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Sector to debate ACFI change proposals


Changes to the residential aged care sector’s funding tool proposed in a government-commissioned report will be outlined at an upcoming industry conference.

Applied Aged Care Solutions director Richard Rosewarne reviewed the Aged Care Funding Instrument (ACFI) including scrutinising clinical items and the tool’s design and looking at independent assessment options (read our background story here).

Minister for Aged Care Ken Wyatt confirmed in September he had received the final report and would further consult with the sector on its findings.

Dr Richard Rosewarne

Dr Rosewarne will outline his recommendations to change ACFI at The COTA Next Phase of Aged Care Reform conference in Sydney in early November.

“I’ll be reporting on the impacts to the industry on the funding and care aspects of my ACFI change proposals. Put briefly, how much they’ll get paid and what they need to do to get it,” Dr Rosewarne told Australian Ageing Agenda in an exclusive conference preview.

Dr Rosewarne said he expected Minister Wyatt to release the report “any day now, perhaps even at the conference” although he was unsure whether the release would come with a firm government response.

“Both the government and industry agreed – though for different reasons – that ACFI needed to be reviewed to provide a more contemporary model,” Dr Rosewarne said.

“Some of the proposed changes are fundamental, such as clarifying definitions of physical assistance in activities of daily living areas and mandating assessment that should have been done anyway.”

He said the behavioural sections would be more straightforward, such as moving depression into complex health care and moving medication on its own into complex health care.

“It will be expected that for any claim for medication assistance, there will have been a three-monthly comprehensive assessment by a nurse on its own, not as part of a care plan. That’s a big change.

“There will also be big changes in pain management enabling broad-based therapy care for all residents, regardless of care needs, to be provided by a range of relevant therapists including exercise physiologists.

“Physical therapy is what the industry wants and is best practice,” Dr Rosewarne said.

He conceded that the industry may criticise any ACFI variations as being yet another change ahead of long-term funding model changes, which are currently being investigated by a team from the University of Wollongong and “will take four to five years to do properly.”

“The department wanted a viable medium-term option to reduce areas of disagreement between them and the sector,” he said.

“My report hopefully will do this, but there’s no guarantee it will happen.”

Panel discussion

In addition to a solo presentation on ACFI, Dr Rosewarne will appear on a panel discussing the future of residential aged care funding with Michael Colane from the Department of Health, Grant Corderoy from StewartBrown and Professor Mike Woods from the Centre for Health Economics Research and Evaluation at the University of Technology Sydney.

The session aimed to be a platform for funding options to be suggested and robustly discussed, said Ian Yates, chief executive of COTA Australia, which is co-hosting the event with Criterion.

“We are looking for the income level that will make residential aged care financially sustainable over the medium to longer term, noting the probable need for higher wages overall and a trend to higher acuity and shorter length of stay,” Mr Yates told AAA.

The funding model would also cover the reasons for the differences in operating costs and financial performance between different cohorts of providers, the right funding mix between government and consumers and the opportunities for extra service income derived from genuine additional services, he said.

The COTA Next Phase of Aged Care Reform conference takes place on 1 – 2 November at the Sydney Boulevard Hotel.

Australian Ageing Agenda is the media partner of the conference.

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5 Responses to Sector to debate ACFI change proposals

  1. Big Al October 13, 2017 at 1:22 pm #

    When washing a residents hair is claimed against a therapeutic massage the system is broken !!

  2. Anonymous October 13, 2017 at 4:05 pm #

    The problem is the whole ACFI is not based on re-enablement and allowing risk taking but on dependence and medical model of care. Some of the anomalies are ludicrous.

  3. Dave October 14, 2017 at 10:59 am #

    So, the people who designed ACFI are now reviewing ACFI?

    http://aacs.com.au/about-us/

    Get ready for more of the same…prescriptive funding for archaic items (massages, heat packs and leg bandages) that will rapidly see every resident magically develop an ‘assessed need’ for whatever’s on the list, while care that actually requires skill and time (behaviour management) is allocated some loose change.

    Or maybe we could bring back aromatherapy? (Time to dust off all those old oil burners in the cupboard)

    Just make sure the end result contains plenty of ambiguity and dozens of loopholes so we can keep the ACFI optimisation industry afloat.

    Our sector just gets curioser and curioser.

    Perhaps we’d do better with the Mad Hatter and a Mock Turtle at the helm instead of asking Dracula to run the blood bank?

  4. vikki October 17, 2017 at 12:14 pm #

    Has anyone ever considered that a reasonable estimate of funding of the general cost to provide 24×7 care to a person with declining health may be a better way to fund the aged care sector. Surely industry at service level with reasonable knowledge of the numbers of staff appropriate to providing the support to the ageing person living in the home model of care could be consulted in regard to funding.
    Not that individualized assessment of the care needs of the individual would be dispensed with but rather have a reasonable funding that will project the required staff with the required skills at a reasonable staffing level that it will require to provide best practice support and care to each individual within a residential service.
    This should factor in optimum care to the individual person on a continuum of care needs. Perhaps a mid-range reasonable funding figure would ensure that funding will cover the required costs of care as there will be a range of persons that fall in the higher, mid and lower care need ranges. Services may have a projected and set mix percentage of residents within their service/s.
    Individual assessment is commenced through the myaged care website initially. The individual will then have an idea of the services they are may be eligible to receive. ACAT complete a more personalized, secondary assessment. Individual care needs are identified.
    Sure this seems simplistic but how many times does the government have to reinvent a Funding Tool that results in hours of staff time in completing assessments and “ludicrous” efforts just to maximize funding to provide appropriate care and try and justify the claims for an individual person.
    I have worked in the Aged Care sector for more than two decades and there has yet to be, in my experience, a reasonable and equitable funding Tool. There needs to be some lateral thinking and approach to funding other than ” we need to claw back the dollars that are going to the Aged Care sector”.

  5. Feed Up January 21, 2018 at 10:20 pm #

    Acfi in aged care totally wastes millions of dollars on massage for pain management whether the client needs or wants a massage. It is the only service offered to aged care residents because that is all the funding guidelines allow. Many care providers are using these services to rake in mega dollars while the patients are left with nothing but ticks in boxes.

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