Final Report on RREF 2001 - Department of Health

Part B: Development of Options for a Revised RREF
Compared to inclusion of the total population aged 70 and over in Base 2,
adjustment for the frail aged by doubling the DACS handicapped population
aged 70+ in Base 3 was seen to give a better match to the actual HACC client
population as it reflects the definition of the HACC target population and broad
eligibility criteria relating to need for assistance, and allows for attention to
secondary prevention among those with some level of activity restriction.
Balancing the discussion of adjustments for the frail aged, some issues
concerning the way in which younger people with disabilities were covered in
the base population were raised:
The concern that adjustment for the frail aged would disadvantage LGAs and
regions areas with relatively lower proportions aged 70+ in the population was
addressed by the age specific rates of handicap being applied to the underlying
age structure, so that relatively larger younger age cohorts would be taken into
account.
It was also noted that 0-4 age group were included in the 1998 DACS, but not
in the 1993 survey.
5. Veterans eligible for DVA Veterans’ Home Care Program (VHC)
Views as to how veterans eligible for the VHC should be taken into account
showed a marked shift between the two rounds of consultations. At the time of
the Round 1 Consultations, in November-December 2000, arrangements for the
VHC had not been finalised, but by March-April 2001, implementation had
commenced and providers’ actual and anticipated experiences were coming into
play.
The resources that VHC can add in Victoria for service provision to some
67,700 eligible veterans, not all of whom will be service users at any one time,
are close to the total annual growth funds for HACC which have to be spread
across the total target population, among which there is a recognised level of
unmet need. Notwithstanding the service limits specified in the VHC
guidelines, access to VHC resources has the capacity to provide eligible
veterans with levels of service at least comparable to existing HACC services
and in doing so, would free HACC resources for other clients. In considering
how veterans should be taken into account in the base population, it is useful to
separate the resource issues of relevance to the RREF as a resource allocation
formula from the practical issues of implementation of VHC that were raised by
providers in the Round 2 consultations.
Implementation issues: The view that veterans eligible for VHC should not be
subtracted from the RREF base population reflected the early implementation
phase of the program. While there was caution overall about the rate of
progress with implementation, and the proportion of existing veteran clients
who would opt to switch to VHC, it was evident that as well as encountering
some problems, providers were reaching satisfactory solutions, suggesting that
early uncertainties could be ironed out in time. Several suggestions were put
forward for promoting take up of VHC by way of positive presentation of
options to veteran clients, especially continuity of direct care staff, and other
practical matters. Negotiations between DVA, DHS, the Municipal Association
of Victoria and other provider bodies also has a part to play in facilitating
implementation, as would the VHC evaluation process.
<strong>Final</strong> <strong>Report</strong> July 2001 27