Aged Care Regulation: The Key Things You Need to Prepare for Under the New Regulatory Model for Aged Care

The Department of Health and Aged Care has released a new Consultation Paper detailing its proposed new model for regulating Aged Care services, and, hold on to your seats – there are some more big changes coming our way.

The paper is the third consultation document released in response to the Aged Care Royal Commission’s finding that the current Aged Care regulatory model is ineffective and not fit-for-purpose. Once finalised, the changes the paper proposes will be outlined in the new Aged Care Act (currently in development) and come into effect when the Act commences.

While we strongly recommend reading the Consultation Paper in full, a summary of the proposed changes is provided below. You can provide feedback on the proposed new model until 23 June 2023. There are a variety of ways to do so through the Aged Care Engagement Hub.

Provider Eligibility and Entry to the Sector

  • Replacing the current aged care approval process, all providers will need to be registered through a new, streamlined provider registration model. Providers will need to register initially, then re-register every three years (this will be shortened in some instances). This universal approach replaces accreditation of residential providers and quality reviews of home services providers. The registration process will include suitability assessments of providers and their key personnel.
  • Sole Traders and Partnerships will be eligible to register to deliver aged care services in home and community settings. Currently, providers must be an incorporated entity (such as a company) to apply to deliver aged care services.
  • Instead of having to demonstrate their ability to deliver all services within a service type (such as Home Care) providers will be able to register to deliver one or more of six different categories of services (registration categories) that have similar risk and service characteristics. These are set out in the Table below.

Table 1. Proposed Aged Care Provider Registration Categories

Category Service Types
1. Home and Community Services
  • Domestic assistance
  • Home maintenance and repairs
  • Meals
  • Transport
2. Assistive Technology and Home Modifications
  • Digital technologies
  • Digital monitoring, education, and Support
  • Goods, equipment, and assistive technologies (non-digital)
  • Home modifications
3. Social Support
  • Social Support
4. Clinical and Specialised Supports
  • Personal care
  • Care management
  • Transition care services in the home
  • Specialised supports
  • Assistance with care and housing (hoarding and squalor support)
  • Nursing
  • Allied health
5. Home or Community Based Respite
  • Respite (home and community based)
6. Residential Care
  • Accommodation Services
  • Residential respite
  • Care and services
  • Transition care services (residential)
  • Transition care support services (residential)

Provider Obligations

  • The current provider responsibilities will become ‘Provider Obligations‘. Some will apply to all providers, while others will be registration specific, and will mostly be implemented through core, category-specific, and provider-specific Conditions applied to providers’ registration.
  • Strengthened Aged Care Quality Standards will apply – but not to all providers. While all providers will need to comply with certain Conditions such as the Code of Conduct for Aged Care, only providers delivering Registration Categories 4, 5, and 6 will need to comply with, and be audited against, the Aged Care Quality Standards. The Quality Standards and other obligations that apply to each Registration Category are set out in Figure 2, taken from the Consultation Paper. This figure also sets out the expected registration periods and registration pathways for each Registration Category.

Aged Care Regulation: The obligations architecture for the provider registration categories

  • Providers will also need to:
    • meet Financial and Prudential Standards applicable to the specific services they deliver
    • act consistently with the Statement of Rights and Principles that will be outlined in the new Act, and have practices in place to support this and
    • for specific registration categories, demonstrate their commitment to ongoing business improvement and capability to deliver high quality care.

Regulatory Oversight

  • The Audit process will only apply to certain providers – those delivering Registration Categories 4, 5, and 6. Grading will replace the current pass or fail approach, whereby an assessment of ‘major non-conformance’, ‘minor non-conformance’, ‘conformance’, or ‘elements of best practice’ will be assigned to each standard.
  • Providers delivering Registration Categories 1, 2, and 3 will be subject to person-centred and rights-based obligations through the Code of Conduct for Aged Care and other category-specific obligations and will need to provide a declaration of their compliance with these requirements.
  • All providers will be subject to enhanced monitoring. This will be informed by data from registration and re-registration processes, complaints, reportable incidents, provider notifications and reporting, audit outcomes, worker screening outcomes, and the Department of Health and Aged Care and other regulators such as the NDIS Quality and Safeguards Commission.
  • The Aged Care Quality and Safety Commission and Department of Health and Aged Care will have broader monitoring, investigation and enforcement powers and more flexibility to use existing ones. The Department of Health and Aged Care’s program assurance powers will also be expanded.
  • A new worker registration scheme will be established that will incorporate the Code of Conduct for Aged Care, as well as worker screening, English language proficiency, and ongoing training requirements.

Complaints and Feedback

  • A revised complaints model will be introduced and overseen by a new Aged Care Complaints Commissioner in the Aged Care Quality and Safety Commission. It will feature whistle-blower protections, including penalties for providers who retaliate against complainants, and early intervention and restorative justice pathways to help prevent complaints before they occur. It will also include compensation pathways for people who are negatively affected by providers who fail to meet their obligations.

Publicly Available Information

  • In addition to Star Ratings (currently applicable to residential providers), sector and provider performance data will be made publicly available through a new register of registered providers and published sanction information. Residential providers will also be required to provide older people with monthly care statements.

Transition

  • The Consultation Paper proposes a single ‘go-live’ commencement date for the new model, which will be the same as the commencement date of the new Act.
  • Existing providers will be deemed (transitioned) into Registration Categories at go-live, and not required to immediately register. Initial re-registration timeframes will then be staggered, to prevent all existing providers re-registering at the same 3-year mark. Certificates of Registration issued upon transition will set out re-registration timeframes.
  • New providers will be able to apply to become an Approved Provider under the current processes until the commencement of the new Act. However, given the length of time the current assessment process takes, in the 6 months prior to go-live, new providers will be encouraged to wait until the new registration process is in place.

Registration and Re-Registration Fees

  • Now this is a sneaky one! There’s been no mention of fees up till now and this Consultation Paper doesn’t shed much light on it either. But with the introduction in 2021 of considerable provider application fees, and a single phrase in the Consultation Paper referring to payments required from existing providers at their first re-registration, we can only assume that registration and re-registration will require providers to pay associated fees. Watch this space!

Provider Institute Best Practice Tip

The Consultation Paper gives us the most detailed understanding yet of what the new regulatory approach for Aged Care services will look like. And if you’re seeing considerable similarities with the NDIS registration and regulatory approach, we’re with you. A key part of the ongoing Aged Care reforms has been ensuring approaches align and harmonise with other sectors, for which the NDIS has provided a useful live learning tool.

If it is like the NDIS, the new Aged Care registration process in practice should be much more streamlined and straightforward than the current application process. However, this in no way minimises the strong regulatory requirements that still need to be met by providers wanting to deliver government-funded Aged Care services.

If you’re not already, become a member of the Provider Institute of Australia to keep across these important changes as they develop, and to stay compliant with existing requirements as they also continue to evolve.