Issues in respite and carer
support
Chris Gration, National Respite
28 July, 2014
Agenda
1.
2.
3.
4.
5.
6.
7.
National Respite introduction
Ability Links presentations
Respite and carer support in 3 service systems
Respite in aged care – CHSP and flexibility
Respite in disability – NDIS
Respite in Mental health
Action!
2:00
2:15
2:45
3:00
3:20
3:40
3:50
1.1 National respite
Communities of strong relationships that
support the lives people choose
Support interconnected wellbeing between
people with disability, frailty from age, mental
illness and their chosen carers, families, and
informal supports
1.2 National Respite
1.
2.
3.
Raise the respite voice: NDIA, DSS
Member services
Research:
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–
–
–
4.
5.
Mapping respite outputs
NDIS transition cost/benefit/impact
carers, participants, communities
government
Volunteer, flexible, family based – cost
benefit; social capital
Evaluate innovation: flexible, early
intervention
Business transformation : CMS, online
tools
National Conference 23-24 October
2. Ability Links
3.1 Respite and carer support in 3 systems
Carer support
Respite Care
Care
recipient
CHSP
3
Carer
NDIS
7
?
?
Family resilience model?
?
3.2 Trends
•
Unmet demand up 33% between the 2009 and 2012 SDAC
– 15.8% or 121,660 carers
•
Unmet demand for respite care increases with age:
– > 65 the unmet demand is 16.9%,
– > 75 it is 19.61% (compared to general unmet demand in 2009 of 11.8%)
•
Respite is already targeted to higher dependency:
– Respite use increases dramatically (60% of respite use is for carers < 40 hours of care a week).
•
But respite users have higher wellness and satisfaction deficits:
– indicating need for more support (significantly more angry, dissatisfied, weary, worried or
depressed, stressed related illness)
•
2/3s of unmet demand in 2012 was from those who have never had access to
respite.
– 12% of carers have never used respite because the primary recipient (aged person) doesn’t
want to use it (2012)
– 10% of those who don’t use respite are simply not aware of their entitlements or what
services are available (2012)
4.1 CHSP issues
General
•
•
•
Key directions – access and equity,
role of carers, pathways, person
centred
Outcome 3 Social Participation
and Outcome 6 Care Relationships
CHSP
General Issues
• “Basic”?
• Pathways and packages
• Case management & linkage
– Vulnerability – SG2
•
Transition principles:
– No client loses – person centred
•
Contestability
3
7
4.2 CHSP Respite issues
Issues for Respite & Carers
• Unmet need – 15.8%
• Access:
– 12% not used because primary recipient unfavourable
– 10% information gaps
• Eligibility for carers
• Carer support – funding
• Carelink information?
• Transition for NRCP clients
• Innovation and evaluation:
– Early intervention respite
– Flexible respite
4.3 Flexibility
Outcome 6
Approach
Care relationships
• 3 types: cottage, emergency, flexible
• Grow flexible respite
• Trial cashing out
•
•
– Drawing in informal supports
– Out of pockets
•
Issues
•
•
•
•
Carer/care recipient goal conflict
Inflexibility of non-residential
respite – hours, continuity of staff,
training, rural remote
Gaps in secure residential respite?
Dementia and younger onset
Supporting challenging behaviours
Learning from CDRC & disability:
Pilots, training, best practice
4.4 CHSP Next Steps
• DSS
– Fees Policy
– Guidelines and Program
Manual
– Contestability end FY15
• Community Care Issues
Forum
1.
2.
3.
4.
5.
Assessment - RACs
Fees
Contestability
Sector Support & Dev
Guidelines and Transition
What are your key
priorities?
5.1 NDIS issues
1. Participants
2. People with lower
support needs & Tier 2
3. Transition and
structural adjustment
1
2
3
3
Person
with
Disability
5.2 NDIS issues
Participants
• NDIS Act :
– Section 31 (da) “build capacity of
families and carers to support
participation by the individual in
life”
– Section 34 (e) “ what is
reasonable for families, carers,
informal networks and the
community to provide”
• NDIS Supports for Sustaining
Informal Supports
• Recreation Guideline
• Flexibility
• Need for data
• Guide to NDIA clusters and price
list
Non-participants with
disability
• Combining informal support,
personal networks, mainstream
inclusion
• Role of specialist disability
services
• Funding – Commonwealth/State
Transition
•
•
Large, medium, microbusiness
IDF and Sector Development
6. Action
1.
2.
3.
4.
Participate in our research
Spread the word
Come to National Conference
Engage in business transformation
www. Nationalrespiteaustralia.com.au