Bills Digest No.
27, 2020–21
PDF version [624KB]
Alex Grove
Social Policy Section
18
November 2020
Contents
Purpose of the Bill
Background
Committee consideration
Policy position of non-government
parties/independents
Position of major interest groups
Financial implications
Statement of Compatibility with Human
Rights
Key issues and provisions
Concluding comments
Date introduced: 21
October 2020
House: House of
Representatives
Portfolio: Health
Commencement: The
later of 1 March 2021 or the day after Royal Assent
Links: The links to the Bill,
its Explanatory Memorandum and second reading speech can be found on the
Bill’s home page, or through the Australian
Parliament website.
When Bills have been passed and have received Royal Assent,
they become Acts, which can be found at the Federal Register of Legislation
website.
All hyperlinks in this Bills Digest are correct as
at November 2020.
Purpose of
the Bill
The purpose of the Aged Care Amendment (Aged Care
Recipient Classification) Bill 2020 (the Bill) is to amend the Aged Care Act 1997
(the Act) to:
- provide
for an alternate system to classify aged care residents into categories. This
will operate alongside the existing classification scheme which will continue
to be used for funding purposes and
- allow
independent assessors to assess residents under this alternate system.
Background
The aged care system supports older people who can no
longer live without assistance in their own homes. Care is provided in people’s
homes, in the community and in aged care homes by a range of not-for-profit,
for-profit and government providers. The Australian Government is the primary
funder and regulator of the aged care system.[1]
Residential aged care is provided in aged care homes on a
permanent or respite (short-term) basis. Services include personal care,
accommodation, laundry and meals, nursing and some allied health services.[2]
Residential aged care is funded by both the Australian
Government and by contributions from residents. The Australian Government pays subsidies
and supplements to approved providers for each resident receiving care under
the Act. In 2018–19, the Australian Government paid $13.0
billion in subsidies and supplements to residential aged care providers. The
majority of this, $12.0 billion or 91.8 per cent, was for the basic subsidy for
permanent residents.[3]
Aged Care Funding Instrument (ACFI)
The basic subsidy for each permanent resident is
calculated using the Aged Care Funding Instrument (ACFI). The ACFI is a tool
used by the provider to assess the care needs of the resident. The ACFI
consists of twelve questions about a resident’s care needs, and two diagnostic
sections (for medical conditions). The answers determine funding across three
domains: Activities of Daily Living (ADL) such as eating, walking
or toileting; Behaviour (BEH) such as wandering, challenging
behaviour, cognitive ability and depression; and Complex Health Care
(CHC) which includes the need for assistance with medication and the need for
ongoing health care procedures. For each domain, a resident’s needs may be
assessed as nil, low, medium or high. The basic subsidy is the sum of the
amount payable in each domain (that is, ADL + BEH + CHC).[4]
For example, as at 20 September 2020, a permanent resident rated ‘high’ on
all three domains would attract a basic daily subsidy of $223.14 ($115.49 +
$37.81 + $69.84).[5]
The ACFI has been a source of controversy, and proposals
for change, for some years. In the Mid-Year Economic and
Fiscal Outlook 2015–16 (MYEFO) and the 2016–17 Budget, the Government made changes to ACFI scoring and
funding due to concerns about higher than expected growth in ACFI
expenditure, particularly in the CHC domain.[6]
The Government argued that the growth in claims could not be explained by an
increase in the frailty of residents, and that some providers were claiming
using ‘sharp practices’ to maximise revenue.[7]
The ACFI savings measures were criticised by aged care providers and unions,
who expressed concerns about ‘the impact of the savings on the quality of care,
staffing levels and service viability’.[8]
The Aged Care Financing Authority (ACFA),
which advises the Government on aged care funding, has outlined a number of
issues with the ACFI. These include fluctuating funding cycles, administrative
burden and perverse incentives:
The Aged Care Funding Instrument (ACFI) has not provided a
stable and effective funding tool for both the Government and providers. Under
ACFI there have been cycles of high growth in payments to providers, followed
by periods of no growth, causing uncertainty for providers, investors and the
Government. ACFI is also administratively complex for both providers and the
Government and has resulted in the sector diverting resources away from
delivering care. In particular, ACFI has perverse incentives that may encourage
outdated modes and types of care and lead to inefficiencies and providers
focusing on maximising ACFI claiming rather than on the needs of residents.[9]
Options for a new
funding model
In the 2016–17
Budget, the Government also announced that it would further consult
with the sector on future options for determining aged care funding, including
the possibility of having funding assessments done by an independent party
rather than providers.[10]
To this end, the Government commissioned two scoping reports in 2017.
Revised ACFI model
The 2017 Review of the Aged Care Funding Instrument
was undertaken by Applied Aged Care Solutions (AACS) to examine options for
redesigning the ACFI to increase sustainability and predictability of funding.[11]
It recommended a Revised Aged Care Funding Instrument (R-ACFI) with changes to
the existing three domains, as well as the addition of a fourth domain to fund
physical therapy.[12]
The Government does not appear to be pursuing the proposed R-ACFI model.
The AACS review also recommended that external assessors
should be trialled for residential aged care funding.[13]
Similarly, the broader Legislated Review of Aged Care 2017 (which did
not specifically review the ACFI) recommended that independent assessors should
be used to reduce the risk of a conflict of interest.[14]
Australian Health Services Research
Institute model
The other commissioned scoping report was the Alternative
Aged Care Assessment, Classification System and Funding Models: Final Report
by the Australian Health Services Research Institute (AHSRI) at the University
of Wollongong. AHSRI examined five options for residential aged care funding,
and recommended a blended funding model taking into account both fixed and
variable costs associated with delivering care:
This option recognises the fixed and variable costs of
delivering care. The two main elements of this model are standard per diem or
fixed payments to cover the cost of ensuring capacity within the facility and
the variable payment to cover the costs of individualised care for residents.
Both the fixed and variable payments under this model would be determined by a
costing study.[15]
Following on from this recommendation, the Government
commissioned AHSRI to undertake a research study to examine costs and cost
drivers in residential aged care, to create a new funding model, and to develop
an assessment tool for use by external assessors.[16]
This national study was called the Resource Utilisation and
Classification Study (RUCS), and was undertaken during 2018.[17] The
primary output of the RUCS study was ‘a new, fit-for-purpose casemix
classification for the Australian residential aged care sector’.[18]
A casemix classification, frequently used in hospital funding, is ‘a consistent
method of classifying types of patients, their treatment and associated costs’.[19]
Australian National Aged Care
Classification (AN-ACC)
The new classification system recommended in the RUCS
study is called the Australian National Aged Care Classification (AN-ACC). The
AN-ACC is based on the separation of resident assessment for funding purposes
and assessment for care planning purposes, with:
- assessment
for funding done by external independent assessors and
- assessment
for care planning done by the aged care facility.
Under the AN-ACC, care funding for each resident is made up
of:
- a
fixed amount per day which will be the same for all residents in a facility
(but may vary between facilities) plus
- a
variable amount for each resident, determined by the cost of their
individualised care and based on their AN-ACC casemix class plus
- a
one off adjustment payment for each new resident when they first enter care.[20]
For the variable funding component, a series of assessment
tools are used to sort residents into one of thirteen classes as shown below.
Each class contains residents with similar needs:
Class 1 Admit for palliative care
Class 2 Independent without compounding factors (CF)
Class 3 Independent with CF
Class 4 Assisted mobility, high cognition, without CF
Class 5 Assisted mobility, high cognition, with CF
Class 6 Assisted mobility, medium cognition, without CF
Class 7 Assisted mobility, medium cognition, with CF
Class 8 Assisted mobility, low cognition
Class 9 Not mobile, higher function, without CF
Class 10 Not mobile, higher function, with CF
Class 11 Not mobile, lower function, lower pressure sore risk
Class 12 Not mobile, lower function, higher pressure sore
risk, without CF
Class 13 Not mobile, lower function, higher pressure sore
risk, with CF.[21]
New residents requiring palliative care are automatically
placed in Class 1. Other residents are classified according to their mobility,
and then again according to factors such as cognitive ability, function and
pressure sore risk, and ‘compounding factors’.[22]
Different compounding factors are considered for different classes. CFs include
activities of daily living, palliative function, functional motor and cognitive
independence, daily injections, behaviour, risk of pressure sores, frailty,
falls, complex wound management and obesity.[23]
Funding under the AN-ACC is calculated using a base unit
of price called the National Weighted Activity Unit (NWAU).[24]
Funding is expressed in multiples of the NWAU for different facility types,
resident classes and the one-off adjustment payment for new residents, as shown
in the table below:
Source: DoH, ‘Resource utilisation and classification study – revised
tables’, DoH website.
It can be seen that for the fixed funding component per
resident (which is the same for all residents within a facility), Indigenous
services in very remote areas would receiving the highest amount, and services
not in remote areas nor catering to homeless clients would receive the lowest
amount.
For the variable funding component, residents in Class 2
(independently mobile without compounding factors) would attract the lowest
funding, and residents in Class 1 (admitted for palliative care) and Class 13
(not mobile, lower function, higher pressure sore risk with compounding
factors) would attract the highest funding.
AHSRI notes that the NWAU price is a policy decision for
government. It could be set at a level that would be cost neutral overall
compared to the current system, or it could be set for funding growth.[25]
AHSRI recommends that an annual national costing study should be undertaken to
determine the following year’s NWAU (similar to the work done by the Independent
Hospital Pricing Authority to determine the National Efficient Price for
hospital funding).[26]
Consultation and trial
The Government has consulted extensively on the AN-ACC through
stakeholder forums, an industry reference group, a consultation paper, and now
a stakeholder working group.[27]
The Prime Minister announced $4.6 million in funding for a
trial of the AN-ACC on 10 February 2019.[28]
The purpose of the trial was:
- to
collect data to validate the expected distribution of care recipient
classifications under the AN-ACC and
- to
field test the performance of
- the
AN-ACC assessment tool
- an
independent assessment workforce trained to administer the tool and
- the
training, clinical and IT supports for assessors.[29]
The trial was initially scheduled to run until June 2020,
but concluded early in April 2020 due to the impact of the COVID-19 pandemic on
aged care homes. Sixty registered nurses, occupational therapists and
physiotherapists from four contracted organisations were trained to undertake
AN-ACC assessments in a two-day course. During the trial, these assessors
completed 7,387
AN-ACC resident assessments across 122 nursing homes. [30]
The distribution of residents between the AN-ACC classes
in the trial was similar to that found in the RUCS study. In both, Class 5
(assisted mobility, higher cognitive ability, with compounding factors) was the
most common classification, with more than 20 per cent of residents assigned to
this class.[31]
The trial also found:
- assessors
can complete an average of six assessments per working day
- a
suitably qualified and experienced independent assessment workforce can be
readily contracted to undertake AN-ACC assessments and
- the
training and clinical supports were effective, but could be improved by
increasing the length of training to three days.[32]
Shadow assessments
The 2020–21 Budget included funding of $91.6 million to
support the potential implementation of the AN-ACC funding model. As well as
payment and IT system modifications, this includes funding for one year of
‘shadow assessment’ starting in 2021:
During this year of shadow assessment, all residents will be
assessed by an independent assessor using the AN-ACC assessment tools though
funding will continue to be provided through the existing Aged Care Funding
Instrument during this period.[33]
The Government will continue to consult on the AN-ACC. A
final decision on the AN-ACC and an ongoing assessment workforce has not been
taken.[34]
The Government is progressing work on this new funding model as it prepares to
respond to the recommendations of the Royal Commission into Aged Care Quality
and Safety (the Royal Commission), which is due to hand down its final report
by 26 February 2021.[35]
Counsel Assisting the Royal Commission recently proposed
an extensive set of recommendations for aged care reform. This included a
proposed recommendation to move to a casemix classification system in
residential aged care, such as the AN-ACC, by 1 July 2022:
By 1 July 2022, the Australian Government should fund
approved service providers for delivering residential aged care through a
casemix classification system, such as the Australian National Aged Care
Classification (AN-ACC) model. The classification system should take into
account the above recommendations for high quality aged care. Ongoing
evidence-based reviews should be conducted thereafter to refine the model
iteratively, for the purpose of ensuring that the model accurate classification
and funding to meet assessed needs.[36]
The Bill does not implement the AN-ACC nor make changes to
aged care funding under the ACFI. Rather, the Bill provides for an alternate
system of classification to operate alongside the ACFI (with details of the
alternate system to be specified in subordinate legislation). The Bill also
provides for the delegation of powers to assessors to assess residents under
this alternate system (the so-called shadow assessments described above).
The Government will use the data from these shadow
assessments to ‘ensure that individuals, care workers, providers and the
government all have the information they need to fully understand the new
funding model’.[37]
Committee
consideration
Senate Community Affairs
Legislation Committee
The Bill was referred to the Senate Community Affairs
Legislation Committee for inquiry and report by 2 December 2020. Details of the
inquiry are at the inquiry
homepage.
Senate Standing Committee for the
Scrutiny of Bills
The Senate Standing Committee for the Scrutiny of Bills
(Scrutiny of Bills Committee) expressed concern about the assessment (proposed
section 29C-3) and classification (proposed section 29C-2) of
residents by the Secretary (or delegate). The Committee questioned why the
details of the process to be followed in assessing and classifying residents
were to be left to delegated legislation.[38]
The Committee also expressed concerns about Item 11, which allows the
Secretary to delegate their powers to assess care recipients to a person who
satisfies the criteria specified in the Classification Principles. The
Committee questioned why this delegation is considered necessary, and why the
criteria are to be set out in delegated legislation.[39]
The Scrutiny of Bills Committee requested further advice
as to how the computerised decision-making provided for in proposed section
29C-8 will operate to classify care recipients.[40]
The Committee also expressed concern about the protection of resident’s private
information contained in a care assessment made under proposed section 29C-3.
The Committee accepted that the disclosure of such information for the
purpose of providing care or assessing needs appeared reasonable, but
questioned whether the disclosure of such information for the purposes of
monitoring, reporting on and conducting research into aged care, or assessing
the level of need in the community, was appropriate.[41]
Policy
position of non-government parties/independents
At the time of writing, no comments by non-government
parties or independents specifically on the Bill had been identified.
Position of
major interest groups
At the time of writing, no stakeholder comment
specifically relating to the Bill had been identified.
Many key aged care stakeholders are represented on the
Department of Health’s Residential Aged Care Funding Reform Working Group,
which is considering issues related to the AN-ACC.[42]
Some stakeholders have also commented on the proposed
AN-ACC model through submissions to the Department of Health’s consultation
paper or to the Royal Commission. In 2019, aged care provider peak bodies
Leading Age Services Australia and Aged & Community Services Australia both
supported the trial of the AN-ACC, but called for more information on the pricing
of the NWAU in the model, which would allow providers to estimate how much
funding they would receive under the new model.[43]
The Combined Pensioners and Superannuants Association of
NSW (CPSA) submitted to the Royal Commission in 2020 that it supported ‘the
ongoing development of the AN-ACC as an alternative to the ACFI’.[44]
National Seniors Australia also submitted that it generally supported the
AN-ACC funding model, including the use of independent assessors.[45]
Dementia Australia has expressed support for the AN-ACC
model, while noting that it needs to be funded sufficiently to provide for
best-practice models of care.[46]
Palliative Care Australia (PCA) has expressed concern that the AN-ACC ‘takes a
narrow view of palliative care and does not allow people to be assessed as
eligible for the only palliative care classification after admission’. PCA has
called for a small study to be undertaken to ensure that the model caters for
palliative care needs.[47]
The Australian Nursing and Midwifery Federation supports the implementation of
the AN-ACC, including independent assessments.[48]
Financial
implications
The Bill has no financial impact.[49]
Statement of Compatibility with Human Rights
As required under Part 3 of the Human Rights
(Parliamentary Scrutiny) Act 2011 (Cth), the Government has assessed
the Bill’s compatibility with the human rights and freedoms recognised or
declared in the international instruments listed in section 3 of that Act. The
Government considers that the Bill is compatible. The Government considers that
the Bill promotes the right to an adequate standard of living and the right to
health, because the new classification scheme aims to more accurately classify
care recipients in order to ‘better target the level of care required to meet
their needs’.[50]
Parliamentary Joint Committee on
Human Rights
The Parliamentary Joint Committee on Human Rights had no
comment in relation to the Bill.[51]
Key issues
and provisions
Residential aged care recipients are classified under the
ACFI according to the process set out in Part 2.4 of the Act. An appraisal of
the level of care required is made by the approved provider under section 25-3
of the Act, according to the procedures specified in the Classification Principles 2014
(the Classification Principles). Section 25-1 of the Act provides that if the
Secretary receives an appraisal made under section 25-3, the Secretary (or
delegate) must classify the resident according to the level of care they need. The
Classification Principles may specify the method the Secretary must follow.
The Bill does not amend Part 2.4 of the Act. This means
that the current system of classification using the ACFI will continue. Rather,
the Bill provides for an alternate system of classification which will not be
used for funding purposes, unless further legislation is introduced.
Classification and assessment of
care recipients
Item 3 of the Bill inserts proposed Part 2.4A
into the Act to provide for classification of care recipients on the
Secretary’s initiative. Within new Part 2.4A, proposed section 29C-1
provides that such classification applies to approved recipients of residential
care, and some types of flexible care (with the types of flexible care to be
specified in the Classification Principles).[52]
Proposed section 29C-2 provides that the Secretary
(or delegate) may classify a recipient for respite (temporary) or non-respite
care according to the level of care they need, relative to other care
recipients.[53]
The recipient may only be classified if their care needs have been assessed
under proposed section 29C-3. The Classification Principles may specify
the methods or procedures the Secretary (or delegate) must follow in
determining the appropriate classification level for the recipient.[54]
The Secretary (or delegate) must take into account the assessment under proposed
section 29C-3, as well as any other matters specified in the Classification
Principles.[55]
The Secretary (or delegate) must notify the care recipient and their approved
provider of matters including the classification and the day it takes effect.[56]
Proposed section 29C-3 provides that the Secretary
(or delegate) may assess the level of care needed by a care recipient, in order
to classify them, reclassify them, or to decide whether to reclassify them.[57]
The Classification Principles may specify the procedures to be followed in
making the assessment.[58]
If the care recipient has been approved for respite care under Part 2.3 of the
Act, and the circumstances specified in the Classification Principles apply,
then the Aged Care Assessment Team (ACAT) assessment made under section 22-4 of
the Act is taken to be an assessment of the level of care required, and the
assessment is taken to have been made for the purposes of classifying the care
recipient under proposed Part 2.4A.[59]
Proposed section 29C-4 provides that a care
recipient may have both a non-respite and a respite classification at the same
time.
Proposed section 29C-5 provides that the
Classification Principles may set out the classification levels under proposed
Part 2.4A, may specify the criteria for determining which level applies to
each recipient, and may set out different classification levels for respite and
non-respite care.
Proposed section 29C-6 provides that the
Classification Principles may exclude a class of care recipients from
classification under proposed Part 2.4A. Unfortunately the Explanatory
Memorandum to the Bill does not provide any examples of the circumstances in
which this might occur.
Proposed section 29C-7 provides that if a person
ceases to be a care recipient under proposed Part 2.4A, their
classification is not in effect, but that if they become such a care recipient
again, their classification continues from that time.
Proposed section 29C-8 provides that the Secretary
(or delegate) may use computer programs to make decisions on the classification
of care recipients under proposed Part 2.4A. The decision of the
computer program is taken to be a decision made by the Secretary, and the
Secretary (or delegate) may substitute a decision if satisfied that the
computer program’s decision is incorrect.[60]
Proposed section 29D-1 provides that the Secretary
(or delegate) may reclassify a care recipient if:
- the
approved provider of the care requests a reclassification in writing[61]
and
- the
Secretary is satisfied that the care recipient’s care needs have changed
significantly (according to any criteria set out in the Classification
Principles).[62]
Proposed section 29E-1 provides that the Secretary
(or delegate) must change a classification under this Part if satisfied that
either:
- the
assessment of the level of care was incorrect or inaccurate or
- the
classification was incorrect for any other reason.[63]
Before changing the classification, the Secretary (or
delegate) must review it, having regard to any relevant material on which the
classification was based, any matters specified in the Classification
Principles, and any other relevant material.[64]
If the Secretary (or delegate) changes the classification, the changes take
effect on the same day that the original classification took effect.[65]
Proposed section 29F-1 provides that, unless
expressly provided otherwise, a classification or classification level under proposed
Part 2.4A does not have effect for the purposes of:
- the
Aged Care Act (other than proposed Part 2.4A and one other
paragraph dealing with the transfer of records between providers)
- any
legislative instrument under the Aged Care Act (other than
Classification Principles as they relate to this Part)
- the
Aged Care
(Transitional Provisions) Act 1997 (the Transitional Provisions Act)
and associated legislative instruments or[66]
- any
other law of the Commonwealth.
It further specifies that a classification level under proposed
Part 2.4A cannot affect any subsidy paid to a provider under Chapter 3 of
the Aged Care Act or Chapter 3 of the Transitional Provisions Act
(such as the basic subsidy), nor can it affect any fees that the approved
provider charges a care recipient.
Item 5 provides that decisions of the Secretary (or
delegate) under proposed Part 2.4A to classify, not reclassify or change
the classification of a care recipient are reviewable decisions.
Requirements relating to delegates
making assessments
Approved aged care providers have responsibilities relating
to accountability for the aged care they provide.[67]
Item 4 of the Bill amends the Act to provide that they must allow
delegates of the Secretary to access the service to assess the care needs of
residents under proposed section 29C‑3.
Item 11 of the Bill provides that the Secretary
may, in writing, delegate their powers and function to assess care recipients
under proposed section 29C-3 to a person who satisfies the criteria
specified in the Classification Principles. This could include requirements
relating to ‘professional qualifications, demonstrated experience,
role-specific training and other formal credentials required of a delegate’.[68]
Item 12 of the Bill inserts proposed section
96-2A, which provides that these assessor delegates must be issued with a
photographic identity card, which they must carry and show on request. Failure
by such an assessor to return the card within 14 days of ceasing to be a
delegate (unless the card is lost or destroyed), is an offence of strict
liability carrying a penalty of one penalty unit ($222).[69]
Concluding comments
The Bill provides for an
alternate system for classifying aged care residents. It will operate alongside
the current ACFI system, without making any changes to residential aged care
funding. This should allow the Government and providers to gain more
information on how the proposed AN-ACC system will operate, prior to a final
decision being made on whether to switch to the AN‑ACC for funding
purposes. It also positions the Government to quickly respond to the final
report of the Royal Commission, due in February next year.
[1]. A
Grove, Aged
care: a quick guide, Research paper series, 2018–19, Parliamentary
Library, Canberra, updated 5 June 2019,
p. 1.
[2]. Australian Government, ‘What aged care homes provide’, My Aged
Care website.
[3]. Department of Health (DoH), Report on the operation of the Aged Care Act 1997, 2017–18, DoH, Canberra, 2019, p. 89.
[4]. DoH, ‘The Aged Care Funding Instrument (ACFI)’,
DoH website, last updated 23 April 2020; DoH, Aged Care Funding Instrument (ACFI): user guide, DoH, Canberra, 2016, p. 13.
[5]. DoH, Aged
care subsidies and supplements: new rates of daily payments from 20 September
2020, DoH, Canberra, 2020,
p. 3.
[6]. A Grove and A Dunkley, ‘Aged care’, Budget review 2016–17, Research
paper, 2015–16, Parliamentary Library, Canberra,
4 May 2016, p. 55.
[7]. A Grove, ‘Residential aged care funding: recent developments’, FlagPost, Parliamentary Library blog, 20 March 2017.
[8]. Ibid.
[9]. Aged Care Financing Authority (ACFA), Attributes for sustainable aged care: a funding and financing
perspective, ACFA, October 2019, p. 14.
[10]. DoH, Aged care provider funding – further revision of the Aged Care Funding
Instrument, Health Budget 2016–17 fact sheet, DoH,
3 May 2016.
[11]. R Rosewarne, J Opie, R Cumpston et al, Review of the Aged Care Funding Instrument: part 1: summary report, Applied Aged Care Solutions, [Melbourne], June 2017, p. 15.
[12]. Ibid., p. 49.
[13]. Ibid., p. 58.
[14]. D Tune, Legislated review
of aged care 2017, DoH, Canberra, 2017, pp. 140–141.
[15]. J McNamee, C Poulos, H Seraji et al, Alternative
aged care assessment, classification system and funding models: final report,
Centre for Health Service Development, Australian Health Services Research
Institute, University of Wollongong (UoW), [Wollongong], February 2017, p. 10.
[16]. DoH, ‘Residential aged care funding reform’, DoH
website, last updated 7 October 2020.
[17]. K Eagar, J McNamee, R Gordon et al, AN-ACC: a
national classification and funding model for residential aged care: synthesis
and consolidated recommendations. The resource utilisation and classification study:
report 6, Australian Health Services Research Institute, UoW,
[Wollongong], February 2019.
[18]. Ibid., p. 5.
[19]. UoW, ‘National Casemix and Classification Centre’, UoW website.
[20]. Eagar et al, AN-ACC,
op. cit., pp. 1–2.
[21]. Ibid., p. 6.
[22]. Ibid., p. 25.
[23]. K Eagar, J McNamee, R Gordon et al, The Australian
National Aged Care Classification (AN-ACC). The resource utilisation and classification
study: report 1, Australian Health Services Research Institute, UoW,
[Wollongong], February 2019, p. 37.
[24]. Eagar et al, AN-ACC,
op. cit., p. 11.
[25]. Ibid.,
p. 18.
[26]. Ibid.,
p. 20.
[27]. DoH, ‘Residential aged care funding reform’, op.
cit.
[28]. S
Morrison (Prime Minister), G Hunt (Minister for Health) and K Wyatt (Minister
for Senior Australians and Aged Care), New
$662 million aged care package to support older Australians, media
release, 10 February 2019.
[29]. DoH,
Report
on the trial of the Australian National Aged Care Classification (AN-ACC),
DoH, Canberra, August 2020, p. 2.
[30]. Ibid.,
pp. 2–3.
[31]. Ibid.,
p. 4.
[32]. Ibid.,
p. 7.
[33]. DoH,
Budget
2020–21: stakeholder pack, DoH, Canberra, 6 October 2020, p. 90.
[34]. Ibid.
[35]. Royal Commission into Aged Care
Quality and Safety homepage.
[36]. Royal
Commission into Aged Care Quality and Safety, Counsel
Assisting’s final submissions: proposed recommendations,
22 October 2020, p. 68.
[37]. D
Tehan, ‘Second
reading speech: Aged Care Amendment (Aged Care Recipient Classification) Bill
2020’, House of Representatives, Debates, (proof), 21 October 2020,
p. 6.
[38]. Senate
Standing Committee for the Scrutiny of Bills, Scrutiny
Digest, 15, 2020, The Senate, Canberra, 11 November 2020, pp. 1–3.
[39]. Ibid.,
pp. 3–4.
[40]. Ibid.,
p. 5.
[41]. The
amendments relating to privacy are items 7–9 of the Bill. Ibid., p. 6.
[42]. DoH,
‘Residential
Aged Care (RAC) Funding Reform Working Group’, DoH website, last updated 22
January 2020.
[43]. N Egan, ‘Calls for more transparency around new funding model’, Australian Ageing Agenda website, 6 June 2019.
[44]. Royal
Commission into Aged Care Quality and Safety, Statement
of Paul Versteege, Policy Manager, Combined Pensioners and Superannuants
Association of NSW, 30 June 2020.
[45]. National
Seniors Australia, Policy
development from the base up, Response to Royal Commission into Aged
Care Quality and Safety: Consultation Paper 2: Financing Aged Care, 2020, p. 7.
[46]. Dementia
Australia, Proposal
for a new residential aged care funding model: a response from Dementia
Australia, [review by the DoH of the current residential aged care
funding model], May 2019, pp. 3, 5.
[47]. Palliative
Care Australia, Submission
to the Royal Commission into Aged Care Quality and Safety, 2019, p. 30.
[48]. Australian
Nursing and Midwifery Federation, Submission,
Royal Commission into Aged Care Quality and Safety, 9 September 2019,
p. 25.
[49]. Explanatory
Memorandum, Aged Care Amendment (Aged Care Recipient Classification) Bill
2020, p. 1.
[50]. The
Statement of Compatibility with Human Rights can be found at pages 2–3 of the Explanatory
Memorandum to the Bill.
[51]. Parliamentary
Joint Committee on Human Rights, Human
rights scrutiny report, 13, 2020, 13 November 2020, p. 18.
[52]. Flexible
care caters for older people who need a different type of care than is offered
by mainstream home and residential services. For details see: Grove, Aged
care: a quick guide, op. cit.
[53]. Aged
Care Act 1997, subsection 96-2(1) provides that the Secretary may, in
writing, delegate all or any of the powers and functions of the Secretary under
the Act, the regulations or any Principles made under section 96-1 to a person
engaged by an Agency (within the meaning of the Public Service Act
1999) or an authority of the Commonwealth.
[54]. Aged
Care Act, proposed subsection 29C-2(3).
[55]. Aged
Care Act, proposed subsection 29C-2(4).
[56]. Aged
Care Act, proposed subsection 29C-2(5).
[57]. Aged
Care Act, proposed subsection 29C-3(1).
[58]. Aged
Care Act, proposed subsection 29C-3(2).
[59]. Aged
Care Act, proposed subsection 29C-3(3).
[60]. These
provisions are similar to section 23B-4 of the Act, which provides for the
Secretary (or delegate) to use computer programs to make decisions about
placing people on the home care waiting list (formally known as the national
prioritisation queue). For a discussion of issues raised by computerised
decision making, see C Petrie, Agriculture
Legislation Amendment (Streamlining Administration) Bill 2019, Bills
digest, 77, 2019–20, 4 February 2020, pp. 2—5.
[61]. Aged
Care Act, proposed subsection 29D-1(1).
[62]. Aged
Care Act, proposed subsections 29D-1(2) and (3).
[63]. Aged
Care Act, proposed subsection 29E-1(1).
[64]. Aged
Care Act, proposed subsection 29E-1(3).
[65]. Aged
Care Act, proposed subsection 29E-1(4).
[66]. The
Aged Care
(Transitional Provisions) Act 1997 sets out grandfathering
arrangements for people who have been receiving care continuously since before
1 July 2014.
[67]. Aged
Care Act 1997, section 63-1.
[68]. Explanatory
Memorandum, op. cit., p. 11.
[69]. See
section 4AA of the Crimes
Act 1914 (Cth) and the Notice of Indexation
of the Penalty Unit Amount.
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