‘Left standing outside in the cold’ – allied health still waiting for appropriate funding

Amid the passing of one new aged care reform bill, the allied health sector is renewing its call to the federal government to adequately fund allied health.

New regulations introduced in the bills include mandated 24/7 on-site nurses in residential homes, ensuring minimum care minutes per resident, and implementing the AN-ACC funding model.

However, Allied Health Professions Australia (AHPA) says that neither the previous two federal budgets nor the new legislation have set a benchmark and funding for residents in aged care.

The new bills are part of aged care reforms begun under the Coalition government and continued by Labor, in response to recommendations by the Royal Commission into Aged Care Quality and Safety.

"We've been arguing with the government, but their response has been grossly inadequate," says APHA's Policy and Advocacy Manager, Dr Chris Atmore.

"Unlike nursing and personal care workers, the government is not setting a benchmark regarding the number of care minutes for allied health." 

While the new AN-ACC model provides funding for allied healthcare in residential aged care, it leaves the specific figures open for discussion.

"What AN-ACC does is simply allocate an overall bucket of money per person to each residential care facility," Atmore says.

She says that without a set minimum of minutes per resident, it's up to providers to decide how much to actually spend on allied healthcare.

"The current model is just leaving it up to individual aged care providers to work all that out," Atmore says.

"And we don't have to criticise the providers to know that even the best of them will not be in a position to provide the funds needed to do that properly."

Allied health peaks have been pushing for the government to pick up the slack and start listening to the Royal Commission's recommendations made a year-and-a-half ago.

Atmore says Labor's lack of attention to allied health is "the elephant in the room" that no one seems to want to talk about. 

"There's just a big silence about that at the moment. They're just leaving it."

On July 27th, the government introduced two bills, of which one will install around-the-clock nurses in aged care homes from July next year.

Labor is also planning to ensure minimum care minutes per aged care resident to be met from October 2023.

The implementation of the AN-ACC funding model, replacing the Aged Care Funding Instrument (ACFI), is said to provide an average per bed day funding of $225.

While providers will need to report allied health care minutes, there is no benchmark of proposed future allied health aged care in terms of minutes.

In the AN-ACC policy brief, it's estimated that providers spent roughly 4 per cent of care funding on allied health services, equating to about $700 million of the government's 2022-23 care capital. 

However, AHPA's own analysis says that it will not be enough to meet residents' needs, and that the yardstick derived from StewartBrown's 2021 survey is an inaccurate estimate.

"The Royal Commission found that people in residential aged care got an average of 8
minutes a day of allied health care," Atmore says.

"The 4 per cent or $700 million at the most generous estimate equates to 8.8 minutes per day."

The AHPA also claims more recent data shows that allied health minutes have decreased
since the Royal Commission's finding, to just over 5 minutes at the end of 2021.

"And we know that providers are going to be increasingly strapped for funds because of factors like the much-needed wage increase for personal care workers," Atmore says.

"So, the only thing that can be dropped off is funding for allied health because nobody's mandating these services."

The frustration among allied health bodies became palpable during Aged Care Insite's conversation with Scott Willis from the Australian Physiotherapy Association.

He voiced concerns that aged care funds were too stretched, leading to providers using funding out of allied health's pockets.

The Royal Commission into Aged Care Quality and Safety had said that there needed to be "a change in culture in the aged care sector, to view allied health services as valuable rather than a burden on funding".

"There's not enough funding for allied health to rectify the situation that the Royal Commission found," Atmore says.

"It's even worse now than when the Royal Commission did their research."

The AHPA calls for the government to honour the Royal Commission's recommendations to adequately provide allied health services. 

We're not critical of the new funding model – in fact, it's a vast improvement on the previous instrument, Atmore says.

"The point is that AN-ACC was never designed to include allied health.

"The idea was that further down the track, something else would have to be developed to address people's allied health needs."

Atmore says that in the end, it boils down to whether the government is going to honour the Royal Commission's recommendation or not.

"At the moment, we're saying they're not."

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