Posted 12/05/2016 by Alex Grove
The Aged Care Roadmap (the Roadmap), released in April 2016 by aged care advisory body, the Aged Care Sector Committee (ACSC), has recommended significant aged care reforms over the next seven years. The Roadmap is intended to ‘generate discussion across the aged care sector and government regarding future reforms to aged care’. With the first four years of the Living Longer. Living Better aged care reforms now largely implemented in a bipartisan manner (with some notable exceptions such as workforce and dementia funding), there is growing interest in the next round of changes that may be ahead for aged care.
The ACSC advises the Australian Government on aged care policy and future reform, and acts as a forum for consultation between the aged care sector and the Government. It includes representatives from peak bodies, aged care providers, consumers and workforce as well as the Department of Health. The ACSC produced the Roadmap at the request of then Assistant Minister for Social Services, Mitch Fifield.
Key recommendations
The Roadmap is a detailed document, setting out actions the ACSC believes are required in the short, medium and long term across nine domains in order to achieve a ‘sustainable, consumer driven and market based system’ of aged care. It is not possible to list all of these in this FlagPost, but some of the key departures from the current system are summarised in Table 1.
Table 1. The current aged care system and key Roadmap recommendations for change
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Area
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Current situation
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Recommendation
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Eligibility for care
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Eligibility for aged care is assessed by Regional Assessment Services (RAS) and Aged Care Assessment Teams (ACAT). Government funding and care needs are determined in a number of ways, including by the provider of care.
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Create a single independent assessment pathway that assesses eligibility, care needs and maximum funding levels for each individual.
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Dementia programs
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Australian Government funds a wide variety of dementia programs including support services, workforce training, advocacy and research, which have recently been reviewed.
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Treat dementia as core business in aged care. Providers are to ensure individualised care is delivered by a skilled workforce. Government and providers to work together to improve care.
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Supply of places
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Australian Government caps the number of subsidised aged care places.
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Uncap supply.
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Allocation of places
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Subsidised home and residential care places are allocated to aged care providers, but home care packages will be allocated directly to consumers from 2017.
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Change to individualised funding that follows the consumer in residential care as well, with additional assistance or block funding for areas that do not have a sufficient market for services.
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Types of care
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Three types of aged care are subsidised under the Aged Care Act 1997 (the Act): residential care, home care and flexible care.
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Remove the distinction between home care and residential care to create a single aged care system.
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Home care funding
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Care in the home is provided by block funded home support services, as well as through individualised home care packages.
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Combine the two programs to form an integrated care at home programme.
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Provider regulation
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Aged care providers must seek approval to provide care under the Act.
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Change from approved providers to registered providers and make it easier for providers to enter the market through recognition of accreditation in related sectors (like disability).
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Cost regulation
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Government subsidies and consumer fees for aged care are tightly regulated.
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Cease regulation of prices and fees. Government funding to take into account the ‘market informed price’ as well as the individual’s capacity to pay for their own care.
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Means testing
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Home care fees are income tested, but residential care fees are income and asset tested (including part of the value of the family home in some circumstances).
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Means test all income and all assets and treat them equally. Develop home equity release and other financial products to allow consumers to use their assets more effectively.
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Source: Parliamentary Library analysis of the Aged Care Roadmap.
The above recommendations, if implemented, would be an extension of current reforms aimed at ‘transitioning aged care into a market-based, consumer-driven system’. Whether such as system can also be financially sustainable for government and consumers is likely to be a subject of ongoing debate.
Is this where we’re heading?
Many of the proposals in the Roadmap are not new, and the ACSC acknowledges it has built on the recommendations of the Productivity Commission’s (PC) 2011 report Caring for older Australians. For example, the PC recommended financial products to unlock equity in the home to pay for care, as well as uncapping the supply of subsidised aged care places.
The aged care sector has a strong interest in which parts of the Roadmap might be implemented by future governments. Although the Roadmap is not a government policy document, the Department of Health has been quoted as advising that ‘the Roadmap's final destination of a sustainable, consumer-driven and market-based system is a shared vision not only for government but also for other stakeholders’. Neither the Coalition nor Labor had responded to the Roadmap at the time of writing, and the aged care measures in the 2016–17 Budget did not provide an indication of the Government’s position.
Aged care policies released during the current election campaign may provide greater insight into whether the major parties intend to follow the Roadmap’s directions to further reform the aged care system.