Innovative Partnership Boosts Medication Safety for Older Australians and Those Facing complex Health Conditions

For dedicated caregivers across Australia who are responsible for managing the medications of their loved ones, ensuring safety and effectiveness can be a daunting task. However, a new collaboration between two prominent healthcare organizations is poised to simplify and enhance this crucial aspect of care.

MedicAlert Foundation Australia and Home Medication Reviews (HMR) Referrals have united forces to address a significant gap in medication safety for Australians residing in the community. This partnership is particularly timely, as recent data reveals that only 6.5% of elderly Australians living at home receive medication reviews, in stark contrast to the 65% of those in aged care facilities who undergo such evaluations.

The statistics surrounding medication management for older Australians are alarming: one in two individuals aged 65 and above take five or more medications daily, increasing their risk of adverse drug reactions by 88%. Even more concerning is the fact that over 500,000 vulnerable elderly Australians have not received the necessary medication reviews in the past year.

 

What This Partnership Means for Caregivers 

The partnership between MedicAlert and HMR Referrals offers a range of practical benefits for those who care for their loved ones:

1. Improved Access to Home Medication Reviews (HMRs): Caregivers can now easily access HMR services through their MedicAlert membership, ensuring that their loved ones’ medication regimens are safe and appropriate.

 

2. Enhanced Emergency Response: Clients referred for HMRs will have access to MedicAlert’s 24/7 emergency response service and medical identification products, providing caregivers with added peace of mind.

 

3. Enhanced Coordination of Care: The partnership is designed to bridge the gap between emergency identification and day-to-day medication management, promoting a more integrated approach to healthcare safety for caregivers and their loved ones.

 

Initiating Steps

If you are responsible for the care of a loved one who is taking multiple medications, it is important to take the following steps:

• Reach out to HMR Referrals to gain a better understanding of the enhanced services they offer.

 

• Inquire about Home Medication Reviews for your loved one.

 

• Explore the identification products provided by MedicAlert, such as their innovative QR ID system, which enables first responders to quickly access vital medical information.

 

This partnership marks a significant advancement in the support of Australia’s caregivers and their loved ones, especially in addressing the pressing issue of medication safety in the community.

 

 

Everyone should have access to quality care and support as they grow older, whether they choose to stay in their own home or transition to an aged care facility. The forthcoming reforms in aged care are designed to offer personalized, high-quality care that is easily accessible and tailored to individual needs.

After conducting numerous consultations, surveys, and community events, the Department has gained a clear understanding of the desires of older Australians:

• Enhanced choice and control
• Fair and reasonable costs
• Robust protection and the preservation of your rights
• The assurance that concerns and complaints will be addressed seriously and without repercussions
• Transparency and accountability from service providers

These reforms are designed to ensure that the aging population receives the care and support they deserve, with a focus on individual needs and preferences.

These changes are crucial for all Australians. It is essential for us to feel assured that we will have access to affordable, safe, and appropriate support as we grow older. That is why the department is implementing consumer confidence protections. Learn more about these protections below.

Choice and Control in Aged Care

The recent changes to aged care have placed older individuals at the forefront of the system. This means that you will now have greater autonomy in selecting the services you wish to utilize, as well as more control over how you allocate your funding.

 

Decision-Making under the New Aged Care Act

The updated Aged Care Act prioritizes the rights of older Australians within aged care legislation. These rights are now legally enforceable by the Aged Care Quality and Safety Commission and the Complaints Commissioner.

The new Act also includes a Statement of Rights specifically for older Australians. This statement outlines your entitlement to make decisions regarding your care and finances, as well as the option to designate a support person if needed.

 

Star Ratings for Aged Care Homes

Star Ratings have been implemented to assist you in comparing the quality, safety, and services offered by different aged care facilities. By utilizing the Find a Provider tool, you can access detailed information about specific aged care providers, including their Star Rating. This valuable information empowers you to make informed decisions that align with your individual needs and preferences.

 

Introducing the New Support at Home Program 

As we age, the desire to remain in the comfort of their own homes becomes increasingly important. Recognizing this, a new Support at Home program has been established to cater to the needs of approximately 1.4 million older individuals, with a focus on promoting supported and independent aging.

 

Contributions made by participants 

Aged care providers are now required to be transparent about the costs associated with their services, including publishing their prices online. Additionally, exit and entry fees, as well as other hidden fees, have been prohibited for home care services.

Individuals receiving Support at Home services will now receive monthly statements detailing the hours of each service provided, along with the associated costs charged to their Support at Home budget and any participant contributions made.

Before moving into residential aged care, the providers must ensure that all care costs are clearly outlined to potential residents. Residents will still have the freedom to choose additional services, with added protections in place to prevent being charged for services they do not want or cannot use. Discrimination based on a person’s ability to pay for extra services is also prohibited.

 

Free advocacy and legal services

Advocacy and legal services are free and available for older Australians, their families, and caregivers through funding from the Australian Government. Advocates can represent you and assist in resolving any issues you may be facing. Organizations such as National Seniors, the Council on the Ageing (COTA), and the Older Persons Advocacy Network (OPAN) offer valuable resources and support.

If you or someone you know is experiencing feelings of unsafety while receiving aged care, there are free services provided by lawyers, social workers, and other specialists to help. It is important to educate yourself on protection against elder abuse and seek assistance when needed.

 

Fairness in Aged Care Funding

To ensure the sustainability and fairness of aged care funding, significant changes are being implemented. The current funding arrangements are not adequate to support our growing and aging population, prompting the need for adjustments.

The government will continue to be the primary source of funding for aged care services. However, financially able individuals will be required to make a co-contribution to their care costs. The amount of this co-contribution will be determined based on the individual’s personal circumstances, level of support needed, and income and assets.

It is important to note that under the new co-contribution structure, there will be no changes to how the family home is treated. This ensures that individuals can still receive the care they need without risking their primary residence.

 

Ensuring Access to Quality Clinical Care

The government is committed to providing full funding for clinical care services in both aged care facilities and the Support at Home program. These essential services, typically administered by registered nurses, encompass vital aspects such as pain management and medication assistance.

In the Support at Home program, individuals will only be required to pay a co-contribution for the specific services they utilize. Co-contributions will be determined based on an hourly rate or unit of service, calculated as a set percentage of the total cost for each service category.

 

Transitioning to Price Caps

Beginning July 1, 2026, the government will gradually implement price caps on services within the Support at Home program.

Until July 1, 2025, providers of in-home aged care will retain the autonomy to establish their pricing structures for Support at Home services, mirroring the current setup in the Home Care Packages Program.

To promote fairness, co-contributions will be capped at $130,000 across both Support at Home and residential care, particularly benefiting individuals who require long-term care and make substantial co-contributions.

Co-contributions for non-clinical care services, such as assistance with mobility and lifestyle activities in aged care facilities, will cease after 4 years.

For every $1 contributed by an older person towards their care in the Support at Home program, the government will contribute approximately $7.80.

In aged care facilities, the government will contribute $3.30 for every $1 contributed by the individual.

 

The No Worse Off Principle

The Principle ensures that individuals accessing residential aged care services on or before September 12, 2024, will not experience any changes in their payments.

This principle also guarantees that those receiving a Home Care Package or deemed eligible for one by September 12, 2024, will not face any financial disadvantages when transitioning to Support at Home.

For full-rate pensioners who are currently not paying any fees under their Home Care Package, will continue to be exempt from fees under Support at Home.

If you were previously required to pay fees under your Home Care Package, the amount you pay under Support at Home will either remain the same or decrease.

Furthermore, individuals will retain eligibility to enter an aged care home under the existing fee structure, regardless of when they decide to make the transition. This ensures a seamless and fair process for all individuals to access aged care services.

 

Priority Funding for Those in Greatest Need

The funding allocation is designed to prioritize individuals with the most limited financial resources. For residents in aged care facilities, the basic daily fee is the only payment required. Furthermore, as a person’s income and assets decrease, so do the fees they are responsible for.

In cases of financial hardship where individuals cannot cover their fees or contribute to their care costs, government assistance will be provided to ensure continued support.”

 

Ensuring Transparency in Aged Care Funding

The Department prioritizes transparency in the allocation of aged care funding and co-contributions to ensure they are utilized appropriately. It is our commitment to uphold the highest standards of accountability and integrity in managing these resources.

 

Setting and Monitoring Prices for Aged Care Services

Aged care providers play a crucial role in delivering quality care to our elderly population. They receive funding to cover the costs of essential workers such as registered nurses, allied health professionals, and lifestyle officers.

To ensure fair pricing and sustainability in the sector, the Department collaborate with the Independent Health and Aged Care Pricing Authority (IHACPA) to establish prices for aged care homes, including hoteling services.

Additionally, the Department sets prices for Support at Home services starting from 1 July 2026.

 

Government Regulations on Contribution Levels

It is important to note that providers are prohibited from increasing contributions for services funded by the government beyond the levels set by the government. This regulation is in place to safeguard the interests of elderly individuals and ensure that they receive the care they deserve without facing financial burdens.

 

Cost Transparency in Aged Care 

When it comes to your hard-earned dollars and the care you receive, transparency is key. With the Find a Provider tool, you can now easily track how your co-contribution is being utilized by providers in aged care homes and Home Care Packages. This includes details on spending for care, food, staff, and accommodation.

By making this information publicly available, you have the power to make informed decisions about which provider aligns best with your needs and preferences. The Department of Health and Aged Care, along with the Aged Care Quality and Safety Commission, closely monitor and audit provider financial reports to ensure accuracy. Providers who fail to report correctly face civil penalties, ensuring accountability and peace of mind for consumers.

 

Refundable Accommodation Deposits (RADs) Cap

To protect consumers, there is a cap on the amount providers can retain from RADs. Starting from July 1, 2025, providers can only keep 2% of their lump sum payment for each year they reside in an aged care home, up to a maximum of 5 years. This measure aims to guarantee that aged care homes have the necessary funds to enhance residents’ comfort, maintain existing facilities, and develop new ones.

 

Accountability

The department ensures that providers are held accountable for their actions, providing transparency regarding how funding is utilized.

 

Enhancing regulations

Recent regulations require providers to deliver services in accordance with the Statement of Rights, emphasizing the importance of person-centered care. Providers are expected to collaborate with older individuals, involving them in decision-making processes.

To receive government funding, providers must be registered and compliant with the Aged Care Quality Standards.

Providers who fail to meet their obligations will be subject to consequences under the new regulatory framework.

 

Confidence in Providing Feedback and Addressing Complaints 

It is crucial to have the confidence to share feedback or make complaints if you have any concerns about the care, you or a loved one is receiving. The department understands the importance of open communication and are committed to providing avenues for providers to address feedback and complaints effectively.

If you find yourself in a situation where you are unable to resolve a concern or complaint by discussing it with your service provider, the Aged Care Quality and Safety Commission can assist you in finding a resolution. Additionally, if you believe that your rights have not been upheld by your provider, you have the option to make a complaint to the independent Complaints Commissioner.

Both older Australians and workers are protected by whistleblower laws, ensuring that they can report information confidently without the fear of facing punishment or unfair treatment. This protection is in place to encourage transparency and accountability within the aged care industry.

 

Inspector General of Aged Care

The newly appointed Inspector-General of Aged Care is responsible for overseeing the aged care system and identifying any potential issues. This includes monitoring the regulation, funding, and administration of aged care services.

The Inspector General’s office operates as an independent agency, dedicated to ensuring that the aged care system remains robust, accountable, and transparent. Their primary goal is to meet the needs of older individuals, their families, and caregivers.

One of the key initiatives introduced by the Inspector General is the implementation of a cap on the amount of funding that can be allocated towards care management within aged care packages. This measure aims to streamline the allocation of resources and improve the overall quality of care provided.

Participants in the Support at Home program will now have access to care management services. Those receiving ongoing care will have 10% of their quarterly budget pooled with their service provider to facilitate the delivery of care management. Additionally, there will be supplementary funding available for individuals with diverse care needs.

Overall, the Inspector General of Aged Care is committed to enhancing the quality of aged care services and ensuring that older individuals receive the support they require to live fulfilling and dignified lives.

The Department of Health and Aged Care has recently released Stage 3 of the Aged Care Rules 2025. This update includes draft Rules that outline provider obligations and reinforce Quality Standards within the aged care sector.

On February 13, 2025, the Department of Health and Aged Care released Stage 3 of the Aged Care Rules 2025 for public consultation. These rules outline provider obligations set forth in Chapter 3 of the Aged Care Act 2024 and the enhanced Quality Standards. Some provisions in the Stage 3 release of the Aged Care Rules including the Aged Care Code of Conduct. In this overview, we will delve into the key aspects of the Stage 3 Rules.

 

Conditions of Registration and Provider Obligations 

Registered providers will have specific conditions on their registration and obligations outlined in Chapter 3 of the New Act. These conditions and obligations are tailored to the provider’s category of registration, taking into account the nature of their services, the environment in which they operate, and any potential risks to individuals. For instance, newly registered providers may face different conditions compared to those who have been registered previously. While conditions and obligations may vary based on registration category, certain requirements apply to all registered providers. The Stage 3 Rules mandate that all providers must demonstrate an understanding of the Statement of Rights, implement practices to ensure compliance with these rights (as per section 144-1 of the Stage 3 Rules), and show a commitment to continuous improvement in delivering high-quality care (as per section 147-5 of the Stage 3 Rules). 

In essence, registered providers are expected to uphold certain standards and principles to ensure the well-being and rights of individuals receiving their services. These regulations aim to promote a culture of accountability, quality, and improvement within the healthcare industry.

 

Enhanced Quality Standards 

The standards are a crucial requirement for registered providers to adhere to. Renewal and modification of provider registration will be determined by an audit of the relevant standards and the overall performance of the registered provider. These standards are applicable to registered providers based on the specific services they offer within their registration category, as detailed below.

 

Quality Standards and Application 

The following standards apply to providers registered in specific categories under the new regulations: 

• Standards 1 – 4: Applicable to providers registered in the ‘personal and care support in the home or community’ category (category 4).
• Standards 1 – 5: Applicable to providers registered in the ‘nursing and transition care’ category (category 5).
• Standards 1 – 7: Applicable to providers of residential aged care (category 6).

 

Commonwealth Home Support Program (CHSP) and the National Aboriginal and Torres Strait Islander Flexible Aged Care Program (NATSIFACP)

Obligations are currently outlined in individual grant agreements with the Department. These agreements are supported by guidance found in program manuals published by the Department. 

Under the new regulations, the regulation of CHSP and NATSIFACP providers will be detailed in the Rules, in addition to the program manuals and grant agreements. As registered providers under the new regulations, CHSP and NATSIFACP providers must comply with any conditions of registration and obligations, such as the Aged Care Code of Conduct.

 

Aged care worker screening 

The Government is working closely with states and territories to expand and ensure uniformity in the National Disability Insurance Scheme (NDIS) worker screening checks. In the meantime, registered providers must continue to verify that their aged care workers and responsible individuals hold either a police certificate or an NDIS worker screening clearance. Starting from July 1, 2025, CHSP and NATSIFACP providers must confirm that their staff does not have police certificates showing serious offenses, such as violent crimes, sexual offenses, or significant dishonesty until NDIS worker screening checks are implemented in 2026. This marks a shift for CHSP providers, who previously had discretion in evaluating criminal backgrounds. For NATSIFACP providers, the change means that fraud-related offenses previously focused on executive decision-makers are now governed by enhanced suitability requirements for responsible individuals under the new Act.

 

It is important to note that several provisions in the Stage 3 Rules have yet to be finalized. The remaining Rules are anticipated to be included in the Stage 4 Release, set to be published in early March 2025. We understand that providers are eagerly awaiting additional information to aid in the transition period.

 

A restrictive practice refers to any action that limits the rights or freedom of movement of a care recipient. There are five main types of restrictive practices: 

1. Chemical restraint
2. Environmental restraint
3. Mechanical restraint
4. Physical restraint
5. Seclusion

 

These practices are used in certain situations to ensure the safety and well-being of the individual receiving care. Care workers and healthcare professionals need to be aware of these practices and use them judiciously to maintain the dignity and autonomy of the care recipient.

 

 

Minimising the Inappropriate Use of Restrictive Practices in Aged Care 

Effective July 1, 2021, amendments to the Aged Care Act 1997 and Quality of Care Principles 2014 have been implemented to regulate and strengthen the use of restrictive practices in Australian Government-funded residential aged care facilities. These changes aim to enhance the safety and well-being of care recipients, as well as to reinforce reporting requirements for approved providers.

 

The Aged Care and Other Legislation Amendment (Royal Commission Response) Act 2022 has introduced additional legislative amendments to further enhance consent requirements and address gaps in state and territory legislation regarding the use of restrictive practices.

 

The Aged Care Clinical Advisory Committee is dedicated to reducing the use of restraint in residential aged care by providing expert advice on clinical policy and legislative oversight.

 

In addition to these measures, there are other initiatives in place to minimize the inappropriate use of restrictive practices, including: 

• mandatory reporting of such incidents through the Serious Incident Response Scheme (SIRS)
• reporting on the use of all restrictive practices (excluding chemical restraint) through the National Aged Care Mandatory Quality Indicator Program (QI Program).
• adherence to the Aged Care Quality Standards is essential in ensuring the appropriate use of restrictive practices in aged care facilities.

 

A restrictive practice should only be implemented as a last resort to prevent harm to a care recipient or others, taking into consideration its impact on the individual receiving care. Before resorting to any restrictive practice, providers are required to test and document alternative strategies. Additional support is readily available to help manage behaviors that may pose a risk to the care recipient or others. 

Dementia Support Support Australia (DSA) offers services aimed at assisting individuals living with dementia who are experiencing behavioral changes. Meanwhile, Dementia Training Australia (DTA) provides a range of free online dementia training courses, practical resources, and training packages. DTA also offers in-person training sessions to providers and professionals in the sector. These resources are designed to help staff gain a better understanding of the root causes of behavioral changes and learn effective strategies to prevent or minimize them.

 

 

Provider Responsibilities 

Approved providers have a responsibility to always consider the rights of care recipients and comply with legislative obligations. When utilizing a restrictive practice, approved providers must adhere to the following guidelines:

 

• Use restrictive practices as a last resort to prevent harm to a care recipient or others, after carefully evaluating its impact on the care recipient.
• Trial and document alternative strategies before resorting to restrictive practice.
• Implement the least restrictive form of practice for the shortest duration necessary.
• Obtain informed consent from the care recipient or their restrictive practices substitute decision-maker (RPSDM) before using the practice.
• Ensure that the use of restrictive practices aligns with the rights and responsibilities of care recipients as outlined in the Charter of Aged Care Rights
• Monitor and regularly review the use of restrictive practices.

 

Approved residential aged care providers are required to include a Behavior Support Plan (BSP) in the existing Care and Services Plan for all care recipients who

 

• exhibit behaviors of concern,
• undergo assessment for the need for restrictive practices,
• have restrictive practices applied to them.

 

The Aged Care Quality and Safety Commission (ACQSC) is dedicated to safeguarding the safety, health, and well-being of care recipients.

 

The ACQSC collects and evaluates information on the use of restrictive practices to ensure that approved providers are following: 

• legislative obligations,
• the Charter of Aged Care Rights,
• the Aged Care Quality Standards.

 

For more information to assist approved providers in meeting their requirements regarding restrictive practices, please visit the ACQS website.

 

 

Informed consent is a crucial aspect when it comes to the implementation of restrictive practices

 

Consent must be obtained from either the care recipient or a Representative of a Person with Decision-Making Capacity (RPSDM) in cases where the care recipient is unable to provide consent.

 

A RPSDM is an individual or entity authorized to provide informed consent for the use of restrictive practices. They also have the authority to consent to the prescription of medication for chemical restraint purposes. All consent procedures must adhere to the laws and regulations of the state or territory where the care recipient is receiving aged care services.

 

Ensuring that informed consent is obtained clearly and transparently is essential to upholding the rights and dignity of elderly individuals in residential aged care settings. It is crucial to prioritize the well-being and autonomy of care recipients while also complying with legal requirements.

 

 

Temporary procedures for obtaining consent for restrictive practices

 The Quality of Care Principles 2014 establishes a hierarchy for determining who has the authority to consent to the use of restrictive practices on behalf of a care recipient is:

• unable to provide consent themselves,
• when there is no clear legal process in place to appoint a Restrictive Practices and Safeguards Decision Maker (RPSDM) under state or territory laws,
• when there is a substantial delay in the decision-making process for appointing an RPSDM.

There are five levels of the hierarchy for determining who can give consent for restrictive practices:

 

1. Restrictive practices nominee – an individual or group nominated by the care recipient, able to give informed consent if the care recipient lacks capacity, has agreed in writing, and can give consent.
2. Partner – the partner of the care recipient with a close continuing relationship, who has agreed in writing to act as the RPSDM and can give consent.
3. Relative or friend who was a carer – a person who was the unpaid carer immediately before the care recipient entered care, has a personal interest in the care recipient’s welfare, a close continuing relationship, agreed in writing to act as the RPSDM, and can give consent.
4. Relative or friend who was not the carer – a person with a personal interest in the care recipient’s welfare, a close continuing relationship, agreed in writing to act as the RPSDM, and can give consent.
5. Medical treatment authority – an individual or body appointed under the state or territory law where the care recipient receives aged care, able to give informed consent for medical treatment if the care recipient lacks capacity.

 

This hierarchy is an interim measure to allow time for state and territory governments to update their consent and guardianship laws. Originally intended to sunset on December 1, 2024, the application period was extended to December 1, 2026, to ensure all states and territories have appropriate laws in place.

 

 

Responsibilities of Medical Practitioners in Aged Care 

Medical practitioners who work with care recipients in aged care facilities have a crucial role in ensuring the safety and well-being of those under their care. Medical practitioners need to always prioritize the safety and health of care recipients.

 

Before prescribing psychotropic medications, medical practitioners are required to explore and document alternative strategies in the care recipient’s clinical record. There are guidance materials available to assist medical practitioners in this process, such as information on:

 

• psychotropic medications commonly used in Australia
• prescribers working in residential aged care

 

When considering the use of chemical restraints, medical practitioners must follow specific guidelines. They must first assess the care recipient to determine if:

 

• they pose a risk of harm to themselves or others.
• a chemical restraint should only be considered a last resort
• medical practitioners are also required to discuss the proposed benefits, risks, and alternatives with the care recipient or their representative,
• seeking their informed consent before prescribing the medication
• Medical practitioners must communicate that informed consent has been obtained from the approved provider in a mutually agreed-upon manner before prescribing the medication.

 

In some cases, approved providers may request that a medical practitioner assess the need for restrictive practice and provide evidence to support its use. The approved provider is responsible for documenting this information in the care recipient’s Behavioral Support Plan (BSP).

 

 

How Medical Practitioners Can Assist in Aged Care 

Medical practitioners play a crucial role in the care of residents in aged care facilities and in reducing the inappropriate use of restrictive practices. There are numerous ways in which practitioners can support approved providers in meeting requirements and ensuring the safety and well-being of residents. Some of these ways include:

 

• Assessing the potential contribution of current medications to confusion, sedation, or other side effects that may cause distress or problematic behaviors.
• Identifying and documenting the risks of harm to oneself or others that medications used as restraints aim to address.
• Communicating prescribing decisions with the aged care provider and relevant staff.
• Obtaining informed consent from the resident or their representative and sharing this consent with the provider.
• Specifying the necessary monitoring for potential side effects.
• Emphasizing the need for ongoing evaluation of the effectiveness and impact of medications, as well as when these evaluations will take place.
• Clearly defining the circumstances under which sedating medications can be used on an ‘as needed’ basis.
• Regularly reviewing medications, particularly psychotropic drugs, to facilitate deprescribing at the earliest opportunity.
• Collaborating with other prescribers, past or present, in cases where the reasons for prescribing and review responsibilities are unclear.

 

By following these guidelines, medical practitioners can contribute significantly to the well-being and quality of care provided to residents in aged care facilities.

 

New Aged Care Act

The Australian Government has recently introduced the Aged Care Bill 2024 to Parliament, marking a significant milestone in the country’s aged care sector. This bill was passed by Parliament on 25 November 2024 and is set to come into effect as the new Aged Care Act 2024 starting from 1 July 2025.

For those interested in learning more about this important legislation, you can review the following resources:

• Minister for Aged Care’s media release announcing the introduction of the Bill for the new Act
• The Minister for Aged Care’s media release announcing the passage of the Bill for the new Act
• Aged Care Bill 2024 and explanatory memorandum An overview fact sheet on the Aged Care Act 2024
• An easy-to-read overview fact sheet on the Aged Care Act 2024

These resources provide valuable insights into the key provisions and implications of the new Aged Care Act 2024, ensuring that stakeholders are well-informed and prepared for the changes ahead.

 

About the new Act

Currently, the aged care sector is governed by a multitude of laws. The upcoming Act is set to replace:

• Aged Care Act 1997,
• Aged Care (Transitional Provisions) Act 1997,
• Aged Care Quality and Safety Commission Act 2018

The primary goal of the new Act is to enhance the delivery of services to older individuals in

• their homes,
• community settings,
• approved residential aged care facilities. 

It will:

• establish the rights of older individuals seeking and utilizing aged care services, * introduce a streamlined entry process with clear eligibility criteria,
• implement a culturally sensitive Single Assessment System framework, support service delivery,
• create new oversight and accountability mechanisms,
• enhance provider responsibility through a revised regulatory framework, and fortify the aged care regulatory body. 

The new Act is scheduled to come into effect on July 1, 2025, coinciding with the launch of the Support at Home program.

By carefully phasing in these reforms, a smooth transition to the improved aged care system envisioned by the Royal Commission into Aged Care Quality and Safety can be achieved.

 

Importance of the New Act 

The Royal Commission has determined that the current Aged Care Act and its associated legislation are no longer suitable for the needs of our aging population. The existing framework focuses on providers and funding mechanisms, rather than prioritizing the individuals who require care and support.

The introduction of a rights-based Aged Care Act will revolutionize the aged care system by placing older people at the forefront. This means that the services provided will be centered around the needs and rights of the individuals accessing them.

The new Act will address approximately 60 recommendations made by the Royal Commission, including:

• the implementation of the Government’s response to the Aged Care Taskforce recommendations,
• the establishment of the Support at Home program, the enhancement of Aged Care Quality Standards,
• the empowerment of the Aged Care Quality and Safety Commission, and the creation of a Statement of Rights for older individuals.

Furthermore, the new Act will build upon previous aged care reforms that have already been successfully implemented.

This comprehensive approach aims to ensure that older people receive the highest quality of care and support they deserve.

 

Legislative Progress in Aged Care Reforms

Significant strides have been made in implementing crucial aged care reforms delivered through amendments to existing legislation. These changes were swiftly enacted to address key recommendations from the Royal Commission.

The introduction of the new Act marks a pivotal moment in the ongoing transformation of the aged care system. For a comprehensive overview of the proposed reforms, refer to our detailed reform roadmap.

The Aged Care and Other Legislation Amendment (Royal Commission Response No. 1) Act 2021 has brought about essential modifications, including:

• Strengthening controls on the use of restrictive practices, ensuring they are only utilized as a last resort
• Implementing assurance reviews to monitor the appropriate allocation of government funding by home care providers
• Disbanding the Aged Care Financing Authority (ACFA) in favor of establishing the Independent Health and Aged Care Pricing Authority, a new advisory body for aged care financing.

 

 

The Aged Care and Other Legislation Amendment (Royal Commission Response) Act 2022

This Act was introduced to address 17 recommendations made by the Royal Commission.

This Act brings about significant changes in the aged care sector, including:

• Implementation of the new Australian National Aged Care Classification funding model for residential aged care
• Introduction of Star Ratings for residential aged care services
• Establishment of an enforceable Code of Conduct for Aged Care that applies to approved providers, their governing bodies, and workforce
• Granting powers to the Aged Care Quality and Safety Commissioner to take enforcement action in cases of Code of Conduct breaches.
• Extension of the Serious Incident Response Scheme to cover home care and flexible care provided in a home or community setting, along with incident management responsibilities
• Strengthening of provider governance
• Improvement in information sharing between regulators in the aged care, veterans’ care, and disability support sectors
• Enhanced financial and prudential oversight of the use of residential accommodation deposits and bonds
• Expansion of the functions of the Independent Health and Aged Care Pricing Authority to provide pricing advice to the government on aged and general health care
• Revision of restrictive practices arrangements to address gaps in state and territory guardianship and consent laws.

 

The Aged Care Amendment (Implementing Care Reform) Act of 2022

This Act was enacted in response to two recommendations from the Royal Commission. This Act aims to enhance the integrity and accountability of residential aged care homes, fulfill the government’s election promises, and bring about positive changes in the aged care sector.

Key provisions of the Act include the prohibition of exit fees and the capping of administrative and management charges in the Home Care Packages Program. Additionally, the Act mandates that a registered nurse must be present and available 24 hours a day, 7 days a week in every residential aged care facility.

Furthermore, the Act introduces mandatory reporting requirements that necessitate the publication of additional provider information to promote transparency. This information includes details on provider spending in various areas such as

• care
• nursing
• food
• maintenance
• cleaning
• administration
• profits

 

Who will be impacted by the new Act?

The new Act will have an impact on all individuals involved in the aged care system, including:

• Older individuals, their families, and caregivers
• Aged care providers
• Aged care workers
• The broader care sector
• Government agencies responsible for supporting, delivering, regulating, and overseeing the aged care system, such as the Department of Health and Aged Care, the Aged Care Quality and Safety Commission,
• Services Australia

This legislation will bring changes that will affect various aspects of the aged care system, making it crucial for all stakeholders to stay informed and prepared for the upcoming adjustments.

 

Partnerships in Developing the New Act 

To ensure that the new Act accurately represents the needs of older individuals, we collaborated and consulted with a variety of stakeholders throughout its development. These included:

• Older individuals, along with their families and caregivers
• Aged Care Council of Elders
• National Aged Care Advisory Council
• Providers of aged care services
• Aged care professionals
• Leading aged care organizations
• Consumer and sector reference groups
• Various experts in the field

By engaging in these diverse groups, we were able to gather valuable insights and perspectives that informed the creation of the new Act. This collaborative approach has helped to ensure that the legislation is comprehensive, inclusive, and responsive to the needs of older individuals in our community.

 

The new Act will have a significant impact on all older Australians involved in aged care services?

It aims to empower older individuals to assert their rights when accessing or seeking Commonwealth-funded aged care services, ultimately supporting them in leading active, self-determined, and meaningful lives as they age.

Providers will be required to register to deliver Commonwealth-funded aged care services and must adhere to a set of obligations, including specific conditions related to their registration. This requirement applies even if they subcontract the delivery of services to other parties.

Additionally, separate obligations will be imposed on aged care workers, responsible individuals of registered providers, and operators of digital platforms that facilitate access to services. These measures are designed to ensure the highest standards of care and support for older individuals in need of aged care services.

The new Aged Care Act the broader sector. It will put

Introducing the Support at Home program, which allows for separate funding of assistive technology and home modifications through the Assistive Technology and Home Modifications Scheme (AT-HM). It is crucial to familiarize yourself with the revised list of inclusions and exclusions under this scheme.  This AT- HM scheme is designed to support older Australians, including those with a disability who are ineligible for the National Disability Insurance Scheme because of the age cut-off, to remain living independently at home.

The anticipated results of a new AT-HM program reveal a significant consensus among stakeholders regarding the critical aspects of:

• providing timely support with adequate funding,
• enhancing transparency concerning the inclusions and exclusions of supports, particularly regarding supplementary services such as trials and educational programs for AT-HM usage, and
• the advantages of implementing a loan program.

However, there exist divergent opinions among stakeholders regarding the authorization to prescribe AT-HM and the clarification of roles and responsibilities in its implementation. This includes considerations of accountability, communication, and the capacity and competency of the workforce.

 

Objectives

The objective of the new AT-HM scheme is to ensure that older Australians have timely access to safe assistive technology and home modifications to help them live independently at home.

 

Principles

Principles

During the co-design process, participants were asked to provide feedback on a set of principles derived from the World Health Organization and UNICEF. These principles were then updated based on the feedback received during the co-design process. The summarized principles are as follows:

1. Accessibility – Products, services, facilities, systems, and information should be accessible, available in a timely manner, and provided equitably.
2. Adaptability – AT-HM products and services should be adaptable to the needs of individuals and responsive to their changing needs and goals over time.
3. Suitability – AT-HM should meet the needs of older Australians, empowering them to make choices and have control over their AT-HM following their assessed care needs.
4. Value for money – The scheme should provide value for money to eligible Australians, as well as to the broader Australian community and government.

 

The provisions that the scheme may offer?

Proper support before and after accessing equipment can help ensure that Assistive Technology in Home Modification (AT-HM) is utilized effectively to prevent decline in older Australians. Stakeholders have suggested a range of complementary services, including:

• Preventative services
• Triage, aged care assessment, and prescription of AT-HM
• Referrals
• Trials and ordering
• Delivery and installation
• Ongoing support as needed
• Reviews and reassessments

For detailed information about each wrap-around support service, please refer to the

Department of Health’s website.

 

AT-HM risk classifications

The Department of Health and Aged Care has released a comprehensive list outlining the items covered by the AT-HM Scheme. These inclusions are categorized into three main groups:

• Low-risk: Everyday products that are affordable, uncomplicated, and do not necessitate a prescription or customization.
• Under advice: Low-risk items that could benefit from expert guidance to guarantee proper selection, installation, or other considerations.
• Prescribed: Items that mandate a prescription from a qualified healthcare professional.

 

Below are three funding tiers for assistive technology and three tiers for home modifications. Each tier will have a set time during which funding must be used; AT-HM funding will not accrue over time.

Much like the Support at Home service list, the AT-HM Scheme will indicate what products, equipment, and modifications are available. Final funding tiers will be made official before the program commences, but you can view the tables below to get an idea of the allocations.

Assistive Technology Funding Tier	Funding Allocation Cap	Time Allocated to Expend Funding
Low	$500	12 months
Medium	$2,000	12 months
High	$15,000*	12 months

*Higher amounts for AT may be approved with a prescription.

Home Modifications Funding Tier	Funding Allocation Cap	Time Allocated to Expend Funding
Low	$500	12 months
Medium	$2,000	12 months
High	$5,000	12 months

 

What are conditional inclusions?

Conditional inclusions are items that require additional eligibility criteria before funding is available. For instance, older individuals with incontinence may qualify for the Continence Aids Payment Scheme (CAPS) to cover costs. Once CAPS funding is depleted, these items can then be purchased using the AT-HM Scheme.

 

What is excluded?

Items that cannot be funded through the AT-HM Scheme are classified as exclusions. Exclusions fall into two categories:

• Currently funded by others: Items that are already funded under other Support at Home streams (e.g., wound care products funded under Nursing Care) or through other government programs (e.g., primary health care or specialized schemes).
• Out of scope for participants: This category includes general household expenses, workplace items, children’s items, and products for public transport use.

 

For more information regarding this Scheme, please visit the Department of Health