National Aged Care Alliance

NATIONAL AGED CARE ALLIANCE

Thursday 27 & Friday 28 August 2015

Venue: Manuka Oval Functions Centre, Manuka Circle, Griffith ACT 2603

Key Points:

ESSA to nominate for National Reform Home Care Advisory Group

AAG to coordinate more communication between professional group

Include in E-News HESTA Awards to promote AEPs in age care.

Consultation paper on Short Term Restorative Care Program to be released Sept/Oct. ESSA to provide comment

Feb 2017 Changes with Home Care, discussion paper to be released October. ESSA to provide comment

Aged Care Reform Groups Updates/General Updates:

Aged Care Sector Committee (Non-NACA committee)

·  At the July 24 meeting of the ACSC, the Aged Care Financing Authority (ACFA) submitted a summary of the initial report it provided to the Government on 5 May 2015. The report on the factors influencing the financial performance of residential aged care providers was published on the ACFA webpage on 2 June 2015. A copy of the report can be found at the following link: https://www.dss.gov.au/ACFA. ACFA also reported that the Assistant Minister for Social Services had requested they undertake further analysis of the financial issues as they affect rural and remote providers and report back to the Government by 16 December 2015.

·  The ACSC Red Tape Action Plan is now available and an update on the progressive implementation of the plan was presented to the most recent ACSC meeting. This report has been provided to NACA as part of the Alliance’s Internal Red Tape Working Group report, along with a comparative analysis of the NACA Red Tape Plan.

·  The Department of Social Services provided an update to the July meeting on the implementation of the key budget measures – increasing choice for older Australians; establishing a single quality framework; short term restorative care; and independent Aged Care Complaints arrangements.

·  Other items covered at the July meeting included a proposed letter from the Chair to Minister Morrison and Assistance Minister Fifield, providing the ACSC’s first annual report, and a one page evaluation for members to complete. The latest NACA Blueprint was provided as an agenda item and this assisted in further discussion about the future roadmap and how the Blueprint might inform and assist in its development.

ACSC Roadmap Advisory Group (Non-NACA Advisory Group)

·  The Roadmap Advisory Group met on 8 July and planned a longer workshop for 28 July to define the approach and expected outcomes of a proposed Roadmap Forum to be held on Friday 21 August in Canberra. Attendance is by invitation only. Subsequent conversation with DSS has led to agreement that the outcomes from the Forum will be available for the Roadmap discussion on Day 1 of the August Alliance meeting. Issues, concerns and feedback from NACA will be presented to the next Roadmap Advisory Group meeting on 8 September, and the final draft version of the Roadmap will be presented to the November meeting of NACA prior to its presentation to the ACSC a week later.

INCREASING CHOICE SPECIFIC PURPOSE WORKING GROUP (DSS – Non-NACA Group)

·  This Group has been established by DSS to ensure a rapid and responsive working capacity to assist in the development of a discussion paper on the requirements for implementation of the Increasing Choice for Older Australians budget measure. The Working Group is comprised of key DSS personnel from the Aged Care Reform Taskforce, several chairs of NACA Advisory Groups and several NACA Sponsors, as well as the Director of the NACA Aged Care Reform Secretariat.

·  The future of this group is yet to be defined. Should it continue a proposal has been put for NACA endorsement that the chairs of the key NACA groups be considered for membership of this group.

NACA COMMITTEES AND ADVISORY GROUPS HOME CARE PACKAGES CDC ADVISORY GROUP

·  The Advisory Group has met to provide input into the development of the 5 Steps to accessing Home Care guide, now available from https://www.dss.gov.au/ageing-and-aged-care/programsservices/home-care/five-steps-to-accessing-home-care-packages.

·  As part of the proposal ‘NACA and DSS Advisory Groups 2015 – 2018’, DSS has proposed that this group be discontinued and replaced with the Aged Care Reforms Advisory Group. Future implementation discussions (inc. relating to the operations Manual) would then be referred to the Home Care reforms Advisory Group

THE AGED CARE GATEWAY ADVISORY GROUP

·  The Gateway Advisory Group met on 20 August 2015 in Canberra. An update on the 1 July 2015 implementation of Phase II of the My Aged Care Gateway was presented. Included in the presentation was information around call handling and call wait times.

·  DSS has developed a Transition Working Group made up of members of the Gateway Consultation Forum and Gateway Advisory Group. It is a time limited group to be revisited in Sept/Oct and is charged with providing advice in relation to IT fixes should be prioritised by DSS in order to address the most critical and most widely affected issues with the Phase II implementation of My Aged Care.

·  Regional Assessment Services, referrals to CHSP providers have commenced and ACAT usage of the My Aged Care referrals are beginning to come online (with all states due to be online by the end of December 2015).

QUALITY INDICATORS REFERENCE GROUP

·  Quality Indicators Reference Group has met a number of times since the last meeting and has scheduled approximately monthly meetings until the end of the year.

·  The group has invested significant time reviewing the advice from KPMG in relation to potential Consumer Experience / Quality of Life indicators. Based on the advice from the Advisory Group, it was decided not to pilot a CE/QoL indicator/s in Collection Phase II of the pilot. Further, the Advisory Group identified that it may not be feasible to pilot the CE/QoL indicator in 2015.

·  KPMG has also been announced as the successful tenderer to support the development of quality indicators in Home Care. Members advised that some indicators may be able to be developed based on data now captured by My Aged Care.

·  It is currently planned that the three Quality of Care residential care quality indicators will conclude their pilot and become part of a full programme in March 2016.

COMMONWEALTH HOME SUPPORT PROGRAMME (CHSP) ADVISORY GROUP

·  A decision was made by the Department to not proceed with a national fees schedule for the Commonwealth Home Support Program. The CHSP Programme Manual was updated to provide a fees framework, encouraging providers to still collect 15% of the programme funds through user fees.

·  Services who have previously been advised of their funding extension until July 2017, were provided further advice that their funding would be continued until July 2018, in line with the May budget commitment of the merger of CHSP and Home Care.

·  In addition to the CHSP Programme Manual, CHSP Programme Guidelines and Living well at home: CHSP Good Practice Guide were all released in July 2015 and are available from:

https://www.dss.gov.au/our-responsibilities/ageing-and-aged-care/aged-care-reform/commonwealthhome-support-programme#09

·  With the release of the CHSP Good Practice Guide it is proposed that the CHSP Sub-Group on Wellness be discontinued.

Other notable updates:

·  Discussion paper for shift of funding to consumer (Feb 2017) to be released in October 2015 for feedback. Legislation changes to support shift of funding to occur in Feb/March 2016. Feedback period to be ~4 weeks.

·  Feb 2017: National pool of packages then allocated by My Age Care. Planning regions would then be removed. Concerns around competency of My Age Care given challenges with 1 July.

·  Fees and Contribution Framework to be published, replacing Fees Policy.

Quality Indicators Pilot with Michael Culhane, Department of Social Services

·  Current trial in RACFs measuring pressure injuries, unplanned weight loss and physical ends 4 Sept.

·  Further testing underway focusing on cost for RACF providers to implement quality indicators program. This will inform how to support providers.

·  Future planning includes developing and trialling a set of indicators specifically for home care.

·  Quality of Life and Consumer Experience quality indicators were hoped to be tested. Pilot for these measured deferred.

Address by Shayne Neumann

·  Reflected on removal of workforce supplement and dementia supplement and substitution with Severe Behavioural Teams

·  Supports concepts that promote active ageing communities with wellness and fitness programs to play a role in managing ageing and dementia.

·  Would like to see the link between ageing and health become closer.

·  Commented that Gateway has proven to be inefficient,

·  Identifies that there are workforce issues in age care, particularly challenges of an ageing workforce and there are gaps in supply of appropriate housing for disability and age care.

Aged Care Road Map Discussion

·  Minster has welcome industry via NACA to create a blueprint of the future of age care

·  Need to increase consumer information, support and advocacy.

·  Feb 2017 concerns around CDC clients choosing “cheap providers” i.e. no police checks, training. Market rate for a quality service may be $45 vs $20 for a “cheap provider”. Balance needs to be struck with consumer choice and quality of trained services.

·  Concerns that with a decrease in quality of services that are comprised with cost will comprise investment into age care e.g. capital into building RACFs.

·  Needs to address to overlap with disability services and NDIS

·  Bringing in CDC to residential care.

·  Sense was the non for profit sector could be among the beneficiaries of Feb 2017 changes with CDC.

·  Information technology and consumer information is recognised to have been performed poorly (e.g. My Age Care) and is a limiting factor in progressing the sector.

SA Innovation Hub with Mike Rungie, ACH Group

·  Looking at models and innovations where focus is more on the wellbeing and QOL of care recipients and prompting autonomy

·  Will look to trial reablement/CDC in residential care. Hope to demonstrate residents are able to move back to the community with the right level of support

·  Individualising budgets in residential care like home care will be a key challenge, open to feedback.

·  Wants to start with understanding QOL in RACFs then have that inform the model.

·  Hub are exploring options of residential care including small group homes with a CDC model

Session with the Department of Social Services (DSS)

Presentation on My Aged Care:

·  Period of presentation based upon data from 1 July-23 Aug.

·  ~16,000 calls per week, 18,000 clients registered, 10,000 for CHSP, 5,000 for comprehensive assessment.

·  Recognise that there have been multiple issues with IT and Auskeys, encourage stakeholders to feedback and notify of any issues.

·  Demand and uptake of MAC is higher than anticipated:

§  Longer than expected wait times

§  Backlog of correspondence back to clients

§  Lower than expected volume of referrals to providers

·  Improvements have been in processes, refresher training for staff, increase in staff numbers and fixing system issues with enhancements.

·  Will improve communication process to include more webinars.

·  Wait Times and Backlogs are expected to decrease into late Sept.

·  Recognise that issues have limited number of and quality of referrals to providers.

·  MAC over referring to ACATs vs RAS, training has increase more balanced referrals to RASs

·  Service Providers had low take up rate in indicating they were ready. 19th of June only 10% of providers ready to receive referrals (ready meaning Aus keys and information about provider up to date). Currently late Aug 36% of providers were ready.

Fees Framework for CHSP/ General CHSP:

·  Approximately 250 Responses to Fees Policy consultation

·  No mandated fees schedule, decision made based upon feedback

·  Recognise the need to be flexible with fees to allow CHSP providers to move towards a nationally consistent over time.

·  Late September update on Fees Framework, possible discussion paper.

·  MDS requirements will change will to providers using the DSS Data Exchange (DEX), will have less data required. Webinars and face to face will demonstrate (DEX)

·  Providers will be finalising contracts for CHSP starting Nov 1 2015.

Home Care Packages:

·  Feb 17: Funding follow consumer not provider.

·  July 18: Integrate CHSP and Home Care

·  Current ACAR. Last ACAR subject to legislative changes

·  Feb 2017 changes:

o  Consultation and Engagement to support transition to include:

§  Informal non-DSS working group

§  Consultation/Discussion Paper October 2015

§  Consultation and information on future changes to My Age Care

§  Legislative Changes need to be passed in Early 2016 to support Feb 2017 changes

Primary Healthcare Advisory Group:

·  Health and Age Care interface needs to be more functional, coherent, benefits with consumer, focus on caring and less on red tape.

·  Will be making short, medium, long term recommendations.

·  Chronic Disease management and preventing major area for improvement

·  Scoping innovation methods including video consultations/telehealth

·  Need to engagement community to access services early,

·  Recognise there is variability of GPs who are proactive vs reactive in regards to Chronic Disease Management

·  Open to suggests should a new system be fee for services or be outcomes based.