Department confirms undersubscription of care supplements
The Dementia and Cognition Supplement and the veterans’ supplements in residential and home care were all underspent at the end of the last financial year, the Department of Social Services confirmed to a senate estimates hearing on Thursday.
The Dementia and Cognition Supplement in Home Care and the veterans’ supplements in residential and home care were all underspent at the end of the last financial year, the Department of Social Services confirmed to a Senate estimates hearing yesterday.
In late September Australian Ageing Agenda first reported the slow take-up of the key supplements, as well as industry concerns over confusing and complex claiming processes. Government documents AAA had obtained under the Freedom of Information Act showed that – at March 2014 – the supplements were under-subscribed by $34 million.
Yesterday Rachel Balmanno, acting group manager, aged care policy and reform, confirmed to the Senate’s Community Affairs Committee that the key supplements came in under budget in 2013-14, but she did not provide the full year financial results.
Ms Balmanno said the underspend was due in part to the delayed start date for the supplements (1 August 2013 instead of 1 July 2013) and usual first-year implementation patterns.
Stakeholders had told AAA that some applications for the Dementia and Cognition Supplement had taken months to be approved by the department.
Ms Balmanno told senate estimates the department would continue to monitor the take-up of the Dementia and Cognition Supplement and the Veterans’ Supplements in residential and home care to ensure expenditure “levelled out” in line with projections. She told the hearing:
“In the first year of new supplements, it takes some time for claiming to actually build up to what will be the new business as usual level. For each of those supplements there has been a period of slow growth which has gradually built as the year has gone on, so each of those supplements finishes under what the original estimates were.”
Ms Balmanno said the Homeless Supplement for Residential Care, also introduced as part of the Living Longer, Living Better reforms, was slightly above budget estimates, tipping approximately $100,000 over-budget at the end of the financial year.
Dementia and Severe Behaviours Supplement
Yesterday’s hearing also discussed the timeline of events between DSS and Assistant Minister for Social Services Mitch Fifield regarding the dementia supplement, which AAA had established in its coverage in late September.
Senator Fifield said he is due to receive a final report produced by KPMG on alternatives for the dementia supplement by the end of October.
He would not say whether the report would be publicly released but said the advice contained in the report would help form the government’s view on what could “practically and effectively be put in place to support aged care residents exhibiting severe behaviours.”
Acting deputy secretary of DSS Carolyn Smith told the hearing a number of options were canvassed during the Ministerial Dementia Forum including better utilising the Dementia Behaviour Management Advisory Service (DBMAS) and Dementia Training Study Centres. A multidisciplinary ‘flying squad’ targeting residents with severe behaviours also drew some support by forum stakeholders, she said.
Senator Fifield told estimates he would like to see a replacement put in place “as soon as possible”.
As revealed by AAA last month, the department told the committee it was not possible to review and redesign the supplement within the original funding allocation. Ms Smith told the hearing that clinicians had raised concerns early on about the suitability of the assessment tool to effectively target the right group, which have “borne out.”
She said training and a misunderstanding of the original target population also contributed to the blow-out in expenditure.
Ms Smith said an initial proposal to amend the ACFI to include a very high behaviour domain was also not feasible.
The Labor Party has campaigned for the axed supplement to be reinstated and Shadow Parliamentary Secretary for Aged Care Senator Helen Polley asked the department on Thursday if it was possible to return the original supplement with validation and compliance measures in place.
Ms Smith replied: “It’s been the view that we have come to after analysis and consultation that it is not possible to redesign the supplement within the original funding parameters.”
Higher accommodation supplement
Elsewhere, Senator Fifield also confirmed yesterday that he had asked the Aged Care Sector Committee and his department to monitor the significant refurbishment supplement.
“Given the experience of the Dementia and Severe Behaviours Supplement, we just wanted to make sure that we have learned the lessons of the design of the previous government and sought to monitor that together,” he said. “We will watch this space.”
On 26 September, Minister Fifield told AAA the significant refurbishment supplement was not under review but he wanted the supplement to “serve as a model for partnership with the industry”.
ARCHIVE: How AAA revealed the underspend, established dementia supplement timeline:
Key supplements under-subscribed by $34 million
