Seven compelling arguments for reimagined aged care funding, by the Royal Commission’s favourite witness – Natasha Chadwick

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Natasha Chadwick has the rungs on the innovation and enterprise board – the only Royal Commission witness across 20 months who had invested their own money into a totally new living and care model.

Launched in early 2018, NewDirection Care’s 17 homes, each housing seven residents (total 114) is what Natasha calls a Microtown, located at Bellmere, near Caboolture, QLD.

She told the Royal Commission that each resident receives ‘5.37 hours of care time each day’ compared to the sector average of just under three hours.

The Commissioners listened hard. But this level of care and risky innovation costs money. Natasha says:

“My commitment to this model and vision meant recognising that there was a need for change and being willing to challenge traditional thinking whilst being open to opportunities to ensure viability through the additional income.”

She has given us the following list of her seven fundamental funding changes she feels are imperative.

  1. Funding for aged care should be setting agnostic

“In my opinion there should be no distinction in the amount of Government funding based on where the care is provided.”

“That is, care recipients should receive the same funding (reflective of their needs) irrespective of whether they choose to live in their own home, in residential care, in a retirement village in a group home or elsewhere.”

“If funding were setting agnostic the funding could follow the individual. I believe this would increase choices for consumers and encourage providers to be more innovative.”

  1. Break apart the funding of care, ‘hotel services’ and accommodation

“All members of society who are able to, should pay for their accommodation and living costs. These costs can range significantly depending on assets and income.”

“Care on the other hand, is, in my opinion, the responsibility of a whole society.”

“By breaking apart care, ‘hotel services’ and accommodation, providers would be able to choose from a more diverse range of service delivery options. In doing so, they could consider consumers’ varied expectations and the capacity of consumers to pay for services themselves.”

“This would facilitate increased innovation and the development of offerings that are market driven and consumer driven rather than being restricted by a rigid funding structure.”

  1. Introduce a user pays model

“Any system of funding must respond to more than just the cost of care. Funding must also address services provided to support emotional needs as well as everyday living services and accommodation for no/low means residents.”

“Services beyond the ‘cost of care’ may need to be funded both by the Government and the individual by way of a ‘user pays’ and means tested approach.”

“There would be a base-line level of funding that is means tested but anything above this base level would be paid for by the consumer and not restricted by means testing.”

  1. Introduce ‘Admission Funding’

“I propose a 12-week fixed funding program (Admission Funding) to enable the aged care provider to undertake a thorough analysis of the new resident to ensure their needs are identified at the outset.”

“This would include a full assessment by skilled professionals; an individual support plan; implementation of that plan with emotional support to help the individual adapt; an education program for the individual and their family/guardians about their needs and how they will be met.”

  1. Individualised or case mix model for ongoing funding

“After the Admission Funding phase funding would be provided on an ongoing basis (Ongoing Funding).”

“This could be provided on either an individual basis akin to NDIS or a case-mix basis that identifies the mix of residents and their needs and then provides the skill sets to meet those needs as base, plus funding for additional individual needs.”

  1. Additional funding for allied health professionals

“Any future funding model needs to recognise the importance of allied health professionals such as occupational therapists, physiotherapists, dieticians, podiatrists, and speech therapists who all assist in delivering a high standard of care for older people.”

“These professionals can also support residents and take pressure off the hospital system.”

  1. Additional funding for registered or enrolled nurses to facilitate communication between GPs, family, and residents

A future funding model should facilitate the provision of a permanent registered nurse or enrolled nurse to assist in the communications between GPs, residents and families. This would result in better outcomes.”

“Poor communications with family members about treatment makes it difficult for the family to support their relative to make choices about health care, particularly in circumstances where a family member becomes a substitute decision maker when a resident no longer has capacity to make their own decisions.”

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