1. CALD W AYS B IANNUAL R EGIONAL F ORUM - P ATHWAYS TO I MPLEMENTATION P ARRAMATTA 5 TH J UNE 2013 CALD A GED C ARE P OLICY – P OST, P RESENT & F UTURE Pino Migliorino Chair, Federation of Ethnic Community Councils Of Australia MD, Cultural Perspectives MD, CIRCA Research

2. 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 O VERVIEW

3. T HE R ATIONALE 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

4. A CALD A GING P OLICY A GENDA 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

5. T HE I NFORMATION / C ONSULTATION I MPERATIVE 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)

6. 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 T HE I NFORMATION / C ONSULTATION I MPERATIVE

7. 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 T HE I NFORMATION / C ONSULTATION I MPERATIVE

8. A CCESSING 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

9. E NHANCING C URRENT S YSTEMIC C APACITY AND C OMPETENCY 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

10. 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 E NHANCING C URRENT S YSTEMIC C APACITY AND C OMPETENCY

11. 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 E NHANCING C URRENT S YSTEMIC C APACITY AND C OMPETENCY

12. 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 E NHANCING C URRENT S YSTEMIC C APACITY AND C OMPETENCY

13. 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 E NHANCING C URRENT S YSTEMIC C APACITY AND C OMPETENCY

14. D EVELOPING A GED C ARE C APACITY IN CALD C OMMUNITIES 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

15. D EVELOPING A GED C ARE C APACITY IN CALD C OMMUNITIES 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

16. E NSURING S ERVICE Q UALITY C OMPLIANCE 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

17. T HE CALD A GEING P OLICY E NVIRONMENT 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

18. T HE CALD A GEING P OLICY E NVIRONMENT 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

19. T HE CALD A GEING P OLICY E NVIRONMENT 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

20. 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

21. C ONCLUSIONS 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