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[Opening visual of Senator the Hon Richard Colbeck, Minister for Aged Care, making some introductory remarks via video link]

[The visuals during this webinar are of the speakers connecting via video link and visible at the top whilst speaking, with reference to the content of PowerPoint presentations being played on screen]

Richard Colbeck:

Hello and thank you for taking part in today's webinar. It's an opportunity to hear about the Morrison Government's Aged Care Reforms around funding, reporting and governance. This first webinar will focus on an overview of the Australian National Aged Care Classification system, AN-ACC, how the new model works and how it's central to delivering major funding uplifts and structural reforms, understanding the basic daily fee and changes to reporting requirements.

The Australian National Aged Care Classification, AN-ACC, model has been developed in consultation with the aged care sector and consumer groups over several years. The AN-ACC will replace the Aged Care Funding Instrument on the 1st of October 2022 and apply to all permanent aged care residents in Australia. A process of shadow assessments to classify residents into their new AN-ACC class is already underway.

Residential respite funding will also change from the 1st of October 2022 with a significant funding boost to support delivery of respite care. The government is also implementing a new financial and prudential monitoring compliance and intervention framework for the aged care sector. Its purpose is to build the sector's financial resilience and improve its accountability. It will help the government identify at-risk providers earlier and it will also ensure providers are able to meet their obligations to refund deposits to residents. The funding reforms will also set us on a path to a more sustainable, affordable and fairer future. It means more choice of care with information on quality services.

Senior Australians are at the very heart of everything we do. We are committed to ensuring that those who have contributed so much, our nation builders, our parents and grandparents, our founders and protectors get the respect, care and dignity they rightfully deserve. The Morrison Government's unprecedented investment in our aged care system will improve quality care, increase viability of the sector and provide services that respects the needs and choices of seniors.

The government has committed $7.8 billion to improving and simplifying residential aged care services. This includes $3.2 billion to support aged care providers to deliver better care and services including food and nutrition through the new basic daily fee supplement of $10 per resident per day. This will continue to be paid through the AN-ACC model from October 2022. A further $3.9 billion will increase the amount of frontline care minutes delivered to residents of aged care and respite services also to be paid through AN-ACC. We will need to use this funding to build a better, stronger aged care system for all senior Australians.

We have a lot of work to do together to make the reforms that will support our system now and well into the future. I thank you for taking the time to participate in this webinar and I encourage you to ask questions and look forward to hearing about your discussions. Thank you for your time today.

Recorded Voice:

Authorised by Richard Colbeck, Liberal Party, Devonport.

Ross Hawkins:

Well good afternoon everyone and welcome to the Aged Care Funding Reforms webinar. Firstly I'd like to acknowledge the Traditional Owners and Custodians on the land on which we meet today. I'm coming to you from sunny Ngunnawal country and so I would like to acknowledge and pay respects to Elders past, present and emerging. I would also like to extend that acknowledgement and pay respects to any Aboriginal, Torres Strait Islander peoples here today.

My name is Ross Hawkins and I'm the First Assistant Secretary for the Reform Implementation Division at the Department of Health and I'm your moderator today for this funding webinar. I'm joined today by my Department of Health colleagues, Mr Hick Hartland the First Assistant Secretary, Home and Residential Division, Robert Montefiore Gardner, Acting Assistant Secretary, Funding Reform Branch, Jessica Evans the Assistant Secretary, Structural Adjustment and Operations Branch, and Amy Laffan the First Assistant Secretary, Quality and Assurance Division.

I'm also joined by Linda, our Auslan interpreter, who's with us for the session. If you do need the interpreters you can pin them or lock them to your video screen by selecting the pin or lock at the top of the screen and selecting interpreter Linda.

We've had significant interest in this webinar today and we know that not everybody that wanted to join us has been able to do so. However a recording of this webinar will be available on our website, health.gov.au/aged-care-funding-reforms.

In the 2021-22 Budget announced early this year the Australian Government committed an investment of $17.8 billion into aged care reform packages. These measures will produce a significant transformation across Australia's aged care sector. The government's reforms will deliver a fairer funding model and a more sustainable aged care system with improved transparency and strengthen accountability across the sector.

The success of the government's aged care reforms rely on a partnership and commitment from the whole aged care sector and a critical collaboration with aged care providers. Within that context today we'll be discussing the new Australian National Aged Care Classification funding model, also known as the AN-ACC and that's an anacronym that you're going to hear a lot today. We will discuss how the AN-ACC, the Australian National Aged Care Classification, will replace the Aged Care Funding Instrument, the ACFI. We'll also be discussing the AN-ACC's shadow assessment process and provider support services and we're going to discuss the introduction of the basic daily fee reporting requirements and changes to the Aged Care Financial Report, also know as the ACFR.

In terms of how this webinar will run today, after each speaker I'll invite you to ask questions if you have any please. The way to submit your questions is through the Q&A function on WebEx which should be at the bottom right-hand of your screen. There should be an option to select Q&A or a little box with a question mark. If you go into there you can type your question in and submit it to the panel. I'll get the questions that are coming through to me and I'll put them to our panel.

We will attempt to respond to as many questions as possible during the webinar. However there will be some questions we will be unable to answer given our time limit. But following today's webinar we will use the questions submitted to review and update the material that's available on our website.

There are many ways for you to continue to connect with us on aged care funding reforms. Firstly you could subscribe to our newsletter at health.gov.au/aged-care-newsletter-subscribe. You can sign up to engage with us through the engagement hub at agedcareengagement.health.gov.au. Or you can download the resources at health.gov.au/aged-care-funding-reforms. And on the screen you'll see those details available to you.

So to begin with today I'd like to hand over to Nick Hartland who will provide an overview of the new AN-ACC funding model. Nick.

Nick Hartland:

Thanks very much Ross. So if we could just go to the next slide.

So look you will be aware that the Royal Commission recommended the introduction of a Casemix funding model for residential aged care using an independent assessment tool. We were particularly pleased to see that recommendation in the Royal Commission. We've been working on AN-ACC since around about 2017 I think. It's taken some considerable development work and lots of discussions with the sector to get it to its current point. So it was as I said particularly pleasing for us that the Royal Commission endorsed this work that had been going on for some time.

The government in its response committed to introducing ACFI on 1 October 2022. So until that time providers will continue to use the old Aged Care Funding Instrument. There is a bit of work, as Ross alluded to, to get from here to October. While the model's built, we need to assess all aged care residents under the new funding scheme. So we're in the middle of that at the moment with what we call shadow assessments. So it's not until residents have been assessed that we're able to implement the AN-ACC model. We think, and I think most providers would agree, that trying to run ACFI and AN-ACC in parallel would be a huge amount of complexity for not much gain. So that's the reason why it's in October next year and there is still a fair bit of work to do to get those assessments done. But it does give us more time to talk to you about how it will work because it is quite a different system. So if we just go to the next slide.

So I've got about three or four slides on how it works. And there is some complexity to the model. As I said it is very different and there's some complexity to the model. And I've tried to step this out in a staged way for you because I won't assume that people are familiar with it, but this means I'll have to probably repeat myself a bit over the slides.

So the first thing about - well one thing about AN-ACC, in a way it is similar to ACFI in that a needs assessment of a resident is done and then that results in a funding amount per resident per day that the government will pay to aged care providers. So in that sense it's a little bit similar.

The first kind of fundamental difference is that rather than providers doing that assessment, independent government employed assessors, or government-commissioned assessors rather, will undertake those assessments. And many of you have been around since 2015 when there was some instability in the ACFI funding instrument and we think having independent assessors is a way of solving that. And it means that the government is bound to accept the outcomes of the assessment and providers can have confidence that if there's changes in needs that the government will recognise the objectivity of the assessment.

So that independent assessment is a pretty important step for us. It does also free up clinical staff in providers, from getting them out of having to do assessments to being able to do clinical planning and case planning and stuff like that. So it's a benefit to providers. It helps the government have faith in the outcomes of the assessment but it is a fundamental change.

The second kind of change really is that the way the funding is calculated works quite differently to ACFI. And I think this is hard for people that haven't been on the full journey to wrap their minds around and there'll be probably some questions that we have to go over to kind of crystalise that.

But ACFI in broad, you'd ask a series of questions and that would result in a funding amount for a specific activity such as say physiotherapy or something like that. AN-ACC works quite differently. It attempts to understand what the total cost for looking after a person in a residential aged care facility is. And of course we all know those costs vary. So what it does is it puts people into classes or classification that reflects the full cost to the service of looking after those people. Now that system, as this slide shows, has three principle components. And it's the variable component that's probably of most interest to us but I'll go over all of them.

So while the cost obviously varies for people with different needs, when we did the research, the University of Wollongong did the research for AN-ACC what it found was that there's a sort of turn-the-lights-on cost that's the same for every resident for each facility. And that's what we call the fixed component. So every resident in a particular facility will have a similar sort of cost just for being there.

 Now that cost actually varies by say the location and speciality of the service. So the AN-ACC model, the first thing it does is in calculating how much a person needs in that residence it thinks about how remote is the facility because that's the principle difference, and whether that facility specialises in homelessness services because that's another big cost driver. So it has a series of fixed base-care tariffs that every resident in the facility gets the same amount.

The second component that it has is one that varies according to the individual resident's care needs. And when we move to the next slide I'll talk about that in a bit more detail. And that variable component is calculated by doing the needs assessment, the shadow assessments that we're running through at the moment.

There is also in the model what's called an adjustment component. So for new residents their costs are quite different to residents that are settled in a facility and I'm sure that many of the people here today will have experienced that. And so that's separately paid just to allow the person who's new to a residential aged care facility to have their needs set or to get used to the facility, to have the facility work out what services are applicable to them.

So those are the principle funding models. Obviously the major thing then is what those components are. So I think we'll go to the next slide at this point.

So I appreciate that this involves some complexity. And you'll be able to get a lot more information about AN-ACC from our website if this slide is hard for you to read or you need time to reflect on it. But look what it's saying is that when the University of Wollongong went and analysed the costs of residential aged care residents what it found was that broadly their costs could be understood by thinking about 13 classes of residents. And what this diagram shows you is how those classes were derived. And some of this I think will be pretty kind of common sense to people that have lived and worked in residential aged care.

So how costly a person is to look after in residential aged care firstly depends on whether they're mobile or not. So then when you look at people in different classes of mobility you start to find that the costs vary by things like cognitive ability. If they need assisted mobility then whether their cognitive ability is a big driver of cost. And if they're not mobile you start to also have to look at compounding factors like the risk of pressure sores, wound care and medical needs such as daily injections.

So when you put that all together you find that the best way of describing what the real cost to a residential aged care service is of looking after different people with different needs is best described by these classes. And effectively what will happen is that the assessment instruments will be used by the independent assessors to put people into these classes and then that will form the basis of payment for residential aged care providers.

It's important to note that this assessment is not a care planning tool. So these classes are the average costs that people get. They're not meant to actually specify the services. That gives providers a lot of flexibility over the types of services that they provide to their residents. And we think that's also one of the great benefits of AN-ACC. So it attempts to say this is the actual cost that you are - sorry, the average cost for looking after a resident like this. Now the service provider has flexibility to go away and talk about care plans and the specific services that they provide. Of course the Royal Commission recommendation about minimum hours is relevant to this too so there is some constraint there.

Before I go on I mean I think many of you, hopefully just about all of you, will have had some experience with independent assessment. We understand, just for clarity, that there is a need to reassess people over time and we also understand that you can't do all the assessments in one day. So this is a 6 to 9 month project of ours to assess everybody ready for the AN-ACC. And that means that the first person we assessed some time ago, that assessment will be quite old by the time you get to October. So there'll be a need to update some of those assessments.

So you can have faith that the system does allow for reassessments. If a resident's been hospitalised for 5 days or more, received a general anaesthetic and been hospitalised for 2 days or more or has had a significant change in mobility they will be needs for reassessment. And there'll also be periodic reassessments in the system. You can get more information about that as you go.

Now the next couple of slides unfortunately are even more complex than this one. So Ross is this a good time to go to some questions? Do we have any in yet?

Ross Hawkins:

There is a couple of questions in Nick. So I'll put those to you. But just before I do I just want to remind participants at the bottom of WebEx it'll either say 'Open Q&A' or there's a little box with a question mark on. If you go into there there's an opportunity for you to type your questions and if you please send them through we'll look to provide those to the panel. But there's a question here Nick which I think kind of goes to part of the costing model that you've been talking around, where it asks:

Q:          Does AN-ACC cover the increasing costs in containing safe programs for increasing levels of behaviour?

So I wonder if you could perhaps talk a bit about what might sit in some of those fundamental costs.

Nick Hartland:

Well so they're reflected in the - so the cognitive ability and compounding factors reflect some of those costs. So the model as a whole looked at all of the costs of looking after someone safely in a residential aged care facility including those with dementia. We haven't used dementia as a specific diagnosis but it's certainly picked up by the assessment of cognitive ability, and compounding factors gets picked up in this as well. So those type of costs are reflected in the structure.

I think it's important to say too that one of the benefits of a Casemix model is that you regularly review it. And so the costs to the sector and the different weights between the classes - and the next slide I'll introduce the concept of weights - will be regularly reviewed. You don't want to review them too often. Like you don't want too much instability so people have no certainty as to what the cost weights are. But you do need to keep this under review. And I was around when ACFI had a moment, and one of the problems there was we hadn't got into a routine of reviewing ACFI and it became out of date and wasn't serving the sector or the government very well. So we need to make sure that the system we adopt does get adjusted over time.

Thanks Nick.

One other question we have here is:

Q:          How the AN-ACC will incorporate the increased costs required to meet mandated staffing minutes?

Nick Hartland:

Well the government has paid - so the government has announced additional funding for the mandated staffing minutes. And so they'll be - the AN-ACC will start with the funding in the system as it will be in 2022. And from October 2022 there'll be an increase in that funding to allow the sector to increase the staffing minutes.

And again I think it would have been a problem I think to have paid the increasing staffing minutes through ACFI because I don't think there's anyone arguing that ACFI's an accurate representation anymore of the real costs of the system. So if you'd paid a $3.9 billion increase in funding through ACFI you would have had all sorts of strange distributional effects that would have meant that that money didn't go where it was really needed. So we had a strong view that the additional staffing minutes should be paid through AN-ACC. And the government's funded the increase. It will be funded through AN-ACC which reflects the best estimate at the moment of the relative costs of people and so the money will go to the right areas.

In addition the pricing studies will also be a way of upgrading AN-ACC over time.

Ross Hawkins:

Nick we've got a couple of other questions here on pricing. But I know you're about to come on to that, so maybe if you continue on to your pricing piece that'd be great.

Nick Hartland:

Okay.

All right. So talking about - I was aware when I was reviewing these slides I'm trying to think about what would someone make of it that hadn't lived and breathed the AN-ACC journey like the Department has for five years. There is some complexity in it when you first see it. We hope that it will become familiar to you and it will seem like the simplest system in the world after you become used to it. But talking about the classes and the distribution of costs is one thing. Actually trying to explain how it works is quite another. So this slide at the moment is our best go at it. And we'll take feedback through the comments section as to how close we've got to a simple presentation ...

So I'll just explain what you're seeing in front of you. So I said before that there's a base tariff that everybody in the facility gets and that's the same for everybody who turns up. So that's that left-hand side box that you can see in front of you. So it's widely known and I don't think in dispute that services that are in remote areas, such as the MMM7 areas or specialise in assisting Indigenous people, have higher costs. The same for homeless services. And so you can see that we've split this base funding that will be paid for everybody in a facility, the same amount, into six different cost brackets. And then the right-hand side of this document shows the 13 classes arranged by their cost weights.

Now when I was looking at this I thought you know what, what's really complex about that is because you think of the tariffs and the classes as dollar amounts and they will come to the service as dollar amounts, what the hell do those little numbers mean in the table? So AN-ACC works - so ACFI tends to spit out a dollar amount for particular categories of people. So you do an assessment, you get basically a pretty immediate translation to the dollars.

In the Casemix system you do it slightly differently. So what you do is you think about the average cost of a person in an average facility and then you think about the costs relative to that. So you use these little weights to say that someone is more or less than the average cost and then that gets multiplied out by a price that actually gives you the dollar amount. So I think this is a hard thing to get familiar with. I'm actually still struggling with it. But I think it'll become familiar to you over time. And some of you that have worked in the hospital system will be familiar with it.

So let me just take you through an example about how this will work. So if we try to think of the average person in an average facility, so let's take someone in a metropolitan facility, tariff 6 down there, so their weighting for that tariff is 0.49 so just under half. And if you look at class 7 that's another 0.49. So together a person in class 7, which is assisted mobility, medium cognition with some compounding factors in a metropolitan residential aged care facility, that person is pretty much going to get the average cost. So what would that mean?

Sorry, I'm getting stuck on my own simplicity.

So the way in which you would calculate what you get for that person is you'd take the average cost and that can be thought of as the average amount for residents per resident per day. So if you took the current ACFI amount - and when AN-ACC gets turned on it will not be the current ACFI amount but just to illustrate the case - currently the average cost we pay across all residents under ACFI is about $188 a day. So if that was the base average price, under this system they would get 0.98 times $188, so that would be $184.24. And you can now, if you'd like using that method, go and calculate the differences for any of the other classes and any of the other types of facilities.

It's really important to say at this stage - and we have sent a grumpy email-gram around to the sector about this - the price hasn't been determined and it will be a lot more than $188 per day. The $188 is what we pay at the moment. By the time that AN-ACC's turned on that amount will be increased to reflect the increase of $10 dollars per resident per day for the supplementation to the basic daily fee and it will be increased to reflect the government's investment to increase the capacity in the sector to meet the 200 minutes per day minimum average time per resident.

So it'll be a lot more than $184 a day. We don't have that price yet and we're not in a position to reveal it. But I don't want to get emails later saying 'This is terrible, at $188 a day my facility is getting this result,' because it'll be a lot more than that. But I think just use that $188, or whatever figure you'd like to make up, to make the calculation work and get yourself familiar with how this all works.

I had to do a couple of run-throughs of this to get it straight in my head. So I certainly appreciate that other people will want to be doing this. And I think we can then just say a short bit about respite and then it's probably over to other people. So we'll just have a look at the next slide.

All right. So respite funding is also changing under AN-ACC. It reflects at the moment - it'll reflect three subsidy components, a fixed component, a variable component that's for separate respite classes because we think they have different weights. And the government made it - in addition to the $3.9 billion for care minutes there was a separate increase for respite funding to allow it to reflect these weights. It'll reflect the accommodation supplement and the supplement to the basic daily fee.

So there is a special respite component of ACFI and one of the things that we're hoping to get out of this is more availability of respite beds. Because the other half of my job, apart from worrying about residential aged care funding, is home-care. And respite does appear to be a pretty important service offer for people who are basically based in the community, and we know we need to get more of that into the system.

So look Ross that's probably enough from me. I hope I've broadly kept to time and happy to take further questions if they come in.

Ross Hawkins:

You have kept to time Nick nicely but there are a couple of questions in. So I'll just flick through them because I think you've touched on some of these already. So we're being asked:

Q:          When the actual modelling of numbers of the dollars will be released, ie the dollars for each classification element?

I think you've covered some of that but did you want to say anything more about that?

Nick Hartland:

So we need to have the final price that's going to be fed into the system for October to be able to do that. We don't have that yet because it depends a bit on - I mean we know the dollar increases for the BDF and for the care minutes. But we haven't set - it'll also have to reflect the indexation point in July '23 and that's not known yet. And it may also change as we complete the shadow assessments because the total amount of weighted units in the system might vary slightly.

So we don't have the price. But we are aware that any resident facility thinking ahead and particularly those who have people that are familiar with the Casemix system - in the hospital system for example the first thing they say to us is 'Stop talking to me about these weights. The most important thing is price. When are you going to tell me price?' So we are aware that we need to come to this but we don't quite have the information yet. So over the course of the next year we'll certainly be looking to release it as soon as we can but we're not in a position to release the price yet.

Ross Hawkins:

And Nick while you're just there on shadow assessments we've had a couple of questions here regarding both:

Q:          How long do we have to wait for reassessment? Will the system allow for reassessment of residents under the shadow assessment process prior to the commencement of AN-ACC in October 2022?

Nick Hartland:

Yes it will. There will be a period - we're hoping to wrap up the assessments around about April or May and then that will give us a period to assess people whose assessments are old or have had one of the events that would normally require a reassessment. So yes we are looking at the need to update it. That's one of the reason why we started the assessments early and we want to try and complete them by April, May. We're going reasonably well on the reassessments. But as will be obvious to people in Victoria and New South Wales there's been some hold-ups in relation to COVID. We don't think that that's going to jeopardise the timing but we are keeping an eye on it.

Ross Hawkins:

Nick we did have a question that came in to us before we started today and it was:

Q:          Regarding the funding for physiotherapy, is that going to be included per resident?

Nick Hartland:

Well this is a complex answer. And this goes to the difference I think between AN-ACC and ACFI that I alluded to Ross so it's a good question. We've had this question a couple of times in the forums that we've presented to.

And I think the answer is that physiotherapy is definitely included in AN-ACC. So AN-ACC took a total view of all of the costs of looking after someone in a residence so physiotherapy was included in that cost analysis. So it goes to the difference between the different classes. So the cost of additional or less physiotherapy for different classes is reflected in their weights. It's different to ACFI in that there's not a specific question which says effectively 'Do you need physiotherapy?' So there's not a specific question in AN-ACC that gets a direct line of sight to any particular service offer. And we think that's actually one of the great strengths of the model. Because what we saw in the old ACFI arrangement was - and it's not just in relation to physiotherapy. There were other issues than this. So it sounds a bit unkind picking on physiotherapy in this context but just because the question was asked.

What we saw was providers' behaviour was to look at the funding source that could be gained by certain questions - I mean not uniformly. Sorry I don't want to ... again. But look there was a motivation to think about the funding that would result from a particular answer rather than the total care needs and we think that was a flaw in ACFI.

And so the idea of trying to better estimate the full costs of providing for someone in a residence we think is a much better model. And that necessarily means that you don't try and think about how much personal care, how much nursing care, how much physiotherapy. You look at the person and their care as a whole.

So no there isn't a particular question that leads to a particular answer in AN-ACC but it is in the cost base. We will monitor it in the hours exercise just to see what is being spent on physiotherapy. And when the Independent Hospital and Aged Care Pricing Authority gets up and starts doing costing studies to look at how costs are changing in the sector, all costs including physiotherapy will be looked at.

So we think the system is probably - well certainly beneficial to providers and residents. And we think actually in the long run it'll be beneficial to practices like physiotherapy where they can improve the functioning of a person and therefore lessen the cost to a service of them. We think incentives in AN-ACC will actually lead to more of that sort of provision.

Ross Hawkins:

Thanks Nick. Perhaps one more question just before I hand over then potentially to Jess Evans.

Q:          I just want to see if you wanted to highlight any of the transition supports that exist to help guide providers through this period?

Nick Hartland:

I might ask Rob who's with us to talk a bit about that.

Robert Montefiore-Gardner:

Sure.

Hello everyone. I'm Rob Montefiore-Gardner, Acting Assistant Secretary, Reform Branch. So sorry Ross would you mind repeating the question for me? It was transition to AN-ACC?

Ross Hawkins:

Yeah. I just wondered if you might want to highlight to people the transition arrangements that you were looking to put in place.

Robert Montefiore-Gardner:

Sure. So as Nick mentioned earlier, when we thought about what sort of transition we would do between ACFI and AN-ACC I did see a question milling around was there going to be grandparenting like there was when we moved from RCS to ACFI. As Nick mentioned the thought of trying to run two systems side by side where one of them had a uniform payment through the form of a base-care tariff and an independent assessment while the other system was based on provider assessments seemed like a big headache for everybody. So what we've ...

Sorry Nick just turned me off. The reason for the shadow assessment process is so that we can have everybody transition to the new funding model. So every resident will be funded under the AN-ACC from 1st of October 2022.

We think that there's a bunch of extra money - as Nick and Minister Colbeck said there's a bunch of extra money being tipped into the system. And as a result we expect that most services and most providers will end up receiving more funding under the new model than there was under the old model. There is a transition fund which is being set up which is running for two years. Where anybody who is in difficult circumstances as a result of the introduction of AN-ACC there will be extra funding available to those providers through that fund.

Ross Hawkins:

Thanks for that Rob, much appreciated. So thanks Rob and thank you Nick for that overview. That was incredibly helpful. Next speaker we have this afternoon is Jessica Evans. Jess is going to provide us some details on the support services available to providers through this transition period and beyond. So over to you Jess.

Jess I'm wondering if you're on mute. We can't quite hear you.

Jessica Evans:

Not on mute. Can you hear me?

Ross Hawkins:

We can hear you now.

Jessica Evans:

Okay. Sometimes if I lean too far back it drops out. So sorry that people can see my face so close to the screen.

I was just saying with the transition from ACFI to AN-ACC and along with some of the other reforms that are happening across the aged care sector we're really aware that providers are - and some providers are concerned about what that will mean for their financial performance and their operational costs. So the government has put in place several programs and they range from helping providers understand how they're performing financially through to getting advice on opportunities to improve financial performance and then grant programs to implement activities that can either drive down costs or improve or increase revenue.

So I wanted to talk just a little bit about some of these programs to make sure providers are familiar with what is available and where they can access this support. So the first program is the Aged Care Financial Monitoring and Business Assistance program. That's run by the Department and we have two teams of accountants that can work with providers to firstly review the factors that are contributing to financial performance and then help to identify options to reduce financial risks and then to track and monitor progress over time. So providers would undertake an assessment and then receive a short report which just provides some information about financial performance, and then options of programs that they may be able to access to receive support which is what I'll also talk through. This program is open to non-government, for-profit and not-for-profit providers of residential aged care. And the goal is to help providers identify financial issues early and to put them in contact with other programs that can help make improvements.

So then a step up from that program which is run through the Department, we've got the Business Advisory Service. Some providers might already be familiar with this because it's been in place for a number of years. The Business Advisory Service is run by PricewaterhouseCoopers and is an independent-of-government service that providers can access. And consultants will work with the provider to do a detailed analysis of the financial circumstances, also benchmark the provider against others in the industry and kind of industry benchmarks, then review business operations and governance and strategies that are in place and provide some detailed recommendations on where they could make improvements. It might be around having a look at the investment plan or governance arrangements or improvements to ICT. And it provides just a set of recommendations that can help think about where increases to revenue or decreases to costs could be achieved.

They're the advisory aspects of the program support. So then in addition to that we have announced a Structural Adjustment Fund. The Structural Adjustment Fund was announced in Budget and will open later in the year. It will include two funding streams. One funding stream is the Business Improvement Fund. So it's a second round of the Business Improvement Fund which was in place over 18 months from early 2020 to middle of this year and will provide a second round of funding through that grant opportunity. And then a second grant opportunity which is the Structural Adjustment Fund and is much more targeted at those providers that are looking to merge or sell or exit the sector where other options are not available or not appropriate.

So those two grant programs. The Business Improvement Fund will give grant funding to a number of activities like doing governance training, financial training, putting in place new IT systems, purchasing equipment that can drive labour efficiencies, as well as workforce reviews to increase efficiencies in the workforce. So grant funding to improve business operations.

Then on the Structural Adjustment Fund side the grant opportunities there will provide funding for a range of different scenarios. There might be a provider that is thinking about merging and wants to do an EOI so funding could be provided to that stream. It might be a provider that has already done an EOI and has found an interested buyer but they might need some support for refurbishments or integration of IT to enable the transaction to go ahead. So those type of activities are able to be funded through the Structural Adjustment Fund.

And these programs, they're intended to support small to medium sized providers, generally those with seven or less. But there are circumstances where larger providers are eligible and can be considered. But the funding is generally targeted at the smaller sized providers as well as those located in regional and rural and remote where there are less services available.

So that's an overview of the programs that we have put in place. I think on the next slide there is the email address and the - yeah there we go - the email address and the website which is the access to the Aged Care Financial Monitoring and Business Assistance but that's a really good gateway to explore some of the other programs. And an email to the Aged Care Financial Monitoring Program, so ACFM [at] health.gov.au if you're interested in having a financial assessment undertaken. Otherwise there is also the PwC Business Advisory Service opportunity and the grant funds that will open shortly.

So happy to take questions on any of those support programs or how people can find out more information.

Ross Hawkins:

Thanks for that Jess. We've had a question here asking:

Q:          Whether providers will have a lead-in time to adjust their model of care in response to the price ahead of implementation?

Is that something you could answer or is that one for Nick?

Jessica Evans:

I think that's a Nick question that one.

Nick Hartland:

So I think one of the things the government's done in phasing all of these reforms is as I said it's paid a significant amount of additional funding at the introduction of AN-ACC to reflect care minutes but that care minutes funding doesn't become compulsory until 12 months later. The way in which the funding has been phased gives providers effectively a 12-month period to assess where they are with the residents with the increased funding in their hand and think about what impacts that has to meet the 200 minutes on their model of care. So we're pretty confident that that sort of pattern of investment from the government gives providers a pretty long lead time if they need to adjust their care models to reflect the AN-ACC payments and the new 200 minutes requirements.

So I think structurally in the way that the funding flows and the way that the reform's been implemented I'd be very surprised if providers weren't able to manage through that.

Ross Hawkins:

Thanks Nick.

Jess there's a question here regarding:

Q:          The PwC assistance or the support that PwC provide the Department, where could people get more information about that?

Jessica Evans:

Yeah. Thanks Ross. I did see that. So I'm not sure whether we can circulate a link to attendees after the session. Otherwise there is a website and it's on the PwC website. So a google of PwC Aged Care Business Advisory Service will bring it up. It shows the overview of the work, how to go about applying, the eligibility criteria.

And I should also say that those providers that are interested in accessing the grant funding, so the Business Improvement Funding grant funding, one of the eligibility requirements there is that some form of business analysis or business advice has been received. Obviously it does not need to be through PwC but that is a free service so obviously one that providers might be interested in. But if they have their own business advisors, that would meet the eligibility requirements.

So certainly if you're thinking about applying for a grant or looking for some business advice I encourage PwC as the independent free option. But start thinking about getting that business advice because it is a requirement for the Business Improvement Funding.

Ross Hawkins:

Fantastic. Thanks for that Jess.

And I know we provide information on our website and in our newsletter that we send out. So I just want to encourage participants to connect into our engagement hub, into our newsletter. When more information is provided or updated that's provided through those mechanisms. But we'll also put the link to PwC on our website as well.

So thank you very much to Jess. That was incredibly helpful. Jess will be coming back to talk in a moment about the Aged Care Financial Report. But before that I'm going to hand over to Amy Laffan who's going to talk to us a little bit about the basic daily fee supplement and associated food and nutrition reporting requirements. So Amy over to you.

Amy Laffan:

Thanks Ross and hello to everyone. You'd all probably be aware that as part of the Royal Commission's final report food and nutrition was called out as one of the four areas of concern in aged care quality and safety requiring immediate attention. To support aged care providers to deliver better care and services with a focus on food and nutrition the new basic daily fee supplement provides $10 per resident per day.

To be eligible to receive the supplement providers are required to (1) give a formal undertaking that they will deliver good quality and quantity goods and services to meet the living needs of residents with a focus on food and nutrition and (2) report quarterly on the quality and quantity of daily living services with a focus on food and nutrition.

Submissions for the formal undertaking opened on the 1st of July this year. And while the initial deadline for submission has now passed, providers who have not yet met the deadline can still submit. However for such providers the supplement will be calculated from the date of submission and not from the 1st of July.

Providers who have agreed to the undertaking must submit a quarterly report on food and nutrition. The first such report is due on the 21st of October covering the quarter July to September. The initial reporting requirements consist of seven fields related to food and nutrition related expenditure and hours worked in food preparation, food service and food management and two free text fields seeking qualitative information on the adequacy of daily living services and plans for review and improvement.

Of these nine reporting fields four are initially mandatory. The nine reporting fields have been developed based on recommendation 112 of the Royal Commission's final report and through consultation with key stakeholders including dietitians and nutrition experts to ensure we are capturing the right kinds of information, and provider representatives and sector peak organisations to minimise the regulatory and reporting burden on providers while also maintaining a useful and meaningful data collection process.

If you do not currently collect the information requested for the non-mandatory fields simply click on the box that states that you do not currently collect this information. However note that these non-mandatory fields are likely to be required in the quarterly financial report being introduced in October next year. We are therefore encouraging providers to start considering how to collect this data now to prepare for your reporting next year.

Of the nine reporting fields requested from providers questions 1 and 2 are mandatory and are designed to capture overall expenditure on food and nutrition including on-site prepared food and ingredients and pre-prepared or bought-in main meals. Initial research suggests that freshly prepared food is generally more nutritious and more flavourful and thus has a higher chance of being consumed particularly in the frail and elderly where taste sensations may be muted or changed. Using these two fields will give the Department the ability to baseline fresh versus pre-prepared foods over time and see if an increase in expenditure leads to improvements in this ratio.

Questions 3 to 7 are discretionary and seek to capture data where it's available to broaden our understanding of factors that might lead to better nutrition outcomes for senior Australians.

Question 8 and 9 are mandatory and are designed to elicit responses around how providers will focus on good nutrition outcomes for residents including seeking best-practice examples.

We acknowledge that we will get a range of responses to these questions but they will be valuable in informing ongoing consultation with the sector.

For residential aged care and multipurpose services this food and nutrition data will be collected through a form on the My Aged Care provider portal. A food and nutrition report tile will be available on the form submission portal from the 30th of September.

So while the form isn't available now, the fields to be reported on are on the Department's website.

This will enable each outlet to fill out their own forms. So please note if you are reporting for multiple outlets you will need to open a separate report for each outlet. We understand that this is a point of discontent for some larger providers and we're investigating options to resolve it. It is important to remember though that the care of older Australians is delivered at the outlet level and reporting requirements are designed to reflect that.

Where your responses to a particular question is identical across one or more outlets you're welcome simply to repeat that response. For those providers who do not have access to the My Aged Care provider portal another method for submitting the data will be made available.

The reporting requirements will be complemented by other outcomes based measures that are currently being developed. This work includes gathering consumer experience and quality-of-life indicators.

For more information about the basic daily fee supplement and how it fits into reporting requirements please go to health.gov.au/aged-care-funding-reforms. And I'm now happy to take any questions about the basic daily fee and the food and nutrition reporting requirements.

Ross Hawkins:

Thanks for that Amy. That was incredibly helpful. I've got some questions that have come through. I think they might sit a little bit between you and Nick. So I'll throw them up and if you want to have a go first. If not we might go to Nick. So there's a question here asking:

Q:          From October 2022 will quarterly basic daily fee reporting still be required if the BDF supplement is rolled into the AN-ACC?

Nick Hartland:

Yes.

Ross Hawkins:

Okay. Thanks for that Nick. Next question:

Q:          The 200 minutes is supposedly an average. Will the AN-ACC assessment provide an allocation of minutes for each individual?

I think that's potentially one more for Nick.

Nick Hartland:

It might be one for Rob. The AN-ACC doesn't have a line of sight to the precise hours but it will be used to weight the expectation about hours across the facility. But Rob you might be able to give a better answer than that one.

Robert Montefiore-Gardner:

Sure. I mean I think that's essentially right Nick. So the average that we're talking about is just an average for the facility. So that across the facility we'll be expecting that the number of care minutes that you provide is the number that you need to provide based on the case-mix of the individuals in your care. But obviously there's no line of sight to individuals so we're not expecting that you provide 176 to the first individual and then 207 to the second. It's a way of just making sure that overall the level of care that you're providing is consistent with the needs of your residents on a whole.

Nick Hartland:

So think about this another way. Within a class there'll still be a lot of variability in the care that a person's needed. It's not an individual plan. It's an attempt to get the resource use right for the facility to provide for all of its residents. So you might have a person within one class who needs more hours of care in one week than another. And that's a natural bit of flexibility in the system that you actually need to encourage. If you lock that we'll all be in a huge nightmare of assessments and churn and planning and stuff like that. So while that looks - that'll take some time for people to wrap their minds around. One of the features of the Casemix system is to allow flexibility on providers but obviously within the guidelines established by the Royal Commission about 200 minutes on average for the average - the minimum for the average resident.

Ross Hawkins:

Thanks Nick. Just while you're on the minutes and the notion of per resident, there's a question here. It's actually saying:

Q:          In reference to the additional basic daily fee of $10 a day and the comment regarding funding for 200 minutes for staffing, can you clarify what the funding is for the 200 minutes?

Nick Hartland:

It's about a $3.9 billion investment that will start in October 2022. So we're investing $3.2 billion for the $10 uplift and that's started. And from October 2022 there'll be another significant cash investment into the system that'll fund the care minutes. Those figures, the $3.2 billion and the $3.9 billion, of course are forward estimates figures and I don't have the per-year figure with me. But in any event it's a very substantial uplift in funding to cover the care minutes.

Ross Hawkins:

Fantastic. Thanks Nick. And Amy we've got a question here regarding:

Q:          The current recommendations for dietician support to support sites regarding the basic daily fee supplement, could you talk a bit more about that for us?

Amy Laffan:

Sorry can you repeat the question?

Ross Hawkins:

Sorry. Yeah. About:

Q:          Are there currently any recommendations for dietician support to support sites regarding the basic daily fee supplement?

Amy Laffan:

Certainly there's lots of information that the Commission has on food and nutrition. Obviously food and nutrition is one of the Aged Care Standards. And if you look in the guidance there, there's a lot of resources and other things about the quality of food and quantity of food and how to adapt menus to people's needs and preferences. So I'd start with the guidance on the Aged Care Standards.

Ross Hawkins:

Fantastic. Thanks for that Amy.

We're now going to move to our final session this afternoon and then we can kind of wrap back up with a few follow-up questions. So Jess is going to talk to us about the Aged Care Financial Report. The Aged Care Financial Report is due on the 31st of October and is a key reporting element to the industry. So over to you Jess.

Jess I think you might be on mute again.

Jessica Evans:

Still not on mute. Just not close enough. Here I am. Okay.

Thanks everyone.

So the Royal Commission made a number of recommendations about introducing additional reporting requirements to ensure that there's a more detailed level of understanding around expenditure and expenses for the sector. So from this year we'll be introducing a number of changes commencing from this year to the reporting requirements and prudential obligations of aged care providers. These changes will build on consultations that have occurred with the sector over a number of years and will start with the ACFR which is due to be lodged for the 2020-21 financial year on the 31st of October. There's been a number of webinars about this. So some of you may have attended and had that information but I'll take you through at a high level now.

The first change for the ACFR in 2020-21 is the introduction of new reporting at the group or segment level. So what that means is we'll be looking to capture income, expenses, assets and liabilities across the broader approved provider group. So beyond residential aged care it will apply to community, retirement and other care and be broken down by assets, liabilities and income and expenditure.

On to the next slide.

The second addition to the ACFR is strengthened approved provider reporting. So this will introduce reconciliation statements for financial assets, loans and non-current assets. This information has generally been provided as part of the notes or additional information that's already provided in the report. However it breaks it down into additional tabs as part of the Aged Care Financial Report form going forward.

The next slide.

And thirdly, which is really key for AN-ACC as Nick has just spoken about, is the detailed facility level reporting. So until now residential aged care providers have submitted their ACFR at the approved provider level. From this financial year report there will be a breakdown for each aged care facility. And this will include income and expense information across a range of different areas which you can see covered in this slide. So we'll have care income and expenses, hotel services, accommodation income and finance. And then at the expenditure side of things it will break it down into - for care expenses it'll be things like labour and resident expenses, for hotel it will be catering and cleaning, for accommodation it will include things like rent. So a much more detailed report on what's happening at the residential facility level.

So in addition to the additional financial information that's being captured as part of the ACFR we're asking aged care providers to submit some additional information alongside the finances. So this will include any changes to corporate structures that have occurred in the previous financial year and that will be through an updated organisational chart that will be submitted.

We'll also be asking for a financial support statement. So where an approved provider has a parent entity or is part of a broader holding company, that company will be asked to state whether or not they are able and willing to provide financial support to the aged care facility to pay debts where necessary.

And then thirdly the approved providers governing body, usually the directors, will be asked to just submit a declaration that the information provided as part of the ACFR complies with the legislative requirements and is true and accurate.

So they're the changes that are being introduced as part of the reporting requirements this year. We understand that these changes are a considerable change and that some providers may need some support in being able to provide this information. We've engaged Stewart Brown to be able to almost undertake a helpdesk function to be able to assist providers in reporting on this information particularly for this first financial year.

I think on the next slide we have the - yes. So the email address for providers as they're completing their ACFR is on the screen. So ACFR.facility.reporting.help [at] health.gov.au. And through that address we'll be able to engage Stewart Brown to work with providers to understand and support how to record some of the information that is being requested as part of the ACFR.

We're also holding a detailed information session just on the ACFR and the reporting requirements on Tuesday the 29th of September at 3 o'clock. And an invitation to this session will be sent out through bids to the aged care providers in the coming days. This will also be recorded and will be put on the website. So if that time doesn't suit you'll be able to watch at a time that suits you. But it will go down into a much more technical description of how the ACFR will work this financial year and going forward.

So beyond the ACFR changes - as I said this is the first phase of reporting changes - we will be introducing additional requirements over the next two to three years. One of those changes has been captured as part of the Aged Care Bill that was introduced to Parliament at the beginning of this month. And that change is just around enabling the Department to be able to request information or documentation from a provider or a borrower on how a loan that has been made using a refundable accommodation deposit is being used to ensure that it's used for permitted uses under the legislation. So that doesn't change ACFR requirements. It's something that sits outside of that but relevant in terms of the obligations on providers going forward.

In the last session I think one of the questions I saw was about what are all of the reporting requirements and getting a copy of the quarterly report. So right now in terms of the Aged Care Financial Report that's open and online for providers to be submitting because it's due at the end of next month. Going forward in terms of the quarterly reporting there will be discussions with the sector and some early - but that won't come into effect until October next year. So there will be advice and guidance and much more detail provided on that element of reporting going forward.

So I'm happy to take any questions now but would encourage the detailed technical questions to go through to that website - sorry, that email address or to attend the webinar next week.

Ross Hawkins:

Thank you for that Jess. A question has come through.

Q:          Will the income and expenditure reporting be shared with the Commission to assess compliance?

Jessica Evans:

Yes. So the ACFR - well the Annual Prudential Compliance Statement is provided to the Commission now. Sorry, I should say the detailed reporting and the income and expenditure is not something that gets shared with the Commission. However the assessment of the financial position of providers is something that the Department and the Commission would use to determine whether or not a provider might be at financial risk and just being able to pay RADs and those sorts of things. So there are definitely elements that are shared.

Ross Hawkins:

Thanks Jess. And there's a question here. There's a couple of questions that have come in regarding the increased reporting requirements and why we're doing this. And I know a lot of this links back into the recommendations that fell out from the Royal Commission.

Q:          But I'm just wondering whether you want to say anything about why these additional reporting requirements exist?

Jessica Evans:

Yeah, definitely. Good question. And I'd say that there are several reasons for the additional reporting requirements. One relates to being able to ensure that providers have the financial capacity to continue operations. So we've seen over the years some providers that the care for residents becomes a problem if they don't have the financial capacity to continue operating. So it assists to profile the risk of providers so that we can engage with them to try and improve the financial performance before it's at a crisis point. So that's one side of it.

The other side is to really help policy and development of the sector so that we can make sure our programs and policies are effectively targeted.

And then third, and I don't know whether Nick or Rob wants to go into this, but the detailed financial information on the facility level reporting - I saw Nick's face has a shock - is really important for the development of AN-ACC. So at the moment we capture it at the approved provider level. And not having information on whether it might be labour costs or by various care types and resident costs, that is helping to inform the AN-ACC model going forward as well.

Amy Laffan:

I might just add there that the general posture of the Department will be to publish as much information as possible and some information will also be fed through the star rating system. So for example government's already committed to quality indicator results to performance, to the compliance ratings and to the staffing minutes feeding into that star rating system. But also the more information that we put out there, the more informed consumers are and the better able they are to make informed decisions.

Ross Hawkins:

Jess this might be quite easy to answer as well. There's a question here about:

Q:          Reporting on other businesses that are not aged care related, do you want to say a little bit on that?

Jessica Evans:

Yes. So the expanded reporting captures those that relate to aged care. So it's outside of residential aged care but it's not necessarily reporting on the income if you provide insurance as well for example. So it's those that do relate to aged care but outside directly of residential aged care.

Ross Hawkins:

Okay. Thanks for that Jess. So just more broadly to the panel, because we've got a little bit of time left and we've got quite a few questions that have come through, so if the panel's happy I might just free-wheel a little bit over some of the questions that we've had in over the last hour or so. There's a question here regarding workforce planning. The question is:

Q:          To undertake workforce planning for a facility ahead of October 2023 and minimum care time introduction, how can a provider determine the average care minutes required at each facility?

Nick did you want to have a go at that?

Nick Hartland:

Rob will have first crack. Then we'll see how we go.

Robert Montefiore-Gardner:

Thanks everyone. So this is something that we're still working through at the moment. But what we do is we plan to have information on exactly what the requirements for each AN-ACC class will be available to providers well before October 2022. So we'll have it well before October 2022 as a mandatory requirement October 2023.

Ross Hawkins:

Nick did you want to add anything else on that?

Nick Hartland:

...

Ross Hawkins:

Sorry I didn't catch that Nick.

Nick Hartland:

Sounds good.

Ross Hawkins:

Sounds good, okay.

Another question we have here:

Q:          Are enrolled nursing hours included in the minimum 40 minutes per day or only registered nurses?

Nick Hartland:

Registered nurses. The Royal Commission recommendation was for registered nurses.

Ross Hawkins:

Fantastic. We've also got some quite technical questions now of the model Nick. So I'm conscious that these might be better things we answer separately.

Q:          As a MMM5 residential aged care facility this provider gets 9% of their funding via the viability supplement. How is this being matched by AN-ACC?

Nick Hartland:

Well the actual outcome for different providers in MMM will depend a lot on their case-mix. So where that provider falls in terms of the AN-ACC result will be worked through when we have a better picture of the results. But we will be watching impacts in relation to the MMM 5, 4, 3 and 2, just to see that things still work.

Ross Hawkins:

Thanks Nick. Another question:

Q:          Will the system be just for residential care or will it be used for community based services as well?

Nick Hartland:

No. Well AN-ACC itself is a funding model only for residential care. So you couldn't pick up those funding categories and use them in community care, the costs wouldn't be the same weights. But we are working on a separate process to look at the funding for CHSP and Home Care to see is there a better way of funding those services.

Because we have a lot of inefficiencies as the Royal Commission observed, and as I'm sure people here might have heard me talking about in various conferences as well, in the way in which those programs are working. None of them work as well as they should. So as a part of that we are looking at developing a sort of similar classification structure. But it won't be the same weights or all the same - the questions are splitting the weights. How the dollars work will all be different because it will have to reflect what is the cost of actually providing care to people in the community, not the cost or providing care to people in a residential aged care facility.

Ross Hawkins:

Nick there's another question here regarding:

Q:          The details of the shadow assessments and at what point the providers will see those details?

Have you got any ideas of timeframes?

Nick Hartland:

Well we're planning to complete them as I said in April or May and we know that providers will want to see them as soon as possible. We don't want to - we will be looking to provide them as soon as we can after April or May. I mean I'm being a bit guarded in my answer because I don't want to - you know obviously there's some providers who completed but it doesn't strike me as a great idea to sort of do them out iteratively because providers are in very different situations in terms of their planning. So at the moment we will be having a structured process to give everybody their results when we have the completed set.

Ross Hawkins:

Nick there's a question here regarding small providers. The question is:

Q:          What happens with very small providers that may have very low care needs? Will the AN-ACC provide for them against the traditional low-care homes?

Nick Hartland:

Well it's designed to give the right level of resources to all providers. So the whole reason to embark on this is to get a fairer distribution of funding across providers.

So there's nothing that we see yet from the preliminary results that would indicate that we've got a problem with small providers being disadvantaged. We think that the system is going to work all right for them. But look obviously it gets you back to that question, and it's a fair comment too I think, of when will we see the results. And the sooner we can get the results out is obviously the better. People will settle and understand what the system means for them. But there's nothing in what we see that seems to us to indicate that small providers will be disadvantaged by this model.

Ross Hawkins:

Thanks Nick. A question in here that I think Jess might be best placed to answer.

Q:          Jess is there additional funding for increased admin hours for the increased reporting that's required? Or just exactly what is the BIF grant for, is it to purchase technology for the provider?

Jessica Evans:

The Business Improvement Fund grant covers a number of things and it can be really targeted to what is necessary for the provider to improve financial performance. So often we see once the provider has received some business assistance there might be something that recommends you could implement some better IT systems to improve workflow, accounting administration and those sorts of things. And those type of activities are able to be funded through the Business Improvement Fund. But it's not just IT. There's a range. We do capital refurbishments. I think there's a limit on that, although - so capital refurbs, governance training, a whole range of things. But definitely in relation to the increased reporting through the Business Improvement Fund, it might be type of IT systems that could be set up to help capture that more effectively and at a more efficient cost.

Ross Hawkins:

Thanks for that Jess. I might just circle back on one last question for Nick. Nick there's a question here asking:

Q:          Do the new reforms attract investment and retain the right providers?

And I think that's probably a good question to kind of reflect on as we end today.

Nick Hartland:

Yeah. Look I should say I mean I was sort of looking at the questions as they've come in. We haven't answered all of them. But just a long-winded answer. I mean I pitched the results - my presentation because I was working on the assumption that people would be relatively fresh to AN-ACC and it's a complex system, so I thought that the issue would be explaining the dynamics of the model. But it's actually true when you look at the - it seems to be when you look at the questions that there's a fair bit of understanding and knowledge of the model and people are hungry for the next layer of detail rather than just AN-ACC 101. So I'm sorry if I kind of gave a gratuitous AN-ACC 101 when we should really have been in if not the Master's class the Honour's year class. But there'll be opportunities for further discussions.

Look I think it's a good question. You're right Ross to identify that question. It's a good question to end on. I think we've got to keep in mind that where we were with ACFI a couple of years ago with - and I'll try to be polite about it but both sides saw funding volatility. The government saw volatility going up in ways that it hadn't anticipated and then the sector saw volatility going down in ways that it didn't appreciate or anticipate.

And that's incredibly unhealthy for everybody in terms of providers and government's relationship and in terms of investment certainty. So the reason why we were interested in jumping to a whole new system was just to get out of that sort of volatility. So we are wanting to build a system that is stable and predictable for providers over the long term, where you can have confidence that the weights are fair and that the price indexation arrangements in it are fair.

And one of the biggest argument points I think for the sector to want AN-ACC is that it's a way of getting a proper cost-based indexation arrangement into residential aged care and it gets us out from the indexation uplift factor that we use at the moment, WS09, which I'm sure there's no one on this call that are familiar with that indexation factor that would be voting for it.

So it is meant to give a lot more stable environment where you've got predictable and reliable cost increases and predictable and reliable ways of distributing resources between facilities. And so we think that that is really where residential aged care needs to go.

A lot of the questions - and I think it's a fair question - go to the transition. So there's always going to be a transition issue. We're aware of that and it is absolutely fair to press us on the access to information issue and we'll keep working as hard as we can on that.

And I think when we look at the transition, as Rob mentioned there is a transition fund that we will use if necessary. But we also need to keep in mind that frontloading the investment for the hours but not requiring the hours does give a sort of take-off path for providers that we think you should be able to manage. But it is worth keeping in mind that we're trying to build new long-term structures with an independent pricing authority, more objective assessments and a better cost base for the system in the AN-ACC reforms.

...

Ross Hawkins:

No. And I'd never call you long winded. I'd say it was a comprehensive response Nick. So that was fantastic, thank you.

Just on that note I'd like to thank all our speakers today and for you for attending our first Aged Care Funding Reform Webinar series. There will be more opportunities for you to have your say and I encourage you to share your views.

On the screen is details of how you can contact and engage with us. I'd encourage you to subscribe to our newsletter, to sign up and engage with us through the engagement hub and to download our resources. And we'll make sure that those weblinks that we put up today are available on our website as well. So if you didn't get a chance to jot them down at the time please head over to our website which will have that information.

Just finally I want to let you know that a recorded version of this webinar will be made available on our website. And we'll inform you the dates of our next webinars within this series or if you subscribe to our newsletter they appear in there as well. If you have any further questions coming up from today you can send them to acfr [at] health.gov.au. I hope you found today really valuable and thanks again for joining us. Take care.

[Closing visual of slide with text saying 'Australian Government, Department of Health (with logo)', 'Ageing and Aged Care', 'Thank you', 'For more information, please contact the Department of Health', 'health.gov.au/aged-care-funding-reforms' ]

[End of Transcript]

Date published: 
19 October 2021
Video type: 
Presentation
Description: 

Later webinars series will include information on new initiatives, changes to reporting and governance arrangements, and support for the residential aged care sector to transition.