Aged Care reboot

You could be forgiven for thinking that the announcement last week of bipartisan support on aged care reforms was only about funding arrangements.  

While the changes to co-contributions are important, and something that older people and their families will rightly scrutinise, they are but a small part of a huge change to the aged care system.   

The new Act’s 574 pages respond directly to around 60 recommendations within the Aged Care Royal Commission final report (and that doesn’t include the many subordinate legislation, standards, and rules that regulate the aged care sector). 

So, what does it mean for you? 

There are several headline protections for older Australians that have been agreed as part of the negotiations between Labor and the Coalition.  

• Anyone already approved for a Home Care Package on the date of the announcement will be grandfathered on the existing funding rules and will continue with the existing contribution regime. 

• No person under the new rules will pay more than a total of $130,000 in co-contributions across the Support at Home and non-clinical care contributions in residential care under the revised lifetime contribution cap. 

• The new Support at Home program will also have a defined list of services and capped budgets for certain items to reduce overcharging by providers. 

• The family home will continue to be largely exempt from the aged care means test as per its current treatment. 

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

The 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.  

Disappointingly, the draft Act continues to locate the Complaints Commissioner within the Aged Care Quality and Safety Commission. 

National Seniors argued in an earlier submission that the Complaints Commissioner should be located within a separate statutory body to give older people greater trust. 

We still hope this will be changed before the Act is passed through parliament. 

The draft Act includes a new system, to change the way services are funded.

Both sides of politics ruled out an aged care levy to pay for increased demand for aged care services. Despite it being a key recommendation of the Royal Commission, both sides cited it as politically unpalatable. Instead, the government formed an Aged Care Taskforce to determine an alternative approach.  

While no one wishes to pay more, it is clear that aged care is becoming an increasing cost to the Federal Budget. Funding reform was needed to improve the quality, accessibility, and sustainability of aged care services into the future. 

The compromise that was delivered by the Taskforce and signed off by Labor and the Coalition is a funding model that guarantees full government funding for clinical care services (for example, nursing care) but increases consumer contributions for non-care services (for example, gardening and accommodation) in both the home and residential care settings. These non-care services are ones that most people pay themselves throughout their lives. 

This change means government can deliver services to more people, reducing waiting times for home care and assuring financial sustainability for the providers delivering aged care services.  

It will also mean that higher level home care packages offering up to $78,000 of support in a year will be on offer helping older people to age at home.

One of the key parts of the new Act is the framework it provides for the new Support at Home program, which will amalgamate the various home care services available into a single streamlined program.  

Older people have a strong preference to receive care at home, and this new system will provide greater access to home-based care by realigning government funding. 

The new Support at Home program will have eight levels with services within each split into three categories:  

• Clinical 

• Independence  

• Everyday living.  

Clinical care services, like nursing care, will be fully funded by government regardless of a person’s means. 

Services that promote independence will be fully funded by government for full pensioners but attract a co-contribution of between 5 and 50% for part-pensioners and Commonwealth Seniors Health Card holders (CSHC), presumably on a sliding scale relative to means, and a co-contribution of 50% for self-funded retirees without a CSHC. 

Services related to everyday living (such as gardening) will attract a 17.5% co-contribution from pensioners, a co-contribution of between 17.5 and 80% for part pensioners and CSHC holders, and a co-contribution of 80% for self-funded retirees without a CSHC. 

While this will mean some people will be required to meet more of the costs of non-clinical care, people should be less likely to wait for a package, with government claiming this should reduce the wait time for home care services to less than three months under the new system.