__Horne care

• 87074362
services
Sheila Rimmer AM

In 1985, legislation Certainly the postcards elicited a response, as J found

established the Home and
Community Care (HACC)
program in Australia. The
HACC agreement between
state and federal
governments is due for
renewal in 2005. At this
stage, a number of
changes are anticipated
when signing takes place.
Over 20 years of the
HACC program, the
number of services has increased, as has the number
of clients. Certain community groups, such as Carers
Australia and the Alzheimer's Association, have been
funded to provide services. The result is that over time,
complexity and duplication have developed and
services struggle to meet the ever-increasing
e:
< demands of the growing number of older people
and the disabled.
Budgets have also reflected these needs and have
increased significantly over the years (running at a
level of $1.4 billion in 2004-05). Even so, reports
continue that home care is not available and clients
are told: 'The books are closed and we have no
vacancies for new clients'.
The level of concern over shortage of services is
reflected in the establishment of the Community Care
Coalition. Aged Care and Community Services of
Australia IACSA) is coordinating the project, which
has been funded hy The Myer Foundation as part of its
'2020-A vision for Aged Care in Australia' initiative.
Some 22 organisations, including ACSA, the
Alzheimer's Association, Carers Australia, the
Australian Council of Social Service and the Australian
Medical Association belong, with others expected to
join. An action kit prepared before the 2004 election
contained a national strategy for each state and
territory to activate. Suggested activities included
regional and local meetings, engaging with the media
and a postcard campaign directed at the Prime Minister.
when I received a reply from Minister Bishop's office.
The postcards sent a simple message: 'Many older
people and younger people with disabilities can't access
enough care services for them to stay at home. I ask
you to urgently increase funding for well-coordinated
community care services so people can be supported to
live at home'.
Members were urged to raise the issue with their local
member of parliament. Examples of complex funding
arrangements, duplication and inefficiencies were
provided along with key messages. The most important,
I think, is the fact that Australians over the age of 65
will increase from 2.4 million to 4.2 million over the
20 years to 2021 (from 12 to 18 per cent of Australia's
total population). However, with the present system not
meeting needs now, reform is urgently needed to
provide for the years ahead. Community Care Services
use paid and many unpaid volunteers to help
vulnerable people. Services such as Meals on Wheels,
Home Care and Home Nursing are a vital part of our
social fabric. Solutions suggest a need for funding
increases of 20 per cent for HAeC for three years,
followed by 6 per cent growth funding per annum plus
indexation. The shared system of funding (federal and
state) means that cooperation and agreement between
the two levels of government is vital.
The case studies provided are heart-breaking.
Without support, carers become stressed and when
a breakdown occurs, they have to see the person they
love and can no longer care for, taken away to a
nursing home, which may be located many miles
from where they live.
So what has been the Federal Government's response
so far?
Two papers on the reform of HACC services have been
produced recently. The first, New strategies for
community care consultation paper, was released by
Minister Kevin Andrews in March 2003, and the final
report, The way forward-better community care, was
released by Minister Julie Bishop in August 2004.

Copyright of Full Text rests with the original copyright owner and, except as permitted under the Copyright Act1968, copying this copyright material is prohibited without thepermission ofthe owner or
itsexclusive licensee or agent or by wayof a licence from Copyright Agency Limited. Forinformation about such licences contact Copyright Agency Limited on (02) 93947600 (ph) or (02) 93947601 (fax)
The aim is to provide easier access to care, a fairer
system of care distribution and coordination of care
between related programs.
HACC is a patchwork of services that have developed
resources for community care and support' will be
required. It urges the Australian, state and territory
governments to put aside their differences and deliver a >
c
new community care system. I heartily agree with their v

over time-some 17 programs in all. Reorganisation to
streamline services and to improve arrangements
should make savings that will he used to increase
services and their quality. At the moment, both older
and disabled people are encouraged to stay in their
own homes rather than move into nursing homes.
This fits in with their wishes and provides budget
savings that the government welcomes. However, to
remain at home, frail older people need services such
statement: 'the group believes that a new community
care system will provide better and more economical
care for frail aged people, people with a disability and
their carers. This is a case where good social policy is
clearly good economic policy'. So many people rely on
these essential community services that we must all
hope to see them come on line, with increased funding,
quality and above all, loving care. r-
c
2
Sheila Rimmer, AM, is on CHF's Governing Committee V

as Meals on Wheels, transport, cleaners, shopping and and holds the position of Secretary. Since taking early
C
s
home maintenance. These are basic Home Care retirement she has been involved in a large range of "o
Services. However, as people age and become more ageing issues. She is a past president af COTA {NSW}
frail and dependent, higher levels of service are and the nationa! body, COTA {Australia}. She chairs
required. These are supplied hy Community Aged Care the Home and Community Care Ministerial Advisory
Packages (CAPS) and more recently, by Extended Aged Committee NSW at the present time.
Care in the Home (EACH), hath of which prevent the
client from having to enter a nursing home. Both
,
provide nursing care as part of the package. c
c
Other issues addressed in The way forward-better
community care are the need for a National Assessment
,",
c
Tool for basic care. Aged Care Assessment Teams are c
~

used to assess the higher levels of care that a patient

might need. This includes disabled people and people
with dementia. Carers are part of such assessments for
the provision of respite care. Transitional care and
rehabilitation services between a hospital stay and
discharge to home will he addressed, along with gaps
in the provision of services such as a need for a
national fee structure, the accreditation of standards
and the provision of training programs for a workforce
that must expand over time and deliver quality service.
Many of the outstanding problems and issues
surrounding home care have been covered in The way
forward-better community care and one only hopes
that successful implementation will follow. As the letter
from the National Reference Group (included in the
appendix to the report) says: 'significantly increased