Submission

Submission on the Aged Care Bill 2023

Introduction

UnitingCare Australia welcomes the opportunity to provide a submission in response to the Exposure Draft of the new Aged Care Bill 2023 (Act) and ‘A New Aged Care Act: Exposure Draft, Consultation Paper No. 2’ (Consultation Paper). We share the Government’s ambition for improving the aged care system and putting the rights of older people first with this once-in-a-generation reform.

This submission, prepared in consultation with the UnitingCare Network, provides a practical roadmap for implementing key components of the Act. We want to ensure we get the policy right and support providers to effectively transition across to a new framework. This will ensure the best possible outcomes for older Australians, their families, aged care providers, aged care workers and the sector at large.

The submission outlines what we aim to see from Government, the Department of Health and Aged Care (Department), and the Aged Care Quality and Safety Commission (Commission) to foster readiness among providers and stimulate effective change management across the sector. We look forward to working with Government to achieve this reform.

We note the Aged Care Rules (Rules), which will accompany the Act and provide much of the detail currently omitted, are yet to be released. The Aged Care Taskforce is also yet to release its final report which covers funding of the aged care system (and assumedly populate placeholders in the Act on fees and payments).

Roadmap

UnitingCare Australia supports a phased approach to reforms being implemented through the Act. The below roadmap outlines how certain elements of the Act could be staged, allowing sufficient time for implementation and readiness activities. In our view, some of these elements require straightforward revisions, otherwise if they require further policy work, we have recommended they not be included in the Act at this time and instead be removed, revised, and introduced at a later stage.

Overview of Proposals

Element

Proposal

Statement of Rights Commence 3 months after passage, with revisions
Objects and Statement of Principles Commence 3 months after passage, with revisions
High Quality Care Commence 3 months after passage, with revisions
Eligibility Requirements Commence 3 months after passage, with revisions
Provider Registration Commence 3 months after passage, with revisions
Complaints Commissioner Commence 3 months after passage, with revisions
Quality Standards Commence 9 months after passage
Statutory Duties and Penalties Commence 9 months after passage, with revisions
Supporters and Representatives Remove and revise
Needs Assessment Remove and revise

Sector Readiness

UnitingCare Australia shares the Government’s ambition for reforming the aged care sector, and we emphasise the need for these reforms to be delivered in a cohesive, clear manner to ensure consistency and clarity for providers and aged care recipients. The project management efforts and system upgrades needed to transition older Australians, aged care workers, responsible persons, and executive staff across to the new framework cannot be underestimated. This will be in addition to the cumulative effect of the many reforms already introduced since the Royal Commission, all of which have required ongoing dedicated resources to upgrade policies and procedures and meet compliance reporting requirements.

A list of considerations for providers

Once the final Act and associated Rules are known to the sector, set out below is a list of what providers will need to determine before transitioning to the new system.

  • How the Act’s new Objects, Statement of Rights and Principles interact with current operating processes.
  • How the new regulatory (registration) model interacts with current processes.
  • How the new responsible person obligation aligns with the current key personnel framework, and how the new duties and penalties apply.
  • How the new provider obligations (including subcontracted providers as ‘associated providers’) compare to the current obligations including:
    • How the new statutory duty “as far as reasonably practicable, do not cause adverse effects to the health and safety of care recipients” compares to current requirements.
    • How the new “significant failure and systemic pattern of conduct” requirement fits into existing risk and quality framework and processes.
    • What the new single aged care service list regulatory structure means compared to current practice.
    • Comparing the new audit requirements to current state, including new entry powers for the regulator.
    • Comparing the new aged care quality standards to the current age care quality standards and determining what needs to change.
    • Ensuring incident management systems are compliant with new rules.
    • How the new “ceasing to provide services” obligation compares to the current regime.
    • How the current responses compare to the new “notices and powers” regime of the regulator.
  • How the current complaints and compensation framework compares to the new proposed framework (including a Complaints Managements System).
  • How obligations under the new whistleblower regime compare to current practice.
  • How current and proposed consumer attraction and retention processes align to the new assessment model and access pathways.
  • How current nominee arrangements compare to the new supporters and representatives arrangement.
  • How information handling processes and storage aligns with the new requirements.

Transitioning to the new Act will not be cost neutral for providers, noting there are already significant administrative and regulatory costs the sector is struggling to absorb. Legislative reforms that require providers to upgrade their internal IT systems and reporting processes are particularly expensive and require significant additional resources. The current aged care funding system does not provide funding
or mechanisms for providers to charge additional fees to recoup these regulatory costs. As such, we recommend appropriate funding is distributed to assist providers with the transition to the new Act. At a minimum, providers should be provided with dedicated transition funding through the 2024-25 Budget. We note the proposed timeframes in the roadmap at the beginning of our submission are contingent on providers being funded appropriately to undertake the activities of transition.

Future Consultation and Next Steps

UnitingCare Australia acknowledges the effort that has gone into preparing the Act, and we appreciate being able to participate in this important consultation process. Noting there are chapters of the Act yet to be drafted, and several references to matters prescribed by the Rules, we call on the Department to conduct early, meaningful, open consultation on these components, not just a targeted consultation as is proposed in the Consultation Paper. Providers need the full picture of reform, and time to meaningfully respond to what is being proposed.

The Department needs to provide both sufficient time for these consultations to occur, and comprehensive gap analyses outlining what is new in Rules, compared to the current subordinate legislation, and how the Act has been updated in response to feedback provided through this consultation.

We look forward to working with Government, the Department and the Commission in reforming the aged care sector.