Industry Update, December 2022

Aged Care Funding Reform Committee

The committee met to specifically discuss concerns and issues of the Department of Health and Minister of Health. The first topic which was quite a lengthy discussion amongst members was regarding the role and funding of Enrolled Nurses in Residential Aged Care Facilities. Focusing on the recent action of Southern Cross Care in Tasmania actively removing EN roles from their care model. The Minister for Health finds this unsatisfactory and has requested the Dept. find solutions to prevent this becoming a trend in aged care.
Information for your consideration that was provided:

• 21% of RACF across Australia already have no ENs in their care model or on staff under any role (see table on next page).
• The funding for care minutes incorporates both EN and PCW based on average salaries.
• The intention of providers to reduce expenditure whilst continuing to receive the same level of care funding is a realistic budgetary management option available, particularly if struggling to recruit and retain RNs with the upcoming 2/7 RN model being made mandatory.
• The value of the EN to support RNs is acknowledged however additional funding or separation of funding is not an option.
• Consideration is being given to several options to prevent this trend including having EN minute targets (unrealistic if 21% of facilities already have no ENs), inclusion of ENs in star ratings (again unrealistic) or open to other suggestions.
• The Dept. would like peak bodies to communicate to members the importance of ENs and their roles and encourage continuation of the care model that includes EN roles – however, with no additional funding.
• The Dept will not consider ENs replacing RN minutes.

Also discussed was the RN 24/7 requirements with the following information provided

• The recently announced exemption for 12 months for MMM 5 to 7 facilities is a temporary measure and the Dept would like a replacement threshold model to replace this by end 2023
• The Dept are hoping a university will assist them to develop a new threshold model through collection of data from QFR reports and compliance with RN 24/7 models prior to it becoming mandatory. Suggestions on a clinically appropriate and safe model of care when a RN is not on site is the outcome the Dept is seeking from any University willing to assist.

PCA role clarification and changes suggested for comments and feedback were

• Provision of emotional and social support needs to be one on one, not in a group setting
• PCAs will work under the guidance NOT supervision of a RN or EN.

Additional information discussed, the QFRs will be audited by the Dept commencing early 2023 to ensure reports provided are accurate and have integrity. This is to prevent Government funds and action will be taken to non-compliance or clear manipulation of data in the QFR that is not correct.

The Dept would like feedback from the industry on how to make the QFRs simpler.

“I can't change the direction of the wind, but I can adjust my sails to always reach my destination.” -Jimmy Dean

AMO Assessors

Some strange opinions, thoughts, advice is being received by providers from their AMO assessors. We have heard comments such as the palliative care Class 1 rules will be removed next year, no one knows how the AN ACC is scored ... not even the designer, and where a single facility has one AMO for new residents and a different AMO for re-assessments!

We will have the opportunity to present these questions to the Dept representatives at our next AN ACC Networking Group Australia meeting. I can confirm the Director of AN ACC and some of her team will be present to answer your questions or concerns.

Legislation Changes

The respite 63 day respite allocation changes is now in draft form, awaiting to be presented to parliament for implementation in 2023.

The new Aged Care Act will focus heavily on the words ‘transparency in funding’ and ‘choice and decision making for vulnerable residents’. We have discussed this in the education and training delivered and aligns with the new Quality Standards currently out for feedback.

The Dept is also seeking a university to support their intention to progress with the sub-acute medical model for RACFs and upskilling staff to assure clinical and care needs are able to be met.

Q&A Section

Our AN ACC assessments for some residents are taking over 28 days – up to 60 days before an assessor comes to our facility. What can or should we be doing to prevent or manage this?

You should have an idea on the class branch the resident will be allocated in according to their mobility status. Make sure your care minutes reflect an average of that grouping so you do not become non compliant in care minutes. Also let the Dept know of this! They are very keen to receive feedback where AMOs have delays or are inappropriate in advice being given when on site, enabling the Dept to act on concerns.

Do you have any thoughts on how the Dept is going to fund the additional labour costs with the increase in PCW wages?

They aren’t. The Dept are of the opinion the AN ACC funding covers the cost of increase in wages, and will reconsider based on the IHACPA advise on costs of aged care in 2023. The link to increase in wages and increase in skills required for a medical sub-acute model is suspiciously linked in my humble opinion.

Services for Next Year

I will be working over the Xmas period with colleagues to develop new materials for education and skill training, as well as develop more resources you can use to facilitate good documentation. I will also be scheduling workshops for each capital city so keep a look out through this newsletter, linked in, or my website for opportunities.

Finally I want to wish everyone a very merry, relaxing, safe and loving holiday season. Thank you for all your support this year, I have really valued making new friendships and loved working with all.

Photo by Burçin Ergünt on Unsplash