$17.7 billion to deliver once in a generation change to aged care in Australia

In response to the final report of the Royal Commission into Aged Care Quality and Safety, the Morrison Government will deliver a $17.7 billion package of support and a once in a generation reform to aged care to deliver respect, care and dignity to our senior Australians.

Senior Australians built our nation. They are our parents and grandparents, our founders and protectors, and they have contributed so much to our Australian communities.

It is our duty and responsibility to give every Australian the care they need in their later years.

This investment of an additional $17.7 billion will deliver generational change with improved quality care, increased viability in the sector with services respecting the needs and choices of senior Australians. It is also the largest investment in aged care.

We welcome the final report of the Royal Commission and have founded our response on the principles of respect, care and dignity.

The Morrison Government is, therefore, responding to the Royal Commission with its five year – five pillar aged care reform plan addressing:

• Home care – at home support and care based on assessed needs
• Residential aged care services and sustainability – improving service suitability that ensures individual care needs and preferences are met
• Residential aged care quality and safety – improving access to and quality of residential care
• Workforce – growing a bigger, more highly skilled, caring and values based workforce; and
• Governance – new legislation and stronger governance

The Government thanks Commissioners, the Hon Tony Pagone QC, Lynelle Briggs AO and the late Hon Richard Tracey AM RFD QC, for their efforts delivering one of the most important documents in the history of aged care in Australia.

In responding to the 148 recommendations, of which 123 were joint, and 25 were specific to the individual Commissioners requiring a decision by Government, the Morrison Government has accepted or accepted in principle 126 recommendations. In addition, the Government supports instead an alternative on four of the recommendations. Twelve recommendations were subject to further consideration or noted in the government response. Six were not accepted, including four which note the discordant views of the Commissioners.

The key elements of the Morrison Government’s response include:

• Pillar 1 of the Royal Commission Response - Home Care: $7.5 billion towards supporting senior Australians who choose to remain in their home, including:
  • $6.5 billion for an additional 80,000 Home Care Packages – 40,000 released in 2021–22 and 40,000 in 2022–23, which will make a total of 275,598 packages available to senior Australians by June 2023
  • $10.8 million to design and plan a new support in home care program which better meets the needs of senior Australians
  • $798.3 million to support the 1.6 million informal carers, including additional respite services for 8,400 senior Australians each year, and
  • $272.5 million for enhanced support and face-to-face services to assist senior Australians accessing and navigating the aged care system.
• Pillar 2 of the Royal Commission Response – Residential aged care services and sustainability: $7.8 billion towards improving and simplifying residential aged care services and to ensure senior Australians can access value for money services, including:
  • $3.9 billion to increase the amount of front line care (care minutes) delivered to residents of aged care and respite services, mandated at 200 minutes per day, including 40 minutes with a registered nurse
  • $3.2 billion to support aged care providers to deliver better care and services, including food through a new Government-funded Basic Daily Fee Supplement of $10 per resident per day
  • $102.1 million to assign residential aged care places directly to senior Australians, and to support providers to adjust to a more competitive market
  • $49.1 million to expand the Independent Hospital Pricing Authority to help ensure that aged care costs are directly related to the care provided
  • $189.3 million for a new Australian National Aged Care Classification to deliver a fairer and more sustainable funding arrangements, and
  • $5.5 million to reform residential aged care design and planning to better meet the needs of senior Australians, particularly those living with dementia.
• Pillar 3 of the Royal Commission Response – Residential aged care quality and safety: $942 million to drive systemic improvements to residential aged care quality and safety, including:
  • $365.7 million to improve access to primary care for senior Australians, including the transition of senior Australians between aged care and health care setting and improved medication management
  • $262.5 million to ensure the independent regulator, the Aged Care Quality and Safety Commission (ACQSC), is well equipped to safeguard the quality, safety and integrity of aged care services and can effectively address failures in care
  • $7.3 million for additional resources to build capacity within residential aged care for the care of senior Australians living with dementia
  • $67.5 million for the Dementia Behaviour Management Advisory Service and the Severe Behaviour Response Teams to further reduce reliance on physical and chemical restraint (restrictive practices), and
  • $200.1 million to introduce a new star rating system to highlight the quality of aged care services, better informing senior Australians, their families and carers, including
    • $94.0 million to expand independent advocacy to support greater choice and quality safeguards for senior Australians.
• Pillar 4 of the Royal Commission Response – Workforce: $652.1 million to grow a skilled, professional and compassionate aged care workforce, which will be the powerhouse of the Government’s reform agenda, including:
  • upskilling the existing workforce and providing training for thousands of new aged care workers, including 33,800 subsidised Vocational Education and Training places through JobTrainer.
  • $228.2 million to create a single assessment workforce to undertake all assessments that will improve and simplify the assessment experience for senior Australians as they enter or progress within the aged care system
  • $135.6 million to provide eligible Registered Nurses with financial support of $3,700 for full time workers, and $2,700 for part time workers, nursing scholarships and places in the Aged Care Transition to Practice Program; and
  • $9.8 million to extend the national recruitment campaign, to help increase the skilled and dedicated aged care workforce.
• Pillar 5 of the Royal Commission Response – Governance: $698.3 million to improve the governance across the aged care system. This will embed respect, care and dignity at the heart of the system, guaranteeing better choice, high quality and safe care for senior Australians, including:
  • $21.1 million to establish new governance and advisory structures, including a National Aged Care Advisory Council, and a Council of Elders, and to work towards establishment of an office of the Inspector-General of Aged Care
  • $630.2 million to improve access to quality aged care services for consumers in regional, rural and remote areas including those with First Nations backgrounds and special needs groups
  • $13.4 million to improve rural and regional stewardship of aged care, with Department of Health aged care officers embedded within eight of the 31 Primary Health Network regions, and
  • The drafting of a new Aged Care Act to enshrine the Government’s reforms in legislation by mid-2023.

The initiatives outlined within the Morrison Government’s five pillars response will be introduced through a five year plan in response to the Royal Commission.

Phase One (2021) will see the Morrison Government focus on setting the foundations for generational change, commencing with key structural and governance change across the aged care system, building the workforce, and addressing immediate priorities across each of the five pillars:

2021

• Home care
• Residential aged care services and sustainability
  • Supplement ($10 Basic Daily Fee) and continue Viability Supplements
  • Independent Pricing Authority
  • Begin phasing in enhanced financial and prudential oversight
• Residential aged care quality and safety
  • Improve Quality Standards for dementia, diversity, food, nutrition
  • Enhanced regulatory and monitoring powers of the Aged Care Quality and Safety Commission to improve clinical standards
  • Additional GP services and access available for aged care residents
• Workforce
  • Additional training places provided for new and existing aged care workers
  • Scholarships to attract nurses and personal care workers
  • Additional advocacy, dementia and palliative care training
• Governance
  • Council of the Elders
  • Inspector-General of Aged Care
  • Funding uplift for MPS and NATSIFAC residential care

Phase Two (2022–2023), the Morrison Government will be rebuilding institutions across the sector ensuring their resolute focus on the dignity, care and respect for senior Australians.

We will develop and pass new legislation and embed regulation with a focus on high quality support for older people, which is simpler to access and better tailored to the needs of the individual. We will reform funding arrangements and make significant changes to service delivery. We will continue to enhance workforce capability, and improve the culture in aged care.

2022

• Home care
• Residential aged care services and sustainability
• Residential aged care quality and safety
  • Serious Incident Response Scheme (SIRS) expanded to home and community care
  • Reporting of staffing hours
  • Enhanced financial reporting transparency
  • Worker screening (workforce register) and code of conduct introduced
  • Stage one implementation of Star Ratings
• Workforce
  • Single assessment workforce model implemented in residential care
  • Financial incentive payments for registered nurses
  • Additional training places provided for new and existing workers, including 6,000 new personal care workers and 33,800 additional training places for personal care workers to attain a Certificate III
• Governance
  • Procurement of Indigenous care finders

• • Transition to AN-ACC funding model
  • Increase in the residential funding base

2023

• Home care
• Residential aged care services and sustainability
  • Mandatory care time (200 care minutes)
• Residential aged care quality and safety
  • National Aged Care Minimum Dataset to improve information metrics about aged care
  • Expanded National Mandatory Quality Indicator Program (NMQIP)
• Workforce
  • Single assessment workforce model implemented in home care
  • Additional training places provided for new and existing personal care workers to attain a Certificate III
• Governance
  • New Aged Care Act commences

Phase Three (2024–2025) will begin to realise the vision of a high-quality and safe aged care system. We will deliver an aged care system that places the needs of senior Australians at its core. Most of all, our care system will treat our senior Australians with dignity, care and respect.

2024

• Home care
• Residential aged care services and sustainability
  • Reformed residential aged care accommodation framework implemented
  • Discontinue the Aged Care Approvals Round process from 1 July 2024
• Residential aged care quality and safety
  • Full implementation of Star Ratings

2025

• Residential aged care services and sustainability
• Governance
  • Strong and effective governance of aged care is in place with senior Australians at the center and improved care outcomes consistently delivered.