What
is Community Care?
In 2012, there will be some administrative changes to the HACC Program (listed below), but there will minimal changes to services on the ground. See Frequently Asked Questions re the transition at
http://www.yourhealth.gov.au/internet/yourhealth/publishing.nsf/Content/hacc-transition-4#.Ty37QcXkIoo
Types of Services
The Community Care sector is a group of services that have been established as a support system for frail older people, people with disability & the carers of both groups. These services aim to provide ongoing support to allow people to remain in the community & live in their own homes, as an alternative to institutional or residential care. Community Care services exist across New South Wales, although they have tended to develop differently to meet the particular needs of each region or community.
Community care encompasses basic service types, with specifications under each funding program:
• Allied Health Care/Paramedical
Professional health care services (eg, podiatry/foot care, occupational therapy, physiotherapy, speech pathology, social work or dietetics).
• Behaviour/specialist intervention
Range of services relating to the management of challenging behaviours, including intensive intervention support, training & education in behaviour management, & consultancy services.
• Case Management
A collaborative & person-focussed process for managing support to people with chronic, ongoing or complex conditions or situations.
• Centre-Based Day Care
Structured group activities to assist with social interaction which are conducted in a centre-based setting; may include bus trips & outings.
• Counselling/Support, Information, Referral & Advocacy
Assistance with understanding & managing situations & relationships associated with the client’s need for care &/or their caring responsibilities (eg. one-on-one advice, information, training, assistance in dealing with other agencies; may include support groups).
• Domestic Assistance
Assistance with housework & chores (eg. cooking, cleaning, dishwashing, clothes washing & ironing, shopping & bill paying).
• Home Maintenance
Assistance with home or yard upkeep & repair to ensure it is a safe place to live (eg. changing light bulbs, carpentry, replacing tap washers & replacing roof guttering).
• Home Modifications
Assistance with renovations or alterations to the client’s home to help them move safely around the home (eg. installation of handrails, ramps, emergency alarms, removal of shower hobs).
• In-home accommodation support
Individual in-home living support &/or developmental programming for people with a disability.
• Meals
Preparation & delivery of meals to clients which contribute to their daily nutrition requirements & to meet special dietary or cultural needs (eg. Meals on Wheels in their homes, either hot & ready-to-eat or with instructions for heating, or in a Community Restaurant centre-based setting).
• Nursing Care
Support in the management of particular health problems by a registered or enrolled nurse; in the home or in a centre (eg. diabetes or continence management, changing bandages & administering medication).
• Other Food Services
Assistance with meal preparation & cooking in a client’s home & provision of advice on nutrition, storage or food preparation.
• Personal Care
Assistance with daily self-care tasks (eg. eating, bathing, toileting, dressing, grooming, getting in/out of bed & moving about the house; may also include monitoring medication).
• Goods & Equipment
Loan or purchase of goods & equipment that help the client with his/her mobility, communication, personal care or health care (eg. wheelchairs, appliances & continence pads).
• Respite Care
Support to carers through the provision of flexible & responsive alternatives to the usual care arrangements (eg. a worker or volunteer going into the recipient’s home or with both carer & recipient on an outing).
• Social Support
Assistance in the home or community to meet a person’s need for social contact & help him/her participate in community life (eg. visiting & telephone monitoring, letter-writing).
• Transport
Assistance with travel to/from essential appointments & social activities, either directly (in a car or bus) or indirectly (through a taxi subsidy or voucher); for groups or individuals (eg. medical transport, non-medical transport, shopping buses, social groups).
• Packages of more than one of the above
[Note: All providers conduct some form of assessment, which involves collection of information about a client’s needs to determine eligibility for service, the extent of their needs & information required for the delivery of services. Development, monitoring & review of case/service plans for a particular client is also a key component of service delivery.]
Funding Programs & Eligibility
VETERANS’ HOME CARE (VHC)
Funded by he Australian Government, through the Department of Veterans’ Affairs (DVA), who contracts a Regional Assessment & Coordination Agency in each VHC region (1300 550 450) & has separate contracts with service provider/s in each region to provide home care services.
To be eligible for a VHC assessment a person must be:
• a veteran of the Australian defence forces; or
• a defence or war widow/widower of a veteran of the Australian defence forces or an Australian mariner; & have
• a Repatriation Health Card - for all conditions (Gold Card); or
• a Repatriation Health Card - for specific conditions (White Card).
<http://www.dva.gov.au/a>
COMMUNITY AGED CARE PACKAGES (CACPS), EXTENDED AGED CARE AT HOME (EACH) & EXTENDED AGED CARE AT HOME DEMENTIA (EACH D)
National programs funded by the Australian Government under the Aged Care Act 1997, which also covers nursing homes & hostels. They are administered by the Australian Government Department of Health & Ageing.
Available to older people when:
1. The person is eligible to receive community care only if the person:
• is assessed as having complex care needs; &
• would be assessed, if the person applied for residential care, as eligible to receive residential care at least at the low level of care; &
• prefers to remain living at home; &
• is able to remain living at home with the support of community care.
2. Complex care needs are care needs that can only be met by a co-ordinated care package of care services.
To be eligible for an EACH D, people must meet additional eligibility criteria. An ACAT assessment & approval is required before people can access residential aged care, & therefore CACPs (at low level) and EACHs (at high level).
click here for more information
NATIONAL RESPITE FOR CARERS PROGRAM (NRCP)
Respite care aims to assist frail older people & others with care needs to continue living in the community by giving carers a break from their usual care arrangements. A carer is defined as a person, such as a family member, friend or neighbour, who provides regular & sustained care & assistance to another person without payment for their caring role other than a pension or benefit. Funded by the Australian Government under the Aged Care Act 1997, it has several key components:
• Commonwealth Carer Respite Centres (CCRCs) can help when carers need to take a break from caring by arranging respite. They can provide information, emergency or short term respite & link carers with providers of regular respite.
• Commonwealth Carelink Centres (CCCs) are funded by the Australian Government to assist individuals & services to effectively navigate through health, community aged care, disability & other support services in the community, acting as a single point to obtain up-to-date information. There is a Carelink Centre for each HACC region, but calls can be made from anywhere in the country for local Centres on freecall 1800 052 222 or www.commcarelink.health.gov.au.
• Various community-based agencies receive NRCP Respite Services funding to deliver respite care to carers & the people for whom they care in a variety of settings that best meet their needs, such as day care centres, activity programs & in-home respite services.
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HOME AND COMMUNITY CARE (HACC) PROGRAM
Funded in each State by the Commonwealth & State/Territory governments through the Home & Community Care (HACC) Act, 1985. In NSW, Ageing, Disability & Home Care in the NSW Department of Family & Community Services (ADHC) contracts a range of providers, including local government, community & voluntary organisations, religious & charitable organisations & commercial organisations, as well as State government agencies.
According to the National Guidelines, the following people are eligible to receive HACC services:
• older & frail persons with moderate, severe or profound disabilities;
• younger persons with moderate, severe or profound disabilities;
• such other classes of persons as are agreed upon by the Commonwealth & the State Minister; &
• the carers of these people.
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DISABILITY SERVICES PROGRAM (DSP)
A State service program reflecting the principles of the NSW Disability Services Act 1993, & with funding from the Australian Government through the National Disability Agreement (NDA), administered by Ageing, Disability & Home Care in the NSW Department of Family & Community Services (ADHC). Additional services have been funded through the NSW Government’s 10 year Disability Plan, 'Stronger Together: A new direction for disability services in NSW 2006-2016'.
These services are provided either directly by ADHC staff or through funded providers. The ADHC Regional Intake Panel is responsible for determining the eligibility status of a person requesting entry & access to the disability services provided directly by ADHC. A potential client must meet specific eligibility criteria in order to receive ADHC disability services.
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ATTENDANT CARE PROGRAM (ACP)
Enables people with severe physical disabilities to move out of the restricted institutional setting of nursing homes & to live in their own homes in the community. Provider organisations are funded under Section 6 of the NSW Disability Services Act 1993. The ACP is administered by Ageing, Disability & Home Care in the NSW Department of Family & Community Services (ADHC) & has a single entry point via the Attendant Care & Physical Disability Unit.
To be eligible for the Attendant Care Program:
• be living in a nursing home, hostel or long-term hospital bed or living at home, & residence in a nursing home, hostel or hospital as a nursing home type patient is their only long-term living option;
• be between 16 & 65 years of age;
• have a physical disability requiring up to 34 hours per week of attendant care. (The person may require more than 34 hours per week of attendant care if the person can arrange additional hours themselves);
• health/medical problems must be able to be managed in the community by a local doctor, specialist, outpatients department in a hospital or community nurse; &
• willing & able to manage their attendants.
ACP recipients are eligible for other programs, like HACC, for service types not included in ACP.