National Aged Care Assessment Program ACAP National Conference 2010

1. National Aged Care Assessment Program (ACAP) National Conference 2010 Tracy Mackey Assistant Secretary Community Programs and Carers Branch Good morning ladies and gentlemen... and welcome to the National Aged Care Assessment Program Conference for 2010. Thank you to those of you who have traveled so far to be with us today. In her presentation this afternoon, the Hon. Justine Elliot, Minister for Ageing, will provide an overview of the changes planned for our health and aged care systems as recently announced by the Rudd Government. I do not wish to pre-empt her talk on the health reforms so, therefore, I will focus more on the impact these reforms will have on those of us who work in aged care. Good morning ladies and gentlemen... and welcome to the National Aged Care Assessment Program Conference for 2010. Thank you to those of you who have traveled so far to be with us today. In her presentation this afternoon, the Hon. Justine Elliot, Minister for Ageing, will provide an overview of the changes planned for our health and aged care systems as recently announced by the Rudd Government. I do not wish to pre-empt her talk on the health reforms so, therefore, I will focus more on the impact these reforms will have on those of us who work in aged care.

2. National Health Reforms How will the Reforms impact on ACATs? Impact of Reform on ACAT members As you can appreciate, I do not have all the answers today, particularly in reference to how these changes will affect you as ACAT Assessors. I am happy to take your questions at the end of this presentation and answer them as best I can. However, I know the question you are all asking is, ‘Will ACATs operate differently within the new system?’ My response to you is that the comprehensive assessments currently undertaken by ACATs will continue to be required in any new system. Whether ACATs in their current guise will continue is still to be determined. You may also be asking, ‘What is happening to my job as an ACAT Assessor?’ The Government recognises the high level of skill and professional expertise required to conduct a comprehensive assessment of the care needs of the frail aged. The Government has invested considerable resources in the training of ACATs and the need for highly trained assessors will not change in the future.Impact of Reform on ACAT members As you can appreciate, I do not have all the answers today, particularly in reference to how these changes will affect you as ACAT Assessors. I am happy to take your questions at the end of this presentation and answer them as best I can. However, I know the question you are all asking is, ‘Will ACATs operate differently within the new system?’ My response to you is that the comprehensive assessments currently undertaken by ACATs will continue to be required in any new system. Whether ACATs in their current guise will continue is still to be determined. You may also be asking, ‘What is happening to my job as an ACAT Assessor?’ The Government recognises the high level of skill and professional expertise required to conduct a comprehensive assessment of the care needs of the frail aged. The Government has invested considerable resources in the training of ACATs and the need for highly trained assessors will not change in the future.

3. Ageing Population 2009 2.9 million people in Australia aged 65 years or over 13% of population One million of these people received aged/community assistance Ageing population As you are all aware, aged care is a growing sector. In fact, the demand for appropriate aged care services has never been greater and will only continue to grow as the population ages. In 2009, there were 2.9 million people in Australia aged 65 or over, accounting for 13 per cent of the population. Around one million of these older Australians received assistance from aged and community care services. While this is good news and reflects well on the general health of Australians, it has – and will continue to – put pressure on Australia’s aged care system. On the whole, Australia’s aged care system provides targeted, affordable and high quality care. But a number of challenges need to be addressed to ensure the needs of Australia’s growing number of elderly people are met.Ageing population As you are all aware, aged care is a growing sector. In fact, the demand for appropriate aged care services has never been greater and will only continue to grow as the population ages. In 2009, there were 2.9 million people in Australia aged 65 or over, accounting for 13 per cent of the population. Around one million of these older Australians received assistance from aged and community care services. While this is good news and reflects well on the general health of Australians, it has – and will continue to – put pressure on Australia’s aged care system. On the whole, Australia’s aged care system provides targeted, affordable and high quality care. But a number of challenges need to be addressed to ensure the needs of Australia’s growing number of elderly people are met.

4. 2010 Intergenerational Report Population forecasts for 2050: 65yrs and over - increase up to 23% 85 yrs and over – quadruple (1.8 million people) The 2010 Intergenerational Report forecasts the proportion of our population aged 65 or over to increase from 14 per cent in 2010 to 23 percent by 2050. The number of people aged 85 or over is expected to more than quadruple over the next 40 years, to 1.8 million people by 2050. The 2010 Intergenerational Report forecasts the proportion of our population aged 65 or over to increase from 14 per cent in 2010 to 23 percent by 2050. The number of people aged 85 or over is expected to more than quadruple over the next 40 years, to 1.8 million people by 2050.

5. Identified Challenges The National Health and Hospital Reform Commission estimates: the no. of aged care places will need to double by 2030 spending on aged care is projected to double by 2050 (from 0.8% of GDP to 1.8% ) Identified challenges The National Health and Hospitals Reform Commission (NHHRC) estimated that as a result of population ageing, using the current targets for provision of aged care, the number of aged care places will need to be at least double by 2030 (from 223,000 places to about 464,000 places). This will lead to increased spending pressure on aged care. Spending on aged care is projected to more than double from 0.8 per cent of GDP in 2009-10 to 1.8 per cent of GDP in 2049-50.Identified challenges The National Health and Hospitals Reform Commission (NHHRC) estimated that as a result of population ageing, using the current targets for provision of aged care, the number of aged care places will need to be at least double by 2030 (from 223,000 places to about 464,000 places). This will lead to increased spending pressure on aged care. Spending on aged care is projected to more than double from 0.8 per cent of GDP in 2009-10 to 1.8 per cent of GDP in 2049-50.

6. Identified challenges (cont’) Less taxpayers to support the ageing population The current aged care system is currently fragmented Difficulty accessing services In terms of funding, by 2045 there will be a far smaller pool of taxpayers to support the ageing population. So the challenge will be to provide choice in aged care while keeping Government expenditure at sustainable levels. The aged care system is currently fragmented, with divided responsibilities between the Commonwealth and the states. As ACAT members you are well aware that older Australians, their families and carers find it hard to access the services they need and often do not know what services are available.In terms of funding, by 2045 there will be a far smaller pool of taxpayers to support the ageing population. So the challenge will be to provide choice in aged care while keeping Government expenditure at sustainable levels. The aged care system is currently fragmented, with divided responsibilities between the Commonwealth and the states. As ACAT members you are well aware that older Australians, their families and carers find it hard to access the services they need and often do not know what services are available.

7. Identified challenges (cont’) Unnecessary admissions to hospitals for older people The supply of high level residential care is not keeping up with demand Workforce issues in residential aged care In addition, too many older Australians are unnecessarily admitted to hospital when better care in the community would have kept them healthy and out of hospital. A recent study[1] estimated that 31 per cent of transfers from aged care homes to hospitals were potentially avoidable. Also, the supply of high level residential care is not keeping up with the increased demand from population ageing. This has been accompanied by falls in recent years in the numbers of registered and enrolled nurses working in residential aged care. As a consequence of this too many older Australians spend longer than they need to in acute hospital beds due to lack of services available in the community. [1] A National Health and Hospitals Network: Further investments in Australia’s Health 2010, page 7In addition, too many older Australians are unnecessarily admitted to hospital when better care in the community would have kept them healthy and out of hospital. A recent study[1] estimated that 31 per cent of transfers from aged care homes to hospitals were potentially avoidable. Also, the supply of high level residential care is not keeping up with the increased demand from population ageing. This has been accompanied by falls in recent years in the numbers of registered and enrolled nurses working in residential aged care. As a consequence of this too many older Australians spend longer than they need to in acute hospital beds due to lack of services available in the community.

8. Government Reforms The Commonwealth will have responsibility for funding care services for older people Create an integrated aged care system Government Reforms As the Minister will reinforce this afternoon, the Government is ‘determined to put in place sound strategies to build a modern health and aged care system that meets the needs of Australia’s ageing population.’ The Government will make additional investments to respond to these challenges. As part of building an end to end health system, the Commonwealth will take responsibility for a nationally consistent aged care system. With the new reforms, the Commonwealth will have responsibility for funding care services for older people (non-Indigenous people aged 65 years and over and Indigenous people aged 50 years and over). This is a significant step towards achieving a national aged care system with nationally consistent services, support assessment, care and regulation. Over the next 2 years, the Commonwealth will work with all levels of government, older Australians, their families and carers to create an integrated aged care system.Government Reforms As the Minister will reinforce this afternoon, the Government is ‘determined to put in place sound strategies to build a modern health and aged care system that meets the needs of Australia’s ageing population.’ The Government will make additional investments to respond to these challenges. As part of building an end to end health system, the Commonwealth will take responsibility for a nationally consistent aged care system. With the new reforms, the Commonwealth will have responsibility for funding care services for older people (non-Indigenous people aged 65 years and over and Indigenous people aged 50 years and over). This is a significant step towards achieving a national aged care system with nationally consistent services, support assessment, care and regulation. Over the next 2 years, the Commonwealth will work with all levels of government, older Australians, their families and carers to create an integrated aged care system.

9. Reform elements Seamless transition of care for clients allowing people to move from one level of care to another as their needs change Simple access to service for clients Important elements of these reforms are: Seamless transition of care for clients allowing people to move from one level of care to another as their needs change Simple access to service for clientsImportant elements of these reforms are: Seamless transition of care for clients allowing people to move from one level of care to another as their needs change Simple access to service for clients

10. Reform elements (cont’) Single level of government with funding and regulatory responsibility for aged care Simplified accountability of governments to the community through clearer responsibility for policy and service provision Important elements of these reforms are: Single level of government with funding and regulatory responsibility for aged care Simplified accountability of governments to the community through clearer responsibility for policy and service provision.Important elements of these reforms are: Single level of government with funding and regulatory responsibility for aged care Simplified accountability of governments to the community through clearer responsibility for policy and service provision.

11. One stop shops A network of one stop shops for people needing information and access to aged care May link to Local Hospital Networks and primary health care organisations. Coupled with the introduction of a network of one-stop shops for people needing information and access to aged care, which over time, these one-stop shops may link to Local Hospital Networks and primary health care organisations. This reform will mean that older people and their carers will access one system of care managed and regulated by a single level of government. COAG have agreed to work together so that the transition to the new aged care arrangements will occur in a way that ensures there is no disruption to the current recipients of these services.Coupled with the introduction of a network of one-stop shops for people needing information and access to aged care, which over time, these one-stop shops may link to Local Hospital Networks and primary health care organisations. This reform will mean that older people and their carers will access one system of care managed and regulated by a single level of government. COAG have agreed to work together so that the transition to the new aged care arrangements will occur in a way that ensures there is no disruption to the current recipients of these services.

12. Consumer Directed Care A flexible and innovative approach to care delivery. Care recipients to have more control of their care – if they are capable & wish to do so. Examples of new flexible community programs Consumer Directed Care An example of a Commonwealth program that aims to provide a more flexible and innovative approach to care delivery for care recipients and their carers in the community is Consumer Directed Care.Examples of new flexible community programs Consumer Directed Care An example of a Commonwealth program that aims to provide a more flexible and innovative approach to care delivery for care recipients and their carers in the community is Consumer Directed Care.

13. Consumer Directed Care Packages The Commonwealth will fund 1,200 community care packages: 2010-11 500 community care packages 200 respite packages 2011-12 500 community care packages The Government plans to increase funding for opportunities for care recipients to be more active in shaping their care through 1,200 innovative Consumer Directed Care packages in Commonwealth funded community care programs. Up to 500 community care and 200 respite packages will be released in 2010-11 for this purpose, with a further 500 community care packages to be made available in 2011-12. Consumer direction allows care recipients and their carers to have greater control over their own lives by allowing them – to the extent that they are capable and wish to do so – to make choices about the types of care services they access and the delivery of those services. This includes choices about who will deliver the services, and when they are delivered. For example, care recipients are able to have a greater say as to which formal carer is employed to deliver their assistance and as to the times when that assistance is provided.The Government plans to increase funding for opportunities for care recipients to be more active in shaping their care through 1,200 innovative Consumer Directed Care packages in Commonwealth funded community care programs. Up to 500 community care and 200 respite packages will be released in 2010-11 for this purpose, with a further 500 community care packages to be made available in 2011-12. Consumer direction allows care recipients and their carers to have greater control over their own lives by allowing them – to the extent that they are capable and wish to do so – to make choices about the types of care services they access and the delivery of those services. This includes choices about who will deliver the services, and when they are delivered. For example, care recipients are able to have a greater say as to which formal carer is employed to deliver their assistance and as to the times when that assistance is provided.

14. ACAT Role The ACAT role will not change in the assessment for CDC packages An Approved Provider will determine if the care recipient has the capacity to manage a CDC package. PLEASE NOTE: The ACAT assessment role will not change in this process. You will continue to assess people to determine if they are eligible for packaged care as is the current practice. An approved provider will determine if the care recipient has the capacity and the ability to manage a CDC approach.PLEASE NOTE: The ACAT assessment role will not change in this process. You will continue to assess people to determine if they are eligible for packaged care as is the current practice. An approved provider will determine if the care recipient has the capacity and the ability to manage a CDC approach.

15. Continence Aids Payment Scheme Another project that promotes greater choice and flexibility Allows client greater purchase control of continence products Continence Aids Payment Scheme The new Continence Aids Payment Scheme is another example that promotes greater choice and flexibility to assist clients who have permanent and severe incontinence so they can meet some of the costs of their continence products. I have been informed that a Departmental representative is available on one of the Conference Exhibition Stands to provide further information about this new scheme.Continence Aids Payment Scheme The new Continence Aids Payment Scheme is another example that promotes greater choice and flexibility to assist clients who have permanent and severe incontinence so they can meet some of the costs of their continence products. I have been informed that a Departmental representative is available on one of the Conference Exhibition Stands to provide further information about this new scheme.

16. ACAP Reform The 2006 Council of Australian Governments (COAG) initiative: “That there be more timely and consistent assessments for frail older people by Aged Care Assessment Teams and simplified entry and assessment processes for the Home and Community Care Program” ACAP Reform The Aged Care Assessment Program is a vital component of our aged care system. I would like to take this opportunity to briefly look at some of the things that have been achieved in the recent past to improve and strengthen the Program. In February 2006, the Council of Australian Governments met for the 17th time in Canberra for what has been described as an historic meeting with significant outcomes. The governments involved agreed to work together to deliver a substantial new National Reform Agenda. Part of that agenda was a $1.1 billion reform package to achieve better health for all Australians over the following four years. The Commonwealth agreed to provide $660 million of this package - and the states and territories the balance. At the meeting, COAG agreed, and I quote: “that there be more timely and consistent assessments for frail older people by Aged Care Assessment Teams and simplified entry and assessment processes for the Home and Community Care Program”.ACAP Reform The Aged Care Assessment Program is a vital component of our aged care system. I would like to take this opportunity to briefly look at some of the things that have been achieved in the recent past to improve and strengthen the Program. In February 2006, the Council of Australian Governments met for the 17th time in Canberra for what has been described as an historic meeting with significant outcomes. The governments involved agreed to work together to deliver a substantial new National Reform Agenda. Part of that agenda was a $1.1 billion reform package to achieve better health for all Australians over the following four years. The Commonwealth agreed to provide $660 million of this package - and the states and territories the balance. At the meeting, COAG agreed, and I quote: “that there be more timely and consistent assessments for frail older people by Aged Care Assessment Teams and simplified entry and assessment processes for the Home and Community Care Program”.

17. ACAP Reform (cont’) $24.2 million over 5 years to improve and strengthen the ACAP Supported many initiatives at all levels Acknowledge the work that has been done and showcased over these two days of the Conference. To meet this broad aim, the Australian Government committed funding of $24.2 million over five years from 2006-07 to 2009-10 for activities to improve and strengthen the Aged Care Assessment Program. This funding has supported a number of initiatives designed to strengthen the ACAP at all levels. This conference provides an opportunity to showcase the hard work that has been done by so many dedicated people associated with the Program to support these initiatives. I would particularly like to congratulate those people on their achievements.To meet this broad aim, the Australian Government committed funding of $24.2 million over five years from 2006-07 to 2009-10 for activities to improve and strengthen the Aged Care Assessment Program. This funding has supported a number of initiatives designed to strengthen the ACAP at all levels. This conference provides an opportunity to showcase the hard work that has been done by so many dedicated people associated with the Program to support these initiatives. I would particularly like to congratulate those people on their achievements.

18. ACAP Reforms (cont’) Regular Updates: ACAT Chat newsletter ACAT specific webpage on DoHA website www.health.gov.au/acats Your health website www.yourhealth.gov.au Conclusion In conclusion, I am sure you will realise we have an exciting and challenging time ahead of us as we work towards implementing even more reforms. As always, we will take every opportunity to keep you informed of the national changes as they develop. Regular updates will be provided in your newsletter ‘ACAT Chat’, on your ACAT specific webpage on the DoHA website and on the Your health website. Meanwhile, this conference is about sharing fresh ideas and identifying workable solutions to improve the work of ACATs. Conclusion In conclusion, I am sure you will realise we have an exciting and challenging time ahead of us as we work towards implementing even more reforms. As always, we will take every opportunity to keep you informed of the national changes as they develop. Regular updates will be provided in your newsletter ‘ACAT Chat’, on your ACAT specific webpage on the DoHA website and on the Your health website. Meanwhile, this conference is about sharing fresh ideas and identifying workable solutions to improve the work of ACATs.

19. Thank you Questions?? I would like to thank you for your past and present dedication to improve a program that is such a vital element of the complex but dynamic aged care industry. I hope you enjoy the conference. I would like to thank you for your past and present dedication to improve a program that is such a vital element of the complex but dynamic aged care industry. I hope you enjoy the conference.