Mar 21, 2022

“Aged care homes are wasting money on allied health”: Providers’ funding ends

Physical therapy aged care

Aged Care Services Minister Richard Colbeck has informed aged care providers they will no longer receive funding specifically earmarked for allied health services, such as physiotherapy.

“The federal government believes aged care homes are wasting money on allied health services such as physiotherapists, which will no longer be directly funded under new rules,” The Sydney Morning Herald reports.

Aged care providers are delivering treatments “that are not necessarily the most clinically appropriate”, according to the letter seen by SMH, owned by media company Nine.

Studies show that mobility programs led by physiotherapists can reduce the number of falls in aged care by more than half (55%).

In their final report, the Royal Commission into Aged Care Quality and Safety said, “People in aged care have limited access to services from allied health professionals.”

“Allied health care in residential aged care is … insufficient and we are concerned that the type of service provided may be influenced by funding arrangements.”

They recommended that allied health services be provided in residential aged care “appropriate to each person’s needs … no later than 1 July 2022”.

“The Federal Government has chosen not to act on all of the recommendations from the Royal Commission,” said a statement from the Australian Physiotherapy Association.

Under the government’s new funding model, it will be up to aged care providers to decide if allied health treatments are necessary.

Paul Sadler, chief executive of not-for-profit aged care provider peak body Aged and Community Services Australia (ACSA), told Nine some providers may be “over-servicing” residents, but the government’s new proposal risks swinging the pendulum “from one extreme to the other”.

“We do need a proper funding model for allied health,” Mr Sadler said.

In a webinar held last Friday, a Health Department official said data from providers would be analysed to ensure they are still providing allied health services to residents.

Research by aged care accountancy firm, StewartBrown, reveals aged care providers spend about $830 million a year on allied health, but the federal government allocated only $27.9 million in its emergency response to COVID to allied health.

The Australian Physiotherapy Association (APA) said the report highlights the “alarming approach” the Morrison government is taking to reforming the aged care sector.

The decisions the government are making will ultimately “lead to poorer quality of care for our most vulnerable people,” the statement said.

“Lifestyle officers, which may replace many allied health services, are neither qualified nor equipped to provide for the complex needs of elderly Australians.”

Aged Care Services Minister Richard Colbeck must produce evidence that physiotherapists are “over servicing” in aged care homes, the statement said.

The APA has asked the government to work with them “to ensure that physiotherapy services in aged care are appropriate and optimised to improve quality of life”.

“Physiotherapy is an integral part of the aged care team that ensures quality care and support, and enhances health and wellbeing of older people in residential aged care.  

“Robbing aged care residents of these essential services will have a significant impact on their quality of life,” the statement said. 

“We must have properly funded residential aged care. Cost cutting reduces the level and quality of care for frail, elderly Australians.” 

The APA expressed its willingness to work with the federal government to ensure older people in residential care have equitable access to timely, high quality and needs-based care, including physiotherapy.

Independent Senator for South Australia, Rex Patrick, described it best, when he shared the following Tweet:  

“The Royal Commission found an absence of 24/7 nurses in aged care facilities was harmful – @ScottMorrisonMP hasn’t acted to get them. The RC found the presence of physiotherapists was helpful – he’s acted to get rid of them. It’s nonsense on stilts.” 

Meanwhile, Minister for Senior Australians and Aged Care Services, Richard Colbeck, told HelloCare the existing Aged Care Funding Instrument (ACFI) will be rolled into the new AN‑ACC funding allocation from 1 October 2022. 

Providers will still be “funded for and required to provide allied health services to residents in accordance with their obligations under the Aged Care Act,” he said.

The September 2021 StewartBrown survey identified that allied health services costs were 4% of the total care costs for providers.

“This would mean that approximately $700 million per annum is available to providers under AN-ACC to spend on allied health services,” Minister Colbeck said.

“Under the AN‑ACC, providers can invest in restorative care services, including … allied health, if it is in the best interest of the resident.”

Providers were required to report on the care time delivered by allied health professionals at the facility level from the 2020-21 financial year, as well as quarterly from July 2022.

“This will give visibility over the use of allied health services, such as physiotherapy, during the transition to AN-ACC and inform future policy decisions,” Minister Colbeck stated.

“Ultimately, the reforms will increase access and makes sure it meets the needs of the resident.

“Providers will be required to offer care in keeping with the resident’s assessed needs and the quality of that care will be reflected in the publicly reported star rated system.

 “This will include consumer experience outcomes, any regulatory activity undertaken by the Aged Care Quality and Safety Commission, the care minutes being provided to senior Australians, and service reporting against quality indicators.”

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  1. The so called over servicing is because of the rules set up under ACFI by the government. They created the system which incentivised physio led pain management services. Now they call it over servicing. Ridiculous. Older people have a right to allied health and quality of life. The government shouldn’t be picking winners and losers, they should be funding aged care so people get the care and allied health they need to live a great life while in aged care.

  2. High care residents are not well enough to join group classes like yoga and tai chi. The statement by the Aged Care Minister shows complete ignorance on his part. Ten minutes of physio once or twice a week helps relieve pain and therefore improve mobility. Even if they put a TENS machine on and come back later to remove it.

  3. The gold medal for wasting money goes to the government. Richard colbeck would know ANACC was created before the royal commission so this funding model will only go as far as the individual care planing and it has been shown this is under par as per the royal commission.

    As for over servicing Physiotherapy 63% for pain management? Does the government know how prevalent pain is in racfs ? It’s more like 80%. All you have to do is read the medical history and look at residents movements and mobility to know. Even better speak to older Australians and if Richard Colbeck and the government still don’t have all the data from the ANACC shadow period that could explain why they don’t know.

    The government is to blame for Acfi and its limited approach to Physiotherapy. Under Acfi currently treatments used by physiostherapists are limited to Eg passive massage. Physios have their hands tied
    and have been calling for Acfi to be adjusted to include access for residents to improve mobility, reduce falls, and provide rehabilitation after illness and injury for years.

    The government not fooling anyone, it is not capable of fixing the agecare sector Because it doesn’t understand it. It is more concerned about changing funding models as a routine rather then actually addressing what is required in racfs. What is required is Physiotherapists who are highly trained allied health professionals working with aged care residents to improve mobility, reduce falls, and provide rehabilitation after illness and injury. Inturn this will produce better care outcomes as it has direct impact on pressure care, continence, falls prevention, pain management, behaviours and more.

  4. The “Alarming approach” taken by Colbeck and Morrison is to ignore the mountain of evidence for preventative, reablement focused physical therapies that can improve both physical and mental health of aged care residents. To simply remove funding without an appropriate framework or support Royal Commission recommendations is another sign of this government’s short sighted and un-informed approach to make the tough decisions that are needed to transform our aged care system.

  5. The view of the Minister is utter nonsense. The current funding instrument, ACFI, fostered the implementation of large scale interventions by a range of therapists under the assessed need for pain management. So, providers took up the view that interventions by them are promoted by, and funded by the government. Obviously the view of the Minister now is that the decisions made by others before him were poorly founded in both logic and clinically. He has also now expressed a view, also supported perhaps by the implementation of AN-ACC, that physiotherapy is of no benefit and should not be provided. Every one who works in the industry is aware of the impact of de-conditioning upon the elderly. Every one who works in the industry is aware of the significant impact of falls upon both the well being and life expectancy of the elderly. To have someone be our Minister whose view is so out of step with the lived reality of life in an aged care facility, completely explains why the industry is in the shape it is in, and why the public have the view of us that they do. Roll on the election.

  6. The services were never directed where they were needed anyway. They were only ever directed where residents needed an ACFI funding boost. Same as RN massage. If they aren’t funded then you won’t see them in facilities at all. More money for them to fork out which they won’t do.
    The system is a disgrace

  7. Absolutely disgusting response. To treat the elderly this way shows how little the government is concerned for the health and wellness of our senior citizens. These politicians will one day need these facilities.
    It takes a qualified physiotherapist to know what sort of activities will benefit or harm each person.

  8. Another stress for an already over stressed area of healthcare. These services will still need to be provided to meet the quality standards so where will the money come from?
    People in aged care need these services – Physio reduces incidences of falls; decreases pain; reduces polypharmacy, etc. The benefits are numerous.
    A study was provided to the Aged Care Minister demonstrating this but no acknowledgement or response was received.
    Doesn’t matter who is in Govrrnment – the elderly always seem to miss out.

  9. Who will assess a resident when their mobility decreases? who will decide what mechanical aid is suitable? what happens after a fall? so many questions. Physiotherapist are an integral and important part of RACF. Nurses and carers rely on physio’s to do assessments after a fall to provide feed back on best management. Richard Colbeck really has no idea on Residential Age Care. We; the nurses, are not paid enough as it is, so what else does this government want to cut? Richard Colbeck is an embarrassment to the government. I understand that ACFI is soon going to be removed and a new funding tool is coming in. What surprises will be added to our work load then as it is, there is no time for staff to have a break, toilet run or a sip of water on a shift. Document, Document, Document… All paper/computer recording, and still expected us to provide 200hrs care including physio requirement care as nurses are that, nurses. Residents with dementia can’t do tai chi or yoga, really! The government need to do a full 24 hour shift on the floor to actually see what we do.

  10. It may be worth mentioning that the APA has been lobbying with government to fund evidence based practise treatments.
    If the government now states that Physiotherapy is overrated , have they not be listening.
    The APA can provide proof and evidence that Physiotherapy is needed to prevent falls, fractures, earlier deaths and most importantly the quality of life for the elder.

    Martin
    (Physiotherapist)

  11. Having worked in Aged Care for many years I find it appalling the government are planning to cut funding for allied health. The service may well need to be reviewed but it is certainly needed for many aged care residents mobility.

  12. So thousands of people die from preventable incidents like falls and just like COVID-19 we are supposed to believe that this is okay ? Physiotherapy is essential to mobilise injured muscles, reduce pain and improve strength and balance. This isn’t a waste this is an investment in prevention.

  13. Hang your head in shame Richard Colbeck. Aged Care has been in crisis for decades. You would have the elderly suffer more by withdrawing physiotherapy. You are not so young yourself. Time has a way of treating those who care so little for others. I worked in Aged Care for 15 years. You should immediately be removed from being the minister for Aged Care and replaced by someone with a heart.

  14. Everything in aged care is about the dollars not always what is best for residents. Its about the residents loneliness, boredom and helplessness. Its the three plagues of old age !!!!!
    The sooner that is medicine is not the master but the servant to our elders and drugs are not the answer to happiness. Most medications could be eliminated

  15. A resident’s need for Allied Health service should not be limited by Aged Care providers unnecessarily.

  16. Richard Colbeck has no idea what he is talking about. If anything more allied health care is required in Aged Care. What use to be Allied Health is now Nursing duties and they are talking of “Lifestyle” doing exercise programs. What a joke.
    Hours of care by nursing staff already erode the time maintaining mobility and safety.
    Pressure on Registered Nurses is ridiculous. Why do you think they are all leaving the industry or wont engage in Aged Care. How many times do the powers to be need to be told the industry is in crisis and yet they aim to make it worse. How about the recommendations of the Commissioner be instituted fully.
    I left after 47 years of nursing – my health now my priority.

  17. Lifestyle Workers are primarily comprised of university qualified Diversional Therapists and workers with Cert IV Leisure and Health. They are trained to meet LEISURE needs and should never be used in place of other Allied Health professionals. Each allied health professional brings their specific knowledge and skills to ensure holistic care for the consumer. All have an essential role which is not interchangeable.

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