Aged

1
Aged Community Care Aged care Reforms
Workforce Issues

• Jill Pretty
• Manger Policy and Consultancy ACS NSW ACT

ACHSE Conference 2006
2
Overview of Presentation

• Current position of aged and community care
• Outcomes of recent reviews
• Likely impacts
• What could the future look like?

3
Current Position

• Highly regulated industry
• Dependent on Government funding
• Increasing ageing population
• Ageing workforce
• Increasing demands by consumers

4
Residential Care Policy Drivers

• Review of Residential Aged Care Pricing
  Arrangements (Hogan Report)
• Funding, planning and accountability changes
• Industry efficiencies and consolidation
• Review of the Funding Instrument (RCS)
• Change from care provided to assessed care
  needs
• Possible change to the assessment /
  validation process
• ? Trial of new Aged Care Funding
  Instrument (ACFI)
• Report due March 2006
• ? ACFI introduced possibly early 2007

5
Broader ChangesImpacting on Residential Care

• Services
• Expansion of retirement living options
• Move to adaptable housing
• Expansion of community care
• Health
• Reducing length of stay transitional care post
  acute care
• Dementia epidemic
• Palliative care
• Hospital in the home / nursing home

6
Impact of Community Care

• Client Choices
• Currently accepted older people wish to remain in
  their community
• Housing options critical
• Changing Service Mix
• High level of care (EACH) now a mainstream
  program future of packaged care
• Dementia EACH
• Respite cottages employed carers programs

7
Community Care ReviewThe Way Forward

• Extensive pressure for reform from sector,
  including ACSA and partners Vision for Community
  Care
• August 2004 Federal Govt The Way Forward A New
  Strategy for Community Care released
• Involves renegotiation of HACC Agreements with
  State / Territory Governments
• Covers eligibility, entry points, assessment,
  accountability frameworks, planning, information
  technology and data, consumer fees
• Includes immediate action to streamline Federal
  community care programs

8
COAG Outcomes

• 1.1 billion health package over 4 years
• 500m for Australian Better Health Initiative
• 176m National Health Call Centre Network, plus
  20m for mental health
• 18m for ACATs to improve assessments and
  simplify assessments for HACC Program
• 150m to improve care for older people in
  hospitals
• 244m to reduce number of younger people with
  disabilities in nursing homes
• 130m on accelerating e-health records including
  covering community care

9
COAG Outcomes

• Other health initiatives
• More pooled funding of health and community care
  services in small rural towns
• Report to COAG in mid 2006 on Productivity
  Commissions report on health workforce
• Mental health action plan by June 2006
• Overarching Human Capital reforms
• Health promotion
• Specific Purpose Payments (SPP) reviews
• Education Training

10
Workforce issues

• Major workforce issues
• nursing and personal care worker shortages
• Average age 45 years
• too much paperwork
• Federal Govt commitment
• 21m for staff training in small homes
• 26m for scholarships to train aged care nurses

11
Workforce

• Issues
• Federal Workplace Relations reforms
• Competition for scare resources rather than
  cooperation with sectors like health.
• Spiralling award increases
• Challenges of a mature age workforce
• Opportunities
• Better workforce planning at State and local
  level
• Organisational partnerships
• Increase flexibility to change roles
• Develop career pathways
• Utilise traineeships new training resources

12
Impact on Organisation

• Residents/Clients and Families
• Potentially more demanding
• Complaints processes
• Staffing mix
• New models of care
• Changes to RN role
• Hopefully less paperwork, more clinical
  leadership nurse practitioners?
• EN/Cert IV role enhanced
• Allied health GP access

13
The Future?

• Changing Role of Residential Care
• Highly dependent residents dementia palliative
  care
• Changing roles for organisation and staff
• More emphasis on user pays
• Federal Govt Discussion Paper on Aged Care Reform
• 1.3m in 2005 Budget
• Yet to be released
• Challenges
• Managing change focus on efficiencies
• Resident/client and family expectations
• Impact of user pays

14
Conclusion

• Aged and community care has managed change since
  1997
• Organisations have consolidated or disappeared
• The population is ageing
• Financial pressures are increasing
• 2006 Growing into the future
• Embrace the changes
• Plan for the future
• Use the changes to benefit your organisation and
  service delivery