A deficit of ‘trust’? Government says clearing home care waiting list would bring in “shonky players” in response to criticism of $537 million Interim Report package

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Aged Care Minister Richard Colbeck (pictured above second from the left) has told the Senate concerns that new home care providers would ‘rort the system’ are behind the decision to only release 10,000 new Home Care Packages in response to Commissioners Lynelle Briggs and the late Richard Tracey’s Interim Report on Monday.

“The reason that the Government has made the response that we have is that we’ve taken notice of the Royal Commission’s Interim Report, which talks about the growth of demand for home care packages as additional capacity is being put into the system,” the Minister stated.

“It talks about concerns about significant growth of home care packages and creating a circumstance like the Labor Party created when they put the pink batts program into place – there was so much capacity put into the market that it brought in shonky players and ended up leading to four deaths.”

$537 million for home care, chemical restraints and younger people

The response follows Monday’s announcement by Prime Minister Scott Morrison (pictured above) of a $537 million package to respond to the three key issues pinpointed by the Commissioners in the Interim Report: the home care waiting list, chemical restraints and younger people in residential care.

The measures include:

  • $496.3 million for another 10,000 Home Care Packages, mainly higher-level Level 3 and 4 packages, starting next week on 1 December (next week);
  • $25.5 million to improve medication management programs and reduce the use of medication as a chemical restraint on aged care residents and at home. Doctors will also be required to apply for additional approval if the antipsychotic Risperidone is to be prescribed beyond 12 weeks from 1 January 2020;
  • $10 million over two years from 2019-20 for dementia training and support for aged care workers and providers, including around the use of chemical restraints; and
  • $4.7 million to help meet new targets to remove younger people with disabilities from residential aged care, namely having no people aged under 65 entering residential care by 2022; no one under the age of 45 living in residential care by 2022; and all people aged under 65 to be moved out of residential care by 2025.

As promised by the Government’s Chief Medical Officer Professor Brendan Murphy at the Sydney hearings in May, resources will also be developed on the appropriate use of antipsychotics and benzodiazepines in residential aged care and targeted letters sent to high prescribers aka GPs.

“The Royal Commission directed that restraint must only be used as a last resort, and amendments to regulations will make this clear,” the press release reads.

The $4.7 million for younger people in residential care will be directed towards:

  • setting up a Joint Agency Taskforce (JATF) between the Department of Social Services, Department of Health and National Disability Insurance Agency (NDIA) to ensure these new targets are met;
  • establishing a specialist team within the NDIA to prevent younger people with a disability who are eligible for the National Disability Insurance Scheme (NDIS) from entering aged care. This team is expected to grow to 80 by the end of March 2020;
  • working with industry to identify all available Specialist Disability Accommodation (SDA) and Supported Independent Living supports across the country to develop a database of existing and new housing options available now and in the future; and
  • undertaking a detailed analysis of younger people currently living in aged care, as well as up to 2,000 young people at risk of entering aged care, to better inform new policies and pathways to find alternate accommodation (building up their store of data).

The same press release also promises to push ahead on two major reforms: the streamlining of aged care assessments into a single service and the unification of the Home Care and Commonwealth Home Support Programs (more on this later this week).

The equivalent of $6 a day for residential care

As I discussed in yesterday’s newsletter, Commissioner Briggs had welcomed the funding announcement, but had not had much time to look at the detail.

Looking closer at the measures now, we wonder whether she is as pleased with the funding.

Most appear to be ‘stop-gaps’ while the promise to move out younger people from residential care simply puts money behind measures the Government had already promised to implement.

One commenter to The Daily COMMISSION noted if the funding had been directed to residential care, it would have equated to $6 a day per resident – not enough to enhance ‘care’.

“What could be done with it?” he asked rhetorically. “Another $6 meal? 15 more minutes of carer time per day? Six minutes of extra nurse time?”

Other parties agree – LASA issued a press release labelling the announcement “a missed opportunity”. CEO Sean Rooney has been calling for an extra $500 million a year for HCP’s and the waiting time to be cut to three months.

Council on the Ageing (COTA) Australia and Dementia Australia also expressed disappointment that more wasn’t done to address the 120,000-strong waiting list for HCP’s.

They want the waiting time for a package to be cut to a maximum of 60 days – a big ask when the current waiting time is over 12 months for high-level packages.

Labor naturally attacked the announcement as a “drop in the ocean”.

“There is absolutely no guarantee Scott Morrison’s miserly package will mean these older Australians receive care sooner,” its statement read.

“The Liberals have been asleep at the wheel for six years, with four Ministers and billions ripped out while Australia’s aged care system has lurched from one crisis to another.”

The Shadow Ageing Minister Julie Collins also went after the PM in Senate Question Time following the announcement.

“When 16,000 older Australians died in one year waiting to receive the home care package for which they’d already been approved, why did the Prime Minister announce only 10,000 new home care places today and why did the Prime Minister today put back only half of the $1.2 billion his own budget papers confirm he cut from aged care?” she asked.

Mr Morrison defended the Government’s actions, saying the Interim Report made it clear the Government is addressing a generation of issues that go back over successive Governments, and argued that his Government has added 44,000 new places since 2018-19.

“It isn’t just a system of throwing more places into the system,” he said.

“The system has to be able to absorb them with the training and the support to ensure that those places are delivered in a way that is safe and supportive of those Australians who need them.”

This is true. We estimate that around 1,000 additional staff will be required to deal with the 10,000 new packages – will the sector be able to find them however?

Regular readers will know I have been reporting on experienced staff leaving the sector as a result of the negative media around the Royal Commission.

As we reported in The Source last week, LASA has also identified 197 providers on the brink of financial collapse.

Mr Rooney – who was calling for a $1.3 billion injection of funds by Christmas to give providers a short-term reprieve – acknowledged money was not the simple solution.

“We can’t just keep putting money into the system. The system is broken,” he said.

But with staff wages making up 70% of providers’ costs, the lack of additional funding means providers will be forced to cut staff on top of their precarious financial situation.

The recent case studies from the Hobart hearings have shown the detrimental effect this can have on quality and safety of care – the very remit of the Royal Commission.

Minister Colbeck’s comments, taken from the Interim Report, also suggest a deficit of ‘trust’ in providers to ‘do the right thing’ – hardly the basis for a strong partnership to overcome these issues.

The PM has confirmed there will be more money for HCP’s in the December mid-year budget update, plus more funding for aged care in the Budget and again after the Final Report is released.

The question is: will this be too late for some providers – and what will happen to the residents they support?