Final Report on RREF 2001 - Department of Health

Part B: Development of Options for a Revised RREF
• Data from the Aged Care Assessment Teams has consistently shown that a
substantial proportion of those assessed as requiring nursing home care are
in acute care immediately prior to admission to residential care rather than
living in the community.
Resource implications
• It was considered that inclusion of the residential care shortfall in the RREF
could imply that HACC rather than the Commonwealth residential care
program should make up for the deficit of resources. The level of resources
available to HACC however means that this is certainly not the case and
funding for residential care places is needed either directly or by way of
CACPs or Extended Aged Care at Home packages.
• Consistent with exclusion of the VHC eligible population on the grounds of
alternative funding being available, the Commonwealth funds the
Residential Care Program and should be responsible for funding up to the
target levels.
• While acknowledging the local impact of shortfalls in residential care on
HACC services, the most appropriate response to this situation is seen to be
through the Commonwealth residential care program. In the light of the
considerations noted above, and especially the need to address the
residential care shortfall directly rather than through HACC, it is considered
that the RREF should not include the residential care shortfall either as a
need factor or in the base population.
Cross-border regions
In regions bordering other states, queries were raised about how cross border
movements could be taken into account in the base population. While
recognising the importance of this issue to local areas, the RREF base
population can only be based on the resident population reported at the Census
and in other data bases. Issues of cross border access and delivery of services
need to be addressed both at Commonwealth-State level and in local planning
in these border areas.
Alternative options for base populations
Some participants suggested additional permutations for the base population.
Some proposals were made for different adjustments for the old-old on the basis
of the high rate of handicap in the 85 and over age group. The small size of this
group however mean that any adjustment in addition to the Base 3 option of
doubling the population aged 70+ with core activity restrictions would make
only a marginal difference but add complexity to a revised RREF formula.
Another variant involved doubling those with a profound core activity
restriction aged under 70. This option is limited by the low rates of profound
handicap at younger age groups, which mean that separating out the different
levels of handicap would reduce the reliability of estimates of prevalence of
handicap, and add complexity to the model. Maintaining use of the full rates
for moderate, severe and profound handicap for all age groups also provides
greater consistency with formulas used in other programs.
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