Victorian HACC Transition Forums - Key themes and notes from March
the discussion and Q&A sessions 2014
Consultation Themes and FAQs from the
Joint Australian Government Department of Social Services and
Victorian Government Department of Health
HACC Transition Forums
(held in February and March 2014)
1.
Introduction
A series of HACC Transition forums across Victoria (12 in total) were jointly conducted by
the Australian Government Department of Social Services (DSS) and the Victorian
Department of Health (DH) from February to March 2014.
These



provided Victorian HACC providers with an opportunity to:
hear about the transition process over the next 18 months,
provide feedback on the benefits of Victoria's community care system, and
ask questions and put their point of view directly to the Commonwealth DSS and
Victorian DH representatives.
The departmental presenters were - Ben Vincent, Branch Manager, HACC Branch,
Australian Government Department of Social Services1 and Jeannine Jacobson, Manager
HACC and Assessment, Victorian Department of Health2 .
Prior to the forums, the Victorian DH provided HACC providers with a background paper
for the consultations that outlined the benefits of the Victorian system (see Attachment
A).
This paper provides a snapshot of the common issues and frequently asked questions
that arose throughout all of the forums. Questions and Answers specific to regional
consultation session are included at Attachment B
2.
Common Issues and Themes
The following five key themes were common across each of the consultations:
 security of funding;
 the Aged Care gateway;
 partnerships;
 small organisations and their role; and
 training and workforce development.
George Pappas, Director Planning and Programs, DSS Victoria, was the DSS government representative for 3
forums
2
Jane Herington, Director, Ageing and Aged Care DH, was the State Government representative for the MAV
forum
1
Page 1
Victorian HACC Transition Forums - Key themes and notes from March
the discussion and Q&A sessions 2014
2.1
Security of existing HACC funding and services
Maintaining funding arrangements for current Victorian HACC providers and continuity of
services as part of the transition to the Commonwealth Home Support Programme
(CHSP) was raised as a key priority across the majority of consultations.
Transitioning existing HACC services into the Commonwealth Home Support Programme
will support a seamless transition for Victorian HACC providers, and the Department of
Social Services (DSS) confirmed the intention to continue current HACC base funding
and outputs in Victoria for a three year period from 1 July 2015 without a competitive
tender process.
This is consistent with the arrangements for other states/territories that transitioned to
the Commonwealth HACC Program and is subject to both governments agreement to the
Joint Victorian HACC Transition Plan.
Arrangements for the allocation of growth funds are being developed as part of the CHSP
and in accordance with current Commonwealth processes. This could include a range of
different approaches, including open and competitive funding processes.
2.2
The Aged Care Gateway- What is it? What does it mean?
There was strong interest in the Aged Care Gateway at each consultation, particularly
around how it will operate; whether or not it will be the only way to access services; and
its relationship to assessment.
My Aged Care is a key component in the development of an end to end aged care
system and began operating on 1 July 2013 with the My Aged Care website and national
contact centre. My Aged Care will progressively help people to navigate the aged care
system and provide referrals for assessment and service provision through multiple
channels.
The Gateway will be the main point of entry for services, however there is scope for
HACC providers to assist people who approach providers directly to enter through the
Gateway.
Over time, My Aged Care will implement a central client record, an assessment capability
to identify needs based upon a national assessment framework, and a linking service to
assist vulnerable people with multiple needs. Further details on how My Aged Care and
the assessment process will operate are being developed concurrently with the transition
of Victorian HACC services.
The Victorian DH also reflected on their experience in trialling the national assessment
framework and tool commenting that the “Gateway needs a capacity for face to face
interaction for those that require it. Information gathered by phone assessment was very
different to what was subsequently gathered by follow up face to face. This highlights
the importance of engaging with people face to face early to understand their needs,
rather than just engaging them over the phone where they are likely to only ask for
what they know about and not what they might need.”
The DSS and Victorian DH are continuing to working together on how My Aged Care will
be implemented in Victoria including assessment arrangements.
Page 2
Victorian HACC Transition Forums - Key themes and notes from March
the discussion and Q&A sessions 2014
2.3
Partnerships and Collaboration
A common theme across all consultations was the strength of the Victorian partnerships
between sectors and service providers and how collaboration for the benefit of HACC
consumers works well in Victoria. The DSS recognises that the partnership
arrangements in Victoria are part of its strength with an ethos of service coordination
and networking. The DSS and Victorian DH are working together to look at how these
partnerships and networks could be supported in the future.
2.4
Small organisations (Aboriginal and CALD) - the importance of their role
The importance of small organisations and the role they have in addressing the needs of
their communities was highlighted throughout the consultation forums. It was
acknowledged how CALD and Aboriginal service providers have done a great job of
implementing current policy. The Commonwealth acknowledged the importance of
continuing a system that is responsive to the diversity of the Victorian population and
that both governments are discussing how best to ensure that access and diversity is
maintained.
2.5
Training and Workforce Development
The breadth of the training and workforce development that has been undertaken in
Victoria was highlighted (particularly in the areas of ASM, Assessment, goal directed care
planning and diversity planning and practice). How the workforce into the future would
be maintained and further developed was raised.
A training and workforce strategy is being developed that will take into account the
broader needs of the aged and disability workforce, including training and education
initiatives.
3. Conclusion and Wrap-Up
New issues arising from the consultations have been incorporated into the joint DSS and
DH transition issues register. Nothing is too big or too small for the register.
The CHSP design paper is due to be released shortly and is an important paper to
provide feedback on in the context of retaining the benefits of Victoria’s current system.
The paper will be distributed via DH regional staff and will also be available on both the
DSS and DH websites. The Commonwealth will also conduct road shows and seek
feedback via submission.
The Transition Plan is due for completion before the end of the financial year. This is an
intergovernmental (i.e. Commonwealth and Victorian State) paper, and will need
approval at government level. It will set the scene for the transition.
Page 3
Victorian HACC Transition Forums - Key themes and notes from March
the discussion and Q&A sessions 2014
4. Frequently Asked Questions
The following provides an overview of the common Questions and Answers provided
across all forums.
Funding Arrangements
1. What will be the funding model under the Commonwealth Home Support
Programme?
The proposed design of the CHSP is still subject to consultation, but it is expected that
on July 1 2015 the Commonwealth will continue to provide block funding to service
providers under the CHSP rather than move to an entitlement based model.
2. It was stated that there is no intention to pursue wholesale tendering as
part of the transition but this is subject to agreement on the transition plan
- what does this mean?
(DSS) Subject to both Governments agreement on the Joint Victorian Transition Plan,
the current intention is to transition existing base funding for service delivery to people
65 and over, into a Commonwealth funding agreement and funding for people under the
age of 64 into a state government agreement. There is no intention to pursue wholesale
retendering of existing services leading up to July 2015. This is consistent with
arrangements agreed with other States in transitions to the Commonwealth HACC
Program and will assist in ensuring a smooth transition.
To this point growth funding within the Commonwealth HACC Program has been
distributed via a competitive process distributed via tender; however no decision has
been made at this point in time on how growth in the CHSP will be allocated.
3. How many funding agreements will there be?
(DSS) Service providers could receive one or two funding agreements depending on
whether the organisation provides care to older and younger people.
Generally, organisations with both younger and older clients will receive two separate
agreements, one for services to people 65 years and over (50 years and over for
Aboriginal and Torres Strait Islander people) from the Commonwealth, and one from the
State for services to people under 65 (and under 50 for Aboriginal and Torres Strait
Islander people).
(DH) If any agency wants to make a major change in the targeting of their service
delivery, they will need to discuss with their DH regional office contact as soon as
possible. The current round of service agreement renegotiation will be the last before the
transition split, so any changes will need to be made by August 2014.
Once the split happens an organisation cannot move funds between buckets where in the
past there was flexibility.
4. You’ve talked about a 70/30 split of resources. How will this work across
regions?
The Commonwealth and the State will review the HACC MDS data for each service
provider to determine the likely split of funding for each provider in the first instance.
This will then be discussed with each provider to finalise the appropriate split of funding.
Page 4
Victorian HACC Transition Forums - Key themes and notes from March
the discussion and Q&A sessions 2014
Services
5. What is the future of Linkages packages?
(DSS) The CHSP will differ from Linkages packages in that it will provide basic
maintenance services to a large number of clients. Linkages packages provide a higher
intensity of services that will be beyond the level of support generally available in the
CHSP.
Future arrangements for the Linkages packages are being developed to ensure that
clients continue to receive services. This could include older clients being transitioned to
a Home Care Package; however provider feedback on the design of the CHSP will assist
in developing transition arrangements.
6. Where do Bush Nursing Services (BNS) fit?
(DH) BNSs are a specific issue on the transition register. It is an accident of history that
BNSs are in HACC because the target group is broader than HACC. It is too early to
have an answer about where BNSs will end up but once the transition plan is agreed we
will be in a better position to respond. The DH can confirm that BNSs won’t disappear
from the service system.
Funding to BNSs is modest, so an age-based split of funding may not be appropriate.
BNSs may be a better fit with another area within the Department of Health (e.g., rural
health). But the issue still needs to be resolved, so discussion amongst all BNSs and the
DH is encouraged.
7. Where will SWEP fit under the new system? [State-wide Equipment Program
– the trading name for the Victorian Aids and Equipment Program]
(DH) SWEP is not funded through the HACC Program. Eventually all equipment programs
for people under 65 will go into the National Disability Insurance Service (NDIS) once
this rolls out across Victoria. Victoria has run a very robust 65+ equipment program,
which is also available to Commonwealth Package Care clients. The issue of a
stand-alone older person’s aids and equipment program will be discussed with DSS.
8. Transport is a major issue, particularly in rural areas. Will Victoria have a
similar system to other states?
(DSS) The design of the CHSP is considering how transport is managed across each of
the programmes that will be consolidated into the CHSP, including what currently works
well in different states.
9. Will Access and Support be kept?
(DH) Access and Support roles are high on the list of priorities in discussion with DSS
and we will keep the sector informed. Access and Support is starting to pay off regarding
outcomes and could be aligned to the Aged Care Gateway. The gateway will drive
different ways of gathering data because there will be a single client record. We are not
clear when this will be implemented. HACC will be reported on a quarterly basis and it
will be business as usual until it’s worked out.
Page 5
Victorian HACC Transition Forums - Key themes and notes from March
the discussion and Q&A sessions 2014
10.Flexible Service Response funding is used for a wide range of purposes,
including funding of multi-purpose services. How will FSR funding be treated
under the CHSP?
(DH) FSR is for supporting areas outside the usual HACC activities. FSR is not an output
and is not measurable. Service System Resourcing (SSR) and FSR are both non output
funded activities. The challenge is to unpack what those funds do and then what the
appropriate response is.
(DSS) We understand that FSR includes funding for such things as hospital to home and
the vulnerable persons program and generally that supports new ways of doing things.
At the moment we are seeking to develop an inventory of non-output funded activity and
identify where the projects best fit, that is CHSP or elsewhere. We will be working
through these projects as part of the transition issues register.
11. What is the future of National Respite for Carers Program (NRCP)?
(DSS) The NRCP will be consolidated under the CHSP. Many providers funded under the
NRCP are also funded through HACC. Consolidation under the CHSP will enable the
reduction of red tape, creation of one assessment process, one fees system, common
eligibility and streamlined reporting.
12. Will the role of volunteers be included in the CHSP discussion paper?
Volunteers form a large part of the system - will there be any funding to
continue this?
(DSS) Volunteers are a large and significant part of the programme and are essential to
the delivery of home support services across the country. They will be an integral feature
of the system going into the future. The CHSP will need to recognise this aspect and
work to support volunteers. We need to consider how this fits with the CHSP going
forward.
(DH) HACC services have generally sprung up as a direct result of local need, and then
have applied and received HACC funding support. Volunteer services are a classic
example of this. This will not go away and volunteers play a very valuable role and it is
important for governments to recognise this effort and support with funding.
In the short term HACC funding will not change for those services already funded in
HACC and their funding will be rolled into their new DSS service agreement.
Diversity Planning
13. Diversity planning and practice is core business. The Department of Health
funds sectoral development positions. Will these be retained?
Providing access to services that recognises the diversity of the Victorian population is an
important element of the design of the CHSP. DSS and DH are discussing the role of the
sectoral development positions to further consider arrangements for these positions.
Page 6
Victorian HACC Transition Forums - Key themes and notes from March
the discussion and Q&A sessions 2014
Local Government
14. Given council’s role as a funder in Victoria, how does the Commonwealth
see the partnership of Councils and Commonwealth? Would you see council
dollars as icing or part of base?
(DSS) DSS recognises the important role of Councils in the Victorian HACC system.
Councils in Victoria currently receive 38% of Victorian HACC funding, and 72 of 79
councils are key providers and contribute around $100m of their own revenue to the
program. The Commonwealth would see a role for Councils as both service providers
and contributors to planning discussions under the CHSP. DSS is looking to retain the
benefits associated with Councils’ role in the HACC Program.
(DH) The department is working with councils through MAV. The MAV forum last
Tuesday was attended by 80 reps had a detailed discussion about what will happen
going forward. We will work intensively through the MAV with councils over the next few
months. Discussions will cover a range of issues including assessment, planning, and
funding.
15. When will council receive the details of these reforms?
(DSS) Further information on the key directions for the CHSP will be outlined in a
discussion paper to be made available shortly. In terms of specific arrangements for
Victoria, further information will be available when both governments sign off on a
transition plan. It is the intention to write to all providers with information about the
proposed funding split in the second half of 2014.
(DH) Department of Health will be having further discussions with councils. Keen to
facilitate services across boundaries with municipal health planning across communities;
assessment processes important part of this and keen to support councils to sustain
involvement in service delivery.
The Aged Care Gateway
16. What about the technical implications of a single client record, such as the
interface with existing client management systems/software? What support
will there be to integrate E-referral and S2S into the gateway?
(DH) The central client record will be accessed via a portal similar to DVA. The goal in
the longer term is to be able to interface between client management systems i.e. portal
to operate with systems like S2S. DSS is taking a standards approach –i.e. vendor will
have the ability to adjust their product to interact with the Gateway system.
17. Victoria has 2 assessment systems ACAS and HACC Assessment Services.
Will they be combined in future?
(DSS) This is a live issue and DSS is looking at what the economy of scale is in the
system to underpin a seamless continuum of care and therefore a single assessment
system. ACAS and CHSP Assessment will not be combined from 1 July 2015.
18. During the presentation, a reference was made to the percentage of users
who’ll need a face to face assessment. How will it be decided who needs a
face to face assessment?
(DH) The DH has done some analysis of new clients. In local government around 77% of
new clients receive a face to face assessment. It’s a lower percentage across all
Page 7
Victorian HACC Transition Forums - Key themes and notes from March
the discussion and Q&A sessions 2014
agencies, but not much lower. DH also participated in the National Assessment
Framework (NAF) tool trial last year, which indicated that 45-50 % of clients would
require a face to face assessment. However the trial involved a small sample, and only a
few agencies. We really don’t know. We need to investigate it further. Victoria has the
capacity to do this. A set of triggers need to be developed from which to make a decision
(i.e., that a face to face assessment is indicated). We also need a feedback loop from
providers (in case a client who wasn’t fully assessed needs to be assessed). Victoria
needs to assist DSS to develop something which can be rolled out nationally.
19. What is happening with the Gateway linking services for vulnerable clients
in remote areas?
The linking service discussion is in an early phase and is being considered.
20. Will there be bilingual workers in the Gateway (similar to Centrelink) and
will the website be accessible for CALD clients?
(DSS) The Gateway will be accessible for CALD clients. Language and cultural sensitivity
of the Gateway is recognised as important. Work has been undertaken to translate aged
care material into a number of languages, with nine translations completed at the
moment.
21. How will the Gateway manage client records with privacy limitations?
DSS understands that privacy is an essential component for the Gateway. This issue and
others are still being worked through.
Partnerships and Collaboration
22. How will connections between community care, primary care and health
services operate under CHSP?
(DSS) The Commonwealth recognises the partnership arrangements in Victoria as a
great strength of the system, providing an ethos of service coordination and networking.
(DH) Government’s challenge is to work out a structure to enable the networks to
continue. There are a number of ideas but will need to have another round of
discussions.
23. The relationship with the regional offices is a real strength of the Victorian
system, and provides intimate knowledge and understanding across
catchments and agencies. What will the future look like?
(DSS) DSS has contract managers based in state offices, and some regional offices.
Opportunities to input to planning and priority setting and ongoing communication at the
regional level are recognised as important.
The consultations have highlighted that the sector values two-way communication
channels, and DSS is looking at ways for best achieving this in the CHSP.
Red Tape Reduction
24. There is concern about the amount of money that needs to go into
administration rather than services. How will ‘red tape’ be reduced in the
CHSP?
(DSS) The Commonwealth is keen to reduce the administrative burden on providers. The
consolidation of existing, separate programs will reduce the number of reports and
Page 8
Victorian HACC Transition Forums - Key themes and notes from March
the discussion and Q&A sessions 2014
guidelines and paperwork and there will be only one set of accreditation criteria. The
CHSP provides an excellent opportunity to reduce red tape for providers, particularly
providers of multiple programmes.
Workforce Development
25. What is being done about workforce development? Where is the system
heading with minimum qualification and the difficulty recruiting staff in
Victoria?
(DSS) By 2050, it is projected that 5% of the workforce will work in aged care. The
Commonwealth is developing whole of aged care training and workforce development
approach to assist in attracting and maintaining a skilled workforce.
26. HACC education and training has recently transferred from a local
(regional) arrangement to a state-wide service which is having an impact at
the coalface. What will happen with the transition?
The Commonwealth is committed to continuing investment in workforce development.
This will be considered in the context of a whole of aged care training and workforce
development strategy. Specific arrangements for training provision in Victoria are yet to
be finalised.
Reporting, Data and MDS
27. Will all states have identical systems, e.g. data collection, reporting, service
agreements?
(DSS) Reporting will need to be coordinated and streamlined, particularly for providers
of multiple programs. In future there will be the Gateway underpinned by an electronic
client record that will collect data. The Commonwealth is bringing a number of program
data collection systems together and looking to have a data system that minimises
burden for providers but is sufficient for evaluation and accountability purposes. In doing
so we are seeking to build on the systems already in use.
(DH) The State expects to use MDS for under 65s. At transition it will be too early for a
single client record but will move towards it over time. In relation to the single client
record, it will need to be a staged solution, and will take time. Victoria will work with the
Commonwealth. In the interim, the HACC Minimum Data Set (MDS) is an efficient
system. It won’t be decommissioned until such time as a certain (still to be determined)
proportion of clients has a single client record.
Reform Reviews
28. There is a review of the Commonwealth’s reforms at the 5 and 10 year
marks. How will this be linked into the State’s review process?
(DH) The DH will develop benchmarks against which the HACC transition is measured
and report to the Victorian Government over 5-10 years. One of HACC’s aims is to
divert people from hospital or more expensive care. HACC is critical in this system. We
will review the Commonwealth’s performance and report to the Victorian Government.
Page 9
Victorian HACC Transition Forums - Key themes and notes from March
the discussion and Q&A sessions 2014
Fees
29. What are the implications of a national fees policy for HACC services? And
will means or assets tests be applied?
(DSS) There will be a nationally consistent fees policy across programs and locations,
ensuring equity of access. In the CHSP, it is unlikely that means testing by a third party
would be applied, as the CHSP is a low cost service. The aim will be to keep it simple.
Mechanisms will need to align with Home Care Packages over time; with the removal of
perverse disincentives for people to move to a Home Care Package should their need for
support increase.
30. There is a difficulty encouraging clients to sign up for Level 1 packages. Are
these being reviewed?
(DSS) The new Home Care Packages Programme, including Consumer Directed Care
arrangements and the new levels of Home Care Package, are being closely monitored
and evaluated. More time is required before any conclusions can be drawn.
NDIS and Under 65s
31. There are many forums for aged care, but how will the State government
engage with those aged under 65?
(DH) A good first step is NDIS forums. The whole sector is going through a massive
transformation and post NDIS, HACC will not exist in its current form. We need to look at
services and what clients need. There will be lots of decisions to be made by
government.
32. What will happen to the under 65 population who will not go to NDIS?
(DH) The State government will still be responsible for those who are not eligible for the
NDIS but need HACC services.
33. Some people under age 65 need aged care services, such as early onset
dementia and war torture situations. Is the under/over 65 split flexible?
The transition from the State to Commonwealth may be difficult for some
clients.
(DSS) In all states and territories the age split will be maintained at 65 years of age
(and 50 years of age for Aboriginal people).
(DH) Early onset dementia will be accommodated by the NDIS. Those that meet the
eligibility criteria (significant and permanent disability) will be able to get support from
the NDIS. NDIS clients can transition to the Commonwealth after age 65.
34. What will happen to those aged under 65 in the transition year? Are there
any transitional arrangements?
(DH) Except in the NDIS trial site, there will be a simple split of resources between
Commonwealth and State. The State continues to have agreement for under 65s;
Commonwealth will have agreement for 65 and over. Further changes will come with
the full scheme from 2016.
Page 10
Victorian HACC Transition Forums - Key themes and notes from March
the discussion and Q&A sessions 2014
35. What is the difference between HACC and NDIS?
(DH) HACC is a program of low level support. NDIS has legislated requirements and
decisions can be appealed, NDIS will be a pool of funds available and run like an
insurance scheme. Clients will pay no fees.
Department of Veteran Affairs
36. Will the Department of Veteran Affairs (DVA) Home Care program be
incorporated into the CHSP?
(DSS) DSS and DVA are working closely to ensure that there is very close alignment
between CHSP and DVA Home Care, but it is not proposed that DVA Home Care will be
part of CHSP.
5. Other Questions
The following specific questions were asked at the Regional Consultations indicated and
have been included for the interest of all consultation attendees.
Barwon South West
1. Packages are not attractive to clients as they are not highly subsidised.
Therefore level 2 packages can be hard to allocate. What is the plan for
packages?
(DSS) The Australian Government is working with clients, aged care providers, workers,
and health professionals to build a seamless, end-to-end aged care system. The CHSP
will provide small amounts of services to lots of people, while Home Care Packages will
offer clients higher levels of case management and co-ordinated care, tailored to their
individual needs. As part of the development of the CHSP, a National Fees Policy will be
introduced. Currently fees are not standard across the country. The fees policy aims to
include fairness, equity and sustainability. However, an inability to pay must not prevent
access to services.
NACA is setting up a fees advisory group. It will look at what’s working and seek input
and feedback.
2. What will happen with HACC nursing funding?
(DSS) It is intended that base funding for service delivery for older people is transitioned
to the Commonwealth and funded under the CHSP. Nursing funding would be included in
this approach.
Wallan
3. Apart from making submissions, how can you have involvement to influence
outcomes?
(DSS) There are a number of ways to have involvement in this process including
contacting our team in DSS through HACC.Victorian.Transition@Health.gov.au ; it is also
important to comment on the Commonwealth Home Support paper when it is released.
Page 11
Victorian HACC Transition Forums - Key themes and notes from March
the discussion and Q&A sessions 2014
4. The Commonwealth has a centralised approach to business. How confident
are you that the Victorian and WA model will be considered for other States?
(DH) There are significant differences between States and Territories and it is intended
to recognise differences between these. There is a keenness to entrench the Victorian
system into a transition plan by an intergovernmental agreement as the Commonwealth
recognise how well the Victorian system works. The process will take time for the
transition from other jurisdictions.
(DSS) Existing Australian Government administered programmes such as the National
Respite for Carers Program and the Commonwealth HACC Program are flexible enough
to deliver services that respond to local needs that can be quite diverse across States
and regions. Service solutions in some parts of the Northern Territory, for example, are
very different to those in metropolitan centres. It is envisaged that the CHSP will
continue to foster and support locally responsive services.
(DH) This is an opportunity for organisations to have a say. A risk for Victoria is the aged
care industry is dominated by Resi Aged Care where dollars and risks are high and with
potential to swamp community care – the option is to contain costs by managing people
at home.
5. The person centred ASM approach is well managed. Will the Commonwealth
have the same support system at a regional level?
(DSS) The Department is committed to adopting a restorative approach within the CHSP
and is considering how to continue ongoing support for this model of care. Consideration
of Victoria’s ASM industry consultant will be important in this space.
6. The role of the ASM IC should be maintained.
(DH) Victoria is arguing for the IC’s to be maintained. How to achieve a support
structure, will be part of ongoing negotiations.
7. How will network links be maintained across a large region like Victoria?
(DSS) There will be a need to explore possible mechanisms that will allow for exchange
of views between a range of providers and service partners.
8. How will the role of carers be incorporated in the new arrangements?
(DH) The Department of Social Services will be running both systems – Home Care and
Disability.
(DSS) This issue is featuring in discussions currently. The CHSP will incorporate the
National Respite for Carers Program which is designed to support and assist relatives and
friends caring at home for people who are unable to care for themselves because of
disability or frailty. The CHSP will provide respite and other carer supports in a variety
of settings.
9. To what extent are the State DSS beholden to Canberra?
DSS State officers and the Canberra office work very closely together, to ensure
effective and efficient programme administration.
Page 12
Victorian HACC Transition Forums - Key themes and notes from March
the discussion and Q&A sessions 2014
10. How will you ensure the maintenance of the Victorian system benefits
beyond the short term?
(DH) The benefits of the Victorian system will be ongoing and we are hoping embedded
in the guidelines of Commonwealth Home Services Program. Guidelines once finalised
are difficult to change.
(DSS) The strengths of the Victorian HACC system are well regarded and have informed
the design of the CHSP. There will be a great opportunity to advocate for the benefits of
the Victorian system in response to the Discussion Paper to be released shortly.
Loddon
11. Are you evaluating different models between states? Will there be a single
model or will there be flexibility?
(DSS) At the moment HACC is different everywhere, it is diverse. The Commonwealth is
looking at what works, including the ASM. Research on the ASM in WA shows that
allocation of targeted services early when needed can lead to savings. The
Commonwealth does not intend to have a cookie cutter approach but will be working to
achieve greater consistency over the medium term in key areas, such as a nationally
consistent fees policy to ensure equity of access across the nation.
12. Will there be two sets of quality standards?
(DSS) It is expected that CHSP service delivery will be governed by the Home Care
Standards.
(DH) Not sure standards will be new as the major priority is to retain stability whilst
working though the NDIS implementation.
North West Metro
13. CALD providers have done a good job of implementing DH policy. How will
the Commonwealth continue this work? Also, what will happen with
translation and language services funding?
(DSS) Access and diversity are issues featuring prominently in discussions between
governments. The Commonwealth is committed to CHSP services being accessible and
culturally appropriate for all clients. Regarding language services, the credit line is being
discussed with the Commonwealth. The Home Care Packages program has access to
Telephone Interpreter Services (TIS). The Commonwealth is working on the issue,
including what services are required for the Gateway.
(DH) Those at the ECCV consultation session emphasised the need for language services.
DH recognises their importance.
14. Today’s session is a celebration of achievements. What is at risk in the
transition? What might we lose? Also, page 4 of the briefing paper talks
about ‘no parallel system’. What does this mean?
(DH) It references the importance of the ethno-specific agencies to their communities,
but it is not possible to develop a parallel system. We don’t have enough resources.
We need mainstream services to be responsive to the needs of all community members.
The scale of the Greek and Italian communities (for example) has afforded specific
service development, but this is not possible for smaller communities. The same issue
exists for Aboriginal Controlled Community Organisations (ACCOs). Earlier debate on
self-determination meant they were expected to do everything, but this is not feasible.
Page 13
Victorian HACC Transition Forums - Key themes and notes from March
the discussion and Q&A sessions 2014
So DH’s focus has been on linking them to other providers. The same applies to smaller
ethno-specific agencies. All mainstream service providers, particularly local government
and health services, have an obligation to all members of the community.
15. Given that the other states have already transitioned, how much can
actually be preserved from Victoria in a national system?
(DSS) The Commonwealth is developing a new program in the CHSP. It provides an
opportunity to look at the strengths of the Victorian system (and those of other states)
to develop the best national approach. The National Aged Care Alliance (NACA) is also
advising us in this regard. We are looking for sustainable, seamless, end to end aged
care services.
(DH) Victorian DH is reasonably confident that we can embed the benefits in the CHSP.
The transition plan is basically an intergovernmental agreement. The Victorian
Government is clear on what it wants.
16. Financial planning for service providers needs to be done ahead of time.
What should they consider in their financial planning?
(DSS) By the end of the year agencies should know their budgets for 2015-16 and
beyond.
17. The HACC program has been going since 1984. Why change it?
(DSS) In 1984, when the HACC Program was first established, it attracted $28 million
from the Commonwealth as well as matched contributions from states. The
Commonwealth HACC Program is now worth more than $1.1b. There has also been a big
increase in NRCP funding. The change is to address fragmentation, growth in the ageing
population, and the size of the program. The Commonwealth is aiming for a seamless
end to end aged care system, where the whole is greater than the sum of the parts;
a system that keeps people in less intensive programs for as long as possible; a system
with increased responsiveness.
18. We are a PAG provider. In 2015, will accreditation processes be the same?
Also, should they focus more on HACC or PAG?
(DSS) The same reporting process will apply. The organisation will need to look at the
needs in the local area and determine internally which services it wants to deliver.
19. DSS’s presentation has a slide about sustainable funding. Can you provide
more detail?
(DSS) The Commonwealth has introduced a range of measures aimed at making aged
care more sustainable against a backdrop of a rapidly ageing population. These include
removal of the distinction between high and low care, consistent means testing for Home
Care Packages, the introduction of a national fees policy, etc. These reforms will mean
more care can be provided to a larger number of people.
20. Social support – is it valued?
(DSS) The CHSP will have a focus on providing a small amount of support to a large
number of people. There is good evidence for the effectiveness of this approach in terms
of client outcomes and return on investment (see research by Anna Howe, Gill Lewin).
Page 14
Victorian HACC Transition Forums - Key themes and notes from March
the discussion and Q&A sessions 2014
Grampians
21. Low cost accommodation programs, such as SAVVI (Supporting
Accommodation for Vulnerable Victorians Initiative) and Community
Connections. What will happen to these?
(DH) There are a number of Victorian programs that are focused on accommodation
support issues for vulnerable Victorians. These are on our Transition Issues register and
an approach will need to be agreed between governments.
22. Where does emergency support (emergency events, fires, floods etc.) sit?
(DH) There has been funding from HACC that leveraged councils’ roles in identifying
vulnerable people. This has been identified as an issue on our Transition Issues register
and we will need to work out how to manage this through the transition.
MAV
23. What are the four top features of the Victorian system to maintain and what
is the feature to eliminate?
(DSS) In consultations to date, I have been impressed by the ASM reablement focus,
(WA has assessment study showing that getting in early with intensive support can
reduce costs long term), effectiveness of assessment, horizontal network and role of
councils in informing local planning. Vic has lots of strengths. Real innovation comes
from service providers. Also want to get rid of red tape.
24. What is in Base Funding and what about any things not in base, such as
senior citizens centres?
(DSS) That portion of recurrent funding dedicated to 65yrs and older (50 and over for
Aboriginal) will be maintained through a Commonwealth funding agreement – the
remainder of recurrent funding will be a state responsibility.
(DH) Base includes all recurrent funding for service delivery whether it is unit priced or
block funded. All funding will be worked through one by one and how each activity fits
with CHSP. In broad terms what is there will stay there or be redirected and
renegotiated. Senior citizens funding could be managed in a number of ways. Things we
do that support the system are part of base and the Commonwealth has been fully
aware of the funding decisions through the annual supplement.
Hume
25. What is the plan to provide cross border services?
These issues may be addressed in an integrated area planning approach, with a
population needs based planning system to support it. End to end aged care systems will
allow for integrated planning that takes account of local demographic needs and capacity
of the system.
26. Where do Primary Care Partnerships (PCP) and Medicare locals fit
especially with role of council?
(DSS) The Commonwealth is interested in the strengths of local networking.
Page 15
Victorian HACC Transition Forums - Key themes and notes from March
the discussion and Q&A sessions 2014
(DH) There are a couple of different elements and a degree of uncertainty. Medicare
locals are being reviewed and their role is unclear. PCP is well established and council
has a strong role in PCP. We are aiming to not set in concrete a set of arrangements
forever but to create a stable platform to support transition over 3 to 5 years so that
new arrangements can emerge productively.
27. Non-HACC funded Central Hume PCP has quarterly forums that provide
input to Victoria and the Commonwealth. Is there interest and support for
that to continue?
Local networks exist. DH is trying to identify a mechanism to provide local input on
needs to government.
Gippsland
28. We are currently using sharakat software system and are concerned about
moving to purchase new software now – it would be good to see the
specifications to support purchasing options.
(DH) Recommend organisations wait to upgrade their software until more information is
available. This information when available will provide direction to support best decision
with purchase.
29. What communication strategy is being planned for consumers?
(DSS) Commonwealth communications will include information for clients and providers
about the CHSP and the Gateway.
30. If Victoria is maintaining its benefits, is WA doing the same?
(DH) WA has agreed to discuss a similar transition from 2016–17.
(DSS) Discussions are at a very early stage with WA. The best elements of the Victorian
system will be retained.
South Metro and East Metro
31. The Commonwealth HACC Program has operated since 2012. It must have
had guidelines – what will future guidelines be?
(DSS) There are guidelines for the Commonwealth HACC Program but the CHSP will
consolidate a number of programs including HACC, NRCP and the DTC. The CHSP
Discussion paper will be available in next few weeks. Feedback will inform the final
program and the development of program guidelines which will be available later this
year.
32. I feel very positive about recognition of local government, integration of the
system and the linking of system and services. What about costs of
integrating systems? There is a need for serious funding and support for
this.
(DSS) The Commonwealth will consider capability, capacity and support in moving to
new arrangements but it’s too early for detail.
Page 16
Victorian HACC Transition Forums - Key themes and notes from March
the discussion and Q&A sessions 2014
33. Is there any feedback from the CHSP review sessions?
(DSS) There have been a number of reviews to support development of the CHSP. Most
have now concluded. DSS is looking at the changes that are being suggested. This is not
yet complete but in food services, for example, there may be a case to develop National
Nutritional Guidelines for delivered and centre-based meals.
A common theme is the role of volunteers, so CHSP will need to be designed with role of
volunteers in mind. One focus of sector support and development under the CHSP will
be maintaining support for volunteers. Volunteers are currently used extensively in
delivering meals, providing transport and social interaction at day care centres and in
the community. It is also recognised that volunteers play a key role in many services
meeting the needs of CALD clients. Volunteers will continue to play a central role in the
CHSP.
The greatest changes could potentially be in Service Group 2 services and the interface
between assessment and the Gateway. More information on the findings of service type
reviews will be in the CHSP discussion paper.
34. We operate community service - subacute and HACC. Has any thought been
given to alignment in transitions?
(DH) The only programs in scope are HACC, resi, etc.
Aboriginal Sector
35. Who will be funding the under 50 age group? Will we have the same
services for the under and over 50s?
(DSS) DSS will consult with providers to determine the funding split. We will also look at
the administration burden.
(DH) There won’t be the same flexibility of funding. Due to the under/over 50 split there
will be more buckets of funding. There will be the same services for the under/over 50s.
However, if an ACCO only has clients over age 50 then the ACCO will not get funding for
the under 50s.
36. Will the 1800 number be toll free and will you accept a text message?
Some community members only have incoming messages.
(DSS) Access arrangements are still being worked through. Currently there are many
systems across the country and they are fragmented. We want to provide a simple,
recognisable means of accessing the system.
37. Can the client ring the ACCO and the ACCO advocate on behalf of the client
to the gateway?
(DSS) Yes, the ACCO can advocate on behalf of the client with the client’s consent. The
intent of the Gateway is to increase access, not put up barriers.
Page 17
Victorian HACC Transition Forums - Key themes and notes from March
the discussion and Q&A sessions 2014
Attachment A
Retaining the benefits of the Victorian HACC System: a state of
stable service delivery
Background Paper for HACC Transition Consultations over
February 2014
Ageing and Aged Care Branch
Victorian Department of Health
The Commonwealth and Victorian Governments NDIS Heads of Agreement (May 20134)
commits the Commonwealth and Victorian governments to work together “to retain the
benefits of Victoria’s current Home and Community Care system” through the process of
transition of services and resources for people aged 65+ to the Commonwealth
Government’s responsibility.
This paper articulates the benefits of the Victorian system.
The community care system in Victoria is unusual in Australia because of:





the connections between community care, primary care and health services that
work for the benefit of older people.
the extensive involvement of local government in service delivery as well as
planning and funding services;
a system wide focus on promoting wellness, aimed at preventing decline and
maintaining people’s independence in function;
a strong assessment framework; and
system wide reform initiatives such as person centred care (Active Service Model
- ASM), and diversity planning and practice.
Connections between community care, primary care and health services
Victoria recognised in the early 1990s that it needed to put concerted work into keeping
people well and out of hospital because it has fewer hospital beds per capita than any
other State or Territory and a relatively older population structure with a high proportion
from CALD backgrounds that migrated to Victoria post World War II. It had a high
proportion of people with chronic disease as well in the 65+ age group.
As a result it developed a range of diversionary strategies aimed at supporting people in
the community and helping them to manage their chronic disease symptoms in a stable
state. Those diversionary strategies were underpinned by an overall focus on
collaborative working relationships between primary and community care providers and
health services.
They include the Primary Care Partnerships Strategy, the Hospital Admission Risk
Program, sub-acute services, Chronic Disease Self Management in community health
services, and holistic face to face assessment and a wellness promoting approach in the
HACC Program. This collaborative approach is now fundamental to the way services are
delivered in Victoria, underpinned by common information collection tools and electronic
sharing of client information.
Page 18
Victorian HACC Transition Forums - Key themes and notes from March
the discussion and Q&A sessions 2014
Local Government involvement
The involvement of local councils in home care services pre-dates the HACC Program by
several decades. Councils had been providers of ‘home help’ and delivered meals going
back until at least the 1950s. The creation of the HACC Program in 1985 brought under
one administrative and funding framework a variety of pre-existing funding and subsidy
schemes, creating in Victorian councils one program with multiple service types.
Today local councils have a foundational role in service delivery. 72 out of 79 Victorian
councils are involved in delivering a broad range of services including domestic
assistance, personal care, home maintenance, respite services social support and
delivered meals. Their role in delivering this range of services is part of their broader
engagement with older people in their local communities.
The Municipal Association of Victoria (MAV) estimates that councils contribute
approximately $115million pa to their aged and disability programs, most of which is
HACC services3.
Councils are active participants in policy and service development and contribute
significant drive to directions set by the State.
In Victoria, council involvement has led to a system where there is one major service
provider in home based services in each Local Government Area (LGA) 4 providing:
 an easily identifiable access point into other HACC and related services, whether
funded or not;
 an holistic assessment of client needs;
 the full suite of HACC home based services (excluding nursing and allied health);
and
 a coordinated approach to referring clients to other aged care, disability and
health services as needed through the Victorian Service Coordination Framework.
Council involvement in HACC gives the program a community services planning base,
links to broader Council responsibilities and involvement with their local communities. It
links to their role in planning and delivering the physical environment for their
communities, their statutory role in developing and executing Municipal Health and
Wellbeing Plans, positive ageing strategies, and emergency management systems for
vulnerable people. Councils also provide effective linkages, based on local orientation,
co-operative relationships and continuity of personnel over time, between community
care services and the other local social, recreational, and health maintaining services
used by older people.
Health Services Involvement
In Victoria, local councils receive the greatest share of total HACC funding at 38%. The
next is health services at 26%, followed by district nursing services at 20%. The
Victorian investment in HACC allied health and district nursing and their location in
organisations that can provide the clinical governance and economies of scale, have
ensured strong links with local hospital and primary health care services. Health and
district nursing services work closely with councils and other HACC providers connecting
them with the broader health care system.
The Royal District Nursing Service is the dominant provider of home nursing across
metropolitan Melbourne.
Municipal Association of Victoria, Submission to Productivity Commission Inquiry: Caring for Older Australians
2010, p.4
4
In 73 of the 79 Victorian LGAs, that provider is the council with the remaining being either Community Health
Services (6 LGAs) or a NGO (1 LGA), with strong planning links to the council.
3
Page 19
Victorian HACC Transition Forums - Key themes and notes from March
the discussion and Q&A sessions 2014
In most rural LGAs, there are primarily two HACC providers: the local council providing a
range of home based services; and the Community Health Service or Health Service
providing district nursing and allied health. There are effective linkages with health
services, particularly acute and post-acute, via the co-location of the Aged Care
Assessment Services (ACAS). There are also strong links with community health services
through investment in community nursing, and with primary care, through allied health.
In six of the 7 LGAs where the council is not providing HACC services, this role is
undertaken by the local Community Health Centre.
Population based funds allocation and local planning processes
The majority of HACC services in Victoria are unit priced – almost 87%. Most growth
funds are directly allocated to funded organisations recurrently through the standard
Department of Health funding and service agreement – in 2012-13 around 85% of
growth was directly allocated to agencies without the need for a resource intensive and
time-consuming submission based process. Where there is more than one possible
provider for additional services, the Department undertakes an invited or advertised
competitive submission process. There are opportunities for agencies to renegotiate their
targets with the Department each year based on demand for services.
The Department allocates growth funds each year to address funds disparities across
different LGAs and regions based on a per capita funds measure based on population
data adjusted to estimate the distribution of the target population. The resource
allocation method takes into account existing funds per capita and seeks to equalise per
capita funds across the State through the allocation of growth funds. The estimate of the
target population is based on the Census needs assistance questions.
This approach is transparent and promotes stability in service delivery.
The Department engages local councils, health services, non government organisations
and key stakeholders in developing a three year plan for the State, based on agreed
policy directions. Annually service providers come together on a regional basis to make
recommendations about where demand is felt and how it can be best met through the
purchase of particular services with growth funds. This planning and consultation process
takes place at a subregional level and is based in local knowledge from service providers.
Generally, the amount of growth funds available in a particular region in a year for a
particular service is too small to attract a new entrant who is not already in the market
delivering those services. There is no in principle obstacle to new entrants, however too
many providers also generates confusion for clients and fragmentation in the service
system, and where they are located at distance from the service delivery area often
results in brokering out of services and lack of local knowledge. New providers should be
evaluated on their capacity to operate on the basis of collaboration with other local
providers, offer integrated services for the benefit of their clients, and be prepared to
have a local presence.
Investing in workforce and infrastructure
Victoria has developed a large, well skilled and relatively well paid community care
workforce in assessment, nursing, allied health and home support. There is considerable
investment in their training, skill development and knowledge, particularly from local
governments.
Page 20
Victorian HACC Transition Forums - Key themes and notes from March
the discussion and Q&A sessions 2014
The Victorian Department has engaged with the sector on training needs over the last
decade. The department has recently moved to a single Education and Training Service
that will plan, coordinate, promote and deliver education and training to the HACC
workforce. The new service will provide consistent, training focused on high priority
training needs that are aligned with the program’s priorities and directions. Chisholm
TAFE, the provider, is exploring information and communication technology learning
options to further improve access to training.
Agencies receive an amount of money each year as a minor capital grant, to enable
them to purchase the equipment they need for service delivery. The size of the grant is
calibrated to their underlying budget and the amount of growth they receive.
There is also considerable investment in infrastructure used for HACC funded activities,
particularly by councils: premises for planned activity groups, senior citizens centres,
vehicles used for community transport and food production facilities. The centralised
food production facility, Community Chef5, is a particular example of large capital
investment from councils, Commonwealth and State Governments. The State
Government has recognised this joint local government initiative by exempting
participating local governments from needing to tender their meals services.
Investing in the system – reform
There has been substantial investment in creating an underlying system that supports
funded organisations in delivering coordinated person centred services that are
underpinned by the wellness approach and appropriate to the diverse needs of their
client catchments. Some of this system support includes:
5

The development of networks of local agencies to coordinate care for people
using their services, underpinned by electronic information exchange and
common information collection tools;
o Service coordination practices and standards have been in place among
primary and community care providers for almost 10 years.
o As part of the PCP Strategy, the Department required the use of Victoria’s
service coordination tools and templates (SCTT) by HACC funded
organisations. Use of SCTT ensures consistent collection of client information
in a standardised way.
o This is a broader system reform than for those agencies funded to deliver
HACC services but they are central to its operation. It has substantially
improved communication between service providers, through client
information sharing, referrals to other service providers for services and
feedback between service providers about the results.

A wellness approach to delivering services (Active Service Model) that focuses on
engaging people seeking services, establishing what their personal goals are and
then working with them to develop the capacity to achieve their goals. This is
largely done by assisting people to do as much as they can for themselves,
encouraging much needed exercise, helping people regain skills and build
confidence to try new things. This might include assisting a person to do their
own shopping and prepare meals again. It may mean building up a person's
strength and mobility through aids and equipment, attending a fitness class or an
exercise regime in their own home so that they can get out and about more in
the community.
Community Chef produces over one third of all Victorian meals for the HACC Program
Page 21
Victorian HACC Transition Forums - Key themes and notes from March
the discussion and Q&A sessions 2014
o
o
Agencies work in a structured planning and review framework supported
by a worker in each region whose role is to build capacity in agencies to
achieve the Active Service Model objectives.
The local linkages developed between assessment services and allied
health also supports the wellness and enablement approach.

Funding of clinical nursing consultants on a regional basis to support district
nursing services and residential services to improve wound management. HACC
funding also funds wound consumables to assist clients in accessing the most
appropriate products for wound dressings. Community nursing has an important
impact on demand for both hospital and primary health. The RDNS has also
provided clinical leadership in developing best practice and associated tools and
processes.

Improving access for diverse groups – the rationale for this approach is that
home and community care services act as a safety net and positive diversionary
capacity from more expensive services. It is important that they are accessible by
all, regardless of ethnic, cultural religious or gender identity. It is clearly not
feasible to establish parallel service systems for people from a variety of ethnic
and other backgrounds. The focus is therefore on making generic services
accessible and acceptable to everyone in their catchments.
o Improving access to culturally appropriate services for Aboriginal and
cultural and linguistically diverse (CALD) communities.
o Ongoing funding for Aboriginal liaison workers providing outreach to
communities
o Aboriginal development workers helping Aboriginal Community Controlled
Organisations (ACCO) deliver services in line with Program and service
agreement requirements
o Support for ACCO regional and statewide networks to ensure service
planning and development meets community needs
o A new service type, Access and Support, has been developed that will
deliver an improved client focus to support people with complex needs due
to diversity (defined broadly to include cultural, ethnic, religious or sexual
identity among other things) to access a wider range of services. This
service type is unit priced with worker positions located in a range of HACC
funded organisations.
o A HACC funded statewide system of language service credit lines that
allows HACC funded organisations access to high quality face to face and
over the phone interpreting services at critical times in a client’s journey
through the service system.
o Outreach programs such as Community Connections, meals services and
the Royal District Nursing Service Homeless Person’s Project that provide
services to, and support for, HACC target group people who are at risk of
homelessness
o Positions have been funded to support the implementation of Diversity
Planning in each region. These positions work to build capacity in smaller
agencies.
This systemic approach ensures that clients and their carers are supported at key stages
in their journey in and through the service system and that funded organisations have
the support and infrastructure to ensure they can link clients to service and non-service
responses appropriate to their needs and goals. This type of systematic approach has
been described by one key stakeholder as the ‘glue that holds the service system
together’6.
6
Conclusion from the Stakeholders’ working group convened by the Victorian Department of Health to define
the benefits of the Victorian HACC system in July 2013
Page 22
Victorian HACC Transition Forums - Key themes and notes from March
the discussion and Q&A sessions 2014
Investing in good assessment
Consistent person and family centred assessment, building on personal goal setting and
a wellness promoting approach to service delivery, is the basis of the Victorian
assessment framework.
Home and community care services reach approximately 300,000 in a year. By
definition, if they are eligible for service, they are people who with some assistance, can
continue to live well and safely in their own homes and in their communities. There is
ample evidence that managing people’s environmental risk and risk of deteriorating
health and function at this point can significantly defer their need to use more expensive
services.
Older people faced with change in their functional capacities deserve an assessment
process that best fits their needs and circumstances. For many this includes the choice of
face to face information about the service systems and advice re options, working on a
care plan to meet their objectives and, when necessary, being allocated a range of
services and given support to access them, particularly where they may not all be
offered by one provider.
The Victorian home and community care program funds face to face, person centred
assessment, care coordination, care planning and review. Assessment acts as
community triage, making sure that people get the response they need, whether that is
a funded service from HACC, a health service or another community based resource.
Face to face assessment of the person in their home at the point where they first signal
that they need assistance includes:

Initial needs identification

A holistic needs assessment

Service specific assessments for HACC services provided by
assessing agency

Goal directed care planning including individual service plans,

OH&S assessment

Care plan implementation and Review

Care coordination for clients with multi agency involvement.
There are 100 designated HACC Assessment Services (HAS) including the 73 councils
funded to provide HACC services and a number of Community Health and district nursing
services. The rationale for this is that they already have a requirement, because of the
nature of the services they deliver, to visit the person at home. The HAS ensure all
services are considered and pick up on other objectives and preferences an older person
may have.
HACC Assessment services and ACAS also do assessments for personal alerts funded
through the Personal Alert Victoria (PAV) program. PAV is a separate $10million Victorian
aged care program assisting 27,000 vulnerable people to remain at home safely. HAS in
local government also assist vulnerable people to develop personal emergency plans to
support the state’s Vulnerable People in Emergencies policy.
The ‘Stable System’ as the key Victorian strength
Victoria’s service delivery occurs from a reasonably stable and integrated suite of
agencies which deliver services aimed at keeping people well and safe in their homes
and communities. It is underpinned by:
Page 23
Victorian HACC Transition Forums - Key themes and notes from March
the discussion and Q&A sessions 2014







A partnership approach – locally networked services that understand each other’s
roles and practices so that individuals get a coordinated response that is tailored
to their needs
State wide service system design and resource allocation that has produced a
stable integrated and localised service delivery platform that is uniform across the
State and anchored by councils, health services and community health centres as
major providers of the most used services
Links between local community care service system planning and co-ordination
with local government’s legislated health and wellbeing planning role, planning for
age friendly cities and positive ageing planning, plus support for activities to
promote wellness and seniors’ participation
Additional State and local government funding - including local government
contribution to service costs,
investment in infrastructure used for meals
production, HACC funded social support activities, and community transport
A wellness promoting approach to service delivery that begins when people first
make contact with the service system; a person centred approach to assessment
and care planning that focuses on taking advantage of early opportunities to
reduce people’s risks and to maximise their capacity to continue to live at home
Fit for purpose assessment – co-ordinated sub regional and local assessment
services, with ACAS retaining close links to health services and face to face living
at home assessment for community care and support services with capacity for
using local knowledge and linkages
A qualified, well trained, established workforce on fair wages.
For the system to continue as it is currently configured, it requires a strong and
locally connected system management approach providing policy leadership,
providing resources for service system development and fostering a networked and
partnership approach between funded organisations at local and regional levels.
Page 24