Stage reform implementation, says ACCPA

Provider peak body Aged & Community Care Providers Association has told a Senate inquiry that providers should have the final legislation, rules, guidance and education materials for at least 6-12 months before any new requirements under the new Aged Care Act commence.

Transition timeframes are important for reforms related to system changes, ICT, pricing frameworks, and changes to Support at Home including care management, said ACCPA who also called for a staged approach to reform implementation in its submission to Community Affairs Legislation Committee reviewing Aged Care Bill 2024.

ACCPA chief executive officer Tom Symondson told the inquiry’s public hearing in Melbourne on Thursday ACCPA “unequivocally support” the bill and is “very excited” about the landmark reforms it provides. But, he added, there were concerns over the time, challenge and cost of transitioning to the new system.

“If we’re going to achieve the changes the bill seeks to deliver on, we need the time to do it properly so that the reform does not just fail,” Mr Symondson said.

“That requires 6-12 months from when we have all the information, that means all of the rules.”

Elsewhere in its submission, ACCPA has called for the removal of the proposed higher everyday living fee requirements on residential aged care providers until a review is undertaken on their impacts.

The new fee replaces the additional service, and extra service fees and aims to protect aged care residents from unfair pricing or pressures to pay for services they don’t need or are already entitled to. While ACCPA supports the aim, it says the current legislation limits the ability of providers and individuals to freely enter into an agreement.

“This is unnecessary to achieve the aim … and will discourage registered providers offering higher everyday living services leading to reduced choices to consumers to enhance their residential care experience,” ACCPA said in the submission.

Other recommendations in ACCPA’s submission include:

• delay supporter provisions until after 1 July 2027 to enable further work to be done
• remove penalties on aged care workers and responsible persons for breaches of the Aged care Code of Conduct
• no penalties for provider for not having a registered nurse on site and on duty at all times in circumstances beyond their control.

As previously reported, CHA Australia among others have also stressed the importance of getting the timing right to ensure reforms are implemented effectively.

Also appearing at Thursday’s public hearing was national aged care provider Bolton Clarke.

Speaking with Australian Ageing Agenda ahead of the appearance, Bolton Clarke CEO Stephen Muggleton said his company also reservations over the proposed legislation despite “looking forward” to the passage of the new Act and welcoming “provisions that will support greater funding certainty and sustainability” for residential care.

“From the home care perspective, we are recommending elements of the proposed reforms be deferred pending further review to minimise the risk of major service disruptions and reduced services for those who most need them,” said Mr Muggleton.

Mr Muggleton said the caps on care management are “perplexing” with most current non-compliance in home care related to low care management spending.

Under the proposed changes care management is set at 10 per cent of all quarterly budgets. That’s for providers to use to deliver responsive care management support across all participants, according to the department. Currently care management fees are capped at 20 per cent and package management fees at 15 per cent. Under new legislation package management costs will be incorporated into prices.

“Restrictions on fixed monthly fees based on package levels and redistribution of overhead costs mean people already fully using their package will pay more, so will be able to afford fewer services,” he said.

“Given the delays in introducing the Act there is also no time to set properly researched prices based on current costs. The existing costing study has major limitations – for example, the proposed $15,000 cap on home modifications is completely out of touch with current supply and installation costs.”

He added: “At the most basic level, the government’s proposed timeline for publication of initial prices in November and detailed pricing in February 2025 is inadequate given the need to adjust business models before commencement of the Support at Home program.”

They also stated that the Government proposing initial prices to be published in November 2024, with detailed prices to following February 2025 is “just unreasonable”.

Key takeaways from Bolton Clarke Group’s submission to the inquiry include:

• the increase in residential care funding provided by the Bill is vital to ensuring there are enough aged care beds
• Support at Home reform is welcome but rushed price controls risk substantial disruption to services
• a rights-based Act is welcome though the absence of a right to care is disappointing
• penalties for severe wrongdoing are appropriate but people should be protected from being penalised for reasonable mistakes
• regulatory powers must avoid impinging basic legal rights.

Published submissions are available on the inquiry’s page.

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