Residential aged care funding reform update – Webinar

Secretary’, ‘Residential Care Funding Reform Branch’, ‘Department of Health and Aged Care’, ‘Wednesday 18 September 2024’, ‘health.gov.au/aged-care-reforms’, with image of QR code]

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

Mark Richardson:

Hello everyone and welcome to our latest Residential Aged Care Funding Reform webinar. As with the previous webinars today’s event is being recorded and will be available later for those who would like to watch it again or who were not able to attend. The slides are available on the Department’s website and you can access these by scanning the QR code on this slide. We will use QR codes throughout today’s presentation so please have your mobile phone ready.

Before I go any further I would like to acknowledge the traditional owners and custodians of the lands on which we are meeting today. I am in Canberra on the lands of the Ngunnawal people. I’d like to pay my respects to Elders past, present and emerging. I’d like to extend that acknowledgment and respect to any Aboriginal and Torres Strait Islander people who are here with us today.

My name is Mark Richardson. I am the Assistant Secretary of the Residential Aged Care Funding Reform Branch at the Department of Health and Aged Care.

Joining me today from the Department are Claudia Dukats, Director, AN-ACC Policy and Funding Reform, Penny Philbrick, Director, Care Minutes Policy, Aden Pulford, Acting Director, Residential Aged Care Funding Assurance Policy, Mark Shen, Director, Hotelling and Stakeholder Engagement, and Mitch Docking, Director, Aged Care Wages Implementation. And joining us from the Independent Health and Aged Care Pricing Authority or IHACPA are Kees Van Gool, Executive Director of Pricing and Analytics, and Rachel Hauenschild, Director of Aged Care Pricing.

I want to clarify upfront that this webinar will cover funding changes for residential aged care not recommendations of the Aged Care Taskforce. The focus of this webinar is AN-ACC, hotelling, care minutes and the 24/7 registered nurse or RN supplement. As such we won’t be able to answer questions about means testing or other Taskforce topics.

Also some of the funding numbers we will step through today are not quoted in the Minister’s media release from yesterday. This focused on the funding for the Fair Work Commission Work Value Case Stage 3 covering residential care and home care. Today the funding numbers referenced will be in relation to residential care only and also include non-Fair Work Commission Stage 3 funding.

At the end of the presentation we will have a question and answer session and we will respond to as many questions as possible including those that have already been pre-submitted. You can lodge questions in the Slido box on the right hand side of your screen and also vote on questions you would like us to answer. If you can’t see Slido you can also access it via a link in the chat on the bottom right of your screen. If we don’t have time to get to your question today we will answer the most common questions in a Q&A document published on our website in the coming weeks. All questions will be used to inform updates to our online resources.

We really appreciate your feedback so we can improve future webinars for you so please let us know what you think of today’s webinar through completing the short survey provided at the end of the presentation.

In summary in today’s webinar I’ll take you through the high level funding numbers. Claudia will take you through the residential aged care funding changes such as the new AN-ACC price, changes to the base care tariffs or BCTs and AN-ACC class weightings and the new hotelling supplement rate. Penny will explain how 215 care minutes is being implemented and outline changes to the 24/7 RN supplement. And last Aden will cover the care time reporting assessments process and some key findings to date that you should be aware of to help improve the accuracy of your reporting.

The Government’s announcement yesterday of the AN-ACC price and hotelling supplement value amounts to a total funding uplift of $5.8 billion provided over four years from 2024-25. As you can see on the slide this $5.8 billion can be broken down into $3.3 billion to fund the Fair Work Commission Aged Care Work Value Case Stage 3 decision and $2.5 billion to fund other costs.

This slide breaks down the $5.8 billion in funding even further. Starting at the bottom left hand corner of the slide and moving clockwise around the slide there is with some rounding a $2.7 billion funding increase to AN-ACC to align with the Fair Work Commission Stage 3 decision from 1 January 2025. This will support wage increases for in scope care workers such as personal care workers, assistants in nursing and recreational activities officers.

A further increase in AN-ACC funding of $2.1 billion for other costs such as the superannuation guarantee increase and inflation. A $0.5 billion funding increase for the hotelling supplement to fund the Fair Work Commission Stage 3 decision for in scope hotelling staff, and $0.4 billion in funding for the hotelling supplement to support providers to meet the costs of hotelling services such as catering, cleaning and gardening.

Collectively these changes to the AN-ACC care funding model and the hotelling supplement represent an estimated 15% increase in average funding per resident per day from $276 in 2023‑24 to an estimated $318 from 1 October 2024.

Looking at care funding only or funding distributed through AN-ACC these changes represent an estimated 13% increase in average care funding per resident per day to an estimated $305 from 1 October 2024.

This slide looks at the Fair Work Commission Stage 3 pay increase in a little more detail. The $3.3 billion fulfils the Government’s commitment to fund the Fair Work Commission’s decision to increase award wages for direct care workers which will be phased in over two tranches with the first tranche commencing on 1 January 2025 and the second tranche on 1 October 2025. And ancillary aged care workers will receive the full award wage increase from 1 January 2025. The in scope workers include personal care workers, assistants in nursing, recreational activity officers and ancillary workers including administration staff, laundry hands, cleaners and food services assistants.

At this point the Fair Work Commission Stage 3 decision does not include further increases for aged care nurses. However the Fair Work Commission is still considering increasing award wages for all aged care nurses as part of Stage 3. The Stage 3 decision is ultimately expected to benefit around 340,000 aged care workers. 

I’ll now hand over to Claudia to take you through the AN-ACC and hotelling supplement funding changes.

Claudia Dukats:

Thank you Mark. The AN-ACC funding model has four significant changes occurring on 1 October 2024. Firstly the AN-ACC price will increase to $280.01. I’ll go through the detail of the costs funded through this price in the next slide. Secondly the base care tariff structure and funding for non-specialised services located in Modified Monash 1-5 areas have been revised to better align funding with costs at different Modified Monash locations. 

The basis of this decision is that before 1 October 2024 85% of services located in Modified Monash 1-4 areas were grouped together in a single base care tariff category and received the same base care tariff funding. Analysis has found that costs for services in Modified Monash 1-4 areas varies and that non-metropolitan residential aged care services have different cost drivers and experience poorer financial outcomes than their major city counterparts.

Analysis has also found the cost profile of services located in Modified Monash 4 more closely resemble that of Modified Monash 5 services rather than services located in Modified Monash 1‑3 areas.

As a result services located in Modified Monash 2-3 and 4-5 locations will be grouped together for base care tariff purposes. In addition national weighted activity units or NWAUs for these base care tariff categories will be adjusted to reflect the higher cost of delivering care outside metropolitan areas.

The third change is that the AN-ACC classification funding for the AN-ACC classes will be adjusted to reflect the actual cost of delivering care at the new AN-ACC price. These changes would see a funding uplift for residents with lower care needs such as residents with low or medium cognition score or classes 3-8 and relatively lower funding for residents with higher care needs such as those with limited mobility or classes 9-13.

And lastly there will be a review of policy settings for remote and specialised base care tariffs. I’ll provide further detail on this in the coming slides.

This slide describes the cost components that are funded through the new AN-ACC price of $280.01. They include funding for the additional cost of moving from the current mandatory 200 care minute requirement to 215 care minutes from 1 October 2024. The funding for the care minute increase was previously part of the 2022-23 Budget which is why there is no funding attached to this cost. This means the funding is already available and the price increase is the mechanism to access it.

The Fair Work Commission Aged Care Work Value Case Stage 2 and 3 decisions, the Superannuation Guarantee increase from 1 July 2024, inflation and other wage rises including the Fair Work Commission annual wage review 2023-24, and funding to cover the difference had the AN-ACC price been updated from 1 July 2024.

The inclusion of an adjustment for the Fair Work Commission Stage 3 decision that takes effect on 1 January 2025 in the 1 October 2024 AN-ACC price will ensure providers have sufficient funding to pass on the 1 January 2025 increases with no further AN-ACC price adjustments required until the Fair Work Commission’s decision affecting registered and enrolled nurses is finalised.

As mentioned previously Government has decided to implement a new, more granular base care tariff structure for services located in Modified Monash 1-5 areas from 1 October 2024. This will result in more equitable and efficient funding for metropolitan, regional and rural services. This realignment was proposed by the Independent Health and Aged Care Pricing Authority and is supported by provider financial reports submitted to the Department, the Aged Care Taskforce Report findings and the University of Technology Sydney’s Australia’s Aged Care Sector Full Year Report 22-23.

The new base care tariff structure and NWAUs will result in a 2% increase in the base care tariff funding for services in Modified Monash 1, a 12% increase for services in Modified Monash 2 and 3, a 16% increase for services in Modified Monash 4 and a 4% increase for services in Modified Monash 5.

The Independent Health and Aged Care Pricing Authority’s 2024-25 pricing advice also recommended base care tariff national weighted activity unit reductions for all non-specialised services in remote, very remote – so Modified Monash 6 and 7 locations – specialised homeless and specialised Indigenous and Torres Strait Islander services. This reflects the reported low expenditure by these services compared with their AN-ACC funding.

IHACPA’s findings were supported by the Department’s analysis of provider financial reports however rather than reduce base care tariff funding for these services on 1 October ’24 the Government has instead asked the Department to review policy settings to ensure that the additional funding provided is spent as intended. The review will consider the eligibility rules for specialised status, the need to deliver appropriate care programs for this vulnerable cohort consistent with the additional care funding that is provided, understanding the relationship between care costs and the proportion of specialised residents, whether these costs are captured in the financial reporting by providers, and under-occupancy levels in remote and very remote locations including operational bed funding. We will provide more information about the review process as this project progresses.

So what does this all mean for your actual funding? These tables show the base care tariff national weighted activity units and related funding from 1 October 2024. As you know the AN‑ACC price is equivalent to one national weighted activity unit or NWAU with NWAU weightings multiplied by the AN-ACC price to work out the amount of the fixed or base care tariff funding and variable or resident case mix funding each provider receives under AN-ACC.

The AN-ACC price change from 1 October 2024 means one NWAU will be equivalent to $280.01. With that in mind the tables on this slide and the next slide show the funding outcome for each AN-ACC component as they are currently designed based on the new AN-ACC price of $280.01 with updated weightings. For the fixed or base care tariff funding component on this slide the subsidy payable to services where funding is based on occupied places will increase to between $140.01 to $257.61 per bed day or to between approximately $51,000 to $94,000 per year from 1 October this year. And between $190.41 to $504.02 per bed day or to between approximately $67,498 to $183,966 per year for services where funding is based on operational places.

These tables show the AN-ACC class NWAU changes recommended by IHACPA and will be implemented from 1 October 2024 for all existing and new residents. For the variable or case mix funding component on this slide funding for permanent residents will increase to the amounts outlined in the green table to the right with new funding ranging from $53.20 for a low care AN‑ACC class 2 resident to $224.01 for the highest care need residents such as classes 1 and 13, or to between approximately $19,418 to $81,763 per year. And for respite residents funding will also increase to between $102.20 and $193.49 for the three respite classes depending on the person’s care needs, or to between approximately $37,303 to $70,623 per year.

Care minutes will be adjusted to reflect the new class weightings which Penny will take you through shortly.

From 20 September 2024 the hotelling supplement will increase to $12.55 per resident per day. This additional funding supports providers to meet the costs of hotelling services such as cleaning, catering and gardening. The $1.09 increase will increase Commonwealth funding to the sector by $537 million with additional consumer contributions bringing the funding to the sector to $634 million. Additionally there will be a further increase of $1.89 from 1 July 2025 which will help providers better meet hotelling costs. This represents additional Commonwealth funding to the sector of $391 million over four years or $475 million including consumer contributions.

The regular indexation on March 20 2025 will still occur. Providers are expected to use the increase in the supplement rate to deliver hotelling services including higher award wages for hotelling staff.

I will now hand over to Penny Philbrick for an update on the care minutes and 24/7 registered nurses.

Penny Philbrick:

Thank you Claudia. As you would be well aware by now from 1 October 2024 the sector wide average care minutes will increase to 215 total minutes per resident per day. This includes 44 registered nurse minutes. The AN-ACC price from 1 October funds providers to deliver these increased minutes.

This slide shows the new care minute allocations associated with each AN‑ACC class. These are used to calculate service level targets applying from October 2024 onwards. The new allocations have been developed to not only increase the minutes but also incorporate the latest IHACPA costing study evidence and align with the AN-ACC class funding weight changes Claudia outlined earlier. This is the reason that the minutes have not uniformly increased and for some classes the minutes have even decreased. This change ensures funding and care costs which in large part relates to care minutes remain aligned. You can see these new allocations in the 24/7 RN and care minutes guide.

Service level care minute targets that apply from 1 October are now published on the Department’s website and will be available in GPMS before the end of the month. As we’ve previously communicated via the Department’s regular channels we implemented additional quality assurance steps earlier this year to check the accuracy of targets before they are published. This is why the targets are now published slightly later than they previously were. Our care minute target calculator is a useful resource to help you verify the targets we publish against your own records. There are now two versions of the calculator on our website, the updated version for calculating targets that will apply from October 2024 onwards and the older version for checking any targets prior to this. You can find these by searching ‘Care minute calculator’ on the Department’s website or scan the QR code that you can see on this slide. If you notice what you think might be an error with the targets we have published please contact us using the email address shown on this slide.

As was announced earlier in the year from 1 October 2024 you can meet up to 10% of your registered nurse specific minutes with care time delivered by enrolled nurses or ENs. This policy adjustment is intended to help services better meet their RN targets where there are workforce shortages and recognises the vital role ENs play in residential aged care. It’s very important to note that this policy adjustment doesn’t impact the responsibilities or scopes of practice of nurses working in residential aged care. ENs will continue to contribute to care outcomes under the delegation and supervision of RNs.

Last this adjustment will not impact the way you meet your 24/7 RN responsibility or how you report your care time through the Quarterly Financial Report or QFR. Our systems will automatically calculate the number of EN minutes that can be attributed to your RN minutes. This means all EN care time must continue to be reported in the EN category of the QFR.

Government has also decided to make two changes to the 24/7 registered nurse supplement on 1 October 2024. The first change is that the supplement will reduce and the full rate supplement will only be available to facilities with 50 residents or fewer down from 60 residents currently. This change is something that we have communicated since the supplement was first announced in late 2022. This reflects the additional AN-ACC funding providers receive from 1 October 2024 to increase their registered nurse care minutes to 44 minutes per resident per day.

The second change is that the structure of the full and reduced rate supplements will change to align with the new AN-ACC base care tariff structure with separate supplement rates for Modified Monash 1, Modified Monash 2 and 3, Modified Monash 4 and 5 and Modified Monash 6 and 7 regions. This allows us to target funding better based on the costs of delivering nursing care by location consistent with AN-ACC funding. You can find the rates on this slide in the care minutes and 24/7 RN guide.

I’ll now hand over to Aden Pulford for an update on care time reporting.

Aden Pulford:

Thank you Penny. I’m going to take this opportunity to talk about how the Department assures the accuracy of care minutes and 24/7 RN information reported by providers through their Quarterly Financial Reports and the monthly 24/7 RN coverage reports.

To provide some background care time reporting assessments were introduced late last year aiming to strengthen reporting on mandatory care minutes and the 24/7 RN responsibility as well as to support continuous improvement of reporting across the sector. It is important to note that all providers will participate in a reporting assessment and services are targeted through random and risk-based selections.

So why are care time reporting assessments important? They help provide us with improving the accuracy and reliability of the reporting and information management processes while ensuring that they are meeting the reporting and record keeping responsibilities. By ensuring the accuracy of this information we support older Australians to make informed decisions about their care through star ratings, we support the Aged Care Quality and Safety Commission in their regulatory functions, and we reliably inform IHACPA’s costing studies and Government policy decisions creating a better representation of the cost of high quality care. 

I have included a flowchart on this slide which outlines six steps of the reporting assessment process. Initially an assessor will reach out to a service’s nominated contact following up with a request for information. Then a review will be conducted and analysis will be conducted over the information provided and we will identify any real or potential issues with reporting. It is important to note that we are committed to working with the service through this process. Providers will receive a finalisation letter at the conclusion of the engagement including recommendations or required actions.

The majority of requested information and documents should exist as part of the preparation of a service’s QFR and the 24/7 RN coverage report. Leveraging this information reduces the burden of developing additional or supplementary materials to go through a reporting assessment. We have also developed more tools, resources and guidance which aim to streamline this process.

While reporting assessments are an assurance activity which targets previous periods we are committed to ensuring the quality of data before and throughout reporting cycles. Through data validations we are able to ensure the quality of reported information about residential hours and care costs. Some of the validations we use include examining average hourly rates, occupied bed days, expenditure and quarterly changes in care minutes. I have included some essential guidance for QFR reporting on this slide. You will find more information and resources on the next slide.

Within the QFR’s residential care hours and costs section it is important to only report relevant information within the quarter.

It is important to understand and become familiar with the reporting definitions for the QFR and to only include relevant information in the labour hours worked section. Do not include non-worked hours such as sick and annual leave, training or voluntary hours. The calculated care minutes should align with the average care revenue per resident per day. Services should require allied health providers to supply hours data alongside their fee invoices delivered by each category of allied health worker at a service level.

On this slide we’ve got some resources and support for providers in conducting their reporting. So we’ve got the QFR FAQs for residential care labour costs and hours reporting, a guide when collating labour costs and hours for financial information. The QFR and ACFR residential care labour costs and hours data validation guide is designed to help aged care providers identify issues with their submitted data. The model pack is an Excel tool aimed at helping guide aged care providers when submitting information and documents for a care time reporting assessment. It contains examples of calculations and reports of information and documents commonly requested. This Excel tool aims to help aged care providers identify gaps in their RN coverage. It contains instructions on how to calculate gaps in coverage for the reported month. We have also provided contact details for support and for further enquiries.

I’d like to finish my segment by taking a look at some common reporting issues that we see through our work in care time reporting assessments. Misreporting can either overstate or understate a service’s compliance with their care minute and 24/7 RN responsibilities both of which reduce the accuracy of measures such as star ratings and reduce informed decision making by the Department, by Government, by IHACPA across the sector. 

But first is the incorrect categorisation of staff, for example reporting hours from a lifestyle worker as though they were worked by a PCW or an AIN. Next is the inaccurate apportionment of staff. Hybrid staff can include roles such as care managers or regional clinicians which have both direct care and non-direct care responsibilities. It is important to only report direct care against the direct care categories.

The next issue is incorrect shift measurements. This can include using incorrect reporting periods when attempting to align payroll reports to the QFR periods or double counting overtime or reporting non-worked hours. With respect to the 24/7 RN report unreported absences are the key type of misreporting. This is generally due to limitations in provider’s systems and we’d refer you on to our 24/7 reporting tool that we’ve recently published to support mitigating those errors. Another key issue is the inclusion of staff that are not on site or on duty towards direct care minutes for the RN 24/7 responsibility. If they are not on site they are unable to deliver care minutes or contribute to the 24/7 measurement. And finally there are generally insufficient records with respect to agency staff which decreases the quality of reporting and decreases its reliability.

I will now hand back to Mark Richardson.

Mark Richardson:

Great. Thank you Aden and thank you I guess to all the presenters today. That completes our presentation and we’ll now open up for a Q&A session for the remainder of the hour. But before we do that I just want to reiterate like I said at the start you can lodge your questions in the Slido box on the right hand side of your screen and if you can’t see Slido you can also access it via link in the chat on the bottom right hand of your screen. And also once again just to reiterate all questions and answers including the ones that we don’t get to we will publish an answer to online on our website as part of our standard practice for webinars. And also lastly we will go through the pre-submitted questions first that we received before the webinar just to do justice to the people that took the time to submit those questions before the webinar started.

But we will move now into those questions. And the first one I’ve seen popping up in the questions a little bit too as well today. So the question is:

Q:        Why effectively these funding changes have been announced two weeks before 1 October?

And look I’ll answer that question. I think in short it’s important to acknowledge the fact that yes this announcement or the provision of this information is a little bit later than what was originally intended. It’s a couple of weeks later. So we do acknowledge that fact and also that it may have an impact on you in terms of your preparations. Look it has been a big year for aged care. A lot of reform has been introduced over the last 12 months and a lot of decisions have also recently been taken. There’s been the Age Care Taskforce Report. There’s been the Fair Work Commission. It’s required a lot of analysis and consideration by Government and we would have preferred to have provided this information two weeks earlier but look we’ve landed where we have.

What I will say lastly is that like AN-ACC the process that we go through is not set and forget. So we will look at our processes and see if we can make improvements for next year.

But look the next question that I think has also popped up in Slido, it’s for IHACPA. So just to put you on notice Kees, Rachel. I’ll read it out so everyone can hear it. The question is:

Q:        The NWAU distribution weightings for AN-ACC classifications have shifted with some higher classifications decreasing significantly. What process and insights led to these changes and will this be the regular pricing review approach moving forward?

Rachel Hauenschild:

Thanks Mark. So I can answer this question. So IHACPA’s pricing advice on those price weights for the AN-ACC classifications was based on the costs of care collected during our 2023 residential aged care costing study. So the costing study collected costs, time and activity data from a representative sample of 118 residential aged care services. And this provided updated resident level cost data building on what was collected in the resource utilisation and classification study in 2018.

So IHACPA’s costing study, the RACCS, showed higher costs for some AN-ACC classes and lower costs for others compared to the current price weights. And this movement reflects changes in the costs of care in residential aged care over the five years between 2018 and 2023. So going forward IHACPA will undertake regular cost collections from residential aged care services and this will inform future pricing advice including updates to those price weights.

Mark Richardson:

Thank you Rachel. Look moving on to the next question and this one’s for you Claudia.

Q:        My service is in Modified Monash 3. Do I need to do anything to get the new base care tariff funding or does it happen automatically?

Claudia Dukats:

Thanks Mark. Yes it will happen automatically. Services and providers don’t need to do anything. It will automatically move to the new base care tariff. So that means for services located in MMM or Modified Monash 2 and 3 they’ll move to that new base care tariff and for services in Modified Monash 4 they’ll move into the base care tariff that the Modified Monash 5 services were in.

Mark Richardson:

Great. Thanks Claudia. Mitch. Sharing it around a little bit. A question here around the Fair Work Commission Stage 3. I’ll just read it out once again.

Q:        Are there any accountability requirements for the Fair Work Commission Stage 3 funding for residential aged care providers?

Mitch Docking:

Yeah. Thanks Mark and hi everyone. I guess there’s a few things that providers should really be aware of when implementing this funding specifically for wages. I guess most importantly – and you did cover this a bit earlier Mark – is that providers are legally required to meet the minimum award rates in the relevant awards. So of course for Stage 3 for the relevant workers they’re all increasing on the 1st of January 2025. So I think that’s really the most important point that those wages are moving and providers need to be compliant with those.

So sort of to keep an eye on. And this really was implemented as part of the Stage 2 decision as well, that we do collect some wages data in the Quarterly Financial Report. So we will continue to do that and where we’re finding providers are reporting hourly wage rates below the lowest point in the awards they will be referred to the Fair Work Ombudsman. So they’re a couple of things to be aware of around the minimum award rates.

In the QFR as well we do require providers to attest that they’re passing on the wages funding to the full benefit of workers and on costs. So that requirement will continue through to the Stage 3 decision and I think we’ll provide a little bit more information on that the closer that we get to 1 January 2025 commencement. For the Stage 2 decision, the 15% that commenced on the 1st of July last year, we did issue a guidance document that set out the Government’s expectations around the pass through of the funding. So regarding that we’re looking at a similar approach for Stage 3 but that is ultimately a decision of Government. So we will be working with Government on the best approach for guidance for Stage 3 that will happen close to 1 January. And we are continuing to work with sector representatives in how we can best support these upcoming changes to the awards leading into 1 January next year. Thanks Mark.

Mark Richardson:

No worries. Thanks Mitch. That was great. Just a heads up once again Rachel. Back to you. So I’ll read out the question again.

Q:        The weight changes are a significant variance from the current settings. Does IHACPA think sufficient evidence was gathered and have you considered the impact on the sector?

Rachel Hauenschild:

Thanks Mark. So the recommendations on the price weight changes were based on the residential aged care costing study which was the most up to date source of resident level cost data in residential aged care. We have made recommendations based on that data. In future years IHACPA will continue to collect cost data from residential aged care services and this will inform future pricing advice.

Mark Richardson:

Thanks Rachel. Penny. Once again sharing it around. This one’s about 24/7.

Q:        Why is the 24/7 registered nurse supplement reducing on 1 October?

Penny Philbrick:

Thanks Mark. So the 24/7 registered nurse supplement is intended to fund the gap between delivering 24/7 RN care and what you’re funded to deliver through the AN-ACC model for your RN care minutes. So on 1 October with minutes increasing to 44 minutes I guess the gap is getting smaller and as a result the supplement is also reducing a little bit.

Mark Richardson:

Fantastic. Thanks Penny. Aden we’ll go to you.

Q:        What is the model pack and do we have to use it?

Aden Pulford:

Yeah. Absolutely. So the model pack is a tool the Department has published to support providers in responding to reporting assessments. So as we went through earlier the first step of a reporting assessment is seeking documentation from providers and the model pack is an example of how we’d like that information to be received to make the reporting assessment process as easy as it can be for the Department, for the provider, for everyone involved. And so in terms of whether or not you need to use it, it certainly makes the process a lot easier but it’s not mandatory. Thank you.

Mark Richardson:

Great. Thanks Aden. Claudia next one for you.

Q:        When will the remote and specialised reviews start and will services be able to participate?

Claudia Dukats:

Thanks Mark. We’re planning to start the review really shortly. The first step will be that the Department will write to the relevant services providing a bit more information and asking them to be involved. So we definitely want their feedback and participation.

Mark Richardson:

Okay. Thank you. Penny back to you again.

Q:        Will the virtual care provided under the new virtual nursing pilot be intended by the Department to be included as part of care minutes?

Penny Philbrick:

Thank you. That’s a good question. It will not. To count as care minutes the care has to be delivered on site and that’s the same for the 24/7 registered nurse responsibility.

If you want a little bit more it will I guess count towards the alternative arrangements that a service would have in place where they can’t find an RN and that’s something the Commission would consider.

Mark Richardson:

Thanks Penny. Back to IHACPA, back to Rachel.

Q:        What evidence was gathered through IHACPA’s costing study to adjust the weights for respite residents?

Rachel Hauenschild:

Thanks for the question. So IHACPA’s costing study collected cost data from some participating respite residents. However due to the small sample size the price weights in IHACPA’s advice for the respite classes are based on existing relativities to the permanent care classes. So for example the increase in the price weight for class 101 reflects the higher costs for the independently mobile permanent classes observed in RACCS and the inverse for some of the higher care classes. So IHACPA again will continue to collect data on respite residents in future cost collections and this will provide updated advice in future years.

Kees Van Gool:

I might just add Mark I think the basis of a lot of the questions for us are around the costing study, and so for those interested to find out a bit more about it the costing study has been published and is available on our website for those interested. 

Mark Richardson:

Awesome. Thanks Kees. Thanks Rachel. Look the next question I’ll answer this one and I’ll interpret I guess what it means. 

Q:        Will there be further changes to AN-ACC before 1 October 2025?

Look I think what the question is getting at is further decisions that may stem from the Fair Work Commission’s consideration around nurses’ wages. Look I think in short ultimately that’s clearly a Government decision. I would say it will depend upon the decision itself. So in other words the size of any increase in the wages and also the timing of the start date. But look ultimately as I said at the start that will be a decision of Government and we’ll see what happens moving forward.

Now some other questions.

I’ll just read them out again as we go.

Q:        Hi Mark. Could the Department commit to providing updates to care minutes per class more than a month in advance for any future changes? We have planned rosters for an expected additional 15 minutes increase yet our target had changed only by one minute.

So look I guess that goes back to a previous question. And once again we definitely acknowledge that this has been announced a little bit later than was originally intended and we will have a look at processes and we’ll try to address that in coming years. But this year should be an abnormality rather than the norm. I would assume that moving forward you’ll get longer lead time before 1 October.

Jumping back Kees, Rachel, there’s another question here for you. I think it’s probably similar to the ones that I’ve previously read out. Nonetheless there seem to be a few questions coming in about this so I’ll ask it again.

Q:        What is the rationale behind decreasing funding for classes 10, 11, 12, 13 and 1?

Rachel Hauenschild:

Thanks Mark. So IHACPA’s pricing advice did recommend reductions in the price weights for some of the higher care AN-ACC classes. This reflects the actual costs observed in the costing study. So we saw a flattening of the costs, so less variation between AN-ACC classes. So that was also offset by higher costs observed for the lower care classes. So these recommendations are based on the cost data and as Kees mentioned before those results are published on our website if you’re interested.

Mark Richardson:

Thank you. Penny this one’s for you in relation to RNs and ENs.

Q:        If we are already meeting our RN care minute target and getting the three star rating for meeting the minimum target and we also employ ENs will the 10% EN care minutes count towards the requirements to exceed minimum RN care minutes and enable us to achieve a four star rating?

Penny Philbrick:

Yeah. Okay. So there’s probably a few things going on there. So where you’re already meeting your RN targets you can still count I guess up to 10% of your RN target in additional minutes of EN time to your RN minutes delivered and they will I guess count towards your star rating. Whether you get a four star rating or not I guess depends on where you are within the matrix. But the EN minutes delivered definitely count. 

Mark Richardson:

Fantastic. And look we might stick with you Penny with just one more question.

Q:        Can we double dip EN minutes to make up 10% RN minutes as well as include same minutes in the PCW EN minutes?

Penny Philbrick:

Yeah. Okay. So I guess there aren’t really PCW EN minutes. What there are are total minutes and there’s registered nurse minutes. And so yes the EN minutes that count towards the RN target will also count towards the total target as will any registered nurse minutes. So it’s kind of not really double dipping in a sense but they do count.

Mark Richardson:

Great. Look there’s a hotelling one here and the question is – and I think Mark if you want to go through the decision that Government’s taken that would be great because I think that’s what the question is ultimately getting at.

Q:        Has the hotelling supplement been reviewed by IHACPA?

Mark Shen:

Thank you Mark. Hi everyone. Mark Shen, Director of Stakeholder Engagement and Hotelling. Without treading on IHACPA colleagues’ toes – and please feel free to jump in if I say something wrong – the Government has obviously reviewed the sufficiency of the hotelling supplement relying on IHACPA colleagues’ advice and the pricing advice that I think should be public now, if not very, very soon. And the decision was taken that obviously first the Government would meet its commitment to the Fair Work Stage 3 decision and that amount will come through on the 20th of September as will the regular indexation process, and that is the biannual process where the hotelling supplement is indexed by CPI.

Then the Government also then chose to have a further increase on 1 July 2025 which will fund the other hotelling costs that providers are experiencing. The gap in time – and I think that goes to the heart of the question – is first of all a significant amount of funding changes have occurred in recent times, I think as Mark Richardson pointed out. Aged care has gone through a significant amount of reforms. There is a need for Government to review the funding sufficiency that occurs over a period of time to then make further pricing decisions. As Claudia mentioned combined this will mean that Government is committing to about $900 million over four years in additional funding for hotelling services and combined with consumer contributions this amount rises to $1.1 billion.

Now the review of the sufficiency of the hotelling supplement will continue to occur on an annual basis and when the 20th of September increases go through whether for the QFR and ACFR more data will be collected and essentially in concert with IHACPA colleagues future decisions may be taken pending Government consideration next year. 

Mark Richardson:

Fantastic. Thanks Mark. Claudia there’s one here. I think it’s fairly straightforward for you. The question is:

Q:        Where can I find my Modified Monash classification?

Claudia Dukats:

Yeah. Thanks Mark. You can find your Modified Monash classification via the Health Workforce Locator Tool. It’s on the Department’s website. And you just need to select the MMM 2019 from the dropdown select list to get the right list with the Modified Monash classes.

Mark Richardson:

Sorry. I’m just flicking through some of these questions. There’s quite a lot.

So there’s a question here about whether or not the AN-ACC price will change again on 1 December like it did last year. So look I’ll answer that. As I mentioned before that 1 December was for the annual wage review from last year and a decision was made as part of MYEFO to adjust the AN-ACC price after receiving supplementary advice from IHACPA. That was implemented on 1 December. The implementation of the 1 October price this year includes back pay of the annual wage review from 1 July this year. So it incorporates funding for that decision. So no we’re not expecting another AN-ACC price change on 1 December this year. The annual wage review is incorporated into funding and we’ll see what happens with the next Fair Work Commission decision.

I think there’s probably time for one more question before we wrap up. So Kees, Rachel, a question for you.

Q:        How do you participate in the residential aged care cost collection process? Is the provider selected by IHACPA?

Rachel Hauenschild:

Thanks for the question Mark. So providers can express interest to participate in IHACPA’s cost collections. There are current collections underway for both residential aged care and support at home. There is information available on our website about how to participate in those and a mailbox to express interest.

Mark Richardson:

Great. Okay. Thank you. Look we’ve got a couple of minutes left and I think that’s probably sufficient time just to quickly wrap up. I just want to thank everyone for attending today’s session. We hope you found the information provided today useful. And just a reminder we will provide this webinar online if you would like to watch it again and also if you have any further questions I should add as per the slide that you can see now please email us. We’ll be more than happy to answer your questions. Also scan the QR codes. There’s a number of useful guides and information here that will take you straight to our website to where they’re located.

But once again also if you could take the time to complete the survey at the end of today’s webinar that would be most appreciated. Thanks again and we will see you next time.

[Closing visual of slide with text saying ‘Australian Government with Crest (logo)’, ‘Department of Health and Aged Care’, ‘Useful links’, ‘AN-ACC guide’, with QR code, ‘Care minutes and 24/7 registered nurse responsibility guide’, with QR code, ‘Care minutes target calculator’, with QR code, ‘My Aged Care Service and Support Portal’, with QR code, ‘Enquiries’, ‘My Aged Care provider helpline – 1800 836 799, or anaccoperations@health.gov.au’, ‘health.gov.au/aged-care-reforms’, ‘Department of Health and Aged Care’, ‘September 2024’]

[End of Transcript]