Aged care – what the new Act means for you

It’s not something people want to hear, but policy is hard. There are always compromises that must be made, because agreement is difficult and budgets finite. The ongoing debate over aged care is no exception. 

Over three-and-a-half years ago, the Royal Commission into Aged Care Quality and Safety made 148 recommendations to fix the aged care mess. However, even the commissioners couldn’t agree, putting forward slightly differing options on funding reform. While both argued for a levy, they were not in agreement on how that would work. 

Funding is a central problem with growing demand as the population ages. Both Labor and the Coalition rejected a levy as politically unpalatable. It has led the government to propose changes to means testing as the mechanism to free up funds to meet demand and improve service quality. Now that the Aged Care Act has been passed with the support of the two major parties, the Federal Government has much to do to bring changes to the care system to life.

A key focus of the new Act is to strengthen home care services. Older people want to age at home as long as they can. To do this, they need a system that provides adequate support, when and where it is needed. 

The new Support at Home program will roll together the various parts of the home care system into a single program that provides older people with access to eight levels of support. The highest-level package will offer approximately $78,000 per year pay for home care services, allowing older people greater capacity to stay at home if they can. 

National Seniors supports this in principle, but raised concerns about the absence of strict timeframes for the approval process and questioned how the transition through packages might occur quickly given the already long wait times for home care. While the government has set a target to have approvals within three months by 2027, this is not a legislated target that has to be met by government. 

Support at Home will also have a defined list of services capped for items to reduce overcharging by providers. Services will be grouped into three categories: clinical, independence, and everyday living to enable cocontributions to be applied at different rates for different types of services. 

Services, such as gardening, will attract limited subsidies, whereas clinical care services, such as wound care, will be fully subsidised. 

This is a sensible approach, but there are already concerns that some items, such as personal care, will attract copayments above what is reasonable. The devil will be in the detail, and the rules will likely need to be reviewed on an ongoing basis to get things right. 

That is why National Seniors called for the inclusion of a more frequent review of the Act and for the inclusion of a formal mechanism to allow anyone to propose a sensible rule change.

One of the most important changes to the Aged Care Act is the inclusion of a Statement of Rights. 

The Statement of Rights includes a positive duty on providers to take all reasonable and proportionate steps to act in ways that are compatible with a person’s rights as set out in the legislation. 

These rights are not absolute. In practice, they can be balanced with other rights, the rights of others and the need for compliance with other laws. 

The rights will also not be enforceable by a court or tribunal. Ultimately, it will be up to the new complaints commissioner to assess whether these rights have been breached and what actions should be taken if a conflict is not resolved and requires escalation. 

Recently, a story came to light of two people in residential aged care being separated from another person as a romance blossomed because it was dismissed by family as “stupid” at their age. 

This contravenes the new Act’s Statement of Rights, which states: “An individual has a right to (a) exercise choice and make decisions that affect the individual’s life … and (c) take personal risks, including in pursuit of the individual’s quality of life, social participation, and intimate and sexual relationships.” 

One wonders if these people’s right to have a relationship would be upheld under the new Act or if balancing this against other rights would mean their forced separation would still occur? 

It is likely there is more to this story, but what it does show is that none of this is easy. While the inclusion of rights is a step in the right direction, it should also include the right to receive care and support commensurate with assessed need and a right to review the spending of a provider. 

This would place greater onus on providers to spend the billions of dollars of public and private funds they receive appropriately when delivering safe and quality care.

The new Act includes an independent complaints commissioner who will have their work cut out for them balancing the new rights and wading through the thousands of pages of legislation and rules when assessing if action is required when a complaint is escalated.

National Seniors had hoped the complaints commissioner would be wholly separate from the regulator, the Aged Care Quality and Safety Commission. But alas, the position will not. 

There are many other changes, too many to list here, but rest assured that National Seniors will continue to advocate for you to promote sensible reform to ensure you can get access to the care you need when you need it. 

This article is featured in National Seniors Australia’s quarterly member magazine, Our Generation. 

Become a member today and receive a yearly subscription to Our Generation digital magazine as part of your membership, along with exclusive discounts, competitions, branch access and more! 

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