Following is a question by the Hon Luk Chung-hung and a written reply by the Secretary for Labour and Welfare, Dr Law Chi-kwong, in the Legislative Council today (November 21):
Question:
In 2000, the Social Welfare Department (SWD) implemented a Standardised Care Need Assessment Mechanism for Elderly Services, under which accredited assessors use an internationally recognised assessment tool to assess the care needs of the elderly and match them with appropriate long-term care services. As some frontline service providers considered that the assessment tool was ineffective in identifying the cognitive and mental needs of those elderly persons with early-stage dementia, SWD commissioned the Sau Po Centre on Ageing of the University of Hong Kong in 2013 to update the assessment tool to interRAI-HC (elderly health and home care assessment tool) version 9.3 (the new version tool). The Government indicated at the end of last year that the new version tool would be introduced within the current financial year. In this connection, will the Government inform this Council:
(1) of the progress of adopting the new version tool, including the launch date and the to-date number of accredited assessors who have attended training programmes for conducting assessment with the new version tool;
(2) whether it has gained an understanding of the edge of the new version tool over the existing version of the tool in respect of identifying the cognitive and mental needs of those elderly persons with early-stage dementia;
(3) whether the Government will accede to requests for conducting reassessment with the new version tool for those elderly persons who have been assessed by the existing version of the tool and found ineligible for subsidised long-term care services; and
(4) whether it has assessed if more elderly persons will be identified to be in need of long-term care services after the adoption of the new version tool; if it has assessed and the outcome is in the affirmative, whether it will increase the quotas for such services gearing to this situation; if so, of the details?
Reply:
President,
My reply to the Hon Luk's question is as follows:
(1) to (3) With the support from the Lotteries Fund, the Social Welfare Department (SWD) commissioned the Sau Po Centre on Ageing of the University of Hong Kong (the Consultancy Team) in 2013 to carry out a research project on the enhancement of the infrastructure of long-term care in Hong Kong. One of the objectives is to update the assessment tool adopted under the Standardised Care Need Assessment Mechanism of Elderly Services (SCNAMES). The assessment tool currently in use, namely the interRAI-HC version 2.0 will be updated to the latest interRAI-HC Chinese version 9.3. Through using the updated assessment tool, clinical information will be collected from the elderly persons on aspects of their cognition, communication, mood and behaviour, social functioning, functional impairment, disease diagnosis and other health conditions, etc., for a more precise assessment of their current care needs and early identification of signs and symptoms indicating impairments (including dementia) for matching with appropriate long-term care services for the elderly.
The Consultancy Team is currently examining the applicability and reliability of the updated assessment tool in Hong Kong and will submit a research report to the SWD in due course. Before the launch of the updated assessment tool, the Consultancy Team will also provide training on the use of the updated assessment tool to about 2 000 serving accredited assessors.
Under the current SCNAMES, elderly persons with long-term care needs or existing service users who find the services they are receiving not able to meet their care needs may request SWD, through their referring offices, for another assessment and apply for long-term care services that match with their care needs.
(4) The new assessment tool should be able to more precisely assess the different level of long-term care services required by the elderly, so as to assist in service matching in a more appropriate manner. The impact on the overall long-term care needs have yet to be assessed pending further detailed studies.
The Government will continue to adopt the approach of according priority to the provision of home care and community care, which are supplemented by residential care, in providing support for frail elderly persons with long-term care needs. The Government has all along been striving to increase subsidised elderly care places under a multi-pronged approach. To this end, the 2018 Policy Address has proposed a series of new initiatives to support frail elderly persons, including those suffering from dementia. These initiatives include:
a) Strengthening the community care and support services for the elderly by providing an additional 2 000 service quota under the Enhanced Home and Community Care Services;
b) Providing an additional 1 000 vouchers (bringing the total to 7 000 vouchers) under the Second Phase of the Pilot Scheme on Community Care Service Voucher for the Elderly to support ageing in place for elderly persons with moderate or severe impairment;
c) Implementing a new scheme to set up day care units for the elderly at qualified private and self-financing residential care homes for the elderly (RCHEs) to increase the supply of day care services;
d) Providing designated residential respite places in private RCHEs participating in the Enhanced Bought Place Scheme to relieve the stress of carers; and
e) Purchasing an additional 5 000 EA1 places under the Enhanced Bought Place Scheme in the next five years to increase the supply of subsidised residential care places for the elderly and enhancing the overall service quality of private residential care homes for the elderly.
Furthermore, the SWD will continue to implement the Pilot Scheme on Residential Care Service Voucher for the Elderly by adopting the "money-following-the-user" approach with a view to offering elderly persons in need of residential care service an additional choice and providing an incentive for RCHEs to improve their services.
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