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National Strategy for an Ageing Australia
Residential Aged Care Program
The aim of the Residential Aged Care Program is to enhance the quality of life of older Australians through support for the provision of a cohesive framework of high quality and cost effective residential care services for frail older people.
Aged care places are allocated to people aged 70 years and older.
Recurrent funding is available for each person in a residential care setting. The funding depends on the care needs of the resident. Each aged care home that provides care is required to meet specific care standards and to be accredited by the Aged Care Standards and Accreditation Agency (ACSAA) in order to receive Commonwealth government funding. Commonwealth government expenditure on residential aged care in 2000-01 is shown in table 7.30.
Community Care Programs
Home and Community Care (HACC) Program
The HACC Program is a joint Commonwealth/State cost-shared program which provided $931m nationally in 2000-01 to service provider organisations. Of the total, the Commonwealth made available $567m or 60%, the States and Territories providing the remainder.
The Commonwealth provides funding for HACC, but the day-to-day administration, priority setting and approval of project allocations is the responsibility of the State/Territory Governments.
The aim of the HACC Program is to provide basic maintenance and support services to enable frail older people, and younger people with disabilities, to remain living in the community and to prevent premature admission to residential care. HACC funded services also assist the carers of these groups. The types of HACC funded services available include home maintenance and modification, as well as home help, food services, personal care, community nursing, transport and respite care.
Commonwealth Carelink Program
The Commonwealth Carelink Program was launched in April 2001 to assist in improving the coordination of information for people requiring community care. Commonwealth Carelink Centres will enable care professionals, including general practitioners, other service providers, individuals and their carers to gain easy access to information about the range of agencies in their local region which provide community and aged care services (via a single contact point).
Community Aged Care Packages Program
Community Aged Care Packages are funded by the Commonwealth to provide personal care services for people in the community with complex needs who may otherwise require entry to long-term residential care.
Service providers use a case management approach to develop and monitor care delivery to older people. One of the great benefits of the Community Aged Care Packages Program is its flexibility in service delivery to meet individual needs. This flexibility enables people to receive assistance with eating meals, using the telephone, personal and domestic care, and transport.
At June 2001 there were some 24,400 packages approved under the program. Total cash expenditure for 2000-01 was approximately $192m.
Aged Care Assessment Program (ACAP)
The Commonwealth provides grants to State and Territory Governments specifically to operate Aged Care Assessment Teams (ACATs). In 2000-01, the Commonwealth Government contributed $37.8m for the operation of 124 ACATs throughout Australia, as well as an evaluation unit in each State.
ACATs are teams of health professionals who provide expert assessment and advice. The main professional groups represented on ACATs are geriatricians, social workers, nurses, physiotherapists, occupational therapists, psychologists and psychogeriatricians.
ACATs assess the whole care needs of an individual, using a multi-disciplinary and multi-dimensional approach. As part of the holistic assessment process, a person’s medical, physical, social, psychological and restorative care needs are assessed before a care approval is made. ACATs are also well positioned to provide advice on aged care services and to act as an interface between aged care services and the health care system.
Clients need to be assessed as eligible by an ACAT before they can receive a Commonwealth subsidy for residential care, a Community Aged Care Package, or flexible care.
Assistance with Care and Housing for the Aged (ACHA) Program
The ACHA Program assists frail, low-income older people who are renting, are in insecure or inappropriate housing, or are homeless, to remain in the community by accessing suitable housing linked to community care.
The Commonwealth contributes recurrent funds to organisations that provide support through paid workers and/or volunteers, assisting clients to access and be maintained in secure and affordable housing. The primary role of program workers is to link clients to appropriate mainstream housing and/or care services.
In 2000-01 the program funded 46 projects nationally from an allocation of $2.6m. The funding for each project varies according to identified community need, the number of staff employed by individual services and the tenure of employment (i.e. full-time or part-time). Most projects are located in inner city areas where there is a concentration of frail elderly people living in insecure accommodation.
National Respite for Carers Program (NRCP)
The aim of the NRCP is to contribute to the support and maintenance of caring relationships between carers and their dependent family and friends. It facilitates access by carers to information, respite care and other support or assistance appropriate to their individual needs and circumstances, and those of the people for whom they care.
Funding for the NRCP increased from $19m in its inception year, 1996-1997, to $72m in 2000-01. The NRCP funds Carer Resource Centres, Carer Respite Centres and respite services.
Carer Resource Centres, located in each State and Territory, were established to act as a point of contact for carers seeking information and advice about the full range of services, support and assistance that is available to carers.
A national network of 82 NRCP Carer Respite Centres and regional office outlets was established to improve coordination of respite service provision and help meet emergency and unplanned respite needs. The Carer Respite Centres provide carers with a single contact point for respite care assistance, whether the respite service required is in an aged care facility, in the community or in the carer’s home. The NRCP also provides funding for over 400 respite services, which include in-home, family-based, centre-based and peer support, to supplement mainstream respite services offered through the Home and Community Care Program (HACC) and other State-based programs as well as local government and community initiatives.
Extended Aged Care at Home (EACH) Program
The Extended Aged Care at Home (EACH) pilot program commenced on 1 July 1998, building on initial projects in South Australia (1993) and Western Australia (1997). This program is supported under the flexible care arrangements of the Aged Care Act 1997. The program provides high level care at home as an alternative to high level care in an aged care home. The EACH pilot program is currently limited to 10 services providing care to around 290 people. Pilot projects operate in South Australia, Western Australia, New South Wales, Victoria and the Australian Capital Territory. In 2000-01, funding of $9.8m was provided to the program.
An evaluation of the pilot was conducted in 2000-01. The aim of the evaluation was to consider the future of this service delivery model and to test the extent to which the EACH packages are economically viable, target recipients' needs effectively, and are able to deliver a high level of care to people in their own homes. It found that the key objectives are being met and made a number of recommendations to support consolidation of the program, including the establishment of quality standards and development of data systems to enable better management and reporting. The May 2001 Budget provided an additional $1.9m for developmental work.
Day Therapy Centres (DTCs) Program
The DTC program has been in operation since 1988, when rationalisation of nursing home funding led to the separate funding of the therapy function. There are 152 service providers across Australia, providing a wide range of therapy services to frail older people living in the community and to residents of Commonwealth funded aged care homes. Funding provided by the Government in 2000-01 was $28.5m.
During 2000-01 the Department identified that a small number of providers have introduced new approaches to the type of services they provide within the DTC model and in the way they deliver these to meet the changing needs of the client target group.
The 2001 Federal Budget provided $4.3m over four years to review current DTC service models to identify innovative therapy approaches. In addition, demonstration projects will be established, with a particular focus on people with dementia. Data options will also be explored to provide more information about service delivery levels.
This initiative will turn Day Therapy Centres much more towards outreach into the community and prevent premature entry into high level care, particularly for those older people with dementia.
National Continence Management Strategy
The package 'Staying at Home - Care and Support for Older Australians 1998' included $15m over four years to address the needs for improved continence management for older Australians through the National Continence Management Strategy. Under this Strategy, a number of national research and service development initiatives are being trialed to complement existing continence care.
The Commonwealth Government also funds the Continence Aids Assistance Scheme (CAAS) which was established to assist people of working age who have a permanent disability-related incontinence condition. CAAS currently provides a $450 subsidy per year to assist eligible individuals. CAAS funding for 2000-01 was $8.43m.
Commonwealth Hearing Services Program
The role of the Commonwealth Hearing Services Program is to purchase services for eligible people with a hearing impairment. The administration of the Commonwealth Hearing Services Program is the responsibility of the Office of Hearing Services (OHS), a branch within the Aged and Community Care Division in the Department of Health and Aged Care.
Access to hearing services for eligible adults is provided through the Hearing Services Voucher System. Eligible adults include: holders of Pensioner Concession Cards; holders of Repatriation Health Cards issued to veterans for conditions that include hearing loss; Sickness Allowees; dependants of the above categories; clients of CRS Australia (the Commonwealth Rehabilitation Service) undergoing a vocational rehabilitation program and referred by their case manager; and serving Defence personnel. OHS purchases hearing services from accredited public and private sector providers. Voucher System expenditure in 2000-01 was $121.6m.
More than 135 accredited hearing services providers are contracted by the OHS to provide services under the Hearing Services Voucher System. Services are provided at more than 300 permanent and around 900 visiting sites throughout Australia by qualified hearing services practitioners (audiologists and audiometrists). OHS also has supply contracts with 16 hearing device suppliers for the supply of quality hearing devices into the Program.
In addition, the Government funds Australian Hearing Services to provide specialised hearing services for children and young adults under the age of 21 years, and to ensure access to appropriate hearing services for eligible adults with special needs. These clients include those who live in remote locations, who are Aboriginal or Torres Strait Islander people, or who have complex hearing needs. Funding is also provided to Australian Hearing Services to undertake research to increase understanding of issues related to hearing loss, hearing rehabilitation and the harmful effects of noise, through its research arm, the National Acoustic Laboratories.