The question of equivalence: aged care or the NDIS for those over the age of 65

Image source: Living Longer Living Better website

The legislation to establish the National Disability Insurance Scheme (NDIS) is due to be debated in Parliament this week. Under the legislation, people with a disability aged under 65 will be able to apply to receive NDIS supports but those aged over 65 will not. NDIS participants who turn 65 will have a choice about whether to remain in the NDIS or switch to the aged care sector. However, once NDIS participants over the age of 65 enter the aged care system (either residential care or home support), they will be unable to access the NDIS. This assumes a degree of equivalence between supports available for people with a disability in the aged care system and those that would be provided under the NDIS.

Changes to community care

Image source: Aged Care Australia

The Government has announced a significant expansion in community aged care as part of its Living Longer Living Better aged care reform package. All existing community aged care packages (Home and Community Care Program, Community Aged Care Packages, Extended Aged Care at Home, Extended Aged Care at Home – Dementia and some smaller programs) will be consolidated into a single program known as ‘Home Care’ packages. The overall number of these home care packages will increase from 59 876 to almost 100 000 by 2016–17.

Changes will also be made to the payment arrangements for community aged care. From 1 July 2014, older Australians may be asked to contribute to the costs of their care via a Care Fee (it appears that whether fees will be charged will be at the discretion of the provider). These fees will be means tested and will be paid in addition to the Basic Fee which is currently charged.

Paying for aged care - should the family home be counted?

Image source: National Museum of Australia 

The Government’s Living Longer. Living Better package represents a new way of paying for aged care in Australia. From 1 July 2014, means tested co-payments, annual and lifetime limits for care costs and accommodation bonds for all aged care residents will be introduced. For further detail of the package see here.

One of the long running debates in the financing of aged care in Australia is the treatment of the family home and whether is should be included in any asset or mean-testing calculations when individuals access publicly funded aged care. In its recent report to the Government, the Productivity Commission (PC) put forward two recommendations (7.3 and 8.1) that would draw on the value of the family home to finance the costs associated with aged care.

Reform of aged care - a small step

Image source: Department of Health and Ageing

On 20 April 2012, after much anticipation, the Government released its response to the Productivity Commission’s (PC) Inquiry into Caring for Older Australians and put forward its reform plan, Living Longer. Living Better, for aged care. The initial response from stakeholders was largely positive. But as aged care providers and stakeholder groups have had the chance to reflect on the package, there have been claims that the cost of care provided in the home will increase for elderly Australians. Discussions about whether the family home should be included in the arrangements for paying for aged care also persist.

Caring for Older Australians report: a sector in need of reform




Image source: Aged Care Australia

  Last week, the Government released the Productivity Commission’s (PC) report, Caring for Older Australians. Most stakeholders have broadly welcomed the recommendations although concerns have been raised in relation to the capacity of the workforce. Concerns also persist among some pensioner groups about the prospect of having to sell their home in order to pay for aged care. The main differences between this final report and the earlier draft report is the proposed arrangements for accommodation bonds and the accommodation subsidy for supported residents. Analysis on the recommendations on the draft report can be found here.

Recent statistics on aged care

The annual Report on Government Services (ROGS) produced by the Steering Committee for the Review on Government Service Provision (SCRGSP) provides an overview of expenditure and delivery of government services. The most recent report reflects the new terms of reference for the ROGS reporting framework agreed at COAG in December 2009. For aged care, this means that there is additional information such as: information about compliance with service standards for all community care packages (including National Respite for Carers Program), selected adverse events in aged care and the number of hospital patient days for patients waiting for residential aged care (these are indicators for aged care in the National Healthcare Agreement) and time series data to enable comparisons across years from programs such as the Home and Community Care program (HACC).

Financing of aged care - recommendations from the Productivity Commission

The draft report of the Productivity Commission’s (PC) Inquiry into Caring for Older Australians, released on 21 January 2011, provides a sobering assessment of the current state of the aged care system. It argues that the current system can not withstand future challenges without comprehensive reform. A staged implementation plan over five years of the Commission’s recommendations has been put forward to address this. The PC’s report has been met with broad support from stakeholders with many welcoming the ‘bold’ proposals for reform.