Aged-care COVID response: govt commits additional $132.2m

The Australian Government will invest an additional $132.2 million in response to COVID-19-related recommendations of the Royal Commission into Aged Care Quality and Safety.

The $132.2 million package includes $63.3 million for a range of Medical Benefits Schedule (MBS) measures including mental and allied health support, and additional allied health group services, $57.8 million to support the costs of engaging infection prevention leads in facilities and a further $11.1 towards a Serious Incident Response Scheme.

As well as improving access to mental and allied health services for senior Australians in aged care, the commitment will also provide additional funding to GPs and allied health professionals delivering in-person care in facilities nationwide.

The federal government accepted and is acting on all six recommendations from the Commission. Below is a summary of progress for each of the recommendations.

Recommendation 1: The Australian Government should report to Parliament by no later than 1 December 2020 on the implementation of these recommendations.

A response was tabled in Parliament on 30 November 2020 on the implementation of the Royal Commission’s recommendations.

Recommendation 2: The Australian Government should immediately fund providers that apply for funding to ensure there are adequate staff available to allow continued visits to people living in residential aged care by their families and friends.

The government has delivered $217.6 million (as part of a $245 million initiative and in addition to $205 million measures earlier in 2020) to support providers with COVID-19-related costs, including supporting visitation arrangements.

On 14 October 2020, the Minister for Aged Care and Senior Australians, Senator the Hon Richard Colbeck wrote to all providers reinforcing expectations with regard to visitation.

In the letter, Minister Colbeck noted that the government agrees with the Royal Commission’s focus on ensuring aged-care residents are not isolated from their loved ones when there is an outbreak or heightened risk; and that the mental and emotional toll this takes is too high a price to pay.

As part of the 2019–20 and 2020–21 Aged Care Financial Reports, providers will be required to report on all COVID-19 sources of revenue they have received, and then allocate the additional expenditures incurred including labour, extra staff costs, resident support, communication, visitation arrangements, infection control and waste management.

Through the establishment of the Victorian Aged Care Response Centre in July 2020, 56 Residential Aged Care Visitation Assistant positions were filled to support Victorian RACFs to support visits between residents and their loved ones.

The Australian Government has released three-tier guidance on actions that aged-care providers should take in response to a situation of escalating or de-escalating COVID-19 threat level in the local community including visitation guidelines.

The government has also prioritised the commencement of the Serious Incident Response Scheme from 1 April 2021, providing a total investment of $67.2 million, including $11.1 million in additional funding.

Additionally, the government is providing increased advocacy support investing a further $2.5 million in the Older Persons COVID-19 Support Line.

Recommendation 3: The Australian Government should urgently create Medicare Benefits Schedule items to increase the provision of allied health services, including mental health services, to people in aged care during the pandemic. Any barriers, whether real or perceived, to allied health professionals being able to enter residential aged-care facilities should be removed unless justified on genuine public health grounds.

The Australian Government has announced additional measures to support the mental and physical health of residents of aged-care facilities.

This $63.3 million investment includes:

• $35.5 million to provide access to Medicare-subsidised individual psychological services under the Better Access to Psychiatrists, Psychologists and General Practitioners through the MBS (Better Access) initiative until 30 June 2022 and to evaluate Better Access.
• $12.1 million for additional individual allied health sessions under Medicare chronic disease management plans.
• $15.7 million for allied health group services for residents living in facilities affected by COVID-19 outbreaks.
   

From 10 December 2020 until 30 June 2022, eligibility requirements for the Better Access to Psychiatrists, Psychologists and General Practitioners through the MBS will be expanded to permit aged-care residents to access up to 20 individual psychological services where their GP or psychiatrist determines they would clinically benefit from additional mental health support.

New chronic disease management Medicare items will allow aged-care residents to receive twice the number of the current subsidised allied health services they can currently access. The extra services being supported can be from physiotherapists, occupational therapists and exercise physiologists. Additionally, in those facilities that have experienced COVID-19 outbreaks and associated periods of extended lockdown, group allied health sessions will be provided to assist the care of residents.

Recommendation 4: The Australian Government should establish a national aged-care plan for COVID-19 through the National Cabinet in consultation with the aged-care sector.

The Updated National COVID-19 Aged Care Plan (7th Edition) was endorsed by the Australian Health Protection Principle Committee (AHPPC) and tabled at National Cabinet on 13 November 2020. The Plan presents a national approach to assist the aged-care sector to be well positioned to prevent, prepare, respond and recover from COVID-19, acknowledging that flexibility is required to suit local situations occurring within jurisdictions. The AHPPC’s Aged Care Advisory Group has been made permanent — meeting another recommendation of the Royal Commission report.

The Australian Government continues to work collaboratively with the states and territories to develop and refine planning documents (linked to the National Plan) for COVID-19 outbreaks in aged care. The Commonwealth and states and territories are committed to further defining specific actions in the event of an outbreak, based on lessons learned from all outbreaks to date.

The Commonwealth has commissioned a national review to examine lessons learnt from the management of outbreaks, and identify critical success factors, which could increase the likelihood of rapid detection, and timely remediation or response from providers. The review will focus on services and relevant government agency support which may have mitigated broader outbreaks in residential aged-care facilities. The review is expected to be completed by the end of March 2021.

To date, the government has funded more than $1.6 billion in aged-care-specific measures to support the Plan.

Recommendation 5: All residential aged-care homes should have one or more trained infection control officers as a condition of accreditation. The training requirements for these officers should be set by the aged-care advisory body we propose.

In August 2020 funding of $217.6 million (as part of a $245 million measure) was announced to assist aged-care providers to support COVID-19 efforts to prepare and respond to COVID-19, including to support the costs of engaging an Infection, Prevention Control (IPC) lead. This was delivered in October 2020 to providers.

In a letter to all residential aged-care providers on 13 October, Minister Colbeck noted that the IPC lead:

• must be a designated member of the nursing staff who has completed (or initially is in the process of completing) an identified IPC course;
• is employed by the Approved Provider and reports to the Approved Provider, which retains overall responsibility for IPC in accordance with its obligations under the Aged Care Act 1997;
• observes, assesses and reports on IPC of the service, and assists with developing procedures/provides advice within the services; and
• must be engaged onsite for each facility and dedicated to that facility; and may have a broader role within the facility and could be an existing member of the nursing staff.
   

The government has also agreed that residential aged-care providers will be required to demonstrate compliance with the IPC Lead requirement as a condition of accreditation via the Aged Care Quality Standards.

Recommendation 6: The Australian Government should arrange with the states and territories to deploy accredited infection prevention and control experts into residential aged-care homes to provide training, assist with the preparation of outbreak management plans and assist with outbreaks.

The Commonwealth is working collaboratively with the states and territories to ensure the extended delivery of high-quality face-to-face IPC training to the sector. In particular, the government has committed $57.8 million to fund jurisdictions to deploy accredited IPC experts into RACFs to provide training and assist with the refinement of outbreak management plans where needed.

The Australian Government has been working with state and territory governments to implement a decision of National Cabinet of 21 August 2020 for three actions to boost preparedness at the provider, local, state and national level of:

• ongoing assessment of the preparedness of aged-care providers;
• auditing of state and territory emergency response capabilities and planning for the standing up of joint health aged-care emergency responses;
• prioritisation of additional face-to-face infection prevention and control training for residential aged-care providers.
   

All state and territory governments have established aged-care emergency response centres and have confirmed that these centres can be activated within 48 hours of an outbreak.

The Aged Care Quality and Safety Commission is also currently working with state and territory governments, and local health authorities across the nation to monitor and test preparedness of aged-care services to respond to a COVID-19 outbreak.

Minister for Health Greg Hunt said the response to the Royal Commission’s report and updated plan demonstrated the government’s ongoing commitment to improving care for senior Australians, and keeping them safe during the COVID-19 pandemic.

“This investment directly addresses issues raised by the Aged Care Royal Commission and will improve and support the health and wellbeing of aged-care residents most significantly impacted by COVID-19,” Minister Hunt said.

“For our aged-care sector, the revised plan allows flexibility to manage individual situations in each state and territory.

“It also builds on and consolidates the critical and successful work already undertaken by the Commonwealth Government.”

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