Given
the growing number of people over the age of 65 years living in the
Northern Rivers region, this may be of some interest to retirees, their families and friends.
Australian
Government, Final
report of the Aged Care Taskforce, 12 March 2024,
excerpt:
Support
older people to age in place
______________________________________
Principle
1: The aged care system should support older people to live at home
for as long as they wish and can do so safely.
______________________________________
A
strong preference for many older people and their families is for
them to age in place and remain in their home for as long as they are
able. This was reflected in responses to the stakeholder survey, with
90% of respondents supporting the principle.
The
decision of whether an older person wishes to remain at home or enter
residential aged care is driven by a wide range of factors.
Consultation showed the top reasons for preferring to remain at home
included comfort and privacy, a desire to remain independent, better
mental and physical health outcomes and maintaining connection to
community, friends and family. For other reasons, such as social
connectedness, increasing clinical care and safety needs, some older
people may choose to enter residential aged care sooner. While
overall there is a shift towards ageing in place, it is important to
meet each person’s preferences for their aged care and provide
continuity of care when needs change.
Home
care programs need an overhaul to meet future demand
The
current home care programs are not ready to meet the needs of a
rapidly growing cohort of older people. Home care currently involves
2 programs, the Home Care Packages Program and the Commonwealth Home
Support Programme, that have evolved over time and with different
design objectives. This has led to a system where:
• applicant
assessments are inconsistent and not well aligned to actual need
• access
to services is constrained and inconsistent, and many older people
are not receiving an optimal mix of services
• services are priced
and fees are charged inconsistently (see Appendix E for details)
• different
funding approaches are impeding the sector from scaling up and
diversifying
• there
is a lack of clarity about what services should be available.
Those
who can access home care under the current system can leave
significant funds unspent, while others can wait for months to access
services. This is due to existing program constraints, limited
availability of services and appropriately skilled workers, as well
as behavioural and attitudinal factors. In the Home Care Packages
Program, unspent funds as at 30 June 2022 totalled $2.3 billion.16
Prices across the programs are inconsistent and inefficient due to
variable price setting arrangements. This undermines the
predictability and sustainability of funding and can cause confusion
when comparing packages with other participants.
There
are also obvious signs of lack of scale and diversification of
providers. As the population ages, these issues will need to be
addressed to deliver a rapid scaling up of services to meet demand.
The
Support at Home Program is an opportunity for generational
change in how home care is delivered
It
will also be important to make sure home care better meets older
people’s needs, while enabling program
scalability
and pricing signals that ensure funds are used consistently and in
line with program intent. In
addition,
home care must provide value for money, transparency and better
quality services.
The
new Support at Home Program, to be introduced in stages from July
2025, is an opportunity to address
these
critical issues in the current home care programs.
As
the Support at Home Program is implemented, it will be important to
ensure the new arrangements
deliver
on the intent of the design and meet the expectations of older
people, their families and carers for:
• greater
choice and control
• easier
and more timely access
• flexibility
to adjust services over time as needs change
• better
value for money through controls on unreasonable administration fees
• better
clarity and transparency around fees and how funding is used.
It
is also important that the new arrangements deliver for providers,
acknowledging the need for:
• more
predictable and sustainable funding that meets the costs of quality
service delivery
• recognition
of the costs associated with complying with regulatory requirements
• flexibility
to adjust services on the ground as participant needs change
• improved
use of a qualified and skilled workforce to increase service
availability
• appropriate
and adequate implementation timeframes.
Support
at Home Program inclusions and exclusions need
to be more clearly defined than under current programs
The
Taskforce was asked to provide advice on program inclusions and
participant contributions for the
Support
at Home Program. In developing this advice, the Taskforce considered
the diverse needs, goals and
circumstances
of participants, the intent of the program and the role of other
service systems. The
importance
of prevention, flexibility and reablement also played a key role in
discussions.
The
Taskforce notes the Support at Home Program needs much clearer
specifications than current programs about what it will and will not
fund. The lack of clarity and consistency in inclusions and
exclusions in current home care programs has led to confusion between
providers and participants. This affects participants’ ability to
make informed choices about their care, diminishes value for money in
the programs, and could also mean that funds are not used according
to the policy intent of home care.
Read
and download the full report at:
https://www.health.gov.au/sites/default/files/2024-03/final-report-of-the-aged-care-taskforce_0.pdf
With
Aging in Place recommendations on pages 16 to 18.