Before your start, please advise your consent to publish response
1. We would like your permission to publish your online survey responses to the discussion paper. Please indicate your publishing preference:
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Publish response (include both my name and organisation's name)
Publish response, but keep my name private (include my organisation's name)
Publish response anonymously (remove both my name and organisation's name)
Do not publish response
Before you start, please tell us about yourself
2. What is your name?
Name
(Required)
Amanda Croker
4. What is your organisation’s name?
Organisation
(Required)
Brisbane South PHN
5. What stakeholder category do you most identify with?
Please select all that apply
(Required)
Consumer
Carer or other consumer representative
Consumer advocacy organisation
Consumer peak body
Carer peak body
Approved provider of residential aged care
Approved provider of flexible aged care
Approved provider of home care
Aged care provider peak body
Provider of private aged care or seniors accommodation
Aged Care Assessment Team/Service
Aged care worker
Health professional
Workforce association or union
Ticked
Primary Health Network
State and territory government
Local council
Commonwealth agency
Lender or investor/financier
Other
6. Where does your organisation operate (if applicable)? Otherwise, where do you live?
Please select all that apply
(Required)
New South Wales
Australian Capital Territory
Victoria
Ticked
Queensland
South Australia
Western Australia
Northern Territory
Tasmania
All states and territories in Australia
Please select all that apply
(Required)
In a remote area
In a rural area
Ticked
In a regional area
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In a metropolitan area or major city
Current arrangements
7. What works well under the current residential aged care allocation and places management model for consumers and/or providers?
Strengths of current arrangements for consumers
In principle places will be spread throughout Australia equitably based on numbers of older people in the local population
Waiting times for RAC are far less than for packaged care
Waiting times for RAC are far less than for packaged care
Strengths of current arrangements for providers
Allocation of places to companies planning to build new RACFs provides them with equity in terms of borrowings from banks
Providers can plan their business (including recruiting workforce) with a known budget range if all places filled (ACFI currently identifies actual subsidies and supplements for care and accommodation)
Providers in regional/rural/remote areas have equitable access to places through ACAR
Providers can plan their business (including recruiting workforce) with a known budget range if all places filled (ACFI currently identifies actual subsidies and supplements for care and accommodation)
Providers in regional/rural/remote areas have equitable access to places through ACAR
8. Are there other issue/s with the current model for the allocation and management of places for residential aged care that have not been covered in this paper?
Other issues with current arrangements for consumers
The time lag between allocation of places for new builds and completion (4-6 years) can see demographic changes in locations with demand shifting to different locations
Other issues with current arrangements for providers
Planning for newer living and care options for ageing baby boomers can be constrained by the current ACAR allocation model. Options such as own home or retirement village living with access to high level care packages (current level 4 and potentially level 5) could mitigate the growth rate in demand for RACF places.
Design principles for alternative allocation models
9. Are the proposed design principles appropriate?
Please select one item
Ticked
Yes
No
Please elaborate on your response
There is some tension between the design criteria re a more consumer driven market and the criteria re maintaining or improving access to RAC and respite services in regional, rural and remote areas and for vulnerable cohorts.
In reality a more consumer driven market may only be feasible in metropolitan areas. RRR areas may require investment in contemporary styled ensuited single rooms attached to health facilities to gain synergies with workforce (current models include multipurpose health services MPHSs). Choice for consumers may be increased if higher level packaged care becomes more accessible as an alternative to moving into an MPHS type environment.
In reality a more consumer driven market may only be feasible in metropolitan areas. RRR areas may require investment in contemporary styled ensuited single rooms attached to health facilities to gain synergies with workforce (current models include multipurpose health services MPHSs). Choice for consumers may be increased if higher level packaged care becomes more accessible as an alternative to moving into an MPHS type environment.
Model 1: Improve the ACAR and places management - Overall model
11. What are your views on the suggested improvements proposed under this model?
Views on model 1
If the decision is taken to retain the ACAR then the improvements outlined in the discussion paper would be beneficial. It would be important for government to retain some control over locational targeting to ensure that RRR locations and ACPRs below the aged care provision ration continue to meet their demographic demand.
Model 1: Improve the ACAR and places management - Key design considerations
12. How can this model ensure/encourage adequate supply of and equitable access to residential aged care and residential respite care (aside from increasing funding or revising the funding model), including:
in rural, regional and remote areas and other thin markets?
Models such as multipurpose health services (MPHSs) incorporating aged care places should be pursued but with an emphasis on contemporary design (not just adapting an old hospital ward).
Model 1: Improve the ACAR and places management - Exploring the potential impacts
16. What do you think might be the impact on the residential aged care sector overall?
Model 1 potential overall sector impact
Incremental change hopefully leading to providers with higher quality services prevailing in areas of stronger market competition.
With sufficient targeting, hopefully RRR communities and vulnerable groups would have high quality options (maybe slightly lesser choice)
With sufficient targeting, hopefully RRR communities and vulnerable groups would have high quality options (maybe slightly lesser choice)
17. If this model were to be implemented, what are the potential impacts on, linkages or interdependencies with, other programs or reforms in aged care that might impact you or the stakeholder group or organisation you represent?
Model 1 & other programs or reforms
The ACAR changes will need to be considered along with increases in availability of packaged care at higher levels in older people's homes and retirement villages. If packages increase in level and availability, the cohort requiring RACF places is more likely to have dementia or cognitive impairment
Model 1: Improve the ACAR and places management - Implementation and transition considerations
18. How could implementation of this model maximise the benefits and minimise risks/disruptions?
Model 1 implementation
This model is unlikely to cause major disruptions to supply
Model 2: Assign residential aged care places to consumers - Overall model
19. Overall, what are your views on this proposed model?
Model 2 views
The benefits of this system are more likely to be available to older people seeking a place in a metro area where there are a number of providers. Prioritisation within a national queue would be critical to ensure that very urgent needs can be met in a timely manner.
The setting of timeframes for selecting a provider is a good safeguard but would need to also factor in actual vacancies in the consumers location.
This model would potentially make it easier for consumers to move from one RACF to another preferred RACF with availability.
The setting of timeframes for selecting a provider is a good safeguard but would need to also factor in actual vacancies in the consumers location.
This model would potentially make it easier for consumers to move from one RACF to another preferred RACF with availability.
Model 2: Assign residential aged care places to consumers - Key design considerations (consumers)
20. What are your views on the establishment of a queue to access subsidised residential aged care, if the demand from eligible persons exceeds the available places?
Model 2 views on queue
Once a person has reached the top of the queue and their is no vacancy in their preferred RACF (but vacancy in a less preferred RACF in their location) they could take up a temporary place while waiting for a place to become available in their preferred RACF and then transfer.
21. What are your views on using date of approval and urgency of need as factors in determining a person’s priority (noting these are the factors used in home care)?
Model 2 views on date of approval and urgency
Urgency of need is a very important factor to cater for situations where a carer of an older person in the queue suddenly dies or loses capacity to care.
25. What additional information or supports would consumers need to assist them in selecting a preferred aged care home?
Model 2 - Additional information or supports for consumers to select aged care home
The current trial of aged care navigators will hopefully lead to a roll out of the program to those in need. For vulnerable groups with a need for a specialist support worker navigator, there would be benefit in this role continuing after assessment until the person is connected with their appropriate service (RACF in this case)
Model 2: Assign residential aged care places to consumers - Key design considerations (providers)
32. What might be required to ensure the residential aged care sector remains an attractive investment for financiers and lenders?
Model 2 how to ensure sector remains attractive investment
In addition to capital grants, governments could consider their role as loan guarantor for low risk organisations with good track records.
Instead of capital grants governments could consider longer term, low interest rate loans to organisations with good track records.
Other supports/incentives may need to be developed to encourage new entries into the market (where there is no track record)
Instead of capital grants governments could consider longer term, low interest rate loans to organisations with good track records.
Other supports/incentives may need to be developed to encourage new entries into the market (where there is no track record)