Government Response - Report on the inquiry into better support for carers 31-35

Recommendations 31 - 35 

Recommendation 31

That the Minister for Families, Housing, Community Services and Indigenous Affairs fund research into the profiles and specific needs of Indigenous carers.



AGREE TO FURTHER CONSIDER

In 2009 the Commonwealth Government, though the Department of Families, Housing, Community Services and Indigenous Affairs, commissioned the Social Policy Research Centre, University of New South Wales, to determine what information is known and what further information is needed about Indigenous carers. This work will inform any future research which will form part of the Department’s strategic research and evaluation agenda.

Footprints in Time: The Longitudinal Study of Indigenous Children is also funded through the Department of Families, Housing, Community Services and Indigenous Affairs. In 2008, the study collected data from 1687 parents and carers of children aged approximately 6 to 18 months and 3 and a half to 4 and a half years old. The study is collecting important information about the lives of Aboriginal and Torres Strait Islander children, covering areas such as health, culture, education, housing and family relationships. Questions which ask parents and carers of children with disabilities for some more in-depth information about the impact of the disability on their family are being piloted for Wave 3 (2010).

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Recommendation 32

That the Minister for Families, Housing, Community Services and Indigenous Affairs and the Minister for Health and Ageing examine the adequacy of culturally appropriate community care services funded by the Australian Government for Indigenous carers, particularly for those living in remote areas, with the intention of increasing the accessibility and availability of those services.



AGREE

The Commonwealth Government agrees with this recommendation and has already undertaken significant work to ensure that culturally appropriate community care services are funded for Indigenous carers.

Furthermore, the Commonwealth Government recognises that overcoming Indigenous disadvantage requires long-term intergenerational commitment to directing major effort across a range of building blocks2 that support reforms aimed at ‘Closing the Gap’ between Indigenous and non‑Indigenous people against six specific targets.

The Council of Australian Governments has begun addressing Indigenous disadvantage by developing national partnerships that focus on addressing one or more of the building blocks: remote Indigenous service delivery; Indigenous economic participation; Indigenous early childhood development; Indigenous health outcomes; and remote Indigenous housing.

The National Partnership on Remote Service Delivery will provide a total of $291.2 million over six years (with $187.7 million provided by the Commonwealth Government) to improve the delivery of services across 29 remote locations. Under this agreement, Governments will provide integrated engagement and service planning through a single interface. The aims of this new remote service delivery model include ensuring that:

  • Indigenous people in the remote locations have improved access to the suitable and culturally-inclusive services required to progress achievement towards the Council of Australian Governments targets
  • Indigenous communities are able to be partners in program implementation through credible and culturally-legitimate mechanisms
  • culturally-competent services are provided to Indigenous people to enable the achievement of equitable outcomes.

The Commonwealth Government has appointed a Coordinator‑General for Remote Indigenous Services to drive the implementation of reforms.

Furthermore, increasing access to services for Indigenous Australians is a priority area for action under the National Disability Agreement. To address this priority, the Commonwealth and State and Territory Governments have agreed to develop a National Indigenous Access Framework, to ensure that the needs of Indigenous Australians with disability, their families and carers are addressed through appropriate service delivery arrangements.

The following are current initiatives and measures the Commonwealth Government has in place to ensure that Indigenous carers have access to culturally appropriate community care services:

  • service providers are required to demonstrate culturally appropriate services for Indigenous carers accessing:
    • the Young Carers Respite and Information Services Program
    • the Respite Support for Carers of Young People with a Severe or Profound Disability Program
    • the MyTime Peer Support Program
    • the Outside School Hours Care for Teenagers with Disability Program.
  • service providers are required to demonstrate cultural competence and accessibility in remote areas under the Mental Health Respite Program.
  • Indigenous people are recognised as a special needs group under the Home and Community Care Program.
  • Indigenous people are recognised as a priority target group in the planning and allocation framework for the National Respite for Carers Program’s Community Packaged Care Programs and Residential Respite Program.

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Recommendation 33

Recognising the ageing demographic of the carer population and the increased longevity of many care receivers, that the Minister for Families, Housing, Community Services and Indigenous Affairs and the Minister for Health and Ageing increase capital and recurrent funding for respite care services funded by the Australian Government as a matter of urgency to more closely match demand across the country. Particular attention should be paid to improving the:

  • availability and accessibility;
  • affordability;
  • responsiveness to the needs of both carer and care receiver of respite services; and
  • responsiveness to the needs of carers and care receivers living in regional, rural and remote areas.


AGREE

The Commonwealth Government agrees with this recommendation and has provided State and Territory Governments with a significant injection of funding to improve and expand services for people with disability and their families and carers, including respite services. The Commonwealth Government has also allocated additional funding to the Respite Support for Carers of Young People with Severe or Profound Disability Program and the National Respite for Carers Program. The Commonwealth Government is also working to address unmet demand by streamlining respite services through the National Respite for Carers Program.

The Commonwealth Government also notes that the community care, aged care, disability and community mental health service systems are all undergoing significant reforms or agreement has been reached to progress significant reforms in the near future. The outcomes of these reforms are critical to future planning in the area of respite services.

Additional respite services

The Commonwealth Government has provided State and Territory Governments with a significant injection of funding of more than $5 billion, over five years, through the National Disability Agreement to improve and expand services for people with disability and their families and carers. This includes the highest ever level of indexation of funding from the Commonwealth for disability services.

State and Territory Governments agreed to provide an additional 10,000 respite places to support people with disability and their carers in a range of forms across Australia.

The Commonwealth Government is providing an additional $2.1 million in
2009-10 to the Respite Support for Carers of Young People with Severe or Profound Disability Program to provide emergency and short-term respite to an additional 600 carers.

In addition, the Commonwealth Government in February 2009 reallocated $12.2 million over two and a half years to expand the availability of respite services across Australia through the National Respite for Carers Program.

Streamlining and improving respite services

The Commonwealth Government recognises that unmet demand for respite services is closely linked to the fragmentation and lack of coordination of respite programs across government. As part of its 2007 election policy on disability and carers, the Commonwealth Government committed to ‘streamlining respite services to create a more sensible system for carers’, noting that ‘responsibility for respite services is currently split between several departments and programs without any attempt at coordination’.

The Commonwealth Government will undertake work to streamline respite services provided through the National Respite for Carers Program to ensure viability, affordability and accessibility; responsiveness to the needs of both the carer and care receiver; and responsiveness to the needs of carers and care receivers living in regional, rural and remote areas.

The Commonwealth Government notes that the Mental Health Respite Program is focusing attention on improving availability and accessibility, affordability and responsiveness and has adapted services to specifically meet the needs of carers and care receivers in rural and remote areas.
The Department of Families, Housing, Community Services and Indigenous Affairs is currently evaluating the Commonwealth Government’s community mental health programs, including the Mental Health Respite Program. Improvements to the effectiveness and reach of the Mental Health Respite Program will be considered as part of the outcome of the evaluation.

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Recommendation 34

That the Minister for Health and Ageing and the Minister for Families, Housing, Community Services and Indigenous Affairs increase funding for in-home assistance for carers in order to more closely meet demand.



AGREE

As outlined in the response to Recommendation 33, the Commonwealth Government has provided a significant injection of funding to drive important reforms to the disability services system, including the need to provide more in‑home support services, through the National Disability Agreement, which commenced on 1 January 2009.

State and Territory Governments have agreed to provide an additional 2,300 in-home support services to support people with disability.

The bulk of Commonwealth funding for in-home assistance is provided through:

  • the Home and Community Care Program, which is delivered by State and Territory Governments who are responsible for monitoring demand for services and responding to unmet need
  • the Community Aged Care Packages, Extended Aged Care At Home packages and Extended Aged Care at Home – Dementia packages, which provide a range of services such as personal care, social support, home help, meal preparation and garden maintenance within an individualised package
  • the National Respite for Carers Program, which provides an element of indirect respite to support carers in performing tasks undertaken in their caring role and may include domestic assistance and home maintenance.

In addition the Mental Health Respite Program delivered by the Department of Families, Housing, Community Services and Indigenous Affairs includes forms of in-home assistance for carers as indirect respite when direct respite is not appropriate. The Commonwealth Government notes that, as stated in the response to Recommendation 33, this program is being reviewed as part of the larger evaluation of the Commonwealth Government’s community mental health programs and changes to the effectiveness and reach of the program will be considered as part of the outcome of the evaluation.

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Recommendation 35


That the Minister for Families, Housing, Community Services and Indigenous Affairs and the Minister for Health and Ageing undertake pilot studies to test the potential for the Australian Government’s funding for carer respite and in-home assistance to be re‑allocated directly to carers through ‘individualised funding programs’ (also known as ‘consumer directed care’ and ‘self managed funding’).


AGREE TO FURTHER CONSIDER

The Commonwealth Government supports a person-centred approach to service provision and the move towards individualised funding. Individualised funding is one of the key reform priorities under the National Disability Agreement and will deliver significant benefits to people with disability and indirectly to their carers and families.

As part of the National Disability Agreement the Commonwealth and State and Territory Governments have agreed to ‘ensure services are person centred and provide timely access to supports based on assessed needs’. Jurisdictions have also agreed to develop a ‘National Framework for Service Planning and Access’ which will ‘focus on providing a person centred approach to service delivery’.

The Commonwealth Government, through the Department of Health and Ageing, is currently considering options for individualised funding programs or consumer directed care for care recipients and their carers accessing aged care services.

The Commonwealth Government notes that while individualised funding approaches for people with disability (and their carers indirectly) have been tested and available since the early 1990s, individualised funding directly for carers has not been sufficiently investigated to implement a pilot at this time.

The Commonwealth Government agrees to further consider this noting that consumer directed care options will not be appropriate for all carers and care receivers, and should be offered as one of several options.

  1. The Council of Australian Governments has also agreed to seven strategic platforms or ‘building blocks’: early childhood, schooling, health, economic participation, healthy homes, safe communities, and governance and leadership.

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