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RECOMMENDATIONS
Chapter 1
Recommendation 1: The Committee recommends that the commencement date for the aged care structural reforms be delayed until 1 January 1998.
Recommendation 2: The Committee recommends that it monitor the operation of the Aged Care Bill 1997 following its enactment and review the implementation of the aged care structural reforms 12 months after the commencement of the Bill.
Chapter 2
Recommendation 3: The Committee recommends that:
- if the Aged Care Bill 1997 is passed by the Parliament with the inclusion of accommodation bonds that the Committee's other recommendations contained in this report be implemented.
Recommendation 4: The Committee recommends that the level of accommodation bonds charged be monitored by the Aged Care Standards Agency.
Recommendation 5: The Committee recommends that in determining whether a person is a concessional resident:
- the requirement that a person has not owned a home during the preceding 2 years should be omitted; and
- the value of the person's principal place of residence should be disregarded for the purpose of the assets test.
Recommendation 6: The Committee recommends that the quota system for concessional residents be monitored to ensure equality of access for financially disadvantaged people, particularly to aged care facilities within the prospective residents' locality.
Recommendation 7: The Committee recommends that the concessional resident supplement be substantially increased to a level that will provide for the necessary capital injection to maintain appropriately high standards of accommodation in aged care facilities.
Recommendation 8: The Committee recommends that the Government ensure equality of access to aged care facilities is provided for all aged people and that the provision of aged care services not be left to the vagaries of a market user-pays system.
Recommendation 9: The Committee recommends that funding for the $10 million capital grants program directed to rural and remote areas and for financially disadvantaged people be substantially increased.
Recommendation 10: The Committee recommends that the Government monitor the impact of the proposed funding changes to hostels, especially in relation to the financial viability of hostels; and that capital funding be provided to hostels that cater for a high proportion of financially disadvantaged residents.
Recommendation 11: The Committee recommends that the Government provide appropriate funding for the Home and Community Care program and other community services and housing programs to address the needs of financially disadvantaged Hostel Care level residents that may be affected by the withdrawal of Hostel Care level subsidies.
Chapter 3
Recommendation 12: The Committee recommends that the User Rights Principles be embodied in the principal legislation.
Recommendation 13: The Committee recommends that:
- an independent complaints mechanism be established as a matter of priority to deal with complaints made by older people or their representatives about aged care facilities;
- in formulating the model for such a mechanism, the Quality Assurance Working Group take into account the comments made by organisations and groups referred to in this chapter to enhance the functioning of the complaints mechanism; and
- the complaints mechanism be independent of all stakeholders, including the Department of Health and Family Services.
Recommendation 14: The Committee recommends that the independent complaints body be given the powers necessary to deal with disputes expeditiously and effectively.
Recommendation 15: The Committee recommends that the role of advocates and advocacy services be encouraged and expanded and that advocacy services be supported by guarantees of recurrent funding sufficient for the services to fulfil their role and responsibilities.
Recommendation 16: The Committee recommends that implied contractual terms be incorporated in all residential care agreements; and that these implied terms relate to national standards of care and that any breach be legally enforceable.
Recommendation 17: The Committee recommends the development of standard form agreements that outline the implied terms and a model agreement that incorporates fundamental rights.
Chapter 4
Recommendation 18: The Committee recommends that nursing homes continue to be required to acquit that proportion of their funding expended on nursing and personal care.
Recommendation 19: The Committee recommends that the accreditation standards and quality assurance system provide for the employment of appropriately skilled and trained nursing staff to ensure that quality of care is maintained in aged care facilities.
Recommendation 20: The Committee recommends that the Aged Care Standards Agency monitor the ratio of trained nursing staff per resident in nursing homes through a transparent reporting procedure which would signal significant change in the ratio.
Recommendation 21: The Committee recommends that the Aged Care Standards Agency be established with the necessary investigative powers to ensure that the quality of care and rights of residents are maintained and protected.
Recommendation 22: The Committee recommends that the Aged Care Standards Agency have monitoring and enforcement mechanisms in place to ensure industry compliance with care standards and be funded to meet those objectives.
Chapter 5
Recommendation 23: The Committee recommends that the requirement for prudential arrangements relating to accommodation bonds, as contained in the User Rights Principles, should be incorporated into the principal legislation.
Recommendation 24: The Committee recommends that the prudential arrangements should:
(i) provide an unconditional assurance that the balance of the accommodation bond is able to be refunded in accordance with the provisions of the Aged Care Bill 1997 when enacted;
(ii) be able to be complied with at the least cost to providers as possible, so as to ensure that as much of the amount received by way of accommodation bonds can be used for the intended purpose of capital improvement;
(iii) be mandatory for all providers of aged care who receive accommodation bonds, subject to the recommendation in respect of church run and church associated facilities;
(iv) be reasonably straightforward and easily understood by residents and their families; and
(v) be in place at the commencement date of the Aged Care Bill 1997.
Recommendation 25: The Committee recommends that while a blanket exemption for church run or church associated facilities is not appropriate, exemptions should be permitted for these facilities in certain circumstances. The relationship between each church-based facility and the relevant church will need to be considered to ensure that the facility is properly backed by the church before any exemption from the prudential arrangements is granted.
Recommendation 26: The Committee recommends that a review of the prudential arrangements including the mechanism for granting exemptions should be undertaken every 12 months for the first 4 years. The review should incorporate an actuarial assessment of claims records.
Chapter 6
Recommendation 27: The Committee recommends that further consideration of the implications of the transfer of responsibility to the States and Territories on the provision of aged care services needs to be undertaken by all parties involved before the transfer is to occur.
Recommendation 28: The Committee recommends that before any transfer of responsibility occurs it needs to be demonstrated that improved outcomes for providers, residents and staff will result from such a transfer, and that adequate protection for all parties involved has been put in place. In addition, there needs to be certainty that transferred funds will be used for aged care services and not diverted to alternative programs.
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