Triennial Plan: Home and Community Care Queensland 2008-2011

The implementation of reform initiatives arising from the common 

arrangements agreed to under the HACC Review Agreement 2007 and 

associated mechanisms are a key element of activity to be undertaken in this 

triennium. The state is committed to the implementation of these arrangements 

in a manner that is cognisant of the National Reform Agenda and accounts for 

intersecting state-based initiatives impacting on the sector. 

2 Needs analysis 

2.1 Queensland’s population 

Queensland’s population passed the 4 million mark in 2006. By 2026 the 

population is expected to increase to 5.6 million and will reach an estimated 

7.1 million by 2051. 

The majority of growth is projected for the older age groups, with the number 

of people aged 65 years and over representing 11.6% of the population in 

2001 and projected to comprise 27.7% of the population in 2051. 

The number of persons aged 80 and over is projected to increase almost 

600% over the next 50 years from 101,900 to 685,500. As a proportion of the 

population, this age group is projected to increase from 2.8% in 2001 to 4.1% 

in 2021 and 10.6% in 2051. The 2001 Census indicated there were nearly 

twice as many females in the 80 years and over age group than males. 

In the 2001 Census, 443,105 of the enumerated population were aged 65 

and over. Of these, 3,041 persons (0.6%) identified themselves as being 

of Aboriginal and Torres Strait Islander origin. Of the Aboriginal and Torres 

Strait Islander population, only 2.7% were aged 65 and over, compared with 

12.7% of the non-Indigenous population. 

Of those people usually resident in Queensland who spoke a language other 

than English at home, 7.3% were aged between 65 and 74 and 6.9% were 

aged over 75. Of those Queenslanders aged 65 to 74 who spoke a language 

other than English at home, 15.6% did not speak English well, or at all. 

Of those aged 75 and over the proportion was 15.3%, compared with 

9.8% for the total population. 

A separate house was by far the most dominant dwelling type amongst older 

persons at the 2001 Census (as a proportion of all dwelling types), although 

this declined with age. The proportion of persons living in nursing homes 

and accommodation for the retired/aged increases with age. Less than one 

percent of the population aged 65–69 lived in these types of accommodation 

compared with over 26% of those aged 95 and over. 

In the 65–74 years age group, 23% of persons lived alone, rising to 38% 

of persons aged 75 and over. 1 

In 2003, under the Australian Bureau of Statistics definition of disability, 

there were an estimated 834,000 people with a disability in Queensland. 

This constituted 22.1% of Queensland’s total estimated population of 

3,775,000 people. 

1. Queensland Government, Population Projections to 2051: Queensland and Statistical Divisions, 

2nd edition, 2006. Queensland Government, Census 2001, Bulletin No. 11, Older Queenslanders: 

December 2003 

2 

Home and Community Care Queensland

Assuming that the age specific disability prevalence rate remains constant, 

the number of people with a disability is projected to increase to 950,500 

people in 2008 (a growth of 14.0%). 

Of the 834,000 people with a disability in Queensland in 2003, an estimated 

279,100 had a profound or severe core activity limitation. This accounts for 

7.4% of the total population of Queenslanders and 33.5% of all Queenslanders 

with a disability. 

This growth in population and the change in demographics can be directly 

translated into increased demand for infrastructure and goods and services, 

and has significant implications with regard to workforce availability as the 

dependency ratios between the age cohorts of the population change. 

2.2 HACC target population 

The HACC target population (HTP) provides an estimate of the potential target 

population and is used to support resource allocation processes at the state 

and planning region level. The estimated HTP is provided to the state by the 

Australian Government. 

The Queensland HTP is estimated to increase from approximately 400,000 

in 2006–2007 to almost 600,000 by 2021. While it should not be assumed that 

all persons in the estimated HTP should be receiving or in fact need a service, 

the projected growth in the estimated population over the next 13 years has 

a significant implication for the community care sector in managing and 

meeting service demand. 

2.3 Delivered services 

2.3.1 Who received services 

The Queensland HACC Minimum Data Set (MDS) collection for the 

2006–2007 period contains the records of over 159,000 individual clients 

reported by HACC-funded service providers to have received a service at 

some point during the financial year. 

The majority (76.42%) of individual HACC clients were aged 65 years and 

over. Clients aged 80 and over accounted for 41% of all clients. 

Females comprised almost two thirds (62.03%) of the HACC client population. 

There were greater numbers of females than males in each age category and 

the gender imbalance increased with age. The variance between males and 

females in the under 65 year group was 2.7% compared to 9.5% in the 65–79 

year group. The gender imbalance in HACC clients was most pronounced in 

the above 80 years group, with a 13.4% variance between males and females. 

Persons born in Australia accounted for almost three quarters (71.16%) of 

clients, with 17.2% reporting a birthplace outside of Australia. The remaining 

11.72% did not report a country of birth. In the collected data, the United 

Kingdom was represented as the largest group of HACC clients who were 

born overseas, accounting for 37% of the total of HACC clients who were 

born overseas, and 5.8% of total HACC clients. Other groups of significance 

were clients from Western Europe (1.9% of total clients), Southern Europe 

(1.8% of total clients) and New Zealand (1.6% of total clients). 

Triennial Plan 2008–2011 3

Most carers take on caring responsibilities because a family member or friend 

needs support and assistance. Carers are considered as vital contributors 

in supporting people to remain living in their own homes. HACC MDS data 

indicates that a third of the total client population (33.84%) had a carer. This 

is a slight decrease from 39.62% in the previous year. 

The figure for care recipients with no carer was slightly higher at 53.57% which 

has increased from 45% in the previous year. It is important to note that the 

focus of this item is on the existence of informal arrangements with family 

members, friends and neighbours, and not on paid carers or formally arranged 

volunteer carers. 

Clients stating they had a co-resident carer represented 22.05% (35,073 

clients) of the total HACC client population. A further 10,477 clients stated their 

carer was non-resident. 

Almost half (49.08%) of clients live with family or others and 35.75% live on 

their own. 

A significant number of clients (76.55%) were in receipt of some form of 

government pension or benefit. Of this group, the Aged Pension was received 

by 53.84% of HACC clients followed by the Disability Support Pension 

(12.59%) and Veteran’s Affairs Pension (7.57%). HACC clients not in receipt 

of a government pension or benefit accounted for 7.39% of all HACC clients. 

Clients were referred to the program from a wide and diverse range of 

sources. Of the 131,284 clients where a source was recorded, 21% were 

self-referred while a further 14.8% were referred by family, significant other 

or friend. Other significant sources of referral include hospitals (10.56%), 

other community-based services (8.94%), and community-based General 

Practitioner/Medical Practitioners (8.49%). 

2.3.2 Nature of services received 

Domestic Assistance was the single service type received by the most number 

of individual clients (31.19%). 

Allied Health Care also reaches a significant number of clients, with 

47,424 clients (29.81%) receiving a service during the year. Other assistance 

types commonly received by clients were Nursing Care (26.19%), Meals 

(21.13%) and Transport (20.90%). 

Levels of service provision measured in hours varied significantly across 

different assistance types. The service type of Centre-Based Day Care 

provided the highest number of hours with a total of 2,901,059 hours in 

2006–2007. This was followed by almost 2.5 million Meals (centre and home) 

and subsequently Domestic Assistance with 1,456,632 hours of service being 

provided. 

The highest average annual hours of assistance to individual clients was for 

Centre-Based Day Care (156.9 hours), followed by Respite Care (52.3 hours) 

and Social Support (33.0 hours). HACC clients also received an average 

29.4 hours per annum of Domestic Assistance and an average 21.9 hours 

per annum of Personal Care. 

4 


43.22% of clients received only one type of assistance, 19.41% received two 

assistance types, 13.16% received three assistance types and 8.74% received 

four HACC service types. Clients accessing the HACC program at a high 

intensity (five or more services) represented 24,610 clients (15.47%). 

2.4 Key trends in Minimum Data Set (MDS) 

A comparison of key elements of 2005–2006 MDS data with 2006–2007 data 

indicates a number of key changes. These include: 

• a 2.7% increase in the total number of individuals who received a service 

• a 12.3% decrease in the number of clients who have a carer 

• a 10.9% increase in the number of clients who live with family 

• a 7.9% increase in the number of clients who live alone 

• a 17.3% increase in the number of Indigenous clients. 

It should be noted that MDS version two was implemented in Queensland 

in late 2006. Intensive sector training was provided at this time resulting 

in improvements in data quality that may result in some distortion of data 

comparisons across these periods. 

2.5 Current purchasing 

The program purchases services across the majority of the HACC service 

types. At the commencement of the 2007–2008 financial year the program’s 

allocations across key service types were estimated as follows: 

• Centre-Based Day Care — 3.1 million client support hours 

• Meals — 2.5 million individual meals 

• Domestic Assistance — 1.6 million client support hours 

• Respite Care — 800,000 client support hours 

• Social Support — 770,000 client support hours 

• Nursing Care — 670,000 client support hours 

• Transport — 660,000 client trips 

• Personal Care — 600,000 client support hours 

• Allied Health — 380,000 client support hours. 


Due to variations in the cost of purchasing different service types the funds 

allocation does not automatically equate to the hours of service purchased. 

Current funds allocation by service type is approximately: 

• Domestic Assistance — 19% 

• Centre-Based Day Care — 14% 

• Nursing Care — 13% 

• Respite Care — 9% 

• Personal Care — 8% 

• Social Support — 8% 

• Allied Health Care — 8% 

• Information, Education and Training — 5% 

• Transport — 4% 

• Home Maintenance — 3% 

• Home Modification — 2% 

• Meals — 2% 

The remaining 5% purchases the service types of Assessment, Case 

Management, Client Care Coordination, and Counselling/Support, 

Information and Advocacy. 

2.6 The service sector 

As at 30 June 2007, there were approximately 340 organisations (legal 

entities) delivering services through approximately 740 service providers 

(service outlets) across the state. These service providers include community, 

commercial, religious, charitable, and state and local government bodies. 

Of the funding allocated, approximately 44% of funds are contracted for 

delivery through large church-based charitable organisations. A further 

25% is contracted through government agencies, 4% to local government 

and the remaining 27% to other non-government organisations, primarily small 

and medium sized incorporated organisations. 

6 


3 Consultation 

Community consultation is an essential element in assisting to identify gaps 

and overlaps in services to highlight planning priorities for the program. 

The program undertakes an extensive range of consultation processes 

across a variety of key stakeholders. These processes and their outcomes 

are outlined below. 

3.1 Consumer consultation 

In 2006 the program commenced a significant work program with regard 

to consumer consultation. The aim was to better facilitate consumer input 

into program planning and service development decisions. This was also in 

recognition that consumer input into previous planning processes had been 

limited and that consumer consultation in and of itself is often difficult, but 

nonetheless very important. 

The program provided funding to an alliance of three HACC-funded agencies: 

Queensland Council on the Ageing (COTAQ), Queensland Aged and Disability 

Advocacy Services (QADA) and Carers Queensland (CQ). These three 

agencies are currently funded to provide a range of information, education 

and advocacy services and it was identified that there were natural synergies 

between their current work and the goals of the program with regard to 

developing an effective consumer consultation framework for the program. 

Identified as the C3 initiative, during the 2007 calendar year the alliance 

undertook twelve consultations across Queensland with current and potential 

clients, their carers, families and interested others, with approximately 

600 participants. The location of the consultations ranged from Brisbane 

metropolitan areas to the more regional and rural locations of Longreach, 

Mount Isa and Cairns. 

This process has provided the program with a unique insight into the way 

individuals and families experience the community care sector and HACC 

as part of that sector, and provides key findings at a number of levels. 

Participants provided specific information on services they were accessing 

and what was working well, as well as information on supports that they had 

been unable to access and believed would be helpful in allowing them to 

remain at home. 

When clients spoke about the services they were currently receiving, they 

were mostly positive about the impact and effectiveness of the services. 

There were a number of themes that emerged as to why people believed 

they were unable to access required services. They primarily related to lack 

of availability (e.g. waiting lists), lack of flexibility of providers (e.g. needing 

a service at a specific time / day) or difficulty navigating the care environment 

(e.g. poor information). 


These three themes have informed a range of proposed actions outlined 

in this triennial plan. Themes include: 

• specific regional and local purchasing priorities 

• service development activities related to operational guidelines 

that aim to facilitate greater flexibility in service provision 

• service access, assessment and coordinated care initiatives. 

Over the course of the triennium the program will work in partnership 

with the C3 alliance to further develop and refine this important consultation 

mechanism including a focus on consultation mechanisms appropriate 

to special needs groups. 

3.2 Service provider / sector consultation 

In October 2007 the program released a discussion document that provided 

a summary of key issues that are likely to impact on the HACC target 

population and program. While not intended as a comprehensive analysis of 

all emerging issues, it provided the impetus for discussion with regard to the 

impact of a range of issues emerging across the target population and sought 

comment on possible local, regional and whole-of-state responses to the 

issues raised. The document highlighted a range of issues including, but not 

limited to, the ageing population, workforce capacity, dementia, Aboriginal and 

Torres Strait Islander peoples, carers, nutrition, and independence promotion. 

A series of 25 planning forums were held across the state from October to 

December 2007. An estimated 800 individuals participated, representing 

a diverse range of the 340 funded organisations that deliver services through 

approximately 740 service outlets. Where possible, officers from the State 

Office of the Department of Health and Ageing attended these forums. 

A further 200 individuals provided written feedback to the program in response 

to the discussion document. 

Historically, service provider planning forums have been very effective in 

providing information with regard to existing waiting lists and service demand 

at a local community level. The discussion document, as noted above, 

provided a key platform to extend the discussion beyond the ‘here and now’ 

to elicit information in relation to trends and possible approaches to these 

emerging issues. 

The information obtained from these consultation processes is reflected in 

the local and regional purchasing priorities as well as a number of the service 

and program development activities as outlined throughout this document. 

8 


3.3 Peak bodies and interest groups 

The program continues to maintain linkages with peak bodies and similar 

statewide organisations to ensure appropriate representation of a range of 

views into program development. These agencies include, but are not limited 

to Aged Care Queensland, Council on the Ageing Queensland, Carers 

Queensland, and Alzheimer’s Australia (Queensland). 

All agencies that are funded to provide information, education and training on 

a statewide basis have recently formed an ‘018 Roundtable’. The group meets 

on a regular basis to discuss emerging issues and identify synergies in the 

way they work to gain better outcomes for the target population. This process, 

while in its formative stages, is beginning to provide valuable information with 

regards to emerging trends and issues across the state. 

3.4 Australian Government Department of Health and Ageing 

The program maintains a strong relationship with officers from the State 

Office of the Department of Health and Ageing. A Joint Officer Group (JOG) 

meets on a regular basis as well as formal/occasional meetings with the State 

Manager. 

This relationship has resulted in significant sharing of information and data 

and reduces duplication of effort in a number of consultation processes for the 

program. The State Office has provided a range of information that is obtained 

through the department’s consultation processes with Aged Care Assessment 

Teams (ACAT) and Divisions of General Practice as part of the aged care 

planning agenda that has contributed to this plan. 

3.5 Advisory forums 

At present the HACC program does not have an established formal advisory 

forum, such as an advisory committee or council. With the transition of the 

program to Disability Services Queensland, there are a range of existing 

formal Ministerial Advisory Councils and committees that have potential scope 

and interface with the HACC program. The most significant of these are the 

Queensland Seniors Council, supported by the Office for Seniors, and the 

Disability Council of Queensland. 

Over the course of the triennium the program will be exploring the potential 

role and interface of these existing mechanisms within the portfolio for formal 

advisory forum processes. 


4 Priorities 

4.1 Regional priorities 

The delivery of additional HACC services remains a key priority for the 

program across all planning regions with the majority of growth funds targeted 

to the purchase of direct services within local communities. 

Detailed information on the funds and output schedules for each of the service 

groups by planning regions is contained in Section 9. 

The allocation of growth is based on the premise that all service types 

contribute to achieving the aims of the program. Accordingly, of the 18 HACC 

service types, the program will be allocating funds to 16 service types at 

various levels within the regions. The exceptions are Formal Linen Service 

which has never been purchased in Queensland, and Goods and Equipment 

which are provided through the Medical Aids Subsidy Scheme operated by 

Queensland Health. 

Of the estimated $95 million in real growth funds, the allocations are as 

follows: 

4.1.1 Service Group 1 — Home Support Services 

This service group contains the service types of Domestic Assistance, 

Personal Care, Social Support, Home Maintenance, Respite Care and Other 

Food Services. Of the total additional funds approximately $40 million (42%) 

is planned for expenditure across this service group. 

Demand for these services, in particular Domestic Assistance, Personal Care, 

Social Support and Home Maintenance, remains high with clients and service 

providers indicating an ongoing gap between supply and demand. 

Conversely, the demand for Respite Care remains relatively low, with service 

providers in particular reporting difficulty in utilising current funding allocations. 

A common theme cited is the increase in carer respite specific programs 

funded by the Australian Government. 

Queensland has historically provided minimal levels of funding for the service 

type Other Food Services, with the primary focus on Meals. While this 

plan does not provide for significant funds to this service type, the planned 

developmental work relating to nutrition amongst the HACC target population 

(refer Section 6.1) may result in changes to this over the mid to long-term. 

4.1.2 Service Group 2 — Coordinated Care Services 

This service group contains the service types of Assessment, Client Care 

Coordination, Case Management, and Counselling/Support, Information and 

Advocacy (carer and care recipient). Of the total additional funds approximately 

$10.8 million (11%) is planned for expenditure across this service group. 

Queensland has historically maintained relatively small levels of expenditure 

in this service group as the priority has been on increasing basic services, 

primarily those in Service Group 1. As the state reaches per capita equity in 

funding across this triennium, the program will commence a more focused 

investment in these service types. 

10 


This is supported through consumer consultation feedback that strongly 

indicated difficulty in negotiating and navigating the system, particularly 

when care services may be provided by multiple agencies. 

In the first year of the triennium the program will consult with the community 

care sector, clients and key stakeholders to clearly identify and define service 

models that will provide a care coordination/case management model for 

clients requiring this type of support, including analysis of existing models 

of service provision. Following this developmental work, the majority of 

purchasing is planned for years two and three. 

This work will be undertaken as a parallel process to activities that are part 

of the National Reform Agenda under the common arrangements regarding 

Access Points (Refer Section 5.1.1). At present the Access Points framework 

in Queensland requires identified ‘points’ to have capacity to not only provide 

the information and assessment portal, but also to facilitate supported referral 

processes. A critical element of the evaluation of this project will be the extent 

to which Case Management and Client Care Coordination as specific service 

types are required. 

4.1.3 Service Group 3 — Clinical and Specialist Care 

This service group contains the service types of Nursing and Allied Health. 

Of the total additional funds approximately $17.6 million (18%) is planned for 

expenditure across this service group. 

The balance between demand and supply for nursing care has remained 

relatively stable for the past two years, with only a limited number of locations 

across the state indicating a level of unmet need/demand. Changes in 

the provision of nursing care at GP clinics as well as the often short-term, 

intensive nature of the intervention are possible underlying factors. 

Conversely, the demand for allied health has increased with service providers 

and clients providing evidence of unmet need. This demand appears to be 

driven from recruitment and retention difficulties, rather than the availability of 

HACC funding and resources. In some locations anecdotal evidence suggests 

it may be related to an issue of critical mass: providers with small levels of 

allied health funding are unable recruit to part-time positions and/or develop a 

viable multidisciplinary team. 

Allied health is critical to the promotion of functional independence amongst 

the eligible population. Notwithstanding the recruitment and retention issues, 

the program will continue to increase the level of funding for allied health 

services, and will work with the sector to identify and develop models and 

mechanisms of service delivery that ensure client needs are met in the most 

practicable manner. 


4.1.4 Service Group 4 — Centre-Based Day Care 

This service group contains the service type of Centre-Based Day Care. 



The delivery of this service is clearly linked to the availability of capital 

infrastructure. Over the course of the Biennial Plan (2006–2008) funding was 

provided for the construction/purchase of a number of new facilities in areas 

of high population growth and/or where existing facilities were limiting effective 

service delivery. The program will continue a focused process to invest in 

capital infrastructure over the course of this plan. (Refer Section 4.2.1). 

4.1.5 Service Group 5 — Home Modifications 

This service group contains the service types of Home Modifications, Goods 

and Equipment, and Formal Linen Service. Of the total additional funds 

approximately $1.9 million (2%) is planned for expenditure across this service 

group. 

The program recognises that home modifications (both major and minor 

modifications) are critical to enabling people to live safely and independently 

at home. Often with the correct environmental changes, individuals are able 

to live independently without requiring ongoing support and care. Modifications 

can extend from relatively simple changes such as installing grab rails, nonslip 

surfaces in bathrooms/wet areas and ramps to replace one or two steps at 

the front and rear door to the house, through to extensive modifications such 

as replacing bathtubs with accessible shower hobs and improving access to 

high-set houses with ramps and lifts. 

As noted above, Formal Linen Service is not purchased as a service type and 

the majority of Goods and Equipment is provided through the Medical Aids 

Subsidy Scheme operated by Queensland Health. 

The program will continue to provide non-recurrent funding for supplies 

of continence consumables to HACC eligible people in recognition of the 

importance that effective continence management has in enabling people 

to remain living independently in the community, with the funding delivered 

in conjunction with the Medical Aids Subsidy Scheme. 

4.1.6 Service Group 6 — Meals 

This service group contains the service types of Meals at home and Meals 

received at centre/other. Of the total additional funds approximately $130,000 

(0.13%) is planned for expenditure across this service group. 

Within Queensland the majority of these services are purchased from Meals 

on Wheels providers who are contracted on a subsidy per delivery basis (refer 

Section 4.2.3). As such, there is minimal increase in planned expenditure, 

except in specific identified communities where there are no Meals on Wheels 

service providers. 

While this plan does not provide for significant funds to this service type, the 

intended work relating to nutrition amongst the HACC target population (refer 

Section 6.1) may result in changes to this over the mid to long-term. 

12 


4.1.7 Service Group 7 — Transport 

This service group contains the service type of Transport. Of the total additional 

funds approximately $12.1 million (13%) is planned for expenditure across this 

service group. 

While transport remains a service type that is experiencing high demand, the 

program is part of a wider community transport framework and network. Over 

the course of the triennium the program will focus additional funds on transport 

delivery approaches that demonstrate collaborative service delivery that link with 

and value add to other government and community initiatives in transport and 

community access such as the Accessible Taxis Queensland Program operated 

through Queensland Transport. 

4.1.8 Service Group 8 — Information and Education 

In Queensland the additional service type that is funded is Information, 

Education and Training. Projects funded under this service type provide services 

across the state and/or multiple planning regions and undertake activities that 

do not necessarily result in individual client services. The type of activities 

undertaken include client and carer information services, program development 

activities and information projects targeting special needs groups. 



As a number of these activities are currently undertaken from a central location 

(South East Queensland) with outreach services across the state, over the 

course of the triennium the additional funds will be targeted to expand the 

provision of information and education programs and services to the target 

population in rural and remote locations, as well as the further development 

of consumer consultation frameworks. 

4.2 Service priorities 

4.2.1 Capital infrastructure for the provision of Centre-Based 

Day Care 

As noted in Section 4.1.4 the provision of capital infrastructure is critical to 

the provision of services such as Centre-Based Day Care. In 2006–2007 

the program undertook a high level survey of all HACC-funded capital 

infrastructure (primarily buildings) to attempt to assess the current status of 

facilities. This process highlighted some facilities of immediate concern and 

capital funding was provided, as appropriate, through competitive funding 

rounds. It also highlighted that a large number of organisations had limited 

capacity to assess the status of their current infrastructure. 

Accordingly, the program will implement a capital infrastructure review program 

over the triennium. This program will enable individual organisations to request 

a formal building survey to be undertaken by an appropriately qualified person/ 

organisation against defined criteria including, but not limited to, structural 

soundness, fit for purpose, capacity to meet population changes and safety 

and security. Recommendations arising from the building survey will form the 

basis of recommendations for additional capital funding for facility maintenance, 

modifications and upgrades. 


4.2.2 Promoting functional independence 

The HACC Review Agreement 2007 provided a change in focus for the 

program to encapsulate a position that allows for support to be provided 

in a way that maintains and promotes independence (Clause 2(1)). 

Following on from the National HACC Forum on ‘Promoting Independence’ 

in February 2008, Queensland will commence a dialogue with the sector 

to identify opportunities for the development and implementation of 

independence-focused service models and outcomes for clients. 

This may include, but will not be limited to the: 

• development and dissemination of a set of principles and practice 

guidelines that promote client and carer independence and that are 

appropriate within the context of the HACC Review Agreement 2007 

and within the Queensland context 

• review of current assessment tools and approaches to ensure they reflect 

best practice in promoting independence-focused approaches to client 

outcomes 

• provision of funding for programs and/or initiatives that develop new service 

models and approaches promoting functional independence 

• provision of funding to existing services to assist them to re-orient/ 

re-engineer their services to incorporate approaches that promote 

independence, through staff training and policy and system development. 

4.2.3 Meals on Wheels 

Services provided by Meals on Wheels service providers are funded on 

a subsidy basis of actual meals provided, with the subsidy designed to cover 

the cost of meal preparation and delivery and the client meeting the cost of 

the food. 

As the contractual mechanism for these providers varies from other providers, 

indexation is not applied under the contract. Instead Queensland will increase 

the level of subsidy per meal from $2.00 in 2007–2008 to $2.20 by 2010–2011 

which is comparable to the estimated indexation rate. 

4.2.4 People living in private rental accommodation 

The Queensland HACC program continues to work collaboratively with other 

funding programs within Disability Services Queensland to provide services 

to people living in private rental accommodation such as hostels, boarding 

houses and aged rental accommodation. 

The HACC program has continued to maintain its focus on ensuring that 

eligible people have access to external supports that improve their quality 

of life and provide access to health and wellbeing services. 

An independent evaluation of the program was undertaken in 2007–2008. 

At the time of submitting this triennial plan the final evaluation report has not 

been released. Preliminary data analysis indicates that the level of access to 

services varies across location. To this end the HACC program has reviewed 

its level of contribution to ensure that access to funding resources is equitable 

with the estimated number of facilities/beds within a given geographic region. 

14 


This will result in a small increase in recurrent funds to this program in the first 

year of the triennium. These services will be purchased as part of the regional 

growth round. 

Should additional resources be required to support the implementation of 

evaluation recommendations relevant to the HACC program, a variation to 

the plan will be submitted. 

4.2.5 Transport 

The provision of transport for the purpose of community access is an 

important element in maintaining an individual’s independence and links with 

their local community. As noted in section 4.1.7, transport remains a service 

type that is experiencing high demand. Consultation has highlighted that some 

previous purchasing has resulted in an unintended overlap between HACCfunded 

transport and other government transport initiatives such as those 

provided through Queensland Transport. 

The program will work with the sector to develop additional service delivery 

models and approaches that ensure that HACC services are situated within 

the broader context of community transport service provision, in order to 

reduce duplication in resource allocation and utilisation and ensure maximum 

outcomes for clients and communities. 

Over the course of the triennium the program will focus planned additional 

funds on service delivery models, approaches and mechanisms that value add 

and demonstrate collaborative links with other government and community 

initiatives such as the Accessible Taxis Queensland Program operated through 

Queensland Transport. 

4.3 Population priorities 

4.3.1 Aboriginal and Torres Strait Islander peoples 

Aboriginal and Torres Strait Islander peoples are a high priority for the 

program and a key component of this triennial plan. Achieving and sustaining 

improvements in the health and wellbeing of Aboriginal and Torres Strait 

Islander peoples is also a key Queensland Government priority. 

Aboriginal and Torres Strait Islander elders play a critical role in the strength 

and stability of Indigenous communities. Improvements in the health and 

wellbeing of elderly Indigenous people through a well targeted and functional 

community care sector, including HACC services, will play a pivotal role in 

maintaining strong and healthy families and communities. 

In 2007, as part of the review of the current HACC Indigenous Service 

Development Plan, the program commenced a comprehensive mapping and 

review of HACC services provided for Aboriginal and Torres Strait Islander 

peoples aimed at identifying proactive solutions to current service provision 

challenges. While the mapping and review process is not yet complete, a 

range of issues impacting on service delivery has been identified and strategic 

actions proposed at the local, regional and statewide level. 


A revised HACC Indigenous Service Development Plan will be released in 

the first year of the triennium. It is anticipated that priority initiatives arising 

from the plan to be implemented in the triennium will include the following: 

To improve access to services: 

• ensure that within regional growth funding, a level of funding for the 

purchasing of targeted services in all HACC planning regions is facilitated. 

Of the $95.7 million for regional growth, $5.4 million has been identified for 

targeted purchasing to this special needs group. 

• work with Aboriginal and Torres Strait Islander peoples in the development 

and implementation of HACC service delivery models. This will ensure 

services for Aboriginal and Torres Strait Islander elders and families are 

culturally sensitive, integrated, developed and delivered in partnership and 

are consistent with the goals and aspirations of Aboriginal and Torres Strait 

Islander peoples. 

• research, review, and develop models of service delivery appropriate for 

Aboriginal and Torres Strait Islander people, particularly those living in rural 

and remote communities. 

• develop and deploy a ‘Cultural Access Guide’ in order to improve access for 

Aboriginal and Torres Strait Islander peoples to services. 

To improve information and consultation: 

• develop and implement an Indigenous Information and Awareness Strategy 

• develop specific strategies within the program’s consumer consultation 

framework that are appropriate for Aboriginal and Torres Strait Islander 

clients and carers (refer Section 3.1). 

To improve efficient and effective management: 

• research and implement a mentorship program for coordinators of 

Indigenous HACC services. Organisations currently experience a high 

turnover in coordinators/managers with lack of support cited as a key 

reason for resignation. 

• in conjunction with the Strengthening Indigenous Non-Government 

Organisations initiative operated by the Queensland Department of 

Communities, the HACC program will implement initiatives aimed at 

strengthening the capacity and governance role of auspice organisations. 

To improve coordinated, planned and reliable service delivery: 

• implement key initiatives of the proposed National Indigenous HACC 

Workforce Development Strategy and build on the training and development 

initiatives for HACC service provider staff. 

• investigate the potential synergies between Indigenous Health Workers and 

community care service provision that may enable these workers to support 

the provision of community care. 

• develop more effective planning and data collection to ensure that services 

are planned and delivered appropriately to Aboriginal and Torres Strait 

Islander people, including specific work with regard to MDS information. 

16 


4.3.2 People living with dementia and their families and carers 

In May 2007, the Queensland HACC program released the Dementia Services 

Development Strategy 2007–2011. The aim of the strategy is to ensure that 

people with dementia have access to quality services which will allow them 

and their carers to remain at home in a supported environment, within the 

scope of the HACC program. 

The strategy endorsed an approach to enhance dementia services through 

two distinct levels of service provision, these being statewide services and 

initiatives, and direct care services. 

With the increasing prevalence of dementia within the community the program 

will continue to implement the key activities of the strategy including the 

investment of additional funds. 

A particular focus will be in increasing the availability of regionally based 

dementia advisory services and dementia support services that support 

people living with dementia, carers and family members and service providers 

to better meet the needs of this special needs group. 

4.3.3 People from culturally and linguistically diverse 

backgrounds 

The Queensland HACC program released the Multicultural Services 

Development Strategy in 2006 to guide the future direction of HACC-funded 

services in Queensland relating to supporting people from culturally and 

linguistically diverse backgrounds (CALD) and their carers. This strategy 

is particularly important given that Queensland has one of the most 

geographically diverse populations in Australia and one of the highest 

proportions of ethnic aged people living outside of metropolitan areas. 

Funding was allocated in the 2006–2008 HACC Biennial State Plan for a 

number of key strategies including the establishment of regionally based CALD 

advisory services, and the purchase of additional Client Care Coordination to 

assist eligible people from CALD communities to access appropriate services. 

The Queensland HACC program remains committed to progressing the key 

initiatives in the strategy and will continue to invest additional funds over the 

triennium with a particular focus on expanding the capacity of regional CALD 

advisory services and the availability of Client Care Coordination to facilitate 

improved access to services. 

4.3.4 Carers 

Carers, be they family, friends or neighbours, form a critical part of the 

community care safety net for older people and people with a disability. 

Over the past five years the program has invested significant funds in respite 

care to support carers to take a break from their caring role. Based on sector 

and consumer consultation there is an emerging need with regards 

to counselling support for carers to assist them in their caring role. 

To support this need the program has allocated recurrent growth funds 

of $3.38 million for the service type Counselling/Support, Information 

and Advocacy (refer Section 4.1.2). A targeted purchasing strategy will be 

undertaken to support models that focus on providing effective information, 

counselling and support strategies to assist carers in their caring role. 


5 Reform and development 

5.1 National reform and development 

The Queensland Government is committed to participating in the development 

and state-based implementation of common arrangements as identified under 

the HACC Review Agreement 2007. The full details of the implementation 

strategy for each element of the common arrangements are presented in 

a separate project plan. This review provides a summary of the key activities 

of the project plan for each element of the common arrangements. 

5.1.1 Access points 

The Queensland Government is committed to a more streamlined pathway 

into, and through, the community care system by the development of access 

points. An initial implementation plan addressing access, eligibility and 

assessment was submitted in April 2008, with a progress report highlighting 

updates submitted in June 2008. 

The development and implementation of any milestones will cover aspects 

such as: 

• the development of new business processes for the access point model 

regarding intake, screening, eligibility, assessments and referrals 

• the role of the state-based eligibility and assessment tool (Ongoing Needs 

Identification or ONI), as well as acknowledging learnings from the national 

assessment tool — Australian Community Care Needs Assessment 

(ACCNA-R) 

• learnings from the evaluation of the demonstration process. 

5.1.2 Fees 

The Queensland Government is committed to working with the sector 

regarding resources and developmental work required for a consistent fee 

collection approach. A detailed implementation plan, including milestones 

for a common approach to consumer fees, was submitted in June 2008. 

The development and implementation of any milestones are dependent on: 

• the outcome of the National Fees Review 

• the outcome of the National Review of Subsidies and Services 

• consultation with the sector 

• consideration of the impact on younger people with disability as part 

of the Commonwealth State Territory Disability Agreement (CSTDA) 

• jurisdictional-specific challenges regarding the current fee policy differences 

between different providers, in particular noting that Queensland Health, 

a provider of approximately 25% of current HACC services, does not 

charge fees. 

18 


5.1.3 Quality 

The Queensland Government is committed to working with the sector 

regarding resources and developmental work required to transition from 

the current HACC National Services Standards to the revised standards 

under the common arrangements. A detailed implementation plan, including 

milestones for the transition process, was submitted in June 2008. 


• the outcomes of the Common Standards and National Quality Reporting 

Framework project, including field testing 

• the integration of the National Quality Standards under common 

arrangements with jurisdictional-specific initiatives (refer Section 7.1). 

5.1.4 Financial report 

The Queensland Government is committed to a simplified framework and 

transparent administration of programs, and decreased administration burden 

on service providers. A detailed implementation plan including milestones 

for a common accountability framework and consistent approach to financial 

reporting will be submitted in June 2009. 


• the outcomes from the National Financial Reporting Framework project 

• the national approach being in line with state legislation requirements 

and other state-based work to ensure consistency within Disability Services 

Queensland and the state. 

5.1.5 Coordinated planning 

The Queensland Government is committed to the development of a more 

robust planning framework that ensures planning decisions are undertaken 

within the context of the broader community care framework. A detailed 

Implementation Plan will be submitted in June 2009. 

Prior to this time the state will commence a review of the current planning 

of regional boundaries. The existing planning regions had previously aligned 

with Queensland Health and local government boundaries. Recent changes 

in both these areas have resulted in boundary disparity and limited information 

sharing opportunities. The transfer of administrative responsibility of the 

program to Disability Services Queensland has further highlighted the 

differences between planning regions. There is also a misalignment between 

the Australian Government’s aged care planning regions and the current 

HACC planning regions. In order to facilitate better coordination in planning 

and service outcomes through data transfer it is critical that a better alignment 

between planning regions be achieved. 

The program will utilise non-recurrent funds in year one of the triennium to 

commence this work in order to resolve the issues of regional boundaries 

before attempting to implement the recommendations of the National Planning 

Framework project. 


5.2 State reform and development 

5.2.1 Older people’s mental wellbeing 

Loneliness and reduced levels of interaction can lead to social isolation, 

a key risk factor for depression. Depression is a common illness, with 

around one in five Australian adults experiencing it in their lifetime. While the 

prevalence of depression decreases with age (except for aged care residents 

where the prevalence increases markedly), it remains very common in older 

people. The friendship, support and sense of belonging an individual has 

within a group or community has a direct link to their physical and mental 

health. 

By definition, those who live alone are likely to spend more time alone and 

hence are at greater risk of social isolation. Approximately 23% of people aged 

65–74 and 38% of people aged 75 and over live alone. 2006–2007 MDS data 

indicated that 35.75% of Queensland HACC clients live alone. The expected 

rise in people over 65 will lead to greater numbers in this situation. 

Along with the significant risk of social isolation, the HACC target population 

has additional risk factors associated with poor mental health (primarily 

depression), including: 

• misdiagnosis of symptoms that can often be interpreted as ‘normal’ agedrelated 

issues, or diagnosed as other conditions such as dementia 

• chronic illness and increase in physical health concerns — research 

shows that around 50% of people with a major chronic illness also have 

depression 

• dementia — depression is common in people with dementia such as 

Alzheimer’s disease, although the reason for the link is not clear 

• side-effects from medication eg. benzodiazepines (sedatives) and 

propranolol (used to treat high blood pressure and angina) 

• stress caused by situations including: losses relating to work, 

independence, and/or relationships; chronic pain; being the primary carer 

for a partner or other relative; financial problems; loneliness; death or illness 

of a spouse, partner or other close relative or friend. 

Over the triennium the HACC program will explore opportunities for 

partnerships with existing mental health initiatives, such as Beyond Maturity 

Blues, and non-government community mental health service providers. 

The overall aim of this work is to develop a sustainable framework that 

provides more timely and appropriate outcomes for older people experiencing 

mental health concerns. This work will: 

• develop and implement workforce awareness and skill development 

initiatives aimed at existing community care staff to assist them to identify 

existing clients and carers who may be experiencing mental health 

concerns (or who are at risk) and make appropriate referrals to ensure 

appropriate intervention 

20 


• identify opportunities to develop programs and initiatives that target current 

HACC clients and their carers and families in identifying mental health 

concerns and providing appropriate referral pathways 

• examine outcomes of the evaluation of the Queensland cross-government 

project to reduce social isolation in older Queenslanders and the 

implications for the HACC program. 

5.2.2 Workforce and sector development 

Workforce and sector development is of critical importance to the 

program and community care sector, particularly in light of the increasing 

demand for services. In 2005 the program released the HACC Workforce 

Skills Development Strategy and since this time has been progressively 

implementing key initiatives and activities from the strategy. 

Although the development stages in the implementation of the strategy have 

been slower than originally anticipated, the strategy is beginning to show real 

outcomes, with particular regard to skills development activities. 

Over the course of the triennium the program will continue the implementation 

of key elements of the strategy with a comprehensive review planned towards 

the end of the triennium. 

In addition, the program will continue to develop partnerships across the 

community care and health sectors with regard to specific workforce 

planning and recruitment initiatives, in particular in the area of allied health 

professionals. 

5.2.3 Volunteers 

The program recognises the critical contribution that volunteers make to the 

provision of community care services, both through direct support services as 

well as management committees and governance structures. Some sections 

of the HACC service provision network have well defined and understood 

reliance on volunteers, for example Meals on Wheels. However the scope, 

contribution and program reliance in other areas is less well understood. 

Anecdotal evidence indicates that it is becoming more difficult to recruit 

and retain volunteers, both for hands on support and within management 

structures. This is already impacting on some providers (primarily small to 

mid-sized incorporated organisations) with regard to management committee 

recruitment and retention. Given that currently 26% of current HACC funds are 

managed by organisations of this nature, this represents an emerging risk for 

the program. 

Over the triennium the program will commence a scoping study to investigate 

the current level of reliance within the HACC sector on volunteer support 

to facilitate effective service delivery. The study will identify barriers and 

opportunities to better engage with and support volunteers and provide 

recommendations for future action where appropriate. 


5.2.4 Technology and home design 

While it is acknowledged that assistive technology can never fully replace the 

value of human contact in supporting people to remain living at home, there 

is a growing body of research and evidence that points to possible initiatives 

that correlate with the aims of the HACC program. Research undertaken by 

the University of Stirling (2006) concluded that ‘smart technology is effective 

in a model of care promoting independence, choice and capacity building 

and in support of older people with their informal carers.’ 2 

While assistive technology provides benefits for the aged and community 

care sector, there are numerous challenges to be overcome before it can 

be fully embraced by clients, carers and service providers. 

Over the course of the triennium the program will begin to explore 

opportunities for the application of appropriate assistive technology 

that is congruent with the aims of the program. 

5.2.5 Assessment and e-referral 

Improved assessment and client referral processes are critical to effective 

care outcomes for clients. 

Since 2003 the state has been progressively implementing the Ongoing 

Needs Identification (ONI) tool for intake, screening, assessment and client 

referral processes. As noted in the Biennial Plan 2006–2008, the program 

has continued to develop a secure web framework to facilitate effective 

client referral processes. This work will continue across the triennium and 

be undertaken in conjunction with work being done as part of the common 

arrangements access points project (refer Section 5.1.1). 

2. University of Stirling (2006). Smart technology and community care for older people: innovation 

in West Lothian, Scotland. 

22 


6 Building the evidence base 

6.1 Nutrition 

Healthy eating is just as important for seniors as it is for young adults, 

adolescents and children. While the emphasis is on ‘healthy’, it is also 

important that eating should be an enjoyable and a sociable activity that 

older people can look forward to. 

Ageing can be associated with changes in lifestyle which affect the food 

older people eat. Loneliness, boredom, depression and worrying about the 

future can lead them to neglect their diet (skipping meals and generally eating 

poorly). Poor dental health can make the task of eating healthy food painful 

and/or difficult. Rising food costs and other financial impacts may cause 

older people to go without adequate intake to maintain an optimal nutritional 

status. Loss of taste and smell senses can diminish the enjoyment of food 

thus affecting the desire to eat. Loss of a partner who prepared the meals 

can leave older people, particularly men, vulnerable. 

Studies on nutrition of Australians indicate that a number of older people have 

poor diets, including a shortage of intake of fibre, some vitamins and minerals. 

As a result, their health can suffer, creating a dependency on HACC services. 

The HACC program currently provides funding for an estimated 2.5 million 

meals annually through the Meals on Wheels program, as well as meals at 

Centre-Based Day Care Centres and other food services. Within some regions 

Allied Health funding has been utilised to provide dietetics services, with a 

range of innovative responses developed that improve individuals’ nutrition 

status as well as their functional independence with regard to meal preparation 

and related activities (e.g. shopping). 

Over the course of the triennium the program will investigate alternative 

service delivery models that address nutrition with the target population. 

This will include provision of funding for programs or initiatives that develop 

new service models and approaches, as well as the possible provision of oneoff 

funding to existing services (primarily Meals on Wheels) to assist them to 

adjust existing services to incorporate an independence promoting approach. 

6.2 Minimum Data Set (MDS) 

Information management, in particular the development of MDS, is pivotal 

to effective planning, purchasing and contract management for the program. 

Over the past two years Queensland has undertaken a significant project to 

transition providers from version one to version two of the reporting elements. 

While the program currently experiences a high participation rate in 

submissions (approximately 90% per quarter), an analysis of some data 

elements would indicate that there remain a number of data quality and data 

integrity issues. Over the triennium the program will develop and implement 

a project to identify common data element errors and work across the sector 

to address these issues. 


Underpinning this work will be the availability of timely and appropriate 

reported data through data repository processes. With the transition of the 

HACC program to Disability Services Queensland there is an opportunity 

for the program to consider the development and integration of a state-based 

HACC data repository with existing state-based Commonwealth State Territory 

Disability Agreement (CSTDA) processes. This would provide the state with 

a unique opportunity to not only access more timely data, but also begin to 

explore issues of service provision for clients accessing support through the 

two program areas. 

6.3 Continence management 

Incontinence is a significant health issue across the lifespan with physical, 

social and economic implications for the individual, their carers and the 

community, and has been identified as one of the major reasons for 

premature admission to long-term residential care. 

The Queensland HACC program has directed significant resources to 

eligible people with continence concerns through the implementation of the 

Queensland Health Continence Management Strategy for HACC Clients 

(the Continence Strategy). The Continence Strategy identified specific growth 

funding each year in order to develop a network of Continence Advisory 

Services for HACC eligible people throughout Queensland. As at 2007–2008 

HACC has provided: 

• recurrent funding of over $4.6 million for 28 regionally based Continence 

Advisory Services projects, and the development of a whole-of-state 

continence information strategy 

• non-recurrent funding each year since 2004–2005 of $1.5 million 

for continence consumables. 

In view of this level of investment, the program will undertake an evaluation 

of the strategy and its implementation to assess the extent to which it 

has achieved its aims, and to make recommendation for future service 

development initiatives. 

6.4 Major home modifications 

An accessible and safe living environment is often critical to the capacity 

of people to remain living at home and in their own communities. In light 

of this, the program has invested significant funds through the development 

of a network of major home modification providers across the state. 

By the end of 2007–2008 the total program expenditure in the program 

is estimated at $5.1 million and is projected to increase by an additional 

$1.5 million across the triennium to meet identified demand. 

In view of this level of investment, the program will evaluate the program 

to assess the extent to which it is meeting clients’ needs, and provide 

recommendations for future investment. 

24 


7 Quality 

7.1 National Services Standards 

The Queensland HACC program is committed to ensuring continuous quality 

improvement within the sector. 

In line with the state’s commitment to implementing common arrangements 

under the HACC Review Agreement 2007, the program will commence the 

transition process with service providers from the current National Service 

Standards to the revised standards in the first year of the triennium. 

While the alignment of the HACC standards with those applicable for 

Commonwealth-only funded programs (e.g. Commonwealth Aged Care 

Packages (CACP), Extended Aged Care at Home (EACH)) will reduce 

duplication for providers, consideration will also be given to state-based 

quality systems. Within Queensland, quality processes are currently in 

place for providers funded under the Commonwealth State Territory 

Disability Agreement (CSTDA) and it is the intent of the program wherever 

possible to achieve alignment at both a national and jurisdictional level to 

further reduce duplication of processes for service providers who receive 

funding under multiple programs. 

7.2 Integrated performance monitoring 

The Queensland HACC program believes that quality service provision 

needs to take a broader view than simply compliance with service standards. 

The program currently monitors service provider performance using 

information from multiple sources. These sources include provider submitted 

financial and performance reports, Minimum Data Set data, complaints, 

National Service Standards reports and associated Quality Action Plan 

initiatives. 

While the program is ‘data rich’, the disparate nature of these information 

sources and the delays that often occur in data availability has limited the 

program’s capacity to implement timely interventions where the performance 

of a contracted provider is of concern and often negatively impacting on 

clients. 

Over the course of the triennium the program will progressively develop 

an integrated performance management and monitoring approach that 

will result in more effective decision making. 

Ultimately this process will assist in identifying gaps and issues in service 

provision for which a service or program development response is required. 


8 Queensland HACC budget 

8.1 Resource allocation approach 

The allocation of recurrent growth funding against the identified direct services 

priorities within the seven HACC planning regions and for the Statewide region 

is detailed in Section 4. 

As noted in the 2006–2008 HACC Biennial State Plan, funds allocation had 

previously been based on an agreed growth / equity formula. The limitations 

of this approach have been documented in previous plans. 

Pending the outcomes of the National Planning Review under common 

arrangements, in 2006–2007 the program transitioned to a resource allocation 

approach based on an allocation model of ‘units of service by service type 

by HACC target population’, regardless of the purchasing cost of that service 

in any given location. 

Equitable access to services, regardless of location, is the key principle 

underpinning this allocation approach. 

The program has progressively implemented purchasing strategies that aim 

to ensure similar levels of contracted (purchased) service provision by service 

type across and within regions as measured by units of service to clients, 

for example hours or trips. 

This approach recognises that for clients, the availability of overall funds in 

a region has little relevance. What is of critical importance is the number of 

units/hours of service provision available relative to the target population. 

Within this approach, the program continues to examine expenditure by region. 

At the commencement of the triennium the state expenditure per HTP will be 

$817 per person. This will increase to an estimated $1,043 per person by the 

end of 2010–2011. 

When examined across planned regions, at 1 July 2008 the range is from 

$754 per person to $862. In 2010–2011 the regional range will be $957 

at the lower limit to $1095 at the upper limit. The regions where the higher 

HTP expenditure is evident cover large geographic regions that are sparsely 

populated, primarily Central, Darling Downs/South West, Northern and 

Peninsula. 

8.2 Indexation 

The state has estimated indexation at 3% for each year of the triennium. 

The actual allocation will be amended annually based on the rate of indexation 

determined by the Australian Government, with variations to funds allocations 

published to account for changes. 

26 


8.3 Recurrent allocations 

8.3.1 Planned regional recurrent funding summary 2008–2009 

HACC region 

2007–2008 2008–2009 

2007–2008 

Real growth 

Annual plan 

Base regional 

Adjustments 

amount * ** allocation 

budget *** (PYE) 

Real growth 

allocation 

(FYE) 

Total regional 

Indexation **** budget 

(PYE) 


budget 

(FYE) 

($) ($) ($) ($) ($) ($) ($) ($) 

Central 37,793,839 169,422 37,963,261 1,467,469 2,934,938 1,118,065 40,548,795 42,016,264 

Darling Downs / 

South West 

24,126,541 –72,514 24,054,027 892,602 1,785,204 710,055 25,656,684 26,549,286 

North Brisbane 92,593,842 –713,393 91,880,449 4,039,830 8,079,659 2,710,736 98,631,015 102,670,844 

Northern 

(Queensland) 

29,181,060 –227,271 28,953,789 1,328,050 2,656,099 854,740 31,136,579 32,464,628 

Peninsula 19,842,515 –197,537 19,644,978 890,158 1,780,315 583,600 21,118,736 22,008,893 

South Brisbane 53,441,270 –431,303 53,009,967 2,356,190 4,712,379 1,568,072 56,934,229 59,290,418 

West Moreton / 

South Coast 

Statewide — 

Queensland 

73,992,302 –807,974 73,184,328 3,404,754 6,809,507 2,174,907 78,763,989 82,168,742 

14,142,631 610,096 14,752,727 423,810 847,619 442,579 15,619,116 16,042,925 

TOTAL 345,114,000 –1,670,474 343,443,526 14,802,860 29,605,720 10,162,754 368,409,140 383,212,000 

Comments: 

* Additional base funding of $887,938 to enhance services to Aboriginal and Torres Strait Islander peoples was identified in 2007–2008. A variation to the Queensland Home and 

Community Care Biennial State Plan 2006–2008 identified these funds were intended for regional direct service delivery, however detailed planning was unable to be carried out in 

2007–2008. Additional funds are therefore reflected in the Statewide region. 

** This column represents recurrent funding of $1,670,474 estimated to be unable to be allocated on a recurrent basis in 2007–2008 and is included in the growth allocation for 

2008–2009. 

*** This column represents the estimated committed regional funding limits as at 1 July 2008 after cross-regional adjustments, and does not include the $1,670,474 noted above in 

Adjustments. 

**** This column includes cost supplementation. 


8.3.2 Planned regional recurrent funding summary 2009–2010 

2008–2009 2009–2010 

HACC region 

2008–2009 

Annual plan 

amount 

Base regional 

Adjustments * budget 

Real growth 

allocation 

(PYE) 

Real growth 

allocation 

(FYE) 


Indexation ** budget 

(PYE) 


budget 

(FYE) 

($) ($) ($) ($) ($) ($) ($) ($) 

Central 42,016,264 0 42,016,264 2,342,364 3,123,152 1,256,188 45,614,816 46,395,604 

Darling Downs/ 

South West 

26,549,286 0 26,549,286 1,442,775 1,923,700 794,093 28,786,154 29,267,079 

North Brisbane 102,670,844 0 102,670,844 6,448,349 8,597,798 3,070,700 112,189,893 114,339,342 

Northern 


32,464,628 0 32,464,628 2,119,823 2,826,431 971,077 35,555,528 36,262,136 

Peninsula 22,008,893 0 22,008,893 1,420,864 1,894,485 659,080 24,088,837 24,562,458 

South Brisbane 59,290,418 0 59,290,418 3,760,933 5,014,577 1,774,125 64,825,476 66,079,120 

West Moreton/ 

South Coast 

Statewide — 


82,168,742 0 82,168,742 5,416,635 7,222,180 2,460,806 90,046,183 91,851,728 

16,042,925 0 16,042,925 722,490 963,320 481,288 17,246,703 17,487,533 

TOTAL 383,212,000 0 383,212,000 23,674,232 31,565,643 11,467,357 418,353,589 426,245,000 

Comments: 

* This column represents recurrent funding unable to be allocated on a recurrent basis in 2008–2009 and is included in the growth allocation for 2009–2010. 

** This column includes cost supplementation and Meals on Wheels subsidy increase. 

28 


8.3.3 Planned regional recurrent funding summary 2010–2011 

2009–2010 2010–2011 

HACC region 

2009–2010 

Annual plan 

amount 

Base regional 

Adjustments * budget 

Real growth 

allocation 

(PYE) 

Real growth 

allocation 

(FYE) 


Indexation ** budget 

(PYE) 


budget 

(FYE) 

($) ($) ($) ($) ($) ($) ($) ($) 

Central 46,395,604 0 46,395,604 2,701,758 3,602,344 1,387,073 50,484,435 51,385,021 


South West 

29,267,079 0 29,267,079 1,594,331 2,125,775 875,352 31,736,762 32,268,206 

North Brisbane 114,339,342 0 114,339,342 7,080,426 9,440,568 3,419,668 124,839,436 127,199,578 

Northern 


36,262,136 0 36,262,136 2,318,549 3,091,398 1,084,672 39,665,357 40,438,206 

Peninsula 24,562,458 0 24,562,458 1,554,064 2,072,085 735,550 26,852,072 27,370,093 

South Brisbane 66,079,120 0 66,079,120 3,985,111 5,313,481 1,929,255 71,993,486 73,321,856 

West Moreton/ 

South Coast 

Statewide — 


91,851,728 0 91,851,728 5,905,135 7,873,513 2,750,805 100,507,668 102,476,046 

17,487,533 0 17,487,533 791,126 1,054,835 524,626 18,803,285 19,066,994 

TOTAL 426,245,000 0 426,245,000 25,930,499 34,573,999 12,707,001 464,882,500 473,526,000 

Comments: 

* This column represents recurrent funding unable to be allocated on a recurrent basis in 2009–2010 and is included in the growth allocation for 2010–2011. 

** This column includes cost supplementation and Meals on Wheels subsidy increase. 


8.3.4 Planned Statewide recurrent funding summary 

STATE/TERRITORY: Queensland 

REGION: Statewide FINANCIAL YEAR: 2008–2011 

Purpose of funding 

Current 

(base) 

funding 


($) 

Planned 

funding 


PYE 

($) 


funding 


FYE 

($) 


funding 

2009–2010 

PYE 

($) 


funding 

2009–2010 

FYE 

($) 


funding 


PYE 

($) 


funding 


FYE 

($) 

Statewide Information, Education and 

Training Services 

Provision of education and training at a multiregional 

or statewide level to improve statewide 

planning and delivery of HACC-funded services. 

(Refer Section 4.1.8) 

9,626,398 10,050,208 10,474,017 11,196,507 11,437,337 12,228,463 12,492,172 

National Service Standards 

Review of providers’ compliance with National 

Service Standards to ensure high quality 

services are provided to the target population. 

(Refer Section 7.1) 

735,423 735,423 735,423 735,423 735,423 735,423 735,423 

Minimum Data Set project 

Provision of sector training and support, data 

quality audits within Local Planning Areas to 

assist in identifying common data quality errors, 

development of quarterly reports and annual 

MDS bulletins, and ongoing support to service 

providers. (Refer Section 6.2) 

Special needs groups development and 

support project Undertake a range of activities 

to provide development and support to the 

special needs groups/population priorities 

identified in each HACC state plan. Continue 

to establish partnerships and linkages with 

other Australian and state government and 

non-government agencies, informing and 

advising on specific needs and coordinating 

the development and implementation of 

Queensland HACC strategy in relation to 

identified population priorities. 


180,447 180,447 180,447 180,447 180,447 180,447 180,447 

218,551 218,551 218,551 218,551 218,551 218,551 218,551 

30 


STATE/TERRITORY: Queensland 

REGION: Statewide FINANCIAL YEAR: 2008–2011 


Current 

(base) 

funding 


($) 


funding 


PYE 

($) 


funding 


FYE 

($) 


funding 

2009–2010 

PYE 

($) 


funding 

2009–2010 

FYE 

($) 


funding 


PYE 

($) 


funding 


FYE 

($) 

Assessment and client referral 

Support the ongoing implementation and 

development of e-referral initiatives. 


112,530 112,530 112,530 112,530 112,530 112,530 112,530 

Workforce skills development 

To facilitate continuous improvement in the 

quality and consistency of services delivered to 

eligible people in the target population through a 

statewide skills development strategy. 


428,238 428,238 428,238 428,238 428,238 428,238 428,238 

Home and Community Care Program 

administration 

3,451,140 3,451,140 3,451,140 3,451,140 3,451,140 3,451,140 3,451,140 

Indexation 

Indexation will only apply to Statewide 

Information, Education and Training Services - 

effective 1 July each financial year. 

– 442,579 442,579 923,867 923,867 1,448,493 1,448,493 

TOTAL 14,752,727 15,619,116 16,042,925 17,246,703 17,487,533 18,803,285 19,066,994 


8.3.5 Planned regional services provision – Statewide 2008–2009 

PLANNED HACC REGIONAL SERVICE PROVISION — STATEWIDE 

2008–2009 2008–2009 Base + Growth 

Current 

(base) funding 

Service type/output ($) 

Type PYE FYE 

2008–2009 Outputs 2008–2009 Funding 

PYE 

($) 

FYE 

($) 

Domestic Assistance – Hours – – – – 

Home Maintenance – Hours – – – – 

Other Food Services – Hours – – – – 

Personal Care – Hours – – – – 

Respite Care 193,269 Hours – – 193,269 193,269 

Social Support 258,676 Hours 29,592 29,592 258,676 258,676 

Service Group 1: Home Support Services total 451,945 29,592 29,592 451,945 451,945 

Assessment – Hours – – – – 

Case Management – Hours – – – – 

Client Care Coordination – Hours – – – – 

Counselling/Support, Information and Advocacy 1,129,625 Hours 19,600 19,600 1,129,625 1,129,625 

Service Group 2: Coordinated Care total 1,129,625 19,600 19,600 1,129,625 1,129,625 

Allied Health Care – Hours – – – – 

Nursing Care – Hours – – – – 

Service Group 3: Clinical and Specialist Care total – – – – – 

Centre-Based Day Care – Hours – – – – 

Service Group 4: Centre-Based Day Care total – – – – – 

Goods/Equipment Provision – Dollars – – – – 

Home Modification 55,585 Dollars – – 55,585 55,585 

Linen service – Deliveries – – – – 

Service Group 5: Home Modifications total 55,585 – – 55,585 55,585 

32 



2008–2009 2008–2009 Base + Growth 

Current 



Type PYE FYE 

2008–2009 Outputs 2008–2009 Funding 

PYE 

($) 

FYE 

($) 

Meals at home – Meals – – – – 

Meals received at centre/other – Meals – – – – 

Service Group 6: Meals total – – – – – 

Transport 643,298 One-way trips – – 643,298 643,298 

Service Group 7: Transport total 643,298 – – 643,298 643,298 

Information, Education & Training, Other 

(Statewide) 

12,472,274 Dollars – – 12,896,084 13,319,893 

Service Group 8: Information and Education total 12,472,274 – – 12,896,084 13,319,893 

Indexation – N/A – – 442,579 442,579 

REGIONAL TOTAL 14,752,727 15,619,116 16,042,925 

Comments: 

The Statewide region would generally only contain services being delivered under Queensland service type Information, Education & Training, Other (Statewide) or 018. Exceptions 

currently include: 

1. Queensland service type 17 Counselling/Support, Information and Advocacy in relation to statewide delivery of advocacy and carer services and program administration. 

2. Some providers in the Statewide region are funded to deliver a range of other HACC service types in addition to the Queensland 018 service type. The HACC program will review these 

providers through the next contract renewal process with the aim of transferring the non-018 service type/s to the region/s where they are actually being delivered. 

Service types held within the Statewide region are not currently included in the calculation of regional outputs. 


8.3.6 Planned regional services provision — Statewide 2009–2010 


2009–2010 2009–2010 Base + Growth 

Current (base) 

funding 


Type PYE FYE 

2009–2010 Outputs 2009–2010 Funding 

PYE 

($) 

FYE 

($) 






















34 



2009–2010 2009–2010 Base + Growth 

Current (base) 

funding 


Type PYE FYE 

2009–2010 Outputs 2009–2010 Funding 

PYE 

($) 

FYE 

($) 







(Statewide) 

13,319,893 Dollars – – 14,042,383 14,283,213 


Indexation 442,579 N/A – – 923,867 923,867 


Comments: 



1. Queensland service type 17 Counselling/Support, Information and Advocacy in relation to statewide delivery of advocacy and carer services and Program administration. 




8.3.7 Planned regional services provision — Statewide 2010–2011 


2010–2011 2010–2011 Base + Growth 

Current 



Type PYE FYE 

2010–2011 Outputs 2010–2011 Funding 

PYE 

($) 

FYE 

($) 






















36 



2010–2011 2010–2011 Base + Growth 

Current 



Type PYE FYE 

2010–2011 Outputs 2010–2011 Funding 

PYE 

($) 

FYE 

($) 







(Statewide) 

14,283,213 Dollars – – 15,074,339 15,338,048 


Indexation 923,867 N/A – – 1,448,493 1,448,493 


Comments: 



1. Queensland service type 17 Counselling/Support, Information and Advocacy in relation to statewide delivery of advocacy and carer services and Program administration. 




8.4 Non-recurrent allocations 

8.4.1 Planned regional non-recurrent funding summary 

Planned Statewide non-recurrent funding summary Financial year: 2008–2011 

Region Purpose of funding 


funding 


($) 


funding 

2009–2010 

($) 


funding 


($) 

Central 

Capital/one-off funding 

New and replacement capital equipment/items and one-off funding to support 

the delivery of HACC-funded services to clients/carers, compliance with MDS 

reporting, National Service Standards and assessment requirements. 

1,253,824 456,704 548,638 


South West 





785,120 304,046 359,529 

North Brisbane 





2,440,034 317,849 562,605 

Northern 






951,900 305,437 379,995 

Peninsula 





564,079 153,454 200,812 

38 


Planned Statewide non-recurrent funding summary Financial year: 2008–2011 

Region Purpose of funding 


funding 


($) 


funding 

2009–2010 

($) 


funding 


($) 

South Brisbane 





1,347,481 159,988 296,944 

West Moreton/ 

South Coast 





1,970,421 313,932 504,978 

Statewide — 




the delivery of HACC-funded services specifically funded to deliver information, 

education and training on a multi-region and/or statewide basis. 

800,000 800,000 800,000 

Service development priorities 

(Refer to Table 8.4.2) 

4,690,000 5,080,000 4,990,000 

TOTAL 14,802,860 7,891,411 8,643,500 


8.4.2 Planned statewide non-recurrent funding summary 

Region: Statewide Financial year: 2008–2011 



funding 


($) 


funding 

2009–2010 

($) 


funding 


($) 

Continence consumables 

The supply of continence consumables for HACC eligible persons to assist in effective continence 

management. (Refer Section 4.1.5) 

1,500,000 1,500,000 1,500,000 

Capital infrastructure program 

Capital infrastructure review program to enable organisations to obtain a building survey to be 

undertaken by an appropriately qualified person/organisation. Recommendations will inform 

allocations of additional capital funding for facility maintenance, modifications and upgrades. 


370,000 490,000 490,000 

Promoting functional independence 

Development and implementation of a range of service models and approaches that promote an 

independence approach to service outcomes for clients. (Refer Section 4.2.2) 

200,000 500,000 500,000 

Aboriginal and Torres Strait Islander peoples 

Implementation of priority initiatives arising out of the revised HACC Indigenous Service 

Development Plan. (Refer Section 4.3.1) 

400,000 600,000 600,000 

Older people’s mental wellbeing 

Development of a sustainable framework that provides more timely and appropriate outcomes for 

older people experiencing mental health concerns. (Refer Section 5.2.1) 

300,000 400,000 400,000 

Workforce development 

Continued implementation of key elements of the HACC Workforce Skills Development Strategy to 

increase competence and skills within the HACC workforce with the aim of ensuring quality of service 

delivery to clients, and a comprehensive review of the strategy. (Refer Section 5.2.2) 

500,000 500,000 500,000 

Volunteers 

Undertake a scoping study to investigate the current level of reliance within HACC services on 

volunteer support to facilitate effective service delivery, and identify barriers and opportunities to 

better engage with and support volunteers. Provide recommendations for future action where 

appropriate. (Refer Section 5.2.3) 

– 80,000 – 

40 


Region: Statewide Financial year: 2008–2011 



funding 


($) 


funding 

2009–2010 

($) 


funding 


($) 

Technology and home design 

Explore opportunities for the application of appropriate assistive technology congruent with the aims 

of the HACC program. (Refer Section 5.2.4) 

– 100,000 100,000 

Nutrition 

Investigate alternative service delivery models to develop appropriate responses that improve 

nutrition status within the target population. (Refer Section 6.1) 

50,000 250,000 300,000 

Continence evaluation 

Undertake an evaluation of the Queensland Health Continence Management Strategy for HACC 

Clients and its implementation to assess the extent to which it has achieved its aims and to make 

recommendations for future service development initiatives. (Refer Section 6.3) 

60,000 – – 

Major home modifications 

Undertake an evaluation of the Major Home Modifications Program to assess the extent to which it is 

meeting client needs and provide recommendation for future investment. (Refer Section 6.4) 

– 60,000 – 

National Service Standards 

Commencement of the transition from the current National Service Standards to those proposed 

under common arrangements. (Refer Section 7.1) 

760,000 – – 

Integrated performance management 

Progressive development of an integrated data system that provides timely information to support 

program decision making, planning, and performance management and monitoring. 


300,000 600,000 600,000 

Regional planning boundary alignment 

Review the current planning region boundaries with a view to ensuring alignment prior to the National 

Planning Framework project implementation. (Refer Section 5.1.5) 

250,000 – – 


New and replacement capital equipment/items and one-off funding to support the delivery of HACCfunded 

services specifically funded to deliver information, education and training on a multi-region 

and/or statewide basis. (Refer Section 4.1.8) 

800,000 800,000 800,000 

TOTAL 5,490,000 5,880,000 5,790,000

Triennial Plan: Home and Community Care Queensland 2008-2011

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