Alex Grove
This Budget introduces significant aged care policy changes,
particularly for home care. The home care changes come with new implementation
funding, but there are a number of savings measures in other related areas. This
reflects the Assistant Minister’s commitment to continue with aged care reform
while ensuring ‘sustainability in terms of taxpayer dollars’.[1]
Changes to aged care in the home
The most significant new measure is $73.7 million over four
years to allocate Commonwealth funded Home Care Packages (HCPs) directly to
consumers, rather than to providers as is currently the case.[2]
HCPs provide individually tailored care and support services to help older people
remain in their own homes,[3] at an estimated cost of
$7.5 billion to the Government over the next four years.[4]
A certain number of HCPs are funded within each aged care planning region
according to the aged care provision ratio.[5] Home care providers currently
compete for an allocation of packages through the Aged Care Approvals Round
(ACAR), which they then offer to eligible consumers.[6]
Under this measure, from 1 February 2017 packages within
each region will be prioritised and allocated directly to eligible consumers by
My Aged Care Gateway.[7] Funding for each package
will be paid to the approved provider selected by the consumer.[8]
The measure is intended to increase competition and improve service delivery through
increased choice for consumers, including the flexibility to change providers
if they wish. It is also meant to reduce ‘red tape’ for providers who will no
longer have to compete in the ACAR for home care places.[9]
A related measure, which has been announced but has not been
funded in the Budget, is to explore options for combining HCPs and the
Commonwealth Home Support Programme (CHSP) from 2018.[10]
The CHSP is an entry-level home support program that commences on 1 July 2015
and replaces a number of existing programs including the Commonwealth Home and
Community Care (HACC) Program.[11] Combining HCPs and the
CHSP is intended to ‘make the aged care system easier for consumers to
understand and further reduce regulation and red tape for providers.’[12]
These changes are in keeping with the Productivity
Commission’s 2011 recommendation for a system of aged care entitlements in
which ‘[i]ndividuals should be given an option to choose an approved provider
or providers’,[13] and were foreshadowed by
the Assistant Minister in a key speech last November.[14]
Reaction
The reaction to the proposed home care changes has generally
been positive. Catholic Health Australia (CHA) has welcomed the HCP changes as
a first step towards ‘a consumer-driven aged care system’, while noting that
the integration of HCPs and the CHSP may leave some service providers ‘alarmed
at the prospect for yet further change.’[15] COTA Australia (formerly
Council on the Ageing) believes the changes will lead to older Australians
receiving better services, allowing them to remain in their homes for longer.[16]
Aged & Community Services Australia (ACSA), however, cautions that ‘strong
supports and safety nets’ for disadvantaged older Australians should be
maintained as the system changes.[17]
Savings measures
A number of other policy measures in the Budget are forecast
to produce small savings. These include:
-
An increase in short term restorative care places (currently
called transition care places) to help rehabilitate older Australians and
reduce premature admissions to permanent residential care.[18]
This measure is anticipated to save $56.2 million over four years as the places
will be included in the aged care provision ratio at the expense of an
equivalent number of permanent residential places.[19]
- Moving the Aged Care Complaints Scheme from the Department of
Social Services (DSS) to the Aged Care Commissioner from 1 January 2016, for an
estimated saving of $2.8 million over four years.[20]
This is in keeping with the Productivity Commission’s recommendation that
consumer complaints should be handled by an independent agency,[21]
and has been welcomed by COTA who has ‘long called for a more independent
complaints scheme’.[22]
-
Charging most residential aged care providers the full cost of accreditation
services undertaken by the Aged Care Quality Agency, including site audits and
unannounced visits,[23] for a projected saving
of $30.7 million over four years.[24] The longer term aim is
to move towards private market provision of accreditation services for aged
care providers.[25]
-
Including rental income in the aged care means test for residents
who rent out their former home and pay their accommodation costs by periodic
payment, saving $26.2 million over five years.[26]
Cuts have been made to two program funds: $20.1 million over
four years to the Aged Care Service Improvement and Healthy Ageing Grants
(ACSIHAG) Fund and $40.2 million over four years to the Aged Care Workforce
Fund (ACWF).[27] The latter cut has been described
by ACSA as ‘poor policy when 55,770 additional [aged care] employees are
required over the next eight years’.[28] As promised, the $54.5
million that was cut when the Dementia and Severe Behaviour Supplement for
residential care providers was ceased on 31 July 2014[29]
has been restored as funding to establish Severe Behaviour Response Teams.[30]
In this Budget, the Government is continuing with reforms intended
to produce a consumer-led market for aged care, but also pursuing savings
opportunities where possible.
[1].
M Fifield (Assistant Minister for Social Services), Senator
the Hon Mitch Fifield address to the CALD Cultural Diversity in Ageing 2014
Conference with Senator the Hon Fierravanti-Wells, media release, 12
June 2014.
[2].
Australian Government, Budget
measures: budget paper no. 2: 2015–16, p. 147.
[3].
Department of Social Services (DSS), ‘Home
Care Packages’, DSS website.
[4].
S Morrison (Minister for Social Services) and M Fifield (Assistant
Minister for Social Services), Supporting
greater choice for older Australians, media release, 12 May 2015.
[5].
Australian Government, ‘3.3.2 How does the
Commonwealth Plan its Allocation of Places?’, Guides to Social Policy Law
website.
[6].
Budget
measures: budget paper no. 2: 2015–16, op. cit., p. 147.
[7].
Ibid. My Aged Care Gateway currently comprises the My Aged Care
website and national phone centre which assist clients to access aged care
information and services. DSS, ‘My
Aged Care’, DSS website.
[8].
DSS, Increasing
choice for older Australians, Budget fact sheet, DSS, 2015.
[9].
Ibid.
[10].
Australian Government, Portfolio
budget statements 2015–16: budget related paper no. 1.15A: Social Services
Portfolio, p. 113.
[11].
DSS, ‘Commonwealth
Home Support Programme’, DSS website.
[12].
Portfolio
budget statements 2015–16: Social Services Portfolio, op. cit., p. 113.
[13].
Productivity Commission, Caring for
Older Australians, vol. 2, Productivity Commission,
Canberra, 2011, p. 173.
[14].
M Fifield (Assistant Minister for Social Services), The
economics of aged care: Speech to the Committee for Economic Development (CEDA),
media release, 11 November 2014.
[15].
Catholic Health Australia (CHA), ‘2015
Budget ushers in welcome next steps in aged care reform’, CHA website, 13
May 2015.
[16].
COTA Australia, Budget
2015: Next big step in aged care revolution, media release, 12 May
2015.
[17].
Aged & Community Services Australia (ACSA), Budget
slices aged care worker benefit while Government lays path for changes,
media release, 12 May 2015.
[18].
Budget
measures: budget paper no. 2: 2015–16, op. cit., p. 147.
[19].
DSS, Expansion
of flexible care initiatives, 2015 Budget fact sheet, DSS, 2015.
[20].
Budget
measures: budget paper no. 2: 2015–16, op. cit., p. 148.
[21].
Productivity Commission, op. cit., p. 422.
[22].
COTA Australia, op. cit.
[23].
DSS, Aged
Care Quality Agency, 2015 Budget fact sheet, DSS, 2015.
[24].
Budget
measures: budget paper no. 2: 2015–16, op. cit., p. 149.
[25].
DSS, Aged
Care Quality Agency, op. cit.
[26].
Budget
measures: budget paper no. 2: 2015–16, op. cit., p. 146.
[27].
Ibid, pp. 148, 151.
[28].
Aged & Community Services Australia (ACSA), op. cit.
[29].
M Fifield (Assistant Minister for Social Services), More
support for people with severe symptoms of dementia in aged care, media
release, 4 February 2015.
[30].
Budget
measures: budget paper no. 2: 2015–16, op. cit., p. 169.
All online articles accessed May 2015.
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