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Program 2.4: Veterans’ Community Care and Support

Objective

Veteran community care and support programs include the Veterans’ Home Care (VHC) program, the community nursing program, carer and volunteer support, and day clubs. In addition, the costs of running Home Front’s telephone service and administration are paid for under this program. The cost of delivering the service is reported under Program 2.5.

The objectives of DVA’s community care programs are to support veterans to remain independent in their homes and to delay entry into residential care. Where a person does enter residential aged care, DVA provides a subsidy for entitled veterans and war widow/ers living in these facilities.

Overview

In 2012–13, DVA provided a comprehensive range of home and community services to assist veterans to stay in their homes and to be engaged in the life of their community.

Demand for VHC, community nursing, residential care, carer and volunteer support and day clubs decreased slightly compared to last year. While there was a decline in the number of veterans needing assistance, there was a corresponding increase in demand for services due to veterans’ age and frailty. This meant expenditure remained relatively stable, reflecting the cost of increased services per client. The increase in the need for respite care is expected to continue, primarily because carers themselves are ageing and will need increased support.

During the year, DVA consulted with its contracted service providers through the Veterans’ Home Care Reference Group and Community Nursing Reference Group, to achieve improvements to the programs and ensure services remained responsive to clients’ needs.

Expenses

The Treasury administers expenditure for the Home and Community Care Services for Veterans’ Specific Purpose Payment as part of the National Partnership payments to the States. These payments are disclosed in the Department of the Treasury’s Portfolio Budget Statements 2012–13 under Program 1.10–National Partnership Payments to the States.

The 2013–14 Budget measure ‘National Partnership on Home and Community Care Services to Veterans–redirection’ provided a further 12 months funding to states and territories for 2013–14, with funding ceasing from 1 July 2014.

Expenses
  2012–13 PBS1 ($ million) Estimated actual2 2012–13 ($ million) Outcome 2012–13 ($ million)
Administered 1668.6 1602.9 1501.2
Departmental 26.1 28.8 26.7
Total resources 1694.7 1631.7 1527.9

1 PBS in performance reporting tables means Portfolio Budget Statements.

2Estimated actual means the estimated expense or total for 2012–13 provided in the 2013–14 Portfolio Budget Statements. As the Budget is released in May each year but the financial year does not close off until 30 June, the current year numbers in the Budget can only be estimates.

Deliverables

Veterans’ Home Care

The VHC program supports veterans and war widow/ers in their own homes to improve their quality of life, independence and health, in particular, maintaining independent functioning within the home environment. The VHC program provides domestic assistance, personal care, safety-related home and garden maintenance and respite care.

The veteran community is ageing and increasingly requiring higher levels of services from the VHC program to remain in their own homes. The provision of these services helps to delay entry to residential aged care and maximises independence for veterans and war widow/ers.

The Department contracts with 182 organisations across Australia to assess veterans and war widow/ers for VHC services and to deliver those services. To ensure services are of high quality, a contract and quality management framework, together with post-payment monitoring, is in place for both community nursing and VHC.

Community nursing

The community nursing program assists veterans and war widow/ers to avoid early admission to hospital and/or residential care by providing access to high quality community nursing services. The activities of this program include the provision of clinical nursing and personal care services by DVA-contracted community nursing providers.

Veterans and war widow/ers are able to access these community nursing services through referral from a Local Medical Officer (LMO) or other GP, a treating doctor in a hospital, a hospital discharge planner or a VHC Assessment Agency.

The Department contracts with around 193 organisations across Australia to provide community nursing services to approximately 28 000 eligible veterans and war widow/ers.

Residential care

Approximately $1.4 billion is expected to be provided by the Department as the Australian Government subsidy for entitled veterans and war widow/ers in residential aged care facilities in 2012–13. This supports approximately 27 000 entitled veterans in long-term residential care.

Key performance indicators

The Department will provide clinical nursing and home care services to eligible veterans and war widow/ers according to their assessed need.

Key Performance Indicators
  2012–13 PBS Estimated actual 2012–13 Outcome 2012–13
Price: Unit cost per cardholder $108 $113 $110

Report on performance

Veterans’ Home Care

Assessment and coordination

In 2012–13, DVA spent a total of $9.2 million on assessment and coordination of veterans and war widow/ers, needs for VHC services and other community care services. This was a reduction of $0.9 million from 2011–12.

DVA also spent a total of $76.2 million on the delivery of domestic assistance, personal care and safety-related home and garden maintenance services, the same amount spent in 2011–12. Another $15.5 million was spent on the delivery of in-home respite services to veterans and war widow/ers, compared with $18.9 million last financial year.

Table 25 shows a comparison of expenditure on these services for the past five years.

Table 25: Veterans' Home Care expenditure 2008-09 to 2012-13
  2008–09 ($ million) 2009–10 ($ million) 2010–11 ($ million) 2011–12 ($ million) 2012–13 ($ million)
Assessment and coordination 10.5 10.7 10.5 10.1 9.2
Domestic assistance, personal care and safety–related home and garden maintenance 77.0 80.1 79.1 76.2 76.2
In-home respite 21.2 24.2 23.3 18.9 15.5

Numbers assessed for VHC and services accessed

Around 64 660 veterans and war widows/ers were assessed for VHC services compared with approximately 68 280 assessed in 2011–12. Of those approved to receive VHC services during the financial year:

  • 89.3 per cent were approved for domestic assistance

  • 30.2 per cent were approved for safety-related home and garden maintenance services

  • 4.9 per cent were approved for personal care

  • 13.5 per cent were approved for respite care

  • 0.02 per cent were approved for social assistance services under the Coordinated Veterans’ Care (CVC) Program.

These figures total more than 100 per cent as veterans and war widow/ers may be approved for more than one service type.

Table 26 shows the approvals for one or more VHC services for the past five years as a percentage of the total number of veterans and war widow/ers approved to receive VHC services.

These figures do not include social assistance services under the CVC Program, which is delivered through the VHC program, as this service is not available to all veterans and war widow/ers.

Table 26: Percentage of clients approved for VHC services 2008-09 to 2012-13
Percentage of Total Approvals
Number of services 2008-09 2009-10 2010-11 2011-12 2012-13
One 72.4 69.9 68.5 63.4 65.9
Two 24.5 26.8 28.2 28.6 30.5
Three 2.8 3.1 3.1 3.1 3.3
Four 0.2 0.2 0.2 0.2 0.2

Social and community services pay equity

The Social and community services (SACS) pay equity payments commenced on 1 January 2013. Table 27 shows some details of the payments in the 2012–13 financial year.

Table 27: SACS pay equity payments made by DVA in the first six months of 2013
Program Payment - Jan to June 2013
Veterans’ Home Care (domestic assistance, personal care and social assistance service) $237 024
In–home respite (emergency and in–home respite services) $63 330
Community nursing (personal care) $120 293

Community nursing

In 2012–13, DVA spent $120.3 million1 on community nursing services, an increase of 9.9 per cent on the $109.4 million spent in 2011–12.

The majority (96 per cent) of DVA-contracted community nursing services are paid through a set schedule of item numbers and fees (Schedule of Fees). The remainder are paid through the exceptional case process managed by DVA’s Exceptional Case Unit, which contracts specialist clinical nurse consultants with a range of expertise in generalist nursing, wound management, palliative care and gerontology to process applications for exceptional case status.

Carer and volunteer support

Carers Victoria has been contracted to undertake the role of National Carer Support Services. Since July 2012, the focus of the contract has been to develop and deliver a national training package to provide carer awareness training to community care service providers that deliver services to members of the veteran community. This training aids compliance with the requirements of the Carer Recognition Act 2010, the associated guidelines as part of the National Carer Strategy and broader carer issues. Carers Victoria successfully delivered 17 training sessions to VHC service providers and assessment agencies around Australia between March and May 2013.

Day clubs

In 2012–13, there were 145 day clubs located throughout Australia, a decrease from 154 in 2011–12. The decrease was as a result of the closing of non–viable clubs. Where a club did close, DVA facilitated members of those clubs, where appropriate, into other clubs or seniors groups within their local area.

1 Community nursing data is subject to providers claiming time lags; therefore these figures are subject to revision.

Veterans’ Home Maintenance Line

The Veterans’ Home Maintenance Line (VHML) is a toll-free telephone service that provides property maintenance advice and referrals to reputable trades people. The service can also arrange home inspections to help identify current or possible future maintenance problems. VHML is part of the Rehabilitation Appliances Program (RAP) program, which aims to assists members of the veteran community to remain living independently in their own homes for as long as possible.

The combined number of calls received from VHML and the HomeFront line was 87 859 in 2012-13. VHML services were provided to 13 138 beneficiaries in 2012-13, with DVA payments totalling $338 760. The commonly requested information this year was for plumbers, household handypersons, and electrical, gardening and roofing services.

HomeFront

HomeFront is a falls and accident prevention program that provides eligible veterans and war widow/ers with a free home assessment once every 12 months. DVA provides financial assistance towards the cost of aids and minor home modifications designed to reduce the risk of falls and accidents in the home.

Approximately 41 712 beneficiaries received HomeFront services in 2012-13, compared with 30 000 who received help in 2011-12. Total expenditure was $13.9 million, which was an increase on the $9.6 million spent in 2011-12. The program is available to Gold and White Card holders.

Grants-In-Aid

The Grants-in-Aid program assists national ex-service organisations with administration costs such as travel on DVA associated business, office equipment and advocacy undertaken on behalf of the veteran community.

The Grants-in-Aid program has an annual allocation of $145 000.Ten national ex-service organisations received funding under the Grants-in-Aid program in 2012-13, totalling $104 057.

Veteran and Community Grants

The Veteran and Community Grants (V&CG) program provides funding for projects that support a healthy, quality lifestyle for members of the veteran community and assist them to remain living independently in their own homes. Grants are also available for initiatives that reduce social isolation, support carers and improve access to community care services.

A total of $2.6 million was provided to 138 applicants under the V&CG program in the 2012-13 financial year. V&CG includes community care seeding grants, joint venture and joint venture day club grants.

V&CG funding is also available for commemorative purposes that are consistent with the aims and objectives of the V&CG program. A total of $944 700 was provided to four applicants for commemorative projects in the 2012-13 financial year. This figure is included in the $2.6 million above.

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