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Friday, 28 November 1986
Page: 4033

(Question No. 4641)


Mr MacKellar asked the Minister representing the Minister for Community Services, upon notice, on 19 September 1986:

(1) Did the Government announce in the 1984-85 Budget its intention to restructure support for the aged, young disabled and families in need of home care services by the creation of a Home and Community Care Program (HACC).

(2) Did that program allow for new types of services in addition to existing programs covered by the four pieces of legislation to be incorporated in HACC; if so, what types of new services are contemplated.

(3) What additional new service types (a) were introduced in (i) 1984-85 and (ii) 1985-86 and (b) are expected to be introduced in 1986-87.

(4) When were the States and Territories formally advised of the Government's intention to introduce HACC.

(5) On what date were the States and Territories invited to participate in negotiations to develop HACC.

(6) Have negotiations with the States and Territories been completed.

(7) Have all States and Territories now concluded agreements with the Commonwealth on the HACC; if not, what States and Territories have not concluded agreements and why.

(8) Will the inability of one or more States or Territories to conclude an agreement with the Commonwealth prevent the HACC from reaching and maintaining an efficient and effective level of operation.

(9) Were ``above base'' funds of $10 million allocated by the Commonwealth to the States and Territories for 1984-85 and were all such funds spent in that year.

(10) On what programs was the allocation spent in (a) each State and Territory, and (b) each year.

(11) If the allocation was not fully expended, was it due to (a) the States and Territories failing to meet the three pre-conditions specified by the Commonwealth; if so, what conditions were not met, and by what States and Territories or (b) other reasons; if so, what reasons.

(12) Were unspent funds from the allocation rolled over into 1985-86; if so, were these additional to the $25 million allocated by the Commonwealth for 1985-86.

(13) Was the total allocation for 1985-86 fully spent, if so, (a) on what programs, by State and Territory was the allocation spent.

(14) If the 1985-86 allocation was not fully expended, was it due to (a) the States and Territories failing to meet the three pre-conditions specified by the Commonwealth, if so, what conditions were not met, and by which States and Territories or (b) other reasons, if so, what reasons.

(15) Were unspent funds from the allocation rolled over into 1986-87; were these additional to the allocation by the Commonwealth for 1986.

(16) What expenditure was occurred against each of the 11 sub-programs indicated in the Minister's second reading speech on the Home and Community Care Bill 1985 in (a) 1984-85 and (b) 1985-86.

(17) Have guidelines been prepared for each of the 11 sub-programs; have those guidelines been made available to organisations.

(18) If the guidelines have not been made available why not, and when is it expected that this will take place.

(19) What is the estimated total expenditure of 1986-87 for each State and Territory by existing and new service types by Commonwealth funding.

(20) Has the Minister indicated that total Commonwealth and State expenditure for the year 1984-85 to 1986-87 is estimated at $564.8 million.

(21) Does the assistance formulae provide for funds in 1987-88 and beyond the basis of a 20 per cent increase in money terms over the previous level by the Commonwealth, matched by the same percentage in the States.

(22) What evidence does the Minister have that the care of Australia's disabled is so inadequate that it warrants a 20 per cent per annum increase in funding for every year that the agreements are in force.

(23) When does the Minister expect that HACC will meet the needs of the frail aged and disabled.

(24) When will a national database to enable effective monitoring of the Program be fully operational.


Mr Howe —The Minister for Community Services has provided the following answer to the honourable member's question:

(1) Yes.

(2) Service types eligible for funding under the Home and Community Care (HACC) Program include:

(a) home help or personal care (or both);

(b) home maintenance or modification (or both);

(c) food;

(d) community respite care;

(e) transport;

(f) community paramedical services;

(g) community nursing;

(h) assessment or referral (or both);

(i) education or training for service providers and users (or both);

(j) information;

(k) co-ordination;

(l) such other service as is agreed upon by the Commonwealth Minister and the State Minister.

(3) Some of the new services types introduced since the Program's inception are respite care, transport services, education programs and co-ordination. The types of services to be funded are jointly agreed by Commonwealth and State/Territory Ministers each year after consultation with community groups. These service types have been and will be developed as priorities and funds allow.

(4) On 22 August 1984, by letter.

(5) On 22 August 1984, by letter.

(6) Yes.

(7) Yes.

(8) Not applicable.

(9) None of the $10 million available in 1984-85 was spent in that year. The States were reluctant to commit and spend these funds in the lead up to signing Agreements. Accordingly, the Agreements provided that the funds unspent in 1984-85 could be rolled-over into 1985-86. The earliest State signed an Agreement in September 1985 and the last State signed in April 1986, well into the 1985-86 financial year.

(10) 1984-85-nil spent. 1985-86-The reconciliation of expenditure by States in 1985-86 is not yet complete. However, it is estimated that the unmatched funds were spent as follows:

HACC 1985-86 Unmatched Commonwealth expenditure by State by service type $'000

Service Type

NSW

Vic.

Qld

SA

WA

Tas.

NT

ACT

Total

Home Help/Personal Care ...

3,487

360

240

241

128

1

37

4,494

Home Maintenance/Modification ...

130

. .

. .

. .

. .

. .

. .

130

Food Services ...

. .

. .

9

173

. .

1

46

229

Respite Care ...

1,492

810

180

266

47

71

19

2,885

Transport ...

43

. .

233

95

75

. .

. .

446

Paramedical Services ...

148

. .

. .

9

. .

. .

157

Community Nursing ...

. .

350

322

. .

. .

. .

. .

672

Assessment and Referral ...

439

. .

116

81

. .

14

23

673

Education and Training ...

6

207

31

3

. .

. .

247

Information ...

7

. .

. .

14

. .

. .

21

Co-ordination ...

. .

. .

. .

5

. .

17

22

Total ...

3,487

2,625

1,607

860

887

281

87

142

9,976

(11) (a) No. (b) Full expenditure was not achieved in South Australia and the ACT largely because of the time frame between commitment dates and when expenditure had to be achieved.

(12) Yes. Yes.

(13) The total HACC Appropriation for 1985-86 was $117.451m (including the ACT). Actual expenditure was $100.845m, the following is the estimated split between service types:

HACC 1985-86 COMMONWEALTH EXPENDITURE BY STATE BY SERVICE TYPE $'000

Service type

NSW

Vic.

Qld

SA

WA

Tas.

NT

ACT

Total

Home Help/Personal Care ...

20,716

11,824

3,617

1,875

2,662

1,477

140

216

42,527

Home Maintenance/Modification ...

. .

130

. .

. .

. .

. .

7

. .

137

Food Services ...

2,414

2,914

1,069

776

1,052

333

32

80

8,670

Respite Care ...

1,185

3,491

1,789

538

662

47

93

19

7,824

Transport ...

. .

43

. .

233

95

75

9

. .

455

Paramedical Services ...

. .

740

. .

1,586

. .

47

. .

. .

2,373

Community Nursing ...

7,262

10,543

5,722

3,342

6,520

1,342

. .

. .

34,731

Assessment and Referral ...

. .

440

. .

116

81

. .

46

23

706

Education and Training ...

. .

6

207

. .

31

3

. .

. .

247

Information ...

. .

8

. .

. .

. .

14

. .

. .

22

Co-ordination ...

874

1,421

181

325

314

5

10

23

3,153

TOTAL ...

32,451

31,560

12,585

8,791

11,417

3,343

337

361

100,845

(14) (a) No. (b) Full expenditure was not achieved due to the time taken in submitting claims, short time frames between commitment dates and when expenditure had to be achieved, and the time taken to develop State/Territory plans for the expansion of the Program.

(15) Yes. Yes.

(16) As the Agreement did not come into effect until 1985-86 the 11 service types shown in the Agreement and indicated in the Minister's Second Reading Speech did not apply until 1985-86. Question 13 provides the estimated split for 1985-86.

(17) No. No.

(18) No, because narrowly focussed sub program guidelines may hinder the development of integrated services providing one or more of the service types listed above.

(b) The document `The Home and Community Care Program, Commonwealth priorities for service development' sets out a checklist for reviewing service. This requires joint development by the Commonwealth and States to provide more detailed guidance to service providers.

(19) Estimated expenditure for 1986-87 is $131.94. It is not possible at this stage to estimate expenditure by service types. The notional allocation of this between States is:

$m

New South Wales ...

44.074

Victoria ...

39.194

Queensland ...

16.904

Western Australia ...

14.406

South Australia ...

11.770

Tasmania ...

3.760

Northern Territory ...

0.676

Australian Capital Territory ...

1.156

This notional allocation is subject to change, depending on the actual expenditures of States. States have the capacity to roll-over into 1987-88 any unspent 2:1 new Commonwealth money and some States will avail themselves of this provision.

(20) I am not able to identify the source of the figure quoted in the member's question. However, the expenditure figure is estimated at $579m for the three financial years 1984-85, 1985-86, 1986-87.

(21) The HACC Agreement provides that the Commonwealth will increase its contribution to the Program in 1987-88 by up to 20 per cent over its expenditure in 1986-87 providing that the State/Territory agrees to increase its contribution by the same percentage. In future years the Commonwealth and States/Territories must increase their contributions to the Program by 20 per cent each year unless otherwise jointly agreed.

(22) There is substantial evidence of a significant deficit in community care services for aged and disabled people including:

studies conducted by the Australian National University and the Department of Social Security (in conjunction with the Australian Council of the Ageing) indicate that fewer than 8 per cent of aged people with a moderate or severe disability have access to a formal community care service;

over the next 20 years it is estimated that the 65 years old and over population will increase by 44 per cent;

`In a Home or at Home: Accommodation and Home Care for the Aged' the report from the House of Representatives Committee on Expenditure 1982 and the more recent report of the Nursing Homes and Hostels Review highlight the historical imbalance of funding for residential care against support for the aged and disabled to live with dignity in the community.

In addition, the annual 20 per cent increase in funds available for the HACC program must provide for cost increases in existing services as well as expansion in service provision. Realgrowth will therefore be somewhat less than 20 per cent.

(23) It is intended that the Program, based as it will be on needs assessment, will go some considerable way in enabling many people in its target group to avoid premature or unnecessary admission to long term institutional care at less cost to the larger community and with greater quality of life gains to the individual.

(24) A national information collection system is expected to be operational by late 1987.