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Allied health peaks are calling for specified time with residents as they are concerned aged care providers will cut specialists under the new residential care funding model.
The Australian National Aged Care Classification (AN-ACC) kicked off in early October and increased government funding per resident from around $192 to $225.
As AN-ACC only covers a resident's time with a nurse or aged care worker, specialists are concerned that providers will spend funding earmarked for allied health on hiring more staff and 24/7 registered nurses.
Australian Physiotherapy Association chief Scott Willis said he is already receiving reports that physiotherapists are losing their jobs despite the funding model being in place for less than two weeks.
"We're hearing that at least 40 per cent of physiotherapists are notified that they're going to lose their jobs within the residential facilities," Willis told Aged Care Insite.
"Many more have been redeployed. So even though some government department officials were saying there won't be a reduction in allied health in aged care, we're hearing this now consistently across the country."
The government based allied health spending on a 2021 StewartBrown survey, which stated that providers roughly allocate 4 per cent ($700 million) of the department's aged care funding on specialist care.
Aged Care minister Anika Wells said the new model will help providers deliver services that better match residents' needs.
"It is a far more transparent system for providers, older Australians, and the community," Wells said yesterday.
The AN-ACC model replaces the previous Aged Care Funding Instrument (ACFI) and honours the Royal Commission's recommendation to classify residents' services based on their needs.
For remote and very remote facilities, providers will be able to receive an average of roughly $290 per bed day, which is $65 more than the average AN-ACC funding of $225 per bed day.
Yet, Allied Health Professions Australia (AHPA) advocate Chris Atmore said that the government had failed to set a benchmark regarding the specific number of care minutes per resident for allied health.
The government instead allocates an overall bucket of money per person to the aged care provider, which they can spend as they see fit, Atmore had said.
The aged care sector is in the midst of major changes after passing the Aged Care Amendment Bill 2022 and the Aged Care and Other Legislation Amendment Bill 2022.
Among the instalment of 24/7 on-site nurses in aged care facilities by July 2023, providers must also deliver an average of 200 care minutes per resident per day by October next year, an increase of 20 minutes.
Although Willis has welcomed the increase in the number of minutes per resident, he said it would be a blow to the aged care sector if they'd lose allied health staff.
"Our biggest concern is the impact it will have on aged care. Once you lose these allied health professionals from the facilities, it will be hard to get them back again," Willis said.
According to the government's guide, 'how allied health care is supported under AN-ACC', the obligation of providing allied health services to residents falls onto the shoulders of the providers.
"It is the responsibility of approved providers to determine how best to meet the care needs of their residents in accordance with their obligations under the Aged Care Act 1997 and the Quality Standards", the guide said.
"Consistent with this, care planning is not conducted as part of the independent AN-ACC assessment and will remain the responsibility of the provider."
Yet, Willis has seen that providers have replaced some physiotherapists with assistants and lifestyle staff.
"We thought that may happen, and it looks like it's starting to happen now."
He said that the situation might improve over time as providers are getting to know the details of the AN-ACC funding model.
"I think many providers are just treading water at the moment and seeing how things go over the next three to four months," Willis said.
"Over the next 12 months, I suspect we'll see whether the situation will improve as the funding model settles down."
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The anticipated loss of specialist care in the Residential Aged Care sector must surely dull the AN-ACC model’s silver lining to the stormy cloud. I am not a health care professional, simply a daughter of parents who were Aged Care residents in two separate facilities.
Prior to COVID, I was able to see the positive effects on the well-being of many residents due to specialists being incorporated into their daily &/or as-needed care. Care Workers and Nurses and Care in-house Management often rely also on their guidance.
I feel sick to my stomach visualising the loss of Specialist care. They are a necessity! Allow me to use my own parents purely as an example – as Dad declined in mobility the in-house Physiotherapist helped to reduce his pain and maintain circulation with the use of exercise, massage and accompanied walking. He provided guidance to staff and family and helped Dad transition finally into a wheelchair.
Like most residents, Dad was unable to cut his own nails and suffered infected and painful ingrown toenails. When a Podiatrist visited the ACF every few weeks, they were in great demand during those times.
A Speech Therapist is often needed after a Resident suffers a stroke as my Mum did, not only to support the Resident in learning how to speak and communicate again if possible but in safely adjusting their diet in order to prevent choking which can lead to Pneumonia.
Towards the end many people with advanced dementia are largely non-verbal, as my Dad was, and have to entrust their every need to someone they do not know. Care and Nursing staff are so overworked and time-poor that they may entirely miss or be able to interpret a resident’s signals of pain or discomfort. They may not be free to determine any needs that could be further evaluated and addressed more thoroughly by a Specialist.
Without appropriate Specialists maintaining a strong presence in the Aged Care sector, I fear there will be gaps and cracks so deep our precious and vulnerable elderly will almost literally, fall through them.