Update

Industry Update, July 2023

Karina Peace

01 Jul 2023 — 5 min read

Aged Care Funding Reform Committee

The Department of Health have requested the following information be shared:

We have some messages around 24/7 registered nurse (RN) reporting, the 24/7 RN supplement, enrolled nurses (ENs), AN-ACC funding and care minutes, that we are keen for working group members to spread throughout the sector. You will note there is a lot of information in this document, so if you prefer, I suggest that you sequence your communications through your channels in the coming weeks. The 24/7 RN responsibility is the first priority below. We thank you in advance for your assistance with this.

24/7 RN reporting & 24/7 RN supplement

A provider readiness checklist is available to give approved providers information on actions they can take to operate smoothly under the new 24/7 RN responsibility. This checklist includes key procedures that they should be aware of, or have in place, and key definitions.

From 1 July 2023, each residential aged care facility will be required to use the new Government Provider Management System (GPMS) to report on their 24/7 RN coverage for each month. Providers are encouraged to access and create logins to the Government Provider Management System (GPMS) as soon as possible to prepare for their 24/7 RN reporting.

Failure to set-up staff roles in GPMS may prevent facilities from being able to meet their reporting obligations. Reporting through GPMS will open on 3 July 2023.

Each residential facility must ensure they complete their 24/7 RN report by 11:59pm AEST of the 7th calendar day of the following month (for example, the first report must be completed by 7 August 2023). Failure to complete reporting by the due date will mean a facility is not eligible to receive any 24/7 RN supplement for that month.

Aside from reporting on time, the eligibility criteria for the 24/7 RN supplement is that a facility must have no more than 60 residents per day on average over the calendar month, and the provider must provide a minimum of 20 hours of RN coverage a day, on average over a calendar month (i.e. have an RN on-site and on duty for 83.33% of the hours in the month).

Information on the definition of on-site and on duty for the 24/7 RN responsibility is provided in the Care minutes and 24/7 registered nurse responsibility guide (section 6.3).

Enrolled nurses and the care minutes responsibility

The department is aware of some misinformation still spreading within the sector that enrolled nurses are not included in the mandatory care minutes responsibility, and that they are not funded under the ANACC funding model.

Direct care time provided by enrolled nurses (along with registered nurses, personal care workers and assistants in nursing) are included in the mandatory care minute responsibility. The AN-ACC includes funding for providers to retain their enrolled nurses and to provide them a 15% award wage increase. The Government will continue to closely monitor any providers that seek to reduce their enrolled nurse workforce through Quarterly Financial Report data.

From around October 2023, average per resident per day enrolled nurse minutes provided by each aged care service will be published on the My Aged Care ‘Find a provider’ website alongside total care minutes and registered nurse care minutes. This will ensure full transparency around the use of enrolled nurses on an ongoing basis.

AN-ACC funding and care minutes

The AN-ACC funding model provides subsidies to approved aged care providers based on the type of service (location and specialisation) and each residents’ care needs.

The new 2023-24 AN-ACC price of $243.10 was informed by the Independent Health and Aged Care Pricing Authority’s (IHACPA) Residential Aged Care Pricing Advice and includes funding for the Fair Work Commission’s 15% wage increase for:

Registered nurses
Enrolled nurses
Personal care workers
Assistants in nursing
Recreational activities officers (lifestyle workers).

This funding also helps prepare the residential aged care sector for the start of the 24/7 registered nurse responsibility from 1 July 2023, and mandatory care minutes from 1 October 2023, through helping to attract and retain staff.
AN-ACC is designed to ensure care funding meets care costs. Most care costs are labour costs, or wages for staff providing care, and in particular, care minutes which are linked to AN-ACC classes. The relationship between funding and service-level care minutes targets means that AN-ACC distributes the right amount of funding to services.

Services are responsible for ensuring they have an appropriate workforce (mix of registered nurses, enrolled nurses and personal care workers) to deliver their required care minutes which means their staffing profile mirrors their funding profile.

Providers can estimate there AN-ACC funding increase, and associated care minutes targets for 1 October 2023, using the online AN-ACC funding and care minutes estimator.

Care minute changes

From 1 October 2023, there will be changes to care minutes allocations for each AN-ACC class. The average care minutes required will be 200 minutes, including 40 minutes with a registered nurse.

Please note that minutes will increase again on 1 October 2024 to 215 minutes, including 44 minutes registered nurse time.

Further information is provided on our website at:
Funding higher wages in residential aged care

Care minutes changes

Improving respite care for people with dementia and their carers grant round DDD Branch is currently finalising the outcomes of a competitive grant opportunity, Improving respite care for people with dementia and their carers, which closed in January 2023. The grant provides $61.63 million in funding to increase access to dementia–specific respite support services for informal carers and families caring for a person living with dementia. The activities focus on innovative approaches to improving the quality and experience of respite care for people with dementia through three streams of funding, intended to support carer education and wellbeing, improve respite care planning and build provider capability to deliver quality respite care to people with dementia.

The grant opportunity was conducted via an open competitive process, as the potential market response was unknown. The grant round was well subscribed with a total of 102 applications received. Stream 1 received 33 applications, a majority of which proposed activities for community-based respite programs rather than in residential respite care. Stream 2 received 58 applications, with 38 indicating they were approved providers of either home care or residential aged care.

The value of grants sought exceeded the amount available by $189.12 million (excluding GST) indicating broad interest from the sector in delivering innovative dementia respite services. Nous Group is assisting the department to develop a monitoring and evaluation framework for the dementia respite measures, which provides an opportunity to develop an evidence base around these innovative respite programs and inform broader respite reforms.