Options for Independence: Australian Home Help Policies for Elderly People

Abstract

An important focus of the Social Welfare Research Centre's work on the welfare of elderly people has been non-institutional care; formal care provided by statutory services, and informal care provided by family members. This report is the first in a planned series to look at one specific formal service, the Home Help service, in relation to elderly people. In the context of theoretical and practical issues relating to the development of home support services, this study examines Home Help service structures across Australia and, in particular, the workings of the service in New South Wales. Data for the study were collected in 1981/82, a time when financial and administrative constraints were markedly restricting the range and amount of home help which could be provided. In New South Wales, where the most information was gathered, the service was facing important challenges in terms of its development into a more comprehensive, caring service but was being hampered by lack of funds. Over the last three years the Home Care Service of New South Wales has experienced a continuous process of change and development. Funding in this period has increased by 187 per cent, total staff by 20 per cent and the number of branches by 5 per cent. Pay rates for field staff have risen by 46 per cent, and a long battle through the industrial courts has been in progress to develop an award. The most recent State budget (1983/84) provided for an increase of 107 per cent in funding of the New South Wales Home Care Service. This has allowed the introduction of needs based allocation of funds, the further development of innovative services and an upgrading of the administrative capacities of branches. The flexibility of branches in planning their expenditure has increased with the introduction of funding of all branches under a system of four monthly blocks compared with four weekly funding under which many branches in our study operated. The Wages Pause Program has also provided 'seeding' resources for an Assessment Program designed to assist branch staff in the development of effective assessment/re-assessment procedures. A training program, established centrally, since the time of our study, has become an important part of the service, with a budget of $0.5 million for 1983/84. Funding changes have meant that the Home Care Service has been able to develop the services it offers for all groups, including non-elderly people. For example, an affirmative action program for disabled people has been designed to ensure that the Service is accessible and appropriate to their needs. The already existing live-in housekeeper program has been extended to provide assistance to families in crisis and to offer extended respite care. Although recent increases in funding have expanded the potential of the service to meet the home care needs of the community, it is clear that even more resources will be needed if this is to be done completely. Many important issues regarding the allocation of home help resources at both the geographic and client level have been raised in this report.