care system governor as well as the Commission’s functions as the regulator. As I mentioned previously when we last met key parts of the new rules are expected to be released for public consultation after the Bill for the new Act has been introduced to Parliament. This will support Parliamentary discussions on the Bill including committee investigations. We welcome your further feedback and suggestions as the rules continue to be drafted and are released for consultation. We would be particularly interested to hear if there’s anything problematic in an MPS context.

Like last time these next two slides are designed to show you what is likely to be the same or different in terms of specific obligations on MPS providers. On this first slide you’ll see the obligations relating to reporting and notifications. In both cases it’s anticipated that there may be some additional or varied requirements for MPS providers however we will work through this in more detail with the MPS Working Group and yourselves as drafting of the rules continues. This will be important to ensure we can minimise any unnecessary duplicative regulation and that these obligations are clear, noting that both of these obligations are civil penalty provisions where non-compliance exists. 

The type of reporting required from MPS providers is likely to remain the same however this is a good time to make sure everyone is clear on their obligations and to consider anything that could be done differently or more effectively. As a result we would encourage you to share any concerns about existing arrangements with the MPS team. It is also important to understand that there is expected to be a clear obligation to ensure information reported is accurate. Clearly this is already implied but the new legislation will be clearer on this matter.

Notification is arguably a type of reporting as well however here we are talking about ad hoc requirements to notify the Aged Care Commission for example where certain events occur. They contrast to the regular cyclical reporting requirements as flagged.

New notifications expected to be required under the Act include when there have been significant changes in the scale of service delivery, the service types delivered or changes to associated providers. These are to ensure that information for clients around services delivered by providers are able to be kept up to date and to inform the regulator or the Department as the system steward of changes in the aged care market that could impact the quality or availability of services. The Act includes that notification must firstly be given within the earlier of 14 days after either the event has occurred or the provider becomes aware of the change in circumstances and are to be provided in an approved form.

Further information in relation to notifications or change of circumstances or events of a kind which will be prescribed by the rules. So we will certainly share more detail on this as it becomes available. Just jump to the next slide thank you.

So this slide outlines obligations where no significant changes are expected. This includes obligations to responsible persons and the Code of Conduct. So that brings me to the end of my presentation so back to you Cathy and look forward to some questions in a moment.

Cathy Milfull:

Thanks Simon and thanks everyone. So I would like to open the Q&A session. Although at this point I think we’ve only got two questions so would encourage providers out there to get in any other questions that you have while I look at the first two, which I think both really relate to those new IAT arrangements. So the first question was:

Q:        Will all existing current MPS residents require reassessment on the IAT by July 2025 even if they are already assessed under the NSAF?

So look we’ll talk more about that next webinar but basically I think my answer would be where at all possible we want to avoid reassessments. We don’t want existing clients have to go through reassessments as a matter of course for the new Act where possible, noting that often they may regularly require reassessment at some point anyway. But we will have some legal and constitutional requirements that need to be met so we’ll talk to you about those in August. I would say though to get these arrangements working we are likely to need to know which clients are currently accessing services from your MPS and what are the services they’re currently accessing. And we may also need to confirm certain information with you about their aged care needs. So we’ll go through that in more detail next time but we’re hoping to be able to if you like group existing clients into cohorts to be able to confirm certain information with you about those and then hopefully we can avoid reassessment in most cases.

I think we also had a similar question.

Q:        Will the IAT be compulsory for all new MPS residents following launch of the Aged Care Act or will there be a lead time before it is compulsory?

So essentially at this stage the intention is that when the new Aged Care Act commences anyone who is seeking subsidised aged care after that time, they would need to apply under the new provisions in the Act. They’ll have to have their eligibility assessed and go through an assessment process which yes will be based on the IAT. So yes in that sense it will be compulsory. At this time there’s no sort of transitional period post commencement of the Act but we can certainly discuss that further next week. Next month sorry. I’m getting excited.

Other questions.

Margaret I might throw one to you if that’s all right. We’ve got:

Q:        Will the Aged Care Module cover services delivered in the community as well as bed based, so I’m assuming residential aged care? 

Margaret Banks:

Absolutely. We expect that the National Standards if they’re applied to a facility and the Module will cover all of those services.

Cathy Milfull:

Thanks Margaret. Simon. And I don’t know if you can answer this off the top of your head, but we’ve been asked for some clarity on any financial penalty for not notifying of material changes within the timeframe.

Simon Christopher:

Thanks Cathy. So the current draft of the Bill has penalty units applied at 30 units. Obviously that’s all still subject to Parliamentary processes and again that’s subject to the Aged Care Quality and Safety Commission taking action for a breach of that provision. But I think the main point to focus in on there is really the importance of those updates of information are flagged in such a way as there’s a penalty provision applied to that notification process. And we think that that helps change behaviour across the entire provider cohort to ensure that we’ve got the most accurate and up to date information.

Cathy Milfull:

Thanks Simon. And I think as Simon’s talked to the group before, obviously the aim of the new model is to have a suite of regulatory powers available to deal with particular scenarios. So it’s not a situation where people are jumping straight to massive financial penalties because someone hasn’t completed a report obviously. I’m sure I’m not speaking for the Aged Care Commission here but they’d be looking at the provider’s conduct as a whole and also past conduct, is there a repeated pattern of issue here. So they’re the sorts of things that we will need to take into account.

Other questions?

Q:        Will there be an invite sent out for the webinar on the 31st?

Tanya I might throw that to you. I’m sure we’ll get invites out as soon as we can. There might just be a placeholder at the moment I suspect.

Tanya Clancy:

Yeah. I’ll look into that as soon as the webinar finishes.

Cathy Milfull:

Excellent. Anything new coming in?

Q:        Could you please share a link to the Exposure Draft for the Aged Care Act?

Yes we can certainly do that. Either post in the chat or I’ll get the team to send it out for you. But no problems there.

All right. Have I missed any questions team, panel members?

Margaret Banks:

No. Can’t see any extras. No.

Cathy Milfull:

Okay. And thanks Kate. You’ve posted the link to the Exposure Draft. That’s great. All right. Well if there’s no other questions we might leave it there and make it short and sweet today. Sorry Simon. 

Simon Christopher:

Yeah. Thanks Cathy. I was just going to just pick up on the Exposure Draft. The copy that’s in there is probably the consultation Exposure Draft. So I would just flag that some of the additional detail in the next iteration of the Bill will become available once that’s introduced to Parliament. So we can circulate that at that point. I just wanted to clarify that what we’ve got is what’s been publicly available to date. So once we cross that threshold we’ll be more than happy to make sure that’s circulated to the group.

Cathy Milfull:

Thanks Simon and good point. All right. Well I’m not seeing any other questions come in. So look that might be short and sweet today. But as I said next time we’ll have a more focused conversation on MPS clients under the new Act. If you have any things you particularly want us to address let us know. Otherwise I wanted to say a big thank you to Simon who’s come along to a number of our webinars now, and also Margaret for joining us. Much appreciated. And Tanya and my whole team for all their brilliant organisation as usual. So thanks everyone. Great to catch up with you and looking forward to talking with you further next month. Okay. Bye.

[End of Transcript]

Cathy Milfull:

All right. I think I’ll kick off everyone. Thanks for joining us for this second MPS reform webinar. My name’s Cathy Milfull. I’m currently Acting Assistant Secretary of Thin Markets Branch in the Department and MPS is my responsibility so I’ll be hosting today’s webinar. Just wanted to introduce also Tanya and Simon who you can see on the screen today, and they’re both Directors in our Regulatory Strategy and MPS team. So they’ll be joining me on the panel and helping answer your questions.

So just a bit of housekeeping to get started. As per the last webinar we’re going to start this webinar with a formal presentation and then we’ll proceed into a question and answer session at the end. So you can submit questions like last time on the side through the Slido function. You don’t need to wait until the end. In fact as soon as you think of something just add it to the Slido so everyone can see. That would be great. We’ll try and get to as many questions as we can but don’t worry if yours doesn’t come up. My team are actually about to finalise a new MPS reforms web page and that’s kind of going to be designed to be a bit of a one stop shop for all our MPS reform material. So we’ll put written answers to those Q&As on that page as well.

If you have any other concerns during the presentation, if there’s a problem with sound, if I inevitably forget to go off mute, then please just let us know in the chat function. But yeah I think that’s pretty much all the housekeeping for today. So I’ll get my team to bring up the slides and we’ll get started. 

But before I start the formal presentation I did just want to acknowledge the traditional owners of the lands on which we’re meeting today across all of us across different parts of Australia. I would like to pay my respects to Elders past, present and emerging. I also want to welcome any Aboriginal and Torres Strait Islander peoples here with us today.

[Visual of slide with text saying ‘Multi-Purpose Services (MPS) Webinar 2:’, ‘Aged care reforms:’, ‘impacts on the MPS program & providers’, ’19 June 2024’, ‘Thin Markets Branch’, ‘Australian Government with Crest (logo)’, ‘Department of Health and Aged Care’, ‘www.health.gov.au’]

Okay. So thanks for the slides guys. So the first slide here just outlines what we intend to cover today. First off I want to provide you with an update on the new Aged Care Act and anything else that has changed about our draft MPS reform schedule since our last webinar. Then I’m going to move on to talk about 24/7 registered nurse trial for MPS which is a key focus for today. We are keen to provide you with more details about what is proposed and get your further feedback and questions before we finalise our communications pack for participating trial sites.

Before the question and answer session I’ll then hand over to Simon Christopher who’s going to talk to you today about provider obligations under the new Aged Care Act and specifically today the conditions that will be placed on registered providers. I just wanted to say upfront when listening to Simon it’s important to note that a lot of the details of those conditions will actually be included in subordinate legislation or what we refer to as the rules. These rules are still in the process of being developed. So to be blunt I’m sure we won’t have all the answers that you’d really like to want right now but our aim is to share as much information as we can at this stage. We hope that will help us head off any potential issues for MPS providers as early as possible and we hope that pre-armed with this information you’ll be in a better position to assist the states and territories to provide more formal feedback on key draft rules when they’re available.

Okay. So this next slide is just a reminder of our suggested schedule for future webinar topics. As you can see July next up we’ll continue this discussion around provider obligations. We’re also hoping to have the representatives of the Aged Care and Health Commissions here with us next time so they can talk to you about the new Standards on providers and also the MPS module that’s being developed. We’re also suggesting we talk about assessment arrangements under the new Act, just give you a further update on 24/7 and care minutes trials and if we are in a position to do so talk a bit about transitional arrangements under the new Act for individuals who are already accessing MPS services when the new Act commences.

But as always if you’ve got suggestions please sing out to my team so we can have a rethink about this schedule. We really want to make sure that the webinars are as useful as possible for providers and you might just have some different views about what is priority to discuss at this time.

[Visual of slide with text saying ‘The new Aged Care Act & MPS reform update’, ‘Cathy Milfull, A/g Assistant Secretary, Thin Market Branch’]

All right. So we’ll move onto the main part of the presentation now. Firstly I just wanted to give you an update on the new Act timeframes. Since our last webinar there has been some movement on this with the new Act proposed to commence subject to Parliamentary processes on 1 July 2025. I just wanted to make sure everyone was aware of that as it was announced during the Budget recently but I’m conscious there’s a lot of information to take in at Budget time.

So why did this happen? I mean this change basically reflects feedback received on the Exposure Draft of the Bill for the new Act which overall was pretty positive but it did raise concerns about the proposed implementation timeframes. So I wanted to just thank everyone who did provide feedback on the Exposure Draft including via your state and territory agencies. It’s greatly appreciated.

As flagged on the slide here a consultation feedback report was published on the 30th of May. So that’s on the Departmental website. And I might just ask my team to pop that in the chat for you, a link, in case you’re interested in reading about the overall feedback on the Bill. That’s really the place to go. I did just put some of the common matters raised on the slide here that I thought were particularly relevant to an MPS perspective. So as I’ve already mentioned implementation timeframes was really the key concern raised and giving providers enough time to get ready. Some providers also raised concerns about the ability to deliver services in a way that upholds older people’s rights, so as outlined in the proposed new Statement of Rights. They also raised concerns about the proposed new duties on board members and other responsible people which we plan to talk to you specifically about at our next webinar in July. 

Other concerns related more not to concepts but how things work in practice, in particular the new supported decision making arrangements, so how nominees and representatives for older people will be appointed, as well as whistleblower protections and the definition of high quality care. There were also some concerns raised about the new Complaints Commissioner’s level of independence. So if you have a chance to read the consultation feedback report I’d encourage you to do so but if it raises any new questions for you feel free to reach out to my team and/or send us a note about something you’d particularly like to see discussed at a future webinar.

All right. So what else is happening alongside the new Act? This slide just gives you a few updates since we last talked. Firstly as some of you would be aware we are very close to finalising the variation to our MPS agreements and those variations will extend all agreements out to 30 June 2025. So this will allow us to keep making all our MPS subsidy payments as normal for next financial year which I’m sure will be a relief to everybody.

Really just wanted to say a thank you for helping to finalise these on time. We know there have been some very tight deadlines and we really do appreciate your assistance. As I flagged with the MPS working group we will need to put in place new agreements to align with the commencement of the new Act but the intention is to start this process a lot earlier to make sure we’ve got more time to discuss and make improvements. So the aim is to commence this process really as soon as the Bill for the new Act is finalised and introduced to Parliament and we know what it is that we need to align with.

Since our last webinar as well I’m pleased to say that our next MPS allocations round has been approved. So there will be an announcement about this prior to the formal opening of the round. At the moment we’re targeting September/October for that. But we’ll certainly keep the MPS working group updated with our progress on this so that you have as much warning as possible.

Other two things I wanted to mention on this slide was that our planned amendments to the Aged Care Subsidy determination for 1 July 2024 are underway with the relevant new legislative instrument to be registered this week. So alongside the new agreements this will facilitate payments being made to MPS providers in July. It will allow for subsidy rates to be increased to cater for indexation. And we’ve also spread the subsidy increase that we passed on in April across the full financial year. So that was the one that related to the 5.75% pay rise for workers.

Importantly the new determination also allows us to increase payments for MPS sites in jurisdictions that have agreed to participate in our care minutes trial this year. And we’ve also just made some technical amendments really just to simplify MPS subsidy provisions. I don’t want anyone to worry about this too much as the changes don’t have any practical effect. They’ll just make it easier to transfer the provisions to the new Act and its rules. For example we’ve alphabetised the subsidy formula components. We’ve got rid of ones that were no longer being used and just done a tidy up. So we’ve replaced for example the terminology of low and high care places that haven’t been used in the program for a number of years and we just use the term residential care places. We’ve also introduced a term of an effective place to make it clear how allocated places are used in the subsidy calculation.

So other thing just quickly to mention here is our residential experience survey for MPS is also commencing next week. So that’s great news and many thanks to New South Wales and South Australia in particular and any other sites who are participating. We think that’s a really positive initiative. There have also been some other changes to our proposed reform schedule but I’ll talk about that shortly and then I’ll also move into talk about the 24/7 RN trial.

Okay. So in terms of the proposed schedule of reforms on the slide here we’ve just given you the reform schedule that we showed you at the last webinar. We’ve just made some changes so I just wanted to walk through those with you quickly. Mainly at the top you can see we’ve shifted the green new Aged Care Act box and that’s because as I just mentioned the Bill is now expected to commence no earlier than 1 July 2025 with exact timing still dependent on Parliamentary processes. We’ve also just made two other adjustments which are still under discussion. The first one is a bit of our control though which is basically you might remember we’ve been intending to implement some new ICT functionality to allow MPS subsidies to be calculated automatically rather than manually by my team and paid to providers by Services Australia. This is an important project because it also offers us opportunities to improve reporting for MPS providers and ensure that providers have improved channels to communicate with the Department and easily keep their site information updated. But unfortunately due to funding and availability of ICT resources – I’m sure you could imagine there’s a lot going on in readiness for the new Act – our project’s not going to kick off now until 1 July 2025. So at this stage implementation would be no earlier than some time in 2026 but we’ll keep those discussions going in the meantime.

The other change in red I just wanted to mention here was revised client contributions. We did have that a bit earlier in the schedule but upon review we really think it makes the most sense to progress that change alongside the new MPS funding model. So that will be a matter for Government and also discussion with the working group but we just wanted to flag that at this stage that’s probably moved back slightly. Noting that also we will need to adjust anything to reflect the new provisions in the Aged Care Act to do with fees and payments.

[Visual of slide with text saying ‘24/7 RN trial in MPS – 1 July 2024’, ‘Cathy Milfull, A/g Assistant Secretary, Thin Markets Branch’]

All right. So I’ll now move on to talk about the 24/7 registered nursing initiative which is a key topic for today. This slide just gives you a bit of a recap in terms of where our proposed trial has arisen from. We discussed this at the last webinar so I won’t go into too much detail but really the key points are that the trial period will commence shortly from 1 July 2024. At first it will only involve nominated trial sites. So we’re referring to that as phase one of the trial. We then hope to expand the trial to cover all MPS sites. This is being referred to as phase two. And we’ll then proceed formal implementation under the new Act and its rules when we’re all ready to go.

So I just wanted to reiterate that exact timings will depend on the outcome from each phase and discussions with jurisdictions. Also just a reminder that there will be no penalties for non-compliance in either phase one or phase two. And then even when we go to formal implementation the Aged Care Quality and Safety Commission has publicly stated that it’s unlikely to consider escalated compliance action in relation to providers who don’t meet their 24/7 responsibility where they’re making genuine, ongoing effort to meet their responsibilities, they’re providing quality and safe care to consumers, and there are no other concerns about their compliance or performance.

So what’s the purpose of the trial? Why are we doing it? This slide just gives you a bit of a summary but basically we want to test 24/7 arrangements in the MPS context and determine if adjustments are required. We want to see if the reporting arrangements for mainstream providers are sensible in the MPS context. So can we do it better? Can we streamline the reporting? How often should MPS providers for example report on this? We also want to consider any necessary exemptions for smaller MPS providers and test whether the current mainstream exemptions for example would actually work in our MPS context. We also want to understand any additional costs that will be associated with compliance and 24/7 responsibilities.

So where are we at? Well who’s going to be participating in phase one? I won’t name them all but I’m very proud to say we’ve had nominations from more than 46 sites across the country as reflected on this slide. As you can see there are a significant number of sites in WA, South Australia and Queensland in particular as well as some sites in New South Wales and Victoria. So that’s really a fantastic outcome and we really thank everybody who volunteered to participate.

So for those providers who are participating in phase one what does that look like? We’ve given you a diagram here at a high level to show how phase one is proposed to proceed. I guess just to summarise once we get feedback today from this webinar and from our MPS working group members this week we aim to send a communications pack to all trial sites next week. We want to give sites July to really digest this information and the intention is also to run a specific short webinar or Q&A session just to answer any questions sites have about the materials.

August will then be the first trial reporting period with reports and a survey due from trial sites in early September. The aim is then to hold a meeting of our new reform implementation sub‑working group in mid-September so we can discuss with providers their initial experiences and any changes that we want to make before a second round of reporting in October. A further implementation sub-working group would then be held in November to discuss the outcomes of round two and any further suggested changes that we want to implement. We’ll then have a discussion with our MPS working group late in the year about the outcomes from both round one and two and see where everyone’s at before we reach agreement to proceed to phase two and to roll out the trial more broadly.

So if you are a participating trial site what will the trial really involve for you? As you can see here mainly it’s just filling out a report for the August and October reporting periods only at this stage. We’ll also ask you to complete a survey in parallel to record your trial experiences and we’re keen for you to participate in the implementation sub-working group to give your feedback and suggestions. Just on that we plan to set up that sub-working group for September and the original intention was to have all sites represented. We’re still happy to do that if you’re a participating site but if your jurisdiction has a significant number of trial sites we’re also happy for you to just nominate somebody or a couple of sites to participate.

We certainly don’t want this trial to be a significant additional administrative burden on participating sites but we do want to use the opportunity to ensure we get as much as we can out of the trial and that we are in the best position we can be to make a decision in consultation with jurisdictions about how to proceed. But I’ll move on to just talk a little bit about how trial sites will be supported during the trial and what we think trial reporting will look like as well as what other information we’ll be collecting.

So you can see here that the intention is that the MPS team at the Department work closely with you all, with the trial sites during the trial. As I mentioned a communications pack will be coming out to you shortly. This will include among other things some MPS specific policy guidelines for the 23/7 RN responsibility including a definition of on site and on duty, and also a number of scenario examples to assist you. Those will be in draft and certainly the aim is to test those with you during the trial. And particularly with those scenario examples we really welcome different MPS sites in the trial to I guess sing out if they don’t feel like their particular way their site is organised is reflected in those scenarios so that we can cover everybody off.

As I mentioned we’re also finalising a new MPS reforms web page. So that will be available shortly. And I just wanted to mention that we had intended to visit all MPS trial sites before the trial commenced. Unfortunately this hasn’t been possible due to the delays in nominations, the number of sites nominated – although we’re very pleased about that – and I have to admit just some internal delays thanks to a fun COVID outbreak in my team. But it is our intention to organise visits and/or online catch ups with each of the trial sites during the phase one. We’ll be seeking to engage with providers shortly to confirm this engagement schedule but outside of these formal meetings you can of course always reach out to my team wherever needed.

All right. So what will the reporting look like? Look this is just a snapshot. The trial sites will get a copy of the reporting template for round one in their communications pack. This will be similar to mainstream 24/7 reporting but it does take into account planned changes to that reporting that are coming for mainstream providers from 1 July 2024 as well as some additional usability improvements. The communications pack also includes a user guide to help you complete this report. The intention at this stage is we wouldn’t give you a template for round two because we might of course amend that based on your feedback from round one.

All right. Just really lastly, completing the report of course will be an important part of the trial but it won’t cover everything we want to know. So this slide outlines just some of the other information that we’re keen to collect from trial sites. To make this as easy as possible we have however designed an online survey that you’ll be able to complete post each reporting period. This will help us design any required adjustments to 24/7 RN arrangements for MPS prior to phase two and then prior to formal implementation.

So that’s pretty much it from me on 24/7. Hopefully MPS trial sites are comfortable with the proposed approach I’ve outlined and haven’t just groaned while I’ve been talking. But we’re really keen to hear from you so please let us know if you’ve got any feedback. And just a reminder that getting involved while it may involve a little bit of extra effort will ensure that the final model is fit for purpose in an MPS setting. This is really your chance to influence.

Anyway that’s it from me for now. But I will hand over to Simon so you have a different voice to listen to and can hear all about provider obligations and the new Act. Thanks Simon.

Simon Christopher:

[Visual of slide with text saying ‘Provider obligations under the new Act’, ‘Simon Christopher, Director, Harmonisation and Regulatory Strategy Branch’]

Thanks very much Cathy and good morning everyone. Thanks for making the time to join us today. Last time we spoke I gave you an overview of the registration processes. Today I’ll start to go into a little more detail on provider obligations.

On commencement of the new Aged Care Act revised and streamlined obligations for aged care providers will be in place under the new registered provider framework. These will be presented as either conditions of registration, specific obligations under the new Act or new duties placed on providers. Broadly they will reflect obligations that already apply via Part 4 of the current Act, the related principles and standards and MPS agreements.

To ensure providers have a clear understanding of their obligations they will be listed on the Notice of Decision from the Commission post a registration or a renewal of registration decision. Additionally the Department is preparing a tool for all providers to utilise which will articulate which obligations apply to which registration categories. Obligations will apply to MPS providers where they are not specifically excluded from application in the rules. We’re continuing to work through these exclusions very closely with Cathy and team. There will be some new obligations but most are similar or varied and streamlined where possible from the existing.

Registration conditions are described in Chapter 3, Part 4, Division 1 of the new Act Exposure Draft that was consulted on late last year and earlier this year. For some conditions there are additional details that will be provided in the rules with those hooks existing within the primary legislation or Exposure Draft. They’ll include such things as the detailed requirements to be met, the kinds of providers that must comply, for example where a provider’s in a particular registration category, if they’re delivering a particular service type, and specific to this group where they’re delivering services via a specialist aged care program like MPS.

As you’d be aware the Department is working to update the Exposure Draft Bill to incorporate feedback received through the consultation process and hope to introduce the Bill for the new Act into Parliament as early as possible. There was more recently the consultation summary report published for the Exposure Draft so I’d encourage you to take a look at that if you have interest.

After this the drafting of rules that support the legislation and Parliamentary discussion on the Bill including committee investigations will be the key focus with key parts of those new rules being expected to be consulted on giving everyone an opportunity to comment. We welcome further feedback and suggestions as the rules continue to be drafted and are released for consultation. We would particularly be interested to hear if anything is problematic in the MPS context and I’m sure Cathy will be actively engaging with you as the policy lead.

Over the next couple of slides you’ll see some obligations that are framed within the current Exposure Draft. I’d suggest you not worry too much about the details as these slides will be available after the webinar for you. And I’ll go through in a bit more detail some of the obligations later in the presentation. You’ll see that those with no highlights are where no significant changes are expected. And a good example of that is the current Code of Conduct expectations and also the Serious Incident Response Scheme expectations. Yellow is where there are some changes expected such as for worker screening. Red highlight is where significant changes are expected including the new Statement of Rights and Statement of Principles as well as complaints and whistleblower policy requirements.

On this next slide you’ll see several areas that are TBC next to them including staff qualifications and care minutes. These requirements are still under development so we don’t have specific additional details to share at this stage but are working towards that detail.

Now I’ll take you through some of the expected changes in workforce requirements. As you’re probably aware a new aged care worker screening framework is being introduced alongside the new Act. The implementation of this will be phased with interim arrangements in place upon commencement and a transitional period after aged care worker screening laws are introduced in your jurisdiction. A national intergovernmental agreement is being negotiated with states and territories currently. Workers in a risk assessed role including responsible persons at a registered provider and people involved in direct delivery of funded aged care services will need to be screened. They will need either an aged care clearance when care worker screening checks commence or an NDIS worker screening clearance or AHPRA registration. Initially and for a transition period police certificates are also expected to be acceptable in certain circumstances. I think really what we’re trying to manage there is that we don’t create hard timelines and that it’s a reasonable transition period for providers to ensure their workforce meet those requirements.

With the introduction of the new Statement of Rights and Principles within the new Act providers will need to demonstrate that they understand the rights in the Statement of Rights and have in place practices to ensure services are not delivered in an incompatible manner with those rights, and understand that safety, health, wellbeing and quality of life of an individual is the primary consideration of the delivery of funded aged care services.

This will be subject to necessary limits to balance competing or conflicting rights, for example where the delivery of services to meet the rights of one individual in a residential care home may impact the rights negatively of other individuals in the same residential care home.

This builds upon existing requirements currently outlined in the Charter of Rights and the existing Quality Standards but goes further to ensure that the rights of older people are central to the new Aged Care Act. Individuals will be able to continue to make complaints to the Aged Care Commission and the Complaints Commissioner if they consider their rights have been breached. Identified breaches of specified rights are also expected to involve breaches of provider obligations under the new framework which may trigger formal compliance and enhanced enforcement pathways available to take action in serious cases.

As currently required MPS providers will need to maintain a complaints and feedback management system. The rules are expected to outline the required details of the system, for example receiving, recording and assessing complaints, enabling anonymity, enabling complaint withdrawal and supporting the roles of advocates. The system will also need to manage complaints and feedback. The rules are expected to outline how this must be done including open disclosure process, reasonable steps that must be taken and providing appropriate support and assistance to complainants. Providers must maintain a whistleblower system and policy. The details of this are still under development and will be communicated as the broader set of obligations are landed.

The condition around delivery of services is quite broad and details will be included within the rules. It will facilitate important requirements in the Quality Standards which apply to categories 4 to 6 and also will have expectations around providers in categories 1 to 3 and apply obligations to providers delivering particular service types or groups, for example requirements for residential care providers to deliver all services within the scope of residential care if and when an individual needs them and outlining the expected scope of services to be delivered. This is similar to the current Quality of Care Principles.

The rules will also require certain information to be provided to individuals accessing services, for example information about their rights, only accurate information about the provider’s registration, a written plan of services and specific fee and payment information for the older person to understand. Further discussions are needed about possible extensions of some requirements under this condition to MPS providers, for example requirements to maintain and manage homes in a good state of repair consistent with Commonwealth, state and local laws, provide monthly care statements to residents and deliver certain combinations of services in the home and community.

On the screen are some topics we’ll look at discussing at the next webinar with guest speakers and the Health and Aged Care Commissions. The key message I’d like to finish on is that we will hopefully be approaching MPS providers later next month to confirm your registration categories for our deeming processes. You’ll be the first providers we undertake this process with and we look forward to engaging with you on this. 

And with that I thank you again for your time and look forward to the questions. And I’ll hand back to you Cathy.

Cathy Milfull:

Thanks very much Simon and thanks everyone. So we’ll just get everyone from the panel up. Look I don’t think we have a lot of questions at the moment but we’ll go through the ones that we have. So I think firstly we had:

Q:        I’m in Victoria and was unaware that there were trials to participate in. Do you have a newsletter?

So basically we don’t have a newsletter at this stage but as I mentioned earlier we do have the MPS reform web page coming. And really we approached these sites through our MPS working group. But Tanya I’m sure if anyone wants to still participate your team would be really keen to hear from them?

Tanya Clancy:

Absolutely. Yep. Happy to hear from any other sites that would like to participate. We’ll put our email address in the chat so you can contact us.

Cathy Milfull:

Excellent. And Tanya while you’re at it:

Q:        Have the participating states been notified?

Tanya Clancy:

The states have been notified. We are actually though waiting for some contact details for some of the sites in WA and Queensland. So once we have the contact details for those sites we’ll be going out more broadly to all of the participating sites with the trial information.

Cathy Milfull:

Thanks Tanya. And so for everyone online basically if your jurisdiction has nominated you we’re accepting that nomination. So we’re just finalising that. And then as I mentioned hopefully we’ll get out the communications pack next week so then you know you’ll be all official and ready to go.

A couple of people have asked whether we’ll be making the copy of the presentation slides available. So I believe yes, we will be distributing the webinar. As I mentioned earlier we’ll have that one stop shop web page as well so we will place copies of our webinars and all the frequently asked questions on that page.

What else have we got? I think there’s a few questions Simon around AHPRA registration. Don’t know if you wanted to talk to them. Basically I guess about in the new world noting that the aged care clearance will cover – AHPRA registration will cover that. Did you just want to talk to that slightly?

Simon Christopher:

Yeah. Sure Cathy. Thanks for the question. So I might answer it broadly. So the aged care worker screening clearance is being built on the NDIS worker screening clearance and what that is seeking to do is ensure that either check can work across those two sectors. It’s a real opportunity to ensure – we know there’s a lot of workforce that actually work between both spaces so it’s really important that we don’t create a duplicative check. Aged care has gone one step further in relation to those allied health professionals that are registered with AHPRA in recognising that registration so that they would not need to undertake a worker screening clearance for aged care. That may still be the case in NDIS because aged care is – that’s about the only place where it differs from the NDIS clearing is my understanding. There will be more information come out in relation to that as those arrangements are finalised through the national intergovernmental agreement and those transition approaches will be articulated. But yes AHPRA – to summarise it again the AHPRA registration for allied health professionals will be recognised and mean that you don’t need to have the worker screening clearance in aged care. 

Cathy Milfull:

Excellent. Thanks Simon. That’s good news for everyone I think. We’ve got one more question.

Q:        If we have a registered nurse rostered to work in the MPS but not directly in aged care does that comply?

So I think in short it’s always going to be dependent on the circumstances but basically if you have a registered nurse at your MPS whose available, who can work if you like across aged care and health, yes that complies. So they don’t have to be – they can still be working in the acute part of the MPS for example. They’re still considered to be on site and on duty as long as their if you like employment conditions doesn’t prevent them from working in the aged care part of the facility when you need them to. So I hope that answers the question. But that’s one of the sort of things we’re really keen to work with the trial sites on in terms of our frequently asked questions and our scenarios. So if you’ve got some scenarios that you’d really like us to include in that pack please just sing out as well.

All right. Hot off the press. I think we have another question coming in saying:

Q:        Is it safe to say that providers can use the pre-audit preparation self-assessment tool for the strengthened standards to assess our MPS services considering that the updated model is likely to be modelled on the new standards and registration categories?

Simon I don’t know if you have anything you want to mention on that one?

Simon Christopher:

Yeah. Sure Cathy. I think the Commission’s absolutely doing a lot of work around the guidance that will support the strengthened standards. So I’m not sure if they’re thinking about releasing a new pre-assessment tool. I don’t want to talk for them. It’s probably likely. But I’d encourage you to go and take a look at their work on the strengthened quality standards. But yes the new module will be reflecting on being based off the strengthened Quality Standards so I encourage you to do those kind of readiness activities as early as possible so that you can see how you might need to tweak or adjust your service delivery.

Cathy while I’ve got the mic I might just pick up on Peter’s follow up question because I did in response to the worker screening talk specifically to allied health. And apologies Peter. It is broader than that. It will absolutely be any of those professions that are registered with AHPRA. So that will include RNs, and my understanding ENs are also there as well. So it’s recognising that work that AHPRA does around monitoring the conduct of all of those professionals that are registered with them.

Cathy Milfull:

Excellent. Thanks Simon. And as I mentioned we’ll hopefully have the Health Commission along in July as well to talk about the new MPS module. But obviously that will be modelled on the strengthened standards that you will have already seen in draft form on our website.

Simon I think one more regulatory question.

Q:        Will the aged care worker screening check also review the ACQSC banning orders?

Simon Christopher:

Yeah. Thanks Cathy. Look I’m not as involved in the detail. It’s absolutely another policy area that’s working it through. My understanding is – and I would encourage you to head back to the Department’s website around those detailed specifications – but it is modelling off the NDIS worker screening which does look at the NDIS Quality and Safety Commission’s banning orders. So I would suggest that it will take a similar approach. And we want to be definitely making sure that any banning orders come into the consideration of the conduct of those individuals. So I think it’s a pretty safe bet to say yes but it’s certainly not my policy area. Hopefully that’s helpful.

Cathy Milfull:

Thanks Simon. And I agree. I think banning orders are always relevant and obviously in terms of suitability as well. But for the people that asked the question we can certainly confirm that with our worker screening policy team and we’ll publish that in our answer.

All right. Do we have any other questions coming in?

Tanya Clancy:

Yeah. I think there’s one about outlining differences in proposed accreditation, Quality Standards between MPS and RACFs. And it would be helpful to know similarities and differences for jurisdiction providers who operate in both spaces.

Simon Christopher:

Did you want me to take that Cathy?

Cathy Milfull:

That would be great. Thanks Simon.

Simon Christopher:

Yeah. And so I think I don’t want to steal the thunder from the Health Commission and the Aged Care Commission as they talk to you next meeting but really sort of based on the current approach it’s recognised that MPS is accredited against the national standards and that the module that Cathy referred to earlier is the gap if you like around the expectations in the delivery of aged care services. So the same auditors that audit against the national health standards then audit against that module which gives the assurances if you like to the Commissioner making the decision around registration that those standards are being effectively met.

So that’s the only real difference. So it’s a modification of what is done in a RACF, in a mainstream RACF versus a difference if that makes sense.

Cathy Milfull:

Yeah. Thanks Simon. And so really we’re trying to maintain the status quo in the current world with the Health Commission’s accreditation arrangements in the new world. The only difference is that to be registered by the Aged Care Commission you’ll need to have that accreditation against the health standards and the module as you would have currently from the Health Commission. But we’ll certainly get an update for you at the next webinar.

I think there’s another question.

Q:        Has there been any consideration for MPS who are also NDIS providers with the challenges with multiple accreditation requirements?

Look thanks for that question. Simon might want to comment on that but I just wanted to say we very much are aware of some of the challenges across the whole care sector in terms of multiple accreditation and regulatory requirements. So it’s probably something that the Government is looking at. But I just wanted to flag that it’s something that my team’s also been talking with some of our MPS working group members with and we’re certainly looking to explore whether there are options to possibly go further with our kind of MPS module arrangements. So watch this space. But certainly it is on the agenda and also I think Simon might want to comment but obviously when we’ve been designing the new Act and the rules and the Quality Standards and the Code of Conduct where possible we’re trying to align with NDIS requirements. Simon is there anything you wanted to add there?

Simon Christopher:

I don’t think there’s anything for me to add at this point Cathy. I think there has definitely been some work over the recent time from the NDIS Commission side to recognise where there’s been accreditations in the aged care space. I’m not sure how that plays out in an MPS context at the moment but I echo Cathy’s words there in that we are really keen to understand and make it as harmonised as possible and recognise where those existing pieces meet the need that they can be recognised in the model. So there’s still further work to be done and we might try and get some further detail of that existing process in the response.

Cathy Milfull:

Thanks Simon. And I would just say particularly on the NDIS side with our MPS providers it would be really great to get any detail around some of those specific challenges and any ideas that you have either through the MPS working group or just directly to my team with our mailbox. Because it is something that we’re looking at and trying to get – obviously there’s quite a few relevant parties involved in these kind of discussions but we’re keen to progress, and having those practical details of what’s actually problematic would be really helpful.

All right. One more question I think we’ve got is:

Q:        One of the concerns I have as a small MPS manager is the consideration of safe staffing levels where your registered nurse may be busy providing care in the emergency department of the MPS limiting capacity to support in aged care.

And look thank you for that comment and I think yes there’s sort of I think some questions around availability of the registered nurse which is one of the things we’re testing with our 24/7 trial. So that’s more about is there a nurse on site. But obviously the care minutes trial or equivalent is where we’re trying to look at what responsibility is appropriate in an MPS context in terms of what you’re talking about here which really saves staffing levels and direct care. So I guess how much if you like the RN is available to provide care for our aged care residents. So we will continue to explore that with you all and that’s one of the reasons we’re really keen for people to get more involved in the care minutes trial so we can really look into some of those challenges that you’re having.

All right.

We’ve got I think a comment about staff who’ve been denied an NDIS screening. Sorry. I’m not familiar with the acronyms. Don’t know if Simon or Tanya – we’ve got WWC and ACCRS. 

Simon Christopher:

Yeah. I think that’s an aged care – the first one’s Working With Children Check I think, but have been denied an NDIS screening. So I think the point – not knowing 100% what the ACCRS is, I think the point is that the NDIS screening check is a more recent creation and that is what aged care will leverage off in creating its check. So the aged care criminal record screening. Thanks Leanne. That’s a lower bar if you like than what the NDIS worker screening check is which does take in real time feeds of a number of different datasets from the Australian Criminal Intelligence Commission and other pieces. So that’s where aged care is headed, to leverage off and model the same approach. So some of those other checks that don’t have that real time feed in of sort of multiple parties may not necessarily identify issues that say an NDIS screening check and when aged care commences what an aged care check may also identify. So I can see how that might happen but we’re headed to that level of screening in aged care as well is probably the point.

Cathy Milfull:

Thanks so much Simon. All right. I think that’s the end of the questions unless anyone can see anything else. So look thank you very much for joining us today. I hope that was useful. We really appreciate the questions. And some of those particular challenges your site’s experienced please reach out. The more we understand about the situations then the more we can take that into account in this reform journey. So we’ve really reached probably the end of the webinar today. I can give you five minutes back in your day. But don’t forget that we’ll have the July webinar coming up as well. If there’s anything you want to add to the agenda let us know. Otherwise I just wanted to thank you for your time in your busy day today. And we look forward to talking with you as this reform journey progresses. So thanks very much everybody.

Bye. Take care.

[End of Transcript]

George Masri:

Good afternoon everyone. Thanks for joining us for the first webinar about how the aged care reforms will impact the MPS program and its providers. My name is George Masri and I’m the Assistant Secretary of the Thin Markets Branch in the Department of Health and Aged Care which has responsibility for the MPS program. I’m pleased to host today’s session with panel members Cathy Milfull who’s the Director of Rural & Remote Policy and MPS in my Branch, and Simon Christopher, Director of the Harmonisation and Strategy Branch.

We’ll start with the formal presentations shortly but before we commence I just wanted to deal with some issues around the possibility of further questions and answers. So we’ll have a question and answer session following the formal presentations. Also just to provide I guess enough time for those questions and answers, today’s presentation will be reasonable high level, even though the slides provide a bit more detail. But please feel free to request to expand on particular matters of interest during the Q&A session. Questions can be submitted using the Slido throughout the presentation. You’ll also be able to view and prioritise other attendees’ questions. We will try our best to get as many questions as we can, particularly any common questions, but don’t worry if your question doesn’t come up or we don’t get to answer it. We will try and publish written answers to any questions that we are unable to provide today. If you have any concerns during the presentation, for example there’s a problem with sound, please let us know using the chat function rather than Slido.

Today’s webinar is being recorded and the slides presented will also be made available following the session. We’ll now bring up the slide pack and get started. 

[Visual of slide with text saying ‘Multi-Purpose Service (MPS) Webinar 1:’, ‘Aged care reforms: impacts on the MPS program and providers’, ‘8 May 2024’, ‘Thin Markets Branch’, ‘Australian Government with Crest (logo)’, ‘Department of Health and Aged Care’, ‘www.health.gov.au’]

But just before we do formally commence, I’d like to acknowledge the traditional owners on the various lands on which we’re meeting today across Australia. I’m here in Canberra. I’d like to pay my respects to the Elders past, present and emerging, and in Canberra that’s the Ngunnawal people, and to welcome and acknowledge any Aboriginal and Torres Strait Islanders that are with us today and also acknowledge I guess that we’re all here to improve access to aged care.

Okay. So the purpose of today’s webinar is really to provide you with information on how we’re addressing the upcoming aged care reforms and how that will impact the MPS program and in turn the providers. As you may be aware the Department is working closely with the states and territories through the MPS Working Group to discuss these reforms, and they’re quite constructive discussions.

But before we move into further policy design and implementation phase for these reforms we want to make sure that we can talk directly to MPS providers, answer your questions, get feedback and support your implementation of these changes. This slide outlines what we intend to cover today. As it is the first of our seminars in a series of webinars it is intended to be an overview and introductory. As I am sure you’ll appreciate there will be also a lot of different levels of knowledge amongst the MPS providers about the reforms so we appreciate your patience as we use today to try to get everyone on the same page about the reform ahead.

Firstly I will provide some context about the current MPS program, the important role that it plays and the important reforms underway in aged care which also impacts on MPS. I’ll try to explain why we need the change, even in a program like MPS which largely receives positive feedback. I want to emphasise also that we’re keen to retain and build the strengths of the existing MPS model which supports innovative, flexible, integrated service delivery so that older people can stay in their own communities and close to family and friends. 

Cathy will then talk about the draft reform schedule for the MPS that we have been developing with the MPS Working Group. This is important as there are a lot of changes going ahead in aged care and as a result we just want to ensure that we’ve planned the approach in managing those changes that are relevant to MPS in a more ordered and appropriate way, and to ensure that MPS providers are actually involved in the journey as we look to improve the aged care outcomes. Cathy will also discuss some of the key reforms that have been planned. We’ll also provide you with a high level overview of how MPS will be impacted by the new Aged Care Act and some of the key structural changes to understand when discussing MPS and the new Act.

Simon will then take you through in a bit more detail really our first deep dive topic for this series of webinars on the provider registration process under the new Aged Care Act. He will explain how the registration arrangements will work and confirm proposed transitional arrangements for existing MPS providers when the new Act commences.

As I mentioned this is the first webinar. It’s just the start of a broader conversation with MPS providers and the state representatives. For future webinars we expect to do a deep dive into further key reforms including topics such as 24/7 registered nurse requirements, obligations on the providers under the new Act. This slide proposes a bit of a draft timetable for future webinars. But we also are really keen to get any suggestions for future topics that you would like to discuss in this series of webinars.

[Visual of slide with text saying ‘The aged care reform context and the MPS’, ‘George Masri, Assistant Secretary, Thin Markets Branch’]

Before we talk about the proposed reforms to MPS I think it’s important to reflect on where we are in terms of the current MPS program, why such reforms are being planned and required. As you can see from this slide the MPS program whilst specialised is already quite significant. There are over 28 providers operating 182 MPS sites across Australia delivering flexible aged care services in rural and remote regions with 3,762 operational places.

It should be recognised that the program is an important working example of delivering integrated health and aged care services. It’s also a program that we think has lots of potential to trial and support more innovative delivery of aged care services moving forward. The MPS program also reflects a significant financial contribution by both the Commonwealth Government and participating states and territories.

The Royal Commission acknowledged the important role that MPS plays. It recognised that MPS provide health and aged care services in areas of rural and remote Australia that could not support a standalone hospital or residential aged care facility. And certainly I would reiterate that at no time when discussing proposed reforms today are we suggesting that the services delivered by particular MPSs are necessarily lacking in some way or problematic. But as you would be aware the Royal Commission made 148 recommendations about how the aged care system should be improved for the future. These recommendations envisage the transition to a new person-centred aged care system where old people can access quality and safe aged care services that they need wherever they are. And providers are encouraged to aim higher than the minimum to deliver quality care. The MPS program must be part of that transition.

The Royal Commission also made specific recommendations around the MPS program, more specifically recommendation 55. These were focused on ensuring the continued expansion and sustainability of the program, equity of access to aged care programs with alignment of eligibility requirements, assessment, client contributions welcomed, as well as the development of a new funding model. But as noted here it was important to recognise that this is not the only Royal Commission recommendation relevant to MPS. The new Aged Care Act is expected to respond to about 50 recommendations of the Royal Commission. Many of these will be relevant to the MPS as well as the other aged care programs.

Since the Royal Commission, the final report of the Aged Care Taskforce has also been published. This Taskforce was established by the Commonwealth and chaired by Minister Wells to review funding arrangements for aged care, develop options for a system that is fair and equitable for all in Australia, and to build on the Royal Commission recommendations. As reflected in this slide, the Taskforce made a number of findings around thin markets. The term thin markets refers to areas where access to services is less than required. Such markets are commonly found in rural and remote areas due to population size and workforce. As a result these recommendations are also relevant to MPS. The Taskforce recommended that block funding be continued for programs such as MPS as mainstream funding arrangements may not work in some of those thin market areas.

A review of a remoteness classification system is also to be undertaken. It was one of the recommendations of the Taskforce. This is relevant to MPS with all the 182 MPS currently located in MM5 to MM7 areas. And the third specific recommendation was older people make fair contribution based on their means. 

The Government response to the Taskforce report is expected to be announced soon but recommendations are consistent with many of the policy initiatives and thinking already underway by the Department.

In terms of context, last but certainly not least we must also recognise that the new Aged Care Act which was recommendation one of the Royal Commission is coming. This new Act is not just a piece of legislation. It will see the introduction of a new person-centred, rights-based aged care system, a system that focuses on individuals and services that they need, not just providers and how they are funded. There are elements of the MPS program that won’t change but other arrangements will need to change and comply with the Act. The new Act also provides a valuable opportunity to further reform the MPS. More broadly it is also an opportunity to simplify complex arrangements for aged care providers that have been developed over time and streamline obligations on providers and ensure that the regulation of the sector is risk proportionate. Whilst change is coming the Department will be engaging directly with MPS providers to ensure that these reforms will work in the context of MPS settings.

I’ll now hand over to Cathy Milfull who will speak about the proposed reforms in a little bit more detail. Thanks Cathy.

Cathy Milfull:

[Visual of slide with text saying ‘What changes are ahead for MPS?’, ‘Cathy Milfull, Director, Thin Markets Branch’]

Thanks George and hi everyone. Now that George has set the scene for us in terms of what needs to change and why we want to take you through what changes to the MPS program are already planned and remain under discussion. But before we even start I just wanted to assure everybody that even where reforms are already planned we want to work with you and our colleagues on the MPS Working Group to make sure these reforms can be implemented as smoothly as possible with adjustments made to mainstream policy settings where this is appropriate if we can. 

We also understand that as they say the devil is in the detail. But to be honest, what we don’t know we don’t know. So we really need your increased involvement in the months ahead. If you have unusual or particularly challenging situations in your MPS or you identify an unintended consequence of an upcoming reform for example, we really want to hear from you. We won’t always have total flexibility to change things but if we work together it will help ensure we can deliver positive outcomes for older people in rural and remote Australia.

So this slide really just gives you a copy of a draft reform schedule for MPS that we had approved in principle in April by what’s called the Senior Officials Group, with some updates we’ve made to reflect progress since then. It shows you the timeframes that are currently being progressed for particular reforms for MPS. Some of these timeframes we have control over. Others will be dependent on other things, for example legislative changes and system changes. As you can see it’s a pretty busy time ahead from now until 2027. As a result it’s particularly important as George mentioned that we really have a planned way forward. We’re also keen to be as transparent as we can around these upcoming changes and our progress towards target dates for particular reforms. 

At the top of the diagram in the red section there you can see the reforms that will be implemented via the new Aged Care Act once the relevant Bills are introduced to Parliament, are passed and commenced. I know that you would all like to know exactly when this will be but it will be the Government’s decision as to when the Bill is introduced and what the proposed commencement date is. And then of course the reality is the time required for Parliamentary passage can vary greatly and can depend on a number of factors.

But below the red new Act section you will see reforms that we can progress with or without the new Act. Although where they involve legislative change we’ll certainly take the opportunity to align with the new Act where we can. It is these reforms that I really wanted to focus on today in this part of my presentation. We consider it important that we move forward with these reforms, some of which as you’d be aware were implemented in 2022 or 2023 in mainstream residential care facilities. Not only were these initiatives committed by Government at the election to improve care outcomes for older people, progressing these initiatives now will also ensure that we can stagger these upcoming reforms and hopefully not have them all commence at the same time.

So the next slide here just summarises some of the key, I’m going to say, non-Act related reforms that are being planned for 2024. The top one, a subsidy increase for all providers, has already been implemented. Some of you may also have nominated to participate in the residential experience survey that you can see there which is being trialled for May/June this year. If not I do really encourage you to do so. This important survey has been in place since 2022 in mainstream residential care. It was recommended by the Royal Commission and it gives residents a chance to tell us about the care they access. Is it working, what’s working well and what can be improved. We appreciate that in rural Australia older people may have less choice about the facilities they wish to access if they want to stay near their family and friends but this information we consider still critical to ensure we can improve MPS arrangements for older people in future.

Just probably two last things to mention here. As per a recent email from my team we’re also planning to send out Deeds of Variation to all MPS providers to facilitate the extension of their current agreements up until 30 June 2025. So keep an eye out for those. We’re also going to be opening an allocation round later this year subject to Ministerial approval. And so that will facilitate additional aged care beds being brought online or even new MPS opening. So that’s really the year in a snap. There’s two more reforms there but I’ll talk about those in more detail shortly.

So this slide really focuses on two key non-Act reforms for this year. One is introducing a 24/7 registered nursing and responsibility and the other, what’s often referred to as direct care targets for providers. So these will be the topic of key deep dives in later webinars so don’t be concerned if you feel like you don’t have enough information right now. But I wanted to try and give you a few highlights about this important topic.

So as many of you would be aware these two types of responsibilities were introduced for mainstream residential care providers as of 1 October 2023 and this followed a trial period. These arrangements were not implemented immediately in a legislative sense for MPS and that was because it was considered we needed some more time to work out how these reforms should operate for our specialist aged care program. For MPS to be honest it was also considered a lesser priority as given the integrated health and aged care context it was considered that many providers would already be meeting direct and clinical care targets. But it is important I think that we can assure ourselves of this and that there are equivalent standards of care being provided in MPS and mainstream residential care homes.

So NATSIFAC has already implemented care minute equivalent arrangements and will be progressing 24/7 as well. So now it’s really time for us to work out what’s the best approach to these arrangements for MPS. Similar to mainstream in discussion with jurisdictions and the MPS Working Group we think the best way to do this is by trialling the possible arrangements first. This will ensure we can operationalise these requirements in a way that makes practical sense for providers but also achieves their intended goals.

So in terms of 24/7 requirements we consider that most MPS will already be providing access to at least one registered nurse on site for residents, noting that on site can include the hospital next door or across the road to the aged care wing of your site. So this trial which it has been agreed will commence on 1 July 2024 will be more about testing these assumptions and working with individual providers who cannot meet these requirements or available exemptions. We also really want to test the reporting that’s in place for mainstream residential care homes in GPMS, see if this will work for MPS or whether we need a different approach or can work together to find a better one.

In terms of direct care targets often referred to as care minute requirements we do think that implementation for MPS will be more complicated. As a result the trial for these newer arrangements is expected to have some additional phases with further codesign work to occur this year in consultation with providers on the ground. A pilot will then be undertaken with a limited number of nominated sites prior to a more expansive trial with all providers of the proposed approach for MPS. The reason for this is we need to work with providers to develop the most sensible approach to these arrangements given the absence of AN-ACC assessments in an MPS context and the diversity of our MPS sites. As a result you might see already some of our slides referring to care minutes equivalent. This is because we’ll be using the trial phase to determine what the MPS approach to this reform actually looks like in practice and whether the language care minutes works well in an MPS context. But regardless of terminology the aim is the same. That is we want to ensure aged care residents receive the dedicated care time that they need.

So really as you can see there’s a lot to work through here particularly for care minutes. So really my key message from this slide was just to say to everyone please get involved early in the trials where you can in consultation with your relevant state and territory agency. If you want to influence the outcome and have great ideas for better approaches for MPS you really need to get involved. My team will be kicking off a new reform implementation sub-working group and initial trial and pilot sites will be part of this group. Ideally my team will also get out and meet with staff at these pilot sites before 1 July 2024. But even if you don’t have capacity as an initial trial or pilot site don’t feel you can’t get involved. We are really keen for you to do so.

I know everyone’s going to ask about money so just wanted to confirm that if your state and territory has agreed to participate in the trial phase additional care minutes related funding is expected to be available to MPS sites. The aim of that is to help you get ready, engage with my team and participate in these trials and then move towards complying with any new requirements. At this stage there is no additional funding available for trialling 24/7 arrangements but that’s because our assumption is that most MPSs are expected to already be meeting these nursing requirements. But the whole point of the trial is to really test that assumption and it will help us build an evidence base on any further costs that are involved for consideration by Government.

All right.

[Visual of slide with text saying ‘MPS and the new Aged Care Act’, ‘Cathy Milfull, Director, Thin Markets Branch’]

So moving on. I’m just going to move on to give you a quick high level overview of MPS and the new Act. Some of the slides are quite detailed but I wanted you to have these for reference material. And noting that we’ve got Slido on the side there I’m hoping that if you have a look at these slides and I don’t cover something it might inform your questions to us and George, myself and Simon can expand later in the Q&A session.

So here on the first slide you can just see basically a high level overview of the areas in which the new Act will impact MPS. You may have seen a similar slide for the Act overall in the Exposure Draft consultations but we’ve tried to do this one for you just to really focus on MPS specifically. It highlights the key areas of change under the new Act. That includes areas that were covered in the Exposure Draft that you’ve hopefully had a look at. So system entry, services and regulation. And then also changes to funding and structure which will be evident in the final Bill for the new Act.

So just moving on a bit we just wanted to have a talk briefly about system entry and service related changes. There will be a future deep dive at a future webinar on this one but today I just wanted to go through a few points to make sure everyone is on the same page and inform your questions. So just some key points I guess in this space. Under the new Act a delegate will need to make a decision to approve certain services for an older person before they can access funded aged care services under the Act. And that includes through an MPS. So it’s different to current arrangements. A delegate’s decision will need to follow an independent assessment of the person’s needs by a needs assessor. It is also important to recognise that under the new Act only people who meet certain eligibility requirements will be able to be assessed by an assessor. So that includes certain age related criteria.

But don’t be concerned. These arrangements will be grandfathered with those already in an MPS able to still keep on accessing the care that they’re receiving. We’re also working on alternative entry arrangements for the Bill and this will facilitate individuals commencing care in an MPS ahead of application and assessment processes where that assessment would be delayed. The individual will still need to be assessed but the idea here is it could be done retrospectively so that it won’t impact care being delivered where needed. As MPS providers you’ll also be able to deliver services on a service list that the person has been approved to access. In some cases this will be a group of services like permanent residential care. In other cases it will be specific types of services as in the case for home support. So it’s quite different to the current world. There is no concept of flexible care in the new Act. Rather MPS will just be funded differently to deliver the same services to older people in their care with adjustments to regulatory arrangements where appropriate and agreed.

So if you have a look on the next slide here this just shows you that service list, I guess an example of the service list that I was talking about. The service list is still being finalised and it’s going to change quite a bit over time. But we will certainly discuss this more with jurisdictions as drafting progresses.

So lastly just on system entry and services, I wanted to give you I guess some assurance with this slide that while there are a lot of changes coming a lot of things will stay the same. But some things are just being relabelled with different terminology. So don’t let that kind of put you off. For example your MPS sites or services will be called a residential care home in the new world and Simon will take you through this in a bit more detail later.

Similarly while older people approved for aged care services will be given a classification and a priority rating for residential care for example this will still not impact how services are delivered to them if they choose to enter an MPS for their services.

Okay. So just to give you a bit of a visual. I’m not going to go through this in detail. We will have a more detailed deep dive into this later. But this slide just gives you an idea of that I guess front entry process to an MPS and this slide really focuses on new clients. It does though reflect the proposed grandfathering and alternative entry arrangements that I’ve already mentioned.

The next slide though shows you just in a bit more detail those transitional arrangements particularly in the green box down to the right. And we will be really wanting to go through this in quite a bit of detail with you at a subsequent webinar because we’ll need your assistance as providers to put these arrangements in place to ensure a smooth transition for existing MPS clients.

Okay. So that’s really it in terms of system entry and the new Act for now. But before I hand over to Simon I just wanted to flag that the new Act does include a new regulatory model. There has been lots of public consultation about these changes over the last two years in particular. You may have seen Simon at some other webinars. But we do appreciate that sometimes it can be difficult to understand what the proposed new arrangements mean for MPS providers. So really we want to use these webinars moving forward to provide some more nuanced explanations for MPS providers and discuss any potential issues or concerns that you have. The regulatory model is obviously a very big topic so we’ve decided to divide that into three. So today’s topic is registration. This was included in the Exposure Draft and is reasonably settled from a legislative perspective. So keen for you guys to listen to Simon, get a shared understanding of where we’ve landed, and if you can raise any red line issues with us as soon as possible that would be greatly appreciated. 

Next month we’ll then move onto provider obligations. This is a larger topic. It was covered in the Exposure Draft but a lot of the details of the obligations are in the rules or the subordinate legislation that is still to come. So we want to try and give you as much I guess forward information about that as possible so we can have a fulsome discussion. And at a later webinar we can also discuss regulatory actions under the Act. We can also get relevant regulatory bodies along to talk to you if that would be helpful.

But that’s it from me for now as I’m sure you’re pretty sick of my voice. So I’m going to hand over to Simon to talk provider registration. So thanks Simon and thanks everybody for listening.

Simon Christopher:

[Visual of slide with text saying ‘Registration as a provider under the new Act’, ‘Simon Christopher, Director, Harmonisation and Regulatory Strategy Branch’]

Thanks Cathy. Good afternoon everyone. Thanks for your time today. Cathy I’m sure my voice would more likely put people to sleep. So hopefully my content isn’t too dry for people. But today I’m looking to provide you an overview of the process by which we’ll what we call deem existing providers across to the new regulatory model on commencement of the new Act. The new regulatory model seeks to embed person-centred, rights-based care as we rebuild trust and confidence in the aged care system.

I’ll also talk you through specifically as Cathy mentioned we’re focusing on the registration process for new providers and what we call the renewal process for those existing providers that existing providers will need to undergo at regular intervals. I’ll also flag a couple of areas that we’re seeking your input on.

A key change under the new Aged Care Act is the introduction of a single universal provider registration model. The registration model will require all providers to be registered by the Aged Care Quality and Safety Commission to deliver funded aged care services irrespective of the program type or funding stream that they deliver services under. Providers must register into one or more of the six provider registration categories based on the service types that they intend to deliver. The provider registration category will determine which obligations and conditions a provider must comply with. Whilst the transitional arrangements are still being finalised it’s worth noting that under the new Act only registered providers can deliver funded aged care services.

To ensure continuity of care for older people all existing providers will be automatically deemed on the commencement of the new Act and considered as registered into the registration category or categories that reflect their service provision. And this may also be in line with their expectations of their current Funding Agreements. The Department will undertake this and this will include MPS services.

Existing providers will be deemed to be registered for a specified period. This initial registration end date will be set by the Commission based on a number of factors such as the length of time since the last audit, a provider’s risk profile, and also sequencing the flow of all providers into a cadence of renewal applications allowing for workforce capacity management for the Commission as they seek to assess and consider these applications.

Government providers will need to opt in to the deeming process, effectively agreeing to be deemed and deliver services under the new Act. We’re continuing to work through the level of agreement required to operationalise this opt in requirement. All MPS providers are expected to be registered in category six, the residential care category, so that they can continue to deliver permanent residential care and residential respite. Some MPS providers will also be registered into additional categories which you can see on the slide to reflect the types of home and community services they deliver. We will be validating your data with you and we’ll reach out to some providers if further clarification or information is required to facilitate the deeming process. This could include confirmation of services delivered or your organisational details. We’ll work collaboratively with the Thin Markets team and the MPS Working Group on this validation process as we progress this work.

As part of the deeming process we’ll set up your information into the Government Provider Management System or GPMS that some of you might be familiar with. GPMS makes it easier for providers to access and report information to Government. The deeming and transition process is intended to prevent any negative impacts on the delivery of care to older people and ensure providers are ready for these changes. On commencement of the new Aged Care Act all providers deemed to be registered will automatically start to be regulated under the new regulatory model.

A new provider who enters into an MPS agreement with the Commonwealth will also need to apply and be registered with the Commission in category six, residential care, and any other relevant categories they wish to deliver services in. The Commission must also approve at least one residential care home if there’s not already an approved residential care home that’s being attached as part of that application where the provider will deliver services under category six.

I mentioned earlier that all existing providers who are deemed on commencement of the new Act will also need to go through a renewal application and assessment prior to the end of their registration period. As mentioned you’ll be advised of that date on commencement of the new Act as part of that deeming process. Prior to the expiry of your registration period the Commission will invite you to commence the registration renewal process. The Commission will advise you of the timeframe for commencing a registration renewal application and the timeframe in which you need to complete and submit the application form.

Registration processes are expected to be streamlined for Government providers. As I mentioned providers will need to apply using approved forms. They will also need to pay a fee if specified for that service type. They will need to specify certain information including the category or categories that they are applying to register in, the service types they intend to deliver, that they intend to deliver services through the MPS program so that we know they are part of a specialist aged care program, each residential care home that they are seeking approval for and any additional information required by the rules for each home, for example the address, person in charge, bed numbers, proof of ownership or permission to use a particulate site and certificate of occupancy. And each responsible person of the entity for the Government provider, nominated contact person.

New and renewing providers will need to meet a number of requirements. These are expected to include the existence of a valid ABN, they are suitable as a provider and they have suitable responsible persons. The Commission will need to consider a provider’s compliance with the law and history of any banning orders or any NDIS sanctions that may be in place. They need to ensure that the provider has an understanding of the services they intend to deliver which will need to align to the proposed registration categories, and that they have the commitment, capability and capacity to deliver these services.

The Department’s continuing to refine renewal of registration in the draft legislation to ensure it’s proportionate and streamlined and recognises existing information held by the Commission. We’re really keen to make sure that the Commission doesn’t need to do tick a box exercises, if it knows and holds some of this information already, that that’s as streamlined and proportionate as possible. This remains subject to final drafting and ultimately a decision of Government in relation to the new Act.

Unlike other providers MPS providers will not need to be audited by the Commission against the Aged Care Quality Standards as part of registration and renewal processes. As you’d be familiar the Australian Commission on Safety and Quality in Healthcare using the National Safety and Quality Health Service Standards and the MPS Aged Care Module will continue to assess MPS providers which will inform a new or renewal registration decision application. The MPS Aged Care Module is being updated to reflect the Strengthened Aged Care Quality Standards.

There are a couple of definitions being given further consideration following community feedback on the Exposure Draft of the new Aged Care Act. The first one I wanted to flag with you is the responsible person. The current definition is on the slide.

We consider that it may not be appropriate for (a) any person who is responsible for executive decisions of the registered provider, and (b) any person who has authority or responsibility for or a significant influence over planning, directing or controlling the activities of a registered provider to apply to Government providers, for example because these provisions could inadvertently capture Ministers or Departmental officials who are not involved in the day to day running of an MPS. So we’re really keen to hear your feedback on this definition and any particular views for your situations which will help us kind of work that through.

The second definition I wanted to raise with you is the residential care home. MPS sites will need to meet the definition of a residential care home. This definition included in the current Exposure Draft for the new Act remains under discussion and is expected to need some adjustment to fully cater for all MPS models. Of particulate note we’re seeking to progress amendments to the text to cover different MPS models, for example closer to something along the following lines. A place where aged care services are delivered that is within or collocated with a hospital or other health service and is covered by an agreement with the Commonwealth to deliver aged care services as part of an integrated service agreement. Your further feedback on this is very welcome. Our email address is on the slide I believe should you wish to provide us any further feedback directly. And with that I’ll hand back to George.

George Masri:

[Visual of slide with text saying ‘Questions?’]

Great. Thanks Simon and thanks Cathy. It’s also pleasing to note that we’ve got a few questions on the Slido so we’ll commence the panel discussion with some of the questions that you’ve sent through and that we may not necessarily have answered in our presentation. So we’re reviewing the questions. So I might just go to some of the ones, not necessarily in order, but we’ll go through them and I might start off I guess with both articulating the question and then maybe just a brief response and then open up to other panel members to add to it.

So for example:

Q:        Will there be an additional 24/7 registered nurse funding for MPSs similar to the increased funding received for residential aged care facilities?

Look at this stage we’re not in a position to really articulate any increased funding and it’s not going to be something that we’ll be looking at at the moment in the trial period. But as Cathy mentioned we want to use the trial period to build on evidence to ensure that we’ve got clarity about the additional costs involved and the need for funding. So that’s something that I think will be a key aspect of the trials for the 24/7.

Happy for any of my other colleagues to elaborate.

Cathy Milfull:

Thanks George. I think that’s right. And apologies everyone. It is a bit confusing because we’ve got the two trials coming potentially, one for 24/7 which has no additional funding associated with it yet, but care minutes which will as long as your state and territory agrees to participate. So happy to explain any of that in more detail as it becomes clear who’s nominated to participate etcetera.

George Masri:

Thanks Cathy. And that’s a good segue to the other question.

Q:        How does someone apply to be on the trial?

So we’re really encouraging providers to participate. This is a good way to influence I guess how we implement some of these reforms. So we recommend that you contact your state or territory agency to discuss being involved but we can also provide contact details so that you can contact us directly through our MPS mailbox.

Q:        Will the My Aged Care portal be updated to allow MPS outlets to accept referrals for permanent aged care?

So that’s a good question. We’re aware that this has been an issue and we have raised it with our colleagues, not least our IT colleagues. That’s something also maybe it would be great to sort of discuss further with providers who’ve got ideas about how we could actually improve that functionality. But that’s going to be an important part of just ensuring that people who want to access aged care can get the most accurate information. But again I don’t know if Cathy you want to add anything further to that? 

Cathy Milfull:

No. I don’t think so George. But yeah obviously there’s a lot of work going on in the background with IT improvements for changes that are associated with the new Act. So I guess I’ll put a general callout to MPS providers if there are things that you feel in the current environment that kind of are letting us down please let us know because now’s the time to get some of those issues reflected in the IT wish list if you like. They’ve got a lot to do by the time the new Act commences so it will need to be prioritised. But the more we’re aware hopefully we can add in additional benefits as we go.

George Masri:

Thanks Cathy. 

Q:        Would the assessment come from ACAT?

So that’s a good question. I guess certainly one of the recommendations coming out of the Royal Commission and other reviews was for that assessment of people who are accessing the MPSs. So the assessments will be done by the proposed new single assessment workforce. What we can do is invite the policy area that’s responsible for assessments to come along to one of these webinars to explain the assessment arrangements in more detail if that’s an area of interest. So I think that’s worth really exploring how that will be applied in the context of MPS.

Q:        What remoteness classification is currently used by aged care and the MPS program?

So it’s the Modified Monash Model. There’s various versions and in fact there’s a review being undertaken as we speak. The final report of that review is due in July this year. But in the context of MPSs it’s the 2017 version of the Modified Monash Model. I guess that sort of reflects what Cathy mentioned earlier was the MPSs sort of sit within small, rural and remote locations, so the MM5, 6 and 7. But also I guess why I think the remoteness classification is important more generally as it applies across the board to other aged care programs, it’s connected to funding, for example in mainstream residential aged care with the AN-ACC funding. It also could look at exemptions, for example the 24/7 nursing, the implementation of that, and some exemptions are possible for the small, rural and remote locations. So there is the application of the MMM classification when we actually recently put out an aged care infrastructure or capital assistance grants round and we were really looking to target many of the rural and remote locations. So there was a focus on using the Modified Monash Model to actually prioritise some of the funding that will go into capital assistance programs.

So I think as the Taskforce, the Aged Care Taskforce recommended, it is appropriate I think to sort of review the application for remoteness classification across the board including MPSs. Again Cathy I don’t know if you want to add anything further?

Cathy Milfull:

I don’t think so George.

George Masri:

Q:        So who is leading the residential experience surveys?

Again the Department has engaged HealthConsult to conduct the trials to look at residents’ experience. That’s across the board but also included in the MPSs. That might be something that we could also provide more detail and a link to the relevant details of that trial if people are interested in participating.

Cathy Milfull:

Team online perhaps you could put those links in the chat for everyone. That might be useful.

George Masri:

Q:        What and how much will the trial funding be as this may influence the decision to participate in the trial or pilot?

So as Cathy mentioned we don’t have any funding available for the 24/7. There will be – subject to certain arrangements we will look at funding for the care minutes trials. They’ll be calculated per place per site and take into account the classification, the Modified Monash Model classification location.

Cathy Milfull:

Yeah. Thanks George. And so the states and territories have I guess some high level information about the amount of funding we have on offer annually moving forward for care minutes. So have a chat with your state and territory but it will really depend as George said on the number of places, residential care places you have, and extent of the remoteness really of your MPS.

George Masri:

Thanks Cathy.

Q:        Will the retrospective approval process for entry be managed in a similar way to emergency respite?

And as I understand it be similar to emergency entry arrangements in the current Act but it will be expanded and will cover MPSs more broadly where this is a delay in the assessment. But again if Cathy or Simon want to add further to that.

Cathy Milfull:

Yeah George. And thanks everyone for the question. I think we’ll try and do some more consultation I think on the alternative entry arrangements once they’re locked down just so people can highlight any unintended consequences. But George and I have been advocating strongly to make sure there’s enough flexibility in the MPS context. We are aware that in some cases you’ll just need to commence delivery of care. So as I mentioned it’s really about how we can retrospectively make sure those people are assessed. And there’s just some outstanding questions I guess how that works in MPS given block funding arrangements. So we’ll confirm that and get back to you all.

George Masri:

Thanks Cathy. There’s another one on 24/7 care.

Q:        As it stands particularly with the on site requirements that were stated is very ambiguous. Will there be any further narrowing of this such as stating that the RN is employed for the sole purpose of the aged care home or will this continue to be interpreted by the MPS providers?

So that’s a good question. There are a range of nuances but I’ll hand over again to Cathy to elaborate further.

Cathy Milfull:

Thanks George. And thanks for the question. I think we’ve had a lot of discussion with our MPS Working Group about what on site means and we did do a bit of a paper on this for the states and territories. But certainly for those who want to participate in the trial our plan was to do a more I guess simple and easy to read policy document that explains what we mean by on site. But I guess just to reassure everyone there is no intention to sort of say that that RN has to be employed for the sole purpose of sitting next to an aged care bed and being available for that specific purpose. They just need to be on site and we need to have someone there 24/7. So they could be in that acute part of the hospital. As long as their if you like employment allows them to cross health and aged care then that would be fine.

George Masri:

Thanks Cathy. Got a question also about:

Q:        When will the provider registration requirements and the associated grandfathering arrangements commence?

Again I’ll hand over to Simon and Cathy.

Simon Christopher:

Thanks George. I might kick it off Cathy because I think the grandfathering piece might be more around clients rather than providers. So thanks for the question. The regulatory model and the provider registration process within it is due to commence with the new Act. And as Cathy mentioned earlier that’s still a decision of Government when that will occur, and based on how quickly it gets through the house and through Parliament. But in relation to the second part of your question around the data validation we’re still working through some of that at the moment and we’ll be working with Cathy and team to engage with the Working Group but we anticipate it will be – and I’m going to say this broadly so apologise. But we’ll be sequencing it from when we start to understand the new Act will come into commencement, as that starts to progress through, it’s introduced etcetera. So we’ll be allowing a really good period of time prior to that to validate the information with you so that we can work through any particular issues and make sure that that deemed information is accurate. I’ll throw to you Cathy.

Cathy Milfull:

Thanks Simon. And I think obviously we’re going to have grandfathering arrangements sort of in two areas. Yourselves as the providers, and I think that will be a reasonably simple exercise that we will start early with you all. There’s also the grandfathering of MPS clients and I think that’s actually going to be a more complex task. So that’s why I’m really keen to focus on that at a further webinar because really as some of you would be aware we don’t currently collect MPS client data in the Department so we will need to be working with providers to work out who are these people that are currently in MPS and what are the services that they’re receiving.

George Masri:

Thanks Cathy and Simon. Acknowledging just about three minutes to go. 

Q:        Is there an update on the assessment tool to be used that will determine care minutes and requirements?

I guess that’s all part of the pilot but Cathy if you want to elaborate?

Cathy Milfull:

Yeah. So thanks George. I think we’ve got two more questions around care minutes about the tool and also nursing hour ratios, things like that. So I think both of those really is why we’re having the trial and pilot phases. We understand that MPS is a bit different. There’s the integrated health component. So we want to understand what other arrangements you already have in place for your nursing staff and whether there’s existing reporting we can use and whether there’s perhaps innovative ways that we can make sure that direct care targets are met. As I mentioned it’s really about that outcome for the client and that’s what we’re after.

George Masri:

Great. So I’m just going through further questions. 

Q:        Additional MPS allocations for 2024. Will there be any impediment to the service applying for allocation where they are located in a community that also has a separate residential aged care facility operating in a community?

That’s I guess part of the criteria for determining allocation but Cathy?

Cathy Milfull:

I think there’s no if you like complete blocker, if that’s the question. So we removed that from policy I think – correct me if I’m wrong team – about a year ago following the recommendation of the Royal Commission. But it is of course something that we would take into account. So if you’re looking to open a new MPS and there is a separate RACF there are some questions around need and community need and competition but there’s no absolute blocker anymore that it can’t be done.

George Masri:

The issue of MPS sites being critical in regional areas for younger people with disability as home care providers are limited or no existence in some of those remote areas. It’s certainly a topic that is very much part of negotiations and discussions with the states and territories. The new Aged Care Act will make it clear I guess the younger people who have access to aged care. There will be some grandfathering provisions but again Simon or Cathy may want to elaborate on that.

Cathy Milfull:

I mean I don’t think I have anything specific on that one guys. I mean I think a lot of people in their submissions to the Exposure Draft obviously raised concerns about some of the new eligibility provisions. But as George mentioned really there are discussions underway between the states and territories and the Commonwealth to work out what are those alternative arrangements going to be. But I think realistically we do understand the pressures in this space in regional areas but we also are conscious of the recommendations of the Royal Commission that aged care is not really ideally the place for younger people. So we want to make sure they’re getting services that best suit their needs. 

George Masri:

Thanks Cathy. And I think the last one.

Q:        For in-home services such as domestic assistance, allied health or community nursing, how will reporting work?

They’re the services that the MPS provide. Sorry Simon.

Simon Christopher:

No. That’s all right. I was just going to say George I think part of what we are doing as we go through, and Cathy’s kind of highlighted the obligations is the next piece of work, I think that’s probably a good question that we can pick up as part of the reporting expectations across categories of registration. So we might put a pin in that if we can and definitely pick it up as a further deep dive when we get into other parts of the reg model. Because I think we’ll have greater clarity for you around that to be honest.

George Masri:

Thanks Simon.

Cathy Milfull:

And George I think we’ve got a few more questions coming in around 24/7 but I note given the time I suggest we park them for now and everybody – as I said we really want the 24/7 trial itself to be a topic at the next webinar so we’ll certainly look at your questions. But if you’ve got other things in that space you particularly want us to address please feel free to ping us at the mailbox.

George Masri:

That’s great. Look on that note I wanted to thank everyone for taking the time out today and to also provide some really useful questions and comments. We hope you found today’s session useful. We look forward to continuing to engage with you around these MPS reforms. As Cathy mentioned we weren’t able to cover off all the questions but what we’ll do is come back to you with some responses to that and also doing a bit of a deep dive in future webinars. And really look forward to hopefully you joining us in a month’s time and continue the conversation.

So thanks again. Have a great afternoon. Bye for now.

Cathy Milfull:

Thanks everyone.

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