- Eliza Hazlett, Acting Assistant Secretary, Emergency Preparedness and Response
- Matt Bulters, Acting Assistant Secretary, Aged Care COVID-19 Grants
- Alison McMillan, Adjunct Professor (Practice), Chief Nursing and Midwifery Officer
- Dr Lyn-Li Lim, Aged Care Quality & Safety Commission.
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Presentation slides and video
Good afternoon everyone and welcome to today’s Aged Care COVID-19 Supports Update. My name’s Eliza Hazlett, Acting Assistant Secretary of the Emergency Preparedness and Response Branch at the Department of Health and Aged Care.
I begin today by acknowledging the traditional custodians of the many lands on which we meet, and for me that’s the Ngunnawal and Ngambri people. And I pay my respects to their Elders past, present and emerging. I also want to extend that respect to any Aboriginal and Torres Strait Islander people here today and to the traditional custodians of all the lands from which we’re joining.
Today I’m joined by two colleagues from the Department of Health and Aged Care, Professor Alison McMillan who’s the Chief Nursing and Midwifery Officer, and Matthew Bulters who’s the Acting Assistant Secretary for the Aged Care COVID-19 Grants Branch. And I’m also pleased to have Dr Lyn-Li Lim join us from the Aged Care Quality and Safety Commission. Dr Lim is the infectious diseases physician consultant for the Commission and she’s going to be here to assist us with the Q&A session.
Thank you very much for sending across your questions in advance. A reminder that you can use the Q&A function which is on the right hand side of your screen if you think of a question during today’s update. We’ll try and get through as many of those as possible but we’ll also provide progressive Q&As on our website.
Before we start today’s webinar I just wanted to give you a bit of an update on the current COVID‑19 situation for residential aged care. So over recent weeks we have seen a small rise in the outbreaks and case numbers across Australia with the latest figures for outbreaks in residential aged care increasing by about 30% and resident cases increasing by about 38% across several states. And this is really consistent with what we’re seeing across the general community with higher rates of hospitalisation and antiviral use. So we just wanted to take this opportunity to remind everyone how important it is for us all to be vigilant by maintaining COVID safe behaviours. So that means doing regular RAT tests for staff and visitors to screen for infection, wearing a mask indoors to help slow infection when in close contact with others, washing hands frequently and being up to date with your vaccinations. These remain the best protective factors against reducing the severity of severe illness, hospitalisation and death from COVID-19. And of course stay home if you’re unwell and particularly if you’re COVID-19 positive.
We know that oral antiviral treatments are safe and effective in reducing the severity of COVID‑19 and eligible Australians can access oral antiviral treatments prior to testing positive for COVID-19. So it is important to plan ahead, talk to family and doctors about your treatment options if you test positive and organise early consent so that you can get onto the oral antiviral treatments as quickly as possible. We want to make sure that as many COVID-19 positive older people receive those treatments in a really timely way.
So today I also just wanted to let you know that the Australian Government will soon be announcing that it will be continuing to provide a level of COVID-19 outbreak management support to residential aged care providers for a further 12 months from 1 January 2024. And this is part of the country’s transition to living with COVID-19 and recognising that the pandemic is over but the threat to older people particularly for aged care residents remains very real. And so you may have actually seen the Chief Medical Officer’s announcement on Friday the 20th of October and he actually said there that obviously COVID-19 is no longer classified as a communicable disease of national significance and Professor McMillan’s going to talk a little bit more about that later and what that means. However the Government’s decision to continue support reflects the aged care sector’s hard work and commitment during the pandemic which has led to an increased capability and preparedness in managing and recovering from future outbreaks but that we still need to continue to work hard together and to support the aged care sector to safeguard the wellbeing and safety of older Australians.
We also know that COVID-19 continues to have a significant health workforce and financial implications for the aged care sector especially when it’s combined with managing other respiratory outbreaks or emergencies.
So the measures announced today highlight the Government’s ongoing commitment and investment in supporting the sector to manage outbreaks including COVID-19 and safeguard the health and wellbeing of aged care recipients and residents. I’ll talk a little bit more about the changes later but first of all I wanted to introduce Matthew Bulters who will provide us with an update on the Aged Care Grants Program. Thank you Matt.
Thanks Eliza. I’ll just share my screen.
Thanks Eliza and good afternoon everybody. My name’s Matt Bulters and I’m the Acting Assistant Secretary for the Aged Care COVID-19 Grants Branch. My branch manages three programs. The COVID-19 Aged Care Support Program – Extension Grant, or just the Extension Grant, the 2023 COVID-19 Aged Care Support Program, or 2023 Grant, and the Aged Care Worker COVID-19 Leave Payment Grant, or Leave Payment Grant.
The COVID-19 Aged Care Support Program Extension Grant opened on the 4th of June 2021 and closed for applications on the 31st of March this year. We received 11,383 applications far exceeding what was anticipated. This volume contributed to delays in processing these applications. However I am pleased to advise that all Extension Grant applications have now been assessed. If your organisation hasn’t received an outcome letter and hasn’t been contacted by the Department you should do so in the coming days to week.
If following assessment you have received a request for additional information to support your application I encourage you to send it through as quickly as possible. Please know the Department is also working very closely with DSS to ensure payments are progressed as quickly as possible.
The 2023 COVID-19 Aged Care Support Program Grant was established as a demand driven grant opportunity under the continued COVID-19 Support for Aged Care Budget measure announced in December 2022.
The 2023 Grant aims to support providers to transition towards managing the costs of COVID outbreaks as part of their business as usual operations. This Grant provides up to $428.8 million to reimburse approved aged care providers to maintain preparedness for and respond to outbreaks between 1 January 2023 and 31st of December 2023 for eligible expenses associated with managing a COVID outbreak.
The design and establishment of this Grant has incorporated many of the lessons learned through the previous Extension Grant. This will mean the application, assessment and outcome processes for this Grant are more clear, streamlined and timely. Notable improvements include streamlining of eligible expense categories, efficient assessment processes to allow for a more systematic approval of applications, an inclusion of tools to reduce the administration process.
Current timeframes from submission to payment of the 2023 Grant is approximately six to eight weeks, that is from application to payment, with over 80% of the applications received to date now finalised. We do want to emphasise however do not wait please to submit your applications under this Grant process. Submitting applications early will enable the Department to assess your application and continue to provide recommended reimbursement in a timely manner. The experience with the former Extension Grant found that many providers who submitted their applications right on the Grant close deadline resulted in a backlog and contributed to delays in having applications assessed and paid. So just to reinforce that, please do not wait to submit your applications under this new Grant process.
Of interest the Department is currently sending requests for information to nearly 50% of all applications received so far under the 2023 Grant. These have been mostly to clarify the COVID‑19 impact periods. Information provided must demonstrate when the first resident tested positive to COVID and when the last resident was released from isolation. Staff isolation periods under this Grant process are not relevant.
Incomplete or partial details in the cost calculator often also require clarification or where abbreviations for staff roles are used that may not be familiar to the Department. Please also try and avoid claiming ineligible items such as cleaning products, air purifiers, disposable kitchen cutlery, crockery or adult wipes. Only limited items are eligible under this grant process and these are available in the Appendix A of the Grant Opportunity Guidelines.
Finally the Aged Care Worker COVID-19 Leave Payment Grant. This Grant opened on Thursday the 10th of August this year and closes on the 16th of February next year, 2024. Under this Grant opportunity the Australian Government funded residential home care providers are able to apply for reimbursement of sick leave payments for directly employed permanent and casual workers with the employees unable to attend work due to a COVID-19 infection and has insufficient sick leave. The Leave Payment Grant is intended to reimburse eligible sick leave expenses incurred between the 1st of April 2023 and the 31st of December 2023.
A reimbursement is a payment of $450 per worker where the worker has lost at least eight hours up to and including 20 hours of work over a seven day calendar period or less, or a payment of $750 per worker where the worker has lost more than 20 hours of work over a seven day period or less.
Application forms and associated documentation can be found on the Grant Connect website for both the Leave Payment Grant and the 2023 Aged Care Support Program Grants. Thank you Eliza.
Thanks very much Matt for that very comprehensive overview. So obviously a reminder about the Leave Payment Grant and also the 2023 Grant.
So as we’ve seen COVID outbreaks can come in waves as you have all seen and all continue to do a really excellent job in protecting our older Australians who are most at risk of severe illness while continuing to provide quality care and services. So as I said the Government will shortly announce that it’s going to continue to provide a level of COVID-19 outbreak management support to aged care providers for a further 12 months from the 1st of January 2024.
So if we just put a slide up and just give you a bit of a sense of the main types of supports that are going to be provided. So they are a new outbreak management supplement which I’ll talk a little bit more in a moment, continued access to surge workforce support, which is the program that is actually used to enable at risk services who have explored all other options for workforce to actually request time limited support through the Commonwealth for surge workforce support. There’s infection prevention and control and we’re particularly going to have a focus on research and the evaluation of the findings of the IPC lead nurse role. And then data monitoring and surveillance. So the Department is going to keep monitoring and providing surveillance on the number of aged care residents and staff that are affected by COVID-19 and that’s a really important thing to make sure that we can hook services into any additional supports that they might need to manage the risks to their clients and residents.
So if we go to the next slide this shows you a little bit about the changes that are being made from the 31st of December when the current supports actually cease through to the 1st of January. So you can see those there on the slide now. So as I said a new aged care outbreak management supplement will replace the current grants process that Matt has just spoken about. So this will remove the current application process for seeking reimbursement of eligible expenses. And so the key points I guess to note there is that the supplement’s designed to provide support for all residential aged care providers to proactively plan and manage outbreaks by providing a contribution to outbreak management costs and to support providers in proactively planning ahead. So where the grants required that you actually incurred the cost and then sought reimbursement through the grants process this payment will actually be made upfront to all eligible residential aged care providers including multipurpose services and National Aboriginal and Torres Strait Islander Flexible Aged Care Services from 1 January 2024. And that will be made through those programs’ existing funding channels.
So providers are expected to receive around $940 per resident per annum in 2024. So for a service with say 100 residents that would be close to $100,000 over that period of 2024. And as I said this is a contribution to the costs of managing outbreaks and preparing for outbreaks as well. Providers will be asked to report on their use of the supplement funding through the Quarterly Financial Reporting process for residential aged care services and through other usual reporting processes that apply for multipurpose services and for NATSIFAC services. And the Australian Government will continue to support aged care homes impacted by outbreaks or other emergencies experiencing critical workforce shortages through the time limited access to surge workforce support which I had mentioned. So this is where resident safety is potentially at risk and all other regular avenues for staffing have been exhausted.
PPE and RAT tests will continue to be deployed up until the 30th of April 2024 from the National Medical Stockpile noting that providers are still required to source stocks from commercial suppliers in the first instance. And then from the 1st of May next year providers will be expected to source their own commercially supplied PPE and RAT kits with the new supplement providing a contribution towards those purchasing costs. The Australian Government is also going to continue to support infection prevention and control and emergency efforts by continuing outbreak monitoring and surveillance and investing in infection prevention and control research and evaluation. And as I noted the IPC lead nurse role is a really important part of that and Alison will talk a little bit more about a process that we’ve got underway there in terms of evaluation.
So I’m not actually going to invite Alison to speak further on the Chief Medical Officer’s announcement as well as recent ATAGI advice and the infection prevention and control measures and as I said the IPC lead nurse evaluation. Thanks very much Alison.
Thank you Eliza and good afternoon everyone wherever you are on what here in Canberra is a beautiful sunny afternoon. And again as Eliza has said I again recognise the important and tremendous role that many of you have played throughout this challenging time of COVID but I hope we are moving forward into some more stable times.
So as Eliza has outlined the Commonwealth Chief Medical Officer Professor Paul Kelly announced that COVID-19 is no longer classified as a communicable disease of national significance or as we know it CDNS. What does this mean? It means COVID-19 no longer requires a national emergency coordinated response and communication activities under the high level crisis management arrangements that we’ve had in place now for such a long time, and that most national coordination and response measures that were implemented as a part of the original announcement have already been stood down. And this does align with the advice from the World Health Organisation as well.
So there are a few key elements from the statement that are very relevant to you in the aged care sector. So the Chief Medical Officer does note that COVID-19 continues to pose a risk for some people in Australia especially older people, aged care residents, people with diabetes and people with serious health conditions. We know now that very much from the data that we have, that we’ve collected now during this pandemic. And with that in mind those at a higher risk of severe disease may wish to still consider wearing a mask particularly in crowded indoor settings or periods where there’s increased viral transmission and where there might be others even in well ventilated spaces. So we need to respect the right of everyone now in Australia to wear a mask if they feel that it’s something they feel comfortable to do so and respect their right to choose that.
The Chief Health Officer also asks that we remain very mindful of the symptoms of COVID‑19 and of course other respiratory viruses and that if we are unwell we should stay at home. And this will by far be the greatest aid to reducing or minimising the amount of transmission. So it’s a really important message and it will come up a little more I think in some of the questions. It goes to everything, whether it’s respiratory symptoms, whether it’s gastro, diarrhoea and vomiting, those sort of things. If you’re unwell stay at home.
Even with this decision we will also be maintaining targeted surveillance activities along with our state and territory colleagues so that we can monitor COVID-19 effectively and respond to any changes we might see or of course if we were to see any more variants as we did for instance with Omicron. Chief Health Officer also points out a range of COVID-19 measures that will continue that aren’t related to the communicable disease announcement, CDNS. Of course this includes vaccination and access to oral antiviral treatments for COVID. So they’re important. They are part of what we’ve all talked about now for such a long time. The hierarchy of controls, the many actions that we take in order to minimise the transmission of COVID and protect the most vulnerable.
Many of you will be aware, and I know that many of you have contacted us, that the states and territories are changing their requirements. And I know for many of you particularly those who are national providers this can be confusing to find out what’s the latest advice and information. Work is underway to refresh guidance and move towards a more nationally consistent approach to things like rapid antigen testing and the use of personal protective equipment. And this was part of the transition to move to living with COVID and working particularly in the aged care setting. So that work is underway to try and provide practical, consistent and reliable advice to you particularly in relation to testing and the use of PPE. But for now the best thing that you can do is to look at the public health advice in the state and territory where the facility is operating. You can find links to a summary of the latest requirements for aged care by visiting the Department’s website and searching for prevent and prepare. So we have summarised that information and you should be able to find it there.
It's important though to emphasise that while we’re making this transition more towards a new way of doing business rather than business as usual, because I think there are some things that we will leave behind forever, it’s important that we don’t drop our guard as we do know how easily COVID can be transmitted and that’s particularly of course we know in residential aged care homes.
You’ve heard me say so many times by now – you’re probably sick of hearing me – but vaccination is of course critical to preventing severe illness and death and hospitalisation. And surveillance programs will continue to identify outbreaks quickly and help prevent their spread which of course will help residents keep safe. So vaccination is really still a major emphasis we have. Eliza’s mentioned earlier that we’re starting to see an increase in COVID cases particularly in residential facilities and of course – I’m going to say it again – vaccine remains the best defence against COVID as it’s now well demonstrated to reduce the severity of illness in particular in the most vulnerable.
The ATAGI advice released on the 1st of September this year says that an additional 2023 COVID‑19 vaccine dose is recommended for everyone over 75 if it’s been six months since the last booster or a confirmed COVID case. But we are hearing that – and I certainly as chair of ACAG am hearing – that sometimes now providers may not know the infection details of the resident. And if you’re not sure if they’ve had COVID in the last six months it is appropriate if they still meet the other requirements, which is over 75, it’s safe to proceed with another booster for that individual. And ATAGI also advised an additional dose should be considered for people aged 65 to 74 after discussion with the healthcare provider. So it may be that a person is vulnerable and they would benefit from that extra dose. But again we know that the vaccines are most beneficial for those who are elderly, with complex conditions, disability or underlying health conditions particularly of course for those in residential aged care facilities.
You as providers or workers in the system are key to playing a role in encouraging residents and residents’ families to consider vaccination and arranging access to that vaccination for the residents or the care recipient.
If the resident or the care recipient or their family members have concerns about the vaccination it’s very helpful to discuss this with them early and encourage them to talk to their doctor or a healthcare professional about the benefits and risks of vaccination. And as providers it’s really important that you work with primary care providers to book those vaccination clinics on site. Even if the numbers are small or low it’s still important for those who are eligible to be as protected as much as they can and so you can access that. And in the home and community aged care providers you can support recipients of the care too and of course your workers to get vaccinated at their GP clinic, at an Aboriginal or Torres Strait Islander community controlled health service or of course at a pharmacy where it’s pretty easy to get a vaccination these days.
There’s also something called EVA which is Easy Vaccine Access service. It’s a simple callback service that helps individuals to book a COVID-19 vaccine. All you need to do is send an SMS with ‘Hey Eva’ to – and this will be on the website – 0481 611 382. And you can find more information on our Department’s website about EVA.
Many of you too who have been on these webinars now for some number of years have heard me talk about infection prevention and control. It’s something that I’m passionate about as you know and it has been such an important part of managing outbreaks and particularly COVID‑19 outbreaks. I can’t under-emphasise – I think you would all agree and the last three years has highlighted the significance and the importance of good infection prevention and control practice particularly in managing outbreaks – how important that is. But it’s important to remind everyone again that infection prevention and control is everybody’s responsibility. And even though we’re seeing overall case numbers reduce doesn’t mean that we can become complacent. These practices that we’ve learned over the last three years are things that now must become part of normal business. So the practices that residents and staff do for COVID also we know need to be done for other things such as flu and gastro.
An important part of readiness of course for any outbreak is making sure you’ve done the appropriate risk assessments and the regular updating of your outbreak management plans and ensuring your staff are aware of what your outbreak plans are and how they need to stay up to date with the advice that you’re providing them. As we all know now all aged care homes have a dedicated infection prevention and control lead nurse as part of their nursing leadership and they should be on site. These infection prevention and control nurses need to work closely with the entire team and of course the leadership on outbreak management and this will help inform the decision making. Their role is to continue to evaluate and refresh the infection prevention and control capabilities across your facilities and the entire workforce and work with you and others in providing advice to visitors as well.
The lead nurse therefore will make adjustments and it may be based on the prevalence or particular things within your facility to make sure that an outbreak management plan is tailored to your organisation. As many of you are aware we introduced this role relatively quickly when we identified the importance of having someone with high level tertiary qualifications in infection prevention and control. But we are interested to understand their effectiveness and what the impact of these roles have been in residential aged care homes particularly during the pandemic.
So an evaluation is being run by an organisation called Healthcare Management Advisors and includes an online survey for the IPC lead nurses, virtual and in-person interviews for a range of residential aged care homes and consultation with other key stakeholders. The results will inform us not only about what we’ve seen thus far but will help us to form our thoughts around policy in relation to these roles into the future. So it’s important to have your say. A link to the survey was included in your aged care update newsletter Issue 36 which came out on the 26th of September. The survey closes at the end of this month on 31st of October and a final report will be provided to the Department early December. So please I encourage you and all infection prevention and control lead nurses to complete the survey as it will be an important part of contributing to the evaluation and our knowledge base and inform better policy decision making into the future.
With this in mind there are three important points I’d like to recap that will help you continue with your planning and preparedness. As I’ve already said the maintenance of an up to date outbreak management plan, a risk assessment of the risk of infection and working with your infection prevention and control lead nurse and clinical leadership is a critical part of your continued planning and preparedness, making sure everyone continuously refreshes their IPC skills and make sure all staff including agency and contract staff and support staff understand the basic principles of infection prevention and control in your facility.
And the third thing as I’ve mentioned before is to continue to discuss with residents, care recipients, families and staff the importance of vaccination as the first barrier to keeping older Australians safe from COVID and of course from other infectious diseases. I’ll leave it there for today. Thank you Eliza. I’ll hand back to you.
Thank you very much Alison for that really comprehensive overview of all the different moving parts and update on work happening at the moment. So before we get into the Q&A session I’d just like to take the opportunity to remind everyone about the 2023 Influenza Vaccination Reporting which is coming up. So the reporting is going to open on the 31st of October and it will remain open until the 29th of February next year. And as it occurred last year it’s going to be available on something called Citizen Space which is one of the Department’s consultation mechanism platforms. So you should continue to report your COVID vaccinations for residents and staff via the My Aged Care portal as well as COVID-19 outbreaks, staff and resident cases and deaths due to COVID. So the vaccination reporting for flu will be through Citizen Space and the COVID vaccinations for residents and staff as well as outbreaks from residents and staff and deaths through the My Aged Care portal.
And we understand that that has caused some frustration and confusion in the past and we are in the Department aiming to streamline the reporting arrangements and consider how to implement changes that result in the least burden for service providers but still making sure that we have a good picture of the rates of COVID infection within the sector as well as vaccination rates as well after hearing just how vitally important that is for people to remain up to date with their vaccinations.
So we’ll now move to take on some Q&As. And thank you to those of you who have already submitted questions. We have got quite a few so we might just get started and we’ll move on. And strangely enough the first question is from Helen Finlay and it goes a little bit Helen to the point that I was just making.
Q: Do we still need to report COVID vaccine data on My Aged Care?
So yes. You do need to continue to report COVID vaccine data on My Aged Care. And we do really understand that the current portal is not ideally set up for COVID boosters. So we understand that that has been a cause of frustration and confusion for providers but we are certainly doing an active piece of work at the moment to streamline reporting arrangements and considering how we can implement the changes so that they are easy to understand and also the least burden possible for providers. And we’ll certainly keep you updated on changes which we hope will be made in the next month or so. So watch this space for this. But for the time being Helen yes there’s still the ongoing requirement to both report flu vaccinations through the Citizen Space platform and COVID vaccinations through the My Aged Care portal.
The second question actually comes from Ngoc Lam and it says:
Q: Do we actually need to continue reporting on resident and staff COVID cases on My Aged Care?
So I think I have covered that one up. Vaccinations need to continue to be reported and also resident and staff COVID cases through My Aged Care. And I guess this data is really important as it allows the Department to maintain a contemporary view of the current outbreaks and exposures in residential aged care homes and it helps the Government to gauge the level of support required by the sector, their workers and those in their care. So it is really important that residential aged care providers keep the information up to date by reporting additional cases as the exposure or outbreak progresses and then remembering to close the record at the end of the outbreak as well. So I just wanted to thank you I guess in advance for your continued efforts in that space. We know how busy everybody is and there’s a myriad of reporting requirements but continuing to report the resident and staff COVID cases is really essential to us having a contemporary picture of how COVID’s affecting the sector.
The next question is from Jan Kerrigan and I think it’s actually probably best for you Alison if you wouldn’t mind. Jan asks:
Q: Would you recommend that home care workers continue to wear masks?
And I know you’ve touched a little bit on that in your presentation already but if you could sort of refresh that for Jan as well.
So yeah thanks for the question Jan. And I will reiterate that there is current advice provided in infection prevention and control available to you both through the National Infection Prevention and Control Guidelines, the Australian Commission for Safety and Quality in Healthcare, and the ICEG advice really continues to be provided. Jan it’s not as simple as me recommending home care workers continue to wear masks or not. It really depends on the circumstances and situations that care is being delivered in.
I think the first thing I’d say is that I think it would be useful to talk to the consumer or the care recipient about what they’re most comfortable having. If they feel it would be most comfortable for them either for them to wear a mask while they’re receiving care or for the care provider to wear a mask I think we need to respect the rights of individuals who may choose to make that decision particularly if they feel very vulnerable. I also want to remind you Jan that masks are not the only means of protection when thinking about infection prevention and control. We need to support care recipients to get vaccinated and maintain their vaccination status. They need to understand the signs and symptoms and seek assistance and support quickly if they are infected. And all of the other measures that we know are so important. Hand hygiene and vaccinations as I mentioned and other aspects.
So I want Jan first to say that please masks are not the only protection to care recipients. And then it really is about looking at what the current risks are, the situation of the care worker. So obviously we need to make sure that care workers are not attending to very vulnerable people if they’ve got symptoms. So if they’re symptomatic they need to stay home until they’re well. And then depending on again the choice of the consumer or the circumstances, the prevalence of COVID in the area, it might be that a mask is worn along with all of the other infection prevention and control measures we use. So wearing a mask in itself is not the only thing. It needs to be put on properly, it needs to be removed properly, and the person delivering the care needs to follow all of those necessary measures to protect against transmission of a communicable disease. So I’m sorry the answer’s not straightforward but this is complex and I don’t want to simply provide an over-simplification of something that needs to be considered both through the care recipient’s needs, the current trend of the infection in the area and making sure that the care worker is familiar with all aspects of infection prevention and control and not solely that of wearing a mask. Thanks Eliza.
Thanks Alison. And then the next question is from Michelle and we might actually ask you Dr Lim to actually answer this one. Michelle says:
Q: I visit my parents at their aged care home and they have a two hour visiting policy with RAT testing required before entry. Is this still necessary?
Dr Lyn-Li Lim:
Thanks for that question Michelle. I think as just flagged in the previous response by Alison this is not really very straightforward. It’s a nuanced approach. But we know that currently aged care providers may apply different approaches to reducing the risk of bringing in transmissible infections into their home. And this is according to the known level of risk. So some of the approaches as Alison has covered include really just not entering the facility if you’re unwell, and that applies to staff and visitors, RAT testing, use of masks, vaccination. So all the things that Alison has talked about. And we know that where we are at the moment that some providers have chosen to relax policies on some of these as they’ve assessed that the risk of COVID transmission in their local area and also as it applies to their facility is low. And so they will then also have processes in place to monitor this as an ongoing risk and they may choose to increase or reduce their levels of response according to these changing levels of risk. So not a straightforward answer but it’s important that it’s a nuanced answer.
Thank you Dr Lim. That’s really helpful. I guess a similar kind of perhaps not as nuanced answer for this one is from Joanne Truen. And she’s asked advice on community aged care workforce who have tested positive. What’s the actual advice for them Dr Lim in terms of when they should be working?
Dr Lyn-Li Lim:
Thanks Eliza. This is straightforward and I would refer us all to the CDNA Guidelines that have been around for around 12 months for aged care workers. And this applies to the community aged care setting as well noting that Joanne is asking for advice on community aged care workforce. So in this situation the community aged care worker has tested positive for COVID so what that means is they cannot attend work for seven days. And after seven days they can attend provided they are symptom free for at least 24 hours. So that is what the CDNA Guidelines recommend.
And what this really means from a practical perspective is that we are protecting vulnerable older people from potentially exposure to staff that are performing high risk activities such as providing close contact personal care. One thing I also wanted to mention is in terms of return to work some people who have had COVID may have a persistent cough or symptoms after the infection and this can sometimes persist for more than seven days. So I suggest that it’s worth getting it checked out by their GP to determine if they still have persistent symptoms whether this is related to COVID and might stop them from returning to work as expected. Thanks.
Thanks Dr Lim. So the next question is from Mary-Clare Smith and Alison I might get you to take this one please. It says:
Q: Will there be ongoing support for residential aged care facilities including multipurpose services moving forward for training of staff in infection prevention?
Thanks Eliza. Thanks Mary-Clare. So I think we’ve already discussed today the recognition that whilst the pandemic is over the threat to older Australia remains particularly at risk in the residential facilities. All residential aged care homes should have an infection prevention and control lead nurse who can undertake training with both new and existing staff. Also the Department of Health and Aged Care along with our colleagues in the Aged Care Quality and Safety Commission have put new arrangements in place for education based on the COVID‑19 aged care infection control online training modules. So there’s new training available that will provide that support both for existing and new staff in infection prevention and control and these modules can be accessed via the Commission’s website also known as ALIS – A-L-I-S. So yes ongoing training for staff is there. I’ve already mentioned work is underway to provide new updated guidelines but that training is online and the feedback has been that it’s really positive and very effective particularly because it’s focused on a particular type of work in a work situation.
Thanks Alison. And then this is a similar related question.
Q: Is there going to be another grant for IPC lead nurse training?
So I might answer that one. So as many people will be aware there was actually a lead nurse training grant available. It was available up until the 30th of June this year where people had to put in their applications before 30th of June and then complete recognised training that was listed in the Grant Guidelines for lead nurse training grant positions. So that grant program was not as well subscribed as we had expected and what we’re going to do is actually wait for the outcomes of the evaluation of the lead nurse position which we’ve talked about a couple of times today and we’ve specifically sought some feedback about that grant and why it did or didn’t work for different people. And then we’ll be looking to put advice to Government about what is the best approach, whether it’s grants or whether it’s some other arrangement to make sure that training for IPC lead nurses is still supported. I think as we’ve talked about today we see that as really critical as part of the IPC kind of clinical infrastructure within residential aged care services so we do intend to actually look at that issue very closely and make recommendations to Government next year about what should happen in that space.
I can now maybe go to a question from Prab Kwa and this is a question for you I think Matt.
Q: Would the grant, I think the Extension Grant, be extended post-December 2023?
Yeah. Thanks Eliza and thanks Prab. The grant that’s open at the moment is the 2023 Aged Care Support Program Grant and no it won’t be extended beyond December 2023. However applications can still be submitted until 4th of April 2024. So the eligibility period is for the 2023 calendar year and the application process closes on the 4th of April 2024. As Eliza indicated earlier the Australian Government will continue to provide COVID outbreak management support funding for residential aged care providers for another 12 months through the Aged Care Outbreak Management Supplement process.
Thanks Matt. I’m now going to go to a question from Matthew Ezika and his question is:
Q: Where do you see COVID outbreaks ending up in residential aged care in 12 months’ time?
That’s a bit of a crystal ball one I guess Matthew but maybe if I start and then I might ask other members of the panel to provide comment on there. Obviously COVID-19 remains a really serious infectious disease but as we’ve heard it’s no longer considered a public health emergency. But the epidemiological outlook at the moment suggests that we will continue to experience continued waves of infection over the next few years. And I think we all hope and expect that those waves won’t be as large as they have been in the past but we have certainly seen a trend over the last few years where we’ve actually had a wave sort of around the Christmas kind of summer time where more people are visiting and moving around and then another one in winter. And we’ve seen that for the last couple of years now. But thankfully the height of those peaks has actually reduced year on year.
So I think the latest advice as best as anyone has it is that we should expect future kind of ripples or wavelets I think is the language people are talking about in terms of COVID-19 for the next few years. And that’s why it’s really important to continue with the COVID safe behaviours and particularly the vaccinations obviously to keep our community immunity up and keep people as safe as possible. So it’s a little bit difficult to know about new strains but I think at the moment that’s the most up to date epidemiological advice that we have. But perhaps Lyn-Li or Alison might like to make a comment on that from a clinical perspective.
Dr Lym-Li Lim:
I’ll jump in there. Sorry. I jumped in before you Alison. I completely agree Eliza. I think if we look at the patterns and trends what’s useful is to look at in terms of hospitalisations. We see ongoing hospitalisations in all jurisdictions. So it goes up, it goes down, but it doesn’t fall to zero. The other thing that we have now that we didn’t have a few years ago is local data in many jurisdictions drilled down to local areas that can inform us on real time risk. So that’s really useful as well. But I think Eliza you’re right. The crystal ball is I think that COVID is here to stay for a while and we need to be prepared for that. Alison?
Yeah. I think we need to understand that life has changed for good. And we know a lot more than we did in November of 2019 about the important elements of outbreak management. So whether it’s COVID or whatever it is that comes next or whether it’s flu or whether it’s gastro or something else we haven’t even thought about yet, outbreak management planning, so the planning, the preparedness, the recognition and the quick response to minimise spread and then the recovery from, are principles that will remain irrespective of the cause. So whilst things may change over time with COVID there may well be something else that comes along. So I think we need to have now a mindset that says that outbreak management is for anything of this type of a communicable disease like this or an infectious disease and that our planning should be – that we should continuously be thinking about the risks to those most vulnerable and make sure our systems are in place to protect them.
So yeah I think we may see as the others have already said ripples, whatever you want to call them, but we still need to be prepared for whatever else might come along that might impact on the most vulnerable in our care and be prepared to do that with good outbreak management planning and the continuous reinforcement of the importance of that upon visitors, residents, family and friends and staff. Thanks Eliza.
Thanks Alison. I’ve just got a question here from Irene Iloma and she just wanted to confirm if IPC leads apply to home care providers or just to residential aged care homes. And so thank you for that question. Yes. At the moment certainly IPC lead nurse roles apply only to residential aged care facilities and that was a requirement that was put in a couple of years ago now and is now sort of covered by the Aged Care Quality Standards as well to have a requirement for an infection prevention lead nurse in all residential aged care facilities on site. So it’s specific to residential aged care. Thanks Irene.
I’m just going through. I think we are probably almost out of time. There have been a number of questions come through and I think the best thing we can do is do up some Q&As and look for some common themes, which there certainly are some here. I might have time just to answer one. There’s a number of questions around vaccination reporting and I think it must be from some Victorian providers saying:
Q: Why do we need to report vaccinations through VICNIS and also through My Aged Care?
So VICNIS is actually a Victorian specific sort of collection. So we have actually met with the people that work in VICNIS recently and we’re certainly talking about what they collect and what we collect. And again it’s part of that kind of streamlining work that I mentioned earlier. But at the moment VICNIS only applies to Victorian services. So it’s important that the data is actually coming into My Aged Care so we can have a national picture and have full coverage of what’s happening in terms of vaccination across the country.
So I think we’re probably out of time. I guess if I can just go back now to thank people for their time. And in conclusion I just wanted to add that if you’ve got any other questions please email email@example.com and we will prepare some frequently asked questions response. And I wanted to thank everybody who was able to join us today. We hope you’ve found the session useful. Also wanted to thank my panel members, so Alison McMillan, Dr Lyn-Li and Matthew Bulters for their time today. And we might just put up on the screen as we close those useful email addresses and websites as well. So thank you very much everybody and we’ll look forward to talking to you again next time.