Industry Update, June 2023
Aged Care Funding Reform Committee
Our June meeting was held 9 June, with some very informative discussions:
The Dept is in consultation with the Quality and Safety Commission to explore opportunities available to aged care providers in reducing the administrative burden of respite documentation without risking client safety or receiving the appropriate clinical care. Further discussions are being organised with some potential trials this year.
AN ACC funding primarily funds care minutes. As an organisation / facility, if you wish to deliver care minutes above the targets derived from the AN ACC funding received, you are to source funding from other areas.
Discussions were had on the level of detail in data the Department thought might be beneficial to the industry in managing their performance with AN ACC against peers. This supports reduction in subscribing to software platforms.
IHACPA are commencing a project to explore alternative arrangements for RACF, and alternative skills mix required when a RN is not on site. These are to be practical and easily implemented, as well as easily monitored by the Department. Guidelines to homes that may be eligible are limited to Homeless, Indigenous, MMM 5 – 7 or other specialised facilities.
Department of health – an acc team updates
Steady stream of end of life (urgent) re-assessment requests being received each day. Of particular concern is a number of these residents whilst are undergoing ‘palliation’, they are not end of life and care needs have not changed. This circumstance negatively impacts others who do require urgent re-assessments.
Delays in assessments over 90 days = 13 nationwide
Delays in assessments over 60 days = 175 nationwide.
Rural and remote do continue to have delays due to nature of location and limited resources, AMOs are now working together with allocated lists to ensure regular visits and stewardship over costs for completing the assessments.
Sydney metro region trending in higher delays than other metro areas. Reconfiguration of AMO allocations commencing 1 July will address this issue.
Feedback welcomed and received regarding recurring issues with particular AMO assessors. Re-training occurring where needed, and ongoing program of quality checks being performed to have confidence in standardization of application of AN ACC.
Where a resident may be not mobile, but is able to roll themselves in bed, or complete a bridge in bed, or sit unsupported, this may increase their mobility score rendering them assisted in mobility. Keep in mind that the not mobile branch involves all parts of bed mobility, transfers and locomotion.
anaccoperations@health.gov.au contact this email if you have any questions or concerns regarding PRODA / respite / admission / transfers or discharge status changes to residents that trigger a block in the system and does result in delays in assessments at times.
Sam.Franks@health.gov.au contact or cc this email in urgent issues only. Sam is happy to support providers with concerns or assist with urgent or difficult issues.
Presentation by Plena
Representatives from Plena were welcomed and discussed their approach to implementation of innovative approaches to delivering allied health services.
The team report a 14% increase in services with the transition from ACFI to AN ACC with residents now heavily involved in choice of services, setting targets and goals relevant to the lifestyle they want to live, and self identify issues they would like to improve.
Services being at pre-admission and the allied health team complete assessments prior to the resident accepting a place. This promotes preparation of equipment and resources or referrals are in place on the day of admission. This approach embeds a multi disciplinary approach to services and care.
Some unique approaches to pain management in the post ACFI environment include involving leisure and lifestyle activities in pain therapy. An example is movement and exercise in music therapy activities. The key is collaboration with all staff and services to co-ordinate care.
Updates to the industry
Care minutes for the 2nd quarter of the next financial year (October to December) will be notified to providers in September using the June, July and August QFR results. Whilst care minutes are mandatory, the changes recently advised in care minutes has a 5 month grace period to ensure compliance. However, you must evidence from now, that you are working towards those care minute changes where predictable, and may include changes in rostering.
The AN ACC costing and NWAU weights are currently under review for changes commencing FY25 by the IHACPA.
Double check all AN ACC publications you have are up to date and the most recent version. The DoH have issued many updates and changes over the last few weeks.
5 pillars over 5 years, pillar 2, increased choice for senior australians receiving residential care with care packages assigned to consumers not providers
Clarification of policy reform intent
Under the Places to People measure, residential aged care places will be assigned to older Australians instead of providers from 1 July 2024. This relates to the initial step of accessing residential aged care. After being assessed and approved for residential aged care, a person will be directly 'allocated' a place, enabling them to take this place to an aged care home of their choice. The AN-ACC assessment process will continue to determine the subsidies paid to approved residential aged care providers based each client's individual care needs. For residential aged care funding will continue to be paid directly to providers as it does now.
What’s being done
In the recent 2023-24 Budget, the Government announced an investment of $41.3 million over four years to implement the IT system changes necessary to move to this new system of allocating residential aged care places, and to develop tools and resources to help older people make informed choices. This investment includes support to:
- design and build information and technology systems to allocate residential aged care places directly to older Australians;
- enhance and improve the My Aged Care website and Find a Provider tool; and
- enhance the capacity of the My Aged Care Contact Centre in transitioning to the new arrangements.
Planning to communicate the changes and support key stakeholders to transition to the new system will also be a key priority moving forward. This will ensure that the sector and older Australians have adequate time to prepare for the transition.
Consultation and Engagement Opportunities
The department consulted with a wide range of stakeholders, including older Australians, their families and carers, providers, peak bodies and industry experts in 2021 and 2022 around the changes and implications. A discussion paper and outcomes report from the first round of consultation is available on the department's website. More specific IT system changes and issues are currently being tested through research with key user groups, which will inform the implementation of the changes as well as communications and transition activities.
Monthly Care Statements
Monthly Care Statements are a new requirement being developed where residential aged care homes must prepare a statement for each resident which includes a summary of the care the resident received and any significant changes or events that occurred in the previous month. The aim of Monthly Care Statements is to increase information flow, communication and transparency between aged care providers, residents and their representatives, and provide older people living in aged care homes, and provide older people living in aged care homes.
The Department is developing and implementing this new requirement through a staged approach, starting with a pilot. The pilot is being delivered in three stages and is testing the design of this requirement with older people living in aged care homes, their representatives, and aged care providers to:
- ensure older people lead the design and content of the Monthly Care Statements
- inform how to best provide older people living in aged care homes with valuable information while minimising the impact on front line care and
- help guide implementation of the statements to improve the delivery of care and relationships between aged care homes and their residents.
Providers who are in trial for the monthly care statements are reporting issues with privacy on who the invoice is sent to versus the EPOA. Also some residents prefer to manage this themselves causing difficult conversations with family who believe or prefer they should also be involved.
The Monthly Care Statements are not financial in nature, nor are they an invoice outlining the cost of care and services provided by an aged care home. Through the pilot, the Monthly Care Statements are only being given to residents or authorised representatives who have consented to participate. Aged care homes are issuing statements either printed or electronically and are taking all reasonable measures to protect the privacy and confidentiality of the information within the statements. For example, using tools such as password protected documents.
The purpose of the pilot is to test this requirement with residents, representatives, and aged care homes, and obtain valuable feedback to inform the development of legislation and other considerations for implementation such as guidance materials or contents for admission packs.
Providers are testing statements with residents as part of the pilot, but in line with new legislation and rules, will be required to provide statements to residents in the future – providers will not be invoicing residents either for testing the statements in the pilot or providing them as per the future legislative requirement.
Providers employing RNs to gather data for compilation of the monthly care statements.
It is at the discretion of the aged care home who collates, produces, and distributes the monthly care statements in the pilot. Through the review and evaluation, we are seeking feedback from providers on which staff members were involved in the pilot and when.
IT software systems feeding back they will not improve systems or assist providers without additional charges to innovate their products aiding the gathering of data for the statements unless the DoH provide a directive.
There are a variety of IT and software systems used in the residential aged care sector. We are collecting all feedback provided by aged care homes on the ease of gathering and collating this information as well considerations for national implementation. Regarding any ‘directive’, the intention is that the statements will be legislated, meaning it will become a legal requirement for aged care homes to provide statements to their residents. We understand the vendors are being made aware of that intention through contact during the pilot.
What is the communication plan for the industry and the consumers for monthly care statements and the change to funding processes in 2024?
The Department established sub-groups of the Consumer and Sector Reference Groups to work with the Department on the design of the pilot, and the 5 prototypes currently being tested. Once the pilot is complete the Department will continue to consult with the aged care sector and consumers on the broader implementation. In relation to the monthly care statements requirement, there will be no changes to funding in 2024. Providing the statements will become a legal requirement in line with new legislation and rules.
In addition, the Department has been informing the general public and sector through:
- Your Aged Care Update newsletters and other alerts.
- You can subscribe to the above newsletters using this subscribe to the aged care sector newsletters link.
- Department’s Monthly Care Statements web page and
- Department’s Aged Care Engagement Hub.
Next AN ACC Networking Group Meeting
Thursday 17th August 11am to 1230 pm. Invitations will be sent to register via Eventbrite.
