Tom Symondson

$78,000 penalties for individual staff for code of conduct breaches were criticised by most key provider and worker voices in their submissions on the draft of the new Aged Care Act. Critics include the main provider association, Aged & Community Care Providers Association, the Australian Nursing & Midwifery Federation, HSU National, large providers like Bolton Clarke, and faith-based networks like Catholic Health Australia. Yet this issue isn’t mentioned anywhere in the published consultation feedback summary. The specific concern with penalties for the code is that they apply to low-income individuals for even minor breaches of the fairly vague and subjective aged care code of conduct, with prosecutors only needing to prove the offense against a civil standard. It’s grossly unfair and unnecessary given other remedies like banning orders and standard criminal offences. However, this is just one example. There are plenty of other important points made in various submissions and meetings that the consultation summary ignores. The summary also tends to summarise sentiment rather than substantive arguments. This summary isn’t the only way that the Government synthesises feedback. But it’s still concerning that it misses so many major issues raised by key stakeholders. I'm not even surprised. Just disappointed. #agedcare

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Update on our recent challenge within the NDIS system: For those of you following our journey with a participant who unexpectedly ran out of funding and faced the prospect of being left at a hospital, here’s what happened: In a desperate move, we went to the NDIA office in Charlestown, where emotions ran high. We found ourselves pleading and even threatening to leave our participants there in hopes of getting some help. It was clear from the expressions of the staff that they felt trapped by the system just as much as we did. They admitted they couldn’t do much as they had no way to communicate directly with the Home and Living team which holds the reins on these decisions. It was an incredibly tense situation. They saw the difficult position we were in and reiterated that leaving him at the hospital seemed like the only option available. Hoping for a miracle, we decided to wait over the weekend where Kristi supported him by herself and had half of her hair extension ripped from her scalp, but he was safe. Seeing our participant's situation firsthand, we believed it might just sway the NDIA staff to advocate for us…And it worked, well—kid of. By Monday, we secured an additional four weeks of funding to continue supporting him, hoping the Home and Living team would reach a decision soon. It's been almost six months since the ROR, and over a year since the initial application.. For those outside the NDIS ecosystem, it might be hard to grasp that the decision-makers, who have such a significant impact on participants' lives, rarely, if ever, meet them in person. The NDIA “reads” ( yes loose term ) a number on a page and some reports and makes a decision based on that. But seeing a person, meeting them can bring a whole other meaning to information. While the NDIA will say you can request a ‘face to face meeting’, everyone working in this space understands the reality is quite different. The option to meet in person is almost a mirage—appointments are so hard to come by and often not available until after the funding dries up. Coincidence? That’s a topic for another day. Home and living planners though are faceless and you are never given the opportunity to meet them and humanise a situation. It’s strange and quite sad, isn’t it? Decisions that dramatically alter lives are made by those who have never met the participant and looked them in the eye. Isn’t this a ‘person-centred’ system? So, the saga continues, and we’re still waiting. The hospital has even escalated this internally, recognising the mental health unit is far from ideal for anyone involved. Still waiting. Six months and counting for a decision.. Thank you to the amazing Julie Cross who has platformed this – read her article below https://lnkd.in/gwdbVy8s

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The Department of Health and Aged Care just published the Home Care Package - Published Pricing Schedule - 30 June 2024 which shows the national median prices for common home care services including care management and package management fees. Home care providers, well worth a look to ensure you are operating in a competitive space. Link: https://lnkd.in/ekkjDrNM Please note that it comes in an excel version so you can have a play with how you want to sort the data, even better. #homecarepricing #pricingdata #homecarepricingcomparisons #

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"NDIS TASKFORCE EXPOSES PROVIDERS RIPPING OFF NDIS PARTICIPANTS   The Albanese Government is continuing to crack down on unfair participant pricing with the NDIS Fair Price and Australian Consumer Law Taskforce (The Taskforce) receiving almost 3,000 complaints since its inception.   The Taskforce is a collaboration between the National Disability Insurance Agency (NDIA), the NDIS Quality and Safeguards Commission (NDIS Commission), and the Australian Consumer and Competition Commission (ACCC) – yielding positive results after less than a year of operation.   Since its establishment in December 2023, the Taskforce has received and triaged more than 2,800 reports, with the majority of these (2,456) focused on matters related to pricing.   The NDIS Commission has referred 34 consumer related matters to the ACCC’ for further regulatory response.   The NDIA has referred more than 140 businesses to the ACCC in relation to potential misconduct under Australian Consumer Law.   The ACCC is actively investigating multiple NDIS providers for contraventions of the Australian Consumer Law and anticipates taking public enforcement action in the near future.   Minister for the NDIS and Government Services, the Hon Bill Shorten MP, said the Taskforce was established to address NDIS providers charging higher prices for goods and services to NDIS participants compared to people not on the NDIS.   “We’re targeting the predatory providers and businesses who think they can take advantage of people with disability simply because they receive NDIS funding,” said Minister Shorten.   “That kind of behaviour is abhorrent and will not be tolerated.   “If someone is on the NDIS, they should not be paying a different price for any product or service than anyone else unless there’s a very good reason.   “The Taskforce is effectively identifying and addressing misconduct, and ensuring every possible dollar in the NDIS is being used to support people with disability.”   To date, the NDIS Commission has resolved more than 85% of the pricing-related matters, sending out warning letters and educating providers about their obligations under the NDIS Code of Conduct.   To strengthen the work of the Taskforce, the NDIS Commission has also developed a set of digital resources designed to ensure that participants understand their rights and that providers are aware of their obligations under the NDIS Code of Conduct.   Assistant Minister for Competition, Charities and Treasury, Andrew Leigh said the common issues identified by the Taskforce include false or misleading advertising of NDIS goods and services, providers not adhering to consumer guarantee laws, unfair contract terms, and providers wrongly accepting payment or charging for goods or services not supplied." Full press release below: https://lnkd.in/gMnWH7YZ

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Have you read the draft National Nursing Workforce Strategy? ❌ No real discussion of nurse graduate numbers, or how to increase them ❌ Migration barely mentioned ❌ No concrete discussion of whether/why more nurses are leaving the profession. ❌ Most recommendations are motherhood statements (e.g. enable nurses to work to their optimum scope of practice in all settings). We have enough people who want to be nurses. Increasing the nursing supply is a production problem. Fundamentally, it is a solveable problem. At least in the medium-term. And it has real implications for the cost and quality of health services. There has been at least year to work on this. I think it is reasonable to expect some sort of practical roadmap. Maybe the issue is the national cabinet process? This doesn't seem like is a wicked problem. As far as I can see it isn't political. It will clearly save money, and probably lives. I'm not saying that there is a magic bullet. I think it'll probably be a lot of hard work. But nothing about it seems intractable. If you share my concerns, you can provide feedback on the draft here: https://lnkd.in/gkCQg8xK #agedcare #health #nursing

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Released today, the “Moving cage to cage’ interim report provides the findings and recommendations from a special inquiry undertaken into children and young people in alternative care arrangements in NSW. This report is one we cannot ignore. The harrowing accounts of children and young people who have lived in hotels and motels due to the chronic shortage of suitable or available carers should serve as a line in the sand. The report highlights the dreadful outcomes for young people who have been housed in hotels, motels and high-cost emergency accommodation. The findings underscore a critical and widespread issue within our child protection system, one that demands urgent and sustained action. The urgency to act cannot be underestimated, and non-government organisations are such an important part of the system and can play an integral role in delivering cost-effective, evidence-based solutions to ensure children and young people are given every opportunity to grow up in safe, loving, stable homes. I commend Families Minister Kate Washington's decisive response to launch an urgent review of the foster care system and applaud the NSW Advocate for Children and Young People, Zoë Robinson's work so far in bringing these sector shortfalls to the forefront.  Investigating the over-reliance on emergency accommodation and how taxpayer money is being spent is a step in the right direction. OzChild supports the Minister's commitment to giving vulnerable children and young people the future they deserve and stands prepared to assist the NSW government with innovative solutions and dedicated partnerships.  At OzChild, we have been proactive in addressing these challenges through the implementation of the Treatment Foster Care Oregon (TFCO) program in NSW since 2019. A specialised foster care model that draws on over four decades of international research and evidence, TFCO aims to enhance positive behaviours in children and young people, facilitate their successful reunification with families, and steer them away from less desirable high-cost emergency arrangements. In NSW, TFCO is delivered as a time-bound intervention, averaging 10 months. Our teams have seen 15 children and young people transition from high-cost emergency arrangements and 14 from residential care.  All 29 children and young people have returned to stable, nurturing environments such as parental homes, foster, kinship care, or semi-independent living. That speaks volumes for the significant value of such a program. 

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As noted by Laurie Leigh it's incredibly disappointing to see the financial pressures on NDIS providers continue to ramp up following the inadequate price increase outlined in the Annual Pricing Review. In a market where more than 60% of registered NDIS providers are already losing money, a 3.19% pricing increase (for a limited number of services) does not even cover the 3.75% increase in wages for FY25. Furthermore, this reduces each organisation's ability to train staff, maintain assets and generally manage rising operational and compliance costs. In a thin market like the Bega Valley, it's hard to understand how regional and rural providers can meet local service and support needs while still operating sustainably under this model.

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Whether you love them or hate them, residential aged care homes are a necessity. If you don’t already know this, allow me to explain. The government does not provide aged care, it funds the majority of it through private businesses, some NFP some not. The ongoing financial losses for those care providers willing to provide 24/7 care to those so vulnerable at the end of their lives cannot continue. Not only will care homes close, no homes will be built to meet the growing demand for high care. If our society wants high quality care, someone has to pay for it, it doesn’t come free from care providers. And if you are wondering why isn’t someone doing something about it… well, there is! The whole sector came together in the form of an Aged Care Taskforce and ageed on a funding solution. However, implementing the report has stalled because it is yet to be accepted by the Opposition and included in the new delayed Aged Care Act. As Derek Dittrich and StewartBrown says, we are at the crossroads. What we have done in the past is no longer working. The Aged Care Taskforce offers us a new way. Anika Wells The Hon. Peter Dutton MP Anthony Albanese

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This report favours a model called 'fundholding' where Navigator organisations would hold our plan funding in a 'pool.' They would use the money in this pool to procure services for us according to their ideas of quality and value. They wouldn't have to spend our plan value on us. They could spend it on someone else, or not at all. If they underspent our plans, they could keep the change. This is literally the definition of extractive abandonment. How easy do you think it would be to convince your Navigator at NIB that you actually needed the $15,000 wheelchair from a different company than the one they usually work with, or that you actually do need the number of support hours in your plan, not slightly less, when their yearly bonus was riding on you underspending enough that there was some left over for them. I can only hope that this has been drafted solely for titilation, and the government has no intention of indulging these purile fantasies.

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Australia’s health care system is one of the best, but regional communities are feeling the pinch of staffing shortages.   It’s not just about pay; liveability matters. To attract and keep health professionals in country towns, we need to focus on housing, partner job opportunities, and community support. There’s work to be done to create environments where health workers want to stay.   In my latest column for The Land, I look at some initiatives that could make all the difference: https://lnkd.in/gpvd_nU9

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As of the 2021 Census, 78% of people under 40 working as registered nurses in aged care were born overseas. Across all age groups, 81% of migrants working as registered nurses in aged care moved to Australia in the previous 20 years with 48% moving to Australia in the previous 10 years. Only a small proportion of the above group would have initially come to Australia on a skilled visa. A significant proportion would have come to Australia as nursing students first, and then applied through the skills stream. But when I look at the number of skilled pathway visas actually granted to RNs, I suspect that most actually came to Australia on other visa types, including as partners or children of primary applicants. Without migrants, Australia wouldn't have an aged care system. Maybe it's possible to reduce broader migration and focus more on the skilled stream. But I'm sceptical that this will be enough. More aged care nurses or less immigration. I think Australia probably needs to pick one. We probably can't have both. #agedcare #nursing

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Delayed action on the Aged Care Taskforce risks future hospital bed block. That's the message from Bolton Clarke and our CEO Stephen Muggleton in response to this year's Budget. The trend in closures and new bed construction over the last ten years is leading us towards net negative growth in new beds. There are already some aged care planning regions recording occupancy of 95%+, based on the StewartBrown approach that takes into account offline beds. This includes regions in Adelaide, Perth, Brisbane, and Canberra. Add frictional vacancies as residents move in and out (at least half a per cent), within year peaks (about half a per cent above the average occupancy) and these regions are pretty close to full already. The bed stock is also ageing. Some data released a couple of years ago suggests about 17% of beds haven't been substantially refurbished since 2012. Even in Sydney and Melbourne, which have lower average occupancy, it's increasingly common to hear about problems with access to respite. The Government should get credit for putting funding reform on the table. It is clear Anika Wells is fighting for action. The sector needs to support this push. Every day of delay in aged care funding reform translate into another day of hospital bed block, including in key marginal seats that will decide the outcome of the next election. #agedcare

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Bill Shorten Media Release: New NDIS providers receive grants to co-design new payment options The Albanese Government is trialling a new approach to paying for disability supports to ensure National Disability Insurance Scheme (NDIS) participants receive high quality supports that produce meaningful outcomes. As part of the 2023-24 Budget, the Australian Government committed $24.6 million over four years to work with participants and providers to trial blended payments which will test if there is a better payment option than the current fee-for-service model. Since then, the Albanese Government has been working closely with participants, providers and representative groups to design the best way forward on the trial.  The National Disability Insurance Agency (NDIA) today announced 31 providers would share in $330,000 and take part in the co-design of blended payment options to explore how they might work. Minister for the NDIS the Hon. Bill Shorten MP said the Blended Payments trial is an opportunity to test different ways providers can be paid which encourage them to deliver better quality supports and achieve outcomes for participants.  “Under the current fee-for-service model, a participant pays a provider for their services and often that’s the end of it. The idea of a blended payment method will test if there might be a better option – where both participants and providers are clearer from the start on the desired outcome and thereby work more effectively towards that,” Minister Shorten said. From next year, following the co-design process, the NDIA and Department of Social Services (DSS) will begin trialling blended payment methods (among small groups of voluntary participants) to test their effectiveness. The trial will involve combining two types of payment. The first is an enrolment payment, where providers are paid for providing supports over a period of time (for example 1 or 2 years). The second is an outcome-based payment where a provider is paid when a participant’s goal is achieved. By trialling the blended payment method, we are testing if changing the payment approach can achieve better outcomes for participants. The fee-for-service payments currently used can narrow the focus to be on the amount of support delivered, rather than whether the supports are achieving results for participants. “This is a necessary innovation in shaping how payments could work differently in the NDIS in the long-term. We need to give participants more options in the future on how they engage providers and how they may pay them.” “To ensure we get this right, we’re co-designing the payment model with participants, Disability Representative and Carer Organisations (DRCOs), providers and peak bodies.” Full story:

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Considered and strategic advocacy can achieve the changes we need in aged care service delivery.

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xpenses in the aged care sector are a critical focus for organizations aiming to balance cost savings with high-quality care. Smaller and regional aged Aged care homes encounter unique challenges in cost management and government funding. Leveraging procurement specialists like S.T.A.R Procurement is key to swiftly identifying savings on various expenditure items. S.T.A.R Procurement offers tailored solutions, delivering tangible savings of up to 30% off baseline costs for organizations such as Healthia Limited, Tristar Medical, and Capitol Health. By cascading these savings to associated entities, procurement not only cuts costs but also aids in achieving strategic goals, enhancing efficiency, and ensuring compliance. Over the last 6 months, S.T.A.R Procurement has achieved significant savings in categories like stationery (25%), printing (30%), utilities (25%), and medical consumables (15%). Implementing procurement improvements is a straightforward process yielding substantial benefits without extensive consulting hours. External procurement support can provide a cost-effective boost to strategic objectives compared to internal resources.

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With a new coalition government there is a hope and public pressure that they will work to strengthen the public health system and revisit decisions to handover district hospitals to private players. The centre needs to speak and listen to the people working on the ground to understand and resolve issues and deliver health care to all https://lnkd.in/deFRi5Yi

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Under the leadership of Haley Lowe and Janece Levien we have incredible things blooming (literally and figuratively) at Green Hill. We are fortunate to have had the opportunity to invest in a team dedicated to education and career services and the team has begun their transformative work. More about that: The Education and Career Services (ECS) Team at Green Hill School has developed a comprehensive strategic plan for 2024, that promises to drive transformative change for incarcerated youth. Through well-defined priorities and initiatives, the ECS Team demonstrates a holistic approach to improving school engagement, enhancing information sharing, and expanding programming opportunities. At the heart of their efforts lies a commitment to empowering youth and equipping them with essential life skills for success beyond the juvenile justice system. The ECS Team's ambitious goals, such as increasing attendance rates and high school/GED completion rates by 25%, reflect a determination to significantly improve educational outcomes for these young people. Recognizing the importance of positive reinforcement, the team plans to implement behavior supports and incentive programs to promote engagement and recognize achievements. This strategy not only fosters a conducive learning environment but also instills a sense of pride and motivation in the youth. Effective communication and collaboration are fundamental to the ECS Team's approach. By sharing attendance and credit data across education, living units, staff, and youth, they aim to improve outcomes through transparent and coordinated efforts. This initiative underscores the team's commitment to treating all stakeholders with respect and welcoming diverse perspectives. The ECS Team's focus on enrichment programs, such as gardening, financial literacy, civic engagement, and arts, ensures a well-rounded educational experience. These programs empower youth by providing them with valuable life skills, creative outlets, and opportunities for personal growth. The ECS Team's core values of safety, transparency, authenticity, respect, and belonging create a strong foundation for positive youth development. By acting as a bridge between education and living units, the team fosters an environment where youth can thrive and discover their full potential. Investing in the ECS Team's strategic initiatives promises to yield substantial benefits for incarcerated young people. Through their comprehensive approach, the team not only addresses academic achievement but also cultivates essential life skills, positive behaviors, and a sense of empowerment. By providing transformative educational opportunities, the ECS Team equips these youth with the tools they need to break free from the cycle of incarceration and pave the way for a brighter future. #future #strategic #lifeskills #mtss #pbis #education

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It's quite revealing to see the data presented in the Aged Care Quality and Safety Commission's recent Sector Performance Report. While it's encouraging that 85% of aged care homes audited were compliant with all eight Standards, the persistent issues highlighted, especially in clinical care and organisational governance, are concerning. The report indicates that clinical care continues to be a major area of complaint and non-compliance. Despite a general improvement in compliance with Quality Standard 3, significant challenges remain in delivering safe and effective care and managing high-impact or high-frequency risks. These are crucial areas affecting the daily lives of aged care recipients and their families, underlining the need for stringent, effective standards and enforcement. Moreover, the low compliance rate in Standard 8, which focuses on organisational governance, suggests systemic issues that might not be swiftly resolved by simply introducing new standards. What we need is not another delay in implementing these standards but a more rigorous, actionable approach that holds facilities accountable and ensures that improvements are not only promised but effectively executed. The increase in audit activity is a step in the right direction, yet, as the report shows, there's a crucial need for continuous and effective monitoring to truly elevate the standard of care. The sector's ability to adapt to and address these issues will be paramount in ensuring the safety and well-being of those under its care. We must advocate for and support changes that bring about real, impactful improvements in the quality of aged care services.

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ACT Labor commits to hiring 800 healthcare workers ACT Labor is making the biggest investments in free public healthcare in Territory history. We are opening the expanded Canberra Hospital, building a new northside hospital and delivering more services in our Walk-in Centres. At the same time, we are investing in our public health workforce – recruiting more staff, providing more support for students and investing in nurse and midwife to patient ratios. To make sure that Canberrans get the right care, at the right place and at the right time – we will hire 800 more healthcare workers. We will hire more nurses, doctors, specialists, midwives, physiotherapists and other allied health professionals to provide free healthcare right across Canberra. And we know that our health workforce goes beyond just health professionals. That’s why, as part of our plan for better healthcare, ACT Labor will also hire more support staff in our health network. This includes admin workers, wards people, and allied health assistants who are all vital to delivering free public healthcare in Canberra. From specialist appointments to mental health services – this commitment will mean better care for every Canberran, no matter where they live. In 2020, ACT Labor committed to hiring 400 more nurses, midwives, doctors and allied health professionals. Over this term of Government, we’ve funded more than 580 additional full-time equivalent healthcare worker jobs across these professions. We are investing in more state-of-the-art health facilities to provide our workforce with access to the best equipment, technology, and training so they can provide world-class care to our community. It’s part of ACT Labor’s practical, progressive and proven plan for Canberra.

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