Thursday, 11 February 2016
Aged Care Legislation Amendment (Increasing Consumer Choice) Bill 2016; Second Reading
That this bill be now read a second time.
I am pleased to introduce the Aged Care Legislation Amendment (Increasing Consumer Choice) Bill 2016.
This bill creates the legislative framework for a more flexible, consumer-driven aged-care system that will support older people to remain living at home.
The bill gives effect to the first stage of the home care reforms announced in the 2015-16 federal budget. These changes will provide consumers with more choice and control over their aged-care services and will reduce red tape and regulation for aged-care providers.
The government has a strong track record when it comes to aged care. The changes announced in the budget will build on our successful record and set the platform for future reform.
The 2011 Productivity Commission Caring for older Australians report identified a number of key weaknesses of the system including that:
• it is difficult to navigate;
• services and consumer choice are limited; and
• coverage of needs, pricing, subsidies and user co-contributions are inconsistent or inequitable.
The government has implemented a range of measures to address these weaknesses. Some were started by the previous government but this government has landed those changes and is going further—moving the system more in line with the Productivity Commission’s recommendations.
In January this year, the government transferred responsibility for the Aged Care Complaints Scheme from the Department of Health to the Aged Care Complaints Commissioner, creating a more independent and robust approach to complaints.
The My Aged Care gateway is now supporting people to find their way through the aged-care system and, despite some initial difficulties, is now undertaking assessments for those people who need low-level care at home. It is increasing its role as the one identifiable place to go for information and support to access aged care.
There has been significant work on addressing inconsistency and inequity in the pricing and consumer contributions to the cost of their care.
The Productivity Commission’s report also stated that competition, rather than extensive regulation, is the key to delivering innovative, quality services and an efficient and sustainable system.
The government maintains a crucial role in setting policy and in ensuring safety and compliance in aged-care services. It will be there to promote equity of access, support vulnerable consumers and address market failures.
But it has to be acknowledged that market-based solutions and consumer choice will increasingly be the driving force for quality, value and performance of services.
Moving to a market-based system, giving consumers choice and allowing providers to run their own services, is central to the government’s plan for the future.
The aged-care system in Australia is world class and well respected, with high-quality services that reach and meet the needs of a very diverse population.
However, as people are living longer thanks to better health and better health care, the demands on Australia’s aged-care system are changing. Older Australians want more choice and control over the care they receive. This demand will only increase as the 'boomers' and future generations require aged-care services.
The government’s home care reforms, announced in last year’s budget, place a priority on ensuring choice and flexibility for older people.
At the same time, the reforms will strengthen the aged-care system to provide high-quality and more innovative services through increased competition.
These reforms will occur in two stages.
From February 2017, home care packages will be allocated to assessed consumers who will be able to direct government funding to the provider of their choice. Even more importantly, they will have the flexibility to change their provider if they want to, or if they move to another area or state they can take their package with them.
Once these changes come into effect, providers will no longer have to apply for home care places through the Aged Care Approvals Round, significantly reducing red tape for businesses. The changes will also establish a consistent national approach to prioritising access to care.
This major policy change has received widespread support and the implementation arrangements for these changes have been developed in close consultation with stakeholders, including the National Aged Care Alliance and groups representing consumers, carers and providers.
Building on this first stage, the government has also clearly signalled its intention to move to a single, integrated care at home program. The second stage of home care reform will further simplify the way that services are delivered and funded, and will commence from July 2018.
This next stage provides an opportunity to explore different funding and service delivery models, including activities that promote restorative care and firmly put the consumer in control.
The integration of the Home Care Packages Program and the Commonwealth Home Support Program in the second stage will be informed by extensive consultations with stakeholders.
This bill implements stage one of the reforms and will amend the Aged Care Act 1997 and the Aged Care (Transitional Provisions) Act 1997 in three main areas.
Firstly, funding for a home care package will follow the consumer, rather than be allocated to an approved provider in respect of a specific location or region.
This will mean that the consumer will be able to take their package to any approved home care provider—consumers will no longer be restricted to providers that hold an allocation of places. Put simply, a consumer will be able to choose a provider that is suited to them. For example, a consumer may seek a service that specialises in providing linguistically and culturally appropriate care.
A home care package will also be portable for the consumer, if they wish to move location or change to another provider. The package, including any unspent funds, will move with the consumer to their new provider.
Approved providers will no longer have to apply through the Aged Care Approvals Round to receive home care places. This will reduce red tape and also increase competition in the sector by allowing more consumer focussed and innovative providers to expand their businesses to meet local demand and consumer expectations, including the needs of consumers with dementia and other special needs. The current Aged Care Approvals Round is expected to be the last round in which home care places are allocated to approved providers.
Secondly, there will be a consistent national system for prioritising access to subsidised home care. 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.
Once these changes take effect, there will be a national system to manage eligible consumers’ access to packages within My Aged Care—the aged-care gateway. An effective national system is important to ensure there is equitable access to care, as the total number of home care packages will continue to be capped in line with the aged-care planning ratio.
A prioritisation process will take into account the relative needs and circumstances of consumers, determined through the comprehensive assessment undertaken by an aged-care assessment team, and the time that a person has been waiting for care. A consumer who has been assigned a package will be supported by My Aged Care with referrals to approved providers, but the consumer will be able to choose which provider delivers their care.
There will be close monitoring of the new arrangements to ensure that all consumers, including people with special needs and those living in rural and regional areas, are able to access care in an equitable manner.
Thirdly, the bill will reduce the red tape associated with providers becoming approved under the Aged Care Act 1997.
Increasing the number of approved providers able to provide home care will support greater choice for consumers, but importantly, new providers will still be required to demonstrate their suitability to become an approved provider. All approved providers will need to meet the Home Care Standards and will be subject to independent quality reviews.
The legislative criteria for assessing the suitability of a person to become an approved provider will be streamlined and made more contemporary. This will encourage new providers, including some current Commonwealth home support providers, to enter the home care market, expanding the choices available to consumers.
Existing providers of residential and flexible care will also be able to become providers of home care through a simple ‘opt-in’ process. This recognises that these providers have already been tested against the standards required to become an approved provider of aged care.
Further, an organisation’s approval to provide home care will commence as soon as the approval is granted and will not lapse. Currently, approved provider status lapses after two years if the provider does not hold an allocation of places. To streamline the approved provider arrangements, the lapsing provision will be removed across all care types—home care, residential care and flexible care.
The changes proposed in this bill are an important step in reforming the home care system so that older Australians have more choice and flexibility to receive care and services at home.
The changes also lay the platform for future aged-care reforms, which will be informed by, and developed with, the Aged Care Sector Committee Roadmap for Reform. I thank the House.