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Live update
- The Department of Health and Aged Care
The inquiry resumed after a break.
Any rules released during consultation are only draft rules and the final rules will be released by the Minister for Aged Care closer to 1 July 2025.
There was a question about putting a floor or cap on the MPIR. Some aspect of financial reforms that have not been addressed in the latest round of reforms, including the appropriateness of the MPIR, will be part of a review that will occur over the next two years.
Michael Lye, Deputy Secretary responsible for Ageing and Aged Care said the process for defining who is a candidate for residential aged care because they are at risk of homelessness has been tightened and will remain essentially the same under the reforms - the royal commission determined residential aged care was not the best place for most of those candidates. Since the rules have been tightened the number of younger people in residential aged care has decreased.
55.6% of aged care residents are non supported residents.
David Pocock Senator for the ACT said the average wait time for an ACAT assessment in the ACT recently was 75 days - the highest in the country. The average wait time for an ACAT assessment is a median of 46 days act, the average is 42 days.
Additional Home Care packages from the Budget are beginning to roll through the system and are expected to reduce wait times. It's expected the wait time for a Home Care package will be about 6 months as of 1 July 2025, and three months by 1 July 2027.
David raised the issue of the new Bill not being based on a needs-based system, as raised by the OIGAC's Ian Yates AM earlier in the day and in their recent submission to the Inquiry. Michael Lye said the Government is expecting to add enough Home Care packages to match the number of people waiting - about 300,000 Home Care packages over the next three years - meaning the wait time will be reduced to 3 months. He said it's "meeting the spirit" of the Royal Commission's recommendation for a needs-based/demand-driven system, but is a better way of managing it to avoid the system being "run out of control" which could mean an important social program, aged care, is compromised or even lost.
1.3% of all hospital patients are categorised as older patients waiting for aged care.
- The Department of Health and Aged Care
Michael Lye, Deputy Secretary responsible for Ageing and Aged Care said the development of "rules" usually follows the development of legislation. The Department is prioritising the rules for Chapter 4 of the Bill, which contains funding reforms, and aims to release them by mid-October. High level information about the rules will be available by 7 October, next week, so they can be discussed at the Senate Inquiry hearings.
Two-thirds of rules are existing rules, but still might require some adaptation. One-third are new.
It was confirmed that providers will be made aware of the categories they will be transferred to in November.
Nick Morgan Assistant Secretary Support at Home with the Department of Health and Aged Care said caps on cleaning and gardening came about through consultations and had been foreshadowed, but was ultimately a "decision of Government"
The 10% pooling of care management was also a "decision of Government" and, again, was based on consultation.
The Department will provide the increases in aged care fees next week, along with the broad information being provided about the rules.
The 2% RAD retention will be charged monthly. There is a 5 year limit on providers' ability to charge the 2% retention. It's intended the 2% retention should go to capital works.
- The Aged Care Quality and Safety Commission (ACQSC) and the Independent Health and Aged Care Pricing Authority (IHACPA)
The Shadow Minister for Aged Care, Senator Anne Ruston asked how the success of the reforms can be measured.
Aged Care Quality and Safety Commissioner, Janet Anderson said, "We draw information about performance from a number of sources. It is not just our assessment of a provider against the standards ... we receive information on serious incident notifications. We have the quality indicator data which is reported, all the financial information and other information coming through the quarterly financial reports.
"We are now maturing our risk engine in a way that hasn't been the case historically, which enable us to understand the performance of a provider and the services within that provider to a to a degree of accuracy and timeliness, which which hasn't been available to us. And I am fully confident that we will be in a position to assess relative performance over time using that full array of incoming intelligence in a way also that hasn't been available to us historically."
Professor Michael Pervan, CEO of IHACPA said they are "on track" to deliver prices for the Support at Home service list provided to them by the Department of Health and Aged Care "early next year". The sector had been expecting prices to be available in November.
On pricing accuracy, Professor Pervan said, "We are increasingly confident that the nature of the work we do means that we're never going to come out and say we are 100% confident, which is why we undertake repeated costing studies, why we put draft frameworks out for consultation into the sector, why we meet with stakeholders from the sector to get better information."
He spoke about price "harmonisation" across all Government programs, such as for lawn mowing. "It's something that we're actually very keen on for all sorts of very obvious reasons at the moment."
- Acting Inspector-General of Aged Care Ian Yates AM
The Acting Inspector-General said passage of the Bill this year to ensure it is in place by 1 July 2025 is of critical importance to the reform process.
The reform process is a "very substantial exercise" involving a "complex system with lots of interactions". It's important to look at how individual measures will work together and consider "unintended consequences".
He noted the "rules" are not available and that the Royal Commission into Aged Care Quality and Safety recommended a needs based system, but the existing system will remain "rationed".
The "rights based" aged care system will ensure the rights of the consumer "drive the future development of the aged care system". "Having that clear statement of expectations is a very significant historic development and the bill does does that well."
"It is a good Bill in terms of the Royal Commission recommendations, and we have made suggestions as to how it might be strengthened in regard to those recommendations. But it is our strong view that this Bill should be passed. It represents significant advances in line with the Royal Commission. It could go further, but it is a very significant positive shift in the aged care system."
On the complaints process, he said, "It's not clear to us that if you get a persistent provider who complies with the requirement to report, but actually disagrees with the finding of the complaints Commissioner, what action that leads to. And it would seem to us clear that what you might call punitive action then, is in the province clearly of the Aged Care Quality and Safety Commissioner. And exactly how that will work is something the committee might like to explore in later session. We are raising it because it is a concern to us and because we know it is a concern to some stakeholders."
The Acting Inspector-General also had questions about enforcing the Statement of Rights.
"It is very clear that there is an intent to push providers into following the Statement of Rights, but, as it is, to push providers into providing high quality care, which is also defined in great detail. But as I said earlier, there are lots of words about encourage and promote and so on that leave us a bit unsure as to how exactly you prove whether you're getting quality of care... It's not a reason not to pass this bill as it is. It is something that we would flag that in monitoring the implementation of Royal Commission recommendations."
"There are still bad providers, and we need the industry needs a regulatory system that helps get rid of them."
"Many of the consumer, both actual consumers and consumer representatives who we consult with, there is a very strong sense of we've been waiting a long time. Let's get it done."
Eight hearings will be held around the country over the month, with the Inquiry expected to be wrapped up by the end of the year.
Committee members are:
- Chair Senator - Marielle Smith, Australian Labor Party SA
- Deputy Chair - Senator Penny Allman-Payne, Australian Greens, QLD
- Member Senator Hollie Hughes, Liberal Party of Australia, NSW
- Member Senator Maria Kovacic, Liberal Party of Australia, NSW
- Member Senator Louise Pratt, Australian Labor Party, WA
- Member Senator Anne Urquhart, Australian Labor Party, TAS
Follow the Senate Inquiry here.
