Outcome 4 – Aged Care and Population Ageing

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Outcome Strategy

This chapter reports on the major activities undertaken by the department during the year, reporting against each of the major activities and performance indicators published in the Outcome 4 chapter of the 2010-11 Health and Ageing Portfolio Budget Statements (PB Statements) and the 2010-11 Health and Ageing Portfolio Additional Estimates Statements (PAES). It also includes a table summarising the estimated and actual expenditure for this Outcome.

Outcome 4 was managed in 2010-11 by the Ageing and Aged Care Division and the Office of Aged Care Quality and Compliance. The department’s state and territory offices and the Aged Care Standards and Accreditation Agency Ltd, which produces its own annual report, also contributed to the achievement of this Outcome.

Program Name	Program Objectives in 2010-11
Program 4.1: Aged Care Assessment	Provide equitable and timely access for frail older people to assessments that determine their eligibility for Australian Government subsidised aged care.
Program 4.2: Aged Care Workforce	Improve the quality of aged care by developing the skills of the aged care workforce.
Program 4.3: Ageing Information and Support	Provide information and support services to assist older people and their carers access care services most appropriate to their needs. Investigate complaints about Australian Government subsidised aged care services and promote awareness of the rights of care recipients. Reduce social isolation for residents in aged care homes by supporting community visitors.
Program 4.4: Community Care	Take full funding and policy responsibility for aged care across Australia. Provide alternatives to residential care to help people remain at home and in the community for as long as possible. Support carers, including through the National Respite for Carers Program. Assist older people to lead independent, active and healthy lives. Improve the quality of care for older Indigenous Australians. Increase access to services for care leavers.
Program 4.5: Culturally Appropriate Aged Care	Provide culturally appropriate aged care services to culturally and linguistically diverse communities. Provide culturally appropriate care to Aboriginal and Torres Strait Islander people.
Program 4.6: Dementia	Support dementia research. Promote dementia-specific training and career pathways for the aged care workforce. Provide behaviour management support for aged and community care workers and family carers. Help people with dementia, their carers and families through information, education and support.
Program 4.7: Flexible Aged Care	Trial innovative approaches to the delivery of community and residential aged care services to respond to the needs and preferences of older people. Improve the care of long stay older patients in hospitals. Ensure older people in rural and remote areas have access to care that meets their needs and preferences, through the Multi-Purpose Service Program. Enable older people with complex care needs to remain in their home, should they wish to do so, through community care packages.
Program 4.8: Residential Care	Ensure the availability of high quality, resident centred care, by promoting equitable access to residential aged care. Work towards financial security for residents to support their choice of an aged care home, improve the quality of aged care services through compliance with minimum standards, and encourage continuous quality improvement. Help older Indigenous Australians access residential services through the provision of building infrastructure and capital works.

Major Achievements

• Negotiated a new National Partnership Agreement to implement the Council of Australian Governments’ agreement that the Australian Government will assume full funding and policy responsibility for aged care services for people 65 years of age and over, and Indigenous people 50 years and over.
• Delivered reforms to the Complaints Investigation Scheme, making it more responsive and customer focused.
• Implemented a range of reforms to the prudential regulation of accommodation bonds to limit the ways in which approved providers may use bond funds.
• Completed a review of the ACFI (Aged Care Funding Instrument).
• Established a new national phone number – 1800 200 422 – and made improvements to the Aged Care Australia Website – www.agedcareaustralia.gov.au – as the first steps in the implementation of a new front end for aged care (operational 1 July 2011).

Challenges

• Attracting a sufficient number of high quality applications from potential aged care providers
  for residential aged care places.
• Attracting an adequate number of appropriately skilled workers to deliver high quality aged care to older people in the current labour market.
• Establishing an end-to-end aged care system as part of the Health Reform Agreement without the participation of Western Australia and Victoria at this time.
• Balancing the delivery of a significant reform agenda and contributions to the Productivity Commission’s inquiry into aged care, with the need to maintain focus on the delivery of existing responsibilities.
• The increasing demand from consumers to have a greater say in the types of care and services they receive in a setting of their choice.

Program 4.1: Aged Care Assessment

Equitable and Timely Access to Assessments

Whole of Program Performance Information

Qualitative Deliverable:	Produce relevant and timely evidence-based policy research.
2010-11 Reference Point:	Relevant evidence-based policy research produced in a timely manner.
Result: Deliverable met.
The department established an expert clinical reference group to develop a set of validated, specific assessment tools and develop criteria for use by ACATs. This group used evidence-based research to identify assessment tools appropriate for use by assessors in the comprehensive assessment of frail, older people. The report Selecting Tools for ACAT Assessment: A Report for the Expert Clinical Reference Group, Aged Care Assessment Program, Department of Health and Ageing37 released in September 2010, recommended core assessment tools for cognitive and physical domains to be used in every assessment. The report guided the establishment of the ACAT Toolkit.
Qualitative Deliverable:	Stakeholders participate in program development through a range of avenues.
2010-11 Reference Point:	Stakeholders participated in program development through avenues such as regular consultative committees, conferences, stakeholder engagement forums, surveys, submissions on departmental discussion papers and meetings.
Result: Deliverable met.
In 2010-11, the department worked with Aged Care Assessment Program Officials and Aged and Community Care Officials to improve the timeliness, consistency and quality of assessments conducted by ACATs. Additionally, the department worked with the National Aged Care Assessment Team Training Reference group to revise and update national training resources. The reference group also assisted with the two-day ACAT Education Officer workshops held in November 2010 and May 2011. These workshops provided the opportunity for networking and information sharing and to receive additional training in workplace coaching and e-learning.
Quantitative Deliverable:	Percentage of variance between actual and budgeted expenses.
2010-11 Target:	≤0.5%	2010-11 Actual:	-14.4%
Result: Deliverable not met.
The department did not achieve the performance target for actual administered expenses. This is attributable to the delayed implementation of planned National Aged Care Assessment Program Training Strategy activities. These activities are now scheduled for the 2011-12 financial year.

Program 4.2: Aged care workforce

Support a Professional Aged Care Workforce

Qualitative Deliverable:	Ensure the aged care workforce is adequately skilled to meet the demands of the aged care sector.
2010-11 Reference Point:	Provision of timely and relevant training.
Result: Deliverable met.
The department set the training priorities for workforce training programs in consultation with the Aged Care Workforce Committee. Registered Training Organisations delivering the programs were selected based on their ability to work with the sector and to deliver high quality, relevant training. A total of 88 organisations were funded to deliver training in 2010-11. Training organisations work with students and aged care providers to ensure that students are able to demonstrate the relevant competencies as they pursue accredited certificate and diploma qualifications.
Quantitative Deliverable:	Number of incentive payments made.
2010-11 Target:	14,400		2010-11 Actual:	5,265
Result: Deliverable not met.
Eligibility for the incentive payments commenced on 1 July 2010 and guidelines for the program were developed in consultation with the Aged Care Workforce Committee. A registration page on the department’s website, where applicants could register their interest in the program, was made available on 5 July 2010. Payment arrangements were finalised and application forms were made publicly available in November 2010 with payments commencing in December 2010. The department continues to promote the program to workers and to providers.
Quantitative KPI:	Percentage of incentive payments taken up.
2010-11 Target:	100%	2010-11 Actual:		100%
Result: Indicator met.
While applications for incentive payments were initially lower than expected, 100% of eligible applicants received payments.

Quantitative Deliverable:	Number of training places funded for aged care workers.
2010-11 Target:	7,200	2010-11 Actual:		19,199
Result: Deliverable met.
Contracts are in place to deliver training to meet specified targets across 2010-11 and 2011-12. The department funded 88 Registered Training Organisations to deliver training for 1,471 aged care workers leading to a qualification as an enrolled nurse as well as 9,289 certificate training places and 8,439 short courses across Australia over two years.
Quantitative Deliverable:	Number of scholarships funded for aged care nurses.
2010-11 Target:	715		2010-11 Actual:		715
Result: Deliverable met.
Demand for scholarships remained high in 2010-11. Of 2,089 eligible applications received, the department offered 715 aged care nursing scholarships comprising 395 undergraduate, 310 postgraduate and 10 nurse practitioner scholarships.
Quantitative Deliverable:	Number of clinical and graduate placements.
2010-11 Target:	180		2010-11 Actual:		0
Result: Deliverable not met.
Contracts are in place with 13 providers and one state-based aged care peak body to deliver 1,300 undergraduate clinical and graduate places for nurses in aged care over three years starting in 2011-12. Although no places were delivered in 2010-11, program design and implementation plans have been completed and it is expected that the total number of places delivered over the life of the program will exceed the original target.
Quantitative KPI:	Percentage of aged care worker training places taken up.
2010-11 Target:	100%	2010-11 Actual:		100%
Result: Indicator met.
All training places were taken up, with 65% of the certificate training places allocated to residential aged care services and 35% allocated to personal care workers employed in community aged services.
Quantitative KPI:	Percentage of aged care nursing scholarships taken up.
2010-11 Target:	100%	2010-11 Actual:		100%
Result: Indicator met.
Demand for scholarships remains high. A reserve list of applicants is maintained in case any students withdraw before the semester begins.
Quantitative KPI:	Percentage of clinical and graduate placements taken up.
2010-11 Target:	100%	2010-11 Actual:		Not applicable
Result: Not applicable.
Contracts are now in place with 13 providers and one state-based aged care peak body to deliver 1,300 placements over three years starting in 2011-12. Although no places were delivered in 2010-11, program design and implementation plans have been completed and it is expected that the total number of places delivered over the life of the program will exceed the original targets.

In 2010-11, the department funded development work around researching staffing levels and skills mix in Australian aged care facilities.

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Whole of Program Performance Information

Program 4.3: Ageing Information and Support

Information and Support for Care Recipients and Carers

As part of the first step to improving access to the front end of aged care, the Government has established a new national telephone number (1800 200 422) which is linked to the Commonwealth Respite and Carelink Centre network. The department supported the Commonwealth Respite and Carelink Centre network of 54 centres across Australia to provide information and access for older Australians and their carers to a range of community, aged care and support services. Centres also help carers identify what supports may be available locally and to use established local networks to provide options to take a break.

The department also improved the Aged Care Australia website⁴⁰ providing more comprehensive information for the growing number of people who like to find their information online. The information technology market was approached through an expression of interest process to test the market’s ability and interest in providing an information technology spine capable of supporting a new front end for aged care. Further changes and improvements to ensure a nationally consistent aged care system that is easier to access and navigate will be considered as part of the Government’s response to the Productivity Commission Inquiry Caring for Older Australians.

Quantitative Deliverable:	Number of calls made to the Aged Care Information Line.
2010-11 Target:	109,200	2010-11 Actual:		100,925
Result: Deliverable substantially met.
Calls to the Aged Care Information Line41 vary from time to time and tend to increase when pension rates and residential fees and charges change, and following major funding announcements, such as the Aged Care Approval Round.
Quantitative Deliverable:	Average number of searches per month on the Aged Care Australia website.
2010-11 Target:	16,700 searches	2010-11 Actual:		10,988 searches
Result: Deliverable substantially met.
The Aged Care Australia website has online search facilities that enable people to look for Australian Government subsidised aged care services to meet their needs. The target is an estimate of the number of possible searches per month. Recently announced improvements to the Aged Care Australia website may lead to an increase in its use.
Quantitative KPI:	Percentage increase in the number of calls received by the Commonwealth Respite and Carelink Centres annually.
2010-11 Target:	5%		2010-11 Actual:	12%
Result: Indicator met.
The number of successful calls to Commonwealth Respite and Carelink Centres was 295,980 in 2009-10. The successful calls in 2010-11 totalled 331,807 which is a 12% increase.

During the year the department also provided community aged care recipients and carers with information on service quality and standards by developing and distributing the ‘Information for People Receiving Community Aged Care’ kit. The kit provides information for care recipients and carers on what they can expect from their service provider, what their rights and responsibilities are and what they can do if they have concerns about the care and services they receive. The department consulted with community aged care stakeholders when designing and developing the kit.

Quantitative Deliverable:	Number of carer information resources distributed, including Carer Information Fact Sheets and Emergency Care Kits.
2010-11 Target:	282,000	2010-11 Actual:	301,526
Result: Deliverable met.
In 2010-11 the department distributed a total of 301,526 information resources.
Quantitative Deliverable:	Number of Commonwealth Respite and Carelink Centres client episodes.
2010-11 Target:	205,000	2010-11 Actual:	291,611
Result: Deliverable met.
The number of client episodes represents the number of times that carers were assisted by a Commonwealth Respite and Carelink Centre. It includes telephone calls, emails, facsimiles and visits to a centre. A carer may have been helped more than once in this period. The increase in contacts in 2010-11 is due to a review of data collection processes by Centres, which has resulted in more accurate number of client episodes being recorded.

Quantitative Deliverable:	Number of searches on the Commonwealth Respite and Carelink Centre website.
2010-11 Target:	256,000	2010-11 Actual:	147,360
Result: Deliverable not met.
Numbers of searches on the Commonwealth Respite and Carelink Centre website can fluctuate for various reasons, including the level of promotional activity undertaken by the centres. The overall level of information provided to carers has been maintained through items distributed under the carer information and support program which totalled 374,695 in 2010-11.

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Maintain Quality by Taking Action on Consumer Feedback

In February 2011, the department released a discussion paper on the proposed complaints management framework, a major component of the reforms to the Scheme. The framework expands the options available to resolve concerns, it encourages complainants to resolve concerns with approved providers in the first instance, if appropriate, and it assesses each complaint’s level of risk to ensure it is managed and escalated appropriately. Forty one submissions were received from a range of stakeholders, including approved providers, consumer advocacy services, unions and peak industry bodies and the Aged Care Commissioner. Legislation supporting the new complaint management framework is expected to take effect on
1 September 2011.

Consumers can contact the Scheme in the following ways:

• Phone 1800 550 552;
• Telephone Typewriter (TTY) users may phone 133 677 and ask for 1800 550 552;
• Speak and Listen users may phone 1300 555 727 and ask for 1800 550 552;
• Internet Relay users can access at www.iprelay.com.au and enter 1800 550 552;
• For languages other than English, call the Translating and Interpreting Service on 131 450 and ask to be put through to the Aged Care Complaints Scheme on 1800 550 552;
• At http://agedcarecomplaints.govspace.gov.au; and
• In writing to Aged Care Complaints Scheme, Department of Health and Ageing, GPO Box 9848 in your capital city.

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Reduce Social Isolation

Qualitative Deliverable:	Community Visitors Scheme recruits volunteers in a timely manner.
2010-11 Reference Point:	Community-based organisations meet targets for volunteer recruitment.
Result: Deliverable substantially met.
The department supports 156 organisations to recruit volunteers for the Scheme. To be considered an ‘active visitor’, volunteers must make 20 visits in a year. While this is a challenging target for volunteers to achieve, volunteers completed more than 178,000 visits in 2010-11.
Quantitative Deliverable:	Number of Community Visitor Scheme volunteers recruited to run the Scheme.
2010-11 Target:	7,500	2010-11 Actual:		More than 6,600
Result: Deliverable substantially met.
The department supports 156 organisations to recruit volunteers for the Scheme. Changes to the nature of volunteering, and to the demographics of volunteers, meant that some volunteers were not able to meet the threshold number of 20 visits to be considered an “active visitor”. Nevertheless, volunteers completed more than 178,000 visits in 2010-11.
Qualitative KPI:	Twelve month activity reports comply with funding requirements.
2010-11 Reference Point:	Program is delivered according to funding guidelines.
Result: Cannot be reported.
The required data will not be available until 1 November 2011.
Quantitative KPI:	Percentage of allocated visits achieved by the Community Visitors Scheme.
2010-11 Target:	100%	2010-11 Actual:	100%
Result: Indicator met.
Despite changes in the nature of volunteering which have made it difficult for organisations to recruit sufficient volunteers, the volunteers that were recruited made more than 178,000 visits.

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Whole of Program Performance Information

Qualitative Deliverable:	Produce relevant and timely evidence-based policy research.
2010-11 Reference Point:	Relevant evidence-based policy research produced in a timely manner.
Result: Deliverable met.
Reforms to the Complaints Investigation Scheme were developed after consulting with Australian complaints bodies and stakeholders, examining the International Standard for Complaints and analysing cases to identify opportunities where outcomes could be improved through strengthened resolution approaches.
Qualitative Deliverable:	Stakeholders participate in program development through a range of avenues.
2010-11 Reference Point:	Stakeholders participated in program development through avenues such as regular consultative committees, conferences, stakeholder engagement forums, surveys, submissions on departmental discussion papers and meetings.
Result: Deliverable met.
The department provided several avenues to allow stakeholders to properly participate in program development. Stakeholders participated by: providing submissions on the draft complaint management framework; providing feedback on the draft Complaints Principles, a revised service charter and consumer information materials; and being involved in a reference group to review materials, strategies and frameworks. The department also established a blog to foster ongoing consultation and communication with stakeholders and the community. In total, the department held 32 meetings with stakeholders, presented at four industry conferences, attended eight industry events, provided two reform updates by email and placed two articles in peak body newsletters. The department engaged with over 1,000 people through consultations on the new front end for aged care around Australia, and more than 500 participated in an online survey on the aged care reforms. Feedback was provided on a discussion paper proposing the elements and functions for the new front end and informed policy development. Stakeholders included local and state and territory governments, non-government organisations, service providers, workforce and peak bodies.
Quantitative Deliverable:	Percentage of variance between actual and budgeted expenses.
2010-11 Target:	≤0.5%	2010-11 Actual:	-5.0%
Result: Deliverable not met.
Funds were provided to support the development and implementation of the 2010-11 Budget measure, Aged Care, Reforms of Roles and Responsibilities – Home and Community Care and related programs. The department identified a more cost effective way to support the measure than was anticipated, resulting in the funds for 2010-11 not being fully expensed.

Program 4.4: Community Care

Taking Full Policy and Funding Responsibility for Aged Care Across Australia

Throughout 2010-11, the department developed a number of fact sheets about the reforms and answers to frequently asked questions published on the website.⁵²

Care for People in the Community

Respite and Carers

The four year Demonstration Day Respite (DDR) pilot was implemented in 2007 to trial innovative respite options for day respite in aged care homes. In 2010-11, an evaluation of the DDR pilot concluded that the pilot had been effective in providing more respite options for carers and had broadened the range of services offered. The evaluation also found that the services were delivered at a higher than expected cost. Funding for the pilot has been extended for 12 months until 30 June 2012. The executive summary of the evaluation report is available on the website.⁵⁵

In response to the House of Representatives Standing Committee report: Who Cares…? Report on the inquiry into better support for carers April 2009, the Government agreed to develop a National Carer Recognition Framework comprising national carer recognition legislation and a national carer strategy. The first element was the Carer Recognition Act 2010, which received royal assent on 18 November 2010. The National Carer Strategy (Strategy) is the second element of the framework. The Strategy, which has been jointly developed by this department and the Department of Families, Housing, Community Services and Indigenous Affairs, was launched by the Minister for Families, Housing, Community Services and Indigenous Affairs and the Minister for Health and Ageing on 3 August 2011.

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Targeted Initiatives to Maintain Independent, Active and Healthy Lives

Indigenous Aged Care Workforce Development

Improve Access to Care

Whole of Program Performance Information

Program 4.5: Culturally Appropriate Aged Care

Culturally Appropriate Aged Care

Qualitative Deliverable:	Grants provided to Partners In Culturally Appropriate Care and organisations representing culturally and linguistically diverse communities to provide information on aged care services.
2010-11 Reference Point:	Timely allocation and expenditure of capital funding.
Result: Deliverable met.
The department funded eight organisations under the Partners in Culturally Appropriate Care Program and 75 projects under the Community Partners Program.
Qualitative KPI:	The Partners in Culturally Appropriate Care Program is facilitating the provision of culturally appropriate care.
2010-11 Reference Point:	Progress reports, and appropriate follow up action by the department, find that relevant and useful products and services are being developed and delivered to service providers, which has resulted in those providers being better equipped to deliver culturally appropriate care.
Result: Indicator met.
Staff in residential aged care homes who have received training are provided with the necessary skills to deliver culturally appropriate care to older people, including a range of translated resources and materials which assists in the day to day management and interaction between staff and residents.
Qualitative Deliverable:	Provision of funding for access to translation services for culturally and linguistically diverse older people in aged care.
2010-11 Reference Point:	Allocation of funding and access to services are delivered in a timely manner.
Result: Deliverable met.
A Memorandum of Understanding has been signed with the Department of Immigration and Citizenship’s Translating and Interpreting Service for providers to access telephone and on-site translating and interpreting services. The service became operational in July 2011.
Quantitative Deliverable:	Increase access to aged care service information.
2010-11 Target:	≥$6.3m		2010-11 Actual:		$6.8m
Result: Deliverable met.
The department funded 83 organisations nationally to increase access to aged care service information and equip aged care providers with the necessary skills to deliver appropriate care to older people from a diverse cultural or linguistic background.
Quantitative Deliverable:	Number of nationally funded projects and services for many culturally and linguistically diverse communities.
2010-11 Target:	>70		2010-11 Actual:		75
Result: Deliverable met.
The department funded 75 projects nationally to provide communities from a diverse cultural or linguistic background with increased access to aged care services and information.
Qualitative KPI:	Usefulness of funded Community Partners program projects and activities in providing access to aged care information and services.
2010-11 Reference Point:	Progress reports, and appropriate follow up action by department, find that products and activities are reaching the intended target audience and that the content is assisting recipients to make informed choices about access to care.
Result: Indicator met.
The information is reaching 40 specific culturally and linguistically diverse communities and over 43 language groups, which assists them to make informed choices about access to care.
Quantitative KPI:	Percentage of aged care recipients, from culturally and linguistically diverse communities, accessing culturally appropriate information and services.
2010-11 Target:	95%	2010-11 Actual:		Not measured by the department
Result: Indicator not met.
The department does not collect data to ascertain the percentage of aged care recipients from communities with diverse cultural or linguistic background accessing culturally appropriate information and services.

Culturally Appropriate Aged Care for Aboriginal and Torres Strait Islander Peoples

Qualitative Deliverable:	Funding provided to aged care providers delivering care under the National Aboriginal and Torres Strait Islander Flexible Aged Care Program.
2010-11 Reference Point:	Funding allocation is timely and culturally appropriate.
Result: Deliverable met.
The department allocated $23.1 million to 29 services funded under the National Aboriginal and Torres Strait Islander Flexible Aged Care Program.
Qualitative KPI:	Funded program projects and activities provide access to appropriate aged care for Aboriginal and Torres Strait Islander peoples.
2010-11 Reference Point:	Progress reports and appropriate follow up action by the department find that funded activities are achieving required targets.
Result: Indicator met.
The projects funded improve the quality of service provider’s infrastructure and/or care delivery and support Aboriginal and Torres Strait Islander people to remain close to family and country, and to receive aged care in a culturally appropriate way.

To support the department’s commitment to culturally appropriate aged care, a two-day forum for National Aboriginal and Torres Strait Islander Flexible Aged Care Program service providers was held in May 2011. The forum provided participants with information about program developments and opportunities to discuss best practice and challenges in delivering culturally appropriate aged care. Topics discussed at the forum included wellness for older Aboriginal and Torres Strait Islander people, assessing and managing dementia, and behaviours of concern.

In 2010-11, the department finalised the first Quality Framework for the National Aboriginal and Torres Strait Islander Flexible Aged Care Program. Twenty-one services participated in pilot testing the framework in anticipation of expected implementation in September 2011. The framework uses a continuous improvement approach and aims to improve the quality of care provided by setting culturally appropriate standards for care delivery, management, and accountability. The framework will form the basis of the department’s quality assurance monitoring for the Flexible Aged Care Program and ongoing support will be provided to services during implementation to ensure that they have the resources and capacity to meet the standards.

Qualitative Deliverable:	Quality Framework is developed and trialled with all flexible services.
2010-11 Reference Point:	Effective stakeholder participation in development of framework and piloting.
Result: Deliverable met.
Twenty-one services participated in pilot testing the framework in anticipation of expected implementation in September 2011.

The department provides funds to support Indigenous Aged Care Services through other programs. For more information please see Program 4.8 in this Annual Report.
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Whole of Program Performance Information

Program 4.6: Dementia

Dementia Research

In response to this emerging public health challenge, the department is taking a two-pronged approach to supporting research into dementia through three Dementia Collaborative Research Centres (the Centres), and the Dementia Research Grants program. The latter is managed and administered by the National Health and Medical Research Council (NHMRC) on behalf of the department.

In 2010-11, the department provided funding for three Centres: the Assessment and Better Care Centre at the University of New South Wales; the Early Diagnosis and Prevention Centre at the Australian National University; and the Carers and Consumers Centre at the Queensland University of Technology. Priority research directions for 2010-11 included dementia and general practice dementia care nursing, transitions in care, technology and environmental design, community and acute care, nutrition, palliation, pain in dementia, quality of care issues, cognitive testing in the community, risk reduction and diagnostic tools and methods. The Centres undertook more than 150 projects in 2010-11, some of which are in progress. The Centres have a strong emphasis on transferring research outcomes into clinical practice and work closely with clinicians and consumers in designing research projects and determining how best to disseminate this information. Several projects have produced and published literature reviews and guidelines for clinical practice.⁶²

Qualitative Deliverable:	Funding provided for dementia research and Dementia Collaborative Research Centres.
2010-11 Reference Point:	Timely delivery of progress reports and funding agreement deliverables.
Result: Deliverable met.
The Centres provided satisfactory progress and annual reports and other deliverables within the specified timeframes.
Quantitative Deliverable:	Number of research projects funded.
2010-11 Target:	90		2010-11 Actual:	153
Result: Deliverable met.
The department worked closely with the Centres and other stakeholders in considering and approving research projects. This includes several ongoing projects as well as new projects funded by the NHMRC through the Dementia Research Grants. These projects will address areas such as early intervention, risk reduction, assessment and treatment, care and service delivery and will enhance our understanding of the causes of dementia.
Qualitative KPI:	Produce evidence based collaborative research in agreed dementia priority areas.
2010-11 Reference Point:	All research projects have 6 and 12 month progress reports that are compliant with funding requirements.
Result: Indicator met.
The Centres provided their six-monthly progress reports, 12-monthly annual reports within the timeframes and to the standards required by the funding agreements.
Quantitative KPI:	Percentage of research projects that are collaborative.
2010-11 Target:	90%	2010-11 Actual:			100%
Result: Indicator met.
Projects from all Centres were considered and approved by the department, consumers, service providers and clinicians collaboratively. Implementation of research projects also involved multiple collaborators, either nationally, internationally or both.

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Dementia-Specific Training for the Aged Care Workforce

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Dementia Behaviour Management Support

Dementia Education, Information and Support

Whole of Program Performance Information

Program 4.7: Flexible Aged Care

Innovative Care to Meet the Needs and Preferences of Older People

Transition Care

Ensuring Access in Rural and Remote Areas

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Community Care Packages for People with Complex Needs

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Whole of Program Performance Information

Program 4.8: Residential Care

Review of the Aged Care Funding Instrument

Equitable Access to Residential Aged Care

Aged Care Approvals Round

The Aged Care Act 1997 provides for places to become operational within two years after allocation, however in practice, this time can be longer, particularly in respect of residential care which is reliant on acquisition of land, finance, planning and construction approvals, and availability of builders. Approved providers with an allocation of residential aged care places are required to lodge quarterly reports on progress towards making the places operational. These reports are used as the basis for the department’s ongoing monitoring of such places and if no reasonable progress is being made, the department can revoke places.

Qualitative Deliverable:	Improved analysis and reporting on relative availability and use of aged care for various groups within the community.
2010-11 Reference Point:	Incorporation in published reports of additional information on availability and use of aged care for various groups within the community.
Result: Deliverable met.
In 2010-11, the department commenced an evaluation of the Consumer Directed Care (CDC) Initiative, which is comprised of 500 CDC packaged care places and 200 Consumer Directed Respite Care (CDRC) places. The findings of the evaluation will be available in early 2012 and will inform future policy and program management decisions related to CDC in community aged care.

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Promote Quality Residential Care Services

Quantitative Deliverable:	Percentage of accommodation bond refunds paid through the Accommodation Bond Guarantee Scheme refunded within the statutory timeframe.
2010-11 Target:	≥95%	2010-11 Actual:	Not measurable
Result: Deliverable met.
The Accommodation Bond Guarantee Scheme provides security to residents of aged care facilities by refunding any outstanding bonds in the event that a provider becomes insolvent or bankrupt and cannot repay the bond. No refunds were required in 2010-11.
Quantitative Deliverable:	Number of annual reviews of Aged Care Funding Instrument funding claims to ensure residents are correctly funded.
2010-11 Target:	20,000	2010-11 Actual	22,330
Result: Deliverable met.
Every year, the department applies risk management principles to target a large number of Aged Care Funding Instrument funding claims for review. In 2010-11, the department completed more reviews than expected, exceeding this target.

The department acted on relevant recommendations from the Productivity Commission’s Review of Regulatory Burdens on Business – Social and Economic Infrastructure Services.⁶⁸ The department implemented changes to the Residential Care Subsidy Principles and the Quality of Care Principles which simplified the way fire safety declarations are reported, which has reduced the regulatory burden on approved providers. The department also worked with the Australian Building Codes Board to pursue the Productivity Commission’s recommendation concerning both privacy and space requirements for aged care services.

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Aged Care for Older Indigenous Australians

Quantitative Deliverable:	Number of projects undertaken to provide culturally appropriate aged care services to older Indigenous Australians.
2010-11 Target:	5		2010-11 Actual:		5
Result: Deliverable met.
Support was provided to five services to improve clinical care, financial management and implement quality systems.
Qualitative KPI:	Funded projects and activities provide access to appropriate aged care for Aboriginal and Torres Strait Islanders.
2010-11 Reference Point:	Progress reports and appropriate follow-up action by the department find that activities are achieving the intended targets.
Result: Indicator met.
The department provided support services to ensure that Aboriginal and Torres Strait Islander people had access to appropriate aged care.
Quantitative KPI:	Amount of grants paid to eligible aged care services to improve capacity, buildings and equipment in remote Indigenous aged care services.
2010-11 Target:	$6.4m	2010-11 Actual:		$6.4m
Result: Indicator met.
All 2010-11 funds have been allocated to eligible aged care services, with a total of 38 projects funded. Major capital works undertaken included the upgrade of facilities, and construction of staff accommodation, at Galawin’ku, a Remote Service Delivery site in the Northern Territory. Other projects covered the provision of vehicles to allow safe transport of staff and residents, refurbishment of kitchen and laundry facilities and general maintenance and upgrades.

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Whole of Program Performance Information

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Outcome 4 – Financial Resources Summary

	(A) Budget Estimate1 2010-11 $’000	(B) Actual 2010-11 $’000	Variation (Column B minus Column A) $’000
Program 4.1: Aged Care Assessment
Administered Expenses
Ordinary Annual Services (Annual Appropriation Bill 1)	1,161	217	(944)
Departmental Expenses
Ordinary Annual Services (Annual Appropriation Bill 1)	5,362	5,365	3
Revenues from other sources (s31)	99	110	11
Unfunded depreciation expense	214	157	(57)
Operating loss / (surplus)	-	-	-
Total for Program 4.1	6,836	5,849	(987)
Program 4.2: Aged Care Workforce
Administered Expenses
Ordinary Annual Services (Annual Appropriation Bill 1)	65,424	57,655	(7,769)
Departmental Expenses
Ordinary Annual Services (Annual Appropriation Bill 1)	8,148	8,154	6
Revenues from other sources (s31)	150	168	18
Unfunded depreciation expense	326	238	(88)
Operating loss / (surplus)	-	1	1
Total for Program 4.2	74,048	66,216	(7,832)
Program 4.3: Ageing Information and Support
Administered Expenses
Ordinary Annual Services (Annual Appropriation Bill 1)	43,329	38,134	(5,195)
Departmental Expenses
Ordinary Annual Services (Annual Appropriation Bill 1)	67,829	67,874	45
Revenues from other sources (s31)	1,249	1,396	147
Unfunded depreciation expense	2,712	1,981	(731)
Operating loss / (surplus)	-	5	5
Total for Program 4.3	115,119	109,390	(5,729)
Program 4.4: Community Care
Administered Expenses
Ordinary Annual Services (Annual Appropriation Bill 1)	295,840	281,571	(14,269)
Special appropriations
Aged Care Act 1997 - Community Care Subsidies	542,341	531,715	(10,626)
National Health Act 1953 - Continence Aids Payment Scheme	40,935	39,541	(1,394)
Departmental Expenses
Ordinary Annual Services (Annual Appropriation Bill 1)	41,909	41,936	27
Revenues from other sources (s31)	772	862	90
Unfunded depreciation expense	1,676	1,224	(452)
Operating loss / (surplus)	-	3	3
Total for Program 4.4	923,473	896,852	(26,621)
Program 4.5: Culturally Appropriate Aged Care
Administered Expenses
Ordinary Annual Services (Annual Appropriation Bill 1)	32,292	32,154	(138)
Departmental Expenses
Ordinary Annual Services (Annual Appropriation Bill 1)	7,357	7,362	5
Revenues from other sources (s31)	135	151	16
Unfunded depreciation expense	294	215	(79)
Operating loss / (surplus)	-	1	1
Total for Program 4.5	40,078	39,883	(195)
Program 4.6: Dementia
Administered Expenses
Ordinary Annual Services (Annual Appropriation Bill 1)	31,278	31,491	213
Departmental Expenses
Ordinary Annual Services (Annual Appropriation Bill 1)	3,158	3,161	3
Revenues from other sources (s31)	58	65	7
Unfunded depreciation expense	127	92	(35)
Operating loss / (surplus)	-	-	-
Total for Program 4.6	34,621	34,809	188
Program 4.7: Flexible Aged Care
Administered Expenses
Special appropriations
Aged Care Act 1997 - Flexible Care Subsidies	660,908	628,321	(32,587)
Departmental Expenses
Ordinary Annual Services (Annual Appropriation Bill 1)	6,840	6,844	4
Revenues from other sources (s31)	126	141	15
Unfunded depreciation expense	273	200	(73)
Operating loss / (surplus)	-	1	1
Total for Program 4.7	668,147	635,507	(32,640)
Program 4.8: Residential Care
Administered Expenses
Ordinary Annual Services (Annual Appropriation Bill 1)	69,476	54,979	(14,497)
Special appropriations
Aged Care Act 1997 - Residential Care Subsidies	6,627,915	6,721,389	93,474
Aged Care (Bond Security) Act 2006	-	5,585	5,585
Unfunded Expenses - zero interest loans
concessional loan discount	124,587	7,835	(116,752)
Departmental Expenses
Ordinary Annual Services (Annual Appropriation Bill 1)	46,060	46,091	31
Revenues from other sources (s31)	848	948	100
Unfunded depreciation expense	1,842	1,345	(497)
Operating loss / (surplus)	-	3	3
Total for Program 4.8	6,870,728	6,838,175	(32,553)
Outcome 4 Totals by appropriation type
Administered Expenses
Ordinary Annual Services (Annual Appropriation Bill 1)	538,800	496,201	(42,599)
Special appropriations	7,872,099	7,926,551	54,452
Unfunded expenses	124,587	7,835	(116,752)
Departmental Expenses			-
Ordinary Annual Services (Annual Appropriation Bill 1)	186,663	186,787	124
Revenues from other sources (s31)	3,437	3,841	404
Unfunded depreciation expense	7,464	5,452	(2,012)
Operating loss / (surplus)	-	14	14
Total expenses for Outcome 4	8,733,050	8,626,681	(106,369)
Average Staffing Level (Number)	1,282	1,280	(2)
1 Budgeted appropriations taken from the 2011-12 Health and Ageing Portfolio Budget Statements and re-aligned to the 2010-11 outcome structure.

³⁸ Available at: www.agedcareaustralia.gov.au
³⁹ Available at: www.yourhealth.gov.au
⁴⁰ Available at: www.agedcareaustralia.gov.au
⁴¹ Telephone on: 1800 500 853.
⁴² From 1 September 2011, known as the Aged Care Complaints Scheme.
⁴³ From 1 September 2011, known as the Aged Care Complaints Scheme.
⁴⁴ Available at: http://agedcarecomplaints.govspace.gov.au
⁴⁵ Telephone on: 1800 550 552.f
⁴⁶ Mail to Aged Care Complaints Scheme, Department of Health and Ageing, GPO Box 9848 in your capital city.
⁴⁷ Available at: www.health.gov.au
⁴⁸ Available at: www.yourhealth.gov.au
⁴⁹ Available at: www.agedcareaustralia.gov.au
⁵⁰ A long wait case is a case open for more than 180 days.
⁵¹ Available at: www.health.gov.au/internet/main/publishing.nsf/content/ageing-rescare-cvs-cvs.htm
⁵² Available at: www.yourhealth.gov.au
⁵³ More information on this topic can be found in Program 4.5 of this Annual Report.
⁵⁴ Available at: www.health.gov.au
⁵⁵ Available at: www.health.gov.au/ddrpilot
⁵⁶ Telephone: 1800 200 422.
⁵⁷ Available at: www.agedcareaustralia.gov.au
⁵⁸ Available at: www.pc.gov.au/projects/inquiry/aged-care/draft
⁵⁹ Access Economics (2009). Keeping dementia front of mind: incidence and prevalence 2009-2050 Access Economics, Canberra.
⁶⁰ Arkles, RS; Jackson Pulver, LR; Draper, B; Chalkley, S and Broe, GA. (2010) Ageing, Cognition and dementia in Australian Aboriginal and
Torres Strait Islander Peoples: Neuroscience Research Australia and Muru Marri Indigenous Health Unit, UNSW, p.i
⁶¹ AIHW (2010) Australia’s Health p.58-59. http://www.aihw.gov.au/publication-detail/?id=6442468376&tab=2
⁶² Available at: www.dementia.unsw.edu.au
⁶³ Telephone on: 1800 699 799.
⁶⁴ Telephone on: 1800 100 500.
⁶⁵ Available at: www.alzheimers.org.au
⁶⁶ Available at: www.dementia.unsw.edu.au
⁶⁷ For more information on the Aged Care Approvals Round, please see Program 4.4 in this Annual Report.
⁶⁸ Available at: http://www.pc.gov.au/

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