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CONTENTS
1.
Key Principles
2.
Executive Summary
3.
Introduction to the NSW Community Care
Coalition
4.
Overview of Community Care in NSW
5.
Fact Sheet - Issues for Carers
6.
Fact Sheet - Dementia and Alzheimer's
Disease
7.
Fact Sheet - Workforce and Volunteer
Issues
8.
Fact Sheet - Issues for People with a
Disability
9.
Case Studies
10.
What Needs to be Done?
11.
Press Releases
1. KEY
PRINCIPLES
Community care means caring
for older people and those with disabilities in their own
homes, providing cleaning services, delivered meals,
personal care, nursing and health care and respite care.
The NSW Community Care
Coalition believes that
- older people and people with
disabilities should be supported so they are able to
remain living in their homes.
- Community care services should
be available where people live.
- The community care system
should support people to navigate transition points
between health, residential aged care and disability
support services.
- The community care system
should support the role of carers who are often
families and friends.
- The community care system must
maximise social capital through supporting volunteers
and building communities.
- Demand for community care
exceeds supply and there is a critical need for
additional resources.
- The community care system is
overly complex, difficult to navigate and needs to be
streamlined.
- Community care services are
choking on excessive administrative and regulatory
requirements.
By 2006, more than 1.3 million
Australians will have a severe or profound disability,
with most preferring to receive care where they chose to
live. It is critically important that people continue to
have the choice to live at home in their community
amongst friends and family, rather than being forced into
institutions.
This Community Care Week of Action
is a first step towards raising awareness and mobilising
public opinion at a local level regarding the importance
of community care. Community care is the most
economically efficient and socially effective model. It
improves people's lives and prevents premature admissions
to residential care facilities. It is the way of the
future.
2.
EXECUTIVE SUMMARY
The importance of the
contribution made to the well being and independent
living capability of older people and people with a
disability by community care in NSW is not well
understood in the broader community.
Community care services are in need
of substantial additional attention and
resources.
The arguments for why community
care is important are indeed compelling because today,
many more people who need assistance with day to day
living receive support at home from community care
services than in residential care settings.
Community care is care delivered to
older people and people with a disability, in their own
home instead of in an institution (otherwise known as
residential care). As the name implies, care at home
often involves volunteers from the community and carers
in addition to paid staff.
Some Key Facts
- In Australia in 2001, 775,500
older people needed help or had difficulty with a core
activity task.
- In 1998 nearly 2.5 million
people aged under 65 had a disability.
- Of these, 655,000 people needed
ongoing assistance with daily living.
However, community care services
must be able to support people when and where that
support is needed. Failure to provide sufficient support
when needed can result in:
- Deterioration in health and
reduced quality of life for older people, people with
disabilities
- Isolation of older people and
people with disabilities
- Carers suffering from stress
and poor quality of life
- Increased costs for governments
through increased demand on the public hospital and
residential care systems.
For the last two decades, the NSW
Government and the Australian Government have pursued
policies that encourage caring for people in the
community, rather than in hospitals, nursing homes or
other institutions.
The community has supported such
policies because the majority of Australians needing
assistance, prefer to be able to live in their own homes,
within their own communities where possible. However,
current community care services cannot meet existing
demand.
Most services cannot even meet the
needs of their existing clients let alone the daily
addition of new people who require support.
Some Key Facts
- 2.5 million Australians are
providing care for family or friends with a
disability, mental illness, chronic condition or older
people. This represents one in every five households.
- 54% of carers said that they
provided care either because alternative care is
unavailable or too costly, or because they consider
they have no choice.
- The 1998 ABS Survey of
Disability, Ageing and Carers reported that only 40%
of people of all ages with a major disability who live
independently and need assistance, felt their needs
were only partly being met.
- The average waiting time for
Community Aged Care Packages is 18 weeks.
Resourcing, both financial and
human, for these rapidly growing needs is falling behind
the current demand. Additional resources must be found,
along with more effective ways of using current
resources.
Community care is funded and
administered by Australian & State Governments. Each
level of Government has created a range of different
community programs and aged and community care services
are choking on excessive administrative and regulatory
requirements.
Differences in levels of resources
exist between regions in NSW especially between
metropolitan and rural and remote areas. Access to
services should not be dependent on where a person lives.
Costs of providing services are often higher in rural and
remote areas.
More resources should be directed
at providing support such as meals on wheels, domestic
assistance and personal care assistance, and less into
sometimes complex and burdensome accountability
mechanisms.
The level of care provided under
these services is embarrassingly inadequate. At least
60,000 older Australians with very high care needs were
assessed by Aged Care Assessment Teams in 2001-2002 as
needing more care than they were receiving.
Some Key Facts
- The average amount of domestic
assistance received by 45,000 NSW Home and Community
Care (HACC) clients last year was just 45 minutes per
week - just enough time to help with one load of
laundry per week and perhaps a quick
vacuum
- The 15,000 NSW HACC clients
receiving personal care received on average just 100
minutes of assistance per week - not even enough time
for them to be showered each day.
We as a community tend to rely on
the goodwill of the community, families and friends to
provide ongoing care often with insufficient financial
assistance.
But the community is also ageing.
The volunteer workforce is ageing. The paid workforce is
ageing. Who will be left to look after those who
currently provide care?
What are the
Solutions?
In the lead up to the next Federal
election, aged and community care providers, carers and
consumers from all over the nation are calling on all
political parties to commit to addressing the challenge
to assist some of our nation's most vulnerable people
by:
- Providing a one off increase of
20% for the Home and Community Care (HACC) program
each year for three years
- Indexing funding
realistically
- Thereafter, increasing HACC
funding by at least 6% growth per annum plus
indexation
- Increasing funding for the
Assistance with Care and Housing for the Aged (ACHA)
program to support homeless older people or those in
insecure housing
- Providing greater recognition
of transitional care through extension and
mainstreaming of successful pilot programs
- Reducing cost and burden of
administrative red tape
- Ensuring there is a flexible
and growing workforce able to deliver community care
services by improving pay for aged care nurses and
personal care workers in the community care sector.
3.
INTRODUCTION TO COMMUNITY CARE COALITION
What is the Community
Care Coalition?
A peak national organisation formed
by a significant number of community care providers
throughout Australia, with each State having a
representative body. Our activities are funded in part by
the generosity of the Myer Foundation.
In NSW, our members
include
- ACROD NSW Division
- Aged and Community Services
Association (ACS) NSW & ACT
- Alzheimer's Australia
NSW
- Australian Association of
Gerontology, NSW Division
- Australian Council of Community
Nursing Services
- Carers NSW
- Catholic Welfare
Australia
- Catholic Health
Australia
- Council on the Ageing (COTA)
NSW
- Community Transport
Organisation
- Chronic Illness
Alliance
- Council of Social Service of
NSW (NCOSS)
- Ethnic Communities' Council of
NSW
- HACC Development Officers
Network of NSW
- Multicultural Disability
Advocacy Association of NSW (MDDA)
- NSW Community
Options
- NSW Council for Intellectual
Disability
- NSW Mental Health Co-ordinating
Council
- NSW Meals on Wheels
Association
- Paraquad
- People with Disabilities
Australia
- Physical Disability Council of
NSW (PDC)
Our primary aims
are
- to raise awareness about the
importance of community care to the diverse range of
people who need its services
- to highlight the implications
of the current drastic shortage of funding in
community care
- highlight the need for reform
of the community care system to reduce complexity and
fragmentation and increase accessibility
What is Community
Care?
Community care now and in the
future should provide support services that will enable
older people, people with disabilities and their carers
to stay in their own communities.
- Most older people and younger
people with disabilities who require care prefer to
live in their own home.
- For two decades governments
have encouraged living at home instead of moving to
residential care.
- However the community care
system in Australia is not meeting all of the needs of
Australians who require it. There are inadequate
levels of service provision; it is fragmented,
services are often difficult to access and are
unevenly distributed across the country.
The provision of care by families,
friends and by community care services is essential to
help people to live in their own homes, but existing
funding and programs do not permit such provision to
occur effectively.
The attached Fact Sheets outline
key issues facing community care in New South
Wales.
Why is Community Care
Important?
More people receive support at home
through community care services, both formal and
informal, than in residential care settings. Community
care services must be able to support people when and
where that support is needed.
Failure to provide sufficient
support when needed can result in
- Deterioration in health,
greater isolation and reduced quality of life for
older and people with disabilities
- Increased stress and poor
quality of life for carers
- Increased costs for governments
through increased demand on the public hospital and
residential care systems.
Key challenges that must be
addressed NOW are
- Ensuring availability and
access to support
- Address funding inadequacies as
costs are rising faster than our income
- Attracting and retaining
appropriately skilled staff
- Reducing excessive, costly and
time consuming regulatory and administrative
requirements
4.OVERVIEW OF
COMMUNITY CARE
Community Care
Now
- The Home and Community Care
(HACC) program in NSW provides services for up to
175,000 people. Over 80% of HACC clients in NSW are
aged 65 years and over.
- In NSW and the ACT, a recent
survey found more than 20,000 people waiting for
residential aged care places and 1,700 waiting for
Community Aged Care Packages.
- 25% of households with people
over 65 years report unmet needs (eg. personal care,
transport, housework, meals and home maintenance)
- On average people in NSW
receive 3/4 of an hour a week of domestic help and
just over 1 ½ hours a week of personal care , but
needs are much greater.
Community care is significantly
impacted by other government policies and services. For
example, initiatives to reduce length of stay in
hospitals have resulted in increased demand for in-home
community care services to support older people, people
with disabilities and their carers without additional
resources. Many carers, families and services are
required to meet greater responsibilities, including
management of more complex care situations and transport
to medical treatments and appointments.
People who have more difficulty
accessing services include
- Aboriginal and Torres Strait
Islander people
- People with
disabilities
- People with
dementia
- People from culturally and
linguistically diverse backgrounds
- Older people in rural and
remote communities
- Homeless people
Funding for Community
Care
Demand for community care will
continue to grow. The Federal Minister's Strategy
estimates that, based on current service use patterns,
the number of people across all age groups who rely on
community care services will rise from approximately
650,000 people in 2002 to nearly 970,000 people in 2019.
Therefore, community care funding
must be increased to meet increasing demand. To function
effectively, the community care system must be
appropriately resourced. Modelling undertaken as part of
the Myer Foundation Report suggests that the cost of
providing aged care could rise by almost 60% by 2020
.
Funding for community care has
increased in recent years, however funding has not been
adequately indexed which means that it is actually
continuing to fall behind the real cost of providing
care. In addition, there are still not enough funds to
even meet current demand, let alone the anticipated
growth in the coming years. There is a lot that
government can do to better ensure ongoing provision of
compassionate and appropriate care to Australians in
need.
Key issues in Community Care
funding
1. restructure and
streamline the number of programs and their reporting
requirements to ensure maximum effectiveness of already
available resources;
2. increase funding to meet
growing demand and increasing complexity of consumers'
and carers' needs.
Both of these issues must be
addressed to make an acceptable level of care available
to all people who need support in NSW.
Community Care in the Future
- By 2006, estimates are that 1.3
million Australians will have a severe or profound
disability.
- Australia's population is
ageing - in number terms, people 65 plus will increase
from 2.4 million now, to 4.2 million by
2021.
How will a system that already is
unable to meet existing demand cope with these
significant population increases?
Availability of and access to a
proper standard of community care is essential to people
choosing to live safely in their own communities and
aligns with government policy.
Community care services must be
able to respond appropriately to
- People of Culturally and
Linguistically Diverse Backgrounds
- Aboriginal and Torres Strait
Islander People
- People in rural and remote
areas
- Homeless people
- People with dementia
- People with a
disability
- Older people
- Carers
5. FACT SHEET
- ISSUES FOR CARERS IN NSW
(WHO CARES FOR THE
CARERS?)
Why are Carers So
Important?
- There are approximately one
million carers in NSW.
- Carers save the NSW economy at
least 5.4 billion dollars annually.
- It has been estimated that 74%
of all care needs in the community are provided by
carers. Therefore, family carers are the mainstay of
the community care and health systems.
- More than two thirds of carers
have provided care for over five years. They do
substantially more domestic work than non-carers, as
well as providing emotional support.
- In NSW, 67% of Primary Carers
are 45+ years of age. With an ageing population and
carers passing retirement age, we are facing a Carers'
crisis.
Why do Carers need
Support?
- Carers have lower incomes than
the average weekly wage. They also face higher medical
and other expenses.
- The stress and pressures
associated with caring can have an adverse impact on
many carers' physical, mental and emotional health
with heightened incidence of high blood pressure,
heart problems and exhaustion.
- When carers are not adequately
supported relationships and families can break down,
resulting in more expensive residential care options
being used permanently.
- ABS data shows the number of
hours per week that caring tasks consume.
Of all carers aged 15 or over
living with the care recipient
- 17% spend 20-39 hours per week
caring; and
- 44% spend 40+ hours per week
caring.
What Kind of Support is
Required?
- More respite support that is
accessible both geographically and financially is
required to give carers a break whilst ensuring those
they care for are safe and well during the respite
period.
- Information services that are
easily accessible and up to date are necessary to
ensure carers know what services are available and how
to use them.
- Improved income support for
carers is vital. Many must manage on around half the
average weekly wage, and also often must cover high
medical costs.
- Counselling services are
essential to provide emotional and psychological
support to carers.
6. FACT SHEET
- DEMENTIA AND ALZHEIMER'S
Who cares for People
with Dementia and Alzheimer's Disease?
- In Australia, there are
currently 176,000 people with dementia, the majority
of which is caused by Alzheimer's disease.
- Most people with dementia are
cared for by family, friends and community care
services.
- More than 80% of people living
in residential aged care have dementia but only 6% of
residential care places are dementia specific. It must
be increased to at least 15% immediately.
- Australians over 85 years have
a one in four chance of developing dementia.
- It is estimated that up to 20%
of Home and Community Care (HACC) clients have
dementia.
- There is a chronic shortage of
respite and emergency care facilities for unpaid
dedicated carers who are often "on-call" 24/7 with
little or no relief.
- Community and family carers
provide 75% of the care required by people with
dementia - not institutions.
What does the Future
Hold?
- In just over a decade - by 2016
- dementia will be causing the highest disease weight
- ahead of cancer and cardio-vascular
disease.
- It has been estimated that if
we can delay the onset of dementia by just 5 years,
this will halve the number of sufferers.
- Yet, there is a dramatically
inadequate funding focus on prevention or risk
reduction - less than 1% of the total cost of dementia
care is spent on research.
- The number of people aged 65+
is now 12% of the population and by 2050, people aged
65+ will more than double to be more than a quarter of
the population. It is this age group that is most
likely to develop dementia.
7. FACT SHEET
- WORKFORCE AND VOLUNTEER ISSUES
Key Workforce
Issues
- In 2001, there were 237,055
people employed in community services. 87% of workers
in community services were female and 51% of these
people worked part time.
- In 2001 nationally there were
1228 people employed in community services per 100,000
of population. NSW is well below the national average
with 1,077 people per 100,000 population employed in
community services.
- The community services sector
has difficulty in attracting and retaining staff
across all levels. A large majority of workers have no
formal qualifications.
- For the same work, wage rates
for public hospital employees are significantly higher
than employees in the community care
sector.
- Unmet and burgeoning demand for
community care contributes to unreasonable workload
pressures
Key Volunteer
Issues
- A 2002 survey of Home and
Community Care services in NSW found 26,213 volunteers
working for 399 services (based on a return rate of
66% of all NSW HACC services excluding State
Government services).
- This represented about 1.8
million hours of volunteer labour per annum in the 399
services.
- Food services
(meals-on-wheels), respite care, transport and social
support make up about three quarters of the volunteer
hours.
- Many volunteers working in
community care services are ageing.
- Rates of people volunteering on
a regular and ongoing basis are declining. People are
volunteering for one-off events rather than on a
regular basis. This has a serious impact on community
care services that rely heavily on volunteers to
deliver services to older people, people with
disabilities and their carers in NSW.
Australia as a whole has an ageing
workforce. We also have an ageing population. What is the
Government's solution to older people and people with
disabilities requiring care, and fewer working age people
to offer it? Action is required NOW.
With an increasing number of people
requiring community care support and a smaller pool from
which to draw the workforce, a crisis is unavoidable
unless governments act.
- 57% of all aged and community
care workers are older than 45 years of age - higher
than the Australian average for all workers. Without
government action, the system will be in crisis when
these workers are at retirement age
themselves.
Working Conditions
- Personal carers working in the
community operate in relative isolation and face
additional Occupational Health and Safety challenges
as their workplace is an individual's
home.
- The majority of the community
care workforce work directly with clients. Despite
this, they are relatively lowly paid, work on a part
time or casual basis and don't get access to training
or formal qualifications.
The impact of low pay, part-time
casual employment and the isolation of their work make it
difficult to attract, train and retain
workers.
Rural and Remote Services
- Workforce issues are even more
acute in rural and remote Australia. Providers have
difficulty finding any professional staff, struggle to
access professional development or formal training for
their staff, and do not have funds to purchase
training from far afield.
- The number of people employed
per 100,000 population declines in rural and remote
areas, and in most areas is well below the national
average.
8. FACT SHEET
- ISSUES FOR PEOPLE WITH A DISABILITY IN NSW
KEY
ISSUES
- In 1998, one in five people in
NSW (1.2 million people) or 19% of the population have
a disability.
- It has been estimated that 79%
of people with disabilities (969,800 people) required
assistance in order to live in the community.
- The proportion of people with
disabilities in NSW is increasing. In 1988, 16% of
people in NSW had a disability and this has increased
to 19% in 1998.
- People with disabilities are
ageing. Between 2000 and 2006, it has been estimated
that those aged under 65 years will increase by 9%,
those aged 15- 64 by 12% and the group aged 45-64
years will increase by 19.3% to 59,500 people .
- It is increasingly difficult
for people with disabilities to access the community
care services they need to live in the community. 87%
of people with disabilities in NSW reported that the
majority of support is provided by family, friends and
partners
- Inflexible program guidelines
and inadequate community care services make it
difficult for people with disabilities who are ageing
to access the services they need.
- People with disabilities
accessing the Home and Community Care (HACC) program
often require a higher level of services to live in
their communities. Many people with disabilities have
great difficulty in getting services they need
particularly personal care services.
9. CASE
STUDIES
These case studies are based
on actual situations and all names have been changed to
protect the privacy of the individuals involved.
The below two case studies
demonstrate how many families do want to care for their
loved ones but also, how they need support to do this.
Mrs Bongiorno would be in residential care without
Theresa's unpaid care and the assistance of other
services. Young Ben has only been able to continue to
cope with the help of the complex nursing care given to
him and his mother by home nursing staff. Both these
stories highlight the capacity of community care services
to support people to remain living independently at home
and participating in their local community. This is
community care at its best - unfortunately this is not
the case for many current consumers and carers as well as
those who need support but are unable to access
it.
Mrs
Bongiorno
- 83-years old
and lives with her unmarried daughter (Theresa).
- Suffered a
major stroke and spent 3 months in
hospital
- The stroke
severely affected her speech and balance and relies
on tube feeding. Assessed as requiring high-level
residential care.
- Theresa was
very keen to care for her at home. The nursing and
physiotherapy staff trained Theresa how to care for
her mother.
- Her local
doctor visits regularly as does Mrs Bongiorno's
married son.
- Mrs
Bongiorno spends most of the day in bed. She has
limited speech and high personal care needs.
- Home nurses
come for half an hour, 3 times a week to help with
showering and skin care, and home respite care is
provided every Tuesday morning.
- Mrs
Bongiorno is on the waiting list for a Community
Aged Care Package which would offer funds to buy in
additional services. She is worried that it will be
months before a "place comes up".
Ben Dobson
and his family
- Nine years
old
- Ben was born
with haemophilia, a disease where blood fails to
clot - a serious painful illness.
- Ben and his
mother, Leonie, contend with a strict regime of
constant medication including frequent injections.
Regular visits to hospital were normal.
- Administering
Ben's medication meant Ben would need injections
but Mrs Dobson has an overwhelming fear of
needles.
- Nursing care
was needed to help with the medication. Andrea,
Ben's nurse, had to come three times a week to do
it.
- Andrea has
also been educating Mrs Dobson on how to give the
injections herself.
- Now, Ben and
his family are becoming more independent each day
in managing Ben's care. The family's life and
routine is much less dependent on visits from
Andrea, or disrupted by the once frequent trips to
hospital.
- "The
district nursing service has changed our lives,"
says a happy and grateful Mrs Dobson. "Andrea's
visits and help with the needles have meant that
Ben does not have to attend hospital for treatment
can do the things he enjoys like playing
footy."
The case study below highlights
both how much community care is valued by Mr and Mrs
Harris and that it is an alternative to residential care.
But Mrs Harris, as the primary carer needs much more
support from formal services. For example, most
Australians would agree that having a shower and shave
only twice a week is not enough. And yet this is all Mr
Harris can get until another "package of care services"
becomes available. Community care service providers are
stretched to the limit and rarely have the funds or
staffing capacity to immediately provide the range and
levels of care they assess are required.
Mr and
Mrs Harris
- Peter is 86
and has dementia and poor balance.
- The Aged
Care Assessment Team assessed him as being suitable
for high-level care in a nursing home. Mrs Harris
however, was keen to support him at home as she did
not want "to put him in a nursing home."
- Arrangements
were made for the local service to send a personal
carer twice a week to give Peter a shower and a
shave.
- Mrs Harris
says "He can help me a bit with the dishes and in
the garden and he likes to play with his dog and
take him for a short walk". "The day centre has
referred us to another service because Peter is
'too high care' so we are waiting for a package of
care services which includes a case manager".
- Mrs Harris
says "But I have no regrets. Peter and I have been
married for 59 years and we have been together in
this house since 1954. I want us to stay together
for as long as I can manage."
Mr Brown's experience of having
numerous assessments and changes of service providers is
not unusual. Mr Brown's story highlights the lack of
integration between these service systems.
As a result of different government
funding and the restrictions for individual programs, he
has had three different home care providers. This is
inefficient, costly and most of all, very upsetting for
people using the services.
Mr
Brown
- Mr Bown is
74 and a widower and lives alone in his
unit.
- He is a DVA
(Department of Veterans' Affairs) gold cardholder,
with a medical history of insulin dependent
diabetes and osteoarthritis.
- The
Commonwealth Veterans Home Care program offered him
1 hour of home care per fortnight. They also advise
that he should go back to a local Home and
Community Care (HACC) service as he is likely to
receive higher service levels!
- HACC staff
assess Mr Brown and finally two weeks later,
services are implemented.
- He is very
happy to receive 1.5 hours of home care per week
including domestic, laundry and shopping
assistance. Mr Brown is referred to the DVA
Rehabilitation Appliance Program where an
Occupational Therapist recommends grab-rails and
step modifications for his bathroom and a
physiotherapist recommends a walking aid, but then
he has to deal with someone else to get the
installation done.
- Then Mr
Brown breaks his leg and on discharge from
hospital, he receives "Post Acute Care" (funded by
the State) which provides home care and personal
care.
- Even though
the care provided is the same as his local service
provider, he has to receive it from a different
organisation because of funding arrangements. This
means that instead of knowing the staff well and
seeing familiar faces at this very difficult time
he has a totally new organisation and staff.
- After Mr
Brown has received the maximum 4 weeks of
post-acute care, he returns to the local service
for home care.
- Mr Brown's
deteriorating health prompts a review of his care
plan resulting in further increases in home and
personal care. These increased needs trigger a
referral for a Community Aged Care Package (CACP).
It is really confusing for Mr Brown which service
he should use and there is a 3- 6 month wait for
services.
- The process
requires Mr Brown being assessed by the Aged Care
Assessment Team. He is subjected to further
assessment by each individual agency who might
provide the CACP.
- Months go by
before he is accepted for a CACP.
- However, the
agency providing the CACP uses different staff and
Mr Bown has yet another change of service provider
and care staff at a time when he is most
vulnerable.
10. WHAT MUST BE
DONE?
In the lead up to the next
Federal election, aged and community care providers from
all over the nation are calling on all political parties
to commit to addressing the challenges service providers
face in assisting some of our nation's most vulnerable
people.
The issues are clear, the need to
address them paramount and the solutions sensible,
logical and practical.
The Federal Government
must
- Provide a one off increase of
20% for the Home and Community Care program each year
for three years. (Approximate Cost: $50m Federal/$33m
State)
- Thereafter, increase HACC
funding by at least 6% growth per annum plus
indexation
- Increase funding for the
Assistance with Care and Housing for the Aged (ACHA)
program to support homeless older people or those in
insecure housing ($3 million approx)
- Provide greater recognition of
transitional care through extension and mainstreaming
of successful pilot programs.
To reduce the cost and burden
of administrative red tape, State and Australian
governments must
- Introduce one set of standards
and reporting requirements for community care
programs.
- Progress community care reform
through a detailed implementation plan.
Workforce Adequacy
Issues
- Ensure that there is a flexible
and growing workforce able to deliver community care
services.
- Co-ordination of efforts of
State, Commonwealth and Industry - leading to the
development of an industry wide (aged and community
care) workforce plan is urgently required.
The current National Aged Care
Workforce Strategy effort needs to be continued
and
- reflect the changing nature of
the workforce with less availability of nurses
requiring more strategic use of their time
- deal with community care
workforce demands and issues
- expand the availability of
traineeships for personal care workers
- develop innovative approaches
to promoting aged care careers, particularly among
young people
- address a number of, mainly
State-based, regulatory barriers to the efficient and
flexible deployment of existing staff which inhibit
the provision of safe, economical and genuinely
person-centred care.
A long term solution (tied to the
ongoing funding of services) to improve the pay for aged
care nurses and personal care workers in the community
care sector must be found.
11. PRESS
RELEASES
Government Must Commit
to Community Care
In the lead up to the next Federal
election, aged and community care providers from all over
the nation are calling on all political parties to commit
to addressing the challenges providers face in assisting
some of our nation's most vulnerable people.
Community care matters. In
2002/2003, 28% of older people aged 70 plus use community
care services. Community care is vital to support carers,
older and people with disabilities to remain in their
communities.
The issues are clear. The need to
address them paramount. And the solutions sensible,
logical and practical. The Federal Government
must
- Provide a one off increase of
20% for the Home and Community Care program each year
for three years. (Approximate Cost: $50m Federal/$33m
State)
- Thereafter, increase HACC
funding by at least 6% growth per annum plus
indexation
- Increase funding for the
Assistance with Care and Housing (ACHA) program to
support homeless older people or those in insecure
housing ($3 million approx)
- Provide greater recognition of
transitional care through extension and mainstreaming
of successful pilot programs and changes
- Work with state and territory
governments to implement community care
reform
Since the early 1990s community
care services have experienced costs rising faster than
income. Providers have managed the impact of this as best
they can by restructuring, cost cutting and improving
productivity within the constraints of Government
regulation and policy. There is no significant scope for
further productivity gains.
Paul Sadler, Chief Executive
Officer, Aged and Community Services Association of NSW
& ACT said
"Inadequate indexation
will continue to be a major problem even if one-off
increases are provided. As a result of inadequate
indexation methods, the Federal Government has
effectively taken $120m funding from Home and
Community Care since 1996/97."
No service provider can continue
operating if its costs rise faster than its income.
Further
information
Gary Moore,
Director, Council of Social Services of NSW
(NCOSS), ph 02-9211 2599 or 0407 567 408 (m) OR Paul
Sadler, Aged and Community Services Association of NSW
& ACT (ACS), ph 02-9799 0900 or (m) 0438218003
The NSW Community Care Coalition
consists of 22 consumer and service provider peak
organisations working across community care in
NSW.
Older People and People with
Disabilities in NSW are Missing Out
Every day people with
disabilities, older people and their carers in NSW miss
out on getting the services they need. Demand for
community care exceeds supply. The community care system
is complex and difficult for people, to navigate.
1 in 5 people (19 % of the
population) in NSW have a disability. There are 1 million
carers who save the NSW economy an estimated 5.4 billion
dollars annually. In 1998, 25% of older people aged 65
plus reported there needs were not being met.
In the lead up to the Federal
election, the NSW Community Care Coalition calls on all
political parties to increase funding for community care
services. The Federal government must work with state and
territory governments to make the system easier to
navigate.
The buck-passing between State and
Federal Governments must stop about who will deliver
services and who will fund it. "The complexity and
inaccessibility of many services to those in need
increases cost and inefficiencies in these critical
services", said Gary Moore, Director, Council of Social
Service of NSW (NCOSS).
"Because of the manner
in which community care programs for older people and
people with a disability and their carers are
structured and funded, community care workers are
every day put in the position of having to decide that
one person in need just isn't desperate enough yet. No
individual should be put in that position".
For further information
contact
Gary Moore, Director,
Council of Social Services of NSW (NCOSS), ph 02-9211
2599 or 0407 567 408 (m)
Paul Sadler, Aged and Community
Services Association of NSW & ACT (ACS) Ph:
02-9799 0900 (m) 0438 218 003
The NSW Community Care Coalition
consists of 22 consumer and service provider peak
organisations working across community care in
NSW.
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