The Alliance continues its work on the issue of younger people living in residential aged care facilities.
Royal Commission into Aged Care Quality and Safety
In March 2021 the Royal Commission into Aged Care Quality and Safety issued its final report and proposed a target of ‘no people under the age of 65 living in residential aged care by 2025’.
The Federal Government accepted the recommendations and significant funding has been allocated to prevent young people from entering residential aged care (RAC) and assist those already living in RAC to transfer to live safely in the community.
However, despite this:
on 31 December 2023 over 1800 young people continued to live in RAC
during 2022-23 over 300 young people entered RAC
a very small number of people transferred to live safely in the community
for the last decade, most young people in RAC either died or ‘aged out’ (turned 65 years and so are no longer counted as YPIRAC).
About the Younger People In Residential Aged Care (YPIRAC) Program
The YPIRAC Program was seen as an important first step on the path to resolving a long-standing problem.
Also known as “My future, My choice” in Victoria, it ran for five years from 2015-2019. It focused on delivering suitable support services and accommodation for young Australians with high and complex support needs.
A “whole system” approach was recognised as fundamental to the wellbeing of these young people, and encouraged a system that allowed individuals to have a choice about where they live and how they are supported. Implementation was by the states and territories.
YPIRAC Strategy
In 2020 the YPIRAC Strategy was launched with three targets:
no young people under 45 years in RAC by January 2022
no young people entering RAC by January 2022
no young people living in RAC by January 2025.
The first two targets were never achieved and the third is off-track for delivery. Over 95% of young people in RAC are NDIS participants or eligible to access the NDIS.
After coming to power in May 2022, the new Federal Government reviewed the progress and, in early 2023, abandoned the Strategy. The Department of Health and Aged Care has commissioned a review of the YPIRAC initiatives, which will report in mid-2024.
In late 2023, the Department of Health and Aged Care released an exposure draft of the Aged Care Bill 2023. The Bill seeks to apply an age restriction for access to aged care services for the first time in Australian history.
The Bill limits access to those people over 65 years but makes exceptions for people who are 50-65 years and:
Aboriginal or Torres Strait Islanders
homeless, or
at risk of homelessness.
The Alliance provided a response to the Bill urging government to add a caveat to the exemptions to remove access to aged care funded permanent RAC for NDIS participants. While this would not prevent NDIS participants under 65 years from entering RAC if that was their choice, they would do so with an NDIS plan with funding that addresses their goals and fully meets their care and support requirements.
Background
YPIRAC initially focussed on persons under 50 years. Its three key objectives were to:
move young people with disability currently in RAC into appropriate supported disability accommodation where supported disability accommodation can be made available but only if the young person chose to move
divert future admissions of young people with disability who are at risk of admission to RAC into more appropriate forms of accommodation, and
enhance the delivery of specialist disability services to those younger people with disability who choose to remain in RAC, if RAC remained the only available suitable supported accommodation option.
With a total $244 million over its 5 years, the Commonwealth Government contributed $122 million with states and territories matching this amount, calculated on a per capita basis. The program was implemented nationwide and run by the states.
COAG YPIRAC Program’s Mid-Term Review report
The Council of Australian Government’s (COAG) Younger People in Residential Aged Care (YPIRAC) Program’s Mid-Term Review report analysed the targets, performance and key issues associated with the YPIRAC Program.
The landmark collaboration was always intended as a first step towards real resolution of the YPINH issue, and not a solution in and of itself.
Aiming to provide community based accommodation and support alternatives to younger people with disability living in or at risk of admission to residential aged care (RAC), the YPIRAC program has three key objectives. These are to:
offer community based alternative supported accommodation options to younger people with disability currently accommodated in RAC
prevent or divert further admissions of younger people with disability who are at risk of admission to RAC
and provide disability services to younger people with disability whose health prevents them exiting RAC, or who choose to remain there for reasons of proximity to family and community in remote and rural areas.
Each state and territory government signed a bi lateral agreement with the Commonwealth to implement the program. These bi lateral agreements contained targets specific to each objective.
‘YPIRAC2’: The YPINH Next Steps report to FaHCSIA
In early 2011, the Alliance was asked to prepare a report for federal and state Disability Ministers that set out the essential next steps for the COAG Younger People In Residential Aged Care initiative (YPIRAC).
The YPIRAC program was coming to the end of its first 5 years and Ministers were considering what shape the initiative might take to continue assisting young Australians living or at risk of placement in residential aged care.
The YPIRAC2: The Next Steps report outlines the need for service pathways across the health, disability and aged care arms of the service system; and the types of collaboration that must be developed to ensure a comprehensive response.
It urged immediate action by all jurisdictions to continue the work YPIRAC1 began and suggests that this continued work is a vital precondition to the successful introduction of an NDIS nationally.
YPIRAC2 was never formally adopted by the Federal Government.
