Final Report on RREF 2001 - Department of Health

Part B: Development of Options for a Revised RREF
STEP 1: OPTIONS FOR DEFINING THE RREF BASE POPULATION
1.1 IDENTIFYING THOSE IN NEED OF HACC SERVICES
In considering options for operationalising the HACC target population and then considering
need factors to be taken into account in weighting the RREF, the Review team found it useful to
distinguish between:
1. The HACC target population which is defined in the 1985 HACC Act
as younger people with a disability and frail aged individuals who are
living in the community and who are eligible to receive HACC services
on the grounds of having a level of disability that affects their capacity
to perform activities of daily living and participate in the community.
2. The RREF base population which in the first instance is based on the
operationalisation of the HACC target population at both
Commonwealth and State levels by reference to the ABS Disability,
Ageing and Carers Survey as those living in the community with a
moderate, severe or profound level of core activity restriction.
3. The RREF weighted population which is the RREF base population
for each LGA weighted by the various need factors considered to more
accurately discriminate between regions on the basis of different levels
of need and hence to be taken into account in resource allocation. The
only weighting factor in the current RREF is for rurality.
The need for HACC services arises when people experience on-going difficulties or need
assistance in carrying out activities of daily living and participating in social and community
life. Defining the HACC target population, therefore, requires a means of identifying those who
experience such difficulties or who need assistance. Two further considerations need to be
noted. First, as HACC services have a preventative function, it is necessary for this definition to
include those who experience difficulties and are at risk of increasing dependency as well as
those who already have a significant limitation and need assistance. Second, eligibility for
HACC is based on dependency and need for assistance only, and fees are assessed only after a
client’s need for support is assessed. Fees paid by many clients cover only part of the cost of
service, and only a relatively small proportion pay full fees; using HACC services on a full fee
paying basis or opting for an alternative provider, if there is one available, is thus a choice for
relatively few, and those paying full or part fees should continue to have the option of
purchasing services from HACC providers.
A number of reservations were expressed about the use of the DACS data for identifying the
base population for the RREF. Frequently Asked Questions concerned the definitions used and
methods and scope of the survey. While answers to most of these FAQs about technical aspects
of the survey can be found in ABS reports on the DACS, these are not readily available in the
field, and the common FAQs and responses are included in Appendix 2.
A further issue of particular concern was the adequacy of the DACS for identifying persons of
Koori background, due to the sample size, declaration of Koori identification and cultural
factors affecting expression of disability and need for assistance.
<strong>Final</strong> <strong>Report</strong> July 2001 16