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Budget 2018-19: the sector reacts

Aged care was touted as a key focus for Government in the 2018–19 Budget; in the lead-up to yesterday’s release, media reports promised a slew of funding measures. So how did the sector fair?

While key industry stakeholders continue to pick through the Budget with a fine-tooth comb, Aged Care Insite canvasses their early reactions.

More packages, more choice ($1.6b for 14,000 additional high-level home care packages + 6000 already announced in the second half of 2017.)

One of the star players in the $5 billion announced for aged care in the Budget was the announcement of more home care packages.

With over 100,000 Australians on waiting lists, Aged & Community Services Australia (ACSA) said the additional home care packages are urgently needed to address some of that demand.

The Australian Nursing and Midwifery Federation (ANMF) said funding to meet the ever-growing demand for in-home aged care services was long overdue.

“It’s simply unacceptable that waiting lists have blown out to this point, with thousands and thousands of people waiting more than a year for the care services they need to remain in their home,” acting federal secretary Annie Butler said.

The additional home care packages, along with a raft of other measures, were tied up in the More Choices For a Longer Life package.

Other announcements included making available 13,500 residential aged care places and 775 short term restorative care places, with $60 million capital investment to support new places, and providing increased flexibility of funding for residential beds or home care packages by combining both programs from July 1 2018.

COTA Australia chief executive Ian Yates said the package will ensure better co-ordination of services across government.

“This is the first time we have had a full ageing package that takes a proactive approach to an ageing Australia and takes a life cycle approach that recognises the need to prepare properly for an ageing population and support all Australians as they move through life.”

Yates called the move a substantial implementation of the recommendations of the Tune Legislated Review and added it will “change the face of aged care towards greater consumer control”.

He said: “The injection of 20,000 high needs home packages… in addition to the growth already built into the forward estimates, will ensure more older Australians waiting for home care will receive a package over the next year.”

The merging of home care and residential funding pools will make more home care packages possible in future, he added.

The Government also announced in-principle support for putting residential aged care places in the hands of consumers.

COTA welcomed this and pushed for a specific date for the change at latest by next year’s Budget. “Until then with residential care allocated to providers, not in response to consumer demand, older Australians still do not have the ability to choose their nursing home, and good providers are restrained from responding to consumer preferences,” Yates said.

ACSA’s Sparrow said she was pleased to see funding for a feasibility study before any changes are made. “This will be critical to ensure thorough planning and forethought, including identification of the timeframe required for the significant adjustments and changes such a move would require,” she said.

Adjunct Professor Kylie Ward, chief executive of Australian College of Nursing, said nurses need to be at the table where all decisions will be made regarding new funding announcements to ensure they will be successful. “The aged care promises in particular are ones that will be closely examined to ensure the changes are creating better outcomes for older Australians.”

Feeding the watchdog ($250 million over four years to establish the Aged Care Quality and Safety Commission)

Funding was set out for the previously announced Aged Care Quality and Safety Commission, which will streamline the functions of the Australian Aged Care Quality Agency and the Aged Care Complaints Commissioner into a single agency.

More than $250 million will be set spent over four years to establish the Commission, with $50 million to help providers implement the new standards.

The Ministers for Health and Aged Care called the new Commission a “tough cop on the beat”.

Dementia Australia said the commission will be supported by other significant measures such as the $50 million for a Quality Care Fund, $32.6 million to enhance the regulation of aged care provider quality to respond more quickly to failures, and $8.8 million to improve the transparency of information on aged care provider quality.

Navigating aged care

The Government will spend $7.4 million over two years to trial Integrated Consumer Supports, including help for older Australians to navigate aged care.

This will include 30 aged care information hubs to provide locally targeted information, 20 community hubs where members support each other in navigating aged care and a dozen specialist positions in consumer-focused organisations and the Department of Human Services to offer additional support.

Dementia Australia chief executive Maree McCabe said the peak was particularly pleased to note funding to assist people seeking information about aged care to make decisions that are right for them.

“Our experience has shown that early intervention supports can be crucial in enabling people to remain in the community, and prevent admissions to hospital and presentations to emergency departments,” McCabe said.

Mental health ($102.5 million for mental health services for older Australians)

This funding includes over $82 million for older Australians in residential care and $20 million for those over the age of 75 years and living in the community.

Leading Age Services Australia chief executive Sean Rooney said measures to support ageing-well, such as the mental health measure, active ageing and a pensions loan scheme, are particularly welcome.

Elder Abuse ($22m commitment to elder abuse)

COTA was pleased to see the Federal Government asking for leadership in the development of a national framework and approach to elder abuse, including a national register of enduring powers of attorney.

President of the Law Council Morry Bailes said the body has long urged the Government to move swiftly towards the development of a national plan to combat elder abuse, as well as a national prevalence study, both of which were outlined in the Budget on top of the creation of an Elder Abuse Knowledge Hub.

Palliative care ($32.8 million over 3 years for extra palliative care in residential aged care)

Liz Callaghan, chief executive of Palliative Care Australia (PCA), said the funding shows the Commonwealth’s commitment to ensure palliative care is included in aged care service provision, and not just end-of-life care.

“Like the Productivity Commission, we call on cross jurisdiction cooperation to avoid problems resulting from poor stewardship, which ultimately leads to aged care services not responding as they should to users’ palliative care needs and choices.

“Australian studies have shown that when specialist palliative care services are brought into residential aged care settings, there is a reduction in unnecessary hospitalisations and an improvement in symptom and pain management,” Callaghan said.

Callaghan added PCA would like to see specific palliative care quality indicators across residential and community aged care. “For example, all staff need to be trained and equipped to recognise the need for appropriate end-of-life or palliative care, including appropriate pain management and the signs of approaching death.”

A snapshot of other key measures

  •  $40 million to support aged care providers in regional, rural and remote Australia for urgent building and maintenance works
  •  $61.7 million to make My Aged Care easier to use
  •  $5.3 million allocated for dementia innovation
  •  $105 million for culturally safe aged care services in remote Indigenous communities
  •  $14.8 million for a new national assessment framework.

All in all

Individually, and collectively, the budget initiatives go some way to responding to the growing demands for age services in Australia, LASA’s Rooney said. However, he added the sector had hoped that the Budget would map out a plan to meet the longer-term needs of Australia’s rapidly ageing population.

“This Budget does not adequately address the growing complexity of residents’ needs, changing consumer and community expectations, and rising operating costs, which are all placing increasing financial pressure on residential care providers and the overall aged care system,” he said.

Rooney added that 2018–19 is a critical year in aged care and more work is urgently needed to ensure for a high performing, respected and sustainable aged care system.

The Aged Care Guild, an association of eight of the largest private residential aged care providers in the sector, said that while the extra funding announced for aged care is welcomed, the outlook is for continuing instability until the funding of future demand is resolved.

The Guild’s interim chief executive, Lee Hill, said: “As our ageing population grows we need a bipartisan solution to this problem: how will this country properly fund aged care into the future in a way that meets the needs and expectations of elderly Australians and their families?

“The demographics are certain. What’s the plan?”

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  1. So you think 14,000 places over 4 years is a good deal, lets look at it by the time we have those packages more than that will have joined the queue, so how can you promote this as a win for aged pensioners, it was 900 days today since I was assessed level 4 a total disgrace I gave my home over today for a live broadcast for ABC News 24 my wife and I spoke about the issues effecting us, we spoke up for 110,000 people much more than you appear to be doing, with your wishy washy comments.

  2. It is good that the new combined quality commission will be a “tough cop on the beat”, but let’s hope the “cop” focuses on poor care outcomes in the biggest providers, and not hammering the small, not for profits who by and large provide a much better care environment, but are also much easier to pick on if they make mistakes.