Aged care’s wish list for 2017/18 Federal Budget

Aged care providers are hoping for no unpleasant surprises in the 2017/18 Federal Budget, which doesn’t seem too unreasonable given the Minister’s continued assurance there will be no major decisions about the future of ACFI without further consultation or before the legislative review is complete.

Thanks to journalists at The Australian, we already know there will be announcements about affordable housing measures, incentives for older Australians to downsize their homes and possible land releases to boost housing supply, as well as increased funding for training.

In pre-Budget submissions made by industry associations and providers earlier this year requests ranged from general funding stability to measures to increase affordable housing, expanded mental health services, a national approach to end elder abuse and a consumer awareness campaign about aged care.

In its pre-Budget statement statement (apparently not to be confused with a submission) COTA outlined a number of initiatives it wants for consumers spanning aged care, health and retirement incomes including:

– an independent, integrated, holistic Retirement Incomes Review comprising the age pension, superannuation, taxation, housing, and health and aged care costs
– increased government support allowances
– an Older Australians Mental Health Strategy linked to the national mental health plan
– residential care clients to able to access mental health services under the Better Access program
– development of an oral health strategy for older Australians
– a dental benefits schedule for older Australians
– an increase in Commonwealth Rent Assistance by 30% for the most vulnerable pensioners
– a national plan to increase supply of affordable, appropriate housing (also sought by Anglicare Australia)
– a legislated timetable for consumers to have control over funding for all aged care services
– a timetable for when funding will not be capped and made available to people at their assessed level of need
– a Consumer Support Platform
– development of a fair and sustainable pricing framework for aged care by 1 July 2018/
– improvements to My Aged Care
– a comprehensive national approach to ending elder abuse including law reform, response services and a program for attitudinal change

While most people were still on summer holidays ACSA was on the front foot with its submission, seeking:

– $2m for development of an industry-led aged care workforce strategy
– an aged care funding system that provides certainty and adequacy of funding for the future growth required, that is locked into future forward estimates
– additional transition assistance funding beyond the $53.3 committed last year, particularly for rural, remote and regional providers.
– continued commitment to funding announced last year to improve My Aged Care
– effective Department of Human Services systems relating to Medicare payments and Income and Asset Assessments
– continued grandfathering arrangements for regional providers receiving the viability supplement

The Aged Care Guild made it easy for the Government asking for just two core outcomes from the 2017/18 Budget:

  1. An approach that provides for a stable financial environment, where providers can make business decisions with confidence in the future of government policy and consumers can structure their affairs with confidence, with:
    – no cuts to aged care expenditure in 2017-18 Budget and the forward estimates
    – consideration of the sector’s capacity to source funds to build the additional beds and the instability caused by regular cuts, revisions to subsidies and incorrect/revised projections, and
    – recognition of the returns and investment required to grow the sector to meet future demand regardless of the source of funding.
  1. The development of a sustainable funding strategy, which is underpinned by increased consumer contributions to care funding and revisions to means testing arrangements.

Alzheimer’s Australia made a detailed submission for additional funding over the next three financial years to run education campaigns. These included:

– $3m per year over three years to educate Australians about brain health to reduce dementia risk

– $1m per year over three years to develop a consumer and carer based Quality in Dementia Care program for people with dementia receiving home care and residential care services

– $15m per year over three years for a dementia respite supplement to support dementia-specific respite services.

Meals on Wheels has attracted a lot of media attention for its funding submission, requesting a 2017-18 Commonwealth Home Support Programme budget allocation of $5 million additional recurrent base funding, plus CPI-linked indexation of existing funding, for Meals on Wheels services across Australia.

It also wants $300,000 Commonwealth Home Support Programme sector support funding, over two years, to the Australian Meals on Wheels Association.

In its submission the Australian Medical Association raised concerns about the increasingly complex care needs of older Australians.

While it represents the interests of doctors, the AMA’s influence as one of the most powerful associations in the country might finally convince the Government and Department that older Australians do actually have more complex care needs these days.

The AMA called on the Government to:

  • ensure that Medicare rebates for services provided by doctors and for services provided on their behalf by practice nurses reflect the time and complexity of providing palliative and medical care in the community;
  • ensure that Medicare rebates cover the time that doctors spend with the patient assessing and diagnosing their condition and providing medical care; with the patient’s family and carers to plan and manage the patient’s care and treatment; and organising and coordinating services for the patient; and
  • substantially increase funding for quality end of life care and nationally consistent palliative care services and advanced care planning in Australia.

It also called for a number of initiatives relating to indigenous health noting the gap in health and life expectancy between Aboriginal and Torres Strait Islander people and other Australians.

Anglicare Australia presented a very broad submission just about covering the full spectrum of Government portfolios. Specifically relevant to aged care and social services it recommended:

  • Funding for disability support, aged care and respite and support for carers to be based on need. The pricing formulas must factor in realistic wage costs that reflect the complexity of the work, allow scope for career development, and give time for the development of meaningful relationships.
  • Ensure higher standards for vocational education in care work and other human services, with competencies reviewed in partnership with high quality providers
  • Wellbeing indicators to be developed and then adopted as outcome measures in disability and aged care, as a matter of priority.
  • That Government evaluate the delivery of existing aged and disability services in terms of equity of access and outcomes, and that a part of that process be the development of wellbeing and quality of life indicators that reflect the experience of the people at the centre of the services.
  • That major reform of other social services not proceed until that comprehensive evaluation has been conducted and that it is clear who is best served by the new systems, what the quality of care and support is, who and where people are missing out, and the additional cost of that system failure.
  • That Government work with reputable locally connected community service organisations to commission, intelligently, the services and support that will meet the needs and grow the capacity of the communities they serve.
  • Invest in partnership programs that deliver wrap-around support, education and on-the-job training for people facing long-term unemployment
  • Restructure vocational education funding agreements to ensure outcomes for job seekers are the primary goal.
  • Establish an arms-length commission or tribunal – much like the Fair Pay or Remuneration commissions – that could independently assess the cost of living and determine or advise on an adequate income accordingly.
  • Superannuation payments should be made with government allowances. In particular superannuation contributions should be paid on the allowances that are effectively remuneration for “informal” caring responsibilities, the great majority of which are currently borne by women, and which contribute in excess of $60 billion to the Australian economy.
  • The Australian Government develops a national plan with industry, state governments and community providers to increase the supply of affordable housing.
  • A thorough, transparent, examination of the impact of capital gains tax and negative gearing rules on the housing market and that they be amended to bolster the supply of secure and affordable housing.
  • That the level of CRA be raised, taking into account both income levels and market rents across Australia.
  • The government adopts the Redfern Statement plan of action to resource Aboriginal and Torres Strait Island led-solutions as a matter of urgency.

While many other aged care providers and industry stakeholders made detailed submission, we think this overview will make for an interesting reference as the Budget is handed down tonight.

Inside Ageing will keep you informed as the Budget detail (not just the headlines) comes to light.


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