Tensions rise over tender for single assessment approach

The aged care minister has refuted claims that the government is intending to privatise the aged care assessment process as part of plans to streamline assessments.

The aged care minister has refuted claims that the government is intending to privatise the aged care assessment process as part of plans to streamline assessments.

The government announced in December that a single assessment workforce will replace the Regional Assessment Service and Aged Care Assessment Teams from April 2021 to assess eligibility for access to all government-funded aged care services.

It will comprise a single workforce and a network of assessment organisations, which will be selected through a national tender process in 2020, it said.

Richard Colbeck

In response to subsequent reports and a statement from the royal commission about the government’s plans to privatise assessments, Minister for Aged Care and Senior Australians Richard Colbeck said the reform was not about privatisation.

“The Government has consistently refuted claims that our intention is to privatise the assessment process for aged care. That assertion is incorrect,” Mr Colbeck said in statement.

The plan to move to a single assessment workforce, which was first floated in 2015, backed by the Tune Review in 2017 and confirmed in the 2018 Budget, underwent a two-month public and industry consultation about 12 months ago.

While there have been no objections from aged care provider peak bodies, other stakeholders have raised concerns since December’s announcement.

Among those are the states’ health ministers who told Fairfax Media (here and here) they were concerned about the government’s surprise decision to privatise aged care assessments.

ACATs are currently run by the states with federal government funding.

Statements in this Fairfax Media report from Mr Colbeck said that the royal commission supported the reform, which led to royal commissioner Gaetano Pagone issuing a statement on Tuesday to clarify its position.

“Public concern has been expressed about statements made by the Minister for Aged Care and Senior Australians that we had decided to support the privatisation of the Aged Care Assessment Teams in our Interim Report,” Mr Pagone said.

“I take this opportunity to make clear that the Interim Report did not endorse the Government’s stated position but noted that we would monitor with interest the implementation which the Government had announced,” he said.

The planned integration of the two assessment workforces needs to be progressed urgently, the royal commissioners said in the interim report.

Mr Colbeck issued a statement the following day acknowledging Mr Pagone’s statement and to clarify that the government has never intended to privatise the assessments approach.

He also said the Government was completely cognisant of the Royal Commission’s view in the interim report about the integration of assessment services and as reiterated by Mr Pagone.

Mr Colbeck said the Commonwealth Government has always managed aged care assessments through various forms of contracts or agreements with either the states or territories or community-based organisations.

“The intention to undertake a tender has been public for more than a year with State and Territory officials consulted on a number of occasions.

“States and territories will be able to tender to provide the integrated assessment services,” Mr Colbeck said.

He said the tender arrangements would include measures to ensure that conflicts of interest are managed.

The Department of Health held a webinar on 11 December about the new assessment arrangements. It is available here.

Peak bodies’ response

Sean Rooney and Patricia Sparrow

Aged care provider peak body Aged & Community Services Australia supports the new streamlined approach.

“ACSA is supportive of the direction of the Government’s announcement to integrate RAS and ACAT workforces to deliver consistent and accurate assessment for older Australians,” CEO Patricia Sparrow told Australian Ageing Agenda.

“Our concerns is not with who delivers the assessment on behalf of the Government, as many government services are contracted out to third parties.

“It needs to be well-resourced so that assessments are accurate and timely allowing providers to confidently deliver the care that’s needed,” she said.

Fellow aged care peak Leading Age Services Australia has no objection either.

“LASA supports an efficient and effective system that delivers the best outcomes for consumers, including accurate assessments that provide a strong basis for providers to develop care plans,” CEO Sean Rooney told AAA.

New stakeholder engagement

The Department of Health announced today it will hold another webinar on 12 February provide an update on the development of new aged care assessment arrangements.

It will address common themes arising from stakeholder questions during the previous webinar, it said.

Comment below to have your say on this story

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Tags: acat, acat-assessment, acsa, aged-care-assessment-team, department-of-health, lasa, news-6, news-ccr-2, pat-sparrow, RAS, Richard Colbeck, royal-commission, Sean Rooney, slider, tony pagone,

13 thoughts on “Tensions rise over tender for single assessment approach

  1. This will lead to the dumbing down of the assessment process as it has at RAS level. There is nothing preventing (further) privatisation of aged care level assessments. It’s stating the obvious but private providers can only provide a lesser service than not-for-profits and state government as they have to turn a profit. This can only be bad for elders.

  2. “It will comprise a single workforce and a network of assessment organisations”
    Dont those two things sit in opposition to each other?
    I can see this turning into a major mess. The same as how people assigned a HCP have a “network of providers” to choose from and total confusion reins.

    I can also see the funding being allocated per assessment and time limits set. So everything has to become rote and tick the box so it can be completed in the allocated time.

  3. This process of amalgamation has been going on for so long that it has slowly dumbed down the essence of the ACAT to the detriment of the consumers and the clinicians.
    Referring to and using the ACAT Clinician as just ‘an assessor so do the assessment and keep it simple.’ is an insult to the ACAT clinicians and our clients, some of the most vulnerable people in our community that Health is trying to care for today.

    Part of the ACAT clinician’s work is to assess the client but while we assess we are using our clinical expertise and skills that we have spent years developing with practice, experience and further education. Our core work should be acknowledged as our ability in being able to see, feel, and clinically diagnose when a client is beyond ‘just an assessment’ but requires the immediate intervention of medical or emergency services.

    An ACAT assessment is not and should never become rote and a tick box experience so that the assessment can be completed in the allocated time to meet a certain quota.

    The concern/ discussion over the privatisation question should be the least of the concerns. The hospitals are already seeing admissions of the older person who has been sent in by an ACAT assessor because they have been failed by a system that is a mess and not working and their carer is at crisis point, no longer able to meet their care needs and are unable to navigate or understand an increasingly complex, clunky and unforgiving system.

  4. A regressive step.”Penny wise and pound stupid”. This will end in disaster for many older people; with assessments done on the run (for profit and time constrained) with little or no consumer education or empowerment. This will no doubt lead to some premature admissions into residential care let alone predictable conflicts of interest …. assessment (being one corporate entity) feeding customers $$$ into another related (service provision) corporate entity. I agree with both previous comments. ACATS work well, RAS should join them in hospital settings. This is the de-skilling and disempowermnt of the ACAT – older consumers and their carers beware. Penny wise and pound stupid -n says it all

  5. I agree with all the above statements.. What will happen with the CHSP funding?Will this mean that a pwd will need to wait for a level1 package even for early needs. It is difficult now to get some services under CHSP but will take even longer if you have to wait for a low-level package. Streamlining the assessment procedure has some merit n as it may avoid some duplication but putting the procedure out to tender is ridiculous.The current teams in each state are working in a professional manner, with trained staff-where is the trained sttaff coming from to work in the ” Consortiums”. ???.

    If it gets to the point where tenders are requested, all states and territories should tender for the assessments . There is obviously no Consortium with the same level of experience , they should, without question ,be allocated the tender…

  6. This governments main aim is to privatise as much as it can,be it aged care or other service delivery agencies. What we have seen with MAC and HCP is a complete shambles.ACSA and LASA also have a vested interests in all this and supporting government policy.No problems with ACAS and RAS merging, but not run by a private company paying peanuts for very well qualified health professionals, especially in Victoria.The whole thing is very disappointing with pollies as usual out of touch with reality and in bed with there mates in the private sector

  7. The minister said government was not privatising but he did not say it was not marketising.

    The consultation at the end of 2018 was over December/January, during the holiday period as was the public announcement a year later in Dec 1019. Was it really seeking critical comment?

    At a webinar conducted with industry on 11 December 2019, participants were clearly informed by the department that the tender process would be a “contestable market approach” and that all would be eligible to tender. It would be a ‘fee for service’ model with broad market participation and contestability. The draft proposals would be by April 2020, closing date in June and contracts negotiated by November.

    When asked about this ‘privatisation’, during questioning, the three-person panel responded without questioning ‘privatisation’ as a description of what was happening. Government were encouraging consortia to apply and supported subcontracting. Tendering was to be “for a new workforce” which was going to be a bigger change than the change to the assessment process itself. Existing agreements would be extended to March 2021 when the new workforce would take over.

    Not long after the webinar, a media release by The Australian and New Zealand Society for Geriatric Medicine (ANZSGM) was very critical of the privatisation of ACAT, urging “the Federal Government to reconsider their decision”.

    So for the minister a “contestable market approach” and open tendering is not privatisation. How far can you split a hair?

  8. This is another nail in the coffin of a decent approach to organising and prioritising aged care. Becuase they offered impartial but expert assessment and advice and reduced the flagrant over-reliance on residnetial care that dominated supply in Australia in the 1960s-1980s, ACATS have been the single most significant innovation in aged care in Australia. No wonder they have been copied by many countries across the world. However they have long been seen as too independent by some providers and their role has been increasingly limited over the past 20 years since the Aged Care Act of 1997.

    Other comments above refer correctly to the shambles that has deveoped with RAS, MAC and HCP assessment procedures. This new step is another poorly designed intervention that seems likely to destroy the independence and professionalism of ACATS. It should not be introduced nationally without clear demonstration of its effectiveness, in at least two large sites in at least two States. The refusal to test it’s effectiveness shows that it is not evidence informed policy – it is simply coalition dogma and is rightly seen as a threat to any integrety remaining in the Australian aged care system.

  9. So if it is not being privatised SERCO will not be the winning tender…or will we be soon saying “what a coincidence Muriel”.

  10. The critical discussion point seems not if a single assessment workforce is best, but the removal of the assessment workforce from the public health system.

    Consumers benefit from a comprehensive assessment, based on expert understanding of that person’s health conditions, prognosis and options. How will an assessment workforce outside of the public health system have access to Geriatricians, Rehabilitation Specialists, other health interventions that may alter the progress of disease, and delay the need for services or residential care? How will an assessment workforce outside of the public health system complete the near 40% of inpatient ACAT assessments that happen across Australia without access to that person’s medical records?

    Leave the assessment workforce within the public health system.

  11. The continuing push to privatise the aged care sector, particularly in light of the Aged Care Royal Commission is a national disgrace. The ‘dumbing’ down of the ACAT workforce to a tick-a-box exercise by non-clinicians will be the final nail in the coffin and is so short-sighted in it’s approach around presumed cost effectiveness in the short-term but will end up costing millions more in poorer outcomes for our aged care population.

    My Aged Care, LAC and NDIA processes are all examples of how commonwealth ICT “assessment” processes fail some of our most vulnerable populations.

    Assessment services must remain in the public health sector conducted by experienced clinicians if we have any hope in ensuring appropriate and independent assessment and recommendations to aged care services and facilities.

  12. The important points have been made in the comments above.

    The poll asks the wrong question. The RAS experiment has failed and it is appropriate to merge RAS with ACAT into a single assessment service.

    The issue of concern is the Australian Government’s proposal to marketise / privatise / fragment the assessment function. This is vandalism which will result in harm. It will reduce the clinical quality of the assessment and fracture the important connections of the Aged Care system and public Aged Health services.

    This proposal must be ideologically driven or arising from a failure to understand the fundamental relationships between health, disability and a consequent need for support services and supported accommodation.

  13. As of today the 28/02/2020 common sense prevails….great news for older Australians requiring a comprehensive assessment. The Commonwealth has decided not to proceed with the tender process to privatize ACAS service –

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