Budget 2021: A Summary for Residential Aged Care Providers

14/05/21

How does the 2021 Federal Budget affect residential aged care providers? How does it relate to the findings of the Royal Commission into Aged Care Quality and Safety?

Overview

Government investment: Government is investing $17.7 billion over five years to “ensure older Australians are treated with respect, care and dignity.”
Most Royal Commission recommendations accepted: Government has accepted 85 per cent of the 148 recommendations either entirely or in-principle. Some are to be decided. Six have been rejected outright, including a Medicare-style levy to help pay for changes to the system.
Increased funding: new Government-funded Basic Daily Fee supplement increase of $10 per resident, per day.
Minimum care time per day: residential care facilities will have to deliver an average of 200 care minutes per resident, per day from 1 October 2023. This will increase to 215 minutes by 2024.
More audits: the Aged Care Quality and Safety Commission will undertake an additional 1,500 safety audits in residential care facilities in 2021-22.
National worker screening: a nationally consistent screening, register and code of conduct for all care worker sectors will be introduced.
Training scheme: Government will introduce a JobTrainer scheme to subsidise 33,800 training places through the vocational education and training sector for personal care workers to attain a Certificate III qualification in individual support.
Nurse retention bonus scheme: under a new retention bonus scheme, nurses who work for the same aged care provider for 12 months will get $3,700, while part-time workers will get $2,700.
Details to be decided: many of laws and regulations required to enact these reforms have not yet been drafted.
The Treasury says: "It's not just more money, it's more reform."

Commentary on the budget

Insufficient funding

According to the ABC, “By the end of the forward estimates, spending in aged care will be at a similar level as the investment in Medicare for the first time in history, costing more than $31 billion annually. But a recent Grattan Institute report calculated the aged care sector would need extra $7 billion a year on top of that, just as a starting point.”

Unclear how the government will pay for the reforms

According to the ABC, the Minister for Health and Ageing, “did not outline exactly how the government would pay for its changes, saying the money would come from revenue, as the government had agreed not to implement a new tax.”

Boost for home care

According to the Australian Financial Review, “Pillar one” of the Government’s aged care plan focuses on home care at a cost of $7.5 billion. “It will see 40,000 new home care packages released from July 2021, with another 40,000 a year later, bringing the total number of home care packages to 275,000 by 2023, compared to just 60,000 in 2015.”

How the Budget relates to the Royal Commission’s recommendations

According to the ABC, “The federal government has accepted 85 per cent of the 148 recommendations either entirely or in-principle, while it is yet to decide on some, including whether to introduce new civil penalties for providers if they fail to provide high-quality safety care for residents in a way that could cause harm. Six have been rejected outright, including, as expected, a Medicare-style levy to help pay for changes to the system.”

Budget Item	Royal Commission Recommendation
Pricing and fees
Establish the Independent Hospital and Aged Care Pricing Authority to support implementation and administration of the new funding model in residential aged care.	Recommendation 6: Australian Aged Care Pricing Authority
Increased funding to aged care homes
The Basic Daily Fee will be increased to provide an additional $10 a day per resident to residential aged care facilities from 1 July 2021.	Recommendation 112: Immediate changes to the Basic Daily Fee
Minimum care time per day
From 1 July 2022, residential care providers will be required to report and publish care staffing minutes for each facility on the MyAgedCare website. Providers will also be required to report to residents and their families on care delivered.	This is not an explicit Royal Commission recommendation, but it does relate to recommendations 24 and 86.
Residential care facilities will have to deliver an average of 200 care minutes per resident per day from 1 October 2023. This will increase to 215 minutes by 2024. At least 40 minutes of that time will need to be with a registered nurse.	Recommendation 86: Minimum staff time standard for residential care
From July 2022, at least one registered nurse will need to be on shift at every facility, for a minimum of 16 hours a day.	Recommendation 86: Minimum staff time standard for residential care
Increased powers for the regulator
Additional $301.3 million will be provided to address failures in care and increase the capability and capacity of the independent Aged Care Quality and Safety Commission. These reforms will include a new Aged Care Act, replacing the Aged Care Act 1997 and the Aged Care Quality and Safety Commission Act 2018.	Recommendations 5-12, 97, 101-103 – these recommendations called for the establishment of a new regulator with more power.
More audits
The Aged Care Quality and Safety Commission will receive about $25 million to undertake an additional 1,500 safety audits in residential care facilities in 2021-22, a dramatic increase on the 600 audits scheduled during that time period.	Recommendations 5-12, 97, 101-103 – these recommendations called for the establishment of a new regulator with more power.
Regional and remote areas, special needs groups and Aboriginal and Torres Strait Islander people
$630.2 million over five years to help Aboriginal and Torres Strait Islander people and special needs groups, as well as people living in regional, rural and remote communities access aged care services. This will include delivering upgrades to aged care infrastructure, and establishing an Indigenous workforce to assist Aboriginal and Torres Strait Islander people to better navigate aged and disability care. This includes $370 million over four years for aged care providers to make improvements to their buildings and expand into underserviced areas.	Recommendations 47-55
Transparency and consumer choice
The Government is providing $200.1 million to empower older Australians and their families to make more informed choices about the quality and safety of aged care. Also, senior Australians able to access assistance and information via 325 Services Australia service centres and aged care specialists in 70 Service Australia centres.	This is based on several recommendations about the foundation of the new aged care system, including recommendations 1-4.
Trialling a regional network of staff to provide face-to-face services to help people navigate the system.	Recommendation 29: Care finders to support navigation of aged care.
A Council of Elders will be established to provide a direct voice to government.	Recommendation 9: The Council of Elders.
Star Rating System
A Star Rating System on the My Aged Care website will be introduced for residential aged care.	Recommendation 24: Star ratings: performance information for people seeking care
Worker screening and accountability
To hold staff more accountable, a nationally consistent screening, register and code of conduct for all care worker sectors will be introduced, at a cost of $105.6 million.	Recommendation 77: National registration scheme
Recruitment and training
$650 million to grow and upskill the aged care workforce. Including: · a national recruitment campaign to lure extra workers to the sector will be extended for two years at a cost of $9.8 million · JobTrainer scheme to subsidise 33,800 training places through the vocational education and training sector for personal care workers to attain a Certificate III qualification in individual support. · $216.7 million over three years to upskill staff including making specialist aged care nursing scholarships available, boost dementia and palliative care training and recruit aged care workers in regional, rural and remote areas. The dementia training will encourage staff to minimise restraining residents · up to 6,000 new personal care workers in workplaces.	Recommendation 114: Immediate funding for education and training to improve the quality of care Recommendations 78-83 (professional development)
Nurse retention bonus scheme
As part of the upskilling measures, a retention bonus scheme for nurses who work for the same aged care provider for 12 months will be introduced at a cost of $135.6 million. Eligible full-time nurses will get $3,700, while part-time workers will get $2,700.	This was generally mentioned under Recommendation 115: Functions and objects of the Pricing Authority
Restraint and restrictive practices
$7 million to strengthen the regulation of the use of physical and chemical restraints, while an additional almost $150 million will help it respond to complaints and initiate investigations quickly. Improved training in minimising restraint and restrictive practices (see “Recruitment and Training” above).	Recommendation 17: Regulation of restraints
Dementia care
Increased dementia care capability. Improved training in dementia care (see “Recruitment and Training” above).	Recommendation 15: Establishment of a dementia support pathway Recommendation 16: Specialist dementia care services

Further Resources

Australian Government: Budget Overview 2021-22

ABC: Government unveils extra home care packages in $18 billion aged care royal commission response

Australian Financial Review: More workers and better training for aged care sector

Mark Bryan

Mark is a Legal Content Consultant at Ideagen CompliSpace and the editor for Aged Care Essentials (ACE). Mark has worked as a Legal Policy Officer for the Commonwealth Attorney-General’s Department and the NSW Department of Justice. He also spent three years as lead editor for the private sessions narratives team at the Royal Commission into Institutional Responses to Child Sexual Abuse. Mark holds a bachelor’s degree in Arts/Law from the Australian National University with First Class Honours in Law, a Graduate Diploma in Writing from UTS and a Graduate Certificate in Film Directing from the Australian Film Television and Radio School.

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