AGED CARE AND DISABILITY REFORM Metro Forum 3 August 2017 Rural Forum 10 August 2017

1. AGED CARE AND DISABILITY REFORM Metro Forum 3 August 2017 Rural Forum 10 August 2017

2. LOCAL GOVERNMENT AND AGED AND DISABILITY SERVICES 7,000 aged and disability staff Commonwealth Home Support Program Est. 80 – 85,000 clients Est. 11,000 clients Est. 11,000 clients

3. WHY IS THIS IMPORTANT TO COUNCILS? • Communities have a strong attachment to these services and look to councils as a leader in planning and service provision • Supports councils’ prevention roles - supporting health & well-being, positive ageing strategies, access and inclusion programs, recreation, libraries and social support • Place based planning ensures community care connects with health and other community support services • Services are accessible and located locally - citizens/residents know that they can rely on the local council for assistance and receive help in navigating other services they might need • There is a direct line of sight for council - builds knowledge of their communities and whether programs are meeting the needs of residents; councillors hear what is affecting their community • Community and civic accountability as a level of government in providing needed services, and ensuring equitable access around the state • Workforce and economic development strengths of 7000 community care staff – many of whom are local residents in rural municipalities • Supports other council roles– e.g. emergency management for vulnerable people, prevention of elder abuse • Navigating new and changing environments poses some challenges

4. NATIONAL AGED CARE AND DISABILITY REFORM Aged Home Support Program HACC Current arrangements to 2020 NationalDisability Insurance Scheme State-wide rollout July 2016 to July 2019 Continued State funding for 0-64 year olds not eligible for NDIS HACC (PYP)

5. Aged Care • The Commonwealth has taken over responsibility for funding community aged care services – now the Commonwealth Home Support Program (CHSP). There are changed access arrangements, through a centralised My Aged Care website and national call centre • Older people are the majority of council clients (70-80%) • Victoria secured commitment to stability of existing funding arrangements to June 2019 – now extended to June 2020 • Commonwealth is considering a range of models for the home support service system post-2020. This MAY include greater individual client budgets; choice of providers; block funding for some types of services; greater consumer choice and a broader market of potential providers • The Commonwealth has assured that no firm decisions have been made as yet on the service design issues, and councils and MAV have the opportunity to try and influence design and service models. There is a strong case to be put for block funding for some types of community support services • What the future service design looks like will affect the nature and degree of impacts that new arrangements will have on councils and their service delivery – we won’t know this for some time

6. National Disability Insurance Scheme • NDIS is being rolled out nationally, to meet the needs of eligible people with significant and ongoing disabilities and who are under 65 • The NDIS is funded by States and the Commonwealth, and the amount of money in the disability system will double as a result, so it is well funded to provide the primary response for people with significant disabilities • HACC has previously filled some of these people’s needs, and about 50% (11,000) of council younger clients are estimated by DHHS to be eligible to transition to the NDIS. Funding estimated for those clients will be transferred to NDIS. • Regions are being progressively being rolled out in Victoria – so councils are all at different stages • Councils can register as NDIS providers, but many will choose not to • A number of transition issues are being experienced with the NDIS roll-out. These are affecting clients and council business processes. While many of these issues should improve over time and as the scheme develops, councils already in transition have had to manage the impacts of these issues.

7. Region Councils Transiti on Date 1) North Eastern Banyule; Darebin; Nillumbik; 1 July 2016 Melbourne Whittlesea; Yarra 2) Inner Eastern Boroondara; Manningham; 1 November Melbourne Monash; Whitehorse 2017 3) Outer Eastern Knox; Maroondah; Yarra 1 November Melbourne Ranges 2017 4) Hume Hume; Moreland 1 March 2018 Moreland 5) Bayside Bayside; Frankston; Glen 1 April 2018 Peninsula Eira; Kingston; Mornington Peninsula; Port Phillip; Stonnington 6) Southern Cardinia; Casey; Greater 1 September Melbourne Dandenong 2018 7) Brimbank Brimbank; Melton 1 October 2018 Melton 8) Western Hobsons Bay; Maribyrnong; 1 October 2018 Melbourne Melbourne; Moonee Valley; Wyndham NDIS rollout - Metro

8. NDIS rollout - Rural

9. HACC Program for Young People with Disabilities - who are not eligible for NDIS • In Victoria, the HACC (PYP) will continue to fund services for those who are under 65 and are not NDIS eligible • State funding arrangements mean that councils will continue to be funded for these services to at least July 2019, and likely beyond. Remaining HACC (PYP) clients under 65 can continue to receive services with the State funding allocated, under current guidelines. • DHHS has estimated the number of clients that will remain in HACC (PYP) is approximately 11,000 – with generally lower levels of support needs • The State government has previously stated that people under 65 will not be disadvantaged by the new arrangements. It is expected that the needs of clients being met by HACC(PYP) might be reviewed in the period up to 2019 • Transfer of funding from councils to cover NDIS eligible clients will occur at a given point in each area’s transition. This is likely to cause issues for councils that have clients who are expected to transition to NDIS and don’t (for a variety of reasons) in that timeframe

10. MAV STRATEGY and ACTIONS • 1. MAV has negotiated a Tripartite Agreement with State & Commonwealth, signed by Ministers, which recognises the role of local government in planning and service delivery. • Through the Tripartite Community Care Officials Group, the MAV is actively aiming to influence the design of the system in Victoria and maintain key strengths. • A Human Services Directors Forum was held in July to enable councils to provide input directly to senior Commonwealth and State departmental representatives. • 2. The MAV has commissioned research with the University of New South Wales to document impacts of similar major social care reforms in other countries, as a further input to design. A number of issues raised by this research have also been raised in the NDIS context, such as: • Block funding enables flexible and appropriate services to be made available to residents at the neighborhood level • There are risks in moving to an individualized contracting model for specific services, as small budgets can limit flexibility of service responses and provision of choice • Some areas risk thin markets, where no/few new providers enter the market place due to high costs of entry or lack of business prospects • Administrative burden and insufficient investment in care coordination can cause anxiety/stress in older groups and decision co-ordination and planning support is needed more intensively than in younger groups • Ability to navigate systems is critical

11. 3. The MAV is preparing a submission/response to the Commonwealth discussion paper Future reform – an integrated care at home program to support older Australians. • This submission will be developed with councils. The MAV encourages all councils to both contribute to the MAV submission and submit themselves. Submissions are due 21 August 2017. • 4. The MAV is providing daily operational support to councils’ managers in navigating the new environment. Councils have also been directly raising these issues with the relevant departments. • 5. The MAV is meeting regularly with senior officials from the Commonwealth, the NDIA and the State • to advocate on behalf of councils: • to raise council issues relating to the NDIS transition • to negotiate arrangements to maintain/ensure continuity of care for clients during the complex transition period • to propose short term solutions to help maintain and support council transition activities, including transitional funding; price support to enable continued delivery where other providers are not available; more proactive planning processes by the NDIA with councils in areas yet to roll out; direct responsibility taken by the NDIA for addressing individual client case management. • there may be scope to explore medium term models/an intermediary structure to support councils (particularly rural councils) to continue to deliver services over a transitional period while market development occurs and other providers become available

12. TRIPARTITE AGREEMENT and Tripartite Officials Group MAV and Council Reps Submission and advocacy to Commonwealth re aged care program design Council input and Council individual submissions Research MAV liaison with Councils re operational issues Discussions with State and Commonwealth Officials and National Disability Insurance Agency