What does the future hold for people with complex needs?

Cherylee Treloar

CEO Footprints in Brisbane

Background

• The Health Reforms applied within Australia over the past few years have transformed the community sector, resulting in paradigm shifts across aged, disability and health sectors and are still changing how service providers will respond to individual care needs.

Individualised models of care

• Characteristics of Consumer-directed care models vary by extent to which individuals control their services i.e.

– who provides services, when they are provided, and how these services are delivered

• Some issues include –

– Costs (real benefit, labour), quality, protections

What are complex needs?

• Interacting concerns that are imbedded over time and continue to perpetuate disadvantage without intervention e.g. housing, homelessness, healthcare, physical, trauma and psychological concerns

• Complex care needs require flexible, coordinated & often integrated service responses to address immediate presentation of concerns; putting into place supports that address the underlying causes of e.g. homelessness and housing instability, recovery approaches to mental illness, restorative practises for health and well being.

The impact of reform

• Split in HACC services (Qld) separating services between over and under 65 years of age

• Removal of group 2 funding for case management Aged Care

• Loss of continuity of care of people with complex needs

• Unclear impact of the introduction of NDIA

Data 2013

<65 years of age• 95% have no carer or informal supports• 90% have mental health diagnosis and / or

behavioural issues• 75% have at least 2 or more medical health

conditions (e.g. cardiac disease, diabetes)• 20% premature aging (e.g. loss of memory,

mobility, incontinence, general issues with daily living skills)

• 87% live in community/public housing/boarding house or hostel

• 3% own home / market rental• 10% roofless / homeless• 85% are on a disability support pension• 15% other pension / new start• 100% utilise case management and / or care

coordination

>65 years of age• 90% have no carer or informal

supports• 40% have mental health diagnosis

and / or behavioural issues• 80% have at least 2 or more

medical health conditions• 80% live in community/public

housing/hostels or boarding houses

• 15% own home / market rental• 5% roofless / homeless• 80% are on an aged pension• 5 – 10% other pension• 100% receive case management

and / or care coordination

Concerns & issues

• Equity of access

• Market failure

• Left out and left behind

Letting our concerns be known

• Position papers

• Talking about it – funders, interest groups, PIR systemic advocacy, conference presentations (LASA, Palliative Care, etc), other providers

• Evidence based on client data

• Research that supported this data

Words to action

• Data to government about what are complex needs

• Analysis of this data

• Formation of the working group

• Continuation of funding at State level

• Homeless HACC

Current perspectives

• Representation

• Control & Choice

Reality check

• Some people need support across their whole of life both episodic and continuous

• They are not old but experience premature aging

• Do not have a psychiatric illness but are psychologically unwell (trauma)

• Are frequent presenters at hospitals and GPs but don’t get well (chronic diseases that lead to reduced life expectancy)

What happens next….

• Ensure that people who are and who are not eligible are identified and their needs recognised

• Appropriate service responses developed –funding….??

RE FORM

Reflections

• “I've learned that people will forget what you said, people will forget what you did, but people will never forget how you made them feel.” Maya Angelou

wellbeing hope support recovery activity trust respect independence confidentiality home dignity strength optimism

Thank you

www.footprintsinc.org.au

07 3252 3488