Providers that cater to special needs groups are given priority when the government is determining ACAR funding, but the government does nothing to ensure any extra beds funded are allocated to the groups that need them, the royal commission has heard.
The government takes each region’s special needs into account when determining the Aged Care Approvals Round (ACAR), the mechanism used to decide how many aged care beds will be allocated in each region.
Providers must specify their special needs requirements, and the information is used to determine the number of aged care beds the government will fund in that area.
But the royal commission heard on Wednesday there is no mechanism to determine whether or not the funding is actually spent on diverse communities, an ommission counsel assisting the royal commission, Peter Gray, described as a “little extraordinary”.
We can’t “effectively monitor”
Counsel assisting the royal commission Peter Gray, asked Jaye Smith, First Assistant Secretary in the Residential and Flexible Aged Care Division of the Department of Health, “Does the department consider that allocation of places to people with special needs through the ACAR is an effective way of responding to the needs of these groups?”
Mr Smith replied, “We haven’t been able to effectively monitor the way in which the allocation of a place for, or places for people with special needs converts to the actual use by those special needs, primarily due to data deficiency.”
“So you can’t gauge the extent to which the special needs are being met?” Mr Gray asked.
“We don’t have a lot of detail,” Mr Smith replied.
“So are you saying that this elaborate, centrally planned allocation exercise is going on and has been going on, presumably at great expense and in a very resource intensive manner, without there being any notion on the part of the Department as to whether it’s effective in meeting the needs of diverse groups?” Mr Gray asked.
“I guess what I’m saying is that, yes – well, I have indicated that we haven’t been able to monitor it,” Mr Smith replied.
“Carrot offered” to encourage focus on special needs
“The supposition must be that there’s a carrot offered, an incentive offered to approved providers to focus on special needs groups. The quid pro quo for which will be they get allocated more weight in the allocation of ACAR places if they promise to give priority to a particular special needs group in a particular region in return for getting those places in that region; correct?” Mr Gray asked.
Mr Smith replied it was.
Mr Smith said since starting the role in November 2017 he has been looking into the matter.
He said, “The last ACAR that was held, the ’18/19 ACAR was well in planning when I started in the role, and it was resolved in… March 2019.
“I was shortly thereafter also presented with a series of questions from the Commission about the way in which the ACAR process operates and it gave me an opportunity to really look in detail at the way in which, having just been through an ACAR process and signing off the results of that, and then sort of doing a forensic on the way the process works from start to finish and have absolutely identified that as an issue. And I have asked my team, who is in the process of preparing the next lot of advice to government about the next ACAR, to look at the way in which conditions of allocation are applied.
“Well, there’s a lot of looking at and advice in what you’ve just said, with respect”, Mr Gray replied, asking if Mr Smith could “guarantee” the Commissioners there will be conditions imposed to make sure providers keep their promise to prioritise special needs groups in the next ACAR round.
Mr Smith said he would commit to this change.
Loophole a “massive issue”
Commissioner Briggs said the lack of follow up was a “massive issue”, “not only about the effectiveness of needs-based planning, but also about the effectiveness of the allocation of government resources.
“If you allocate a lot of resources to special needs groups and can’t be guaranteed that those resources are then being brought to bear to support those special needs groups, then there’s a serious misallocation of a lot of government money, isn’t there, Mr Smith?” she asked.
Tune recommendation neglected
Mr Gray with the Tune report identified a lack of data regarding how different groups have been able to access data. He recommended that consumers should be able to indicate they belong to a population with special needs at the point of assessment.
The government has not addressed this issue in full.