Q&As - part 1
1) Why is NSW Health moving away from the business of residential aged care?
NSW Health currently provides care for only 1.4% of the NSW residential aged care population. The majority of these services are provided by the charitable, not-for-profit sector (51%), the private sector/for profit sector (25%), community based organizations (19%) and local government (3%). It is clearly in the non-government sector that the necessary expertise and experience is concentrated.
2) What has led to the decision to transfer these facilities?
The NSW Health Department began the transfer of State Owned Nursing Homes to the non-Government sector under the Residential Aged Care Reform Program in 1996, and the current initiative aims to complete this process with the transfer of the remaining 11 facilities in 2009.
3) Why doesn't NSW Health spend the funds in nursing homes?
NSW Health's core business is providing quality health care. The priority is investment in health services. The Australian Government, through the Department of Health and Ageing, has funding, policy and regulatory responsibility for residential aged care services in Australia.
4) At a time when the general population is ageing, why is NSW Health moving away from caring for aged care residents?
The funding and regulation of residential aged care services is an Australian Government responsibility and these services are largely provided by the non-Government sector. The role of the NSW State Government is in the provision of health services. NSW Health has consulted with the Australian Government Department of Health and Aged Care (DoHA) about this transfer strategy.
This Strategy offers an opportunity to enhance the care available to aged care residents. We are working with the Australian Government on this proposal and see it as an opportunity to create new models of care in partnership with non-government providers.
5) What alternative care will be available for these people?
Ensuring that the needs of existing residents are met will be central to this process. The aim will be to minimise any disruptions to residential aged care services throughout and following the transfer of State Owned Nursing Homes to the non-government sector. In addition, for those residents with more complex care needs, existing services will continue to be provided under service agreements with the new providers.
6) What if non-government aged care operators don't want to take responsibility for caring for those residents who have special or complex care needs?
NSW Health will make it a condition of transfer of ownership that the aged care places providing specialised care to people with advanced dementia or other complex care needs continue to be provided under partnership arrangements.
7) What will happen to funds raised through the sale of these facilities?
It is NSW Health's priority to provide quality care for residents by the new operator in the transfer process. Funding is a secondary consideration. However, funds arising from the transfer of these nursing homes will be returned to the health system to enhance frontline health care.
8) Will NSW Health guarantee future employment for the staff currently employed in these facilities?
The State Government Nursing Home Framework Agreement signed in 1997 will continue for this project. This means that the entitlements of staff transferring to the non government or private sector will be protected.
The 1997 Framework Agreement continues to apply specifically and exclusively for the purpose of the State Owned Nursing Home Project.
Staff will be offered a range of options including a transfer to employment with the potential new operators of the aged care facilities or redeployment within NSW Health where this is viable and appropriate.
New non government sector providers will be able to assess and determine the staffing structure/profile required to operate and provide the same services to the existing and future residents.
There will be a consultative process in the transfer of ownership of the State Owned Nursing Homes.
9) Will staff be offered alternative employment - either with the new operator or elsewhere within the health system?
Redeployment within the NSW health system will be available where this is viable and appropriate.
10) Are there other nursing homes other than those 11 facilities included in the Project?
There are three nursing homes providing aged care places owned by NSW Health which are already operated by non government organizations. These are Carrington (operated by the Carrington Centennial Trust), Lottie Stewart (operated by the Wesley Mission) and Graythwaite (operated by Hammond Health Care). There are very specific existing arrangements for each of these nursing homes, the transfer process will be decided separately in the coming months. Further information will be available later.
There are two retained small aged care facilities (Peg Cross and Portland) as they are operating akin to a Multi-Purpose Service.
Q&As - part 2 (21 July 2009)
1) How were the shortlisted organisations selected?
The shortlisted organisations were selected based on a stringent evaluation process by an Evaluation Committee. The evaluation criteria include:
• Depth of experience in residential aged care service delivery and service strategy
• Experience in developing and implementing service strategies for aged care residents with special care requirements
• Respondent structure and appropriate capacity to manage the transfer of similar size aged care facilities to provide certainty of delivery of the transfer requirements
• Financial capacity
• The extent of exclusions or qualifications that the Respondent would require in the transfer.
2) What level of interest was expressed in the State Nursing Homes?
Expressions of Interest were received in respect of all eleven of the State nursing homes. Some organisations expressed interest in one nursing home, while others expressed their interest in multiple facilities.
3) Why was there a separate Expressions of Interest invitation for the aged care services at the Lottie Stewart Hospital site?
Following advice from the Wesley Mission regarding their intention to change the focus of services at their Dundas site by June 2012, the aged care places and services provided by the Lottie Stewart Hospital, Dundas on behalf of NSW Health have been added to the Project list. NSW Health is currently working towards the placement of residents and vacating the Lottie Stewart Hospital site, as requested by the Wesley Mission, by 2012.
It is noted that the Huntington's Unit at Lottie Stewart (with 17 residents) will continue to be operated in a new location in western Sydney. A new model of care, including outreach components, is being explored with relevant stakeholders.
4) What will happen during the Request for Detailed Proposals?
Proponents shortlisted from the EOI process will be invited to attend a briefing regarding the 11 State nursing homes, as well as undertaking site inspections. The Project Team will ensure this process will cause minimum disruption to the residents and staff at the nursing homes.
The Request for Detailed Proposals will be conducted in accordance with State Government tendering policy and probity requirements. A probity auditor has been engaged to ensure the process is fair and equitable.
A project structure and an evaluation framework have been finalised. An evaluation committee has already been established, as well as specialist technical advisory teams to support the tender evaluation process and provide advice on specific elements of the transfer process.
5) How does the Request for Proposals work where there are a small number of shortlisted proponents for some State nursing homes?
The shortlist is based on the level of interest in each State nursing home and a stringent EOI evaluation process. Regardless of the number of pre-qualified aged care providers (i.e. the number of proponents), each proponent must demonstrate compliance with all evaluation criteria and a value for money test.
In the case of Corowa, where there is one proponent, the evaluation of the RDP proposal is the same as for other State nursing homes. In evaluating individual proposals for smaller state nursing homes in the regional areas, NSW Health will take account of other proposals submitted for these nursing homes as a comparator, as well as service performance against industry benchmarks and value for money assessment.
6) Will all the nursing homes be transferred to a single aged care provider?
This is not a transfer requirement. The nursing homes may be transferred to a single aged care provider/operator or the facilities may be transferred to a number of providers.
NSW Health will proceed to negotiations and contract award with a provider for any particular site, only if a Detailed Proposal meets all the requirements set out in the Guiding Principles. This relates to both nursing home service delivery and value for money.
7) With the ageing population and the anticipated increase in the prevalence of residents with dementia and challenging behaviour, why is NSW Health transferring the nursing homes to the non government sector?
Expertise in the provision of aged care services, both community-based and residential, lies in the non-government sector. The decision to transfer the 11 facilities to the non-government sector has been made because residential aged care is now largely provided in that sector, and is funded and regulated by the Australian Government.
A number of conditions have been placed upon the transfer arrangements. Most importantly, the NSW Government will ensure that local communities will continue to have access to the existing residential aged care places and to the levels and quality of care currently provided to residents. This means that the non-government operator selected to assume responsibility for providing these aged care places must be able to demonstrate that the needs of existing residents, including those with dementia, challenging behaviour and complex care needs, will continue to be met.
8) Will the quality of services be affected after the transfer?
As described above, a key undertaking of NSW Health is to ensure the continued quality care of all residents throughout the transfer of State nursing homes to the non government sector, and into the future.
9) What happens to residents with special care and their places?
To ensure the special care requirements of the existing residents are brought to the attention of the new provider, NSW Health has carried out a preliminary survey to identify residents with individual special care requirements.
NSW Health has engaged the Aged & Community Services Association of NSW & Act (ACSA) to undertake the assessment of selected residents. ACSA is a peak body representing residential and community-based aged care services in NSW and ACT, with a strong background in aged care nursing, and expertise in the residential aged care setting.
The information obtained through the assessment process will be incorporated into specifications for the ongoing care of residents with special care requirements throughout and beyond the transfer of the nursing homes to the non government sector.
It is expected that service agreements will be entered into between Area Health Services and the new aged car providers. Service agreements will need to take account of any funding implications of looking after residents with special care requirements. A service review will be conducted annually to ensure the care needs of these residents are met.
It is NSW Health's priority to preserve existing aged care places for residents with special care requirements in the future.
10) Will access to respite care services be affected?
No. The respite care services, as approved and funded by the Australian Government Department of Health and Ageing, will continue to be provided by all the nursing homes.
11) Will the terms of residency change now or after the transfer?
No. Existing residents' tenure is fully protected and is a requirement under the Commonwealth Aged Care Act. Those residents living in nursing homes that transfer to a non-government aged care provider will continue to enjoy care and accommodation under the same financial arrangement as they do now.
12) What will happen to the fees and charges to existing residents?
There will be no change to the financial arrangements for existing residents now or in the future.
13) Will the nursing homes be moved off-site?
This depends on the transfer options nominated for each nursing home. Purpose built nursing homes will be transferred as a "ongoing concern". Some other nursing homes will require capital upgrades and there may be opportunities for investment by the Proponents in new nursing home facilities.
Where the Proponent proposes to relocate the nursing home off-site, the nursing home must stay in the local township for the smaller state nursing homes in the regional areas, or the local council area for the large state nursing homes.
14) Will the nursing home remain a high care facility?
Yes. Where the nursing home is operated as a high care aged care service, the transfer condition requires the new aged care provider to continue existing services.
15) Will a new nursing home or other aged care services (eg self care units) be developed as part of the transfer project?
There are opportunities for some of the nursing home sites as identified in the Expressions of Interest Brief to develop further aged care infrastructure, including 'ageing-in-place' models of accommodation. This is a decision for each Proponent and will be subject to planning approval requirements and financial viability.
16) Why can't the nursing homes be retained at the existing locations?
In some cases, it may be desirable for a new nursing home to be developed which will improve amenities to residents. If a State nursing home were to be relocated, it must stay within the local township in accordance with NSW Health's Guiding Principles.
17) What will happen to nursing home staff after the transfer?
All staff who are transferred to the new aged care provider will be protected in accordance with the 1997 State Government Nursing Home Framework Agreement. This means that all their existing entitlements will continue, including membership of the State superannuation funds.
18) What will the staffing model be after the transfer?
The Proponents will be required to submit their proposed staff structure. Each proposal will be evaluated against the relevant criteria. This is to ensure that the staff structure is at an appropriate level to meet the care needs of the residents.
19) Will staff be required to apply for the positions?
NSW Health expects the successful proponents will offer all the positions under its staff structure to existing staff.
An application and selection process will occur where the number of existing staff wishing to be transferred is greater than the number of positions offered by the new aged care provider.
20) Are there other nursing homes in addition to the 12 facilities included in the Project?
Carrington Centennial Nursing Home is operated by the Carrington Centennial Trust on facilities and land owned by the Trust. Given the specific existing arrangements, NSW Health has commenced a process to seek a proposal from the Carrington Centennial Trust. Evaluation of the proposal will be in accordance with government policies, including value for money assessment.
Two other facilities which are very small have not been included.