1996-1997
5.3: Home and Community Care for the Aged and Assistance to Carers
The 1996-97 Portfolio Budget Statements, informs Senators and Members of Parliament of the proposed allocation of resources to portfolios outcomes and their objectives and targets including the agencies within the Health and Family Services portfolio.
Objective
- To support frail older people to remain in their homes through the provision of a comprehensive range of high quality and cost-effective services to them and their carers.
Goals
- Improvements in the level and quality of services for people assessed as requiring support.
- Equitable distribution of Home and Community Care (HACC) programme outputs between regions.
- Improved HACC assessment process to support appropriate referral available to services.
- Improved support for carers through the National Carer Action Plan.
- An output-based framework for monitoring the effectiveness, efficiency and quality of community care services.
- Improved provision of post-acute care for people in the HACC target group.
- Equitable fees policy based on financial need of the client.
Strategies
- Approve new HACC regional/project funds with State/Territories, and new Commonwealth Respite Care projects, in line with growth funding.
- Improve equitable access to HACC services by:
- continuing to work towards equalising HACC dollars per capita across States and Territories;
- implementing regional output planning and regional funding allocations, taking into account regional demography, existing service delivery patterns and costs of services; and
- developing the HACC National Fees Policy in consultation with States and Territories.
- Implement the National Carer Action Plan by:
- expanding and reconfiguring the respite programme to more flexibly meet the needs of the carers, including assistance for carer resource centres;
- developing mechanisms for providing better carer needs assessment and advice; and
- reviewing current financial support arrangements for carers including Domiciliary Nursing Care Benefit.
- Develop measures to assure the quality of HACC services against the national service standards at the regional, state and national levels.
- Develop output measurements for HACC.
- Develop agreed outputs, outcomes and quality measures for Day Therapy Centres.
- Conduct a national survey of Community Aged Care Package service providers that includes data on clients, and establish a comprehensive data base on the programme.
- Facilitate the development with States and Territories of a national framework for independent assessment of people with complex care needs which enable referral to the broader health and community services network, consistent with COAG reforms.
- In the context of the broader COAG reform agenda aimed at improving appropriateness and quality of care across wider range of health and related community services develop, together with States and Territories, plans to implement decisions on:
- the responsibility for the provision of post acute care for people in the HACC target group; and
- the development of an integrated care model covering hospital and post acute care, including a common unit record system.
Performance Indicators and Targets
Effectiveness
- Number of services provided to people assessed as needing them.
Target: Increased provision. - Number of carers receiving services.
Target: More carers receiving services. - Development and implementation of protocols on the provision of post-acute services to people in the HACC target group.
- Progress on the development of a common unit record system.
Efficiency
- Costs to Commonwealth per client and cost of client of HACC service, Community Aged Care Packages and Day Therapy Centres.
- Average unit cost to Government of these services.
Target: Reduction in unit cost of Government proportionate to increased user charges.
Quality
- Quality performance on HACC measures by region.
Target: Equitable quality performance across regions. (This cannot be reported on for 1996-97.) - Client satisfaction with services provided, as measured by client surveys and complaints.
Equity
- Comparative performance of States and regions against HACC output targets, including for carers.
- Level of service use by, and level of specifically targeted service provision for, older people with dementia, older ethnic people, older indigenous people and older people in rural and remote areas as compared with levels in the whole population.
Target: Provision appropriate to proportion in population.
Budget Measures
Election Commitment
Increased Funding for Commonwealth Respite Care
Financial Implications
1996-97 $m | 1997-98 $m | 1998-99 $m | 1999-00 $m |
2.8 | 5.6 | 5.7 | 5.8 |
Expenditure on this measure will start in January 1997.
Purpose of Measure
To ensure that carers have access to an appropriate range of respite care and other support.Top of page
Expected Implementation Strategies for Measure
A National Respite for Carers programme will be established which will draw together existing programmes and provide a focus for respite care service provision.Carer Resource Centres will be established in each State and Territory to improve co-ordination of respite care and provide support and information for carers.
Intended Impacts of Measure
Carers will benefit from the improved co-ordination of respite care. More respite services will be available and there will be better linkages between service planners and deliverers.Savings
Increase User Charging in the Home and Community Care Programme
Financial Implications
1996-97 $m | 1997-98 $m | 1998-99 $m | 1999-00 $m |
-4.5 | -14.4 | -22.3 | -31.1 |
The savings shown here reflect a reduction in the Commonwealth contribution to HACC over four years in line with assessed capacity for increased fees revenue, thereby maintaining real growth in the programme at six per cent.
Purpose of Measure
To increase the contribution user charging makes to HACC funding.Expected Implementation Strategies for Measure
States and Territories will be expected to increase user charges over the next four years depending on the level of fee revenue they already collect. States and Territories will also be encouraged to adopt a National Fees Policy as recommended by the Efficiency and Effectiveness Review of HACC. The policy should address issues of multiple service use, the maximum level of payment by an individual for community care, equity in charging fees and ensuring fees are used to enhance the provision of community services.Intended Impacts of Measure
The development of a user charging policy for HACC will enable the real growth of the programme to be maintained while yielding efficiencies for Commonwealth and State governments. States and Territories which adopt a National Fees Policy will put in place protections for financially disadvantaged clients.Top of page
User Charges for Day Therapy Centres
Financial Implications
1996-97 $m | 1997-98 $m | 1998-99 $m | 1999-00 $m |
-1.0 | -2.0 | -2.0 | -2.1 |
Purpose of Measure
To increase the proportion of Day Therapy Centre costs funded by user charges.Expected Implementation Strategies for Measure
Funding for Day Therapy Centres will be reduced. Service providers will be encouraged to adopt a standard national system of user charging over the next four years which will include protections for the financially disadvantaged. This user charging will offset the reduction in Commonwealth funding.Intended Impacts of Measure
Day Therapy Centres currently adopt widely varying user charging policies and practices. Clients will be charged additional fees but will be protected by arrangements for the financially disadvantaged.Application of Efficiency Dividend to Commonwealth Own Purpose Outlays and Specific Purpose Payments of a Running Costs Nature
1996-97 $m | 1997-98 $m | 1998-99 $m | 1999-00 $m |
-0.02 | - | - | - |
Across-the-Board Reduction of 2% in Running Costs
1996-97 $m | 1997-98 $m | 1998-99 $m | 1999-00 $m |
-0.1 | -0.1 | -0.1 | -0.1 |
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