INDUSTRY UPDATE – MARCH

The first quarter of the year has ended, and with it an extremely busy month in the industry – although we can say that every month! March saw more witness hearings for the Royal Commission. The focus for the Royal Commission this month was Home Care, and with it of course, a great deal of media surrounding the state of Home Care funding and Providers. Big news with the Resource Utilisation Classification Study reports released, and of course with it, a fresh wave of interest in what the proposed new funding tool could be. The new Aged Care Charter of Rights was launched, amongst some controversy, and a 9.5% increase to ACFI rates with the March rates update has been implemented for 100 days, in the lead up to the new Financial Year. Let’s march through the month that was!

RUCS REPORTS RELEASED

The 15th March saw the release of the Resource Utilisation Classification Study (RUCS) Reports. The RUCS is a University of Wollongong study that began in 2017, and utilised data collected from 4,500 Residents from over 180 Residential Aged Care Facilities. The aim of the study was to establish the types of characteristics of Residents that drive care costs – making the relationship between price and cost clear – and utilise that information in the Government’s consideration of a future funding tool that would replace the Aged Care Funding Instrument (ACFI). A media release from Ken Wyatt, Minister for Senior Australians and Aged Care, expressed that the proposed ideas released in the RUCS had removed issues identified in ACFI and would be a ‘completely different’ way of funding Aged Care. One such change would be that Residents would fall under one of 13 payment classes, and Facilities would not be advised of the payment classes of their new Residents, until they were already under their care. An additional $4.6M of funding was announced by the Government in the 2018-19 MYEFO for a trial.

You can view the RUCS reports on the Department’s website here.

A consultation paper on the RUCS has been released and a consultation process opened for submissions. You can find the paper, and provide a submission here.

There has been no clarification from the Government on which funding tool will replace ACFI. For more information on the myths and facts surrounding the RUCS and a new funding tool, you can refer to our article here.

FUNDING BOOST

The $320M funding boost to Aged Care that was announced in February has started to roll out to Aged Care Providers, with the Temporary Subsidy Increase released with the March 20th rate update.

From the 20th March 2019 to the 30th June 2019, Providers will receive an additional daily ACFI subsidy for the Temporary Subsidy Increase. This is in addition to the Quality Care Fund additional daily ACFI subsidy that came into effect from the 20th September 2018, and paid until the 30th June 2019. A temporary RCS subsidy boost will also be paid in addition to the daily RCS subsidy rates for the period 1st April 2019 to 30th June 2019.

To see the new ACFI rates total, including the Temporary Subsidy Increase and the Quality Care Fund daily subsidy that was released in 2018, you can refer to our article here.

ROYAL COMMISSION

March saw the Royal Commission hold its second round of witness hearings in Adelaide, as well as community forums beginning around the country, and a background paper was released. The background paper is the first to be released by the Royal Commission, with the Commission intending to release further background papers from time to time on relevant issues to its work. Background Paper 1 covers a number of issues, such as expectations for care, funding and accreditation and quality, as well looking at findings of previous reports, studies and surveys into the sector.

You can find the background paper here.

The second Adelaide Hearings commenced on the 18th March, this time with a focus on Home Care, and Personal Care Workers shared concerns for the need for better wages to attract future employees to the sector. Community forums were held throughout the month in Wollongong – NSW, Bendigo – Victoria and Bankstown in Sydney, NSW. The next upcoming community forum will be held in Maidstone in Melbourne in early May.

Public submissions are now to be accepted until at least the end of September 2019, with a formal close date to be released later in the year. Reported up until the 28th March, there had been by this date 1,704 submissions received by the commission.

With a great deal of media reports surrounding the Royal Commission, the Aged Care Guide, Australian Ageing Agenda and The Weekly Source are excellent sources of information. You can also access live and past hearings via the Royal Commission webcast channel here.

HOME CARE

A huge month for Home Care news. Home Care pricing information will become mandatory to publish in a pricing comparability Schedule, available on the My Aged Care Service Finder from July 1st 2019, with Providers encouraged to publish their prices immediately. The mandate has come after concerns over transparency of the costs and comparing Home Care Providers, and the requirement to publish current pricing information that came into effect on 30th November 2018. You can read the legislation amendment here.

This month, the Royal Commission focused on care provided in the home in the March hearings. The extensive wait list of approved people waiting for Home Care Packages has long been in the media; and the amount of unspent funds is expected to reach $600 million by the end of the financial year. The hearings saw witnesses from the sector sharing personal stories as care recipients and their families, as workers in the Home Care sector, and the Department of Health, among others. You can also access the second hearing via the Royal Commission webcast channel here.

The Home Care packages program data report for the period 1st October – 31st December 2018 was also released in March, with an update on the operation of the Homes Care Packages Program. You can find the report here and read the Aged Care Guide’s wrap up of the report here.

A Government-funded report into the delivery of Home Care has been released, featuring personal experiences and written by an independent researcher, Dr Sarah Russell, the Director of Age Care matters. The Report, Older People Living Well with In-Home Support covered issues such as costs and mark-ups on services and staff turnover, as well as positive stories of Home Care enabling connection to the community and peace of mind provided to family members. You can view the report here.

In recent changes to Home Care and the March 20th 2019 rates update, the dementia and cognition supplement, and veterans’ supplement in Home Care increased from 10 per cent to 11.5 per cent.

SERIOUS INCIDENT RESPONSE SCHEME FOR AGED CARE

The Government has released a new report, developed by KPMG, that provides recommendations and options to strengthen reporting and investigation of reportable incidents in Aged Care. Initially announced in April 2018, the report Strengthening protections for older Australians – Development of models and options for a Serious Incident Response Scheme for Commonwealth-funded aged care service providers proposes models for reporting incidents in Aged Care and options for a Serious Incident Response Scheme (SIRS).

More than 130 Aged Care Providers, peak bodies and representatives from the industry were involved in reviews and consultation in order to inform the report.

A proposed implementation phase would see the SIRS set-up phase begin immediately for the next two and a half years, with a go-live date of 1 July 2022.The report recommends that a SIRS would be overseen by the Aged Care Quality and Safety Commission.

Find more information on the report here.

AGED CARE PLACES

March saw the Government’s release of the results for the 2018-19 Aged Care Approvals Round (ACAR), with some interesting statistics: three Providers won 22% of the Residential places; the Eastern states received 80% of places, and over 5,000 places were allocated to regional areas. The ACAR, which was 13,500 new Residential Aged Care places, saw 79 brand new Facilities sharing in the round.

The 2018-19 ACAR aimed to add much needed support to older people living in Australia who are financially or socially challenged, people of Aboriginal & Torres Strait Islander descent, living in regional and remote areas, veterans and LGBTI communities.

Additionally, the number of 2018-19 ACAR places are a record and a 36% increase on the 2016-17 ACAR (no 2017-18 ACAR was released), worth $906M per year. You can read the Department’s release here and a breakdown of the allocation by state, metro and regional here.

PHYSICAL & CHEMICAL RESTRAINTS

Physical and chemical restraints in Aged Care have been big news in the media this year. In January, as reported in our Industry Update, Minister Ken Wyatt stated that there would soon be better regulations for physical and chemical restraints, and an update to the new Standards occurred (Standard 3 – Personal Care and Clinical Care) referring to the use of chemical restraint and appropriate use. The drafting of new regulations took place in March, with consultation occurring with stakeholders across consumer and Provider peaks, the Department of Social Services, the Australian Nursing and Midwifery Federation (ANMF), the Aged Care Quality and Safety Commission, the Australian Commission on Safety and Quality in Health Care and researchers. A special advisory committee was been established and met in March. At the close of the month, the Minister stated the move to ‘significantly strengthen the regulations’ had occurred, to be signed into law in the first week of April. The changes apply to the new standards, as well as an amendment to the Quality of Care Principles 2014. From July 1st 2019, Residential Aged Care Providers will need to fulfil several conditions, including that assessment is completed by an approved person, and alternative options have been tried prior to physical or chemical restraints – with restraints being the very last resort. You can read the amendment to the Quality of Care Principles here.

MONITORING MEDICATION USE

A big topic for the industry currently is antipsychotic drugs, and their use in Aged Care as a form of chemical restraint. The new Quality Standards, that all Providers will be measured against from 1st July 2019 were updated earlier this year to address the issue of and concerns surrounding chemical restraints.

In the midst of this news, an exciting new tool has been developed by Dementia Training Australia (DTA), which intends to monitor antipsychotic medication use. The Antipsychotic Tracking Tool (APTT) also generates audit reports, graphs with state-based benchmarks included for comparison and tracks the use of the medication over time.

You can download the tool and accompanying video tutorials from the DTA website here.

EXPANDING AGED CARE SERVICES IN TORRES STRAIT

A $19M building, purpose built to provide much-needed services, has opened on Thursday Island and is a huge step forward for Residential Aged Care in the Torres Strait. The Blue Care Star of the Sea Elders Village is currently the only Residential Aged Care service in the Torres Strait, and had been previously operating from a building that had been deteriorating. Up to 38 Indigenous older people requiring care will be able to receive specialist and culturally appropriate care. The building will also be able to provide accommodation for homeless people.

In February, the Government released a statement committing to ‘ensuring equality of access to high-quality, culturally appropriate aged care for First Australians’ with the Aged Care Diversity Action Plan for First Australians.

AGED CARE NAVIGATOR SYSTEM PILOT

The Aged Care System Navigator trials are underway, led by COTA Australia. As reported in our February Industry Update, the $7.4M trial includes a number of Aged Care navigator centres, specialist advisors and information hubs, intending to offer face-to-face assistance, as well as phone and online support for older people and their families attempting to navigate the system. The trials will run across 62 locations between now and June 2020, and have been specifically designed to include a very wide range of those who may be accessing the system, from people living with dementia, older Australians from ethnically-diverse and LGBTQI communities and older Australians at risk of homelessness.

AGED CARE CHARTER OF RIGHTS

The new Aged Care Charter of Rights, based on the upcoming quality standards, has been released, and with it the requirement that every Provider will need to sign it and give to every person who receives care under their service.

The Single Charter of Aged Care Rights was developed following consultation in 2018, and on the back of the Carnell Paterson review of Aged Care regulation, that found that awareness of consumer’s rights was low. The new charter comes into effect from July 1, and is the date that all Providers can begin supplying a Provider-signed copy to consumers, who have the ability to counter-sign. In a controversial move, the deadline for Providers to provide the charter to their Residents is 30th September 2019 for Residential Aged Care and the 31st December 2019 for Home Care. Consumer peak COTA Australia has expressed concern that the timeline to provide the charter to consumers is a long delay, with Chief Executive Ian Yates expressing that 6 months to communicate basic rights to residents is troubling. In comparison, CEO Sean Rooney of peak body Leading Aged Services Australia (LASA) has stated that the timeframe is required, allowing Providers to explain the charter and give their consumers the appropriate opportunity to sign it, without impacting additional administrative costs. Despite these conversations, COTA Australia, LASA and other peak bodies have all welcomed the new charter.

It is the first time that a signed copy of the charter has been required to pass on to Residents and Care Recipients. You can find the charter template for signing here.

LASA ELECTION CAMPAIGN

Peak body LASA has launched a campaign in the lead up to the federal election to raise awareness, highlight key issues and encourage politicians to address the crucial major issues facing Aged Care. The campaign, ‘I Care for Aged Care’, focuses on funding relief for Residential Aged Care Providers, and the wait for Home Care packages, calling for a legislated minimum wait time to be introduced.

You can read more information on the campaign on LASA’s ‘I Care for Aged Care’ page, and the Australian Ageing Agenda’s wrap up of the campaign here.

TECHNOLOGY & INNOVATION

A big month in March for technological progression and exciting innovation in the Industry! Let’s run through a few of our favourite stories from this month:

  • A new study, designed to measure frailty and the relationship between frailty progression and the use of space, as well as a resident’s perspective of their quality of care launched in March in South Australia. The FIRST study (Frailty in Residential Service Over Time) is a collaboration between the University of Adelaide and Resthaven.
  • A Sydney startup, NomadVR, is using Virtual Reality to allow Aged Care Residents who are no longer physically able to travel or even leave their Facility, to have experiences in places like Africa, Antarctica and even the bottom of the ocean. Specially curated experiences with older people in mind, Nomad VR has said demand for the service is rapidly increasing.
  • Google technology is part of an Australian-first program that utilises the Google Assistant. Not-for-Profit Aged Care Provider Feros Care has developed the program, using voice-command technology instead of computers or iPads that some people may find harder to use. The program allows older people living at home to manage aspects of their lives such as appointments, care details and account information.
  • A cloud and mobile based technology that helps Providers to deliver better care, and enable older people wanting to remain at home with support, has been named a finalist in the 7th Asia Pacific Eldercare Innovation Awards. hayylo is an Aged Care and Disability customer experience platform, and has already won the award for the ITAC2018 Best Solution Providing Consumer Independence and Joint Overall Winner for 2018.
  • Residential Aged Care Provider RSL LifeCare are trialling a new smart floor technology, aiming to ensure the safety of Residents living with dementia. SensFloor can track the movements of people within their room, their entry and departure of the room, and sent off alarms for falls or if there has been a long period of time spent in the ensuite.
  • We all heard about Paro the seal, but robotic kittens and puppies are the new kind of pet therapy being rolled out across Perth. The robotic animals look and sound like real kittens and puppies and respond to interactions such as being patted and tickled.
SCREENING FOR DEPRESSION

A call for those living in a residential Aged Care setting to receive regular screenings for depression has been released, backed by a study into depression and suicides in Aged Care. The 2018 study found that between 2000 and 2013, there were 140 suicides of people living in Aged Care. The study was conducted by Monash University researcher Briony Murphy and Professor Joseph Ibrahim, and Ibrahim is currently preparing for a submission to the Royal Commission. Speaking to The Guardian, Ibrahim is calling for transition programs to be provided to new Residents entering care, and that there needs to be better staff training and improved access to mental health. The 2018-19 federal budget saw $82.5M for mental health services to be provided over 4 years.

You can read the study, published on the International Journal of Geriatric Psychiatry here.

DRAFT RETIREMENT LIVING STANDARDS

The draft of the proposed set of new standards for the Retirement Living industry is now open for feedback. An extensive process has been underway by the industry, peak bodies and stakeholders to develop the new accreditation standards and ensure quality and consistency for retirement village Residents.

You can review the draft standards here.

PALLIATIVE AGED CARE

palliAGED, the palliative care evidence and practice resource for Aged Care, has released tip sheets to support the delivery of quality Palliative Care. The resources are evidence-based and have been designed for both care provided in the home or in a Residential Aged Care setting.

You can find the Tip Sheets here.

In other Palliative Care news, Aged Care Nurses have received scholarships to complete Post-Graduate Palliative Care programs, a new initiative to improve end-of-life care. The Brisbane North Primary Health Network scholarship initiative launched in 2019 and aims to improve end of life care across all settings, which naturally includes Aged Care.

FACILITIES STILL OPERATING AT A LOSS

The latest StewartBrown half-yearly report for December 2018 has continued to show Facilities operating at a loss, with 42.3% of Providers facing these issues. Despite the small improvement from the yearly report ending in June 2018, where the number was at a high of 45.1%, the figure shows the continual challenges facing the funding of the sector.

The Royal Commission may add to the issue of financial sustainability in the Aged Care industry, with potential recommendations, such as boosting staffing levels, increasing the financial burdens of Providers.

QUALITY

To quality news this month, and the Quality Commission has released a report based on the data collated from the Aged Care Quality and Safety Commission’s Consumer Experience Reports (CERs). The report describes and analyses what 17,195 Residents have said about a number of aspects of Residential Aged Care, from randomised interviews between 9 May 2017 and 4 July 2018. Conducted by La Trobe University’s Australian Institute for Primary Care & Ageing, you can read the report from the quality commission here.

In further news, the results of the National Aged Care Quality Indicator Program will be made available online later this year. The voluntary program began on January 1st 2016, and approximately 10% of Providers have participated from that time. From July this year, the program will be compulsory for all Commonwealth subsidised Residential Aged Care services. Currently collecting information on pressure injuries, physical restraints and weight loss that is unplanned, it is expected that chemical restraints and falls will also be added to the list of information to be collected. For more information, you can refer to the Department’s website here.

ELDER ABUSE

A framework designed to ensure coordinated action to combat Elder Abuse across state, territory and federal governments was launched in March, and is set to roll out over the next four years. The National Plan to Respond to the Abuse of Older Australians framework aims to cover five key priority areas through research, education, prevention and improving support services and safety measures:

  1. Enhancing our understanding
  2. Improving community awareness and access to information
  3. Strengthening service responses
  4. Planning for future decision-making
  5. Strengthening safeguards for vulnerable older adults

Launched by Attorney-General Christian Porter, a new national elder abuse free call number, 1800 ELDERHelp (1800 353 374) was also officially launched.

MULTICULTURAL WORKERS

A new scheme has been introduced by the Government that will open Providers to hiring workers from overseas, in an effort to support older Australians who have culturally and linguistically diverse (CALD) backgrounds. One of two new Visa agreements have been announced, the agreement for the Aged Care sector will enable Aged Care Providers to sponsor Carers, who are appropriately skilled, to be able to care for the elderly in their respective communities. The company specific labour agreement means that skilled workers from overseas can be sponsored and employed on a Temporary Skill Shortage (TSS) visa, or an Employer Nomination Scheme (ENS) visa.

The new initiative was announced by the Minister for Immigration, Citizenship and Multicultural Affairs, David Coleman, and acknowledges the need for bilingual Carers in Aged Care when elderly people can revert to their native language as a result of dementia or lose the ability to speak a secondary language.

The Federation of Ethnic Communities’ Councils of Australia (FECCA) have welcomed the acknowledgment of diversification in the Aged Care workforce to support the needs of older people living in care in Australia; however FECCA Chairperson Ms Mary Patetsos has highlighted the importance of ensuring that local workers are also continued to be trained to ensure that the sector’s workforce needs are supported.

In an additional multicultural care news, an article on Hospital & Healthcare has a first-hand perspective of delivering culturally safe care to Aboriginal and Torres Strait Islander (ATSI) communities, and the considerations that must be addressed when caring for the elderly from any background.

WORKFORCE

To other workforce news, and there has been a renewed call for Personal Care workers in Aged Care to be regulated, upon the release of the Australian College of Nursing’s (ACN) white paper Regulation of the Unregulated Health Care Workforce across the health care system in March. The report addresses the federal Government to ensure that minimum training requirements are enforced, criminal checks completed and an annual or bi-annual registration process to take place.

This year, the Aged Care Guild, Aged & Community Services Australia (ACSA) and Leading Age Services Australia (LASA) have united in support of the formation of an Aged Care Workforce Industry Council to tackle the issue of the growing workforce requirements in the industry.

INTERNATIONAL WOMAN’S DAY

International Women’s Day (IWD) was held on the 8th March and many Facilities celebrated the women living in them and the outstanding achievements they have accomplished. Some extraordinary acts were highlighted, and in particular a phenomenal national campaign started by a 96 year old woman and launched on IWD 2019, as a part of the #SheToo movement. #SheToo is a campaign that recognises that some women are unable to share their stories or speak up against violence and abuse, feeling or knowing that they may not be heard or believed. The difference between #SheToo and the #MeToo movement is the understanding that the #MeToo movement encouraged women who had a level of empowerment to speak up; whether that be through independence from the offender, access to communication such as social media, or in a position of having speech or cognitive abilities to speak out.

The campaign to listen to older women was launched by Margarita Solis, an exceptional Queensland woman who is currently Australia’s first and only older (65 plus) woman to share her story of sexual abuse and assault by a service provider publicly. Coordinated by the OPAL Institute, you can read more about the campaign here, and watch the short film in which Margarita shares her story here.

That’s all for this month but check back in with us next month for another industry update!

 

Kelly LISSIE LYONS – CHAMPION OF EDUCATION & MARKETING
Author

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