Chapter 3
Aged Care Funding Instrument (ACFI) Appraisal
3.1
The current wording of the section in the legislation requires that a substantial
number of appraisals must be involved before invoking the Secretary’s powers to
suspend providers from making ACFI appraisals
3.2
The proposed change is to remove the words 'substantial number'.
3.3
The Coalition is concerned that the proposed change to remove the
wording “... substantial number ..." will provide greater opportunity
for the Secretary of the Department of Health and Ageing to suspend an Approved
Provider based on any false, misleading or inaccurate information.
3.4
It is our contention that the current wording provides sufficient scope
and capacity for the Secretary of DoHA to take necessary action in any
situation where such intervention is required.
3.5
Our position on this issue is supported by evidence from, Dr Lucy Morris
from ACSWA, who gave the following evidence during the hearing in Perth:
But now with the proposed removal of the word 'substantial'
it means that you can make one mistake and get pinged for it, whereas the
current system says that it could be several and you have time and room to work
stuff out and make sure that it was a genuine mistake and correct it. Now there
is the capacity under the proposed legislation with the removal of that word
to, in theory, get done after one mistake. It means that the accreditation can
be quite inconsistent between assessors. So there is a lot more room for error
on both sides. [1]
3.6
Mr David Kemp from ECH Inc, has similar concerns:
Our final, main concern is around the ACFI appraisals and
the proposal to remove the word 'substantial' number of claims and make the
sanctions provisions, if I can call them that, apply in the case where
after, I think, a first warning, if there is a second offence, if you like, a
provider could be suspended from making appraisals. We think that is quite a
radical shift away from what is now a word of 'substantial' to a term of 'just
one or more cases,' which might just be an inaccurate claim. It could be an
inadvertent error. [2]
3.7
Masonic Care Alliance, Board Director, Mr Felix Pintado has these
reservations:
The legislation proposes to impose sanctions on providers if
they make a single mistake in appraising or reappraising that person's level of
care. We believe that that is excessive and punitive to providers. We see no
evidence to suggest that there is a large proportion of providers in the
current system who have been sanctioned because of errors they have made in
claiming for ACFI[3].
3.8
Adjunct Professor John Kelly, CEO ACSA states that the current
legislation provides procedural fairness and that there is no need to change:
We would recommend that we stick with the existing legislation.
The secretary has wide powers currently. The major difference- we are
approaching it from a procedural fairness point of view- is currently the
secretary would have to show that there are substantial numbers of appraisals
that are involved in a process where you might consider a suspension of that
approved provider status. To change it to 'false, misleading or inaccurate on
any one or more occasions' is just in our view not procedurally fair. You may
make a mistake in you ACFI statement- it may not be fraudulent; it may be an
innocent misrepresentation - yet that would count as the first strike, if you
like, of a process that could lead to sanctions. We feel that it is going too
far and that the current powers of the secretary are sufficient for her to
carry out her responsibilities under the act.[4]
Recommendation
That the current wording and intent of the existing
legislation regarding ‘Suspending an Approved Provider from ACFI Appraisals’ be
retained.
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