LCQ18: Pilot Scheme on Home Care and Support for Elderly Persons with Mild Impairment


     Following is a question by the Hon Shiu Ka-chun and a written reply by the Secretary for Labour and Welfare, Dr Law Chi-kwong, in the Legislative Council today (March 20):
     In December 2017, the Social Welfare Department (SWD) launched a three-year Pilot Scheme on Home Care and Support for Elderly Persons with Mild Impairment (the Pilot Scheme) to provide, on a co-payment basis, home care and support services to the elderly persons on the waiting list for the Integrated Home Care Services (IHCS) (Ordinary Cases).  The Pilot Scheme offers 4 000 service places.  SWD has commissioned a consultant to formulate a standardised assessment tool for use by the IHCS teams to conduct assessments on elderly persons, with a view to identifying elderly persons eligible for taking part in the Pilot Scheme.  In this connection, will the Government inform this Council:

(1) of the reasons for limiting the number of service places for the Pilot Scheme at 4 000;

(2) as SWD has commissioned a consultant to conduct a review on the effectiveness of the Pilot Scheme, of (i) the number, name list and qualifications of the members in the consultant team responsible for such task, (ii) the consultant fees involved, and (iii) the timetable for the review and whether the review will include public engagement activities;

(3) regarding the Pilot Scheme, of (i) the cumulative total amount of expenditure to date and the details of the various expenditure items, (ii) the expenditures for the previous and the current financial years, and (iii) the estimated expenditure for the next financial year; the cumulative total amount of funds allocated to date to service providers taking part in the Pilot Scheme, as well as the average cost per service session for each item of the services provided under the Pilot Scheme;

(4) of the details of the assessment tool, including the criteria adopted and a list of the items in the tool (with the whole assessment tool attached);

(5) of (i) the number of runs and (ii) the dates of the training programme on the use of the assessment tool conducted by SWD for members of the IHCS teams;

(6) of the respective numbers of elderly persons, since the introduction of the Pilot Scheme, who have (i) applied for joining the Scheme, (ii) undergone assessment, (iii) been assessed as being eligible for joining the Scheme, (iv) used the services provided under the Scheme (with a breakdown by the co-payment category to which they belonged), and (v) withdrawn from the Scheme, together with a tabulated breakdown by District Council district; the respective numbers of persons currently on the waiting lists for the various items of the services provided under the Scheme;

(7) of a breakdown of the number of elderly persons who have withdrawn from the Pilot Scheme by the reasons for withdrawal as set out in Table 1;

Table 1

Reason for withdrawal Number of persons
(i) No suitable service providers/service packages  
(ii) Expiry of the service period  
(iii) To be/Having been admitted to subsidised community care services or subsidised/private residential care services, or to receive/receiving such services  
(iv) Deceased  
(v) Having carers such as family members or domestic helpers  
(vi) Others (including hospitalisation and having left Hong Kong)  

(8) in respect of each item of services provided under the Pilot Scheme, of (i) the number of elderly persons who are currently using the service, (ii) the percentage of such number in the total number of users of the various services under the Pilot Scheme, (iii) the average monthly number of users for the service, and (iv) the number of user-times to date for the service (set out in Table 2);

Table 2

Service item (i) (ii) (iii) (iv)
a. Escort service (for going out/medical appointments)        
b. Meal service (meal delivery)        
c. Personal care        
d. Simple nursing care        
e. Physical exercise        
f. Home-making        
g. Home safety assessment and health management        
h. Purchase and delivery of daily necessities        
i. Other services (e.g. support for carers)        
Total user-times:  

(9) of (i) the average waiting time for the various items of services provided under the Pilot Scheme and (ii) the average time per person for which they are used; and

(10) of the criteria adopted by SWD for setting the charges for meal service and other services provided under the Pilot Scheme at $54 per meal and $131 per hour respectively?

     My reply to the Member's question is as follows:

(1) The Government launched the Pilot Scheme on Home Care and Support for Elderly Persons with Mild Impairment (the Pilot Scheme) in December 2017 to provide further assessments for elderly persons waitlisting for Integrated Home Care Services (Ordinary Cases) (IHCS(OC)) throughout the territory, and offer additional service quota for those elderly persons assessed to be of mild impairment. At the planning stage of the Pilot Scheme, the Social Welfare Department (SWD) set the number of service quota under the Pilot Scheme at 4 000 by making reference to the  number of elderly persons waitlisting for IHCS(OC) at the time.

(2) SWD commissioned the Sau Po Centre on Ageing of The University of Hong Kong (Sau Po Centre) to evaluate the effectiveness of the Pilot Scheme in February 2018.  The consultation team is led by Professor Terry Lum, Head of the Department of Social Work and Social Administration of The University of Hong Kong.  Other major members of the consultation team include the Director of Sau Po Centre and two other Assistant Professors, as well as several researchers. The total cost of the consultancy study is about $1.4 million. 
     The consultation team will conduct focus groups and interviews with the Approved Service Providers (ASPs), service users and their carers to collect their views on the Pilot Scheme during the evaluation process. The evaluation is expected to be completed by end-2019.

(3) The Community Care Fund provided a funding of $383 million to cover the expenditure involved in the Pilot Scheme. In the one-year period from the launch of the Pilot Scheme in December 2017 to December 2018, the total subsidy disbursed under the Pilot Scheme was about $22.26 million, which included subsidies for services provided to the participants, subsidies for staffing provided to ASPs, and subsidies for other service operation, etc. In addition, about $0.91 million was spent on administration costs, including the cost for the evaluation.  SWD does not have information on the average cost for each item of the services provided.

(4) SWD commissioned Sau Po Centre to design a simple and standardised assessment tool to identify elderly persons with mild impairment and analyse their service needs, so as to provide them with suitable home care and support services.  The accredited assessors of the Pilot Scheme have been using the assessment tool to conduct comprehensive assessments on such aspects of the elderly persons as their cognition/communication, mood/psycho-social well-being, functional status, health conditions, disease diagnoses, nutritional issues and procedures/treatments, etc. The assessment tool was designed with reference to the assessment tool of the internationally recognised InterRAI Check-Up. Due to copyright regulations, the assessment tool of the Pilot Scheme will only be provided to trained assessors for the purpose of conducting assessments.

(5) SWD and Sau Po Centre have so far conducted five rounds of training programmes for assessors, with the dates as follows:
(i) December 28, 2017 and December 29, 2017;
(ii) January 11, 2018 and January 12, 2018;
(iii) January 30, 2018 and January 31, 2018;
(iv) February 6, 2018 and February 7, 2018; and
(v) January 17, 2019 and January 24, 2019.

(6) to (9) As at end-December 2018, a total of 2 691 elderly persons waitlisting for IHCS(OC) were assessed upon being invited to join the Pilot Scheme, out of which 2 412 elderly persons were eligible and had applied to join the Pilot Scheme. Among them, 1 567 elderly persons had received the services and the subsidy payments, and their breakdowns by co-payment categories and service types are as follows:

Co-payment Category (Note 1) No. of
Service Type No. of Persons
I 693 Home Services 994
(63.4 per cent)
II 715
III 79 Meal Services 343
(21.9 per cent)
IV 73
V 7 Home and Meal Services 230
(14.7 per cent)
Total 1 567 Total 1 567

Note 1: The five co-payment rates for meal services are set at 20 per cent, 30 per cent, 35 per cent, 40 per cent and 45 per cent of the service values, whereas the five co-payment rates for home services are set at 0 per cent, 9 per cent, 15 per cent, 21 per cent and 27 per cent of the service values.

     In addition, as at end-December 2018, a total of 43 elderly persons left the Pilot Scheme and their breakdown by reasons for termination of services is as follows: 

Reasons for Termination of Services No. of Persons
Passing away 17
Admitted to residential care services 5
Admitted to subvented community care services 2
Withdrawn from services (Note 2) 19
Total 43

Note 2: SWD does not have information on the service users' reasons for withdrawing from the services.

     Through the 55 IHCS teams of the 24 non-governmental organisations operating IHCS(OC), the Pilot Scheme provides elderly persons receiving services under the Pilot Scheme with the necessary home care and support services as soon as possible. At present, elderly persons do not have to wait for the relevant services.
     SWD does not have the breakdowns of the statistics of the Pilot Scheme by District Council districts, and the information on the average usage time per case, the average number of user-times per month of the services, etc.

(10) The prices for each meal and each hour of home services under the Pilot Scheme are set with reference to the permitted ceiling prices in respect of the relevant services recognised by SWD under the Pilot Scheme on Community Care Service Voucher for the Elderly.

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