Senate Community Affairs Legislation Committee, , 2:36:51 to 2:57:11
Officials discuss mandatory care minute targets, the financial impact of non-compliance, and trends in agency staff usage across the sector.
Topics: Public service staffing, Health
Speakers: Hon Anne Ruston, Speaker 23, Emily Harper, Sonja Stewart, Speaker 26, Dorinda Cox, Liz Hefren-Webb, Speaker 24
>> Yeah. So I'd be really keen to understand what kind of things you're looking at when you're likely to come up with um some recommendations. I mean you don't have to go into it now but just just keen to understand um how that process might >> operate to get this working a bit better than it is at the moment. Um so I mean I'm not sure whe these are [clears throat] they're probably still questions for you miss from web. So um in if you have a look at the um the care minutes um from the data from the department I'm trying to find the date um in relation to care only 61% of metropolitan age care homes met their RM Mare minute targets.
>> Uh that that is a matter for the department.
>> So I'm sorry might have let you off the hook because I think that one of the >> take the afternoon off.
>> Question was >> proportion of metropolitan centers that have meeting >> and the comment was only 61% that's
correct. That's all I had.
>> Sorry. Um senators uh Dane Dazzio, first assistant secretary of residential care division. Uh yes Senator I can confirm that's correct.
>> So how many facilities would that be? How many homes
>> in total um those that met both their targets? So that is the total [clears throat] care units and the um nursing care units uh is 1469 homes.
>> 1469 met both
>> met both targets. one um was um well it will depend on which one we look at. The numbers that met their nursing minutes was 1,982 and
>> but see that would be included in the ones that met both too though wouldn't it?
>> Yeah that's right.
>> Yeah in approximately 2,400 homes. >> Yeah. Maybe. So maybe the better metric is how how many didn't meet
>> uh didn't meet. Uh I can Well, it's there's 2,449 homes in total.
>> 24,449.
>> Yes. Of which 1982 met their nursing minutes. Um and so I haven't done the math on that, but the difference between those is the ones
>> So how many met neither? Sorry. >> How many met neither?
>> Uh those that met neither uh would be Well, uh I'll just just give me a moment. Do you have that? >> Yeah, we'll we'll just get that for you.
>> Yeah. Okay. Okay. Um so, what are the penalties that that these homes are likely to failure to meet their care minutes?
penalties is perhaps a slightly stronger term that I'd use for the first part of my answer. Sorry, Senator.
>> What will be the implications?
>> Yeah, the implications. So the um part of the um funding provided to homes is for a care minute supplement which is tied to performance. So those that fail to meet [clears throat] that >> uh do not receive their full amount of the care minutes supplement. um that is to the extent that there are very significant non-compliance that becomes a matter for the commission.
>> We just let Liz have from we've have the afternoon off.
>> Sorry, didn't catch that.
>> Oh,
>> You get you go through your question. I give you the afternoon off too. I think
that's more about you than about them is
is it a fair assessment that if only 39% of Metropolan facilities are able to meet their mandatory care minutes that maybe those targets are too high given the current um environment we find ourselves in particularly with workforce shortages
>> Um Senator um I at risk of offering opinion um I would say that in total the sector is averaging 220 minutes of care. >> Yeah. So there are a large number of providers that are exceeding their care 10 care minute targets.
>> But to be fair, let's be fair, that is of no value to the ones that aren't.
>> Yeah. to the extent that they those that are not meeting of that group um 46% are within five minutes of meeting their targets and there has been a general pattern of improvement over time so to to go back to your question is this a concern what we are seeing is consistent improvement in performance towards those targets and
>> I think that's a really important point that since the introduction we're seeing a steady increase um uh from reporting period to reporting period and um there are some that are offtarget however as um Mr. Datio said they're offt target um by um just a few minutes and then the other thing is the u myo measure around link linking care minutes to funding. Um so we have a level of confidence that that um will continue in terms of that positive trajectory.
>> Okay. So I'm just trying to understand what the So we we've talked about um 39% of these facilities not meeting their care minutes and I think you mentioned that the supplement is the thing that's likely to come under threat. What what kind of quantum of funding is that likely to be a reduction of? So you've got you must a certain amount of funding to be able to provide the supplement for those that are able to meet their care minutes. The fact that 39% of them haven't, what is your estimation about how much is likely to be withheld from these 39% of facilities for their inability to meet their care minutes.
so senator at the time of the announcement of this measure um which was a 2425 mifo announcement at that time the expected saving in total was 192.86 86 million over four years. Um
>> expected saving for
>> sorry the the expected I guess um imp impact of um withholding of the supplement for those who did not deliver was expected to be 192.86 million over the Ford estimates
>> over the four years
>> um but at that time uh that's not to say that's we we don't have a updated number based on current performance.
>> So you didn't do that the 192 was over the forward. So, have you got the breakdown yearbyear on that?
>> Uh, I don't have that with me.
>> Okay. Because it be obviously it'll be interesting in terms of what did that $192,000 mean in terms of how much non-compliance you were expecting >> and how much non-compliance you are actually seeing. So, what is the the difference? So, when did when over the this was over the forwards 20 425 through to 28 20 27 28. So that would be
it was in the 2425 mifo I'll have to just confirm it would be the four years. So
>> so 24 mifo or 25 mifo
>> uh 2425. So that would be you would
refer to that as the 24 myo. Yeah. Okay. So that means [clears throat]
>> can I just ask how much more time you need in this block? I'm going to shift the call to Senator Roberts shortly.
>> Um if you give me five minutes then I'm happy to. >> Yeah. Okay. Great. >> Okay. So, so, so if it was in my EO, was it expected to start in 25 26?
>> Yeah, that's correct.
>> Okay. So, you really probably don't have a great deal of line of sight over it as yet.
>> As yet. So, the um first quarter in which this will apply is effectively the one that we're in now. So, we won't know until this later this year.
>> So, you haven't withheld any money at all from any facility. And did you at
this stage? No.
>> No. So every facility got the money included in their ANAC. Is it or or however you you're paying it through ANAC? >> Yeah. Correct. >> So the money was included in the ANAC. Everybody was assumed as they were going to meet their minutes and it's only so so if if you're already receiving so the money in ANAC if you haven't complied do they have to pay it back or something?
>> Uh so although ANAC is the funding is kind of allocated on an annual basis we don't actually transit. We transact that on a monthly. We don't call it.
>> Yeah. >> Yeah. We don't call it back. We
effectively um uh deduct it from future payments.
>> Okay. So if if I failed in the last 6 months to meet my care minutes for the entire time, I would I and I've received the the supplement, then not only would I not get the supplement for the next one, would I actually have to pay back the supplement that I paid for the
No, sorry.
>> Hi, Senator Mark Shen, um, acting assistant secretary, residential care division. So, all um, all homes will be fully funded um, up until the end of March this year. So, it won't be until April this year that um, homes experience the impact of the supplement. Um
>> so the h the so for the nine months between the 1st of July until the 31st of March all homes will have been deemed to have complied and so they all will be receiving the the the staffing supplement
>> but their future um uh the future supplement value will be based on whether they have reported um meeting their care minutes y
>> from the past. So, but so the the supplement that they've received for the nine months, it doesn't change. You don't have to pay that back. It'll just be anything going forward. Okay. Thank you. That's what I want to do. Um, now this may or may not be true, but the I think it was the weekly source suggested um that the um the funding that they're likely to lose could be up to $3341 a day. Is that correct? I mean it is only not only it's something that is in the media.
>> Yeah, that's that's correct. Uh Senator up to [clears throat] and those Yeah. would would be those who underperformed by 15%. So those who only met 85% of their targets would >> would receive less that amount less. So,
in a sense, it sort of strikes me as if you've got a home that's that's quite clearly struggling um to get access to staff, they're already under an incredible amount of pressure um and then you're going to whack each resident potentially up to $3341 a day of reduced funding. you know, has has there been any other um sort of analysis around potential ways that um you could encourage compliance with your staffing targets without actually quite frankly penalizing the resident because it's the resident that was going to feel the impact of the $3341. Not I mean obviously the home will too, but like at the end of the day the money goes to the resident. So you're punishing the resident for the non-compliance of the home and quite often the home will be under pressure through no fault of its own. So have you considered any other ways that you could maybe sort of deal with
>> So Senator perhaps I could just um explain a little more how the the withdrawal of funding through the withholding of the uh care supplement works. the um if a service is underperforming um they will have their supplement withdrawn on a sliding scale that sliding scale means that if they are 85% of the target they lose a
certain amount >> I understand that but I'm just sort of my question was more around have you thought of other measures as opposed to um like you know sort of a punitive financial um penalty in order to try and see if you can meet >> the get to to incentivize homes [clears throat] or to assist homes, help homes, whatever to be able to meet their their targets because as I say whether it's you know $3341 whatever it is if you are taking away the supplement you are punishing the person is there have there been other things that have been considered as measures in order to deliver the outcome you're trying to see as opposed to this measure
>> so perhaps just before I went to the measures [clears throat] I I just wanted to explain that the current design doesn't necessarily in It does not punish those for underperforming. If a if a home is not delivering its minutes of care, it's not spending the money on its staff at the moment. The withdrawal rate of that supplement is designed such that um for example, a home that's meeting 90% of its minutes will be funded effectively for 92 minutes. So although it does withdraw some of that funding, there is still an incentive for that home to um deliver and it is still adequately funded for the for the minutes that it is currently delivering.
>> I can start asking you questions on that. That makes no sense how you've done that because the incentiv you actually don't incentivize people to operate at 100%. It's completely perverse. But we won't go into that. We have enough money challenges for today. Um but does any of these considerations take into account the extraordinarily high cost of agency staff particularly for those um homes that are in you know particularly shallow markets because I mean you know you can say okay we've only funded them for um you know they've only if they're not meeting their full staffing requirement they haven't paid for the full staff amount but in many instances it's no through no fault it's just that they can't get access to them they're overspending because of the extreme amount of money, extra money they have to pay on on agency staff, etc. I mean, it strikes me as is a very blunt instrument to recognize what is an incredibly complex um environment out
>> So, Senator, I would just clarify the um provision of the uh care minutes supplement, which is the amount that's effectively at risk, only applies to homes in the MM1 region. So, they are metro >> homes. So it does not apply to those in thin markets that you've you've just
>> So what happens in thin markets if you don't meet your care? in out of MM1
>> Yeah. Yeah. Outside of MM1. So um then um the response is the regulatory um response that um my colleague Mren Webb um would have been able to take you through. Um in that case we don't apply a a um penalty. it is much more of that we work with the homes to um to endeavor to achieve compliance. Perhaps going to the second part of your question if I may around agency staff, we've not seen a significant increase. In fact, if anything, agency usage is trending down across the the sector. So, we're not seeing this driving excessive or an increase in agency in agency staff. I'd
love to know if you had any outline of sight over what the level of agency staff is in homes across all of the MM levels. I mean, you may not have that, but
>> Senator Ruston Emily Harper um first assistant secretary of the market and workforce division. We can certainly provide that um information to you on notice and the um the uh the quarterly financial snapshot um and and reporting that the obviously we analyze >> um the the next report is due to be released I think at the end of this month. So that will be publicly available. >> What I can state is that um as Mr. Datio um I I can um confirm um that as Mr. Datio was indicating agency usage is trending down not only in um in um metro so M1 but also um inm 2 to 7. Now in saying that I acknowledge that everywhere is very different and it is absolutely not uniform and we know that there are areas that experience
significant >> a pretty high level so it's great news. Yeah. Yeah. No, no, we're very happy about that. So, that's great. Um, so do we have um any idea of how many beds have closed in the 12 months to the 31st of December?
>> I'm just asking my colleague to come to
>> Just I will need to
>> Okay, look, I'm going to a different line of questioning. So, if you want to go to Senator Roberts, I'm quite happy.
>> I'll wait for this answer and then I'll go to Senator Roberts. I [clears throat] know he's been waiting a while. very patiently.
So, what I'd love to know is beds closed, beds open in the 12 months to the 31st of December. And of those beds um that opened and closed, how many of them were fedally funded and how many of them were private sector funded? Okay.
So, um I have figures between I have figures at the moment in in front of me, Senator, that relate to um between 20 1 July 2021 and one and 30 31st of December 2025. So, I can provide that information.
>> You can't break it down by the last
year. Um I I may very well be able to very rapidly and within this hearing
immediately we can go to Senator Roberts if you want to have a little place. So yeah so in the 12 months um if we could have a look at the Yes. say beds beds new beds um beds open beds closed um government funded whether that be AAP funded or I know state governments particularly Victoria sometimes fund them and what has been um delivered in terms of opening and closing in the
private sector. Uh, Senator, I'll just clarify what I think we'll be able to provide in terms of um the time frames that you ask for. We do a stock take at the end of every financial year. Sorry, Jessica Evans Market and Workforce Division. Uh, we do a stock take at the end of every financial year. So, the latest data we would have in terms of beds opening and beds closing would be accurate as at the end of June 2025,
>> which you gave to us at
>> which I gave to you at the last estimates. So,
>> but did we ever end up with the breakdown between what was funded by
AAT? We did we gave the um we gave the funding for openings. We have no further >> um data. We have the number of services that have um opened and closed during that period. Um
>> be interesting. Um Miss Harper said that she had the data through to December 31st. I if if there's any way to understand what that data would tell us between from the 1st of July through to the 31st of December. I mean I understand it's not going to be what I'm actually asking for, but in terms of are you seeing change? It' be really interesting to know is anybody building any age care homes >> y >> and and particularly understanding if the private sector is building any new [snorts] beds as opposed to them the building that's going on because of the the additional IAP funding.
>> Thank you Senator Ruston. Um just before I move to Senator Roberts, um the tableabling of outstanding government responses has been given by the Department of Health, Disability and Aging. So that document has been tabled to the committee. Um Senator Roberts,