By Linda Belardi.
In the final hours of the Gillard-led government, an amended Living Longer Living Better package passed through both houses of parliament in what many have described as a historic day for older Australians.
On Wednesday morning, after just 45 minutes of debate in the upper house, Greens and Labor senators voted to pass the five amended aged care bills, 34 votes to 29. The reform package then returned to the lower house and was passed without further debate just before 6pm on Wednesday night.
The bills passed with key amendments moved by the government and the Greens, including recognition of the Aged Care Financing Authority as a statutory committee separate from the DoHA, and new powers granted to the Age Care Commissioner to request and receive information from the department and the new Quality Agency.
Critical to the passage of the bills in the senate were commitments made by the federal government to address key concerns raised by the Greens and the Senate Community Affairs Legislation Committee’s final report.
In letters tabled to the Senate, Minister for Ageing Mark Butler committed to implementing a $29 million Homelessness Supplement for aged care providers who specialise in caring for people with a history of homelessness or a risk of homelessness.
The minister also confirmed the introduction of subsidised business advisory services for residential aged care providers to assist them to transition to the new accommodation payments system – a package worth $6.9 million over three years.
In other correspondence tabled, Minister Butler wrote to the chair of ACFA, Lynda O’Grady, asking the authority to monitor and report on the impact of the accommodation payment reforms on aged care providers. In particular, this undertaking would monitor the number and distribution of care recipients choosing refundable accommodation deposits and daily accommodation payments, and the impact on different types of providers.
Given the range of concerns raised, the minister also requested that the authority assess the impact of the reforms on rural, regional and remote aged care providers.
In other amendments, the government also accepted a senate committee recommendation to include those affected by forced adoptions in the package and to rename the dementia supplement to acknowledge that the supplement also covers cognitive impairment and complex behaviours.
WA Greens Senator Rachel Siewert recognised the vital importance of the aged care reform package for older Australians and acknowledged the efforts of many organisations over a long time to put aged care on the political agenda. “It is because of this tenacity that there will be more options for care, particularly in home care, which will help Australians be able to age in place for as long as possible,” she told the Senate on Wednesday.
However, she said that more work had to done to address access for older Australians, including residential aged care clients, to quality mental health services and she recommended that the government consider a special supplement for mental health in the future.
Homelessness supplement announced
The government agreed to provide more than $29 million over four years for the Homelessness Supplement, which will be implemented in two stages. From 1 October 2013, a Transitional Homelessness Supplement will be introduced utilising the existing criteria of the Viability Supplement but it will provide an additional $15 per resident per day to eligible providers.
Following a period of consultation, ongoing arrangements will be developed and will commence from 1 July 2014.
In evidence presented to the senate inquiry, specialist provider Wintringham said that it had lost about $20 per day per resident under the new ACFI arrangements.
Amendments to the Workforce Supplement
To help address concerns over implementation costs, the government said it would amend the supplement guidelines to state that excess supplement funding – after the provider pays a one per cent wage increase to their employees – must be used to provide further wage increases or to support additional workforce commitments as part of the supplement, which may include implementation costs.
The government would also change the guidelines to allow providers to opt in and out of the supplement.
All stakeholders including industry peak bodies, unions and consumer advocacy groups welcomed the final passage of the legislation through the last days of parliament. However, provider groups continued to raise concern over the long-term financial sustainability of the sector.
ACSA and LASA reiterated their positions that the reform package did not go far enough in implementing the recommendations of the Productivity Commission and expressed disappointment that the Workforce Supplement was not removed from the legislation.
ACSA CEO Adjunct Professor John Kelly said that it was imperative that proper scrutiny be given to monitoring the financial impact on providers, particularly those in rural, regional and remote areas.
LASA CEO Patrick Reid said aged care providers were still in the dark about much of the reform’s details and providers faced a capital crisis when bond revenues fall.
“Despite concessional pensioners being considerably disadvantaged over those with greater resources the Greens and Government refused to adopt LASA amendments that would deal with assets equally, and importantly prevent Daily Accommodation Payments being more attractive to Refundable Accommodation Deposits and thus threaten the industry’s capital base,” said Mr Reid.
Catholic Health Australia’s CEO Martin Laverty said the legislation’s passage was just the beginning of a long and challenging implementation process.
“…[W]e shouldn’t think the job of reform has been accomplished just because the bills have passed through the Parliament,” he said.
“It is now time for providers to roll up their sleeves and ensure that the hopes and aspirations of the aged care reform movement can be fulfilled and the care of older Australians improved,” said Mr Laverty.
UnitingCare Australia hailed the successful passage of the reforms through parliament as an historic moment for older Australians.
“It makes good social and economic sense to invest in the wellbeing of older people so they can remain healthy, active members of their communities,” said Lin Hatfield Dodds.
Meanwhile COTA Chief Executive, Ian Yates said hundreds of thousands of frailer older Australians would now receive support and care at home than would have done under the current system.
He said the passage of the LLLB package was a victory for the unprecedented alliance of older people and families, aged care staff, and industry that have pushed for these reforms over the last four years.
Louise Tarrant, National Secretary of United Voice, described the legislation as a milestone for older Australians by improving the standards of quality care.
“This legislation recognises that a professional, well-paid, stable and much larger aged care workforce is essential for Australia’s growing aged care needs,” she said.
Ms Tarrant also praised the “constructive process of cooperation” by all sections of the aged care sector to achieve these reforms.
The Australia Nursing Federation (ANF) commended federal MPs and Senators after the passing of new legislation, which it called a “once in a generation reform” of the aged care sector.
“The ANF is now calling on the Opposition to commit to continuing the Workforce Compact if it wins the Federal Election in September to ensure these improved wages for low paid aged care nurses and care staff who can deliver quality care to Australia’s elderly,” said federal secretary, Lee Thomas.
While the Coalition voted against the reform bills, the opposition did support the changes to home care levels and arrangements, the introduction of the homelessness supplement, establishing ACFA as a senate committee and granting the Age Care Commissioner new powers to request information from the department.