Call for ACFI overhaul to cover exercise therapy for pain management
The peak body for physiotherapists is calling on the Federal Government to fund contemporary pain management therapies in residential aged care, including exercise, and overhaul the funding instrument to support restorative care practices.
The Australian Physiotherapy Association (APA) wants the government to amend the Aged Care Funding Instrument (ACFI) to enable residents to access clinically-prescribed and evidence-based therapies managed by allied health professionals including physiotherapist-led exercise.
The call has been backed by the umbrella group of 19 allied health professions, Allied Health Professions Australia (AHPA), which in a joint statement to government called for pain management to be brought in line with contemporary practice and consumer directed reform.
Rik Dawson
APA gerontology chair Rik Dawson said exercise was proven to manage pain and help improve independence and quality of life for aged care residents.
“Exercise is the most effective way to reduce musculoskeletal pain. There’s strong evidence and lots of it,” Mr Dawson told Australian Ageing Agenda.
While exercise was one of the key elements, there were other proven natural therapies that helped manage pain, such as joint mobilisation, occupational therapy, psychology and posture correction, Mr Dawson said.
Missed opportunity
Responding to the changes to ACFI announced in last month’s budget, AHPA executive officer Lin Oke said it was opportunity to bring pain management in line with contemporary practice and support consumer directed reform in conjunction with reducing expenditure and incentive for industry gaming in ACFI funding.
“Whilst the announced changes will reduce ACFI expenditure and reduce incentive for gaming in the sector, they will see client care move further away from contemporary practice, limiting existing services, and prohibiting evidence based services and consumer choice,” she said.
Consumers requiring pain management were limited to a choice of massage or transcutaneous electrical nerve stimulation (TENS), but a range of allied health services such as exercise were available to assist pain relief and aged care residents should have access to the full range, Ms Oke said.
“Limiting access to services through outdated and prescriptive description of funded treatment modalities is inconsistent with evidence-based practice and consumer-directed care,” she said.
Among the budget measures to redesign the scoring matrix for complex health care is a minimum weekly delivery requirement of at least four sessions and 120 minutes of treatment for complex pain management by allied health professionals.
“The 120 minutes is excessive,” said Mr Dawson. “It will interfere with other opportunities that older people may have using their times when their energy levels are compromised. It will limit the take up of these treatments and it will compromise people’s pain experience and perhaps lead to increased medication.”
ACFI needs to cover restorative care
Mr Dawson said ACFI continued to fund passive treatment to manage pain that caused resident dependence rather than evidence-based active treatments that promoted independence and function. The ACFI needed to be reformed to include restorative care therapies, he said.
“At the moment you can only apply treatment for pain management. There is nowhere in the ACFI funding for restorative, wellness or preventative healthcare measures,” Mr Dawson said.
“It’s time to say goodbye to ACFI and start thinking about what makes sense soon, not in 2020. It is a really good opportunity with the five-year review to bring funding in line with the accreditation guidelines,” Mr Dawson said.