Just over three years ago, then Prime Minister Scott Morrison said the federal government would finally solve the problem of young people with disabilities being forced to live in nursing homes. The government developed a strategy and determined getting all young people out of aged care by 2025.
This week NDIS (National Disability Insurance) Secretary Bill Shorten said this remained “definitely the goal”. The 2023-2024 budget commits $7.3 million to “further reduce the number of people under the age of 65 living in residential aged care”.
As of 2020, the federal government has spent more than $50 million initiatives who have done little to improve the lives of young people living in aged care or at risk of entry.
Given the lack of progress to date, the three new initiatives funded by this pledge are unlikely to meet the 2025 target of no younger Australians living in facilities designed for much older people.
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Why are young people in retirement homes?
Younger people are usually admitted to retirement homes after a late-onset disability, such as a brain injury, or deterioration from a neurodegenerative disorder such as multiple sclerosis.
Two-thirds of young people go from the hospital to care for the elderly. They may not be able to return to their previous home because it is not wheelchair accessible or they require a high level of paid support.
While Australians under 65 who become severely disabled are eligible for the NDIS and housing and support funding, the NDIS processes are slow. Young people can get lost in the gap between health care and disability care and end up in care for the elderly.
Us recent analysis looked at the pathways to and from elderly care in 2021-22. It shows that fewer young people end up in residential care for the elderly every year.
In June 2022, 2,934 young people were in residential care for the elderly, compared to 3,899 in June 2021. There were 553 new admissions during the year.
About 1,518 people left. But this was mainly due to people turning 65 and “aging” or dying.
Summer Foundation
There are estimates 3,000 vacancies in accommodation for the disabled across Australia, including 1,000 newly built specialist accommodation for the disabled.
Yet only last financial year 39 young people left residential aged care to go to NDIS-funded specialty accommodation for the disabled. More than 500 NDIS participants under the age of 65 remain in residential aged care with the goal of relocating.
So while the number of young people in residential aged care is declining, they are not necessarily finding alternative accommodation.
What has the work failed to do so far?
Since 2020, the federal government has one range of ideas with limited success.
a $29.5 million program employed coordinators to support young people in leaving or avoiding residential aged care.
This has not yielded goals. Results reported in a recent public forum included supporting two younger people to leave aged care and nearly 80 youth in residential aged care to become NDIS participants.
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The National Disability Insurance Agency (the NDIA, which administers the NDIS) has introduced a specialist planners and an accommodation matching team.
But this team has had limited success, with less than 90 young people in residential care for the elderly in 2022 move to their own home or housing for the disabled that meets contemporary standards.
What’s in the budget?
The federal budget divides $56.4 million to a “home and living” NDIA panel. This aims to increase the NDIA’s capacity to make timely and consistent decisions for NDIS participants seeking housing and support funding. This will improve the consistency and timeliness of funding decisions and is urgently needed.
The budgetary allocation specifically for young people in residential care for the elderly includes training ($3.6 million) for the people to support and influence the decision of young people living in residential aged care do not have a purpose to move.
The other funding is to centralize decision making for younger people who want to get into aged care ($2.4 million) and an evaluation of the youth initiative to date in residential aged care ($1.3 million).
What is missing from the budget?
The federal budget does not focus on funding for the trained staff necessary to support this group in the transition from residential care for the elderly.
Currently, youth are provided with a list of generic NDIS-funded support coordinators who do not have the expertise or skills to support them in making an informed choice about where to live or transitioning to age-appropriate housing. There are no minimum qualifications for support coordinators.
Each young person in residential aged care needs approximately 40 hours of expert support from an experienced paramedic to make an informed choice about housing and support options, and to move into their new accommodation.
Read more: The NDIS is about to restart, but we also need to reform disability care outside the scheme
Only of the 2,153 youth in residential aged care who are NDIS participants 26% (556 people) currently have a goal of moving. The budget focuses on the 1,597 people who do not have a relocation goal and not on the 556 who do have a relocation goal. This is confusing.
A more logical approach would be to work with both groups and demonstrate great housing outcomes for the 556 people who want to move and share these stories to build the hope and confidence of people who are unsure about moving.
The initiatives announced in the budget fail to address the main barrier preventing young people in aged care from achieving better housing outcomes: skilled support in seeking alternative housing and exiting aged care.
A new approach
The federal government should work with organizations with a track record of supporting young people in residential aged care to move, rather than continuing to rely on generic support coordinators with limited expertise.
The NDIA needs to step it up a notch and provide timely funding for modern housing for the disabled and support for NDIS participants who have raised their hands to move out of aged care.
For young people in retirement homes where there is no suitable disability housing close to family and friends, the NDIA should provide the specialist disability housing market with detailed demand data so that new homes can be built.
The NDIS abandons younger people in aged care or is at risk of ending up in aged care. A new approach is needed.
