COMMONWEALTH HOME SUPPORT ADVISORY GROUP - MEETING This paper has been prepared for the CHSP Advisory Group meeting of 15 September 2014. It is designed to generate discussion on the policy parameters of the CHSP and does not necessarily represent a preferred or final position. 15 September 2014 Agenda Item No: 7 AGENDA TOPIC: Sector Support and Development under the CHSP Purpose The purpose of this paper is to seek feedback from the Advisory Group on key elements of a potential approach to sector support and development under the Commonwealth Home Support Programme (CHSP). It poses a number of questions designed to stimulate discussion on: Key priorities for CHSP sector support; The alignment of CHSP supports strategies with broader whole of sector support initiatives; and The role of development officers in the sector into the future. Current Situation Historically, the HACC Program has supported a broad range of activities that are not direct service delivery, but are designed to support and develop the service system and the sector. To distinguish them from direct service delivery, these activities are referred to as HACC nonoutput activities. They are often focused on specific issues, regions and population groups and their diversity reflects the evolution since 1985 of various state-specific approaches and priorities for the Program. The Australian Government currently (2014-15) funds a range of organisations under HACC to deliver a wide variety of activities, with funding distributed differently in different jurisdictions. These activities are being funded in QLD, NSW, South Australia, Tasmania and the Northern Territory. The Australian Government does not fund non-output activities in Victoria, Western Australia or the ACT through HACC. HACC non-output activity funded in 2014-15 included the following: 115 dedicated positions of various kinds are funded– HACC Development Officers, Indigenous Access / Development Officers, Multicultural Access / Development Officers, Ageing and Disability Officers and Volunteer coordinators. Activities that focus on providing advice, information and support to providers, carers and clients on particular issues – primarily dementia and incontinence. Supporting delivery of specific service, including information and advice on assistive technology, support for day centres and coordination of transport services and meals on wheels. Support for special needs clients (primarily Indigenous and CALD clients), with activities designed to improve access to culturally appropriate services and the funding is over and above the funding for Aboriginal and Multicultural Access / Development Officers. Volunteer-related activities, including volunteer coordinators as well as support to recruit, train and retain the volunteer workforce. Activities such as assessment, case-management, client care coordination and information as well as advocacy and carer support services. Discussion Paper and Consultation Feedback The Discussion Paper proposed that sector support and development activities that apply to the broader aged care sector, such as workforce development, will be considered primarily in the context of whole of aged care supports available through the Aged Care Workforce Fund (ACWF) and the Aged Care Service Improvement and Healthy Ageing Grants (ACSIHAG) Fund. The Paper noted that some activities will be specific to the CHSP and proposed targeting the following areas: activities to support and improve service delivery under the CHSP; the role of Development Officers (and their equivalents) in supporting implementation of the CHSP. This includes assisting service providers and clients to move to the new arrangements, including enabling consumer choice, and ensuring access to services for special needs groups; the implementation of a wellness approach; and support for volunteers. CHSP consultations elicited around 400 submissions, many of which contained recommendations, suggestions and proposals for the kinds of sector support and development activities that should be supported under the CHSP. There was considerable support among submissions (from peaks, government agencies and providers) for funding to develop and deliver information, education and advice on specific issues (Dementia, continence, mental health issues and various physical disabilities) and specific groups (CALD and Indigenous groups and people living in rural and remote locations). A recurring theme among submissions was the importance of (and need to continue funding for) dedicated Development Officers and Indigenous and CALD Access workers. A number of submissions noted the critical importance of volunteers to the effective delivery of the CHSP, with a range of suggestions for maximising volunteer participation and outcomes, including developing a separate CHSP volunteer network, linking into existing volunteer networks (noting that some will exist outside the aged care sector), funding for dedicated volunteer manager/coordinator positions, funding to recruit and develop volunteers from Indigenous and CALD communities and support to develop the volunteer workforce. The importance of ensuring the needs of people with dementia are supported was also noted. A number of submissions identified the need to improve on existing data and reporting requirements, including developing outcome measures for the wellness and reablement approaches and more meaningful overall program outcome measures. These submissions referred to the need for new or updated IT systems to support data and reporting requirements and training for providers to operate those systems. IT systems were also referenced in the context of achieving an interface between My Aged Care and providers. Several submissions noted the importance to the sector of small providers and the outcomes and flexibility they can deliver. These submissions recommended sector support and development activities that specifically targeted small providers, including advice on writing tenders and support to form partnerships/alliances with other organisations to build overall capacity. Some other submissions recommended support to increase awareness, knowledge and understanding of assistive technology among clients, carers, providers and assessors. Whole of Sector Support The Discussion Paper proposed more tightly focusing sector support and development activities, targeting activities that directly support improved service delivery under the new CHSP. The Paper proposed targeting activities that strengthen CHSP service delivery, a national network of Development Officers, support for volunteers and support to implement a wellness approach. The Discussion Paper sought to make a distinction between CHSP-specific activities on the one hand, and on the other, activities that apply more broadly to the wider aged care sector which can be delivered in the context of whole of sector supports available through the Aged Care Workforce Fund (ACWF) and the Aged Care Service Improvement and Healthy Ageing Grants (ACSIHAG) Fund. Aged Care Workforce Fund Aged care workforce training and education programmes funded through the Aged Care Workforce Fund (the Fund) provide a continuum of support for training, education and professional development to the current and future aged care workforce. Programmes being delivered under the Aged Care Workforce Fund seek to maximise the recruitment and retention of staff in the aged care sector by providing: opportunities for individuals to up-skill through participation in a range of vocational education and training (VET) and university courses; and supporting aged care organisations to build capacity and improve clinical care. Assistance is also available to reduce the financial burden associated with undertaking study through aged care education and training incentives to eligible individuals to build their career in aged care. A range of employment and training programs for Aboriginal and Torres Strait Islander aged care workers are also available to assist in the provision of culturally appropriate aged care. The fund includes grant funding to aged care providers, educational providers and peak bodies to improve clinical care, assist industry recruitment and retention, and create career paths through: Aged Care Vocational Education and Training, including Enrolled Nurse Training (ACWVET) Aged Care Education and Training Incentives (ACETI) Dementia Care Essentials (DCE) Training Indigenous Aged Care Employment Aboriginal and Torres Strait Islander Aged Care Training Indigenous Remote Service Delivery Traineeships (IRSDT) In addition, the Aged Care Workforce Fund supports Dementia Education and Training Centres. In supporting the future direction of the aged care workforce, the Department of Social Services has committed to a stocktake of the Australian Government’s aged care workforce activities funded over the last three years, across a range of portfolios. This Stocktake will inform development of an aged care workforce development strategy which will inform future funding priorities for the Aged Care Workforce Fund. Aged Care Service Improvement and Healthy Ageing Grants (ACSIHAG) The ACSIHAG aims to strengthen the capacity of the aged care sector to deliver high quality aged care and promote healthy ageing by targeting the following six priority areas: 1. activities that promote healthy and active ageing; 2. respond to existing and emerging challenges, including dementia care; 3. activities that build the capacity of aged care services to deliver high quality care; 4. activities that provide information and support to assist carers maintain their caring role; 5. services providing aged care to Aboriginal and Torres Strait Islander people and people living in remote areas; and 6. support for older people with diverse needs. ACSIHAG funds a range of organisations delivering projects and services that broadly fall into the following key categories: activities that support specific sub-sets of the older population or aged care sector, such as individual special needs groups (e.g. Partners in Culturally Appropriate Care) or people with Dementia or carers. projects that encourage better practice in aged care (either in residential or home care) projects that support better health care connections to the aged care sector Historically, these two Funds have been focused on funding activities that support Home Care and/or Residential Care service delivery. However the focus of these Funds in funding rounds held from 2015 could be expanded to support projects that promote whole-of-sector initiatives (including CHSP services) relevant to the Fund’s broader priorities and encourage innovation within the sector in line with aged care reforms. National Sector Support and Development Priorities/Outcome areas The following set of possible national priorities/outcome areas for CHSP sector support and development are put forward for discussion: The sector is supported to transition to the CHSP. The sector is supported to deliver socially and culturally appropriate services to special needs groups. The sector is supported to recruit, retain, develop and coordinate volunteers, including volunteers from special needs groups. The sector is supported to implement nationally consistent approaches to wellness, reablement, restorative care and consumer direction. The sector is supported to train and develop their workforce. The sector has access to up-to-date information and advice on key issues, assistive technology and models of good practice for service delivery. The sector is equipped to support people with dementia, and their carers. Do you consider this list appropriate and comprehensive? Which areas of support do you think are most important for CHSP Providers? Which areas do you consider CHSP-specific and which would more appropriately be considered in the context of ‘whole-of-aged care’ sector support strategies? CHSP Development Officers CHSP Development Officers will play a key role in supporting the sector to transition to the CHSP as well as arranging, delivering and coordinating CHSP sector support and development activities. The precise role of CHSP DOs into the future needs to be defined, and might include: Supporting the implementation of the CHSP by identifying and responding to transition issues and barriers to implementation. Providing information to CHSP funded agencies and related community care services about the CHSP and relevant government policies and guidelines. Supporting CHSP funded agencies to embed the concepts and practices of wellness, reablement, restorative care and consumer direction into their operations. Strengthening the capacity of the CHSP service infrastructure to deliver quality services which respond to client needs, including special needs groups. Strengthening interagency and community relationships and understanding of the CHSP. Promoting better practice in the delivery of the CHSP. Facilitating the participation of CHSP funded services in regional planning and issue resolution. Providing the Commonwealth with a point of contact as conduit for advice and feedback from the sector. Providing and /or facilitating the provision of information and training of relevance to CHSP service provision and management. What should be the precise role of CHSP Development Officers? Implementing a national network of Development Officers will represent a significant investment in the CHSP. One key issue to be resolved will be how to manage the network, including processes for communicating with and coordinating the activities of Development Officers to ensure a consistent and nationally strategic approach to sector support and development. What should be the goal of maintaining a national network of Development Officers? What kinds of Governance arrangements are required for CHSP Development Officers? Would it be appropriate to establish a National Expert Advisory Group to guide the activities of Development Officers? Should there be regular state or national Development Officer Forums? Should there be a national Development Officer Coordinator and/or state coordinators in each jurisdiction to oversee and coordinate their activities? Next Steps The Department will use your feedback to further refine a potential approach to sector support and development under the CHSP, and across the aged care sector more broadly.