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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)
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Before you start, please tell us about yourself
5. What stakeholder category do you most identify with?
Please select all that apply
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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
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Aged Care Assessment Team/Service
Aged care worker
Health professional
Workforce association or union
Primary Health Network
State and territory government
Local council
Commonwealth agency
Lender or investor/financier
Other
Please select all that apply
people from Aboriginal and Torres Strait Islander communities
people from culturally and linguistically diverse backgrounds
veterans
people who live in rural or remote areas
people who are financially or socially disadvantaged
people who are homeless or at risk of becoming homeless
people who are care-leavers
parents separated from their children by forced adoption or removal
lesbian, gay, bisexual, transgender and intersex people
people with disabilities
people with dementia
other group
Prefer not to answer
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Not applicable
6. Where does your organisation operate (if applicable)? Otherwise, where do you live?
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New South Wales
Australian Capital Territory
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Victoria
Queensland
South Australia
Western Australia
Northern Territory
Tasmania
All states and territories in Australia
Please select all that apply
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In a remote area
In a rural area
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In a regional area
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
-Ageing population with the need to build additional RACF places/current ratio and allocation of places based on area population aged over 70years.
-There appears to be an adequate number of RACF vacancies in my region i.e. not extensive wait times.
-2 MPS Services in the region which are the only RACF in their area (thin market however clients wish to remain in their local community for psychosocial reasons).
-There appears to be an adequate number of RACF vacancies in my region i.e. not extensive wait times.
-2 MPS Services in the region which are the only RACF in their area (thin market however clients wish to remain in their local community for psychosocial reasons).
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 providers
Government providers are the minority (4.2 %).
In my region these RACF providers are auspiced by hospitals and as a requirement provide nurse to client ratios. Funding for trained/qualified workforce needs to be considered. Is care to be the responsibility of the State (ie. Government) or continue to be privatized-await the outcome of the Royal Commission.
In my region these RACF providers are auspiced by hospitals and as a requirement provide nurse to client ratios. Funding for trained/qualified workforce needs to be considered. Is care to be the responsibility of the State (ie. Government) or continue to be privatized-await the outcome of the Royal Commission.
Are these problems occurring at national level, or only in certain areas (e.g. rural, regional and remote areas) or for particular consumer groups?
My experience lays in only regional areas.
What evidence supports your view that these are significant issues which need to be addressed?
ANMF data re nurse to patient/client ratios in relation to quality of care for clients/patients.
Design principles for alternative allocation models
10. Are there any other principles that you consider should be included?
Please select one item
Ticked
Yes
No
Please elaborate on your response
Ongoing potential for those who have capacity to pay for residential aged care to be 'cherry picked' by RACF providers which is not fair/equitable.
Need for advocacy to be provided by an independent body to assist clients to make informed choices & to source the most appropriate accommodation.
Multi Purpose Services are not for profit within smaller communities in my region and tend to take responsibility/ownership for providing residential care to facilitate clients to remain in their own community.
Need for advocacy to be provided by an independent body to assist clients to make informed choices & to source the most appropriate accommodation.
Multi Purpose Services are not for profit within smaller communities in my region and tend to take responsibility/ownership for providing residential care to facilitate clients to remain in their own community.
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?
- ACAS is generally approving care recipients for respite care who have the intention to access respite care in the next 6 months. Generally in rural areas respite care is booked well in advance with clients/carers reporting they often have to wait for over 12mths at some RACF's to have access to a respite booking. More respite needs to be available to assist clients to remain living at home longer (most clients preference is to remain at home).
-Greater research and understanding of unique considerations for rural/regional/remote areas.
- Increase the number of concessional places available. Clients report it is their belief they are not able to afford residential care. Clients express concern about the quality of residential care.
-Greater research and understanding of unique considerations for rural/regional/remote areas.
- Increase the number of concessional places available. Clients report it is their belief they are not able to afford residential care. Clients express concern about the quality of residential care.
for consumers from vulnerable cohorts (such as Special Needs Groups, consumers with dementia)?
Provide formal advocacy services to facilitate access to residential care if this is the clients choice.
13. Are there variations to this model which should be included in the impact analysis?
Model 1 variants
Once a client accepts care at a RACF and if they then wish to transfer to another RACF they are often disadvantaged as any other prospective RACF considers their care needs are being met and they are a lower priority to be transferred. In addition to this there are often Administrative/Financial disadvantages for transferring.
14. What other key changes could be made to the existing ACAR and/or places management arrangements to encourage a more consumer driven and competitive residential aged care sector?
Other key changes to ACAR
Independent client/carer satisfaction reports to be considered when a RACF makes application for additional ACAR places i.e only allocate places to RACF's which are meeting Commonwealth standards and client satisfaction.
Model 2: Assign residential aged care places to consumers - Overall model
19. Overall, what are your views on this proposed model?
Model 2 views
From an Assessment Service perspective model is based on current HCP national queue principals.
Uncertain re the benefits of this model. ? is it just perception that an assigned place empowers the consumer to negotiate with providers as it remains up to the provider to advise if they can/will accommodate the client.
Uncertain re the benefits of this model. ? is it just perception that an assigned place empowers the consumer to negotiate with providers as it remains up to the provider to advise if they can/will accommodate the client.
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
Structure/procedures/policy needs to be in place if demand exceeds the number of available places i.e. who advocates for clients waiting for extended periods for residential care. This often relies on the relationship between Assessment Services (Assessors Advocating/Care Coordinating) and Aged Care Facilities to ensure a client is supported (eg. with services) in the interim.
Often clients are waiting for a HCP and due to wait times are unable to be sustained at home necessitating residential care.
A queue would most probably mean additional associated requirements would fall back on Assessment Services.
Client care needs may change whilst on a queue, who is responsible for monitoring this?
Often clients are waiting for a HCP and due to wait times are unable to be sustained at home necessitating residential care.
A queue would most probably mean additional associated requirements would fall back on Assessment Services.
Client care needs may change whilst on a queue, who is responsible for monitoring this?
22. What other factors should also be included in the criteria for prioritising a person in the residential aged care queue?
Model 2 other prioritisation factors
Special Needs status.
HCP status.
Need for Advocacy.
HCP status.
Need for Advocacy.
23. What are your views on the validity period of the assigned place for residential aged care?
Model 2 validity period of place
This prompts clients/carers to act within a time frame with option for an extension.
Some clients will require formal Advocacy support with the process of researching and applying for permanent care.
Some clients will require formal Advocacy support with the process of researching and applying for permanent care.
24. Where a place is withdrawn, how can we balance the need to allow consumers to re-join the queue while also avoiding creation of perverse incentives for people to join the queue without intention of taking up a place at that time?
Model 2 withdrawn place
Client may be deemed eligible for permanent care by an Assessment Service however and noted as 'non seeking' at the time.
A Support Plan Review could be undertaken in the event this status changes and client 'seeking' / actively pursuing permanent care.
A Support Plan Review could be undertaken in the event this status changes and client 'seeking' / actively pursuing permanent 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
Formal Advocacy Services e.g. Access and Support Workers.
Option to access respite care to assist in decision making process.
Option to access respite care to assist in decision making process.
26. What would need to be in place to ensure equitable access to appropriate services when requesting entry to an aged care home i.e. in particular for consumers with limited capacity to pay, consumers from Special Needs Groups and those with dementia?
Model 2 equitable access for particular consumers
Formal Advocacy Services e.g. Access and Support Workers.
Option to access respite care to assist in decision making process.
Increased number of Concessional places.
Option to access respite care to assist in decision making process.
Increased number of Concessional places.
Model 2: Assign residential aged care places to consumers - Exploring the potential impacts
35. What would be the overall potential impact of this model (consider benefits, costs, and risks) on you or the organisation or stakeholder group you represent?
Model 2 potential impact
Potential increased workload for Assessment Services.
36. What do you think might be the impact on the residential aged care sector overall?
Model 2 overall sector impact
Increased interest by private providers (for profit) if competitive market encouraged.
It would be advantageous to see government providers increased for quality of care purposes e.g. nurse / patient ratios.
It would be advantageous to see government providers increased for quality of care purposes e.g. nurse / patient ratios.
38. How could residential respite care places be distributed, and to whom, if residential aged care places no longer exist?
Model 2 respite care
Residential Aged Care places are essential and need to be allocated by the Commonwealth.
General views
42. Aside from the two proposed models, how else could we encourage greater consumer choice and a more consumer driven market in residential aged care?
Other models to consider
Await the findings of the Royal Commission and be informed by this in relation to policy making.
43. Do you have any other overall comments you wish to provide?
General comments
Consider:
Formal Advocacy Services/Support.
Increasing government sector RACF's
Maintaining MPS's in smaller regional communities.
Increased number of Concessional Places.
Trial Option 2 in a pilot area.
Outcome of the Royal Commission to guide this policy.
Formal Advocacy Services/Support.
Increasing government sector RACF's
Maintaining MPS's in smaller regional communities.
Increased number of Concessional Places.
Trial Option 2 in a pilot area.
Outcome of the Royal Commission to guide this policy.