As the aged care royal commission prepares to hand down its final report, peak industry bodies have declined to give their full support to recommendations to eliminate the home care waiting list contained in Counsel Assisting’s final submissions last year.

Among the recommendations is a proposed target of allocating a home care package to each of the more than 100,000 people on the waiting list by the end of this year and capping wait times at one month by July 2024.

Both Aged and Community Services Australia (ACSA) Leading Age Service Australia (LASA) have given the recommendation in principle support only, saying it will place significant pressure on providers and could compromise quality of care.

Major structural change

LASA says in its submission that expanding home care represents a major structural change and will have to be carefully managed.

LASA CEO Sean Rooney

That includes taking a staged approach and consulting closely with home care providers on a manageable schedule.

Residential care providers will also have to be supported to ensure “supply and stability” isn’t compromised.

“Clearing the HCP wait list by near doubling the current number of HCPs across the next 12 months will place significant pressures on workforce recruitment, retention and management,” LASA says.

“This will not be without additional cost and quality impacts that will need to be accounted for.”

LASA says home care providers must be given maximum notice about the release of new packages.

It is likely that significant wage increases, additional training places, as well as increased use of subcontracting arrangements will be necessary to rapidly scale up supply.

LASA submission

“It is likely that significant wage increases, additional training places, as well as increased use of subcontracting arrangements will be necessary to rapidly scale up supply,” the submission warns.

ACSA CEO Pat Sparrow

 “More broadly there should be a review of the expectations for caring for older Australians with more complex needs at home, and greater clarity in the future design of the home care system to support this immediate expansion.”

ACSA says the workforce will have to be significantly ramped up if 100,000 packages more packages are injected over the next twelve months and corners mustn’t be cut with staff.

“There is a risk that the required number of ‘right-fit’ people might not be able to be sourced and trained in the timeframe proposed,” the submission says.

Maximum funding

Counsel Assisting also recommend that from July 2024, the maximum funding for a person getting home care should be on par with residential.

ACSA says it supports this while LASA supports it in principle, raising a number of issues.

These include a need to clarifying the process and criteria for someone can’t be cared for at home, and considering additional accreditation for providers managing care or delivering nursing and personal care to clients with more complex needs.

However ACSA says equal funding is consistent with supporting an individual’s informed support choice but“costing and pricing will be needed to ensure parity as these are different between the two environments”.

Civil penalties and whistle blowers

Meanwhile, ACSA expressed concern about the recommendation that providers who fail to provide high quality and safe aged care, or directors and other people who aid or abet in the breaches, should be subject to civil penalties.

ACSA said it does not support the  recommendation “which we believe would set a precendent in governance”.

The peak also shies away from calls for new aged care act to contain whistle-blower protections covering aged care recipients, family members, carers, employees and board members who make allegations of suspected breaches of safety and quality standards.

ACSA says the Corporations Act already has extensive whistle blower protections and it doesn’t support the recommendation.

The royal commission is scheduled to report to the government by February 26.

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