The government has accepted 130 of the 148 recommendations made by the aged care royal commission and rejected six, including funding the system via an aged care levy.
Twelve recommendations remain under consideration.
The government’s five-year $18 billion plan for aged care reform, to be introduced in three phases, was detailed in the federal budget handed down on Tuesday.
In a separate document providing a point-by-point response to each of the royal commission’s recommendations, the government rejects calls to establish or investigate a Medicare-style levy to finance aged care, with Mr Hunt telling reporters on Budget night that aged care reforms will be funded through revenue within the budget.
It has also rejects recommendations relating to fees for residential aged care living costs and accommodation and changes to the means test, noting the discordant views of the commissioners in its response.
On other points where the commissioner’s disagreed, the government has favoured Commissioner Lynelle Briggs’ government‐led departmental governance model over the independent commission approach Commissioner Tony Pagone recommended.
This includes supporting Ms Briggs’ recommendations to:
- expand the Independent Hospital Pricing Authority to include aged care rather than establishing a separate one
- establish a Council of Elders
- replace the Aged Care Quality and Safety Commission Quality and Safety with a new independent Aged Care Quality and Safety Authority
- set up a taskforce in the department overseen by a cross‐departmental steering committee to implement and direct implementation of the royal commission’s recommendations.
The recommendation to link home aged care and support program indexation to wages, abolish contributions for certain services and limit fees in respite care are subject to further consideration.
As are the recommendations to mandate minimum qualification for personal care workers, establish a Senior Dental Benefits Scheme and provide equity for people with disability receiving aged care.
Also under consideration is Ms Briggs’ recommendations for enforceable employment status standards including that providers prefer the direct employment of workers, which the government said would be referred to the Productivity Commission for examination.
Ms Briggs recommendation to phase out Refundable Accommodation Deposits is also being considered with the Government saying it will work with relevant stakeholders to develop a reformed RAD framework with a review of RADs and options to reduce the current dependence.
On the recommendation to increase award wages for aged care workers and nurses, the Government responded that the matter was being considered by the Fair Work Commission (FWC) and would provide information and data to the FWC as required.
The first phase of the government’s reform takes place in 2021 and focuses on setting the foundations for change including kicking off structural and governance change across the system, building the workforce and addressing immediate priorities across each area.
Reform in 2021
- 40,000 additional home care packages, and work towards a new home care model with care and support based on assessed need
- $10 Basic Daily Fee supplement, continued Viability Supplements, independent pricing authority and start of enhanced financial and prudential oversight for residential services and sustainability
- better quality standards for dementia, diversity, food, nutrition, enhanced regulatory and monitoring powers of the quality regulator to improve clinical standards and additional GP services and access for aged care residents
- training places for new and existing aged care workers, scholarships to attract nurses and personal care workers and advocacy, dementia and palliative care training
- Fund a Council of the Elders, Inspector-General of Aged Care and more MPS and NATSIFAC residential care services.
In phase two, which will run across 2022–2023, the reforms focus on rebuilding institutions, developing and passing new legislation and embedding new regulation.
It also focuses on funding reform arrangements, changes to service delivery, enhancing workforce capability and improving the culture in aged care.
Reform in 2022
- release of 40,000 additional home care packages and expand the Serious Incident Response Scheme to home and community care
- transition to AN-ACC funding model and increase the funding base in residential aged care
- report staffing hours, enhance financial reporting transparency, introduce worker screening and code of conduct and implement the first stage of star ratings in residential aged care
- implement the single assessment workforce in residential care, start financial incentive payments for registered nurses and training places for 6,000 new personal care workers and 33,800 places for personal care workers to attain a Certificate III
- procure Indigenous care finders
Reform in 2023
- network of 500 local Care Finders in place and single in-home care program
- mandatory minimum 200 minutes of care time for aged care residents
- National Aged Care Minimum Dataset to improve information metrics about aged care and expanded National Mandatory Quality Indicator Program
- single assessment workforce for home care and training places for personal care workers to attain a Certificate III
- new Aged Care Act commences.
The ministers said the third phase of reform from 2024–2025 would begin to realise the vision of a high-quality and safe aged care system with needs. Dignity, care and respect of seniors at its core.
Reform in 2024
- new support at home program supports seniors to remain at home and connected to their communities
- implement the reformed residential aged care accommodation framework and discontinue the Aged Care Approvals Round from 1 July 2024
- full implementation of Star Ratings
Reform in 2025
- meet target of no people under 65 living in living in residential aged care by December
- strong and effective governance of aged care in place with senior Australians at the centre and improved care outcomes consistently delivered.
A version of this story first appeared on Australian Ageing Agenda.