HACC in Victoria & National Reform

1. HACC in Victoria & National Reform Jane Herington PSM Director, Ageing and Aged Care, Department of Health Victoria .

2. HACC in Victoria & National Reform • National Disability Insurance Scheme (DisabilityCare Australia) - agreement between the Victorian and Commonwealth Government • included an agreement to broader revision of roles and responsibilities for people 65 and over and people aged under 65 (and indigenous people over/under 50) • The Agreement will affect the HACC Program in Victoria, which is currently funded by both the Victorian and Commonwealth Government • the program will be split, with funding and management of services for people over 65 transferring to the Commonwealth • The Heads of Agreement state that: “the Commonwealth and Victoria will work together to retain the benefits of Victoria’s current Home and Community Care service system.”

3. Timelines • Transition being overseen by a CW/State Steering Group • Commonwealth PM&C, Treasury, DoHA • Victorian P&C, DTF, DH • First meeting to discuss terms of reference and timelines for transition plan – June 2013 • Transition plan agreed (and approved by Victorian Cabinet) early-mid 2014 – key milestones, funding and activities agreed • Transition implementation activities over 2014-2015 • identification of agency splits – funding for over/under 65 y.o clients • agreement around other funding types – FSR, SSR and projects • integration/interface with C’w Home Support Program • C’w funding agreements for service delivery agencies commence 1 July 2015 • C’w Home Support Program intended to commence 1 July 2015

4. Impacts 2013-15 • What will be the impact in the short term? • no immediate impact on HACC clients or service providers • seeking undertakings about current service delivery arrangements (“stable state”) • transition plan will document milestones to enable agencies to make decisions and to plan for change • What will happen over the next 2 years to 30 June 2015? • HACC will continue to be funded jointly by the Commonwealth and Victorian Governments and managed by the Victorian Department of Health • decisions about growth funds and indexation each year will continue to be taken by both Governments in the context of their respective Budgets • growth consultations for 2013-14 to commence next two weeks • DH will continue to pursue the directions in Victoria’s Triennial Plan 2012-15

5. Key elements of Steering Group considerations • “The CW and Victoria will work collaboratively to ensure successful communication and implementation of the transition of HACC and related services for older people in Victoria from 1 July 2015.” • “The CW and Victoria will work together to retain the benefits of Victoria’s current HACC service system.”

6. Commonwealth/State discussions to include: • The unique arrangements for HACC in Victoria • How Victorian HACC will inform development of Commonwealth Home Support Program • introduced from July 2015 in all states • future integration/interface issues with Victorian HACC • Financial arrangements, including • split of funds over/under 65 • budget neutrality (neither govt better or worse off as a result) • pricing issues • relationship with related programs and NDIS

7. Victoria’s view of the benefits of the Victorian HACC system • significant role and involvement of local government in HACC • local government role in positive ageing, planning for age-friendly communities and community support services • Partnership approach to developing and managing service system • Local area planning and population based resource allocation • Framework and structure of assessment (inc. care planning, care coordination) • Range of services available, including investment in community nursing and allied health • Victoria has spent more on home nursing and allied health than any other jurisdiction

8. The benefits of the Victorian HACC service system (cont.) • Focus on HACC as locally connected prevention and support services • Policy directions, including wellness and reablement; diversity planning • Sector wide service development • eg. statewide training; ASM industry consultants; access and equity for CALD and ATSI; wound care management; regional planning and projects • Relationships between health services, community health and community aged care to provide more integrated services for older people • Service coordination encouraging electronic referral protocols and networked services working together around the client • Investment in infrastructure • eg. local government buildings, transport vehicles, Community Chef, workforce, funding for minor capital

9. Towards a Victorian position • Maintain stable and planned platform • Continuation of base funding to existing providers • exc. underperformance/closure and new types of services • Schedule F to NHA included undertaking to ‘not substantially alter service delivery mechanisms for period of 3 years, and “there is no requirement for services to be delivered under competitive tender processes” • Growth funds continue to be directed into key services and sectors, on equitably planned basis • note recent C’w advertising of growth in other jurisdictions • Continued investment in community nursing and allied health – consideration being given to retention by State • Retention of current network of HACC Assessment Services • interacting with national Gateway service, and maintaining face to face assessment where appropriate

10. Towards a Victorian position (cont.) • Recognise role of ACAS in both health services and aged care services, and build on existing links with HAS • Embedding ASM approach to reablement objectives – building on Victoria’s participation in NAF trial • Consultative planning (C’w, State, Local Govt, service providers) • Seek C’w to endorse evidence-based approach to resource allocation • recognising existing service networks, demand pressures and rates of older population growth, and allowing for population diversity • Develop mechanism for continued sector wide service development initiatives • Discuss C’w approach to program management

11. What does this mean? • Discussions with C’w will continue • Significant work to be undertaken by DH/DoHA, reporting to Steering Committee • Bilateral discussions re design of Commonwealth Home Support Program – proposing C’w/State workshop • Context is a national approach to delivery of CHSP and need to rationalise very different (prior) approaches in different jurisdictions • C’w response to our propositions yet to be tested

12. Next steps • Further engagement • peak bodies stakeholder group meeting 25 July -MAV, RDNS, ECCV, VACCHO, NDS, LASA, AAV, CarersVic, VHA, AMA, GPV, PCP Network - development of position paper for endorsement • Joint communication with DoHA to the sector • Regional forums • Suggested DoHA meeting with local government • Transition Team established - Calvin Graham, Deb Warren, Sarah Wilson • Transition information will be posted at: www.health.vic.gov.au/hacc/transition/index.htm