Improving availability and access to specialist disability accommodation is central to getting young people out of residential aged care, the royal commission has heard during final submissions.

The SDA market is failing to respond to demand, Commissioners Tony Pagone and Lynelle Briggs were told, with an estimated shortfall of 9,000 places.

The situation has been exacerbated by lack of data about SDA, which is hindering planning and capital investment.

The submission by Counsel Assisting call for the NDIA to publish a Specialist Disability Accommodation National Plan with yearly updates on priority locations and action on thin markets.

“In some areas, the supply of Specialist Disability Accommodation and other disability support services is limited and does not meet demand,” the submission says.

“To address this problem, the Australian Government should develop a Specialist Disability Accommodation National Plan that puts forward strategies to build supply of SDA or viable alternatives in these areas.”

The submission says the sector can’t sit back and wait for the market to respond and calls for new approaches from government, including commissioning SDA developments or taking on the role of service provider.

The government could also offer grants to SDA providers, and local government planning powers could be leveraged to incentivise SDA developments.

Aged Care Commissioner Tony Pagone responds to final submissions from Council Assisting on October 23, 2020

Aged care ‘not for young people’

Aged care is not intended for younger people, Counsel Assisting Peter Rozen QC said.

“Their needs are not the same as the needs of older people. No younger person should have to live in residential aged care but too many younger people do and too many have done so for too many years,” he said.

“Aged care should only be used as a last resort for younger people and only where there are no other care facilities or care services more appropriate to meet their need.”

At the end of June this year, there were 4,860 younger people living in residential aged care in Australia. Of these, 3,978 were aged between 55 and 64. There were 110 aged between 35 and 44, and 20 people under the age of 35 living in residential aged care.

In response to the royal commission’s Interim Report, the government earlier this year pledged that no one under 65 would enter residential aged care from 2022, no one under 45 would live in residential aged care from 2022, and by 2025 no one under the age of 65 will be living in residential aged care.

“These commitments are commendable, they must be achieved and they must stay achieved,” Mr Rozen said, noting that past initiatives haven’t been delivered and “there have been false dawns before.”

“Fulfilment of the Government’s commitment will require dedicated, continuing and systematic action,” he said.

Holding government to account

He proposed a four-pronged approach to holding the government to account, with a requirement for the responsible minister to report on progress every six months.

The submission also proposes taking assessment of young people who at risk of ending up in residential aged care out of the hands of the ACAT and putting in place hospital discharge protocols to prevent them being discharged into residential care.

Aged Care Assessment Team staff can’t be expected to understanding of the needs of younger people or the options available to them, and NDIA assessors are more likely to understant age-appropriate alternatives, it says.

Between January and December 2019, aged care assessors rejected only 60 of the 1,231 recommendations for a younger person to move to permanent residential aged care, the commission was told.

Funding for ‘wranglers’

The submission also calls for improved advocacy.

The government announced in the 2020–21 budget that it would provide $10.6 million in funding for a national network of ‘up to 40’ system coordinators or ‘wranglers’ to help younger people find age-appropriate accommodation and supports to allow them to live independently in the community.

But that was insufficient considering they will have to help more than 4,500 younger people get out of residential aged care, and over 1,000 younger people avoid residential care, the submission says.

It also calls for there ongoing funding for system coordinators.

Counsel Assistings’ proposed recommendations at a glance:

  • Government must monitor and report every six months on progress towards its goals of keeping young people out of aged care
  •  Ensure young people at risk of going into aged care are assessed by a disability assessment team rather than an aged care team
  • Develop hospital discharge protocols to prevent young people being discharged into aged care
  • Develop, fund and implementing government programs for accommodation and care options for younger people who aren’t eligible for the NDIS
  •  NDIA must publish an annual Specialist Disability Accommodation National Plan
  • Ongoing collection and publication of data on younger people living in residential aged care

See the full list of recommendations here and the final submissions here.

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