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Programme 2.4: Veterans’ Community Care and Support

Objective

The objective of Programme 2.4 is to manage the provision of community support and residential care to entitled veterans and war widows and widowers, including development and review of policy and operational guidelines and procedures, and assessment of their effectiveness.

Veteran community care and support includes Veterans’ Home Care (VHC), the Community Nursing Program, the Carer and Volunteer Support Program and the provision of the payment of Australian Government subsidies and supplements for entitled veterans and war widows and widowers living in residential care facilities.

The Veteran and Community Grants Program provides funding aimed at benefiting members of ex-service organisations and funds projects that support a healthy lifestyle for members of the veteran community.

The costs of running HomeFront’s telephone service and administration are also paid for under Programme 2.4. The cost of delivering the service is reported under Programme 2.5.

The objectives of these programmes are to support veterans to remain independent in their homes, and to improve their quality of life and health.

Overview

In 2013–14, DVA provided a comprehensive range of home and community services to assist veterans to remain in their own homes and to engage with their community. Demand for home care, community nursing and residential care decreased slightly in 2013–14, when compared with demand in 2012–13. Despite a decline in the numbers requiring assistance, there continued to be a corresponding increase in the need for services due to the age and frailty of the veteran community. A smaller yet defined group of contemporary families were also supported by VHC. Respite services also continued to increase as carers aged and required continued support.

In two major developments this financial year, DVA extended VHC service provider contracts until 30 June 2016 and launched the Veterans’ Home Care Pilot Provider Portal. The Portal improves the way VHC providers conduct their business online with the Department, including how they access service plans and submit claims.

Another major initiative was a review of the Community Nursing Program classification system and associated schedule of item numbers. The review was aimed at ensuring the Community Nursing Program continues to meet the veteran community’s care needs, and reflects current community nursing industry standards. The review was completed in March 2014 and the Department is implementing the review’s recommendations.

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 2013–14 under Programme 1.10 – National Partnership Payments to the States.

Administered and Departmental expenses – Programme outcomes against Budget
  2013–14 PBS ($m) ESTIMATED ACTUAL 2013–14 ($m) OUTCOME 2013–14 ($m)
Administered 1694.9 1614.7 1557.0
Departmental 29.1 30.1 30.5
Total resources 1,724.0 1,644.8 1,587.5

PBS = Portfolio Budget Statements

Deliverables

Veterans’ Home Care

VHC supports veterans and war widows and widowers in their own homes to improve their quality of life, independence and health, and to maintain independent functioning within the home environment. VHC services include domestic assistance, personal care, respite care and safety-related home and garden maintenance. Additional social assistance services are also provided, as part of the Coordinated Veterans’ Care (CVC) Program.

Community nursing

The Community Nursing Program assists veterans and war widows and widowers to avoid early admission to hospital and residential care by providing access to high-quality community nursing services.

Residential care

Approximately $1.5 billion was provided by the Department as the Australian Government subsidies and supplements for entitled veterans and war widows and widowers in residential aged care facilities in 2013–14. This supported about 27,000 entitled clients in long-term residential aged care.

Key performance indicators

The Department provides clinical nursing and home care services to eligible veterans and war widows and widowers according to their assessed need.

Deliverables – Programme outcomes against Budget projections
  2013–14 PBS ESTIMATED ACTUAL 2013–14 OUTCOME 2013–14
Price: Unit cost per cardholder 120 124 131

PBS = Portfolio Budget Statements

Report on performance

Veterans’ Home Care

Assessment and coordination

In 2013–14, DVA spent $8.9 million on assessment and coordination of veterans’ and war widows and widowers’ needs for VHC services and other community care services. This was a reduction of $0.3 million from 2012–13.

DVA also spent $78.5 million on the delivery of domestic assistance, personal care and safety-related home and garden maintenance services. This was an increase of $2.3 million from 2012–13. Another $10.4 million was spent on the delivery of in-home respite services to veterans and war widows and widowers, compared with $15.5 million in 2012–13.

Table 23 shows a comparison of expenditure on these services for the past five years.

Table 23: Veterans’ Home Care expenditure 2009–10 to 2013–14 ($ million)
  2009–10 2010–11 2011–12 2012–13 2013–14
Assessment and coordination 10.7 10.5 10.1 9.2 8.9
Domestic assistance, personal care and safety-related home and garden maintenance 80.1 79.1 76.2 76.2 78.5
In-home respite 24.2 23.3 18.9 15.5 10.4

Numbers assessed for VHC and services accessed

The Department contracts with 174 organisations across Australia to assess veterans and war widows and widowers for VHC services and to deliver those services.

Around 63,700 veterans and war widows and widowers were assessed for VHC services in 2013–14, fewer than the 64,660 people who were assessed in 2012–13. Of those approved to receive VHC services during the financial year:

  • 88.8 per cent were approved for domestic assistance
  • 31.5 per cent were approved for safety-related home and garden maintenance services
  • 5.3 per cent were approved for personal care
  • 13.7 per cent were approved for respite care
  • 0.02 per cent were approved for social assistance services under the CVC.

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

Table 24 shows the percentage of veterans and war widows and widowers approved for one or more VHC services for the past five years.

These figures do not include social assistance services provided under the CVC, which is delivered through the VHC, as this service is not available to all veterans and war widows and widowers.

Table 24: Proportion of veterans and war widows and widowers approved for VHC services (%)
Number of services 2009–10 2010–11 2011–12 2012–13 2013–14
One 69.9 68.5 63.4 65.9 65.3
Two 26.8 28.2 28.6 30.5 30.8
Three 3.1 3.1 3.1 3.3 3.2
Four 0.2 0.2 0.2 0.2 0.2

Social and Community Services Pay Equity

DVA made the following Social and Community Services Pay Equity payments in 2013–14:

  • Veterans’ Home Care (domestic assistance, personal care and social assistance services) – $666,000
  • In-Home Respite (emergency and in-home respite services) – $184,000
  • Community Nursing – $273,000.

Community nursing

The Department contracts around 190 organisations across Australia to provide community nursing services to approximately 26,119 eligible veterans and war widows and widowers.

Expenditure on community nursing

In 2013–14, DVA spent $129.3 million on community nursing services, an increase of 7 per cent on the $120.3 million spent in 2012–13.

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.

Consultation with community nursing providers

As part of ongoing consultation with contracted providers, DVA convenes the Community Nursing Reference Group comprising 14 service provider representatives. This group plays an integral part in the continuing development and improvement of the programme, including advising on industry-wide issues, developments in nursing standards and best practice, and workforce issues within the industry. It also provides feedback on proposed enhancements to community nursing policy and procedures.

During March and April 2014, the Department conducted information sessions with service providers about the new community nursing classification system. The sessions were attended by 124 providers, who together provide services to 97 per cent of the programme’s clients.

Carer and volunteer support

The carer and volunteer support program supports the health and wellbeing of the veteran and service community by improving access to health services in the community. Those services include day clubs for frail aged veterans, drop-in centres and men’s sheds for younger veterans, and other health-related information activities that keep veterans active and integrated within the community. Training and support is also organised for volunteers working with the veteran community.

DVA engages Community Support Advisers to assist with services that focus on day clubs, health promotion, men’s health peer education and other community, recreational and social health initiatives.

In 2013–14, DVA contracted Carers Victoria to develop and deliver carer awareness training to service providers who provide community care for veterans. The training focused on compliance with the Carer Recognition Act 2010, associated guidelines to the National Carer Strategy and broader carer issues.

DVA worked with Carers Victoria to develop the training material into a self-paced e-learning package for DVA staff and providers. The package covers a range of topics, including an overview of the Act and priority action areas of the strategy, and provides contact details.

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 tradespeople. The service can also arrange home inspections to help identify current or possible future maintenance problems. VHML is part of the Rehabilitation Appliances Program, which aims to assist 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 lines was 87,649 in 2013–14. VHML services were provided to 11,540 beneficiaries in 2013–14, with DVA payments totalling $404,000. The most commonly requested information this year was for plumbers, household handypersons, electrical trades, gardening and roofing services.

HomeFront

HomeFront is a falls and accident prevention programme that provides eligible veterans and war widows and widowers 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 at home.

Approximately 43,738 beneficiaries received HomeFront services in 2013–14, compared with 41,712 who received help in 2012–13. Total expenditure was $13.5 million, a slight decrease on the $13.9 million spent in 2012–13. The service generated 10,283 RAP referrals and is available to all holders of Gold and White Cards.

Grants-In-Aid

The Grants-in-Aid programme assists national ex-service organisations (ESOs) with administration costs such as travel on DVA associated business, office equipment and advocacy undertaken on behalf of the veteran community. To be eligible, organisations must be an effective national representative body, have direct links to the ex-service community and have objectives which aim to benefit the welfare of their members.

The Grants-in-Aid programme has an annual allocation of $145,000. Eleven national ESOs received funding under the Grants-in-Aid programme in 2013–14, totalling $104,474.

Veteran and Community Grants

Veteran and Community Grants (V&CG) provide 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.

Applicants must be a community-based ex-service organisation or private organisation that can demonstrate the ability to contribute to the welfare of members of the veteran community through the project. A total of $2.132 million was provided to 108 applicants under the V&CG programme in 2013–14.

Funding is available for projects that are sustainable and financially viable, or for one-off projects that have an ongoing health benefit for the veteran community. The grants are not intended to provide for ongoing financial assistance. Examples of projects funded in 2013–14 include bus trips to reduce social isolation, equipment for men’s sheds and day clubs and facility upgrades to support the veteran community.

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