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National Strategy for an Ageing Australia
Current Commonwealth initiatives include the Intergenerational Report, the development of a mature age workers strategy, and legislation to prohibit discrimination on the basis of age.
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 in proportion to the number of people aged 70 years and older.
The Government subsidises the costs for each person in a residential care setting. The level of funding depends on the care needs of the resident. Also, residents can be asked to pay fees and charges. 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 in order to receive Commonwealth government funding. Capital funding is available on a competitive basis to support residential aged care where the aged care provider is unable to fund necessary building works. Commonwealth government expenditure on residential aged care in 2001-02 is shown in table 7.16.
Community care programs
Home and Community Care (HACC) Program
The HACC Program is a joint Commonwealth/state cost-shared program which provided $1b nationally for the 2001-02 financial year to service provider organisations. Of the total, the Commonwealth made available $615m or 60%, the states and territories providing the remaining 40%.
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 and 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 their home and the community and to prevent premature admission to long-term 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 domestic assistance, food services, personal care, community nursing, transport and respite care.
Commonwealth Carelink Program
Nationally, over 60 Commonwealth Carelink Centres provide information about local community aged care, disability and other support services to over 9,000 clients each month. Clients include care professionals including general practitioners, service providers, individuals and their carers. Total program funding of $41m is provided from 1999 to 2003.
Community Aged Care Packages Program
Community Aged Care Packages are funded by the Commonwealth to provide a community alternative to low level residential care to assist frail older people with complex needs to remain living in the community.
Service providers use a case management approach to develop and monitor care delivery to eligible older people. One of the great benefits of the Community Aged Care Packages Program is its flexibility in service delivery which is designed to meet individual needs. This flexibility enables people to be given assistance through a package of care services which may include personal care, assistance with preparing meals, home help and assistance with transport.
By June 2002, there have been 26,650 packages approved under the program. Total cash expenditure for 2001-02 was approximately $250m.
Aged Care Assessment Program
The Commonwealth provides grants to state and territory governments specifically to operate Aged Care Assessment Teams (ACATs). In 2001-02, the Commonwealth Government contributed $40m for the operation of 123 ACATs throughout Australia, as well as an evaluation unit in each state.
ACATs assess the care needs of people. 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/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 2001-02 the program funded 46 projects nationally from an allocation of $3m. 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 provides information, respite care and other support or assistance appropriate to carers' individual needs and circumstances, and those of the people for whom they care.
Funding for the NRCP increased from $19m in its inception year, 1996-97, to $88m in 2001-02. The NRCP funds Commonwealth Carer Resource Centres, Commonwealth Carer Respite Centres and respite services.
Commonwealth 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 over 90 Commonwealth Carer Respite Centres and regional office outlets has been established to improve coordination of respite service provision and help meet emergency and unplanned respite needs. Commonwealth 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 carer respite services, which include in-home, family-based, centre-based and peer support services, to supplement mainstream respite services offered through the HACC and other state-based programs as well as local government and community initiatives.
Extended Aged Care at Home (EACH) Program
The EACH Program commenced as a three-year pilot in 1998 to test the feasibility of providing the equivalent to high level residential age care to people living at home. There are currently 10 provider organisations with a total of 290 approved places.
EACH service providers are required to deliver individually tailored, coordinated packages of care in keeping with a client's care plan. Services can include, but are not limited to, the following: personal care including continence care; specialist nursing care and 24-hour emergency assistance; support for people with cognitive deficits; assistance with meals; and home help and maintenance.
The 2001 Budget Initiative on EACH provided an additional $2m over two years for development work to lay the foundations for possible expansion of the EACH Program and address data management, quality and accountability issues. Through 2002-03 further development will be undertaken, including a census of EACH services in May 2002.
In the 2002 Aged Care Approvals Round, 160 EACH packages have been allocated to provide for a moderate expansion of the EACH Program. The expansion is planned to target Tasmania, Queensland and the Northern Territory, none of which hosted a pilot program. This expansion will build provider familiarity with the program, and provide an Australia-wide base for program development.
Day Therapy Centres (DTC) 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 151 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 2001-02 was $29m.
In the 2001-02 Budget, as part of the 'Increasing Care and Diversity for Frail Older Australians' package the Government provided an additional $4m over four years to enhance the DTC Program. This initiative will turn DTC much more towards outreach into the community and prevention of premature entry into high level care, particularly for those older people with dementia.
National Continence Management Strategy
The 'Staying at Home - Care and Support for Older Australians 1998' package 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 subsidy to eligible individuals of $465 per annum. CAAS funding for 2002-03 is $11m.
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 Ageing.
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, Commonwealth Rehabilitation Services Australia clients 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 2001-02 was $134m.
There are 139 accredited hearing services providers contracted by the OHS to provide services under the Hearing Services Voucher System. Services are provided at 462 permanent sites and around 880 visiting sites throughout Australia by qualified hearing services practitioners (audiologists and audiometrists). OHS also has supply contracts with 15 hearing devices 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, through its research arm, the National Acoustic Laboratories, research to increase understanding of issues related to hearing loss, hearing rehabilitation and the harmful effects of noise. Total funding of these Community Service Obligation activities in 2001-02 was $28m.