Response to the Sydney Morning Herald about Aged Care

As a provider of Allied Health to the Aged Care Industry, Sea Change Health Professionals is particularly aware of the aged care ministers recent comments in regards to Physiotherapists over-servicing to aged care clients.

The minister has called for nursing homes to stop over-servicing aged care clients. This is a very important point from the minister. Aged care providers are already acutely aware of changes to funding that is coming in the latter half of 2022, but now we have confirmation from the minister, through this leaked letter, that providers can no longer hope for the funding changes to be overturned and will face an uphill battle to retain current funding levels for allied health care.

The current model provides incentives for specific types of treatment to aged care residents. To be clear, this is not a system that aged care providers can choose. This a funding model that was put in place by the government that aged care providers must follow.

To draw your attention just for a moment to the ridiculousness of this funding model, aged care providers pay professionals to fill out forms to make claims for funding. The government then pays professionals to review and critique these forms to try and get funding back from the providers. Then aged care providers pay professionals to protect the funding by gathering information and data to support the original claim. There is a percentage of funds that is absorbed by this ridiculous dance, and it isn’t negligible or optional.

To put this another way, all aged care providers and facilities have staff employed to gather and monitor paperwork for funding submissions for each client, rather than provide actual care to a client.

The funding gathered for each client, adds up to the funding that is available for the facility to provide care. So it is very important that each facility does its absolute best to gather as much funding as possible, inside the rules. You cannot blame providers for that.

What this means is that aged care providers “game” the system, because they are being forced to do so by this inadequate funding model. We have seen examples where providers instruct allied health professionals to give services to clients based on meeting funding requirement targets. All allied health staff have at some point been asked to provide services to clients that they think the client did not need, but it made the client meet a funding target that benefited the entire facility as a whole. There is no blame on the providers, there is no blame on the allied health professionals. The rules of the funding model were set by the government and the providers are doing their best to work within the constraints of this broken system.

We must acknowledge that aged care providers and allied health providers have been a part of this game for years and that many allied health providers have benefited tremendously through this system.

There is a void of information on what to expect after October 2023. Best guess at this point has funding set on the new system that does not incentivize specific treatments for allied health. What does this mean? Well, this means that specific allied health work may not be needed to achieve funding targets. I want to be very clear that this does not and should not mean that allied health is not necessary in an aged care facility.

Residents in all aged care settings have complex needs. From arthritis to hip fractures,  motor-neurone disease or quadriplegia aged care clients are complex and all stakeholders expect they will be well looked after from assessment, to provision of care.

If any of these clients were admitted to hospital, and they will be, they will most definitely see allied health professionals as part of their stay. A physiotherapist will help them move after a fall, an occupational therapist will assist with pressure relieving devices or a specific wheelchair to get them out enjoying the community.

That same client residing in an aged care facility should expect and receive that same level of service. I could even argue that allied health treatments and intervention targeted at aged care will reduce the likelihood of needing a hospitalization. No one would argue the literature on that.

So to summarise, the aged care funding model is changing and so it should. It has been broken for years and we all know that, but the industry is frightened by this change. There is a lack of information because there is a lack of description from the government in what will replace it and people are fearful of these changes, their jobs and the impact on the residents of aged care.

Given the uncertainty it is very likely that allied health professionals and physiotherapists will look to leave an industry that already struggles greatly to attract professionals and carers alike. With no guarantee of work beyond October we are already seeing an increase in people assessing their options and looking to other areas of work, such as within the NDIS.

Aged care cannot afford to lose these amazing professionals, it needs them and their experience more than ever. In spite of the change in funding and the void in formation, aged care providers must look to describe a model that is effective and efficient for them.

To do this they must:

  • Assess their residents needs and complexity, both as individuals and as a collective
  • Ascertain the required skill mix for their site
  • Proactively review the model of allied health care, with a view to implement a more efficient assisted care model
  • Deliver allied health services throughout the funding model change and into the future

Providers that fail to do this will face the challenges of:

  • Losing staff and not being able to replace them in such a competitive environment
  • Not meeting expectation of minimum care as set out by the findings in the royal commission into aged care and the new care standards
  • Not providing specialized care when it is required

At Sea Change Health Professionals we have been planning for this for almost 2 years. We know that aged care and allied health go hand in hand. We know that allied health is necessary and we know it can be delivered in an efficient and effective way. We know this because we have been doing it already.

We are experts in assessing the clients as an individual at their particular site and being able to accurately describe an allied health model based off of an efficient and effective level of service. Our services are delivered by a funding efficient combination of allied health professionals and allied health assistants. Assistants are cost effective alternatives to the professionals, that work in conjunction with the professionals to deliver greater clinical face to face time at a lower cost

Assistants to health care professionals are not new, however in the old funding world they couldn’t be well utilized. Assistants work directly with and under the direct supervision of the professional to implement planned activities and treatments that they have been specifically trained to deliver for an individual. It is crucial to this model of delegation that the allied health assistant works directly with the allied health professional as a part of the team to deliver excellent results.

It is also important that new treatment models focused on the dignity of risk around individual choice and the improvements this can have on quality of life. Quality-of-life activities can be utilised to provide their known physical and mental health benefits to aged care residents. A world with allied health after October does exist and it can be done well. Embrace the changes and together lets make them work for your team, your site and the residents under your care. If you would like to discuss the options for your residential home, have access to our client and facility needs calculators or discuss allied health assistant training and models of care please reach out for a no obligation discussion.

Our unique approach has worked towards moving away from an ACFI funding model and is delivering client specific treatments and care plans in preparation of this funding change.

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