Second bill passes lower house

The second piece of aged care legislation – the Aged Care Amendment (Implementing Care Reform) Bill – passed through the House of Representatives Thursday.

Announcing the news on Twitter, Minister for Aged Care Anika Wells said:

Meanwhile, interim CEO of industry peak the Aged & Community Care Providers Association Paul Sadler posted:

The amendments Mr Sadler refers to include one made by the Federal Government concerning registered nurses. And another by independent MP for the South Australian seat of Mayo Rebekha Sharkie in relation to home care charges.

The bill’s successful passage follows approval by the Senate Standing Committee on Community Affairs on Friday.

It passed with almost unanimous support with just one dissenting report – from independent Australian Capital Territory senator David Pocock, and a recommendation from the Australian Greens in response to concerns raised by the allied health sector about the impact of change in funding models.

While broadly supporting the bill, Mr Pocock shared the concerns “reflected in the submissions and expert testimony provided to the committee relating to the unlimited power given to the executive to establish an exemption framework for the one registered nurse requirement in subordinate legislation.”

Mr Pocock also noted that the subordinate legislation was not available for scrutiny at the time of the inquiry.

The implementing care reform bill contains three major proposals, as recommended by the royal commission:

• increased transparency measures for providers
• a cap on home care charges
• mandatory requirement for facilities to have registered nurses on-site 24/7.

There will be exemptions, however, for rural and regional facilities unable to recruit a registered nurse.

Regarding on-site RNs, Mr Pocock has asked that the bill be amended “to identify either the Secretary of the Department of Health and Aged Care or the Aged Care Quality and Safety Commissioner as the decision-maker for granting exemptions.”

Greens support with allied health consultation

Submitting additional comments to the inquiry, the Australian Greens largely supported the bill’s passage through parliament.

“We particularly welcome the implementation of 24/7 nursing support, to provide the care and support that older Australians need and deserve in residential care. As a number of stakeholders noted in submissions to the inquiry, a requirement for on-site nurses is an important and overdue reform.

“We also want to see improvements in workforce conditions for aged care workers, supported by staffing ratios, improved award wages and conditions, and access to training.”

However, the Australian Greens noted the concerns raised by physiotherapists and other allied health providers about move from the Aged Care Funding Instrument to the Australian National Aged Care Classification. The Greens have recommended “the Australian Government consult closely with aged care residents, providers, and allied health specialists, to ensure that allied health services are appropriately funded and available to all who need them.”

Coalition senators also submitted additional comments that stated their view “that this bill does not provide the necessary detail to transparently inform providers, the sector or the general public of the requirements to be imposed on aged care homes.

“Much of the detail of this policy reform will be determined by subordinate or delegated legislation, of which there are currently no details. These concerns were continuously expressed throughout the committee inquiry.”

Responding to the committee green-lighting the bill, CEO of the Older Persons Advocacy Network Craig Gear said: “OPAN strongly supports round-the-clock nursing – including in regional, rural and remote aged care homes where providers have been unable to recruit staff with requisite skills. An older person’s location shouldn’t determine the hours of nursing care available to them.”

As for any exemptions, Mr Gear said they must be “time-limited, carefully calibrated and monitored to ensure older people get the right level of care.”

OPAN also welcomed the bill’s transparency measures, which will lead to the publication of more detailed information about providers’ spending and performance.

“We know from what older people have told us that greater transparency will be crucial to rebuilding their confidence in the aged care system,” said Mr Gear.

Referencing the cap on home care charges, Mr Gear said the measure “addresses one of the issues most frequently raised with advocates across all of our nine member organisations.”

The Aged Care Amendment (Implementing Care Reform) Bill was introduced to parliament at the end of July along with the Aged Care and Other Legislation Amendment (Royal Commission Response) Bill – which passed both chambers of the house within days of being presented.

The Senate could vote on the implementing care reform bill this week.

While OPAN praised the Albanese Government for the speed with which it has implemented aged care reform, “there is a lot more to be done,” said Mr Gear.

Citing the rollout of the Support at Home Program, OPAN backs its postponement until July 2024 and is calling for senior Australians to be consulted in the decision-making.

“It’s a once-in-a-lifetime opportunity to reform home care,” said Mr Gear. “Older people must be involved in the design of the program – since they are the experts.”  

This story was updated on Thursday 8 September with new information

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