Aged care providers in regional and remote settings are struggling to remain viable and require government subsidies to remain afloat, The Royal Commission into Aged Care Quality and Safety heard on Monday.
The commission heard that aged care facilities in regional and remote areas are “overwhelmingly” owned and operated by not-for-profit organisations and government, and because the facilities are smaller and there are fewer, “scale and professionalism issues” arise.
Higher costs, less income in regional areas
A report by The Aged Care Financing Authority in 2016 showed that rural providers face higher costs and lower income, “leaving them worse off overall”, Counsel Assisting Peter Gray QC told the commission.
Mr Gray proposed that aged care services in regional and remote areas should be funded “to a level that accords with the additional costs incurred in supplying the services in these areas”.
Royal commission to propose government subsidies
Mr Gray proposed the government provide subsidies to remote and regional aged care providers to help them remain afloat.
Allan Codrington, the volunteer chair of the board of Pioneer House in Mudgee, said sanctions have “the potential to virtually break facilities like us”.
He suggested that a “flying squad” could come in to assist regional facilities in returning to compliance, or to identify problems before they lead to non-compliance.
Mr Codrington said the Department of Health and Aged Care Quality and Safety Commissioners do not provide advice. When asked questions, they told Pioneer’s DON to read the Act, “which isn’t very satisfactory”, he said.
Mr Codrington, who has volunteered on the board of Pioneer for 16 years, said more needs to be done to attract aged care staff to regional areas, and that there are high costs associated with attracting staff in regional areas.
Mr Gray proposed the government develop better links with RTOs and scholarships for aged care staff to work in regional areas.
Sanctions cost almost $1 million for struggling facility
When Pioneer House failed a compliance audit, Mr Codrington estimated the sanctions that were applied cost the facility $934,000 from lost revenue because it couldn’t take new residents and because of the cost of employing various people to help them return to compliance.
Mr Codrington said the board of Pioneer House is “all lay people doing our very best as volunteers”.
He said being struck with sanctions was “a shock and a hell of a lot of embarrassment, to both Pioneer House and Mudgee locally.”
“Unless the government do something with money to ease the burden on boards having to make sure you covered everything, then the viability is going to be harder and harder,” Mr Codrington said.
“We’re going to lose small community-run facilities that were actually put in place by the community for the community,” Mr Codrington said.
Access in remote areas can be a challenge
On Tuesday, the commission heard from Suzanne and Phillip Dunlop, who live on a property in rural New South Wales.
Ms Dunlop was receiving help at home each week, until her provider cancelled her service saying the dirt road was not accessible for the care staff.
“The road is a dirt road but it’s an all-weather dirt road and it’s been used for by the neighbour up the road for the last 17 to 20 years with no problems… They were adamant that they had nearly rolled their car and so services were suspended immediately,” Ms Dunlop said.
Despite services being cancelled, the Dunlops continued to be charged.
“These additional charges appeared on the account,” Mr Dunlop said. “If we hadn’t spotted them, they would have just stayed there. It’s not right.
Ms Dunlop wept as she told the commission of her desire to remain being cared for at home.
“I would hate to be in a nursing home… It’s not home,” she told the commission.
“I do love it. I don’t want to move,” she said.
“But it is so, so hard when you can’t get any help out there.”
The hearings continue.