1999-2000
Outcome 6: Hearing Service
The 1999-2000 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.
To reduce the consequence of hearing loss for eligible clients and the incidence of hearing loss in the broader community
Outcome Summary - The Year Ahead
The Portfolio will achieve this outcome through purchasing high quality hearing services from a range of service providers, including Australian Hearing Services as the Government provider.
The Office of Hearing Services within the Department acts as Government purchaser and regulator, providing three main types of services:
- contestable hearing services for eligible consumers through a voucher system;
- client services provided to children under 21, eligible Aboriginal and Torres Strait Islander people, eligible clients with complex hearing rehabilitation needs and eligible clients who live in remote areas (Community Service Obligation clients); and
- research and other related services (as a Community Service Obligation).
Since November 1997 eligible clients (pensioner concession card holders, DVA Gold and White Repatriation card holders, Sickness Allowees, certain Commonwealth Rehabilitation Services clients and Defence Force personnel) have received hearing services under a voucher system. Under this system the Office of Hearing Services issues vouchers to eligible clients who can then choose from a range of some 125 accredited service providers, including Australian Hearing Services. To be accredited service providers must be professionally qualified and agree to a Code of Conduct and Clinical Standards designed to ensure that clients receive high quality care.
Hearing aids which can be fitted free to clients under the system must satisfy technical requirements laid down by the Government and clients have the choice of paying extra for hearing aids with additional features under "top-up" arrangements.
Payments to service providers are made through the Health Insurance Commission while the Department of Health and Aged Care (the Office of Hearing Services) monitors service quality and provides policy advice to Government. Centrelink is contracted by the Department to perform eligibility checks.
Certain categories of clients with special needs, including children under 21, are funded as a Community Service Obligation because of their special needs. The Office of Hearing Services pays Australian Hearing Services to provide these services.
In addition, the National Acoustic Laboratories (also funded as a Community Service Obligation) plays an important role in achieving the Program objective through ongoing research into hearing loss and with community education.
In 1999-2000 the main policy focus will be on addressing structural issues to improve the efficiency and effectiveness of service delivery, whilst the main operational focus will be on consolidating the voucher system with particular emphasis being placed on further refining quality assurance practices. This will include a greater emphasis on auditing service providers to ensure adherence to quality standards.
Significant effort will also be made to establish baseline information on the delivery of Community Service Obligations, in particular the extent to which the provision of services to children leads to ongoing benefits through enabling full participation in such activities as education. The establishment of contracts with Australian Hearing Services will enhance this monitoring and reporting regime.
Budget Measures Affecting Outcome 6
Better hearing services
Top of pageExpense ($m)
 | 1999-00 | 2000-01 | 2001-02 | 2002-03 |
| Department of Health and Aged Care | 50.5 | 51.1 | 52.5 | 54.2 |
| Department of Veterans' Affairs | 0.3 | 0.3 | 0.3 | 0.3 |
Total | 50.8 | 51.4 | 52.8 | 54.5 |
Explanation
The Government will ensure the demand for hearing services vouchers by eligible clients is met, by providing access to an additional 67,000 vouchers per annum over and above the 83,000 vouchers per annum currently provided for, and that contracted service providers continue to provide quality services. This measure also includes additional funding to ensure that community service obligations are met, particularly in relation to services to children.
In addition the measure includes the indexation of the maintenance charge (which service providers collect from clients) in line with Consumer Price Index movements. It will also introduce a new client charge for replacing lost or damaged hearing aids, and will encourage greater prescription of Assistive Listening Devices in preference to hearing aids where this will provide appropriate outcomes for the client.
Performance Information and Resource Allocation
The following indicators are designed to measure how effectively the outcome is being achieved:
| Indicator 1: | Improved communication ability for individuals with a hearing impairment. |
| Target: | Maintain the effectiveness of the hearing devices and level of hearing device usage(37% more than 8 hours a day, 28% five to eight hours a day, 29% 1 to 4 hours a day). |
| Info source/rept freq: | Survey data/Annual. |
| Indicator 2: | Take up of hearing habilitation and rehabilitation services in the community. |
| Target: | Increase in the issue of hearing services vouchers in line with changes to the demographics of the ageing population. |
| Info source/rept freq: | Departmental and ABS data/Annual. |
| Indicator3: | Improved participation in education and the community by children with a hearing impairment. |
| Target: | Establish baseline survey data in 1999/00. |
| Info source/rept freq: | Survey data/Annual. |
| Indicator 4: | Optimal clinical outcomes for clients through the regulatory controls on enforcement of quality assurance in service provision by hearing service providers. |
| Target: | 100% of service providers adhere to Clinical Standards and Rules of Conduct prescribed in service provider contracts. |
| Info source/rept freq: | Departmental information systems/Ongoing. |
| Indicator 5: | Proportions of special needs groups (including Aboriginal and Torres Strait Islander peoples) receiving hearing assistance. |
| Target: | Maintain level of special needs groups receiving hearing assistance as a proportion of total number of program clients. |
| Info source/rept freq: | OHS and AHS data bases/Quarterly. |
| Indicator 6: | National Acoustic Laboratories research contributes to improved habilitation and rehabilitation outcomes for hearing impaired people and to community health. |
| Target: | All research results are relevant and available to the community, service providers and manufacturers of hearing products. |
| Info source/rept freq: | Feedback from hearing service delivery and manufacturing industry, hearing impaired people and overseas/Annual. |
Resource Allocation
The allocation of resources for Outcome 6 is described in the following two Tables:
- Table C6.1 describes the relationship between the appropriation structure for Outcome 1 and the 1998-99 appropriation structure; and
- Table C6.2 sets out the allocation of resources across administered items and output groups for the Department for Outcome 6.
Table C6.1: Relationship between old appropriation structure and new Outcome structure for Outcome 6
| Outcome | Program |
| 6. Reduced consequences of hearing loss for eligible Australians and a reduced incidence of hearing loss in the broader community. | 4.5 Hearing Services |
| Appropriations
Department Appropriation Bill 1 Departmental outputs Administered expenses
| Appropriations
Appropriation Bill 1 Hearing Services - payments for contestable services through a voucher system (340.2.15) Hearing Services - payments for community service obligations (340.2.16) Running Costs, including Section 31 receipts (340.1) (p) Other Appropriation Bill 1 Compensation and legal expenses (340.2.01) (p) |
Table C6.2: Resource summary for Outcome 6
Contribution of Administered Items and Departmental Outputs to Outcome 6
Top of pageThe Government has committed $143m in administered funds to achieve this outcome.
The $116m provided for the Voucher System funds the provision of around 130,000 hearing rehabilitation programs for hearing impaired Australians and hearing device maintenance for a further 210,000 clients. Of the $26m provided for the delivery of Community Service Obligations some $18.3m funds the provision of hearing rehabilitation to children under 21, $5.2m funds services to eligible Aboriginal and Torres Strait Islander people, eligible clients with complex rehabilitation needs and eligible clients in remote areas, and $ 2.5m funds the National Acoustics Laboratories to undertake research and development activities relating to hearing impairment, hearing rehabilitation and the harmful impact of noise.
The Department will provide contract administration and funds management services with special emphasis on ensuring quality service delivery. The Department will also continue to provide specific information to eligible clients as a direct service to clients.
To ensure that allocated funding is spent effectively, the Department will provide policy advice to Ministers on ways to further improve efficiencies and on longer term reform to hearing services.
The following performance information provides a comprehensive overview of the administered items and departmental outputs together with performance measures for these items and outputs.
Table C6.3: Performance Information for Administered Items
1. Provision of services for contestable clients, including:
| Quality: The extent to which client satisfaction levels with hearing services are maintained or improved compared to the last survey (i.e. 91% very satisfied or satisfied).
Quantity: All eligible clients who apply for a voucher receive one (estimated at 140,000 - 150,000 vouchers per year). Efficiency: Maintain or reduce the existing average unit cost per voucher ($735 as at 1 July 1999). |
2. Provision of Community Service Obligations:
| Quality: Proportion of complaints does not exceed current levels and clients are seen within a timely period (baseline data to be established).
Quantity: The number of services delivered to match or exceed present levels (baseline data to be established). Efficiency: Existing average cost per unit of service to be maintained or reduced (baseline data to be established). Quality: Complete approved projects to a high standard within cost and schedule. Quantity: Number of papers accepted for publication in peer-reviewed journals to be maintained at or exceed current level (25 to 35 papers). |
Table C6.4: Performance Information for Departmental Outputs
1. Policy advice to the Ministers and Governmentin relation to:
| Quality: A high level of satisfaction of the Minister with the relevance, quality and timeliness of policy advice provided.
Quantity: Policy, research and advice service commensurate with the funds allocated. Price: $0.494m. |
| 2. Services to the Ministers and Parliament. | Quality:A high level of satisfaction of the Ministers and Parliament with the relevance, quality and timeliness of services provided.
Agreed timeframes met for responses to ministerial correspondence, Question Time Briefs, Parliamentary Questions on Notice and ministerial requests for briefings. Quantity: Number of responses to ministerial correspondence, Question Time Briefs, Parliamentary Questions on Notice and ministerial requests for briefing will be recorded in 1999-00 and used as a benchmark. Price: $0.351m. |
| 4. Information and education services on program eligibility and hearing services for clients and referrers (usually GPs), and on contract requirements and claiming procedures for hearing service providers. | Quality: A high level of satisfaction with the relevance, quality and timeliness of information provision and education services.
Quantity:Bulletins provided to service providers at least on a quarterly basis. Price: $0.565m. |
5. Contract administration and funds management, including:
| <em>]Quality: All providers adhere to the terms and conditions of the Service Provider Contract.
Projections of administered and Departmental expenditure are made on a monthly basis to ensure sufficient funds are available to meet program commitments. Budget projections are met and actual administered expenditure varies by less than 10% of estimates, and departmental expenditure monies by no more than ±2% of estimates. 100% of payments to service providers are made within the Commonwealth payment guidelines in service provider contracts. Quantity: Minimum of 37 site audits conducted by Office of Hearing Services within the Contract period. Minimum of two providers reviewed each month using the Client Record Management Review process. 120-130 provider contracts serviced. Price: $2.834m. |
6. Regulatory activity - conduct of audits to ensure compliance with:
| Quality: New devices are evaluated by the Department against quality standards that have been agreed with industry.
All applicants for a Hearing Services Voucher have eligibility checked through Centrelink. All providers comply with Rules of Conduct and Clinical Standards. Evaluation of new devices completed within 6 weeks subject to information being provided by manufacturers in a timely manner. Decisions made within legislated timeframe where applicable. Quantity: 20 to 30 devices per year evaluated subject to number of requests for approval by manufacturers. Quality: A high level of compliance with the elements of the Government's regulation reform agenda, and their particular reporting requirements. Price: $0.922m. |
7. Direct Delivery of Services, including:
| Quality: Consumer and service provider satisfaction with the quality of information provided through the Client Services Hotline and correspondence as measured through focus groups, consumer survey and consumer/provider feedback.
All vouchers to be issued within 14 days of receipt of application. Quantity: 200 to 300 enquiries dealt with per week by the Office of Hearing Services. Price: $1.334m. |
Performance Assessment: Evaluations and Reviews
No major evaluations or reviews are planned for this outcome in 1999-2000.
