What do the reforms mean for older Australians, their carers, and service providers?

The recommendations in the 2011 Productivity Commission (PC) report will introduce significant changes to the aged care sector. This section discusses the major implications for older Australians, their carers, and aged care providers.

Older Australians and their carers:

The Commission’s recommendations will significantly improve the quality and quantity of aged care services for older Australians. As a result of the reforms, older Australians would have ready access to general advice on aging issues, as well as specific information about their local aged care services.

This advice and information would be available from a range of sources that all draw from a national information platform run by the Australian Seniors Gateway Agency (the Gateway):

be assessed for their care and support needs by the Gateway. They could also go directly to community-support services (such as meals delivery and community transport) which would continue to be block funded (or receive a Gateway referral to them).

receive an entitlement to services that matched their needs, and be advised of the price of those services and the details of approved providers in their local area;

be offered a care coordination service run by the Gateway and a case management service when needed.

have a single, updated, aged care electronic record that means that they do not have to keep repeating their history and personal circumstances.

benefit from a new intermediate community care package between CACP and EACH as part of the transitional arrangements.

choose their preferred provider (quantity limits on providers having been lifted), having regard to the quality of services being offered, including the professional and relationship skills of the personal carers, the cultural awareness, and languages are spoken, and the ability to negotiate the timing of service delivery.

seek a reassessment of their needs if there is a material change in their circumstances.

be subject to a fair and comprehensive financial means test – based on income and assets – to determine their level of co-contribution for approved care and support services (whether in their home or in residential care), with a safety net for those of limited means and with a lifetime stop-loss for care co-contributions.

have access to a government-backed Australian Aged Care Home Credit scheme with a no negative equity guarantee to meet their care and accommodation costs.

if their wealth is held mostly in the form of their house while protecting the share of the equity held by a spouse/partner.

be able to retain their house and be confident that their spouse, dependent child, or other protected persons’ would continue to be able to live in that house, rather than be forced to sell their home in order to go into residential care, as is the case for some at present.

if in residential care, pay a basic daily fee (currently set at 84 percent of the single age pension), pay their care co-contribution, and pay a daily periodic accommodation charge or equivalent bond, with a safety net for those of limited means

retain their Age Pension if they sell their home to move to alternative accommodation (such as a retirement village, serviced apartment, or a residential care facility) and pay a lower capital sum or daily charge by investing the excess proceeds from the sale in a Government-guaranteed Australian Age Pensioners Savings Account scheme.

benefit from measures to improve the quality of aged care services, including through a quality assurance framework, better evidence and information, and a more competitive environment facing approved providers.

receive enhanced access to general practitioners at residential aged care facilities through an increased Medicare rebate.

be given every opportunity to maintain or regain functional independence (including re-enablement)

be free to choose whether to purchase additional aged care services (including accommodation) beyond the minimum approved entitlement and meet the associated costs themselves

be confident that the AACC is monitoring the quality of care by providers and the price of residential accommodation during the transition period to protect against providers exploiting supply shortages and is an independent avenue for examining consumer complaints

receive improved access to information about advanced care directives, with a link to the proposed electronic records.

get better palliative and end-of-life care through an assessed entitlement from the Gateway.

Aged Care Providers:

The Commission’s reforms will involve significant changes for community and residential aged care providers, overcome current financial pressure points and create scope for individual providers to grow within an emerging competitive market. Good managers who meet the needs of empowered older people will have significantly more opportunities to be successful contributors to the caring of older Australians.

Providers would:

be subject to quality accreditation, but be free of any quantity limitations such as bed licenses and numbers of care packages (with a five-year transition to an open market).

compete with other providers for clients who had entitlements to care and support services, subject to being approved providers of those services.

receive a price set by the Government for those approved care and support services determined through the assessment process by the Gateway (comprising a care co-contribution from the client and a subsidy from the Government).

while meeting the approved quality and safety standards, and operating within the price set for the entitlement, compete on a range of dimensions such as the professional and relationship skills of their workforce, the cultural awareness and languages on offer, the quality of food, and other services and their responsiveness to the particular requests of individual clients.

offer a range of additional services, at a quality and price set by the provider

liaise with the Gateway on matters of initial assessments of client needs and entitlements, and be able to undertake subsequent assessments in response to a material change in a client’s needs, subject to a risk management audit process.

liaise with the AACC on matters of quality standards and assessments, complaints handling and costs of service delivery

be able to access information from the proposed AACC regarding projections of future demand trends and ways to improve the quality of services.

In addition, providers of residential care would:

be able to seek approved provider status for all levels of care and support delivered in a residential setting (with the inability to meet the demands of specific residents being dealt with on a strict exception basis), with the distinction between low, high, and extra service care being removed.

receive care payments for community and residential care set by the Government on the transparent advice and recommendation of the Australian Aged Care Commission.

charge all residents for their everyday living costs by way of a basic daily fee (currently set at 84 percent of the single-age pension).

set their own periodic accommodation charge for all new residents and, if desired, offer an accommodation bond of up to the equivalent amount, and publish those charges and bonds (with current bonds being grandfathered).

receive a set daily accommodation fee for supported residents, based on the average cost of 1.5 beds per room per facility at a level designed to meet the value of that standard of accommodation.

be required to provide for a minimum quota of supported residents with a pilot scheme on a tradeable ratio obligation within the relevant region.

be able to offer a range of other services in their facilities, such as respite care, transition care, re-enablement, sub-acute care, rehabilitative and restorative care, behavior management stabilization, palliative pain management, and end-of-life care, subject to meeting the relevant quality and safety requirements, and reaching agreement on prices and other terms and conditions.

access a transitional assistance package for small residential providers.

We welcome these changes as outlined in the report and eagerly await their implementation by the government.

Southcare is a Western Australian not-for-profit organisation that provides personalised aged care and support and community services to help you or your loved one live with dignity and respect in your own home and neighborhood.