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Following is a question by Hon Cheung Kwok-che and a written reply by the Secretary for Labour and Welfare, Mr Matthew Cheung Kin-chung, in the Legislative Council today (November 11):
Question:
Under the Pilot Scheme on Community Care Service Voucher for the Elderly (the Pilot Scheme) launched by the Government in September 2013, service vouchers are issued to eligible elderly persons with impairment at moderate level who are living in the pilot districts, so that they may use the vouchers to obtain community care services which meet their individual needs. The voucher has a value of $6,250 per month, which includes a co-payment amount borne by the elderly persons. The co-payment amounts payable by the elderly persons are set at five levels (depending on the elderly persons' household income). The Pilot Scheme Phase I, which lasted for two years, ended in September this year. It has been reported that the Government plans to implement, in the middle of next year, the Pilot Scheme Phase II across the 18 District Council districts in Hong Kong. In this connection, will the Government inform this Council:
(1) of the respective numbers of elderly persons, in each quarter during the Pilot Scheme Phase I, who (i) were issued with the service vouchers, (ii) used the service vouchers, (iii) did not use the service vouchers despite holding the vouchers, and (iv) withdrew from the Pilot Scheme (set out in Table 1);
(2) among the elderly persons who used the service vouchers in the first and second years of the Pilot Scheme Phase I, of the respective numbers of such persons who belonged to (i) dementia cases and (ii) general cases (set out in Table 2);
(3) as the services under the Pilot Scheme have been delivered in the single mode (i.e. day care centre (part-time)) and the mixed mode (i.e. day care centre (part-time) and home care services), in respect of the elderly persons who used these two modes of services during the first and second years of the Pilot Scheme Phase I, (i) the respective numbers of them, (ii) the respective average numbers of days for which they used the relevant services, and (iii) the respective numbers of persons among them who withdrew from the Pilot Scheme (set out in Table 3);
(4) of a breakdown, by reason of withdrawal, of the number of elderly persons who withdrew from the Pilot Scheme as mentioned in (3) above;
(5) as the report of the mid-term evaluation on the Pilot Scheme has indicated that the reasons for elderly persons' withdrawal included the high prices charged for the services and additional services, and given that as at April 30, 2015, among the elderly persons who used the service vouchers, 69 per cent needed to pay only the first level of the co-payment amount (i.e. they came from families with the lowest income and 210 of them, i.e. 17 per cent, were recipients of the Comprehensive Social Security Assistance), whether the Government will consider abolishing the arrangements whereby the elderly persons are subject to co-payments and the means test; if it will, of the details; if not, the reasons for that;
(6) given that the report has indicated that as at October 10, 2014, among the 184 elderly persons who withdrew from the Pilot Scheme, 130 of them withdrew due to "no suitable services packages" (109 of them with the specific reason for withdrawal being "unwilling to receive centre-based care service"), whether the authorities have reviewed if the scope of services under the Pilot Scheme can meet the needs of those elderly persons with impairment at moderate level; when launching the Pilot Scheme Phase II, whether they will consider (i) relaxing the categories of elderly persons eligible for participation in the Scheme, so as to cover those with impairment at mild level, and (ii) allowing elderly persons to purchase individual items of services according to their own needs; if they will consider, of the details; if not, the reasons for that;
(7) as some recognised service providers have relayed to me that the elderly persons have great demand for general care services such as household cleaning, escorting services and meal delivery, but due to constraints imposed by the requirements of the Pilot Scheme, they cannot flexibly adjust the service-hour ratio of professional services to general care services, whether the authorities will consider, when launching the Pilot Scheme Phase II, allowing service providers to flexibly adjust that ratio so as to meet the actual needs of elderly persons; if they will, of the details; if not, the reasons for that;
(8) given that the social welfare sector opposes to an expansion of the categories of recognised service providers for the Pilot Scheme to cover private enterprises because they generally hold the view that the quality of services provided by the private enterprises varies greatly and there is a lack of regulation, whether the authorities have planned to expand the categories of recognised service providers to cover private enterprises when implementing the Pilot Scheme Phase II; if they have, of the reasons for that and the details;
(9) of the expected time for the release of the final report on the Pilot Scheme Phase I; the details of the Pilot Scheme Phase II, including the relevant timetable and the respective numbers of places for day care services offered in various districts; and
(10) as the public have all along doubted the service quality and regulation of private residential care homes for the elderly, whether the authorities will consider shelving the implementation of the Pilot Scheme on Residential Care Service Voucher for the Elderly and re-allocating the relevant funds for use in the Pilot Scheme on Community Care Service Voucher for the Elderly; if they will, of the details; if not, the reasons for that?
Reply:
President,
The reply to the question raised by Hon Cheung Kwok-che is as follows:
(1) The Pilot Scheme on Community Care Service Voucher for the Elderly (the Pilot Scheme) is implemented in two phases. The First Phase, launched in September 2013, is still ongoing. Information on the number of elderly persons issued with community care service (CCS) vouchers and those who had used the vouchers in the past two years is set out in Annex 1.
(2) The Social Welfare Department (SWD) does not have information on the number of cases suffering from dementia among voucher holders.
(3) The numbers of elderly persons who had utilised or withdrawn from single mode (day care) or mixed mode (day care and home care) services under the Pilot Scheme and the volume of usage from September 2013 to June 2015 are set out in Annex 2.
(4) As at end-September 2015, the cumulative number of elderly persons having withdrawn from the Pilot Scheme was 1 282. Based on the findings of the questionnaire survey conducted by SWD, the reasons for withdrawal are set out in Annex 3.
(5) In its report in 2010 on a study on enhancing CCS, the consultant of the Elderly Commission (EC) put forward two fundamental principles: first, elderly care is a shared responsibility of taxpayers and service users; and second, those who can afford should pay more, so that more public resources can be deployed to assist elderly persons who are most in need. The "affordable users pay" principle is supported by the majority of stakeholders. Having regard to their views, elderly persons participating in the First Phase of the Pilot Scheme are required to co-pay with the Government for receiving services, and the required co-payment amounts are determined based on their household income. The co-payment rates are set at five levels on a sliding scale, so that the less that the user can afford, the more the Government pays.
(6) and (7) Services covered by the First Phase of the Pilot Scheme are similar to other existing CCS subvented by SWD. SWD has commissioned the Sau Po Centre on Ageing (COA) of The University of Hong Kong to conduct an evaluation on the First Phase of the Pilot Scheme. SWD is examining possible areas for refinement in the light of the initial findings and recommendations of the mid-term evaluation submitted by COA as well as other relevant views and considerations with a view to drawing up the implementation details of the Second Phase of the Pilot Scheme.
(8) Having regard to the initial findings of the mid-term evaluation of the First Phase of the Pilot Scheme, COA has recommended, among others, that the pool of service providers be expanded in order to enhance service quality and diversity by encouraging more non-governmental organisations (NGOs), social enterprises, self-financing service providers and private operators to become recognised service providers. SWD will draw up the implementation details of the Second Phase of the Pilot Scheme having regard to all relevant considerations and views.
(9) COA is finalising the mid-term evaluation report of the First Phase of the Pilot Scheme. The Government will provide the report to the Legislative Council Panel on Welfare Services (WS Panel) when it is ready. SWD is drawing up the implementation details of the Second Phase of the Pilot Scheme and will consult the WS Panel and stakeholders on the proposals later.
(10) The Government is committed to strengthening the monitoring of residential care homes for the elderly (RCHEs). Our priority at this stage is to further strengthen the monitoring mechanism of RCHEs under the existing legal framework to ensure their service quality. SWD will continue implementing and expanding the work of the Service Quality Groups on RCHEs, under which community personalities pay regular visits to different types of RCHEs. Meanwhile, SWD will explore how training for both the management and staff of RCHEs can be strengthened to enhance care standards.
The purpose of the Pilot Scheme on Residential Care Service Voucher for the Elderly (Pilot Scheme on RCSV) is to enable eligible elderly persons, through the "money-following-the-user" approach, to choose from residential care places run by NGOs or private operators participating in the scheme. Such residential care places are required to meet the standards stipulated under the scheme, and the voucher value will be higher than the average value of the Comprehensive Social Security Assistance received by elderly persons residing in private RCHEs. This will provide economic incentives for RCHEs to improve their services. The Government has tasked EC to study the feasibility of RCSV. In response to the invitation of the responsible working group under EC, the consultant team assisting in the study is further examining the design of the Pilot Scheme, especially on aspects including case management, quality assurance, complaint handling, etc. Subject to the recommendations of the report to be submitted by EC later, the Government has earmarked $800 million for issuing a total of 3 000 RCSVs in phases over three years.
Ends/Wednesday, November 11, 2015
Issued at HKT 15:53
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