Peak says allied health can’t thrive under current policy
Allied Health Professions Australia insists it is impossible for allied health to thrive under AN-ACC and current policy.
Peak body Allied Health Professions Australia insists it is impossible for allied health to thrive and meet royal commission recommendations under residential aged care’s new funding model and current policy.
As reported last week, aged care consultant and provider chief executive officer Mark Sheldon-Stemm said full-time allied health staff was key to maximising accurate assessments under the forthcoming Australian National Aged Care Classification (AN-ACC) funding model.
He told Australian Ageing Agenda that this and the model’s policy that residents can stay at the same class and funding level after their health improves indicates that allied health could thrive under AN-ACC.
However, this was a misperception encouraged by the Coalition Government that appears to be being perpetuated under Labor, said AHPA policy and advocacy manager Dr Chris Atmore.
“The AN-ACC overall – and its researchers, including the lead architect Kathy Eagar, have said quite plainly – was never designed to address the allied health part of the equation,” Dr Atmore told AAA.
“Even if your funding does go up under AN-ACC, it’s highly unlikely that you will have enough to cover what your residents need in terms of allied health and that was actually what was recommended by the royal commission – it should be needs based.”
AHPA is among many stakeholders who have been raising concerns since last year about the future of allied health in residential aged care.
AHPA is calling for residents to receive a clinical assessment by a multidisciplinary allied health team – which can consider issues like speech therapy, occupational therapy and psychology in addition to physiotherapy – after receiving their AN-ACC funding allocation, and care planning to ensure identified and possibly various allied health needs are met.
“We have always said – and so did the royal commission – that there has to be a multidisciplinary allied health team approach built into the provision of allied health services so that people are assessed for their actual needs, and then that care has to be delivered and coordinated appropriately,” Dr Atmore said.
AHPA analysis highlights funding shortfall
AHPA published a policy brief in July that analyses the changes and federal government claims concerning allied health care in aged care facilities. The analysis is based on a Department of Health informal benchmark of $700 million available for providers to spend on allied health per year, which is based on previous 4 per cent of total provider expenditure.
“First of all there’s no guarantee that providers will continue to spend 4 per cent because of issues like the forthcoming increase in wages for personal care workers. And the AN-ACC is a bit larger but it’s not going to be large enough to cope with that,” Dr Atmore said.
The brief highlights a conservative costing, which assumes every allied health provider is an employee of a facility with hourly labour costs, and a more realistic costing based on sourcing services externally and paying for them.
“Even if providers stuck to spending 4 per cent – which we say is unlikely – when you translate the 4 per cent … it works out that the absolute best is still under nine minutes of care per day per resident, which is less than a minute more than what the royal commission found was totally inadequate. And at worst it is quite a bit less than the 8 minutes that they found inadequate,” Dr Atmore said.
Neither option addresses the royal commission’s recommendation to provide needs based allied health and is at best continuing that “woeful” eight minutes a day, she said.
“Something’s got to give; you have to either say we’re not going to honour the royal commission’s recommendation – even though we said we would – or you’re going to have to find some other way to fund the provision of allied health services.”
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There never will be enough aged care funding for AHP. The ‘price’ assumed by DH&A is significantly undercooked and he claim that under ANACC funding will be maintained in spite of improvements due to AHP treatment is the same that was made when ACFI was introduced. Surprise Surprise – that was the very first change in the Department ‘business rules’ and the first funding loss from ACFI. Having operated both aged care and establishing a specialist private rehabilitation hospital the benefit of good AHP treatment is always under-appreciated by funding decision-makers.
This is a nice article but not a view that matches reality. Given the fact that AN-ACC is based primarily, on mobility and cognition, then unless you have Allied Health assessments to support a condition then the class the person receives will be less than what is really required. Cutting back on Allied Health will only lower your AN-ACC score. We know this from particular experience. To be honest we are happy to see the end of senseless waste of Allied Health professionals doing so called “pain management”. The future is about using their skills to provide assessments and plans that will support funding and at the same time put measures in place that improves peoples lives
Bring back a model based on the previous RCS model of funding at least under that modeal each domain of health was catered for including: social needs, Diversional/Recreation Therapy other speciallised therapy such as music, art etc, and of course included :spiritual needs cultural needs physiotherapy and the usual physcial care needs and communication. It was a much better system looking at true person centered needs.
Under the previous funding, providers exaggerated allied health assessments to attract more government funding without giving residents the assessed care required. Residents Care Plans became compromised. It was extremely dangerous for their health and quality of life. Is extra funding going to make life any better for residents or more profit for providers. Stop using the vulnerable for profits. Figure out a better way. More transparency required.
We need to acknowledge that ACFI was never intended to fund allied health services. Physios only entered the sphere when providers realised there was money to be made in the CHC domain.
Of course, everyone become greedy (one physio ‘treating’ 90 people/day???) and the rules were changed to require 80 minutes/week. Its disingenuous to claim residents were receiving effective pain management through the passive treatments mandated under ACFI.
The entire AN-ACC model is flawed…designed by academics with no practical experience in residential care. Why do we keep making the same mistakes? Once again, the funding model will just promote another cycle of new business opportunities that will rort the system and eventually force government to tighten the rules. A fixed rate system would save everyone time and money…or is that just too simple?
There are a few issues to address in the above comments. Ascribing calls for allied health service benchmarks and associated funding as greedy and exploiting the vulnerable is completely misguided. Yes, the ACFI focus on pain management did not address the needs of residents and was open to exploitation, and allied health sector – including physios – welcomes its replacement by the AN-ACC. We don’t have an issue with the AN-ACC but as its developers stressed, its current iteration was never designed to address allied health needs. The problem is that both Coalition and Labor governments have used the introduction of the AN-ACC model to claim that they have sufficiently addressed allied health, even though there are no current proposals for an allied health service provision benchmark similar to nursing or personal care minutes, and no onus on providers to ensure the full range of allied health needs are met – despite the Royal Commission emphasising that allied health must be an intrinsic part of aged care.
You can find our analysis of the current problem at https://ahpa.com.au/advocacy/ahpa-policy-brief-residential-aged-care-july-2022/ Our vision for what residential care should look like – and why – is at https://ahpa.com.au/advocacy/ahpa-proposed-allied-health-aged-care-solutions-for-jobs-summit/ .