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New report outlines residential aged care funding reform options

The release of a new report into aged care funding highlights a range of options to modify Australia’s residential care funding instrument.   
 
Minister for Aged Care, Ken Wyatt AM, said the Review of the Aged Care Funding Instrument (ACFI) would inform the Turnbull Government’s continuing aged care reforms.
 
“We are determined to put residential care funding on a more consistent, sustainable and equitable footing,” said Minister Wyatt.
 
“The Commonwealth currently contributes a record $18.6 billion per year to aged care and by 2020-21 this is expected to reach more than $22 billion.
 
“We are committed to a system centred on safe, quality care for our older Australians, while ensuring expenditure is affordable for consumers and sustainable for taxpayers.” 
 
The report, prepared by Applied Aged Care Solutions, undertook a comprehensive review of ACFI, focusing on ways to improve the current tool, including adapting it for external assessments of funding needs and updating it to bring it into line with current care practices.
 
“We welcome the new report on residential aged care funding reform, which adds to the options provided in a recent University of Wollongong report,” Minister Wyatt said.
 
The Government-commissioned study was released in April this year, outlining a variety of potential new funding models and tools for the aged care sector. 
 
Minister Wyatt said no decisions had been made, with the next step in the long-term reform process a Resource Utilisation and Classification Study, now underway at the University of Wollongong’s Australian Health Services Research Institute.
 
This study is investigating the drivers of residential care costs, according to location and the varying needs of individuals in care.
 
“We will continue to monitor use of the existing Aged Care Funding Instrument to ensure expenditure remains under control, while maintaining quality care,” Minister Wyatt said.
 
“We are equally committed to continue working with the community and the aged care sector to get these reforms right.”
 
The report is available on the Department of Health’s website.
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$3.7m in additional support to improve indigenous aged care services

Aboriginal and Torres Strait Islander people living in aged care in regional, rural and remote communities will benefit from more than $3.7 million in one-off grants. 
 
The grants, in response to funding applications, are provided to aged care services across New South Wales, Victoria, South Australia, Queensland, Western Australia and the Northern Territory.  
 
Minister for Aged Care and Minister for Indigenous Health Ken Wyatt said the grants, under the Australian Government’s National Aboriginal and Torres Strait Islander Flexible Aged Care Program (NATSIFACP), were in addition to the $33.5 million the program provides annually for service delivery.
 
“The National Aboriginal and Torres Strait Islander Flexible Aged Care Program is designed specifically to improve services to elderly indigenous people, mainly in remote locations,” Minister Wyatt said.
 
“These grants will provide practical assistance to 18 aged care providers to improve the lives of their elderly care residents.
 
“They will ensure that buildings are appropriate for Aboriginal and Torres Strait Islander cultural activities, customs, ceremonies and family visits.” 
 
The grants also give providers an opportunity to refurbish or upgrade living spaces for clients or staff, buy a range of necessary equipment for kitchens or laundries, and to fulfil medical or security requirements.
 
“The Government’s reform vision is to deliver integrated aged care services not only to major centres, but also to small regional and remote communities,” Minister Wyatt said.
 
“We want aged care that is flexible, non-discriminatory and culturally appropriate, no matter where people live, and inclusive of elderly Indigenous Australians who are among our most vulnerable citizens.” 
 
Recipients of NATSIFACP funding include:
  • Wami Kata Old Folks Home Inc. Port Augusta
  • Ceduna Koonibba Aboriginal Health Service (Aboriginal Corporation)
  • Ngaanyatjarra Health Service (Aboriginal Corporation)
  • Pintupi Homelands 2016-17
  • Calvary Community Care, Bathurst Island
  • Palm Island Aboriginal Council
  • Injilinji Aboriginal and Torres Strait Islander Corp for Children & Youth Aboriginal Community Elders Service Inc. Brunswick
  • Uniting Church Homes Guwardi Ngadu Frail Aged Hostel Fitzroy Crossing Mabuji Aboriginal Resource Aboriginal Corporation Borroloola
  • Tullawon Health Service Inc Yalata.
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Seniors and Sexuality

Ageing is a particularly sensitive issue for the lesbian, gay, bisexual, transgender and intersex (LGBTI) communities. Part of the sensitivity is underscored by the fact that older LGBTI people face very specific forms of discrimination, having lived through an era where sexuality was not simply stigmatised, but same-sex relationships were effectively criminal.

While numerous legislative and social changes have opened up the spaces for sexual and gender minorities to exist without the same levels of harassment, there are still significant elements of discrimination that LGBTI people have to face.

For example, accessing aged care services has been particularly difficult where LGBTI elders have been coerced into regulating or silencing their sexuality within a heterosexual environment. Unfortunately, such silence has also been met with the erasure of sex, sexuality and gender diversity from a range of ageing policies.

Of particular concern, is the release of the new draft Federal residential aged care accreditation standards do not recognise sexual or gender minorities.

While the draft standards identify the differences among all people accessing residential aged care, noting a list of important cultural differences, they fail to specifically reference sex, sexual orientation and gender identity as an important difference.

The Department of Health and Ageing (DOHA) has funded projects that aim to promote non-discrimination. Such projects include ACON's cultural sensitivity aged care training project and LGBTI targeted community aged care packages provided by QAHC and Care Connect in Queensland.

It is therefore surprising that there is no mention of LGBTI older people in the new draft residential aged care accreditation standards.

Submissions to the recent Productivity Commission Inquiry into aged care in Australia, noted that sexual and gender minorities face particular difficulties in accessing services when they are forced to ‘out’ their identities or relationship status.

Historically non-heterosexual older people in aged care settings have experienced high levels of stigma and harassment and many have been coerced into remaining silent about their sexuality.

Moreover, the assumption that all individuals and couples are necessarily heterosexual, leads to a double bind. Either an individual or couple must ‘out’ themselves to an aged care provider, undermining their right to privacy, or they are insidiously coerced into silence, breaching their right to dignity and non-discrimination in relation to their sexual or gender identity.

In order to avoid reproducing this culture of shame and discrimination, the residential aged-care accreditation standards should refer specifically to sex, sexuality and gender diversity, and the need to protect the privacy and dignity of all residents.
Given the absence of comprehensive Federal statutory protections, it is important that departmental polices include specific principles of non-discrimination on the grounds of sexual orientation and sex and gender identity.

Ageing is not a discrete issue. Understanding how people relate to ageing involves considering the intersections with gender, sexuality, class, ethnicity, religion and other social categories of difference. We have multiple and disparate identities.

The challenge then becomes ensuring that policy and legislation does justice to these complexities in order to address the needs of a diverse range of LGBTI elders.

To take action on this issue, I would strongly urge you to email DOHA (This email address is being protected from spambots. You need JavaScript enabled to view it.) and inform them that sexual orientation, sex and gender identity must be expressly mentioned in the residential aged care accreditation standards. This will be a necessary step to help ensure the rights to dignity and non-discrimination for older LGBTI people are always taken into consideration.

 

Senthorun Raj

is the Senior Policy Advisor for the

NSW Gay and Lesbian Rights Lobby.

 


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