Who is going to pay for allied health in nursing homes after October?

You might have heard that there is a new funding model replacing the current one that funds allied health in nursing homes in Australia from October 2022. Or you may not have. A LOT of people, including allied health professionals, journalists and some working in government aren't aware of this yet.

There is a LOT of detail and discussion of this funding model (called the AN-ACC), but it's currently very, very difficult to find a straight answer about who is going to pay for allied health in aged care after October 2022. In this article we'll do our best with the info we've read/found/discussed and what we believe is most likely to happen. We've done our best, but there may be information we don't know about yet - and/or information yet to be announced. As this comes to light, we'll share that too and update this page. If you find any other information please feel free to contact us and let us know.

Let's start with what you can get right now and up until October 30th, 2022 when the new funding model has been confirmed to start.

How much allied health would I get in a nursing home in Australia right now? Every home is different of course, and it can be harder to get allied health in some regional areas, especially. The Royal Commission into Ageing Quality and Safety heard that on average a nursing home resident in Australia receives 8 minutes per a day of allied health, of which around 2 minutes would be physiotherapy. Some residents do get more, for example if they are under a pain management program (see below) they would get 80 minutes per a week of massage and technical treatment from a physio or an OT.

How is allied health paid for now? Nursing homes provide basic maintenance allied health and pain management without cost to residents. They are paid by the government to do this with the current funding model (ACFI), which gives nursing homes extra funding for residents in pain especially.

Podiatry is also paid for by nursing homes generally, although in some cases they ask residents to pay for this or use Medicare care plans for this services with no out of pocket expenses.

A resident or their family can also ask for extra sessions of private physio and some of the fee may be rebated from private health or Medicare if they are eligible for a care plan from their doctor (5 sessions for all allied health per a calendar year, can be extended to 10 if doctor decides this is needed after the first five sessions have been used). Currently we rarely hear of allied health being paid for privately or under Medicare within aged care and the reasons cited are usually due to cost not comparable for a private allied health to visit compared to what they earn in a clinic, or the facilities having trouble finding available allied health professionals at all.

The take-home message is allied health in nursing homes is currently not paid for by residents but by the nursing home using dedicated government funding provided for the purpose of treating pain in older residents.

How will allied health be paid for from October next year? Great question! No-one seems to know!

What we do know is

* The government has not put any requirements or incentives for nursing homes to fund allied health as they do in the current system

* Nursing homes are in financial distress - especially those in regional areas. According to an accounting group Stewart Brown, 54% are losing money. Even with more money promised to nursing homes, many have expressed concern they'll survive with extra staff costs especially nursing. It seems VERY unlikely nursing homes will pay for allied health themselves, even if they want to provide allied health. They have to prioritise nursing and immediate resident care.

* The government has only allocated $27.9 million over 4 years for allied health access - this equates to 7 million a year, or less than 2 sessions with a physio per a year, 2 secs per a day compared to the 8 minutes received now.

* They haven't increased Medicare rebates or sessions which exist now.

* This means more than likely if someone wants allied health they will have to pay for it, either in a package or privately.

In summary - we are drawing awareness to this issue because we don't think its fair or right that allied health has to be paid for by residents. The Royal Commission said it was a vital service and inadequate at the moment with 8 minutes per a day. They also recommended that residents or their families shouldn't have to pay, and that Medicare wasn't enough to fund or have allied health visit regularly. The government agreed with this. Then in their budget only funded $27 million over 4 year, which is clearly (from the author of the new funding model, and the Royal Commissioner) nowhere near enough.

There is nothing we've seen to date that suggests/shows any way other than that residents will end up having to pay for allied health if they want it. And we don't think that's fair. If you don't either, or are concerned please take action and write to your MP about this issue. Older people need more allied health not less. And they and their families shouldn't have to pay for it.

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