Wednesday 11 February Senate Estimates Questions to Community affairs about Burrangiri Respite Care
10:12 - 10:13
Senator David Pocock
Firstly I wanted to ask, people have been reporting to me that they can no longer access Burrangiri aged care respite in the ACT using Support at Home packages. And they're saying that they could access them when they're on Home Care packages. Now they’re on Support at Home, they can't, and I'm just interested in what's going on there.
Cathy Milfull Acting Assistant Secretary Market and Workforce Division
So I'm happy to start. And then my colleagues might jump in as well. Senator, my understanding is that essentially, Burrangiri is largely operated from a Commonwealth aged care perspective on a private basis. So they have had these services available both before and after the 1st of November. They were private fees. What we understand is that before 1st November some people were using their home care package fees to supplement those private fees. So that's the difference if you like between before the 1st of November and after. But Greg, you might want to add to the post 1st November situation.
10:13 - 10:14
Greg Pugh, First Assistant Secretary of the Access and Home Support Division.
Do you want me to keep going or do you have another question?
Senator David Pocock
I'm interested. Everyone was told that there'd be no worse off, so why could they access respite care when they had a Home Care package, and now they've got a Support at Home package despite in these hearings and that inquiry we did into the transition, we were told that people wouldn't even notice. It was just a new system and things would actually be better. So what's going on here? You'd know how hard respite is to access in the ACT.
10:14 - 10:15
Greg Pugh, First Assistant Secretary of the Access and Home Support Division.
So probably two parts to your question. First is around the policy. So you are right. Support at Home service list does give access to the following respite types. It gives you access to flexible respite that gives you support and assistance in an older person's home during the day or overnight, and also the community and centre based respite. So that's providing support through small day outings or structured group activities. The service type cottage respite is not available under the Support at Home program. However it is accessible under the Commonwealth Home Support Program. So if you are in the Support at Home program, you can still access cottage respite simultaneously to getting it with CHSP and you can do that by getting a referral for the CSHP cottage respite. So you can either do that by getting a support plan review undertaken, or you can get an urgent referral for CHSP cottage respite and you do that by contacting the My Aged Care Contact Centre. So it is a change, but the access to the cottage respite service is still there. And then I think there's a secondary issue with which Miss Milfull was just going through around then access in the broad once you're approved for it.
10:15 - 10:16
Senator David Pocock
So how are these Canberrans no worse off?
Susan Traynor, Assistant Secretary Residential Care Division
Senator I might take that. As I think we talked about at the last hearings, the no worse off principle is specific to the amount of contribution in dollars that a person makes to their care. So at the announcement of the reforms on the 12th September 2024, Minister Wells noted a no worse off principle will provide certainty to people already in aged care and they won't make a greater contribution to their care. So it's a very specific principle and is not about all matters to do with aged care around service provision and what may or may not be on service lists.
10:16 - 10:17
Senator David Pocock
I mean talking to Canberrans, that's not what they were hearing. They were hearing they’d be no worse off. And I think when you talk to older people, that's about the services that they receive. So it sounds like there's a lot of hoops to jump through now if you do actually want to go to Burrangiri on your Support at Home packages. So they have to get assessed through CSHP currently?
Greg Pugh, First Assistant Secretary of the Access and Home Support Division.
That's right.
Senator David Pocock
But isn't the government shutting down CHSP?
Greg Pugh, First Assistant Secretary of the Access and Home Support Division.
So Senator, the commitment to transition the CHSP program is currently committed to do so no sooner than the 1st of July 2027. As we gave evidence at the inquiry hearing last week, there is absolute merit in retaining a whole raft of either fee for service or block funded programs. Cottage respite, we know that it is a great service for people. And so that is absolutely forming part of our consideration around what the future of that service looks like post 2027.
10:17 - 10:18
Senator David Pocock
So why were these changes made? We're having a conversation about hospital funding and just how many people are unnecessarily in hospital beds in this country. We're also having a conversation about productivity and the need to improve productivity. And it seems like we've come up with a system that's going to make it harder for people to get respite and is less productive because you've got to jump through all these ridiculous hoops. So what's the intent behind this? Is it to reduce the number of people going into respite? Is it to save the Commonwealth money? What's the why? Why was this decision taken?
Greg Pugh, First Assistant Secretary of the Access and Home Support Division.
So a couple of things on that, Senator. It's not about saving money at all. The support at home service list, as I said, still gives you access to flexible respite and community incentive based respite through the broad consultations that were undertaken on the Support at Home service list that went on for multiple years before it was agreed by the government.
Cottage respite did not feature because there was a view that it would be more readily maintained and accessible through the Commonwealth Home Support Program. So that was the way that the distinction was made between the two. Having said that, we're not deaf to the cause of the community. We understand that people would like to be able to access cottage respite either through using their Support at Home funding or be able to access it more in general. And so this forms part of our ongoing review processes into what's on the Support at Home service list.
Senator David Pocock
And one of the things I hear from older Australians, and particularly from carers, is just how complex this whole thing is to navigate. So why have you decided for cottage respite to be assessed through CHSP when you've committed to ending CHSP in July next year? One, why have you made that decision to shift it to a service that you're going to abolish anyway? And two, what happens after that?
10:19 - 10:20
Senator Dorinda Cox
In the opening statement, it's quite clear around asking officials to give their opinion about why things are happening. I know what you're asking. And I think officials are capable of answering that question. I think we just tread the line very carefully in relation to asking them about what their intention is or what their opinion is in relation to why these things are happening. I would ask that possibly those are directed to the minister at the table around the government and those decisions rather than officials. They are here to assist us from a departmental point of view in relation to answering questions that are within their remit. So I would just maybe caution you in thinking about who you're asking the question in what frame
10:20 - 10:21
Senator David Pocock
Thanks Chair. To be clear, I don't want any opinions here. I want to know why you've made the decision to shift the hoops you have to jump through, when the government has been very clear that CHSP will end. Why did you do that? And then what happens after July next year?
Sonja Stewart Deputy Secretary
I just wanted to clarify something, Senator, which was your characterisation about what's happening on the first 27 July, 2027. I think you're using terminology around abolishing and something is ending. I just wanted to before Mr Pugh went into detail to say that the actual commitment and what the government has stated a couple of years ago, was that the CHSP will move into Support at Home no earlier than first July 2027.
So I just wanted to check, how do we answer that question? Because it's not about a program being abolished.
Senator David Pocock
So CHSP will continue or it ends next July?
Sonja Stewart Deputy Secretary
That's a decision for the government.
Senator David Pocock
They have already said it will end.
Sonja Stewart Deputy Secretary
So it says no earlier then. It doesn't say on that date or by that date. It says no earlier than the 1st July 2027 is what the government has committed to.
Senator David Pocock
But their intention is to move it into support at home?
Sonja Stewart Deputy Secretary
So, the government has made a commitment that it will move into the Support at Home, but not in terms of the details of that and not with the time frame.
Senator David Pocock
I think this is Semantics
10:22 - 10:23
Blair Comley PSM
Senator I think what is already occurring prior to any transition is there already consultations happening with people in the sector to look at what the consequences of that transition would be. So I think the commitment no earlier than the 1st of July 2027 was effectively to ensure there's a smooth transition.
Senator David Pocock
Thank you. And I'll come to consultation later on. But maybe, Mr Pugh, if you want to contribute.
Greg Pugh, First Assistant Secretary of the Access and Home Support Division.
Well, Senator, I was basically going to say the same thing that Mr Stewart said and then just referring to my previous statement around we know the importance of cottage respite ongoing. So, it's a broad statement to say that CHSP is being shut down and with that cottage respite is just going to be eliminated. So, I just want to make the point that that is not the case or not forming part of our advice. But I will just ask Miss Atkinson to supplement.
10:23 - 10:24
Julia Atkinson, Assistant Secretary, Access and Home Support Division.
So Senator, I will refer back to some of the evidence I provided at the Senate inquiry on Friday. There's a bit of a misunderstanding in the community around what Support at Home could look like in the future. And if we look back to what the royal commission initially recommended, they recommended that we have one in-home aged care program. And they also recommended that some of the services in that program be funded through block funding. The government of the day did not fully agree to that second recommendation, but undertook to continue consultation and consideration, and the current government continues to consider and consult on that matter of funding model. So that is an open question that the government has not taken a decision on. The government has been clear that CHSP will not roll into support at home until 2027 at the soonest. That is the commitment to date and anything further, any further detailed decision around that remains with the government.
10:24 - 10:25
Senator David Pocock
OK, thank you. I can see what carers are saying about just how complicated this is to try and deal with when you also have a job and other commitments. So to be clear you have to go through CHSP now to get cottage respite. But when CHSP transitions into Support at Home no earlier than July 2027 at some future date decision of the government, you'll have to be assessed through Support at Home.
Greg Pugh, First Assistant Secretary of the Access and Home Support Division.
That remains to be a decision of the government. However, just taking in your points, if there are complexities around the way that it's currently working, we would obviously want to move to a system that was as easy for people to access as they possibly can. So, there's no decision. But that's the broad principle that's guiding our thinking and advice.
Senator David Pocock
So, the Canberrans who are telling me that they can't access Burrangiri with their Support at Home package, but they could with their Home Care package. What do I tell them?
10:25 - 10:26
Greg Pugh, First Assistant Secretary of the Access and Home Support Division.
I think it's a matter of My Aged Care. Get an urgent referral and get access to cottage respite that way.
Senator David Pocock
Thank you. I'll pass that on. And then just to go to consultation and the $10 million for respite earmarked for ACT, which I really thank the government for. It's a really important investment. When we're talking about Burrangiri, this is half of the ACT’s respite bed. So it's incredibly consequential for Canberrans. In a Question on Notice, I think you said that you've met with local providers to determine viable options and I was interested in which providers you've met with.
10:26 - 10:27
Cathy Milfull Acting Assistant Secretary Market and Workforce Division
Look, I can certainly provide you with a full list on notice. I've attended some of those meetings, so I certainly could from memory with Goodwin and Warrigal, my state and territory colleagues have met with you. I think there's up to 16 providers and I think they've met with I'd say approximately 10. I'm happy to give you that information on notice if you'd like specifics.
Senator David Pocock
Thank you. That'd be great. And then one of the other things which I was pretty disappointed reading in the Question on Notice and kind of goes to the Secretary's point around consultation is that you said you recognise the strong community interest in respite, and yet you haven't consulted with any community groups or people outside of the providers. And I was just interested in whether you think that sort of consultation is important.
10:27 - 10:28
Cathy Milfull Acting Assistant Secretary Market and Workforce Division
Senator, I think we have been consulting, you know, on some quite technical details with ACT Health and Community Services Directorate and those providers. We really wanted to see, what's the best, you know, most viable option to get those beds online before the date that Burrangiri is targeted to close. So Senator, I think he's been very much focused on that infrastructure solution and making sure those beds are available. So as you say, we don't end up in a situation that's worse. I think both the department, the government and certainly ACT government, are really cognisant of the need to continue to work together. This is not the end of the story. I think solving one plank of that respite problem. I meet personally regularly with the directorate. We're very keen to continue working together and communicating together with the community. So I know there are some, for example, meetings coming up where there'll be joint representation. And the idea is we can listen to the concerns of the community and start to think about not just the $10 million but what are the other issues and what do, what is the community looking for beyond that point. So hopefully that's helpful.
10:28 - 10:29
Senator David Pocock
Miss Milfull surely it should be the other way around. Surely you want to consult with the community to ensure that you're then designing the solutions that will actually work for the community? Because that's what respite is about is providing respite to the community. So I'm interested in why full steam ahead on this is the solution - and then potentially down the track there'll be some sort of tick a box with the community. Surely community should have a say in giving you feedback on how Burrangiri has been working, how the other cottage respite options have been working, and then you as a department can say, OK, well these are obviously the solutions we should be heading towards.
10:29 - 10:30
Cathy Milfull Acting Assistant Secretary Market and Workforce Division
Look, I think, Senator, perhaps for me it's just the difference between working out what those viable options are and making sure that we have both governments agree to, what are those possible options. And then I think the next step is to really have those discussions. So say we went down a particular road, for example we've sorted out what the location might look like, what would actually the services look like? Because I think a lot of the questions from the community go not necessarily to the location, but to how those services would be delivered and what that may look like and who would be delivering them.
Senator David Pocock
- Thank you. I mean, there's a lot of anxiety around the looming June 2027 shutdown of Burrangiri. Could just provide some information about what options you're exploring and whether or not there's a sort of firm commitment for there to be no loss of beds in mid next year, with Burrangiri shutting down.
10:30 - 10:31
Cathy Milfull Acting Assistant Secretary Market and Workforce Division
Senator, it's probably a question for the government, but I think we are very close at getting to a position that both governments are comfortable with. So I would expect there would be some more information that we could release reasonably soon that hopefully will give the community an idea of the proposed way forward. And then those further discussions can also happen.
Senator David Pocock
Thank you. I'm keen to follow up on this.
12:06 - 12:07
Senator David Pocock
I just wanted to circle back to Burrangiri before moving on to some other questions.
12:07 - 12:08
A Canberran who was obviously tuning in to estimates, sent me an email just over the break and they say that Burrangiri does not receive CHSP funding. So CHSP assessment won't provide access. And so if a person wishes to access Burrangiri, they will need to have either NDIS funding, a grandfathered Home Care package or pay for it privately. I'm just wondering if that's the case.
12:08 - 12:09
Julia Atkinson, Assistant Secretary, Access and Home Support Division.
Senator, it's correct that Burrangiri is not a funded provider.
Senator David Pocock
So Mr Pugh, why were you telling me that someone with a Support at Home package could get a CHSP assessment and then access Burrangiri?
Greg Pugh, First Assistant Secretary of the Access and Home Support Division.
Thanks, Senator. So I believe the framing of the question was around access to cottage respite, but I do accept I should have clarified around Burrangiri and that was an oversight. So my apologies.
Senator David Pocock
So you've known all along that this is the case.
Julia Atkinson, Assistant Secretary, Access and Home Support Division.
Senator, to clarify further on Mr Pugh's previous response for your constituents, if you're having those conversations in the context of Burrangiri; if they are seeking to access cottage respite, as Mr Pugh recommended, the best course of action would be to contact My Aged Care. My Aged Care can provide them with a referral to cottage respite, which is at this point in time funded through CHSP. So as I just stated, Burrangiri is not a CHSP provider. However, there is a provider in ACT and that is Carers Act.
12:09 - 12:10
Senator David Pocock
But Burrangiri is half of our respite beds. So if you are now on a Support at Home package, you don't have access to half of our respite beds in the ACT. How are people no worse off under this?
Julia Atkinson, Assistant Secretary, Access and Home Support Division.
I can clarify further. So for those who are on Support at Home, there are some circumstances in which a Support at Home participant can also access a CHSP service. And this is one.
Senator David Pocock
Yes but they're not a CHSP provider.
Julia Atkinson, Assistant Secretary, Access and Home Support Division.
Not through Burrangiri. But if they are a Support at Home client, and they need a CHSP service through cottage respite, they are permitted to access both programs and I accept that's not through Burrangiri at this time. It would be through Carers ACT.
Senator David Pocock
How do we change this? This just seems like a ridiculous system where you exclude people from half of the respite beds in the ACT?
12:10 - 12:11
Greg Pugh, First Assistant Secretary of the Access and Home Support Division.
So probably back to my previous response before the break. This does form part of our annual review process. So that's the mechanism by which we can change it.
Senator David Pocock
When's the annual review due to be done?
Greg Pugh, First Assistant Secretary of the Access and Home Support Division.
Well, we're three or four months into the program, but we provide advice to the government on a regular basis around some of the implementation and other issues that we're seeing. So it'll ultimately be a decision for the government.
Senator David Pocock
Have you provided that advice to the government?
Greg Pugh, First Assistant Secretary of the Access and Home Support Division.
We provide a range of advice to the government, I can't go into the specifics.
Senator David Pocock
Why not?
Greg Pugh, First Assistant Secretary of the Access and Home Support Division.
Because their deliberative matters for the government Senator.
Senator David Pocock
Odgers on page I think what is it? Six or eight expresses concern that advice to the government is not generally accepted as a grounds for a PII claim. And there was actually a Federal Court case that looked at this.
12:11 - 12:12
Minister Malarndirri McCarthy
So sorry, can I just jump in, Senator, have you had the opportunity to to meet with the minister to work through these issues? Clearly you've had direct requests from your constituents. So I'm just trying to find a way through with you.
Senator David Pocock
No and I believe constituents have been trying to reach out and raise this issue.
Minister Malarndirri McCarthy
I'll certainly find out more for you.
Senator David Pocock
Thank you.
Blair Comley PSM
To your question, Senator. You're right. The general line we would take is that we don't comment on the content of the advice, but we'd comment on whether we've provided advice. So we'll take on notice when and when we provided that advice. If we provided it on the Burrangiri issue.
Senator David Pocock
Thanks, Secretary. I know that's kind of has become the status quo, but that's not actually in line with the Senate standing orders.
Blair Comley PSM
I think if we're providing deliberative advice to the government, we wouldn't normally say which way and what we've recommended.
12:12 - 12:13
Senator David Pocock
I know you wouldn't usually do that, but I'm just pointing out that the Federal Court actually rejected that. And we saw in the Robodebt royal commission, Commissioner Holmes really taking exception to this sort of catch all advice to government thing that we hear. I think far too often and I just want to put on the record, I think we need to reassess and do better here because my understanding is that if you want to do that, you actually have to make a PII claim. And we go through that process and I know that will kind of slow up this whole estimates process. But it's frustrating to continually just hear this. Yesterday I was asking questions and was told, “well that may form part of our advice to the government, so we can't go into that”
Senator Dorinda Cox
Yes. And I think just on that note, Senator Pocock, you did try and prosecute this last night in legal and constitutional affairs and I think officials were quite clear in saying that if it is advice or forms, advice to the government and there is grounds for a PII claim that they will submit that. What I heard from Mr Comley just then is, is that in fact it will or may form part of that advice. What I hope is that if you have a question on notice that goes to the heart of some of these, that you would put that in and that if it is grounds for a PII claim, that then can be applied for and the committee as a whole will consider that. So that's my understanding of the process. So, happy if the officials wanted to take that on notice and if or, but what I heard is that if it is forming part of that advice to the government that there are grounds for them to look at it under the PII claim.
12:14 - 12:15
Senator David Pocock
Alright. Thanks, Chair. So just to finish up on Burrangiri and, so Minister, my office has actually asked the Minister about this and we haven't received a response. He never replied to that.
Minister Malarndirri McCarthy
I'll follow up on that Senator Pocock
Senator David Pocock
When it comes to Canberrans access to respite, the Commonwealth and as I said, I welcome this investment, is investing 10 million to replace Burrangiri in 2027.
Minister Malarndirri McCarthy
Absolutely that 10 million is critical.
Senator David Pocock
But in the meantime people can't actually access it under this new Support at Home scheme. I find this quite shocking. And in a jurisdiction where we have one facility providing 50% of respite beds, if you're on a Support at Home package, you can't access that. So can we get some sort of commitment from the government? Can you look at this?
12:15 - 12:16
Minister Malarndirri McCarthy
I was just listening to you and hearing the exchanges between yourself and officials. I'll certainly follow that up. But I'm also conscious just listening and looking at my notes on it with Burrangiri, they are due to close - and that was a decision by the ACT government. Is that correct? Yes? OK. I'll follow it up.
Senator David Pocock
Thank you.