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Quality and funding dominate aged care agenda


With numerous reviews, inquiries and changes slated for 2018, AAA presents a helpful guide to navigating the aged care year ahead.

Even the most informed and engaged aged care executives have commented lately on the amount of significant change facing the sector this year.

By the middle of 2018 we are slated to see a new single quality framework commence, a workforce taskforce issue its report to government, and new plans for how the sector cares for seniors with special needs.

We’ll also likely see the conclusion of lengthy work on providers’ main source of residential funding, as well as changes arising from last year’s review of aged care reform.

And that’s all aside from the busy agendas that aged care providers individually are pursuing in terms of organisational focus and growth – as we reported in recent weeks.

To help providers and stakeholders keep on top of this significant year, AAA’s reporters have put together a list of the key events and developments we’re keeping an eye on:

1. New quality scheme to commence

Nothing grabs headlines quite like the issue of quality in aged care and you can expect to hear a lot more about it in 2018 as a new single quality framework commences from 1 July – at least according to the current timetable. The single set of eight standards will replace the four sets of standards currently covering residential, home care, Aboriginal flexible care and transition care. The Department of Health released the latest draft of the standards last Friday, ostensibly marking the way for the Single Aged Care Quality Framework that’s due to come in from 1 July, with assessment against the standards commencing in mid-2019. But as we reported on Wednesday, there is still much unknown, including about a pilot that’s supposedly underway. Led by the Quality Agency, the pilot is slated to run from January to April this year (the agency tells us it’s still selecting the participating providers) and will include testing of the different assessment processes that have been suggested. The lack of detail around how the standards will be applied and the “optimistic” 12-month transition period are causes for concern, providers have told AAA. Meanwhile, there’s the ongoing debate around the rollout of the quality indicators scheme.

2. The fate of ACFI

As part of government’s plan to address residential aged care funding, work on the “landmark” Residential Utilisation and Classification Study (RUCS) into costs in residential aged care is progressing, according to a Department of Health update last week. The minister announced the study in August, and the department says the final report is due in December 2018. Its being undertaken by the Australian Health Services Research Institute at the University of Wollongong, which proposed the study in its earlier report into alternative funding models, released in April last year, that recommended dumping ACFI. That report also called for a revamp of ACFI in the interim, which was subsequently carried out by Richard Rosewarne. When Minister Wyatt released Rosewarne’s ACFI revamp in October he said no decisions have yet been made on changes to the beleaguered funding instrument.

3. Budget measures for aged care

While the chances of the Commonwealth allocating new money to the sector are slim, this year could still be an “aged care budget” with government already flagging in its December mini-budget that it will respond to both the Tune review of aged care reforms and Carnell and Paterson’s review of quality in the May Budget. Aged Care Minister Ken Wyatt already ruled out Tune’s key recommendations to increase user contributions through the family home and annual and lifetime caps, but providers tell us they hope many of the other 38 recommendations, including removing the cap on the daily fee, will be outlined in this budget. When Mr Wyatt released the Carnell-Paterson Review in late October he endorsed the recommendation to replace planned accreditation visits with unannounced spot checks but didn’t respond to the nine other recommendations.

4. Action on sector’s workforce woes?

Mid-year will also see the aged care workforce taskforce hand its report to government outlining short, medium and long-term options to tackle recruitment and retention, and improve workforce productivity. AAA understands the taskforce’s chair, Professor John Pollaers, has been out engaging with a wide range of groups and professionals in the sector, beyond the usual suspects. The 12-member taskforce includes strong provider, academic and departmental representation but controversially left out unions representing the sector’s frontline workers. The taskforce, which was funded with $2 million in the May 2017 budget, will provide its wide-ranging workforce strategy by 30 June.

5. Home care: queue for packages

In home care, the elephant in the room remains the national waitlist for home care packages, which at last count stood at 100,000 people, including more than 60,000 who are not receiving any home care package funding. Provider and consumer peaks are calling on the government to act swiftly on the Tune Review’s home care recommendations and to increase the overall investment in home care packages in this year’s budget. Another big issue to watch this year is the move to an integrated care at home program, with the merging of the Commonwealth Home Support Program and home care packages, which was delayed by the Turnbull Government in May. We’re also awaiting a response to the review into wellness and reablement in community aged care. The national implementation of quality indicators for home care is also currently slated for 2018.

6. Action plans on diversity

In efforts to build a more inclusive aged care system and hot on the heels of the launch of the Aged Care Diversity Framework in December, work on the three separate action plans targeting particular barriers and challenges faced by Aboriginal and Torres Strait Islander people, culturally and linguistically diverse communities, and people who identify as lesbian, gay, bisexual, transgender or intersex is still underway. The Federation of Ethnic Communities’ Councils of Australia is now calling on providers, CALD consumers and carers to complete a survey as part of its work developing the CALD action plan. The plans are due to be finalised by May.

Our tips for others to watch:

  • Computer says no: Who could forget the ongoing saga with the Department of Human Services’ online payments system? In October 2016, Canberra announced plans to build a new digital payments platform for health and aged care. It undertook consultations with providers early in 2017 and then issued a tender to outsource the building of said system. In the May Budget last year the Commonwealth announced an additional $67.3 million for the initative and then in the December budget update a further $16.6 million “for remediation and essential maintenance” of the system.
  • Elder abuse laws: We’re still awaiting the Commonwealth’s response to the extensive elder abuse report from the Australian Law Reform Commission, handed down in June last year. The report’s 43 recommendations outlined changes across guardianship, family agreements, banking and superannuation. A third of the recommendations centred around aged care. Last October, the government announced it would fund an elder abuse prevalence study, training, and a “new elder abuse peak body” (which was given a meager $250,000 over two years). The then Attorney General George Brandis said an elder abuse working group was considering the recommendations of the ALRC report and would report to state and federal ministers later in 2017. The issue is likely to dominate the national elder abuse conference later this month.
  • Another inquiry: Just when stakeholders thought they were done with inquiries, in late December the House of Representatives Standing Committee on Health, Aged Care and Sport announced it had commenced the Inquiry into the Quality of Care in Residential Aged Care Facilities in Australia, after a referral from the Health Minister Greg Hunt. Committee chair Trent Zimmerman said it would focus on the quality of care and services provided to residents. Submissions to the inquiry closed yesterday.

Additional reporting by Linda Belardi.

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One Response to Quality and funding dominate aged care agenda

  1. Russell Egan February 10, 2018 at 11:19 pm #

    The government has reduced average residential care funding from $185/per resident/per day to $175. This rate will continue to fall as new residents replace the remaining residents grandparented under the old funding rules.

    The workload is the same so providers are expected to work for less. In what other industry would such an outcome be acceptable (especially since the provider has invested very large sums of capital upfront based on assumed returns). The Turnbull Government wants a gold plated aged care system but is paying with silver. Providers have no other ability to offset these revenue reductions due to price regulation, especially with increasing vacancies in the system (due to the growth of home care) creating intense competition in accommodation payment pricing.

    Like every incompetent government decision, a substantial response or recognition of error will only occur when aged care services start closing.

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