1. Heather Witham Manager, Government Relations and Policy ACSA Victoria Finance Forum 23 April 2015

2. Outline Aged care in Australia Aged care expenditure Aged care reform RADs and DAPs Delays in access to care Trends: Investor sentiment increasing The future for aged care Upcoming ACSA work New ACSA Any questions?

3. Aged Care in Australia In 2014/15……. over 231,500 people accessed permanent residential care over 83,100 people accessed home care packages over 23,500 people accessed transition care over 775,900 people aged 65 years and over accessed HACC services As at 30 June 2014, there were: 192,834 residential aged care places 66,954 home care places 4,000 transition care places

4. Aged care expenditure Australian Government expenditure for aged care increased by 5.6% in 2013-14. This totalled $14.2 billion $9.8 billion on residential care subsidies ($9.2 billion in 2012-13) $1.3 billion on home care packages ($1.2 billion in 2012-13) $367.4 million on flexible care programs ($354.2 million in 2012-13) $1.2 billion on HACC + $539.8 million on payments to VIC and WA $212.3 million on National Respite for Carers Programme (NRCP) $38.5 million on Day Therapy Centre (DTC) Programme

5. Aged care reform Issues related to aged care reform since 1 July 2014: Income testing in home care and means testing in residential care Delays with assessment letters Inconsistent information from DHS & DSS Low take up of level 1&2 HCPs Ongoing problems with online Medicare claiming process

6. RADs and DAPs Aged Care Financing Authority’s survey of aged care providers in their November 2014 Report (released January 2015) showed consumer choice of accommodation payment options for: RADs ranged from 41-44% DAPs ranged from 32-36% Combination RAD/DAP options ranged 23-25% Sample size: Approximately one third of services

7. RADs and DAPs

8. Lump sums held The overall pool of lump sum accommodation payments held or receivable grew by 2.3% between 30 June 2014 and 31 October 2014.

9. Choice of accommodation payment by ownership type

10. Delays in access to care Concerns over delays in access to care stem from: Delays in issuing means tests by DHS. Changes in provider admission behaviour, with more providers requiring prospective care recipients to have completed means test assessments before care is provided. Changes to consumer behaviour, with more time being given to understanding financial implications of choices. Delays with ACATs in some regions

11. Trends: Investor sentiment increasing

12. The Future Introduction of CHSP 1 July My Aged Care Gateway: DSS will closely monitor whether there is RAS/ACAT influence over consumer take up of places Next phase of reform: o Merger of CHSP/HCP – consumers as fund holders o Quality being a baseline “safety” focus (via accreditation) and “quality” focus based on consumer experience o Reform of ACAR/freeing up supply – ideas needed o CDC in residential care Examination of alternative funding models for RRR Aged care workforce stocktake and strategy Information Technology

13. What needs to change Providers: market leaders and innovators There must be greater safeguards for more vulnerable providers, especially those in Rural, Regional and Remote Australia Consumers and families will want more care choices Consolidation: A sustainable sector will mean fewer providers

14. Upcoming ACSA work Submission to tax white paper “RE:Think”: NFP and tax benefit focus (due 1 June) Work with DSS on RRR issues Await the release of the Reform of the Federation White Paper- Health and Housing – before 2016 election 2015/16 Budget – ACSAs Pre-Budget Submission available at: www.agedcare.org.au 2016: Federal Election

15. New ACSA ACSA has made a commitment to move to a national entity so it is well positioned to meet national challenges and ensure ongoing and increased effectiveness in service delivery to its members. Purpose To enable our diverse range of members to deliver quality services and support Mission Strengthen the community benefit sector to enhance the health and well-being of older Australians Values Community, Collaboration, Compassion, Courage Leadership Objectives Influence, lobby and advocate Research, policy development Enable networking Foster innovation Build partnerships and relationships

16. New ACSA guiding principles The quality of local services provided to members is our highest priority The transition will occur over a two-to-three-year period following agreement at General Meetings in June 2015 Change management and communications with members and staff is vital The transition process will be managed and monitored to ensure delivery of expected benefits throughout the transition period Minimise the impact on people while not compromising the quality of services

17. New ACSA guiding principles Maintain and maximise corporate knowledge Over the initial two-year period it is expected there will be some redefinition of roles across the New ACSA National work (as opposed to local) will be undertaken in the most appropriate locations In the medium- to long-term ACSA will seek efficiencies in operations Pre-transition commitments at State and National levels will be honoured

18. Any questions? hwitham@agedcare.org.au