2023-24 Federal Budget Delivered

On Tuesday 9 May the Federal Government released the 2023-24 Budget which contained a range of spending measures targeting health, NDIS, welfare, and the energy sector. 

There were measures to boost wages and skills, and it predicted a big fall in inflation to less than 3 percent by July 1 next year. 

However, the growth forecast is predicted to fall to just 1.25 percent next year as global economies battle high inflation. Treasurer Jim Chalmers warned of the massive structural challenges facing the nation due to increased health, aged care, NDIS, defence and interest payments. 

OTA attended post budget briefings in the health, aged care and mental health portfolios during budget week and undertook an analysis of the Budget papers to identify key spending and items that are relevant for occupational therapists.  

Aged Care 

Home Care reform 

The commencement of the Support at Home Program will be postponed to 1 July 2025 to allow for further refinement of the final design. Grant arrangements for the Commonwealth Home Support Program will be extended for a further 12 months to 30 June 2025. 

Additional funding of $338.7 million over 4 years from 2023–24 has been pledged to improve the in-home aged care system. This includes funding for:  

• $166.8 million in 2023–24 to release an additional 9,500 home care packages. 

• $15.7 million over two years from 2023–24 to establish a single aged care assessment system, including the establishment of a First Nations assessment workforce.   

• $487 million has been pledged over four years from 2023–24 (and $133.6 million ongoing) to extend and make ongoing the Disability Support for Older Australians Program, for those who were not eligible for the NDIS at the time of rollout.  

Residential Aged Care 

Government is investing in the aged care workforce through a 15% wage rise for aged care nurses, which OTA hopes will see better care outcomes for older Australians. 

The Government has pledged funding to directly support initiatives that ensure sustainability and quality in residential aged care services. This includes:  

• $112.0 million over 4 years from 2023–24 to introduce a new General Practice in Aged Care incentive payment to improve general practitioner attendance and continuity of care in residential aged care homes, and to reduce avoidable hospitalisations.  

• $41.3 million over 4 years from 2023-24 (including $11.9 million in capital funding from 2022–23) to build a new place assignment system, allowing older Australians to select their residential aged care provider. 

• $1.3 million in 2023-24 to require residential aged care services to provide residents with Monthly Care Statements on care provided and occurrences of significant change.  

• $7.3 million over 3 years from 2023–24 for a package of initiatives to further reduce the number of people under the age of 65 living in residential aged care.  

Regulation and governance  

$309.9 million over 5 years from 2022–23 has been committed to implement initiatives to address regulatory and governance recommendations from the Aged Care Royal Commission and strengthen existing regulatory models. This includes: 

• $72.3 million in 2023–24 to support the development and implementation of a new, stronger Aged Care Regulatory Framework to support the new Age Care Act which is due to commence from 1 July 2024. 

• $139.9 million to enable continuous improvement and enhance Star Ratings for older Australians and work to expand the Quality Indicator program to in-home care services.   

• $11.9 million in 2023-24 to expand staffing quality indicators in residential aged care and undertake work to expand the Quality Indicator program for in-home care services.  

First Nations Elders 

Government will provide $363.1 million over 4 years to support its commitment to close the gap in Aboriginal and Torres Strait Islander peoples’ health and wellbeing outcomes and improve outcomes in aged care, and support access to culturally safe care for First Nations elders, including: 

• $52.1 million over two years from 2023–24 to increase the funding available to aged care providers in very remote areas under the National Aboriginal and Torres Strait Islander Flexible Aged Care Program by calculating funding levels for residential care services using the Australian National Aged Care Classification price. 

• $4.1 million over 4 years from 2023–24 to develop mandatory cultural awareness training for aged care staff. 

• $1.7 million in 2023–24 to appoint an interim First Nations Aged Care Commissioner.  

• $15.7 million over two years from 2023–24 to establish a single aged care assessment system, including the establishment of a First Nations assessment workforce. 

 

Mental Health 

$556 million (and $36 million ongoing) is allocated for improved mental health. This budget extends critical services, addresses urgent gaps and workforce shortages – laying the groundwork for future reform.  OTA feels this does not go far enough to support the role of mental health occupational therapists, despite OTA’s ongoing advocacy to government to recognise and support mental health OTs. Government investment includes:  

• $260.2 million over 2 years is being invested for psychosocial support for more than 18,000 people with severe mental health illness who cannot access the NDIS. 

• $17.8 million over five years to upskill the broader health workforce in mental health, to alleviate workforce shortages and deliver high quality mental health treatment and support across a range of settings. Undergraduate nurses, midwives and allied health students receive contemporary training in mental health treatment and support.  

• Expanded supports for workplaces, children and young people, people with eating disorders, those bereaved by a suicide loss and individuals and communities impacted by natural disasters.  

• Boosting mental health support for First Nations people in the lead up to, during and following the Voice referendum.  

• Further protection for vulnerable members of the community, including refugees and migrants who have experienced torture and trauma, and culturally and linguistically diverse communities. 

• 500 additional postgraduate psychology places.  

• 500 one-year internships for provisional psychologists.  

• 2,000 supervisor training sessions for provisional psychologists. 

 

National Disability Insurance Scheme 

OTA welcomes announcements to reform elements of the NDIS and increase staffing and capability within the NDIA to relieve administrative issues and make it easier and quicker for participants to access much needed supports. We are particularly pleased that NDIA will extend participant plans beyond annual planning cycles and establish an expert advisory panel (in consultation with stakeholders) to identify evidence-based supports.  

The Government signalled its intent to curb NDIS spending through an 8% growth target, which will be delivered through a range of measures to improve claims management and reduce fraud. We are pleased to see this is a target, not a cap, and that it will be supported through a major investment package to drive improvements within the scheme. 

Improving the effectiveness and sustainability of the NDIS  

$732.9 million over 4 years from 2023-24 is being invested in initiatives developed in consultation with the NDIS Independent Review CoChairs. This includes: 

• $429.5million to will improve NDIA capability and systems.  

• $73.4 million to better support participants to manage their plans. 

• $48.3 million over two years to address scheme fraud. 

• $29.3 million to support the quality and effectiveness of services provided to participants, through improving oversight of services and increasing take up of evidence-based supports. 

• $7.6 million to partner with communities to pilot alternative commissioning approaches to improve access to supports in remote and First Nations communities. 

Other measures to support and safeguard the Scheme and people with a disability 

• $142.6 million to support the NDIS Quality and Safeguards Commission to do its job of keeping NDIS participants safe. 

• $14.1 million to deliver a COVID-19 Leave Grant to help stop the spread of COVID-19 to vulnerable Australians and support disability workers. 

• $13 million investment in the Department of Social Services in 2023-24 to strengthen the Government’s oversight of the NDIS. 
   

Workforce 

The budget saw some measures to support existing allied health workforce but fell short of funding a national allied health workforce strategy (which has been called for by many stakeholders including OTA and AHPA).  

Workforce Incentive Program changes 

Investment of $445.1 million over five years from will improve the quality and accessibility of multidisciplinary primary care and improve the financial sustainability of multidisciplinary general practice by immediately increasing all payments under the Workforce Incentive Program – Practice Stream.  This funding will support practices to expand multidisciplinary teams and employ more nurses, allied health and other health professionals in practices. 

Scope of Practice Review  

OTA welcomes the announcement of a Scope of Practice review that will see $3 million invested over two years to undertake a review that examines current models of care against community needs and recommends appropriate expansion to scopes of practices and models of care for a range of health professionals providing primary care services (both registered and self-regulated, including allied health, medical practitioners, nurses and midwives).  

The Review will involve extensive consultation with various stakeholders including (but not limited to) state and territory governments, health services, peak bodies, employers, relevant health professional Boards and education and training institutions.  

 

Veterans  

OTA was disappointed to see no meaningful investment in improving the quality of health services accessible to Australian veterans, despite our calls for an increase in occupational therapist fees under DVA. 

Claims processing 

There is some investment in claims processing to reduce claims backlog including $64.1 million in 2023-24 to retain 500 DVA staff, and $254.1 million over four years to fix IT and payment systems.  

Suicide intervention training program  

$2 million over 2 years from 2023-24 to continue the Department of Veterans’ Affairs mental health literacy and suicide intervention training program for the ex-service community. 

 

Primary Health Care 

Investment in the primary health system was a cornerstone of the Budget and will see major support for Australians to see their GP, and support for more multidisciplinary care. 

Bulk billing 

$3.5 billion over five years from 2022-23 in bulk billing incentives, which we hope will see more Australians be able to afford to visit their GP to receive important care including referrals for allied health services.   

$99.1 million over five years will support establishment of a new MBS item for longer consultations over 60 minutes, which is expected to support an increasing number of patients with chronic conditions and complex needs. 

Strengthening the role of Primary Health Networks 

$79.4 million over four years from 2023-24 to support PHNs to commission allied health services to improve access to multidisciplinary care for people with chronic conditions in underserviced communities.  

It’s expected this will improve access to affordable multidisciplinary health care including allied health professionals, nurses, nurse practitioners and midwives, and will enable health professionals to work together to deliver better patient outcomes in line with the recommendations of the Strengthening Medicare Taskforce.  

Included is $17.1 million over four years to extend PHNs’ existing role in general practice support to private allied health, nursing, nurse practitioner and midwifery practices. This includes $0.235 million in 2023-24 to develop an allied health practice support toolkit and ongoing funding to deliver practice support to allied health (including non-dispensing pharmacists), nursing and midwifery practices. 

The age limit for multidisciplinary allied health case conferencing items  

The age limit for multidisciplinary allied health case conferencing items (MBS items 82001, 82002 and 82003) will be raised from 13 to 25. This will increase access for people that have, or are suspected of having, a complex neurodevelopmental disorder or eligible disability. It will be implemented on 1 March 2024. 

Streamlining GP chronic disease management (CDM) items 

From 1 November 2024, the GP CDM planning and review items will be restructured. The current GP planning items - the GP Management Plan (GPMP) and Team Care Arrangement (TCA) - will be consolidated into a new CDM planning item. The same benefit will be paid to create as to review a CDM plan. Patients enrolled in MyMedicare (see more on this below) will need to access CDM items through the practice they are enrolled at; patients that are not enrolled will continue to be able to access the services through their usual GP, consistent with the current arrangements.  

Patients will need to have a CDM plan that has been created or reviewed within the last 18 months to access allied health services. Patients will also need a plan to access a Domiciliary Medication Management Review. There will be transition arrangements from 1 November 2024 to 31 October 2026 to during which patients will be able to continue to access allied health services using their existing GPMPs and TCAs. 

My Medicare 

MyMedicare is the Voluntary Patient Registration Model that was announced by the Prime Minister following National Cabinet on Friday 28 April. It will strengthen and formalise the relationship between the patient, their practice and general practitioner to support wraparound and multidisciplinary care for patients registered with their local GP.  

It will blend fee-for-service with patient-centred funding to improve patients’ access to comprehensive, team-based care in the community. Governance and implementation oversight processes will be established and will include a range of expert stakeholders, including allied health professionals. 

My Health Record  

$6.1 million in 2023-24 to 2024-25 will support allied health professionals to develop connections to My Health Record. This will be alongside a comprehensive marketing and education campaign to promote My Health Record use amongst allied health professionals. It will ensure that all members of a patient’s primary care team have access to their key health information to support clinical decision making at the point of care. This funding will be complemented by additional investment to modernise My Health Record.  

 

Rural and First Nations Health 

Better access to Allied health services for First Nations Australians 

First Nations Australians with a chronic condition, or following a Health Assessment, will have streamlined access to the 10 allied health services through MBS items 93000, 93013, and 81300–81360, 93048 and 93061, and 10950–10970. This includes occupational therapy, MBS item 10958. 

All 10 items will be able to be accessed following either a GP Medical Plan/Team Care Arrangement or Health Assessment, rather than requiring both. This measure was due to be implemented on 1 March 2023, however, due to implementation challenges and the need for additional stakeholder consultation, it will now be implemented on 1 March 2024.  

Improving primary care access in thin markets 

$27 million over 4 years to improve the provision of, and access to, primary care and support services in thin markets by trialling integrated services and joint commissioning across primary health, First Nations health services, disability, aged care, and veterans’ care sectors in up to 10 locations. 

 

More information 

Read more about the budget announcements in the Health and Aged Care portfolio here.