1 SETTING THE SCENE : The Challenges in Community Care Dare to Care South West Sydney Ageing & Disability Conference Christine Regan Council of Social Service of NSW (NCOSS) 19 July 2007

2 Challenges in Community Care: Acknowledgements for information and cartoons to:  Productivity Commission Report on Government Services 2007  HACC Minimum Data Set  Ministerial Advisory Committee on Ageing for graphics from past publications of the NSW Consultative Committee on the Ageing

3 A picture of NSW HACC HACC reached 196,442 people in NSW in or 25.42% HACC clients in Australia HACC spending in in NSW will be $533.9 million

4 HACC Services 3.7% Australian population were reported in the HACC MDS IN NSW: 45.9% HACC clients received only one service type 23.3% received 2 service types 14.7% received 3 service types 16.3% received 4 or more services types

5 NSW HACC Client Profile 65.8% of NSW HACC clients were female, 34.2% male 14.5% of NSW HACC clients mainly spoke a language other than English at home 3.4% NSW HACC clients were Aboriginal & Torres Strait Islander people 23.8% NSW HACC clients were aged under 70 years 68.1% NSW Aboriginal HACC clients were aged under 70 years 0.3% NSW HACC clients were carers

6 NSW HACC Client Profile Income status in NSW:  91.5% HACC clients received a government pension or benefit 67.4% Aged Pension 11.2% Disability Support Pension 11.2% Department of Veterans Affairs Living situation in NSW:  54.6% of HACC clients lived with family or friends,  45.4% lived alone

7 Reproduced from Retirement: A Survey 1996, NSW Consultative Committee on Ageing

8 NSW HACC Client Profile Type of Housing: 72.9% in own homes or under purchase 10.1% in public housing 9.5% in private rental 3.9% in self-care in retirement villages 1.2% in residential aged care facilities 0.6% in supported accommodation 0.4% in temporary or insecure housing

9 HACC Client Profile in NSW Location:  60.1% major cities  26% inner regional areas  12.1% outer regional areas  0.9% remote areas  0.1% very remote areas

10 Community & Aged Care Comparisons Residential Aged Care in NSW: 56,107 people $1.540 billion government funding Home & Community Care in NSW: 196,442 people $443.9 million government funding Veterans Home Care in NSW: 25,863 services $29.1 million government funding

11 Community & Aged Care Comparisons Community Aged Care Packages in NSW: 11,945 people $124.1 million government funding Extended Aged Care at Home in NSW: 816 people $19.9 million government funding National Respite for Carers 34,551 people $ million government funding

12 HACC in South West Sydney ,308 HACC clients clients per 1000 HACC target population 38.4 average hours per client 70.5 average age youngest in NSW 26.4% clients aged under 65 years highest in NSW 1% clients are Aboriginal or Torres Strait Islander

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14 Challenges in Community Care: What are we trying to do?  People are healthy & supported while maintaining independence at home  Home and social supports  Focus on flexible and social outcomes  Growth in industry

15 Challenges in Community Care: Pressures on Demand:  Escalating populations of both older people and people with disabilities  People are living longer  Higher client expectations  Under-met needs

16 Reproduced from Volunteering and Older People 1996, NSW Consultative Committee on Ageing

17 Challenges in Community Care: Changing expectations :  Standards of care  Familiar environs  Balancing low needs against high needs  Deluxe versus regular

18 Reproduced from Volunteering and Older People 1996, NSW Consultative Committee on Ageing

19 Challenges in Community Care: Pressures on Demand:  Gap between rich and poor growing  Increased workplace participation  Changing volunteer profile  Families dispersing  Failure or limitations of other service systems

20 Challenges in Community Care: Pressures on service provision:  Many programs  Co-ordinated care  Streamed funding, ie silos  Flexible solutions vs data and contracting

21 Reproduced from Never too late to learn 1997, NSW Consultative Committee on Ageing

22 Challenges in Community Care: Pressures on Industry:  Greater admin & reporting responsibilities  Slowing of growth in funding relative to demand  Paid Workforce issues  Volunteer workforce issues  Escalating costs in metro areas  Reduction in regional and rural infrastructure

23 Challenges in Community Care: Pressures on Industry:  Continuous reforms  efficiency requirements  more with less  Staying competitive  Market forces

24 Challenges in Community Care: Pressures always on the Horizon:  Commonwealth State relations  User pays  Demand continues to outstrip supply  Two tiered system

25 Reproduced from Volunteering and Older People 1996, NSW Consultative Committee on Ageing

26 Challenges in Community Care: What is the role of community care into the future? How can community care be sustainable? Why do you work in community care? Do we Dare to Care???? Absolutely!