Bob Baldwin (Paterson, Liberal Party) Share this | Hansard source

I rise to speak on the Aged Care Legislation Amendment (Increasing Consumer Choice) Bill 2016. This bill provides the necessary legislation for a more flexible aged care system that will support what the whole of our community wants and, in particular, affected seniors want—that is, to remain in their homes for as long as possible. Home is where they are familiar, comfortable and engaged with their families, neighbours and friends.

One of the roles of government is to care for its people. To this end, the government subsidises aged care packages for those who are no longer able to live, independently, in their own homes. The Paterson electorate, before the redistribution of boundaries by the Australian Electoral Commission, was ranked the fourth highest electorate in Australia where residents were aged over 70. My electorate had 18,642 people over the age of 70, which is 15.6 per cent of its population.

Unfortunately, this redistribution has meant that many wonderful organisations I have had the pleasure of visiting and, more importantly, working with for a number of years will no longer be in the electorate of Paterson. These include the Lara Aged Care facility at Dungog, Stroud Community Lodge, Glaica House and Beaumont Terrace at Tuncurry, Baptist Care at Kularoo Centre and Barclay Gardens at Forster, the Great Lakes Nursing Home at Bulandelah, the Peter Sinclair Gardens at Hawks Nest, and The Frank Whiddon Home at Largs. I have shared their battles. I have been involved in the development, establishment and refurbishment of many of these fine facilities over the years.

However, the boundary changes mean that other aged care facilities will now come under the federal electorate of Paterson. These include Green Hills Nursing Home, Mount Carmel Village and Benhome at Maitland, Kurri Kurri Masonic Village and Maitland Opal at Rutherford. They will join the Opal at Raymond Terrace Tanilba Shores, Salamander Bay United Aged Care facility, the Regis The Gardens at Salamander, the Bill King Aged care facility at Fingal and Harbourside Haven at Shoal Bay plus the many assisted living facilities and service provider organisations, throughout my electorate, servicing the growing needs of my community.

This bill gives effect to the first stage of the home-care reforms announced by this government in the 2015-16 budget. Consumers are right to demand more choice and control over their aged care service provider, as is the industry right to demand reduced red tape and regulation for aged care providers. This bill will provide for this outcome—and it is all about the outcome. The changes also lay the platform for future aged care reforms, which will be guided by the Aged Care Sector Committee Roadmap for Reform and will be jointly developed with the sector. These reforms will improve the way home-care services are delivered to older Australians.

They will be implemented in two stages. In the first stage, commencing February 2017, importantly, funding for a home-care package will follow the consumer, and I welcome that. This will enable the consumer to choose a provider that is suited to their needs and allow them to direct their funding to their provider of choice. The consumer will be able to change their provider, if they wish, including if they move to another area to live. The second stage of reforms will build on these changes by integrating the Home Care Packages Program and the Commonwealth Home Support Program into a single care-at-home program. This will further simplify the way services are delivered and, in particular, funded.

These changes are an important step in moving towards an aged system that is more consumer friendly, market based and less regulated. It is all about the consumer—their rights; their needs—first and foremost. Thankfully, Australians are living longer and healthier lives and it is important that as people age they have choice about their care. The home-care reforms will strengthen the aged care system to provide high quality and more innovative services through increased competition. Our elderly Australians deserve nothing less.

Home-care packages are available at four levels, with the majority of packages funded at levels 2 and 4. There are around 73,000 operational home-care packages across Australia. At present, home-care places are allocated to providers through the Aged Care Approvals Round, ACAR, and around 6,000 new packages will be allocated to providers through the 2015 ACAR. We expect the results to be announced shortly. It is important to note that this will be the last ACAR, in which home-care packages are allocated directly to providers, before the proposed February 2017 changes commence. In addition to having an allocated place, to receive a home-care subsidy, a provider must also be approved by the Department of Health, under the Aged Care Act 1997—that is, be an 'approved provider'. The subsidy is paid to the approved provider for a home-care place occupied by the care recipient, the consumer.

It is critical to understand that providers are required to comply with a range of responsibilities, under the act, relating to factors such as quality of care, user rights and accountability requirements. Currently, to access a home-care package, a consumer has to be assessed and approved as eligible for home care by an ACAT and offered a package by an approved provider. The new Consumer Directed Care, CDC, system gives consumers greater flexibility in determining what level of involvement they—I repeat, they—would like to have in managing their own home-care package. Consumers and providers work in partnership to identify the consumer's goals and needs, which form the basis of their care plan. The CDC also provides consumers with clear information about what funding is available for their care and services and how those funds are spent through an individualised budget and monthly income and expenditure statements. These tools ensure that providers and consumers have a shared understanding of available resources and how those resources are being expended to meet the consumer's needs.

The expansion of the CDC across all home care packages in July 2015 was an important step in moving to a consumer-driven system, but further reform is required to fully empower consumers to be in control of their care. Through the introduction of the CDC, many consumers now have more choice as to how their care is delivered, with increased transparency over what budget is available and how funds are spent. However, under current arrangements, it is difficult for consumers to change to another provider or move to another location.

Once the changes take effect, all consumers, both new and existing, will benefit from these changes. We all want and expect choice. These changes will provide greater choices for consumers when selecting a provider. The new arrangements will be closely monitored to ensure that all consumers, including people with special needs and those living in rural and regional areas such as Paterson, are able to access care in an equitable manner. Service providers that do not currently have an allocation of home care packages, and in some cases may be providing subcontracted services to an approved provider, will be able to provide services directly to consumers, should they become an approved provider.

As I outlined earlier, under these proposed changes providers will no longer need to apply for new home care places through the ACAR. While welcoming the reduction in red tape, some existing providers in my electorate of Paterson have expressed concerns about the impact of increased competition and the loss of certainty of business income once home care places are no longer allocated to providers. The financial impact of the changes on providers will be closely monitored by the Aged Care Financing Authority. The monitoring will particularly examine the impact on service delivery in regional and rural areas. I welcome that.

This is not a piece of legislation designed to reduce funding or care places. In fact, the total number of home care packages is continuing to increase each year, so there is an opportunity for all providers to continue to operate in the market. The challenge for all providers is to understand their consumers' needs and to deliver services which meet the needs of the consumers. It is all about the consumer and the outcome. That is what this bill is about.

Changes are also proposed to streamline and simplify the process for becoming an approved provider of subsidised home care. Providers will still need to be approved by the Department of Health under the Aged Care Act 1997 in order to provide subsidised home care, but the process for becoming an approved provider will be much simplified. This will include updating the suitability criteria for approved providers, streamlining the processes for becoming an approved provider and providing a simpler model for existing residential and flexible care providers to also provide home care. Simplifying the process for residential and flexible care providers to become home care providers recognises that these providers have already been tested against the standards required to become an approved provider of aged care.

Once an organisation has been approved as a provider under the act, approved provider status will no longer lapse after two years if the provider does not hold an allocation of places. That is critically important. This change will apply across all care types, including home care, residential care and flexible care.

Making these changes will remove some of the barriers to entry for new providers whilst still ensuring that standards of care remain high. Increasing the number of approved providers able to provide home care will support greater choice for consumers. Importantly, new providers will still be required to demonstrate their suitability to become an approved provider. All approved providers of home care will need to meet the Home Care Standards and will be subjected to independent quality reviews.

ACATs undertake comprehensive, holistic, multidisciplinary assessments to determine a person's eligibility to access Commonwealth-subsidised aged care. In Stage 1 of the reforms the role of assessing eligibility for home care will continue to be undertaken by the Aged Care Assessment Teams. Once home care places are no longer allocated to providers, the assessment approval will indicate a specific package level—level 1, 2, 3 or 4. A guidance framework is being developed to inform and assist ACATs in determining a specific home care package level for each consumer. All consumers who have been assessed by an ACAT and approved as eligible for a package will be prioritised in order to access subsidised home care. From February to mid-March 2016 all ACATs will commence using the full functionality of the My Aged Care assessor portal to conduct comprehensive assessments, create support plans, make delegate decisions, transmit approvals to the Department of Human Services and make referrals to services or waitlists. The changes in Stage 1 will build on this platform.

At present, new home care places are allocated to providers at a regional level through the Aged Care Approvals Round. While this system aims to achieve an equitable distribution of the total number of packages, there are significant variations in the distribution of packages between states, regions and local areas. Currently waiting lists for packages are managed by individual providers. There can be significant variation in the waiting periods for packages across Australia, with no systematic way of measuring or addressing the variation. The move to a consistent national system for prioritising access to subsidised home care will allow a more equitable and flexible distribution of packages to consumers based on individual needs and circumstances, regardless of where they live. There was general support from stakeholders for a national approach in the consultations.

Once these changes take effect, there will be a national system to manage eligible consumers' access to packages within My Aged Care. This is important to ensure there is equitable access to care. The national prioritisation process will take into account the relative needs and circumstances of consumers, determined through the comprehensive assessment undertaken by an ACAT, and the time that a person has been waiting for care. A consumer who has been prioritised for a package will be supported by My Age Care with referrals to approved providers. But the consumer will be able to choose which provider delivers their care. The department will closely monitor the new arrangements to ensure that all consumers, including people with special needs and those living in regional and rural areas, are able to access care in an equitable manner.

We are a government that cares for our ageing. We face an issue with an ageing population. The challenge is upon us to make sure we have the best possible systems in place to care for our elderly with dignity. Therefore, I commend this bill to the House.

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