CALD WAYS BIANNUAL REGIONAL FORUM -

PATHWAYS TO IMPLEMENTATIONPARRAMATTA 5TH JUNE 2013

CALD AGED CARE POLICY –

POST, PRESENT & FUTURE

Pino MigliorinoChair, Federation of Ethnic Community Councils Of

AustraliaMD, Cultural Perspectives

MD, CIRCA Research

The importance of Conferences at this particular time (Living Longer, Living Better)

The need to move onto the first foot as a sector, leading rather than following

An agenda which is about CALD inclusiveness in planning, developing and facilitating equitable access for and responsiveness to CALD older people

The CALD Ageing Policy Environment

Challenges

OVERVIEW

THE RATIONALE

Numbers, more number and more number still

CALD Aging

23% aged 65-74

21% aged 75-84

15% aged 85+

A higher rate of Aging

18% in 1996

23% in 2011

30% in 2021

A CALD AGING POLICY AGENDA

The information/ consultation imperative

Accessing the aged care system

Enhancing current systemic capacity and competency

Developing aged care capacity in CALD communities

Ensuring service quality compliance

THE INFORMATION / CONSULTATION IMPERATIVE

Aged Care Information

Information barriers due to lack of English, poor first language literacy and poor IT proficiency

Lack of service awareness a key factor in service utilisation

Increasing tendency to online communications especially DoHA

Increasing levels of good practice – DHS (Centrelink) but not consistent across government though change expected through AMPs (the Access & Equity Report)

Consultation and Representation

Increasing presence of CALD representation in key industry and consultative bodies (FECCA)

An increasing trend to challenge the positioning of CALD in a more generic ‘diversity group’

A need for structure and mechanisms that can provide a CALD sectoral voice

A need for more effective mechanisms to directly consult with the CALD aged care organisations and CALD older people

THE INFORMATION / CONSULTATION IMPERATIVE

Failure to address the issues of meaningful 2-way information flow will continue to marginalise the

CALD aging sector and consequently older people from CALD backgrounds and their families

THE INFORMATION / CONSULTATION IMPERATIVE

ACCESSING THE AGED CARE SYSTEM

The implications of the proposed Aged Care Gateway

Competency issues around the single point of entry, especially given past performance

A centralised system would re-establish a direct service delivery function in DoHA which it has not had in the past

The need to consider complementary structures and processes to allow CALD information access

The responsibility of the Gateway to capture client ethnicity data and to use this to access and respond to community gaps

ENHANCING CURRENT SYSTEMIC CAPACITY AND COMPETENCY

The discussion of systematic capacity and competency needs to be based on the following service principals

All services, ethno specific, multicultural and generalist need to be culturally responsive

CALD older people should have a choice of service providers according to their wont and need

Capacity gaps across service types need to be identified and filled

Community Care

Demonstrated importance of community care for CALD communities

The need to ensure that informal care is supported and replaced by formal community care

The need for capacity and resource building around community care for smaller and emerging CALD groups

ENHANCING CURRENT SYSTEMIC CAPACITY AND COMPETENCY

Residential Care

While not a preferred option in CALD communities there is an increasing community recognition of the need for high level care especially for end of life and advanced dementia situations

Residential care is arguably the most problematic with regard to the ethno specific, multicultural and generalist service continuum

There continues to be significant capacity and competency issues across this range

ENHANCING CURRENT SYSTEMIC CAPACITY AND COMPETENCY

There is a subsequent need for significant interventions and supporting resources to achieve a system wide enhancement

Maintaining and supporting partnerships programs and resources such as PICAC and other partnership programs to increase the cultural responsiveness of generalist providers

Promoting and enhancing multicultural residential models in specific and relevant demographic settings

Supporting ethnic specific structures in demographic or social situations in which other models would not function

ENHANCING CURRENT SYSTEMIC CAPACITY AND COMPETENCY

Carer support

CALD carers need to be given particular attention in the overall consideration of aged care provision

Carer support organisations that are funded by government should have greater expectations placed on them to ensure greater access and equity for CALD carers and consumers to their services

There is an ongoing need to promote and deliver culturally responsive respite services to CALD carers

ENHANCING CURRENT SYSTEMIC CAPACITY AND COMPETENCY

DEVELOPING AGED CARE CAPACITY IN CALD COMMUNITIES

An existing 2-tier CALD aged care capacity

Capacity development in CALD communities needs to be pursued to enable service choice and relevance

CALD Community sector briefings on service criteria and requirements to attain service provider status

Aged care system information to create understanding of the new aged care approach, with their being targeted to smaller communities

DEVELOPING AGED CARE CAPACITY IN CALD COMMUNITIES

Earmarked resources to enable flexible approaches to meet the needs of smaller communities

Earmarked funding in the Aged Care Approvals Round for service models that partner CALD communities with existing service providers

ENSURING SERVICE QUALITY COMPLIANCE

The new Australian Aged Care Quality Agency provides an important opportunity to measure cultural responsiveness

The CALD Aged Care Sector needs to be involved in setting the standards and performance benchmarks to measure culturally responsive services at all levels of the aged care continuum

THE CALD AGEING POLICY ENVIRONMENT

A History of Marginality

No CALD aged care policy since 1995 leading to decreased validity and visibility

A lack of a broader policy framework with the weakening of Multiculturalism and an almost non existent Access & Equity requirement

Almost 20 years of attempting to bring CALD ageing issues from the margin to the centre

THE CALD AGEING POLICY ENVIRONMENT

Re-establishing a Policy Framework

After 4 years, current government through, Minister Chris Bowen reintroduces Multicultural policy in February 2011

A Policy totem that affects overall departmental thinking and increases the pressure for change

Minister Mark Butler through LLLB and his conversations that also included conversations with CALD communities

21 December 2012 Minister Butler launches the National CALD Ageing and Aged Care Strategy

THE CALD AGEING POLICY ENVIRONMENT

The National CALD Ageing & Aged Care Strategy – An Enablement

Role of the Minister and diverse conversations

Role of FECCA as a strategy leader

Role of the CALD aged care sector providing both policy smarts and organisational grants

Role of DoHA in working with the sector to develop the policy

CALD AGED CARE POLICY CHALLENGES

Integrating CALD perspectives into the planning and design of the new Aged Care components

Identifying and influencing the key systems and mechanisms in the aged care area such as the Gateway, CDC, community care and residential care

Building CALD capacity by the development of workforces that have the competency and linguistic skills to meet CALD needs

Building capacity in ethnic communities, so that they can fully participate in the communities aged care

CONCLUSIONS

Ongoing policy relevance will need the following ingredients:

Strong and consistent political leadership

Supportive equity policy framework to legitimise and drive CALD responsiveness

Vocal CALD advocates

Capacity and knowhow in ethnic communities to articulate need and provide care

Service design that is influenced by and appropriate to CALD needs