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Aged Care Amendment (Resident Welfare and Provider Disclosure) Bill 2019

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2016-2017-2018-2019

 

 

 

 

 

THE PARLIAMENT OF THE COMMONWEALTH OF AUSTRALIA

 

 

 

 

 

SENATE

 

 

 

 

 

Aged Care Amendment (Resident Welfare and Provider Disclosure) Bill 2019

 

 

 

 

 

 

 

EXPLANATORY MEMORANDUM

 

 

 

 

 

 

 

(Circulated by authority of Senator Griff)



 

Aged Care Amendment (Resident Welfare and Provider Disclosure) Bill 2019

 

 

OUTLINE

 

This Bill amends the Aged Care Act 1997 to make two modest yet important changes that will better assist, inform and protect consumers.

 

The Bill creates a new provision to mandate that Commonwealth-subsidised residential aged care providers (approved providers) must report the numbers of falls among residents, and the number of medication errors suffered by residents. Reporting would be on a quarterly basis.

 

The Bill also amends the Aged Care Act to require providers to post any sanctions against them on their website. The aim of this is to provide increased transparency to aged care recipients and their families by ensuring important information, such as sanctions, can be accessed through an approved provider’s website, as well as the My Aged Care portal. It ensures that the information is made available irrespective of the online means through which a consumer researches or engages with an approved provider.

 

Reporting of falls and medication errors will complement the three clinical indicators that have recently been mandated as part of the (now obligatory) National Aged Care Quality Indicator Program, and which aged care providers will have to report on to the Department of Health:

·          Unplanned weight loss

·          Use of physical restraint

·          Pressure injury.

 

Reporting on these clinical indicators, including falls and medical errors, will assist in monitoring the ongoing wellbeing of residents. Importantly, this data will serve to highlight facilities that are statistical outliers, which may be due to insufficient resourcing, poor procedures or lack of appropriately trained staff. This information can then be used to drive improvements at a provider or system level - to fix what might otherwise have been allowed to continue.

 

Falls-related injury is one of the leading causes of morbidity and mortality in older Australians. According to the Australian Commission on Safety and Quality in Health Care’s 2009 report on Preventing Falls and Harm from Falls in Older People , residents in aged care facilities experience nearly five times more falls than people of the same age who live in their own home.

 

In her final annual report, the Aged Care Complaints Commissioner said most complaints for 2017-18 were about residential aged care, and the most common issues raised in these complaints were about medication administration and management (706 of the 4315 complaints made).

 

A 2017 survey of medications in aged care by the NSW Nurses and Midwives Association found residents were being exposed to avoidable risks from medication errors due to poor staffing ratios and insufficient or inappropriate staff training. This was leading to the administration of wrong medication dosages and to residents receiving incorrect medicines or not being given their prescribed medicines.

 

In the two years since the full horrors at South Australia’s Oakden Older Persons Mental Health Service were revealed, the sector has been undergoing substantial reform. It is an ongoing process, far from complete.

 

 

The Royal Commission into Aged Care Quality and Safety will seek to address failures in the quality and delivery of aged care services. It will run for about 18 months and will no doubt touch on issues raised in this Bill. However there is substantial existing evidence that already supports the changes outlined in the Bill.

 

The report on the outcomes of the National Aged Care Quality Indicator Programme Residential Care Pilot found that the pilot stage - which trialled data collection and reporting processes - had the unexpected benefit of prompting improvements to services and procedures among some participating facilities.

 

In the United States, significant reform followed the 1999 report by the Institute of Medicine: To Err Is Human: Building a Safer Health System . At the crux of the report was a push for mandatory reporting of medical errors on the basis that reporting errors is fundamental to preventing them.

 

The provisions in this Bill are relatively modest but the benefits are clear, and can be enacted now to drive transparency and ongoing improvements for aged care residents.

 

NOTES ON CLAUSES

 

Clause 1: Short Title

 

1.                   Clause 1 provides for the short title of the Bill to be cited as the Aged Care Amendment (Resident Welfare and Provider Disclosure) Act 2019 .

 

Clause 2: Commencement

 

2.                   This clause specifies that the Bill’s main provisions will commence the day after the Bill receives the Royal Assent.

 

Clause 3: Schedules

 

3.                   This clause provides that each Act specified in a Schedule is amended or repealed as set out in the applicable items in the Schedule. Any other item in a Schedule has effect according to its terms.

 

Schedule 1 - Amendments

 

4.                   Schedule 1 amends the Aged Care Act 1997.

 

Item 1 - After section 9-3B

 

5.                   This item inserts new section 9-3C which creates an obligation for approved providers to provide information to the Secretary relating to care recipients who received care from the approved provider. This information is required to be in writing, at the end of each quarter.

 

6.                   Paragraph 9-3C(1)(a) requires approved providers to provide information on the number of falls.

 

7.                   Paragraph 9-3C(1)(b) requires approved providers to provide information on the number of medication errors and to include, for each error, the type and dosage that was prescribed, and the type and dosage that was administered.

 

8.                   Subsections 9-3C(3)-(5) allow for the Secretary to request further information to be specified and set out the applicable penalties if the provider fails to comply with the Secretary’s request(s).

9.                   The penalty for not complying with this section is 30 penalty units.

 

10.               The effect of this amendment is that reporting on these clinical indicators can assist in monitoring the ongoing well-being of care recipients. This information can then be used to highlight facilities which need improvements, and used to drive improvements.

 

Item 2 - After section 67-5

 

11.               This item introduces new section 67-6, which requires the publication of notices under Division 67 of the Aged Care Act on the approved provider’s website. The section applies to approved providers if they receive a notice under section 67-2, 67-3, 67-4 or 67-5 of the Aged Care Act.

 

12.               Subsection 67-6(2) sets out how and when the approved provider must publish the notice. It must be published on the approved provider’s website within 24 hours of receiving the notice and it must be published in a way which is readily accessible by the public.

 

13.               Where the provider operates more than one facility or more than one website, the publication must be published on the website of the facility to which the notification relates.

 

14.               The penalty for not complying with subsection 67-6(2) is a daily penalty of 10 penalty units. The maximum penalty that can be imposed for this section is 100 penalty units, as provided by subsection 67-6(3).

 

15.               Subsection 67-5(4) requires that an approved provider must, as soon as reasonably practicable, publish on their website any submissions they have made in response to a notice received under section 67-2.

 

16.               The effect of this amendment is that consumers will be better informed when making choices and decisions relating to care providers. The requirement for care providers to publish information relating to notices and sanctions on their website provides consumers with greater transparency and availability of information in a way which is easily accessible to them.

 

Item 3 - After section 96-3

 

17.               This item introduces new section 96-3A which requires the Secretary to publish information received under new section 9-3C, namely the number of falls and medication errors.

 

18.               Under this provision, the Secretary must publish or make available the information within 30 days of receipt. The provision also sets out that protected information may be published or made available by the Secretary, except if it is personal information relating to care recipients.

 

19.               The effect of this amendment is to ensure that the information is published in order to meet the objectives of better transparency of information and protection for consumers, and help drive systemic improvements where necessary.

 

Item 4 - Application provisions

 

20.               This item stipulates that the obligations outlined in section 9-3C apply in relation to the quarter that begins after the commencement of this item.

 

21.               This item also provides that the obligations outlined in section 67-6 apply in relation to notices received by an approved provider after the commencement of this item.

Statement of Compatibility with Human Rights

Prepared in accordance with Part 3 of the Human Rights (Parliamentary Scrutiny) Act 2011

 

Aged Care Amendment (Resident Welfare and Provider Disclosure) Bill 2019

 

This Bill is compatible with the human rights and freedoms recognised or declared in the international instruments listed in section 3 of the Human Rights (Parliamentary Scrutiny) Act 2011 .

Overview of the Bill

This Bill requires Commonwealth-subsidised residential aged care providers (approved providers) to report the number of falls and the number of medication errors, along with information relating to the type and dosage of medication prescribed and administered. The Bill requires this information to be provided in writing to the Secretary, reporting on a quarterly basis.

The Bill also requires that approved providers list any notices and sanctions against them on their website, in a way which is easily and readily available to the public.

The aim of this Bill is to assist consumer choice and increase the protection for consumers through better transparency of information which may then be used to drive provider and systemic improvements.

Human rights implications

The Bill engages the following human rights as contained in article 12 of the International Covenant on Economic, Social and Cultural Rights and article 12 of the International Covenant on Civil and Political Rights:

•           The right of everyone to the enjoyment of the highest attainable standard of physical and mental health; and

•           The right to liberty of movement and freedom to choose his residence.

This Bill facilitates the provision of the highest attainable standard of physical and mental health by ensuring that care providers report on falls and medication errors, allowing this information to drive improvements and ensure the highest standards of care can be provided.

As facilitated by this Bill, the reporting of sanctions and notices on the provider’s website means that Australians have access to the necessary information to be able to make a fully informed decision in regard to the aged care provider they choose.

Conclusion

The Bill is compatible with the human rights and freedoms recognised or declared in the international instruments listed in section 3 of the Human Rights (Parliamentary Scrutiny) Act 2011 as it promotes the human right to the enjoyment of the highest attainable standard of physical and mental health and, the right to liberty of movement and freedom to choose his residence.

 

Senator Stirling Griff