Saturday 27th of February 2021

running age care facilities like private dunnies?

porkies
Coalition Spin Kings: Expecting accountability in aged care is mere tilting at windmills

 


By SARAH RUSSELL | On 9 December 2020

The federal Health Department has learnt a thing or two from Scotty from Marketing. It has just announced version seven of the aged care pandemic plan. Never mind that the previous six versions never existed. 


Where to start in listing the deceitful behaviour of the Coalition government regarding aged care.

Is it that the “7th edition” of the Updated National COVID-19 Aged Care Plan has just been released by the federal Health Department when there was no 1st, 2nd, 3rd, 4th, 5th or 6th edition? A great trick from Scott Morrison’s marketing playbook – revise history by giving the impression there were six earlier editions when in fact there were none.

That the government continues to make announcements that are just re-announcements?

That it continues to throw huge amounts of taxpayers’ money at aged care providers but refuses to tackle the real changes that are needed?

That it can demand accountability for the $1.5 billion in pandemic funding given to aged care providers but it won’t demand accountability for the whopping $21 billion the providers receive annually?

And on it goes.

Bonanza for providers

By all accounts, the pandemic has been a cash bonanza for aged care providers, with funding announcement after funding announcement. While these give the impression the government is doing something, until it tackles the systemic failures that led to the deaths of 665 residents in aged care homes, the government is pouring our money down the drain.

The government announced its first cash injection in May: $205 million to contribute to the extra costs of managing Covid-19, including “screening visitors”. Yet most aged care homes, which had locked out visitors back in March when the pandemic took off, continued to keep families locked out. In some aged care homes, visitor lockout didn’t end until November, six months after the funding was provided.

In August, the government provided a further “$245 million injection into all facilities”. According to the media release this money was to “fund and support enhanced infection control capability, including through an on-site clinical lead”.

A further $132.2 million has just been announced in response to the royal commissioners’ six recommendations in Aged care and COVID-19: a special report. Yet several of the funding initiatives are re-announcements.

For example, in response to the recommendation that aged care homes employ trained infection control officers as a condition of accreditation, Aged Care Minister Richard Colbeck and Health Minister Greg Hunt simply re-announced their August cash announcement to support enhanced infection control capability.

The federal government has also committed a further $57.8 million to fund infection control experts to “provide training and assist with the refinement of outbreak management plans where needed”. A shame these infection control experts weren’t around when they were needed months earlier in Newmarch House, St Basil’s Home for the Aged and Heritage Care’s Epping Gardens? Some 98 residents died in these three homes alone.

The deaths of 665 residents in aged care homes highlight the federal government’s lack of planning for aged care sector. Yet Aged Care Minister, Richard Colbeck, told a Senate estimates hearing that he did not “feel responsible”.

As the royal commissioners confirmed in October – and a point I had made back in August – the federal government did not have a plan.

Older people not a priority

Care for older people in aged care homes during the pandemic was not a priority of this government.

The federal government is creating two new Medicare Benefits Schedule items at a cost of $63.3 million for mental health and allied health services for residents in aged care homes. Older people living in aged care homes finally have the same entitlements as older people living in the community – access to 20 subsidised sessions with a psychologist. That federal Health Minister Greg Hunt omitted this support for residents in the government’s earlier announcement speaks volumes about the government’s ageist attitudes to those in aged care.

The government has also announced $12.1 million for a new chronic disease management Medicare item. Let’s put this in perspective. Residents under a chronic disease management plan are currently entitled to five allied health sessions per year – physiotherapy, podiatry, exercise physiology and so on. They can now get 10 per year – less than one session per month. This is not nearly enough to support older people getting back on their feet – what the Health Department refers to as “reablement”.

The federal government has also allocated $15.7 million for group allied health sessions. However this money is only for residents living in facilities affected by COVID-19 outbreaks.

Providers claim the rising costs of keeping residents safe from coronavirus has pushed them closer to breaking point. Several large providers in the aged care sector, including Anglicare, BaptistCare and UnitingCare, used the Covid-19 pandemic to ask the Federal Government for a funding boost.

Described as a “COVID-19 rescue package”, their request had no information about how they intended to spend it or why they needed it. Business as usual in the aged care sector where a lack of financial transparency is the norm.

However, providers will be required to report on how they allocate the COVID-19 sources of revenue into the following items:

  • Labour
  • Resident support
  • Infection control or
  • Other, with details to be included.

If the providers are able to account for the pandemic money, they well and truly have the capacity to account for all the money they receive from taxpayers, including the $21 billion they receive annually in subsidies. As Senator Griff said recently during second reading of the Aged Care Legislation Amendment (Financial Transparency) Bill 2020:

“For that sort of money you would expect real accountability, you would expect providers to show what that money is being used for, and you would expect the government to know how much is being spent on care.”

However, we currently don’t know if providers spend this $21 billion subsidy on providing nursing care, meals and activities for residents or on sports cars for their executive team.

Last year, Senator Griff’s amendments were defeated.  The peak bodies representing providers lobbied against the financial transparency amendment by claiming that all this “red tape” would lead to excessive costs. Labor, the Greens, Centre Alliance and Jacqui Lambie didn’t buy it. But the Coalition and One Nation did.

The federal government’s idea of reforming the aged care sector is to shift deck chairs on the titanic. This does not bode well for their response to the Royal Commission into Aged Care Quality and Safety’s recommendations due in February. Continuing to pour money into a leaky bucket will not fix the aged care system.

 

Read more:

https://johnmenadue.com/coalition-spin-kings-expecting-accountability-in...

replacing robodebt with debt collectors...

Critics of the federal government’s botched Robodebt system fear Centrelink’s new debt collectors have failed to learn the mistakes of the unlawful recovery program.

Tender documents reveal a panel of new collection agencies must continuously compete to beat rigorous financial targets for recovering money from customers: Either winning more work or facing penalties.

Australian Unemployed Workers Union spokeswoman Kristin O’Connell said she was surprised the department was going to outsource the work.

“As the government’s own documents acknowledge, this outsourcing model means debt collectors have incentives that can result in ‘unintended and perverse’ behaviour to meet targets and trigger fees,” Ms O’Connell said.

Tender documents for the new contracts reveal Centrelink will engage three different debt collection agencies.

Initially the work will be split in thirds, but those that collect a greater percentage of debts will be given an increased share of the work.

Those that fail to meet targets will be penalised by losing work.

debt collecting

Robodebt lessons

The Commonwealth is in the middle of a $1.2 billion settlement over Robodebt.

The failed system was widely criticised for using computer algorithms to raise debts against hundreds of thousands of welfare recipients, with little to no human oversight.

Carissa Smith was chased for a fake $11,000 debt, allegedly accrued years earlier.

“I feel for the people that didn’t make it, because I know how close … I was, you know?” she said.

“They just don’t realise what they do to people, that’s all. They have no idea.”

Ms Smith was pursued by the agency for years, despite having payslips that proved she didn’t owe anything.

She is concerned the new contracts will make it impossible for companies, which are required to hit targets, to listen to customers.

“There’s going to be so many innocent people, you have to constantly prove yourself,” she said.

“You’ll never be able to fight against them.”

Whether or not new external debt collectors break the law won’t be weighed as a factor in winning the contracts.

While tenderers must comply with legislation, such as the criminal code and racial, sex, age and disability discrimination laws, there don’t appear to be penalties if they do not.

 

Read more:

https://thenewdaily.com.au/finance/welfare/2020/12/09/centrelink-debt-targets-revealed/

 

Extortion is a fun game used by politicians like Trump (sanctions), by religions (behave or you go to hell) and by the Mafia (concrete boots). The ScoMo has learnt from all three. ScoMo should be ashamed of himself...

 


 

old, decrepit and absent...


Australian aged care is a crisis waiting to happen

 


By PETER BAUME | On 8 February 2021


Providers know they are in the box seat and that they can, and do, operate sub-standard homes. Bad homes cannot be closed – imagine the furore if older people were suddenly evicted from a home that does not measure up.

We have many more aged Australians overall, many more people requiring residential care, and a veritable tsunami of people with dementia requiring a special kind of residential care, all locked into the pipeline.

The need is there, and it is going to be enormous, but governments are not responding adequately.  Because we are ageing as a society, young medical graduates in hospitals are treating an older cohort than did previous generations of interns.  What is threatening is outside the electoral cycle and the main pre-occupation of too many politicians is to get themselves re-elected – they ignore the future even when they know it is inevitable.

Where are these older people to live?  Some will continue to live in their homes,  in which they raised children, sometimes with help, but some will have to go into aged residential care.

We have a society where people no longer try to keep the elderly with them. People now live in smaller houses without space for another generation.  They might not even live in the same district as the elderly. If the elderly do remain with children, they are in loving families, there is good inter-generational mix, and the experience of life that the elderly bring is valuable.  

Many economically less developed societies continue to do this.  It is possible for some people, impossible for many. People do get old and emergencies do happen. Older people do need care and relatives with good intentions often do not know what to do.

Government sanctions are weak.  Providers know  they are in the box seat and that they can, and do, operate sub-standard homes.  Bad homes cannot be closed – imagine the furore if older people were suddenly evicted from a home that did not measure up.  For sanctions to be effective there needs to be a sufficient supply of places and a choice for potential buyers.

We are trying to care for our elderly on the cheap, resulting in poor care. If we want a “Rolls Royce” system, it will be expensive.  But we seem to be ready to spend more on defence than we are willing to spend on the elderly.

Older people want to stay in their own homes. The Australian Government has programs that encourage this. More is needed in this area but the thrust is right.

Catastrophic events such as advanced dementia or a stroke might force any older person to look for residential care.  If capacities diminish significantly, for any person living in their own home, there should be community services and community nurses and community support so they can continue to live, with their help, in their own homes. But if paid helpers are unable to meet their needs, older people might have to go to some residential facility. 

If one of an older couple becomes physically or mentally incapable, things have to be ordered differently. The other person has to become a full-time carer. A grandchild, or a student, might have to live with them in a paid capacity.  They might be able to use paid helpers to allow them to continue to live where they have always lived. They might need more money and might need to re-mortgage their home to get that money.  Again, the Commonwealth has programs to allow this to happen.

It is more sensible humane to try to make the competent elderly person safer where they are than it is to move them, almost automatically, into residential care. Having someone move in with them or moving in with family is sometimes better than moving into an institution – sometimes the elderly can contribute to extended families with their wisdom and by contributing to baby-sitting and general home making.

Australian aged care institutions are not working.  People generally do not want to go to there, many residents dislike the institutions to which they are forced to go, there are scandals reported regularly in the papers and on television, and the level of need is increasing fast.  More of the same will produce the same awful results and would merely magnify the problems we have already.  

The more desirable alternative is that people remain in their own homes. It would not be a cost-free approach but it would be a cheaper (in the long run), better for the wider community, and more humane approach than the one we have now.

 

Peter Baume 

 

Peter Erne Baume AC is a retired Australian doctor and politician. He was a Senator for New South Wales from 1974 to 1991, representing the Liberal Party. He served as Minister for Aboriginal Affairs and Minister for Education in the Fraser Government.

 

 

Read more:

https://johnmenadue.com/australian-aged-care-is-a-crisis-waiting-to-happen/

 

 

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age care in the good old USA...

EARLY IN THE coronavirus pandemic, as the country was being hit by the first wave of the deadly outbreak, New York state, under the leadership Gov. Andrew Cuomo, issued an order directing over 9,000 coronavirus-positive patients be discharged from hospitals into nursing homes. The Cuomo administration claimed that the order was necessary due to the risk of hospitals becoming overwhelmed by Covid-19. In fact, nursing homes tend to have much less effective infection control policies than hospitals, and the order, which likely contributed enormously to the spread of Covid-19 in nursing homes, was reversed in May.

In the meantime, though, the Cuomo administration moved to further protect nursing homes. In April, New York became one of the first states to implement liability relief for nursing home operators, after aggressive lobbying and years of donations from the hospital and nursing home industries. Besides New York, at least 27 other states have implemented liability protections for nursing homes.

Across the country, 161,000 nursing home and other long-term care residents have died from Covid-19, an astonishing 36 percent of the total coronavirus deaths in the U.S., and there have been over 1.2 million cases in nursing homes, meaning about half of all nursing home residents contracted the virus. The Government Accountability Office released a report in May 2020 titled “Infection Control Deficiencies Were Widespread and Persistent in Nursing Homes Prior to COVID-19 Pandemic.” And study after study has shown a connection between nursing home staffing and Covid-19 deaths, from the New York Attorney General’s office to researchers at the University of Chicago to researchers at the University of California, San Francisco.

The industry, with its powerful lobby, has escaped significant scrutiny, however. Just two nursing home executives have been indicted for Covid-19 deaths, while the industry showered over $10 million on candidates and political action committees in 2020, according to data collected by the National Institute on Money in Politics. Congress has held just one hearing on Covid-19 deaths in nursing homes, in the Ways and Means Health Subcommittee, chaired by progressive Rep. Lloyd Doggett.

 

Read more:

https://theintercept.com/2021/02/20/covid-nursing-home-cuomo-clyburn/

 

 

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