24-Oct-2011 Given their strident criticism of ACAR, observers have warned some peak bodies to be careful what they wish for. Megan Stoyles reports.
The industry's two national peak bodies have differed in their response to the recently announced ACAR, with ACAA CEO Rod Young saying the Department of Health and Ageing should be "applauded not criticised for doing the best they can in difficult circumstances".
His comments to INsite follow statements of strongly worded criticism from some state peak body CEOs, as well as the new CEO of ACSA, Patrick McClure, who was critical of the 'current design and application' of ACAR.
Young, whose planned retirement has been delayed so that he can lead his members during the period of the Productivity Commission (PC) report's release and subsequent developments, said that he had until now "deliberately not commented" on the ACAR.
He said that the minister and the department had consulted with the industry and were in a difficult position with limited options in the light of the forthcoming PC changes.
"They have delivered on promises they made about the current round and should be applauded not criticised for doing the best they can in difficult circumstances.
"Taking into account the bed take up in the last round, and the big allocation of packages, they have made the bed numbers on offer as attractive as possible," he said.
"Except this ignores the fact that it is a mess of their own making. They do not enforce their own legislation, they have continuously put off reform, continue to allocate beds like the Soviet Union allocated bread rations. This is not the way a modern government or society such operate. It is hurting innocent people, and defending it is just not feasible," said Jason Falinski, MD of CareWell Health.
Young's view differs to that of several of his counterparts, such as McClure, who claimed the current system of bed ratios had no evidence base and the design was 'outmoded'.
In his ACAR statement McClure focussed on last year's under-subscription of beds on offer in WA, and problems in other states. A mature and effective industry requires transparency and predictability and cannot operate efficiently when its livelihood is based on a lottery, he said.
ACSWA's Stephen Kobelke accused the department of taking beds from WA and moving them to "the eastern states". He called the 2011 ACAR a "shemozzle".
CEO Gerard Mansour Aged and Community Care Victoria (ACCV) said he saw "both good and bad" in the allocation, but commented on the growing mismatch between demand and supply.
"Victoria has the worst occupancy rate, running at 92 per cent...I am unsure how we will support this increased ACAR allocation across Victoria," he said.
Meanwhile, Mollie Sullivan, the managing director of Verso Conculting, has told INsite that the critics of ACAR "may not be fully aware of the strength of sentiment among older people and their families in favour of community options for care, almost at any personal cost".
Sullivan, who has assisted organisations with applications for ACAR and has undertaken consumer research, said it is more than a preference for staying at home, "it is a real aversion to even the thought of residential care".
"Most people who have assessments want community care not residential care. Do we really need as many residential care facilities? There are great new facilities going up but there are more approvals for packaged care than there are for residential care. Are we getting the planning ratio mix right?"
Verso Consulting surveys providers across Australia every year to gauge changes in the availability of care options. Results of this year's surveys identified "hot spots" and areas of chronic under-servicing.
Sullivan concedes that the situation in WA is quite different to some other parts of Australia, with recruitment difficulties limiting and delaying access to packages even when providers have been allocated new places.
She believes the broad approach taken by the department appears to be well grounded.
"I am confident that they have crunched the numbers accurately and gathered relevant information from the Aged Care Planning Advisory Committees (ACPACs) s in each state/territory."
She said that based on her involvement with many providers over the past 11 years she feels the ACAR process is well managed and rationally planned. Allocation decisions are based on the quality of the proposals submitted and evidence of their capacity to meet community needs.
Industry leaders at both state and national level, meanwhile, are pinning their hopes on a better system emerging from the PC report, one which will be more flexible and responsive to the aged care market.
Aged care commentator and former ACSA CEO Greg Mundy said that "a federated structure such as ACSA or ACAA is fundamentally impotent to deal with an issue such as the distribution of places between states and the contradictory comments from several states illustrates this".
Most human services programs "would give their eye teeth" for a resourcing regime that guaranteed growth in supply in proportion to growth in demand. The aged care sector should be careful that it doesn't argue for throwing the baby out with the bath water, he said.
"Notwithstanding this, I think a resourcing formula based on demand (clients' needs) rather than supply (what providers get) would be a step forward if properly implemented. The PC is on the right track here.
"The current system, which has formed part of the 'gilded cage' within which aged care providers have operated, may have run its course."
Sullivan echoed Mundy's warning for the peak bodies to consider the consequences of what they campaign for.
"The PC's recommendations offer a blueprint for change. However, it is impossible to generalise about community needs across the country as a whole. Each state and territory is very different.
"The ACAR offers a genuine process for addressing changing needs at a regional level. It is less than perfect, but an unregulated market would only worsen the inequities that already exist between regions due to a lack of detailed research about the health system and community care interface and its impact on local patterns of demand," she said.
The industry's two national peak bodies have differed in their response to the recently announced ACAR, with ACAA CEO Rod Young saying the Department of Health and Ageing should be "applauded not criticised for doing the best they can in difficult circumstances".
His comments to INsite follow statements of strongly worded criticism from some state peak body CEOs, as well as the new CEO of ACSA, Patrick McClure, who was critical of the 'current design and application' of ACAR.
Young, whose planned retirement has been delayed so that he can lead his members during the period of the Productivity Commission (PC) report's release and subsequent developments, said that he had until now "deliberately not commented" on the ACAR.
He said that the minister and the department had consulted with the industry and were in a difficult position with limited options in the light of the forthcoming PC changes.
"They have delivered on promises they made about the current round and should be applauded not criticised for doing the best they can in difficult circumstances.
"Taking into account the bed take up in the last round, and the big allocation of packages, they have made the bed numbers on offer as attractive as possible," he said.
"Except this ignores the fact that it is a mess of their own making. They do not enforce their own legislation, they have continuously put off reform, continue to allocate beds like the Soviet Union allocated bread rations. This is not the way a modern government or society such operate. It is hurting innocent people, and defending it is just not feasible," said Jason Falinski, MD of CareWell Health.
Young's view differs to that of several of his counterparts, such as McClure, who claimed the current system of bed ratios had no evidence base and the design was 'outmoded'.
In his ACAR statement McClure focussed on last year's under-subscription of beds on offer in WA, and problems in other states. A mature and effective industry requires transparency and predictability and cannot operate efficiently when its livelihood is based on a lottery, he said.
ACSWA's Stephen Kobelke accused the department of taking beds from WA and moving them to "the eastern states". He called the 2011 ACAR a "shemozzle".
CEO Gerard Mansour Aged and Community Care Victoria (ACCV) said he saw "both good and bad" in the allocation, but commented on the growing mismatch between demand and supply.
"Victoria has the worst occupancy rate, running at 92 per cent...I am unsure how we will support this increased ACAR allocation across Victoria," he said.
Meanwhile, Mollie Sullivan, the managing director of Verso Conculting, has told INsite that the critics of ACAR "may not be fully aware of the strength of sentiment among older people and their families in favour of community options for care, almost at any personal cost".
Sullivan, who has assisted organisations with applications for ACAR and has undertaken consumer research, said it is more than a preference for staying at home, "it is a real aversion to even the thought of residential care".
"Most people who have assessments want community care not residential care. Do we really need as many residential care facilities? There are great new facilities going up but there are more approvals for packaged care than there are for residential care. Are we getting the planning ratio mix right?"
Verso Consulting surveys providers across Australia every year to gauge changes in the availability of care options. Results of this year's surveys identified "hot spots" and areas of chronic under-servicing.
Sullivan concedes that the situation in WA is quite different to some other parts of Australia, with recruitment difficulties limiting and delaying access to packages even when providers have been allocated new places.
She believes the broad approach taken by the department appears to be well grounded.
"I am confident that they have crunched the numbers accurately and gathered relevant information from the Aged Care Planning Advisory Committees (ACPACs) s in each state/territory."
She said that based on her involvement with many providers over the past 11 years she feels the ACAR process is well managed and rationally planned. Allocation decisions are based on the quality of the proposals submitted and evidence of their capacity to meet community needs.
Industry leaders at both state and national level, meanwhile, are pinning their hopes on a better system emerging from the PC report, one which will be more flexible and responsive to the aged care market.
Aged care commentator and former ACSA CEO Greg Mundy said that "a federated structure such as ACSA or ACAA is fundamentally impotent to deal with an issue such as the distribution of places between states and the contradictory comments from several states illustrates this".
Most human services programs "would give their eye teeth" for a resourcing regime that guaranteed growth in supply in proportion to growth in demand. The aged care sector should be careful that it doesn't argue for throwing the baby out with the bath water, he said.
"Notwithstanding this, I think a resourcing formula based on demand (clients' needs) rather than supply (what providers get) would be a step forward if properly implemented. The PC is on the right track here.
"The current system, which has formed part of the 'gilded cage' within which aged care providers have operated, may have run its course."
Sullivan echoed Mundy's warning for the peak bodies to consider the consequences of what they campaign for.
"The PC's recommendations offer a blueprint for change. However, it is impossible to generalise about community needs across the country as a whole. Each state and territory is very different.
"The ACAR offers a genuine process for addressing changing needs at a regional level. It is less than perfect, but an unregulated market would only worsen the inequities that already exist between regions due to a lack of detailed research about the health system and community care interface and its impact on local patterns of demand," she said.
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