Final Report on RREF 2001 - Department of Health

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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. <strong>Final</strong> <strong>Report</strong> July 2001 30
Part B: Development of Options for a Revised RREF 1.8 RESOLUTION OF OPTIONS FOR THE RREF BASE POPULATION Data for defining the population in need of HACC services Continue to use DACS data, with DHS to continue to liaise with the ABS to optimise the usefulness of the next DACS survey for planning of HACC and other programs. Options for prevalence of handicap Use statewide prevalence Population living in the community: Proceed with modelling on a provisional basis with use of currently available data for aged residential care on approved beds as at September 2000, but to be updated with data on actual residents in implementation of a revised RREF. Adjustment for the frail aged The views expressed at the consultations and the tally of the response sheets completed by participants showed that: • Preferences between Base 2 and Base 3 showed a marginal preference for Base 2. The grounds that Base 2 gave a larger base population can be set aside as the size of the base population does not affect resource levels, while the goals of early intervention and primary prevention in the young-old population go beyond the scope of HACC. • Those preferring Base 3 perceived that it was more balanced towards the frail aged 70+ and those with chronic illnesses, more accurately reflected the current HACC user group and those requiring complex care, and allowed for secondary prevention. • Given this balance of preferences and to provide comparison of outcomes, models are presented below for a revised RREF with both base populations Option 2: including the total population 70+, and Option 3: doubling the moderately, severely and profoundly handicapped population aged 70+ Veterans As the RREF is a resource allocation tool, the veteran population eligible for the VHC program should be excluded from the base population because of the additional resources that are now available to these clients. This exclusion in the formula does not mean that VHC eligible veterans are excluded from receiving HACC services. <strong>Final</strong> <strong>Report</strong> July 2001 31
Page 1 and 2: FINAL REPORT REVIEW OF THE RELATIVE
Page 3 and 4: STEP 3: OPTIONS FOR SCALING NEED VA
Page 5 and 6: ABBREVIATIONS AND NOTE ON TERMINOLO
Page 7 and 8: ACKNOWLEDGEMENTS An exercise as ext
Page 9 and 10: EXECUTIVE SUMMARY The Review of the
Page 11 and 12: Executive Summary All regions will
Page 13 and 14: Executive Summary Beyond the detail
Page 15 and 16: Executive Summary 9. The planning a
Page 17 and 18: PART A: BACKGROUND AND SCOPE OF THE
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Page 39 and 40: Final Repo
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Page 59 and 60: Step 4: Options for weighting need
Page 65 and 66: Profiles of Need Variables Part B:
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Part C: Outcomes The adjustment for
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Part D: Achieving Equity in the HAC
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Unit cost structure The unit cost s
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Part D: Achieving Equity in the HAC
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APPENDIX 1.1 continued Commonwealth
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APPENDIX 1.4: SUBMISSIONS RECEIVED
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Frequently Asked Questions A number
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DACS • 2.5% of children in the 0-
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LGA Median H’hold Inc. YLD Lang o
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Department of Human Services 1999b.
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Final Report on RREF 2001 - Department of Health

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