Aged Care Nurses Push for Equality.

[Snappo]

Justine Elliot attended the launch, at Parliament House on the 17/3/09, of the 'Because We Care' campaign by the ANF, which highlights the work of aged care nurses, and the increasing pressure they are under to get more done, in less time, and with fewer resources. She says that it is a 'major concern' that aged care nurses are being paid up to $300 less a week than their counterparts in other sectors. She further says that it was down to the aged care providers and nurses to negotiate a fair deal (Oh, my !!!!) She says "I acknowledge it is a major concern, that's why I'm encouraging employers to work with their employees to pay them better wages and make sure they've got better conditions, given the fact WE DO GIVE THEM RECORD AMOUNTS OF FUNDING".

The federation says that while the Federal Government funds nursing homes, it does not require their owners to show how much is spent on direct care, including nurses' wages.

ANF national secretary, Ged Kearney, stated "We want some accountability for this Federal Government funding that goes into the sector. There's very little feedback or transparency about where the funding goes or how it's spent. It could be spent on infrastructure, it could be spent on capital costs, it could be on profit, it could be on a number of things, we don't know. All we know is that it's not going on nursing care, and it's not going to wages. We would like to see something that ensures that it does".

So could somebody please explain to me why the Government gives away hundreds of thousands of dollars to a bunch of charlatans without demanding accountability!!

[wanda]

Last figures I saw, facilities were spending, on average, nearly 70 per cent of income on wages. Usually, they have only one source of income - the elderly (governments don't "give" money to aged care, they do subsidise the fees the residents pay). The fees the facilities can charge are tightly regulated - and rightly so, some of the fees already are exorbitant. And, for the majority of aged care providers, the law does not allow them to seek external sources of funding.

It's fine for nurses and carers to seek more pay - we all know this is one of the fundamental problems in aged care. But how do nurses and carers propose to lower costs so that more wages can be forthcoming?

[Snappo]

Which, and whose, figures were these, Wanda? If facilities are under staffed, and staff are paid minimal wages, and owners aren't required to show how much they actually allocate to direct care or wages, and resident fees are tightly regulated (including the 'exorbitant' fees !), then surely it isn't asking too much for more transparency concerning the actual allocation of monies received from both resident and government contribution.

Elsewhere on this Forum it was discussed where some $8.5 MILLION dollars just 'went missing'. Read through 'Aged care as a profitable enterprise'. $8.5 million dollars is an awful lot of money, it would buy an awful lot of direct care, but since it 'went missing', it didn't. Must have taken some time for $8.5 million to grow legs and walk. Why wasn't it being monitored?

It's not the nurses' or carers' role to manage fees or funding. Perhaps if management were to forego on their huge salaries and 'bonuses', and remember just what we are there for, then the residents may get the care they deserve from appropriate staffing levels and appropriately paid staff.

[danielle]

You're right Snappo - staff have enough on their plates without thinking about how monies are allocated. The "we need more money" whining from the providers should be backed up with "this is how we spend tax-payers funds". Let's not forget the EACH (Extended aged care at home; etc.) packages, which only approved providers presently are allocated - worth approx. nearly $50,000 per pop. By the time the "administration fees" are accounted for, there is not much leftover for the recipients at all.... checkout this article: Aged care warrior takes on system

Here's a snippet from the article (Pay particular notice to Gerard Mansour's (aged care provider representative) response):

HEATHER EWART: George Vassiliou obtained what's known as an EACH Deed package for his mother when she was in the early stages of dementia. This package amounts to $48,000 a year. The Commonwealth funds are handed over to what's termed a care provider, usually a church body, which then outsources to a private agency.

George Vassiliou thought he'd get ample hours of care for his mother in her own home. He was wrong. Only 15 hours a week was offered.

GEORGE VASSILIOU: What I discovered was, and I was quite shocked when you did the maths, I calculated that there was only about $15,000 of the package that actually went to face-to-face support. There was $33,000 that just went somewhere, and I slowly discovered that 18 of that went to what they called case management and administration.

HEATHER EWART: Why do you have to have a case manager?

GERARD MANSOUR, AGED & COMMUNITY CARE VICTORIA: Absolutely critical element. When you get older, and you get a little more frail and families often aren't, don't have a lot of time, you don't understand the aged care system. A family doesn't know what they don't know, and so a case manager plays a role in connecting the family with the range of services availability to them and explaining the types of support and assistance that's available.

HEATHER EWART: That wasn't good enough for George Vassiliou. He decided he'd rather case manage his mother's care himself and use the savings on extra hours of care for her.

GEORGE VASSILIOU: There are incredible costs to the system which can be curtailed if people are given the option to choose to manage these things and employ their own people. Obviously under a model where there is strict supervision.

HEATHER EWART: After strong resistance from the first care provider he was assigned, he finally found one that would accept his proposal, and this boosted his mother's care to 35 hours a week.

Hmmm..... "a family doesn't know what they don't know, and so a case manager plays a role in connecting the family with the range of services availability to them and explaining the types of support and assistance that's available."...

What a nice little "bonus" for providers - which then guarantees additional revenue/income of taxpayers funds. I don't see any of the provider groups or nursing homes issuing any fact sheets on this - or online self-help articles to help people help themselves? Probably too busy helping themselves!

In the words of Cath and Kim: "Noice"

[Snappo]

'Noice' indeed!!! Bit of math here - 15 hours per week = 780 hours per year. At $48,000 per year per person, this equates to $61.54 per hour. Carers receive approximately $20 per hour, equals $15,600 per year. This leaves a surplus of $32,400 per person per year. If a service has only 10 EACH packages, this is a staggering $324,000 surplus to be allocated in any way they see fit. A lot of community care operates directly from the premises of the organization they are run by, so rent is either non existant, or minimal. Where I work, there are only 2 people administering this service, so take into account their wages and basic administrative running costs, and there you have it, a comparitively lucrative business. I would estimate a profit of somewhere in the region of $100,000 to $200,000 per year for 10 packages. Where does it go?

[wanda]

Your aged care facility will produce an annual report and balance sheet. Church and community facilities report publicly and I'd be surprised if most others don't. Our local non-profit facility is investing over 70 per cent of its income in wages. The average was about 68 per cent a year or two ago (can't recall who published these figures). The balance sheet generally shows only total wages, but they do generally show the breakdown of staff by RN, EN, carer, admin. etc. (The one thing they uniformly don't show is how much the CEO earns!)
The balance sheet should give you a breakdown of all income, including government subsidies, and all expenditure, including resident food, laundry, medication, entertainment and so on.
It's true there's enormous wasteage in aged care. If you could zap all the opportunists who are milking it for all it's worth, you'd probably knock $2 billion of the annual budget in one hit. But just by finding the “missing” $8.5 million or cleaning up the home care packages doesn't mean all that money would naturally flow into the facilities. Governments won't pour an endless stream of dollars into the homes, providers have to find a way of being more or less viable.
I really do invite you to seek out your facility's annual report. I can look back on the past 12 years of reports from my local facility – and it's plain as the nose on your face where the money's been going – and where it stopped going as a result.
Carers are far from alone. We have in our community school cleaners who earn $15 an hour. If their vacuum breaks down, they take it home and fix it. When their cleaning rags get dirty, they take them home and wash them (yuk!). They can lug 20 garbags a day 200m to the skip in all weather, and never a trolley to ease the load. We have women who get $13 an hour to work in hospitality. They are paid “in cash”, that is, “under the table” - outside the tax system and minus superannuation or any other benefit – and barred by the employer from working in any other hospitality job.
Employers do this purely because they can. But if women want to be less victimised in their workplaces, they must stop acting the victim – sitting round complaining, beating up on each other. It's self-defeating to say “staff have enough on their plates”. Some of us would like to see women gain more power in these types of workplaces. But there's only one route to that kind of power. Knowledge.

[Snappo]

The church run facility I work for encompasses many services in many areas. I just looked up their Annual Report on-line. Their 'breakdown' lumps all these services and areas together and covers just 3 points, employee expenses, depreciation expenses and other expenses. Not terribly transparent!! None of the individual services has an individual breakdown, they all come under the one umbrella. I assume there would be a breakdown somewhere at the facility, but I am a bit loathe to ask for obvious reasons. Any suggestions?
There is no balance sheet, and there is no breakdown of wages. It does show where the funding comes from though (exclusive of resident fees, etc), and this exceeds total wages. It also states that the company is running at a loss.
Regarding your last paragraph, as you rightly stated in another area, staff are looked after by unions, etc. Where is the union for these underpaid, illegally employed, over worked staff?? There are OH&S issues coming out of your ears!! The services are there to be used, they should use them. It actually angers me that people will work inder these conditions and do nothing about it, why do they do it? The Workplace Ombudsman would have a field day.

[wanda]

The unions can help with OH&S and other industrial issues, but they can't do it all, and the unions themselves recognise this. As you know, there are 1001 ways in which employers can make life difficult for those who complain, especially casuals. On the one occasion I got involved with the union (and it was in an aged care facility) we got the best union rep. ever. What she lacked in height she made up for in aggression and she sorted them out big-time. But she also left us with this thought:

“Youse gotta get tougher!
Youse gotta learn your rights!
And youse gotta learn to be as cunning as they are!”

And she was 100 per cent right. You won't get better advice than that.

I assume there would be a breakdown somewhere at the facility, but I am a bit loathe to ask for obvious reasons. Any suggestions?

Not really. One of the problems with the “church” providers is that a lot of them are no longer run directly by churches – but the providers hang onto the “brand” because they know people naturally trust churches more than they trust companies (just like the American Kraft Foods bought out Vegemite years ago, but they'd never dream of changing such a familiar and trusted “brand” name). Somewhere your provider has “stakeholders” they have to report to, but who knows where.

Twenty years ago, probably all aged care facilities presented reports like ours. More and more, they are beginning to look like yours. And we are losing all power, all ability as a community to play a democratic part in the decision-making, because of it. If the unions are onto this, then that's great. But we have to do our bit, too.