The royal commission has asked aged care provider peak Leading Age Services Australia about its record on advocating in the interests of residents.
“Does LASA ever advocate for changes that are in the best interests of residents at what might be thought to be the expense of providers?” Counsel Assisting Timothy McEvoy asked LASA CEO Sean Rooney.
Mr Rooney answered that LASA did not do this but always tried to support its members to deliver the best possible care they could.
“I cannot recall a – any occasion where that has been the case,” Mr Rooney told yesterday’s hearing in Adelaide.
“I would say is that where … an issue has arisen, we would point out to government or the regulators or whoever that with that outcome would come a series of issues that would need to be resolved from a provider’s perspective in order to deliver that outcome.”
The question came after Dr McEvoy asked Mr Rooney about LASA’s feedback during discussions about the new standards in relation to a comfortable service environment.
A reference to “comfortable internal temperatures” included in the consultation draft is not included in the final standards.
Dr McEvoy asked why LASA suggested that “comfortable internal temperatures” be removed from the standards in its submission, and why the peak was concerned its inclusion might be interpreted as all services would require air-conditioning.
Mr Rooney said LASA didn’t request the reference be removed.
“What we sought in our response in the consultation process was clarification, if this now required all residential aged care facilities to install air conditioning,” he said.
Teaching nursing homes
Representatives from fellow aged care peak bodies Aged & Community Services Australia, and Catholic Health Australia, which represent not-for-profit and Catholic-based providers respectively, also gave evidence at yesterday’s hearing.
During her evidence of examples of good practice or innovative models for delivery of aged care services, ACSA CEO Pat Sparrow talked about the teaching nursing homes pilot, which created residential aged care facilities that were multidisciplinary training sites.
“The idea was that it does two things: it improves people’s skill and understanding about aged care, but also what we found out of that was people actually really liked working in aged care and were more than inclined to say after they had graduated that they wanted to move into aged care.
“And, obviously, it had fantastic benefits for the residents as well,” Ms Sparrow told the hearing.
Commissioner Richard Tracey asked Ms Sparrow to expand on the concept of teaching nursing homes and said he was interested in seeing the evaluation of the program.
Commissioner Tracey said “it does strike me as being a very useful concept given that we are going to need an expanding workforce of people with qualifications in dealing with the elderly, and this may be one of the solutions. But I gather from your evidence that the trial was run but nothing has come of it.”
The Commonwealth Government provided just over $8 million from 2012 to implement the Teaching and Research Aged Care Services (TRACS) program across 16 projects.
The national evaluation published in 2016 concluded TRACS “brought a range of positive returns which mean that this amount should be regarded as an investment rather than simply a cost.
“Overall, the early impact of the TRACS investment is positive for most of the aged care organisations involved, their workforce and their consumers,” the evaluation said.
Funding was not continued for the program.
Issues with ACFI
Elsewhere, Dr McEvoy asked CHA director of aged care Nick Mersiades to explain some of the issues with the Aged Care Funding Instrument from the perspective of CHA members.
Mr Mersiades said the biggest problem with ACFI was its volatility. The government’s current strategy to pull back on the rate of growth means the sector has gone from a relatively high level of government subsidy to a low level, he said.
“The issue there is that I think the indexation formula is particularly harsh, and as a result it’s not keeping up, it’s not faithful with the with price movements that are being incurred in comparable sectors of the economy.
“[It] means that providers who administer the ACFI understandably look at ACFI as the only avenue for having an impact on their revenue, as they’re looking to maximise it as much as they can,” Mr Mersiades told the hearing.
He said the fluctuation from year to year was an indication of a flawed system.
Additionally Mr Merciades said that being a very technical document, the ACFI required people with clinical skills to do it effectively, which meant it was diverting skilled people away from the care of residents to doing an administrative task
Alternative funding models
In response to a question from Dr McEvoy about alternative funding models CHA supported, Mr Mersiades said it the eligibility and funding assessments should be done externally and independently.
“We also support the thrust of the Resource Utilisation and Classification Study, which is moving towards creating a funding system based on the case mix system, which is used throughout public hospitals,” he told the hearing.
“We would also argue that that new instrument ought to be administered by an independent statutory authority of some kind, rather than by the department or by providers themselves.”
He pointed out that CHA has advocated for an independent approach since the 2011 Productivity Commission review of aged care
Mr Mersiades said the Aged Care Financing Authority should have been an independent pricing authority rather than just an advisory body on funding and financing.
UnitingCare Australia Claerwen Little National Director, Aged Care Guild CEO Matthew Richter, Australian Medical Association president Tony Bartone and Melissa Coad, executive projects coordinator at United Voice, are scheduled to provide evidence today.
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