Allied Health Professions Australia is calling for a minimum standard of allied health provision in aged care, as minimum care minutes cause service deterioration.
Allied Health Professions Australia is backing calls for a “needs-based and demand-driven approach” to aged care, rather than the “rationed” approach encouraged by mandatory minimum minutes and the AN-ACC funding model.
Earlier this month, the Inspector-General of aged care released a progress report on the 148 recommendations of the Royal Commission into aged care, which were released in 2021.
According to the progress report, access and navigability remain the focal shortfalls of the federal response.
“In the current system, access to care is rationed,” read the report summary.
“The Royal Commission called for a paradigm shift, recommending establishing a new seamless aged care program with access to care as an entitlement based on assessed need.”
The Inspector-General said he was “disappointed” that the new Aged Care Act and the new Support at Home Program remained “ration-based”, and called for a system review.
Speaking to Health Services Daily, AHPA’s policy and advocacy senior advisor Dr Chris Atmore said the current funding model – the Australian National Aged Care Classification model – and the introduction of mandatory minimum care minutes for nursing and personal care only had the inadvertent side-effect of reducing allied health service in aged care.
While the AN-ACC funding model was meant to incorporate allied health provision, the minimum minutes – without any minimum standard for allied health – has meant providers are focused on meeting the requirements, sidestepping allied health provision, said Dr Atmore.
“A recent study from the University of Technology Sydney and also Stuart Brown’s most recent financial analysis have both shown that, at best, providers are using AN-ACC funds to pay for the minimum minutes that they have to achieve.
“And at worst, they’re not even doing that, they’re siphoning off [what’s] left to pay for non-care items.
“They’re subsidising the cost of maintaining the building and that is not what AN-ACC is designed for.”
Dr Atmore said the government seemed to be turning a “blind eye” to the misuse of funds, an outcome that was “easily fixable” by making providers accountable for their AN-ACC spending.
Dr Atmore has ventured to Canberra to discuss two key next steps with ministers: embedding a multidisciplinary team care approach into aged care and introducing a minimum standard for allied health provision.
Rather than having minimum minutes, AHPA has pivoted to call for the development of a needs-based assessment tool.
“That [assessment] needs to happen once the person’s entered the aged care system, rather than just relying on individual facilities to ask questions themselves, some of which may be thorough and some of which are extremely cursory,” said Dr Atmore.
“We’ve heard from carers and consumers that sometimes they’ve raised that they need to see an allied health professional, and they’re told by providers, ‘we don’t have those on staff, so you’re going to just have to find that yourself’, and by implication, pay for it.”
The allocation of funding may be somewhat of a “question mark” while the needs-based tool is developed and implemented.
But collection of clinical data on need should give a better understanding of where the money is best spent, added Dr Atmore.
“It’s not rocket science that if you want to provide essential services that older people have a human right to receive and not have to pay for themselves, then you need a system to assess their clinical needs,” she said.
“You need a system that triages and then refers people to the appropriate allied health professionals.”
Dr Atmore said the “piecemeal” reforms hadn’t maintained the aim of the Royal Commission to form “one seamless aged care system”.
And the allied health workforce was feeling the pressure.
“[Allied health professionals] are really despairing of the decline in quality that they’re able to offer because of reduced hours and the fact that there isn’t a multidisciplinary focus in [aged care] facilities,” said Dr Atmore.