Additional Comments by the Australian Greens
The Aged Care Amendment (2008
Measures No. 2) Bill 2008
The Australian Greens support measures to ensure high
standards in aged care and appreciate that the intent of the proposed
amendments in this Bill is to improve standards. However, we are concerned that
there are issues with the provisions of this Bill that are creating
uncertainties for the sector and require further clarification.
Defining key personnel
On the widened definition of key personnel, the Australian
Greens are concerned that in the case of not for profit providers, a large
number of voluntary board members would be encompassed within the definition of
key personnel. As the Bill is currently stands, there is ambiguity. The
legislation should clearly define what groups of people are to be included and
excluded from the definition of key personnel.
Recommendation: That the
legislation provide a clear exclusion principle on the definition of key
The resource shortfall affecting ACAT teams was noted in
several submissions to the inquiry. Although many of the concerns raised were
beyond the scope of this legislation and this inquiry, they clearly require
The Australian Greens concur with the move to reduce
unnecessary ACAT assessments. In their evidence to the inquiry, aged care
providers indicated that there are often disagreements between ACAT and ACFI
assessments on the level of care needed by incoming residents. When this
occurs, ACAT is required to return to the facility to re-assess the resident.
The delay can be a lengthy one. Therefore, it has been argued that when the ACAT
reassessment concurs with the ACFI assessment, the level of subsidy funding
should be back dated to the date of admission as this reflects the level of
care that the resident has received.
Recommendation: The higher
level of subsidy should be paid from the date of admission rather than the date
of the second ACAT assessment.
The reporting of missing residents to DOHA
In the case of a resident going missing, it is not clear
what benefit is to be gained from the proposed requirement that DOHA be
notified. Nor is it clear what action DOHA will be expected to take once they
have been notified that a person is missing. The Australian Greens note the
concerns about the potential for the infantilising of residents of aged care
facilities. As the Catholic Health Australia evidence highlighted, there may be
an increased pressure placed on providers to increasingly restrict the movement
of residents in the effort to avoid sanctions that might be imposed should a
resident go missing.
In their initial evidence to the inquiry, the Department
was unable to provide an assessment of the extra workload and operational
procedures necessary to administer this requirement. The Australian Greens are
concerned that this amendment will create a greater impost on the Department
than has been planned for yet without necessarily adding any benefit to the
well being of residents.
Recommendation: That this
amendment be deleted or further clarified.
Overall comment on administrative burdens
Given the additional administrative burden arising from the
amendments to the Bill, the Australian Greens concur with the evidence
presented by aged care providers who have requested that, wherever possible,
electronic communications be made available for providing up dated information
to the Department of Health and Ageing.
administrative reporting requirements be facilitated in the most cost efficient
There is disagreement between the views of the Department of
Health and Ageing and a number of aged care providers who gave evidence to the
inquiry about the nature and extent of the consultative process surrounding
these amendments. Several aged care providers commented that while some formal
meetings took place whereby DOHA advised providers of proposed changes, there
was no opportunity for providers to view the proposed amendments. Even now, in
the absence of the aged care principles, some providers are still unsure as to
the full operational requirements and impact of the proposed amendments.
Recommendation: That the
Department of Health and Ageing improve their consultative processes.
It was clear from a number of submissions that aged care
providers are concerned that sanctions are increasingly viewed by the
Department as the means through which to address any problems in the sector.
This was contrasted with the preferred approach whereby consultations take
place between providers and the Department with a view to making improvements
that benefit residents. Of particular concern are the broadened powers of the
Department to take into account the needs of future residents and future
incidents of non compliance.
The Australian Greens remain concerned that provisions
relating to possible future compliance remain vague and ambiguous and are thus
open to subjective interpretation and likely to result in uneven application.
It is not at all clear how the Secretary can make decisions and impose
sanctions based on an event that has not yet occurred. We do not consider that
an emphasis on a punitive approach, particularly where it is somehow intended
to deter events that have not yet occurred, is likely to be productive, and
suggest that a cooperative approach geared towards enabling and incentivising
service delivery would be more conducive to improved outcomes.
The example given by the Department for the need for this
amendment was to protect bonds in the future. We believe that rather than
taking this broad, ill-defined approach, a more specific amendment that
specifically deals with bonds would be better.
compliance measures intended to address future non-compliance be abandoned and
amendments for bond protection be developed.
These amendments seek to improve standards and compliance in
aged care under the current model. Many submissions raised the need for
broader reform in the aged care sector to address the long term sustainability
issues of the sector. This is also reflected in recent report by the
and the Grant Thornton Survey.
The Greens look forward to the inquiry by the Standing Committee of Finance and
Public Administration into the aged care sector.
Senator Rachel Siewert
Productivity Commission 2008, Trends in Aged Care Services: Some
implications, Productivity Commission Research Paper, Canberra.
Grant Thornton 2008, Aged Care Survey 2008: Summary findings, October 2008,
available at www.grantthornton.com.au
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