Budget Review 2020–21 Index
The 2020–21 Budget includes $2.7 billion in new funding for
aged care. This funding is outlined in two omnibus measures in Budget
Measures: Budget Paper No. 2: 2020–21. The ‘Ageing and Aged Care’
measure (pp. 90–91) comprises $2.0 billion over four years, including increased
funding for existing programs, and funding to explore or implement aged care
reforms. The ‘COVID-19 Response Package – ageing and aged care’ measure (pp.
94–95) provides a further $700.2 million over four years to continue the
Government’s response to the pandemic in aged care. Some measures respond in
part to reports already handed down by the Royal Commission into Aged Care
Quality and Safety (the Royal Commission), while others lay a foundation
for a response to the final report which is due on 26 February 2021. The most
significant initiatives in terms of funding or policy change are briefly
outlined in this article. Of the initiatives listed below, only the Serious
Incident Response Scheme appears to require legislation.
More home care packages
The largest single item is $1.6 billion over four years to
release an additional 23,000 home care
packages (HCPs). HCPs are coordinated packages of care to help eligible
older people remain at home rather than entering residential care. As at 31
March 2020, there were 103,599
people waiting for an HCP (p. 12). 44,528
(43%) of these had been offered a lower level package while waiting for a
package at their approved level, and most of the rest had been offered access
to entry-level support services through the Commonwealth
Home Support Programme (CHSP) while waiting (p. 3). Waiting times for an
approved package exceed 12 months for all but the lowest level HCPs (p. 13).
The Royal Commission’s Interim
Report: Neglect: Volume 1 recommended that the Government urgently release
more HCPs to ‘reduce the waiting list for higher level care at home’ (p. 10).
The Royal Commission heard
evidence in March 2019 that it would take ‘an additional two to two and a
half billion dollars per annum’ to give everyone on the waiting list a package
at their approved level with a three month waiting period (pp. P1057–P1058).
Support for people with
Continuity of Support (CoS) Programme supports older clients who were
receiving state-managed specialist disability services but not eligible to
transition to the National
Disability Insurance Scheme (NDIS). The CoS will be replaced by a new Disability
Support for Older Australians program (p. 96) at a cost of $125.3 million.
The new program will be more in line with the NDIS, providing a client-centred
program and funding for higher needs.
For younger people with a disability living in residential
aged care, or at risk of entering such care, the Budget includes $10.6 million
to establish a network
of up to 40 system co-ordinators to help them find age-appropriate
accommodation and support. This aligns with the Royal Commission’s Interim
Report recommendation that the Government should stop young
people entering residential aged care, and speed up the process of getting
younger people out (p. 10).
Aged care reform
The Budget provides a further $29.8 million to bring forward
the implementation of a Serious Incident Response Scheme (SIRS) for aged care.
The scheme will replace the current reportable
assaults provisions in the Aged Care Act 1997.
The SIRS was a key recommendation of the Australian Law Reform Commission’s Elder
Abuse – A National Legal Response final report (p. 111), and will
broaden the types of abuse and neglect that must be reported. The Government
plans to introduce
legislation for the SIRS this year, with the scheme to commence in early
$91.6 million has been provided to continue reforming
residential aged care funding. The current Aged
Care Funding Instrument (ACFI) is used by providers to assess the needs of
each resident, which in turn determines how much government subsidy they will
receive for that resident. The Legislated
Review of Aged Care 2017 recommended that independent assessors should be
used to reduce the risk of a conflict of interest (pp. 140–141). The budget
measure funds a year of ‘shadow
assessment’ (p. 90) in which residents will be assessed by independent
assessors using the proposed new Australian
National Aged Care Classification (AN-ACC) funding model (but still funded
under ACFI). The AN-ACC
has been trialled in a number of nursing homes but a final decision on
implementation has not been made.
Home care reform is also foreshadowed, with $4.6 million for
further research and consultation on options for a single
in-home care program (p. 72). This appears to relate to a proposal to merge
the HCP and CHSP programs, which was first canvassed in the 2015–16
The Government has provided extra funding to the aged sector
to address the COVID-19 pandemic. Key measures in the Budget include:
- $245.0 million for further lump sum payments for residential aged
care providers, and the continuation of increased supplements for rural, remote
and specialist homelessness providers
- $205.1 million ($159.0 million after income tax is paid) for a
third instalment of the Aged
Care Workforce Retention Bonus for direct care employees, and additional funding
for the second instalment
- $103.4 million for preparedness measures, including infection
- $92.4 million to expand Support
for Aged Care Workers in COVID-19 grants in ‘hotspot’ areas, to allow
workers to work at a single site, or to quarantine if necessary
- $71.4 million to provide CHSP services to aged care residents who
have temporarily moved back home and
- $10.8 million for scholarships and skills development for aged
Some of these measures were announced
in August, and later cited in the Government’s
initial response to the Royal Commission’s Aged
care and COVID-19: a special report, particularly with regard to
recommendations that funding be provided for staff to support visits to aged
care residents (p. 6), and that infection control expertise should be increased
The extra funding for HCPs has been widely praised,
peak provider and consumer bodies. However, some also point out that the
23,000 HCPs will not be enough to clear the current waiting list. Funding for
system coordinators to help younger people leave residential aged care has been
welcomed by the Australian
Healthcare and Hospitals Association and the Young People in Nursing Homes
National Alliance. Consumer peak body COTA
Australia has welcomed the implementation of the SIRS and the trial of
independent assessors for the proposed new residential aged care funding tool. The
Pensioners and Superannuants Association has welcomed funding for various
residential care measures, and the Australian
College of Nursing has commended funding to enhance the skills of aged care
Australia raised concerns about the ‘lack of focus on dementia’ in the
Seniors Australia were hoping for measures to ‘make aged care providers
more accountable’. Both the United
Workers Union and the Australian
Nursing and Midwifery Federation wanted to see measures directly addressing
aged care staffing. For-profit provider peak body the Aged
Care Guild hopes to see more long-term reform in next year’s Budget, noting
that the Government
has promised a comprehensive response to the Royal Commission’s final
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