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Low RAS referrals for remote clients could hamper aged care: audit

Some older indigenous Australians, particularly those living in remote areas, face challenges in accessing My Aged Care which risks reducing their take-up of services, a national audit has found.

Poor access to the internet, unstable phone lines and mobile reception in rural and remote areas and insufficient call credit can act as barriers to accessing My Aged Care, says the report from the Australian National Audit Office.

Having sufficient time to build trust and rapport with Aboriginal communities in order to facilitate the increased use of the gateway was also raised as an issue.

Regional Assessment Services (RAS) told the audit office they had received very low referrals to conduct assessments in remote communities.

Given these concerns over access, the ANAO urged the Department of Health to benchmark the impact of the aged care reforms on this group over time.

The health department said it was considering changing assessment and service referral processes to accommodate the challenges in travelling to remote areas.

The ANAO’s report also revealed that the department commenced an evaluation of the RAS in October 2016 to improve its operations, with a final report due this month.

The department told the audit office it will be analysing the performance of the new national queue, including the outcomes for Aboriginal and Torres Strait Islander people.

Between 2012-13 and 2015-16, the report found that while growth in high-level home care packages to indigenous-focused service providers had been higher than for mainstream services, allocations for low-level packages had not grown at the same rate as mainstream providers.

This lack of growth in Level 1 and 2 packages has resulted in an increase in reliance on Commonwealth Home Support Program, despite clients being assessed for higher level services.

Flexible program

The audit found the government’s National Aboriginal and Torres Strait Islander Flexible Aged Care Program has been effective in increasing access to culturally appropriate aged care services, but it would benefit from opening up its application process to new service providers to enter the market.

The distribution of the program funding has remained largely unchanged since its inception, the report found.

In 2015–16, the government funded 32 flexible program service providers to deliver 820 aged care places.  Annual funding was approximately $37 million.

Viability supplement

The viability supplement was found to have a significant impact on the financial performance of small indigenous-focused providers, which have higher operating costs and limited capacity to collect consumer fees.

The ANAO estimated that in the absence of a viability supplement, five indigenous-focused home care providers would have recorded a net loss greater than 5 per cent of total revenue.

In a third of cases, the viability supplement was the difference between these providers recording a net loss or breaking even.

In 2015–16, some $10 million in viability supplements were paid to indigenous-focused service providers, representing around 24 per cent of total viability supplement funding.

Overall, the audit found government-funded aged care services are largely delivered effectively to Aboriginal and Torres Strait Islander people.

The audit defined indigenous-focused service providers as having 30 per cent or more indigenous clients. In 2014-15, this included 432 service providers.

Read the full report here

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2 Responses to Low RAS referrals for remote clients could hamper aged care: audit

  1. Barry Arnott June 13, 2017 at 8:40 am #

    It is not only aboriginal communities but people in rural remote communities in general who have poor internet connectivity, and are being forced onto mobile phone plans due to failings of the NBN. I met one lady recently who had used up $50.00 of her mobile phone credit contacting her private health insurance fund to sort out an issue with her yearly account. Due to there inability to engage with MAC call centres they just struggle on.

  2. Susie June 13, 2017 at 1:35 pm #

    I agree with Barry, My Aged Care is not working successfully in rural and remote areas in general (for all people). Besides the difficulty of poor phone coverage and internet connectivity, there are people who prefer to visit their local service when they wish to access a service. The old idea of ‘no wrong door’ was a very good one. It takes a lot of courage to walk into a service/organisation to ask for help, if people are turned away after doing so, or told to ‘ring a central number’, they can lose momentum and often will not go further. Furthermore, one of the core purposes of My Aged Care was to ‘reduce duplication of assessments’. This has not occurred in many areas, with 1. My Aged Care assessment 2. Regional Assessment Team assessment and then 3. Assessment from the service themselves (to get the remaining information not attained in prior assessments and find out what people’s goals are). The whole system appears to be failing people in rural and remote areas.

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