It is fitting that the first piece of legislation passed by the newly convened 47th Parliament of Australia initiated the start of long-overdue aged care reform.
The new legislation implements several key recommendations from the Royal Commission into Aged Care Quality and Safety. While a great deal is still to be done, including introducing more legislation to establish the details of how the reforms will operate, this legislation establishes the framework and authority for further reform.
The legislation, passed on 2 August 2022, provides for amendments to the Aged Care Act 1997 which will enable the following reforms:
ACFI to AN-ACC
Funding for residential aged care via the Aged Care Funding Instrument (ACFI) will be replaced by the new funding model, the Australian National Aged Care Classification (AN-ACC), from 1 October 2022. The new model will change how funding is calculated and reflect the independent assessment and classification of each resident according to care needs.
Star Rating system
The Department of Health and Aged Care will be required to publish information about the new Star Rating system, which will allow members of the public to see how residential aged care facilities are rated. The publication of Star Ratings will be based on measurable indicators of quality and available data. It is intended to assist older Australians and their families to make meaningful comparisons of quality and safety between residential services and approved service providers.
Code of conduct and banning orders
The Aged Care Act will require compliance with a Code of Conduct by approved providers and their aged care workers, including all personal care workers and governing persons. The Quality and Safety Commission will be given powers to take action concerning compliance with the Code. The Commission will be able to take enforcement action for substantiated breaches, including making ‘banning orders’. These orders could, for example, result in an aged care worker being restricted or not allowed to work in aged care for a period of time if found to have breached the Code.
Extension of incident management and reporting
The Serious Incident Response Scheme (SIRS) will be extended to cover not only incidents in residential aged care but also home care and flexible care delivered in a home or community setting from 1 December 2022.
Governance of approved providers
From 1 December 2022, approved providers will be required to meet new governance responsibilities in relationship to the membership of their governing bodies as well as measures to improve leadership and culture.
This amendment provides for greater information sharing between Commonwealth bodies across aged care, disability and veterans’ affairs sectors. It also allows information sharing concerning non-compliance with the Code.
Refundable deposits and accommodation bonds
Creates stricter reporting and accountability on the use of accommodation bonds.
Independent Health and Aged Care Pricing Authority
The Hospital Pricing Authority will be expanded to include aged care pricing. The authority will have power to provide advice on aged care pricing and costing matters.
Interim measures will be introduced concerning who can provide consent where a care recipient does not have the capacity to consent. These changes are intended to address inconsistencies between federal law and state and territory laws.
What do the changes mean for aged care?
The ANMF broadly supports each of the above changes to the Aged Care Act, particularly as they reflect recommendations of the Royal Commission. Nevertheless, the devil will be in the detail and how the changes are implemented. Particular matters to consider will be the smooth transition to the AN-ACC funding model in a short timeframe. The development of the Code of Conduct will be of strong interest, and it will be important to ensure any banning orders are supported with procedural fairness. The expansion of SIRS to home and community aged care settings will need training and resources to allow all participants to understand their obligations.
Much of this change sits in the context of other aged care reforms, and the work ahead for the ANMF will ensure the detail achieves the right outcomes for older people and is fair for members. We are looking forward to working to address long outstanding issues and moving the aged care reform agenda along.
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