Update

Industry Update, August 2023

Karina Peace

01 Aug 2023 — 5 min read

Aged Care Funding Reform Committee

Our August meeting primarily focused on a restructure of palliative care funding:

The Department has received feedback from providers the current classification processes for new residents who enter RACF for the purpose of receiving palliative care (Class 1) and existing residents whose condition declines to a point that they need imminent end of life care (life expectancy of one week or less) are limiting access to higher AN ACC funding classes that are intended for this purpose.

Issues identified with the the Class 1 approval based on completion of the Palliative Care Status Form have around a 60% rejection rate based on non-compliance with the guidelines specified in the document and is limiting payments required for palliative care.

Three options were raised to replace the current process and being considered. Details of the options may be published for feedback by the Department – watch their website for further information.

Issues identified with the end of life expectancy re-classification includes length of time for completion of urgent re-assessments was not quick enough depriving providers of funding.

A number of options were presented to replace the current process and being considered, as above, details may be published for feedback by the Department.

IHACPA Conference

The first combined hospital and aged care pricing authority conference was held in Brisbane this month and well attended by representatives of aged care. Some great discussions were held with insights into the performance of our funding tool AN ACC, and future possible changes. A summary follows of high points in discussions and presentations:

The sample size used by IHACPA – from this point to be referred to as the PA (pricing authority) is 128 aged care facilities representative of the cross section of all types of aged care services and providers. Concerns were raised this sample size is too small and does not adequately represent the cost drivers, spend or funding requirements of our aged care industry. Discussion into enlarging the sample size sits with the DoH and is being considered. In the meantime data is being cross referenced with the QFR and AFR data for matching of information.
The cross matching of information with the QFR and AFR reveals disparities particularly with the care minutes information. Providers self reporting care minutes is different to what AN ACC is reporting the care minutes should be sitting at. Also, rostering and staff mix is not matching and noted to be a risk in data quality.
The AN ACC model does not adequately capture complex behaviour care needs and as such is undergoing consideration for further research and data gathering.
There is a possibility as information is to hand, additional classes may be added to the AN ACC model.
The AN ACC price point is based on indexation (as we saw this year with the FWA increases in wages decision) as well as prior period reporting of costs. The Minister for Health considers this information and advises of the NWAU funding amount. Note, the price point for this financial year is based on prior periods without additional forecasting of price rises in FY24.
It is noted our funding is misaligned with expectations of the Aged Care Quality and Safety Commission as well as expectations of the customers entering care. A higher expectation of compliance, innovation and service delivery is expected however this is not adequately covered by our current funding price point.
Indirect costs in a facility are noted to specifically be the primary cause of facilities being financially non viable. It is clear in the data gathered the cost of delivering care is adequately supported under AN ACC. The increasing expectations of reporting, information gathering and other indirect costs is burdensome for the industry and being discussed. Noting additional information and data is required to provide a statement or outcomes for future funding support.
The Activity Based Funding model which AN ACC is designed from is noted to be not appropriate for aged care funding. Hospital ABF is relevant due to episodic care that mostly is able to be predicted such as planned surgery. In a RACF, care is variant and the lack of ability to predict decline impacts the application of a ABF model. Discussions were had on alternative funding models.
It was noted by the DoH “an increase of funding does not equal an increase in the quality of care”. Support was given to providers who are delivering exceptional care under the same funding model as others who are not performing so well.
It was noted by the DoH “the right care, at the right time by the right place” is essential for health care reform and to reallocate care to appropriate services and availabilities.
It was noted by the DoH the aged care industry receives appropriate funding to deliver care and providers are to be encouraged to review their spending.

presentation by the resident experience and food policy section choice and transparency branch regarding monthly care statements.

Please refer to attached powerpoint delivered by representatives of this branch within the DoH.

Discussion was had on the interaction already taken place with 5 aged care software vendors to adjust their programs enabling gathering of data to inform the monthly care statements. These vendors were:

THealth
Autumncare
MANAD
Leecare
Acreediacare

It is an expectation that as changes are made to reporting expected by the DoH, providers will discuss these changes with their vendor to be prepared and minimize manual labour.

Feedback from trial sites included:

Timeliness of the statements and what might be appropriate with a range of suggestions being considered by the DoH.
The template design and level of detail gathered to ensure communication was improved with care recipients without too much and unnecessary information being gathered.
Further studies are being considered on the administrative burden however this is expected to be minimal as the software vendors improve their processes to support data gathering.
Gathering of clinical information is NOT to be considered as contributing to care minutes however reviewing and adjusting the care plan to support the monthly care statements is considered as care minutes.
There is not discussions at the current time any information gathered in the monthly care statements will be held or analysed by the DOH and inform future star ratings.
The Quality Commission will include reviewing the processes and outcomes of monthly care statements as part of their standard auditing processes.
Acknowledgement given there may be replication of data and the DoH will be reviewing this.

If you have any questions for the team please do not hesitate to contact via the email address on the last page of the power point.

Updates to the industry

The new Aged Care Act consultation paper is out for feedback.

I cannot stress enough that all providers strongly consider providing feedback.
Informal discussions with the DoH acknowledge the new Act is much broader and more detailed than what is presented. This is your only chance to affect change and prevent issues arising.

https://agedcareengagement.health.gov.au/aged-care-act/

Upcoming Education, Support and the Aged Care Report Short Day Conferences

The short day conferences planned for Sydney, Melbourne and Adelaide will have representatives from both the Department of Health and the Aged Care Quality and Safety Commission present to interact with participants. This is a unique opportunity for Facility Managers, Clinical Managers and Registered Nurses / Team Leaders to receive information and support from experts in our industry, with advice on what you actually need to do right now.

Sydney is soon on the 31 August at Castle Hill RSL, please share this with your colleagues and encourage them to attend. Tickets are only $55 and catering is provided.

Sydney (Castle Hill RSL) order through this link https://events.humanitix.com/the-aged-care-report

Adelaide (The Terrace Hotel) order through this link https://events.humanitix.com/the-aged-care-report-adelaide

Melbourne (Waverley RSL) order through this link https://events.humanitix.com/the-aged-care-report-melbourne

Complaints Management reform webinar

This Friday 18th August.
https://www.eventbrite.com.au/e/677198989407?aff=oddtdtcreator
how to structure your anacc evidence
27th September
https://www.eventbrite.com.au/e/672824625567?aff=oddtdtcreator
next an acc networking group meeting
Thursday 12th October 11am to 1230 pm. Invitations will be sent to register.