Aged Care Legislated Review Multicultural Access Project Officers Network
Aged Care Legislated Review – Multicultural Access Project Officers Network
Table of Contents
1.Tell us about you
1.1What is your full name?
1.2What stakeholder category do you most identify with?
1.3Are you providing a submission as an individual or on behalf of an organisation?
1.4Do you identify with any special needs groups?
1.5What is your organisation’s name?
1.6Which category does your organisation most identify with?
1.7Do we have your permission to publish parts of your response that are not personally identifiable?
2.Response to Criteria in the Legislation
2.1Whether unmet demand for residential and home care places has been reduced
2.2Whether the number and mix of places for residential care and home care should continue to be controlled
2.3Whether further steps could be taken to change key aged care services from a supply driven model to a consumer demand driven model
2.4The effectiveness of means testing arrangements for aged care services, including an assessment of the alignment of charges across residential care and home care services
2.5The effectiveness of arrangements for regulating prices for aged care accommodation
2.6The effectiveness of arrangements for protecting equity of access to aged care services for different population groups
2.7The effectiveness of workforce strategies in aged care services, including strategies for the education, recruitment, retention and funding of aged care workers
2.8The effectiveness of arrangements for protecting refundable deposits and accommodation bonds
2.9The effectiveness of arrangements for facilitating access to aged care services
3.Other comments
1.Tell us about you
1.1What is your full name?
-
1.2What stakeholder category do you most identify with?
Other
1.3Are you providing a submission as an individual or on behalf of an organisation?
Organisations
1.4Do you identify with any special needs groups?
People from culturally and linguistically diverse (CALD) backgrounds
1.5What is your organisation’s name?
Multicultural Access Project Officers Network
1.6Which category does your organisation most identify with?
Other
1.7Do we have your permission to publish parts of your response that are not personally identifiable?
Yes, publish all parts of my response except my name and email address
2.Response to Criteria in the Legislation
2.1Whether unmet demand for residential and home care places has been reduced
Refers to Section 4(2)(a) in the Act
In this context, unmet demand means:
•a person who needs aged care services is unable to access the service they are eligible for
e.g. a person with an Aged Care Assessment Team / Service (ACAT or ACAS ) approval for residential care is unable to find an available place; or
•a person who needs home care services is able to access care, but not the level of care they need
e.g. the person is eligible for a level 4 package but can only access a level 2package.
Response provided:
The demand for residential and home care places not been reduced , however The Map network has identified concerns with the number of CALD consumers who do not access services due to multiple and complex barrierssuch as low literacy levels , aged care concepts that are not understood, complex contracts and information and lack of support to navigate the referral pathway. The MAP network is concerned that the lack of a targeted communication strategy for CALD community to access timely services will be compromised
The MAP workers have found that many CALD consumers struggle to understand the concept of CDC, wellness and re- enablement. Although aged care reform emphasizes the many broad benefits from the CDC approach, such as increased consumer and carer satisfaction, improved health and wellbeing outcomes, the extent to which these benefits have been experienced by older people, has been compromised. CALD consumers have withdrawn form Homecare support and packages because they are not well informed of the service to be provided.
We know that unmet demand for more hours of HCP services by consumers is well documented. The reduction of service hours has found many consumers unprepared and unable to effectively use the help of fieldworkers.
Demand for residential and HCP have been affected as CALD consumers do not understand the fees policies and cost structured. Further education and resources are required to provide CALD consumers with a clear understanding of the services that they are purchasing, benefits and options
Service providers are struggling to provide case management to consumers due to keeping the contribution cost to a low minimum.
2.2Whether the number and mix of places for residential care and home care should continue to be controlled
Refers to Section 4(2)(b) in the Act
In this context:
•the number and mix of packages and places refers to the number and location of residential aged care places and the number and level of home care packages allocated by Government; and
•controlled means the process by which the government sets the number of residential care places or home care packages available.
Response provided:
We need to ensure that needs are addressed and budgets aligned to the support plan like in the NDIS. As per the Roadmap “We also need to ensure that the system can support older people to maintain their independence and receive support and care that is sensitive and appropriate, where and when they need it. The current system actively sought to identify CALD consumers to fill CALD specific packages. This was a collective effort as coordinators and aged care service providers providing CHSP identified CALD consumers at risk and actively sought to link them in to the appropriate package. Now with the introduction of generalist packages there is no active focus of navigating CALD consumers into packages. As a result with the absence now of CALD specific packages for CALD consumers the MAP network is concerned that CALD consumers will be doubly disadvantaged, as providers have no incentive to promote their services in CALD communities he number, level and type of HCP packages as well as places available need to be determined in government’s consultation with the wider sector and the whole community. It should also be guided by demography and not budget constraints. The philosophy of CDC is that the consumer drives the services they need. Package levels create limitations to the client. Core program based funding could be offered at a local level to provide added support to consumers and their families to built connections, wellness, active ageing in their community
2.3Whether further steps could be taken to change key aged care services from a supply driven model to a consumer demand driven model
Refers to Section 4(2)(c) in the Act
In this context:
•a supply driven model refers to the current system where the government controls the number, funding level and location of residential aged care places and the number and level of home care packages;
•a consumer demand driven model refers to a model where once a consumer is assessed as needing care, they will receive appropriate funding, and can choose services from a provider of their choice and also choose how, where and what services will be delivered.
Response provided:
To change key aged care services from a supply driven model to a consumer demand driven model it is necessary to provide more adequate bilingual information and resources to CALD consumers.
CALD Consumers have to have appropriate information so that they can fully understand the services that they are about to receive. A number of complaints and disgruntled consumers could be avoided if the consumer is well informed of their rights and responsibilities. If CALD clients would be able to clearly understand what their needs were and the services types that are available then they would be able to influence the consumer demand
The majority of feedback the MAP network has received todate indicates that definition of CDC does not reflect many people’s experience of CDC. For example, people are waiting for appropriate levels of care for extended periods of time, there are consumers being unable to get service for weeks after being discharged from hospital, others are unaware of the systems processes are unable to seek clarification of when and how the service will be delivered. In addition, CDC seems to be at odds with the re-enablement’ in both theory and practice. That is to say that many consumers should not be directed into activities that are not of their choice. Furthermore, it is important to note that the average person using home support services is 80 years or over. Many consumers, whose sole income is the pension, are better off under the previous model. The changes that occurred in 2015 meant that some consumers end up with less income when they are required to pay higher contribution fees for services and they experience far less face to face services with a greater proportion of the budget going into financial reporting and no real services provided.
The process of co-design and consultation should be in place before changes are suggested and/or imposed. The Map network suggest that parties should work in a collaborative manner, designing services/systems and products with consumers in the co design process. To meet the needs of the consumer group(s) there is an opportunity to utilise the knowledge and expertise of all parties not only peak bodies such as the FECCA and NACA as the main representative.Needless to say, many organisations and service providers have been advocating for numerous core elements to be changed, since the inception of MAC. We are pleased to see that the co design workshops facilitated by the Commonwealth have identified a number of recommendations which have been implemented to date. We recommend that multicultural specific codesign workshops utilising the expertise of sector support and development officers and the MAP would be an opportunity to identify the most recent issues at a grass roots level.
2.4The effectiveness of means testing arrangements for aged care services, including an assessment of the alignment of charges across residential care and home care services
Refers to Section 4(2)(d) in the Act
In this context:
•means testing arrangements means the assessment process where:
- the capacity of a person to contribute to their care or accommodation is assessed (their assessable income and assets are determined); and
- the contribution that they should make to their care or accommodation is decided (their means or income tested care fee, and any accommodation payment or contribution is determined).
Response provided:
Nil
2.5The effectiveness of arrangements for regulating prices for aged care accommodation
Refers to Section 4(2)(e) in the Act
In this context:
•regulating prices for aged care accommodation means the legislation that controls how a residential aged care provider advertises their accommodation prices.
Response provided:
Nil
2.6The effectiveness of arrangements for protecting equity of access to aged care services for different population groups
Refers to Section 4(2)(f) in the Act
In this contextequity of access means that regardless of cultural or linguistic background, sexuality, life circumstance or location, consumers can access the care and support they need.
In this context different population groups could include:
•people from Aboriginal and/or Torres Strait Islander communities;
•people from culturally and linguistically diverse (CALD) backgrounds;
•people who live in rural or remote areas;
•people who are financially or socially disadvantaged;
•people who are veterans of the Australian Defence Force or an allied defence force including the spouse, widow or widower of a veteran;
•people who are homeless, or at risk of becoming homeless;
•people who are care leavers (which includes Forgotten Australians, Former Child Migrants and Stolen Generations);
•parents separated from their children by forced adoption or removal; and/or
•people from lesbian, gay, bisexual, trans/transgender and intersex (LGBTI) communities.
Response provided:
MAC is not user friendly for people from CALD background and is unusable for people with low levels of reading and writing in English. MAC needs to move from a call centre model to an assessment and referral agency, with staff needing to have full knowledge of aged care services, assessment and have communicating skills dealing with older people including people from different population and language groups. The call centre system is aimed at efficiencies of time and the numbers of calls processed. CALD consumers have reported that the use of TIS has not always been available for them and call centre staff have been insensitive and at time oblivious to their cultural needs.
The call centre model is thus not seen as appropriate in responding to the needs for older people and people from CALD backgrounds.
There have a number of incidents where interpreters have not been actively engaged during the RAS assessments stage thus creating issues in consumers accessing correct services.
It is necessary to consult with CALD communities when producing language appropriate resources. There is lack of language specific material regarding the MAC as well as lack of education/information sessions for CALD communities around the use of new aged care system. There is an assumption that the written information located on a website is sufficient. For many older non-English speaking consumers accessing and navigating the internet is incredible challenging for example to access bilingual information on My Aged Care the CALD consumer must navigate through a number of English written webpages to finally select the language tab to locate their language specific resource. These first stages of navigation are creating barriers of access.
Even though for many CALD communities the community radio is an important source of news and information, there is no specific CALD marketing and communication strategy. The only exception has been a MAP’s local initiative which has included a radio program in SWS Western Sydney and across NSW.This strategy is working effectively and would be a best practice model for wider distribution
The MAP network has found that benchmark figures for identifying CALD access demonstrates that access is lower than expected It is recommended that skilled CALD organisations and services which provides skilled bilingual workers are considered as part of the assessment model to assist the MAC with appropriately responding to CALD needs
For example a project in SWS has brokered 7 ethnic and multicultural organisations to work as a linkage hub toassist frail older community members with information on aged care services and referral into the MAC. The bilingual links workers employed by these organisations have reported that each referral may take up to 6 hours to complete. Many of their consumers have little or no family supports to assist them accessing services. Hence, there is a major access and equity issue that persist in many of the CALD communities where advocacy, and referral supports are lacking.
The MAP are introducing MAC booths in medical centres in 2017 across NSW, the booths will be operated by Bilingual workers which aims to increase the number of CALD consumers who are aware, understand and access the MAC. Other suggestions to be considered that could enable better access to the aged care system would be to introduce service centre hubs in shopping centres as now appear in NSW for State run services like RMS, Housing, Fairtrading, Opal Cars, and Senior cards
2.7The effectiveness of workforce strategies in aged care services, including strategies for the education, recruitment, retention and funding of aged care workers
Refers to Section 4(2)(g) in the Act
In this contextaged care workers could include:
•paid direct-care workers including nurses personal care or community care workers, and allied health professionals such as physiotherapists and occupational therapists; and
•paid non-direct care workers including: managers who work in administration or ancillary workers who provide catering, cleaning, laundry, maintenance and gardening.
Response provided:
Effective workforce strategies are needed to recruit bilingual staff and to improve recruitment so that a language match with consumers is possible. This will mean a targeted campaign in various CALD communities to attract care workers in to the sector. The MAP network has identified workforce models which are being tested at the present in the community care sector that could equally be adapted in the aged care sector. Cultural competency training should be undertaken by all staff employed in aged care services. Undertaking online course in cultural competence is deemed inadequate. Many organisations perceive the employment of bilingual staff to equal cultural competence and strong monitoring should be imposed to ensure organisations satisfy the culturally competence criteria. Equally frontline staff has no knowledge or understanding of dementia. Therefore, dementia training should be compulsory.