Budget delivers welcomed funding for aged care

The 2023 Federal Budget has dropped, altering the landscape of aged care and health care for the coming years. There are major funding boosts for aged care workers and bulk-billing, but little change for disability support.

Elsewhere, there’s an increased focus on aged care services for Australia’s First Nations people while in-home aged care services have received plenty of attention. Industry experts have welcomed the funding – especially for the aged care pay rise – and responses have been positive. 

Budget benefits aged care

The additional $11.3 billion to fund the 15% aged care pay rise is arguably the most important part of the Budget for the aged care sector and one that’s been welcomed by all.

Aged & Community Care Providers Association (ACCPA) Chief Executive Officer (CEO) Tom Symondson said it would help to make aged care a more attractive sector to work in, and that cannot be denied. In addition, he praised the increase in Australian National Aged Care Classification (AN-ACC) funding that will see the daily price rise by 17%. 

We have been dealing with a critical shortage of workers which has put enormous pressure on services,” Mr Symondson said. “We expect the new funding commitments will help support aged care providers to meet the requirements for increased care minutes and having a Registered Nurse on duty 24/7, so older people will receive the quality care they need.”

Baptist Care NSW & ACT CEO Charles Moore also praised what he’s labelled a historic Budget, echoing the thoughts of most aged care leaders.

“Facing an ageing population and workforce shortages, we know that smart and strategic investments are the best way forward to future-proof the industry and ensure quality care remains available to all ageing Australians,” Mr Moore said.

“We know that investment in the aged care sector pays off and creates value, not just for the individuals receiving care, but for their families, for the community and for the economy.”

There was also positive feedback from the Australian Nursing and Midwifery Federation (ANMF), although ANMF Federal Secretary Annie Butler was clear that all funding must go towards the workforce. She said the Government must enforce how providers use the money.

“We applaud the Government’s genuine commitment to improving care for older Australians and valuing those caring for them, but we emphasise, once again, the critical need for the Government to formulate mechanisms which ensure accountability and transparency around these taxpayer funds to guarantee that all funding intended for wage increases is used solely for its intended purpose, that is, for the pay packets of all aged care workers. We will continue to work constructively with the Government to ensure this happens,” Ms Butler said.

What else was announced?

• $309.9 million will assist in the implementation of recommendations made by the Royal Commission into Aged Care Quality and Safety, including the creation of a new Aged Care Act and National Worker Registration Scheme 
• $200 million of that funding will be used to improve the transparency of the aged care Star Rating system and the Quality Indicator program
• An Aged Care Sustainability Taskforce will be established to provide advice on the sector’s sustainability
• $112 million will be set aside as incentive payments to General Practitioners and primary care clinics to promote more residential aged care visits and care planning
• A single assessment system will be introduced from July 1, 2024, to simplify the process for older people accessing aged care services
• $58.9 million for National Aboriginal and Torres Strait Islander Flexible Aged Care (NATSIFAC) residential aged care services to support increased wages and access to more resources
• An interim First Nations Aged Care Commissioner and First Nations assessment workforce will be introduced to strengthen the delivery of culturally appropriate care

Home care services not forgotten

The major news for home care providers is the further delay of the Support at Home program which will replace the Commonwealth Home Support Programme (CHSP) and Home Care Packages (HCP).

Support at Home has again been pushed back by 12 months and it will not be launched until July 1, 2025 – two years after first intended. Both HCP and CHSP will continue to operate in the meantime and there will be additional Government funding, including:

• $2.2 billion will support the 15% wage rise for direct care staff providing HCP
• An additional 9,500 HCP will be released for 2023-24 at the cost of $166.8 million
• CHSP providers will also have access to additional funding but they will have to apply for a grant
• $82.5 million will go towards increased fees paid to providers offering Veterans Home Care and Community Nursing programs

The Support at Home program delay is not necessarily bad news. ACCPA CEO, Mr Symondson, said they have long felt the program wouldn’t be ready for a 2024 launch. 

“Whilst this will clearly be disappointing to many, we would much rather delay implementation for 12 months and get the new scheme right. However, we do not want to see further delays so we are keen to work with the government to ensure that this new deadline is met,” he said.

The Government has stated it will use the time to refine program design and address critical issues in home care. The new Aged Care Taskforce will assist in informing the program’s final design. In addition, funding has been allocated to:

• Trialling an assistive technology loans program – $10.9 million over two years
• A costing study of home care services by the Independent Health and Aged Care Pricing Authority (IHACPA) – $71.5 million across four years
• Enhancing the information and communications technology (ICT) capability development of home care services – $73.1 million over 12 months

For HammondCare Chief Executive Mike Baird, the delayed launch of Support At Home could not come at a better time, as it will give providers more opportunity to prepare.

“Aged care providers are under stress adapting and implementing more changes in the last 12 months than ever before in the sector’s history. Changes recently have included Star Ratings, care minute requirements, 24/7 Registered Nurses and a new AN-ACC funding model,” Mr Baird said. “Placing a pause on these home care sector changes will give providers some breathing space.”

Catholic Health Australia Aged Care Director Jason Kara was also pleased by the Government’s willingness to take on feedback that will improve aged care services.

“We welcome the opportunity to co-design the new Support at Home program with [the] Government and consumers. The extra year was critical to ensure that the new system would provide quality, sustainable services that support people to remain in their own home for longer,” he said.

Home care providers can also anticipate additional funding in the coming years as Treasury has forecasted a $2.2 billion decrease in payments over the next three years for residential aged care. This is due to more people choosing to age in their own homes.

A quiet time for disability services

For people with disabilities, the most important announcement in the Budget was the goal to limit National Disability Insurance Scheme (NDIS) growth to no more than 8% a year. The Treasury predicts it won’t achieve this, but it could save a projected $60 billion over the next decade. 

Other key measures introduced for disability in the Budget included:

• The extension of the Disability Support for Older Australians program, giving older people not on the NDIS ongoing home care services until June 30, 2026
• $910 million to improve the operations of the National Disability Insurance Agency (NDIA) and NDIS Quality and Safeguards Commission
• Another $14.1 million to support people with disability who contract COVID-19 and do not have access to leave entitlements

People With Disability Australia (PWDA) supported the Government’s goals and wide-ranging approaches to improving housing and cost of living measures for people with disability. However, PWDA President Nicole Lee was disappointed by the lack of targeted accessible housing support for people with disabilities.

“It is important that the community is given an ongoing commitment that their choice and control over access to essential supports is protected,” Ms Lee explained.

“People with disability fought hard for essential supports from the NDIS. To maintain and build stronger trust, it’s crucial the government delivers essential supports in a demand-driven way.”

“Inaccessible housing is a long-lasting issue on top of the unaffordability of housing, so measures through a national housing plan for people with disability would have addressed accessibility and affordability barriers.”

Medicare boost and cheaper medications

People receiving aged care services will be among those to benefit from higher bulk-billing incentives for General Practitioners (GPs) as the Government looks to stop the declining rate of bulk-billing.

The Budget sets aside $3.5 billion over five years to give pensioners, Commonwealth concession card holders and children under 16 better access to bulk billing. GPs will receive a $20.65 bonus per applicable patient, while regional and rural GPs will receive $39.65. In total, $5.7 billion has been put towards Medicare-related services.

“This much-needed boost to Medicare funding and primary care will directly benefit the most vulnerable patients in our communities including the elderly, those with chronic illnesses, and people with disabilities,” CHA Director of Health Policy, Caitlin O’Dea said. “The extended GP consultations will allow for more comprehensive and personalised care, improving health outcomes for patients with complex needs.”

Supporting older people

• Hundreds of Pharmaceutical Benefits Scheme (PBS) listed medications will have prices reduced
• Older people can access two months’ worth of medication on one script
• There will be expanded medical support for older patients with complex chronic diseases to reduce the time they spend in the hospital
• $445.1 million is to be directed toward strengthening the Workforce Incentive Program-Practice Stream to provide improved multidisciplinary care for aged care residents and home care clients

A missed opportunity for rural communities

Although the measures in the Budget have been welcomed by rural healthcare providers, the National Rural Health Alliance (the Alliance) still believes the Budget was a missed opportunity for change. Alliance Chief Executive Susanne Tegen said the measures will support rural healthcare, but are unlikely to improve it.

“The Alliance notes that the Budget gives overarching measures for healthcare service delivery, however many are not rural specific,” Ms Tegen said. Ms Tegen highlighted bulk-billing incentives for regional GPs as a much-needed boost, but she was concerned by the lack of measures to address regional workforce shortages. 

“Further reform is needed to support the 30% of the population who live outside urban centres. The Alliance is disappointed that significant reform of rural health care has still not been tackled with these modest Budget measures failing to address major medical and health workforce inequities. These measures also do not allow for the innovative community-led models of multidisciplinary primary health care that are desperately needed in rural areas,” Ms Tegen said.