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And the commentary rolls in…



 

Reactions to the government’s aged care reform package announced today are as follows (more to come soon):

The 28 organisations of the National Aged Care Alliance (NACA), representing consumers, aged care service providers, health care professionals and aged care workers said today’s package provides a firm foundation for ongoing reform of aged care.

Ian Yates, CEO, COTA Australia said the announcement today signals the beginning of a new era of care and support for older people and their families,” he said.

“The package provides far greater support for older people to be to be able to age at home, a plan to tackle dementia and a Compact to improve pay and conditions for aged care workers. 
In addition to these fundamental blocks of the package the Alliance particularly welcomed:
• Improved access through a single Gateway, including the My Aged Care website;
• Giving older people choice and options for how they pay for their accommodation;
• The introduction of a fair and equitable user contributions;
• The establishment of an independent Aged Care Financing Authority;
• Better palliative care and support in aged care; and
• More support for consumer advocacy and community visitor program.”
 

Aged Care Association Australia CEO, Rod Young, gave the broad thrust of the reform proposal a tick of approval.

“It was a shame,” Mr Young said, “that the Government had not been prepared to adopt all of the reforms recommended by the Productivity Commission; however the package announced today does achieve many of policy objectives sought by the aged care providers.”

That said, “the package appears to provide a solution to the perennial issue of sufficient capital whilst recognizing that most Australians wish to stay in their home for all their lives and remain independent for as long as possible,” said Mr Young.

“The package maintains a balanced package with a strong safety net for those with limited means whilst modifying the means test in such a way that will require people with the capacity to do so, to make a greater contribution,” said Rod Young.

“The additional funding to enhance care for dementia sufferers, whether in their own home or residential care, is very welcome,” said Mr Young.

“Gaining access to services or even finding out what is available in the area in which a person lives is currently very difficult and confusing,” said Rod Young, “therefore the decision to invest in a new Gateway to give older citizens a much simpler point to access information and services is a major step in helping people to navigate their way through the aged care system.”
 

Aged and Community Services Australia (ACSA)’s president, Rob Hankins, commended the federal government for the phased reform timetable announced.

“ACSA is particularly pleased with the emphasis in today’s announcement of supporting people in their own homes and greater equity in the way people fund their aged care support and accommodation, while ensuring access by those with lesser means,” said Mr Hankins.

“An overwhelming number of older Australians want to remain in their own homes as they age. This expansion of community care will allow our members – in the charitable and not-for-profit sector – to provide support to those most in need. The two additional Home Care package levels will provide more service options for consumers.

“However, it will be important that residential care remains sustainable and today’s announcements will need further detailed consideration to ensure that this will be the case.

“While stopping short of an entitlement system, the significant increase in community care and support for carers is a positive step forward. Nevertheless, ACSA remains committed to an entitlement system in the long-term.

“The establishment of an independent pricing authority is a critical advance towards determining the true cost of care, although just how the new authority will go about this task has yet to be fully revealed.

“It is fundamentally important that Government and the sector understand the actual cost of providing care – in a number of diverse settings and for people with diverse needs- so that the funding is right to provide high quality care and appropriate remuneration for nurses and care staff.

“We are pleased to note that a large portion of the projected increase in ACFI funding will be redirected to improving the terms and conditions for age care workers.”

 

Aged and Community Care Victoria CEO, Gerard Mansour said the package “provides a significant step forward in our quest for a viable, fair and sustainable industry, one that can deliver access and choice for older Australians and enable them to age well”.

The package includes substantial increases in funding to provide in-home care, a commitment $1.2 billion over five years to sustain the aged care workforce, increased support for those suffering from dementia and increased choice and flexibility in the ways older Australians will be able to pay for their care needs.

“The package seeks to strike a balance between meeting the needs of people to receive care in the own home whilst ensuring we have viable residential aged care systems for those who need additional support” said Mr Mansour.

ACCV welcomed other incentives included in the reforms, such as flexible service provision and fairer means testing – both solid building blocks for the future of the aged care system.

“Streamlining of the aged care entry system, both through the creation of a single gateway and the abolition of the outdated concept of high and low care, was long overdue.”

Importantly, ACCV said the inclusion of a Conditional Adjustment Payment (CAP) for home care packages was certainly welcome, as no peak body has been stronger than ACCV in advocating for the introduction of a CAP for community care.

In moving forward, Mr Mansour said “our focus will be to work closely with government to ensure the implementation outcomes deliver on the commitment to provide a more sustainable industry for the longer term.

“This will include a critical focus on levels of care funding and accommodation payments required to ensure residential aged care services are viable in all settings.

“It will be critical to implement changes of this magnitude carefully, to ensure there are no anomalies or unintended consequences.

“When we plan for implementation, ACCV will prioritise the vital importance of a viable industry. This includes special needs groups, rural and remote facilities”. 

 

CEO of the Retirement Villages Association, Andrew Giles, said: “The increased commitment by the government to ‘ageing in place’ is right.  Australians want to remain in their own home for as long as possible and the RVA welcomes the significant increase in home care packages.

“Retirement villages are an exceptional accommodation option for Australians to ‘age in place’.  The industry has over $50 billion of assets on the ground where this is already happening. This is an amazing opportunity for village residents to access care when they need it, and for governments and taxpayers to benefit from economies of scale.

“Fire sales of the family home are something everyone wants to avoid and we are pleased with the Government’s commentary.  Having said that, there are other ways this can be avoided that need to be assessed.

“Australian seniors need to be encouraged to downsize to appropriate accommodation earlier so a fire sale isn’t even a possibility.  We need to look at changes to the pension and equity release schemes.

“The RVA looks forward to continuing discussions with the Federal Government about how we can leverage the industry’s $50 billion in assets, to provide care for older Australians and the 160,000 residents in villages (similar number of Australians in villages as in residential care).

“We also look forward to working together on ways to remove the regulatory barriers to increase senior housing supply.  Without policy changes and leadership, Australia will face a shortfall in seniors housing within the next decade.”

 

Alzheimer’s Australia Vic CEO, Maree McCabe, said the federal government’s package showed that the PM and Minister Butler have not only listened to people with dementia but have responded comprehensively to their priorities.  

“Thousands have spoken out about the failings of the health and care system in relation to dementia; the Government’s decisions are both a reward and a relief to those 280,000 Australians with dementia and their 1.2 million carers,” Ms McCabe said.

The news is timely in Victoria as Alzheimer’s Australia Vic released the latest Deloitte Access Economics prevalence data today indicating that the number of people with dementia in Victoria is projected to hit 245,813 by 2050 – unless there are medical breakthroughs.

Alzheimer’s Australia Vic has sent every state parliamentarian in Victoria the new dementia prevalence information, including what the increases are in their electorate.

“We hope that by hearing how their individual electorates will be impacted, parliamentarians will build on the federal government’s commitment in the coming state budget.

“We know what we need. The federal government has taken action. We now need the State Government to outline a funding plan for dementia – not for the next year or five years but for over the next decade to 20 years.”
 

PROVIDERS

Goodwin Aged Care Services CEO, Chris Lamont said it is critical that government address what will be the needs of ageing Australians over the next 30 years.

As a provider of residential care, community care and independent living, Goodwin believes the current system does not provide adequate funding and needlessly limits choices for those looking to remain in their home.

‘The currently regulatory system is inefficient and consists of needless red-tape that costs millions of dollars and does little to improve the quality of care or availability of services’, said Mr Lamont.

Goodwin has called for additional funding to support more ageing-in-place outcomes and practical and fair funding models to support improvements in residential care.  A tailored approach has been called for, one that recognises that as we age we will each have different needs and preferences and that these should be supported as, and when, required.

Funding is needed to support more home and community care packages, particularly as cost and demand increases.  Reform needs to comprise comprehensible and sustainable funding mechanisms.  The aged care sector has been subject to minor changes over the last 10 years many of these have added to the cost of providing services and led to supply shortages.

Goodwin has urged the Government to consider a sustainable and equitable system that addresses aged care and support for the next 30 years.  Goodwin believes that there is also a need for clarity around aged care bonds and the treatment of the family home in the context of how care costs are met. The announcement states there will be no change to the current treatment of the family home in means testing.

“There is a need to support consumer choice and assist providers in improving services and support to clients who shouldn’t have to settle for second best, and from a preliminary assessment today’s announcement is a step in the right direction.”

 

Benetas CEO, Sandra Hills, said she supports the government’s response to the Productivity Commission recommendations and the Living Longer and Living Better plan. “The announcements of reform present more control and choice for consumers and a much more sustainable industry,” Ms Hills said.

“The additional $268.4million for dementia is a fantastic result for the entire Australian community. It is particularly important for these funds to be allocated to people who have high care needs, especially people with dementia in palliative care.

“…Benetas was extremely pleased with not only the additional funding announced today, but also the increased number of Home Care packages. The ultimate goal is to provide a system where people can choose the type of support that best suits them and then move around the system as they please, so this is a step in the right direction,” Ms Hills said.

“The $1.2 billion investment in the aged care workforce is long overdue and highlights the respect our Government holds for the thousands of committed, dedicated and caring staff who work in the aged care sector with passion and pride every day.”

“…The government has acknowledged the very real need to provide safeguards for people who are disadvantaged, so anyone requiring care and support receives it, regardless of their circumstances. This will be hard work, but it is vital to support our most vulnerable community members.”

“The package today is a good start towards fixing our aged care system, but what we need is the investment and reforms to occur quickly, and in the next five years. To make this happen, we need the political will and commitment of our leaders to continue down this path of true reform to ensure Australia can provide world class aged care services for our ageing community now and into the future.”
 

UnitingCare Australia’s  national director, Lin Hatfield Dodds, said the aged care reforms announced today put older Australians at the centre of a new aged care system.

“More and better support to age at home, and a simpler and fairer financing system are the keystones of the new system,” Ms Hatfield Dodds said.

“We know that older Australians want to stay in their own home and community as long as they can.

“$1B of the $3.7B of spend announced today will go to care in people’s homes. That’s a very good thing.

“UnitingCare Australia welcomes new fair and flexible financing arrangements. Equity has been missing in action in aged care financing for too long.

“We are very pleased to see measures that will ensure vulnerable and disadvantaged Australians are protected and supported, while those who can afford to pay a fair share toward the costs of their accommodation and care, do so.

“The Government’s commitment to invest in structural reform is a welcome priority.

“Establishing a single Gateway for information and access to care, an independent financing authority, better supporting our workforce and an expert implementation council will ensure the Government can ensure the intent of the reforms are actually delivered.

“Finally, the focus on alleviating workforce pressures is welcome. $1.2 B will go a long way to delivering higher wages, better training and professional development, and improved career pathways.

“The reform package invests in the structural transformation required of aged care that will ensure a better life and better care for older Australians.

“Over the coming days we’ll be assessing the detail of the package and we look forward to being part of implementation planning. We call on all political parties to support these reforms.”

 

Catholic Health Australia (CHA) CEO, Martin Laverty, said care quality improvements will take some years to deliver.

Mr Laverty said “Not everything the Productivity Commission proposed has been endorsed, but the government has set a path for structural change over the next decade, and we’ll work with the Government to achieve aged care improvement in the interests of older Australians.

“The CHA-commissioned Grant Thornton report of February revealed it costs a provider an average of $60 per day to operate a residential aged care bed.

“We welcome the Government’s measures that will increase daily accommodation payments from the current $32.58 to $52.84 for residential services meeting certain quality standards.

“The introduction of new payment options for those who can afford to contribute to the cost of their accommodation will also lead to improvement in the quality and sustainability of residential aged care services.

“Over time, the number of people accessing care will also improve. Today, 113 people per thousand aged over 70 are able to access care. Over 10 years, that number will increase to 125. The Government didn’t go as far as we’d wanted to make aged care an entitlement to all assessed as in need, but more care places over the coming years, particularly in a person’s own home, is welcome,” Mr Laverty said.

The detail the Aged Care Reform Implementation Council will need to focus on includes:
• The new rating system of aged care services that will be published on a new My Aged Care website;
• The Workforce Compact, which will tie payments to aged care providers to improved wages and conditions for aged care staff;
• How the Aged Care Financing Authority will base approval of prices for aged care services on the actual cost of delivering them.

“We understand many in coming days will focus on changes to means testing for consumer contributions to care and accommodation.  The Government has done a good job in shaping how those who can afford to contribute will, while also improving funding for those who cannot.

“Any debate on means testing must not overshadow the improvements today’s announcements will enable such as improved palliative care,  better support for low-income earners, and support for disadvantaged groups – improvements which won’t get the headlines they deserve,” Mr Laverty concluded.
 

THE UNIONS

The Australian Nursing Federation (ANF) today congratulated the Gillard Government for injecting $1.2 billion over five years for Australia’s under-resourced aged care workforce as a centrepiece of its landmark overhaul of the aged care sector.

ANF federal secretary, Lee Thomas, hailed the reform package announced today as a “victory for hard working nurses and care staff” across the country.

Ms Thomas said that thousands of nurses and assistants in nursing (AIN) will be relieved that the extra funding will go toward higher wages; improved career structures; better training and education and workforce planning.

“This is the largest investment in Australia’s aged care workforce and is a significant victory for the sector’s underpaid nursing and care staff,” she said.

“We are confident this extra funding will now assist in closing the wages gap for aged care workers and results in more nurses being attracted and retained in the sector.

For the past three years, the ANF’s Because We Care campaign has focused on the delivery of quality care for older Australians, through better wages, staffing levels and skills mix.

“We thank Prime Minister Gillard and the Minister for Ageing Mark Butler for listening.”

The Health and Community Services Union (HACSU) is relieved that the government has included workforce in its plan for aged care reform.

HACSU Assistant State Secretary Tim Jacobson said “We welcome the overall package of greater funding and equitable access for aged acre services.”

“It is a credit to the Government that they have allocated specific funding for workforce issues which has been ignored for too long.”

“After years of our members campaigning so that they can provide the elderly with the quality of care they deserve, finally they have been acknowledged”.
 

THE MEDICAL WORLD

The Australian Medical Association’s president, Dr Steve Hambleton, said that the plan is a strong response to a policy area that has been long neglected, but the government should have gone the extra step of giving older Australians the comfort of knowing they could get access to their doctors at a time of life when they most need them.

“Living at home allows individuals to age with dignity as an active participant in the community with a sense of place, and this is very important,” Dr Hambleton said.

“But it is equally important to have easy access to medical care, at home or in residential aged care.

“The AMA welcomes the commitment to improve access to general practitioners through the use of video consultations.  This is something the AMA highlighted with the Government in the Telehealth initiative.

“The government will provide increased support for doctors to undertake more timely dementia diagnosis.

“We also welcome the additional funding for palliative care. And we are pleased that there is a safety net for the many older Australians who don’t have the financial capacity to pay for aged care.

“However, the funding for the health care aspects of the package falls well short of what is needed, and many areas of primary care for older Australians have not been addressed in this package.

“We will be seeking more details from the Minister for Health and Ageing about the health care aspects of this package, especially access to primary care services.”

 

The Royal Australasian College of Physicians (RACP) and The Australian and New Zealand Society of Geriatric Medicine (ANZSGM) are encouraged by government action on aged care reform, but have called for further health reform to improve care for the largest consumers of health services; older Australians.

However, they said, further detail is needed as to what the linkages will be, and how they will be implemented.

“Reforms to improve the delivery of healthcare to older people require an increase in focus and detail,” RACP President, Professor John Kolbe said.

“The Australian Government must ensure that aged care reforms are integrated with national health reforms to deliver more seamless and coordinated heath and aged care services to older Australians, in particular, the 266,574 Australians with dementia.

“It is important that the aged care reforms integrate with national health reforms to improve access to specialist medical care for older people.”



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0 Responses to And the commentary rolls in…

  1. Norbert Sidney April 21, 2012 at 3:34 pm #

    The net cost to government is $577m over 5 years with $55m increased spending in the first year. Divide that by 220 odd thousand care recipients, 365 days in a year and it’s an extra 70 cents per day of funding for older Australians – when it in a couple of years. ‘A cup of tea and a couple of iced vo vo’s’ of additional care. The ‘redirection’ of $1.6 billion in ACFI money will take approximately $20m from what otherwise would be the revenue stream of providers with say 2,000 beds. High care bonds are an efficient source of capital and it is useful to see that in the package. In the long run, only if the funding is adequate will there be adequate beds for our frail aged.

  2. Good advances but long way to go , beore the veil over dementia diagnosis and care is lifted.
    General public, patients and carers and those lack awareness and direction. My interest is in disseminating “proper information” about this very complex condition, as potential for harm is there if not.
    A bigger challenge lies in dealing with those with behaviour problems with dementia , where the suffering of carers and indignity of patients can escalate many fold.
    Very few pathways currently exist when these situations arise.
    Executors of the effective use of resources recently made available should take these into account.

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