Changes in aged care and directions for community care in victoria
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Jane Herington PSM, Director Ageing and Aged Care 24 October 2012. Changes in Aged Care and Directions for Community Care in Victoria. Aspirations for older Victorians. Older Victorians: Make their own choices Are valued and respected Can take risks Connect with family and friends

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Changes in Aged Care and Directions for Community Care in Victoria

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Jane Herington PSM,

Director Ageing and Aged Care

24 October 2012

Changes in Aged Care and Directions for Community Care in Victoria

Aspirations for older Victorians

  • Older Victorians:

  • Make their own choices

  • Are valued and respected

  • Can take risks

  • Connect with family and friends

  • Are involved in their communities

  • Feel safe and comfortable

  • Are active

  • Get their health and care needs met

  • Have fun and enjoy life!

Victorian Directions and Plans

  • Victorian Health Priorities Framework 2012-2022

  • Final Report of the Parliamentary Inquiry into Opportunities for Participation for Victorian Seniors

  • Victorian Public Health and Wellbeing Plan 2011-15

  • Improving Hospital Care for Older People

  • Action Plan for Mental Health 2012-14

  • Victorian primary health care strategic directions

  • Victorian Charter: Supporting People in Care Relationships and Carers Recognition Bill

Strengths of Victoria’s health and aged care systems

  • Aged care and health services more integrated than elsewhere

  • Older people needing an aged care assessment get them more quickly than in other states, reducing the time they wait in hospital

  • Older people leaving hospital can access home nursing

  • Community care was delivered to close to 300,000 Victorians in 2011-12; more than in NSW.

  • Refocusing assessment, care planning and service delivery to a wellness promoting approach.

  • The foundational role of Local Councils as partners in:

    • planning and developing age friendly communities,

    • integrating responses and services to promote wellbeing and social connections

    • delivering community care services that maximise people’s function and independence

    • ensuring that diversity is not a barrier to access to services

Living Longer, Living Better announced in April 2012 - key features

Rebalance aged care services by building up community care at the expense of residential aged care

Impose consistency on means testing and individual contributions to cost of care regardless of setting

Eliminate the distinction between high and low care in residential settings

Introduce two additional funding points for packaged care

Consumer Directed Care

Consolidate HACC, NRCP, DTCs and ACHA into one Home Support Program

Reorganise entry into aged care services and assessment and introduce a single consolidated client record.

National Aged Care Changes

National Disability Reform

  • National Disability Insurance Scheme – a social insurance model

  • Funds allocated to individuals by Launch Transition Agency/National Disability Agency,

  • reasonable and necessary supports for an eligible person

  • Local area coordinators will facilitate planning and service access for those who need it

  • Trialled in 5 sites, including 4 LGAs in Barwon starting from 1 July 2013.

Themes from national changes in both disability services and aged care

  • Top level objectives

  • More efficient and more transparent resource use

  • Adequate resources in the right place to meet need

  • Doing more with resources already in the service system

  • Enabling people to have more choice and control over their care (Consumer Directed Care) and their lives

How will national objectives be achieved?

  • Investing more in community based services to change the balance of service delivery

  • Improving access and navigation through use of call centres and websites.

  • Streamlining assessment

  • A single view of the client – information collected once to be used many times

  • A wellness promoting and re-enabling approach to service delivery

Differences between NDIS and LLLB

  • NDIS

  • Clear commitment to changing the way resources are allocated to individual budgets:

    • Government → service provider in a block grant → person using services

  • To:

    • Government → central assessment and resource allocation agency (Launch Transition Agency/NDIA) → person using services → service providers of person’s choice.

  • This is already happening in Victoria to a certain extent – Individual Support Packages. A new method in other States.

  • Differences between NDIS and LLLB, contd

    • LLLB

    • Resources will continue to be allocated from government to services providers.

    • People to make a greater contribution to the costs of their care if they can afford it.

    • Income testing will be consistent and streamlined across all types of care regardless of setting.

    • Product led service response rather than person led service response, with overlay of Consumer Directed Care.

      • Eg new bands of packages A, B, C and D rather than resources allocated on basis of assessed needs; consolidated Home Support Program incorporating HACC, NRCP, DTCs and ACHA.

    What does this mean for Victoria?

    • Changes in Disability Services and Aged Care nationally raise issues for Victoria.

    • Changes to access arrangements through the implementation of the Commonwealth’s Gateway in Aged Care run the risk of moving Victoria backwards into a service led approach to responding to people’s care needs,

    • Introduction of new lower value band of packages ($7,500) has implications for the role of HACC services.

      • How will they work together?

      • How is the boundary defined?

    • Resources will move from HACC to the NDIS.

      • How much?

      • Will there be residual HACC services for people under 65 not eligible for NDIS but requiring assistance?

    Future Directions and Work - NDIS

    • Working closely with DHS on the development of the Barwon trial site for the NDIS.

    • Transition arrangements will need to protect viability of agencies delivering services to people who are likely to be covered by the NDIS.

    • Phasing in of coverage over a yet to be defined period.

    • Challenge of uncertainty as all elements of scheme are being developed simultaneously over a tight timeframe:

      • Policy

      • Legislation

      • Intergovernmental agreements

      • Administrative arrangements

      • ICT system and data collection

    Future Directions and Work – Aged Care

    • Align with national work program and developments 2012 - 15

      • Review of prices } in conjunction with

      • Review activity definitions} Commonwealth and Vic DTF

        • To embed ASM

      • Work with local councils to redesign community care worker roles in light of requirements of ASM

      • Seek to work with the Commonwealth on its approach to access to services to ensure that the strengths of the Victorian service system are built on.

      • Test scope for joint planning on a reciprocal basis with the Commonwealth across all aged care services by agreeing global parameters.

      • Commission ASM and Diversity evaluation

      • Health Literacy research project with Deakin University.

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