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New Zealand Home Health Association media release, 2 August 2011

The challenges of providing care to more people with increasingly complex health needs – in a time of restrained health spending – will be a focus for delegates attending a conference of home health providers in Wellington tomorrow.

The conference, themed, Fronting Up, is being hosted by the New Zealand Home Health Association (NZHHA), which represents 48 organisations that provide health care, personal care and support for people living in their own homes. Members include both private and not-for-profit organisations across New Zealand.

The three-day conference, which runs from 3 to 5 August, is being opened by Minister of Health Hon Tony Ryall.

Keynote speakers include UK expert in health and social care, Gerald Pilkington, who will talk about the benefits of helping people to re-learn the skills necessary for everyday life; Dr Rod Watts from Presbyterian Support, who will talk about results-based accountability; Chai Chuah, Director of the National Health Board who will talk about key health trends and new models of care; Tania Thomas, Deputy Health and Disability Commissioner (Disability), who will talk about what it takes to be consumer-centred, and Phillippa Smith, Deputy Auditor General, who will talk about the recently released performance audit on home based support services for the elderly.

There will also be presentations on how health services responded to the Canterbury earthquake, as well as a look at some exciting new developments in homecare in New Zealand – including a presentation by Professor Matthew Parsons on intensive home support for people leaving hospital after surgery or illness.

NZHHA Chief Executive, Julie Haggie, says the conference will address critical issues for the home health care sector.

“As a larger proportion of our citizens age, networks and services in the community will need to be strong so we can be supported to live for longer, where we want to live.

“Our providers know that current and future demands on the health system can be eased through good service design, encouraging greater independence and self-care, and fully using and resourcing the home health care workforce.”

Ms Haggie says she doesn't expect the conference to come up with all the answers but believes it will provide the opportunity for reflection and learning.

“We hope it will give us all confidence that we can ‘front up’ to the challenges ahead.”

Media welcome

Media are invited to attend the whole or any part of the conference. For all media inquiries or information about the conference please contact Julie Haggie on 0274 989 126. During the conference, if Julie is not available, contact Neil Maitland on 021 944 448 or Gay Maitland on 021 446 809.

What: NZHHA annual conference, with theme Fronting Up
When: Wednesday 3 to Friday 5 August 2011
Where: Conference floor, level 16, James Cook Grand Chancellor Hotel, Wellington

www.nzhha.org.nz

Home Health Association welcomes report on support services for older people

New Zealand Home Health Association media release 15 July 2011

The New Zealand Home Health Association¹ welcomes the report from the Office of the Auditor-General on home-based support services for older people (released this week), which notes no systemic problems with how providers and workers deliver home-based support services.   

"We know how hard our members work to support their clients and how important quality and professionalism are to them and their staff," says Julie Haggie, CEO of the Association. 

The audit team talked to home-based support services clients who felt their support workers and the services they received were essential and helped them to live independent lives. The Auditor-General, Lyn Provost, also noted that it costs District Health Boards (DHBs) significantly less to provide home-based support services than it costs to support people in rest homes, making it vital that home-based support services are sustainable, effective and efficient.

Ms Haggie also welcomes the Auditor-General's recommendation that the Ministry of Health look at making mandatory the current voluntary standard for the provision of home-based support services to older people, but thinks that the message should have been stronger. 

"Our members have already made this commitment – they agreed that they need to get positive auditing against this Standard to retain membership. Consumers need to know that the service they receive has met a common benchmark."

The Auditor-General is more critical of how DHBs and the Ministry of Health collect and use reporting information and whether they know if home support is effective and efficient. She says progress against the Health of Older Persons Strategy has been slow, with many DHBs at different stages of implementation. Services for older people and those with chronic disease are not yet fully integrated or coordinated within many regions.

The Auditor-General has also commented on the fact that the economic downturn has put public spending under pressure, and that this presents a significant risk to the future delivery of home-based support services. She tasks the Ministry of Health to provide clearer guidance on how to support the changing needs of older people. She states that with an absence of clear key performance indicators the Ministry cannot effectively monitor and improve service delivery. 
Julie Haggie says the economic stress on providers and their staff is severe, as they try to support clients with increasingly complex needs.

"Staff can get paid more stacking supermarket shelves than they can supporting and enabling older people to live independent lives. We have lost many staff because we can't value their skills and experience. Contract rates are very low, which prevents providers being able to reward qualifications, experience or good performance, or even assure workers of a set number of hours."

Ms Haggie urges the Ministry of Health and District Health Boards to look at the bigger picture.

"Support and health services delivered into the home can significantly reduce pressure on hospitals and avoid admission into residential care.  It just needs the will and the imagination to think about it and plan for it.

"My concern is that health leaders will respond to the report by increasing auditing and box ticking, and that this will simply miss the point."

ENDS

For further information contact Julie Haggie: 04 472 3196, 0274 989 126

1. The New Zealand Home Health Association Inc is the national body representing providers of home health care services.

The New Zealand Home Health Association¹ is calling on Hawke's Bay District Health Board (DHB) to put more funding into the care of elderly people in their own homes.

Association Chief Executive Julie Haggie says that over the past three years, like other health boards, Hawke’s Bay DHB has received over 12 percent additional funding from the Government for hospital and community services.

During that time most other DHBs have passed on funding increases of 1.5-2.0% per annum to providers of community services, she says. But for three consecutive years, Hawke's Bay DHB has failed to pass on any increase to those who support people to live at home, and over the last year has also reduced the level of support to individual clients.

"The Government wants to provide more health and care services in the community. How can the DHB meet the health goal of delivering care closer to home when its decisions result in lower levels of support for vulnerable elderly and severe underfunding of providers?"

Mrs Haggie says more than 2600 of Hawke's Bay older citizens are able to live in their own homes with the assistance of home support.

"We know that people prefer to stay in their own home for as long as it is safe to do so.

"But home support agencies and their employees just can’t keep providing high-quality care indefinitely on the smell of an oily rag. Underfunding home support is false economy for the DHB.

"If people can be supported to stay well at home, they are also less likely to use more expensive residential care or suffer falls or illness that needs hospital-level support. Hawke's Bay DHB is one of the three lowest paying DHBs in New Zealand for rates to support elderly in the community.

"As well as the usual increases in overhead costs, agencies have had to face an increase in the minimum wage, Kiwisaver contributions and ACC levies as well as the increase from three to four weeks holiday. They are really struggling to keep going, and to retain staff who are expected to work in the community for rates that are 20% lower than working as health aids in the hospital.

"The New Zealand Home Health Association urges the DHB to increase its investment in this service, for the sake of the region’s older people."

ENDS

For further information contact Julie Haggie: 04 472 3196, 0274 989 126

________________________________________

1. The New Zealand Home Health Association Inc is the national body representing providers of home health care services. For more information see www.nzhha.org.nz.

Media Release
New Zealand Home Health Association

3 June 2011

Welcome to our world

Home based support and mental health providers can only manage a wry sigh at hearing that hospital managers from throughout the country are not prepared to sign contracts with ACC because the contract prices vary from nothing to a mere 1.3 percent. The Southern DHB is intending to meet with ACC to renegotiate their contract situation.

“If the situation wasn't so desperate for our community providers we would smile at the irony of hearing Southern DHB complain about the lack of increase for one year” says Julie Haggie, CEO of the NZ Home Health Association.

“That DHB has increased its rates to home and community support services by a pitiful 1 percent since 2008! And the same applies to many other DHBs around the country, despite the fact that they have received funding from the government every year to address cost pressures for all services. It appears that sustainability of services outside the hospital door just isn't a consideration."

For the 2011-12 year the government is giving all DHBs 1.72 percent to allow for additional cost pressures. This year a few of the 20 DHBs are passing on that increase to organisations that have contracts to provide community services.

"Those few understand the serious impact that general inflation, petrol price increases, additional service requirements and the minimum wage increase have had on community organisations. Other DHBs though have gone two and now it seems three years without providing any increase."

Marion Blake, CEO of Platform Trust agrees, as DHBs across New Zealand have applied the same scattergun approach to passing on contract increases to mental health and addiction providers.

"It is hard to understand the reasoning behind the decisions that are being made by some Boards who are keeping the money the Crown has given them instead of passing it on to community providers," she says.

Home health, mental health and addiction organisations play a vital role in supporting people to live in their own homes, and in reducing the use of residential and hospital care, say Blake and Haggie.

"The government needs and wants to move care closer to the community. But the DHBs place secondary care at the top of their priority list. They talk about providers becoming more efficient and that fewer providers will make savings – but those beliefs don't have a sound basis. Meanwhile key community services are being driven into the ground."

For further information contact:

Julie Haggie 0274 989 126, ceo@nzhha.org.nz

Marion Blake 021 790 587, ceo@platform.org.nz

New Zealand’s growing home and community support industry is calling on the Government to take a series of urgent actions to support the sector, as demand for home-based services increases. 

Today the New Zealand Home Health Association (NZHHA), which represents home support providers, released Making the Most of Home Support Services. The paper outlines New Zealand’s increasing reliance on home-based services for people living with illness, disability and age-related conditions, but paints a picture of an industry that is fragmented, unregulated and chronically under funded.

NZHHA Chief Executive Julie Haggie says government policy promotes care and support closer to home as the preferred economic model, both to address our ageing population and reduce in-patient healthcare costs, but she says more needs to be done to support the sector.

“More than 110,000 New Zealanders receive home support each year at a cost of over $591 million. Our services keep people in their homes and out of hospitals and residential care. That’s a huge economic benefit to this country and also supports the choice of people to live for as long as possible, and to recover from illness or injury, in their homes.

Ms Haggie says over the last 10 years there has been a huge increase in demand for home-based services. This is because more sick, disabled and elderly people are at home rather than in residential care, people are being discharged from hospital earlier, and those with chronic conditions are being encouraged to manage these conditions at home.

“Not only are there more people needing our services, as the population ages, we are also seeing more clients with a range of complex health needs,” says Ms Haggie.

In spite of this, she says there has been no strategic investment in the sector, few controls on quality and no consistency in contract arrangements or payment. And, Ms Haggie says, poor pay and conditions continue to plague the industry.

”Community support workers in our industry generally earn less than $15 dollars an hour. That amounts to 30 percent less, in some cases, than health care assistants or nurse aides working in a hospital. They don’t get penal rates; they’re not paid for doing paperwork and not fully reimbursed for travel time or mileage.”

Ms Haggie says in spite of the obstacles, the home support sector - which comprises a range of providers - has become a valuable and specialised workforce, ready to play a strategic role in meeting New Zealand’s growing healthcare needs.

“We have the workforce, the expertise and willingness to meet increasing future demands but we need support to deliver structured services that are better resourced, more consistent and underpinned by regulations setting minimum standards for safety and quality.”

Making the Most of Home Support Services, which has been circulated to the Minister of Health and key government officials and agencies, calls for:

• mandatory standards for service providers
• minimum training requirements
• standardisation of service specifications and purchasing frameworks
• better support for workers dealing with complex care needs
• more realistic payment for services
• integration of service providers in strategic planning
• research to measure the economic contribution of home support services
• analysis of projected future needs.

For more information contact:

Julie Haggie
Chief Executive Officer
New Zealand Home Health Association Inc
PO Box 5344, Wellington
Ph: +64 4 4723196
Mob: 0274 989 126
www.nzhha.org.nz

NZHHA extends its sympathy and aroha to those who are bearing the loss, of family, and friends and their homes. 

The following agencies operate in Canterbury, providing home support, community health and disability services.   Those seeking home support should contact one of the Christchurch providers.  If you or your family are already receiving support and have not had contact with the agency since the earthquake, please contact them, as all agencies are trying to contact the staff and the people they support.

Planning for the NZHHA 2011 Conference is well underway.  The Conference will be held in Wellington (James Cook Grand Chancellor) fom 3-5 August 2011.   Hon Tony Ryall, Minister of Health, will open the conference and also host a function in the Parliamentary legislative chamber.   The programme is being developed, and speakers being sourced.  We are very pleased that Gerald Pilkington will be one of the keynote speakers.  Gerald works for the UK Department of Health and has developed re-ablement packages - these are short term packages of care designed to maximise users long-term independence, choice and quality of life, and to appropriately minimise ongoing support required.

A conference website is now up and running at www.nzhha.org.nz/conference.  Registrations open from 1 March 2011

10th September 2010

Checking on sick, disabled and elderly people under their care has been a challenge for the staff of Canterbury organisations that provide health and support services to people in their homes, but they are managing.

Providers of home health care in Christchurch say they have had a frantically busy few days making sure clients are safe.   The damaged roads continue to cause problems getting round the city.  Managing support worker rosters has been made more difficult with the closure of schools, as many support workers have school aged children.  Many workers have also had to cope with damage to their own homes.  And ensuring client safety has been difficult where families have taken their elderly relatives into their own homes without notifying the provider.

New Zealand Home Health Association Chief Executive, Julie Haggie, says provider members take their duty of care obligations to their clients very seriously and have been visiting people to offer support and comfort.

“For some of our disabled or immobile elderly clients, it’s all the more terrifying being in a quake because they know they can’t move fast.  Other clients have been less daunted by the event but still need to talk about it.” 

Ms Haggie says, for some home-based clients, without family, their home health carer is their link with the outside world. “Coordinators are spending time with clients who ring in to talk about their experiences during the main earthquake and afterwards. In an extraordinary situation like this our carers and coordinators provide support and comfort as well as practical assistance.”

Graeme Titcombe from Access HomeHealth, which provides care to just under 2000 clients in the Canterbury area, says that their busy staff have been touched by kind gestures from others.  “Clients and support workers in other parts of the South Island have rung in offering breaks for clients and support workers in their homes. And we have had calls from retired support workers volunteering their time to visit clients.”  

Deb Wolken from Nursing New Zealand reports that the majority of Nursing New Zealand’s clients in Christchurch have managed to remain safe in their own homes.  One high needs client had significant damage to his home, and one staff member lost her home.

HealthCare NZ which provides home-based support and community nursing services for 2,800 people in Christchurch acknowledges the great work their staff have been doing under the circumstances.  Southern General Manager, Community Services, Kathryn Jones says, despite experiencing losses in their personal lives, a large number of staff have still come to work and continued to offer the best support they can to the people they support in the Christchurch community to live independently in their own homes. 

“In the immediate aftermath, staff not only ensured the safety of the clients they were caring for that day but also their other clients they knew wouldn’t be seen for a couple of days. Staff have been instrumental in helping to clear up, restock cupboards and provide emotional support to clients in their homes.  It is good to see that our crisis planning has stood up to real-life application and that senior staff worked effectively with those on the ground to ensure the ongoing safety of people we support.” 

The New Zealand Home Health Association would like to acknowledge that there is a long road ahead for staff and clients during the coming months. “We’d like to take this opportunity to recognise the courageous and generous attitude of our Christchurch providers and their staff - their actions have shown us all what the kiwi spirit is really about,” says Ms Haggie.

10 September 2010

The New Zealand Home Health Association (NZHHA) is calling for greater recognition of the importance of home health support in the wake of the release on Wednesday of the Aged Residential Service Review.

The review, commissioned by leaders of the aged residential care sector, District Health Boards and the Ministry of Health, found that 26,500 to 37,500 new and replacement beds will be needed over the next 16 years to avert a crisis in aged residential care.

Julie Haggie, Chief Executive Officer of the NZHHA commends the collaborative approach taken by the government and private providers to complete the review, but urges government to take a wider perspective before making significant funding decisions.   “Home health care is now, and will continue to be an essential part of health care, it assists people to live independent lives, and is cost-effective. Many innovative solutions germinate in the home and community sector and a higher quality of engagement with funders is needed to ensure these are successful.”

Ms Haggie notes that the report acknowledges the cost of providing home support is substantially lower than for residential care and it also mentions alternatives that are already being provided.

”Models such as individualised funding, restorative care and integrated family health care are already being piloted successfully in the home health sector, for elderly, and those with mental and physical disabilities and illnesses.”

Ms Haggie says an example is the Restorative Home Based Support contract being run by Capital and Coast District Health Board.  This contract includes multi-disciplinary teams which provide physiotherapy, occupational therapy and nursing oversight to their clients.    It has great potential for improved outcomes and independence for clients, yet the providers struggle to manage this contract within the DHB funding model.

“Home health providers across New Zealand currently support people who have been assessed as requiring hospital level residential care. Most already employ nurses and other allied health professionals and are well and truly ready to expand multi-disciplinary teams to support clients funded by DHB older persons contracts.   They just need the willingness of DHBs and other funders to partner with them to work out manageable, cost-effective funding models.” 

“Our sector is ready to provide part of the solution,” says Ms Haggie.

For more information, contact Liz Price 04 527 3290 or 0276 957 744.

At the recent Annual General Meeting, members passed two remits that fundamentally change membership of the Association and attest to NZHHA's commitment to the provision of quality home and community support services.

The AGM of NZHHA was held at the Holiday Inn, Auckland on 3 September, the third day of the 2010 NZHHA Conference. 

The first remit embedded changes to the Constitution arising from a decision made at the 2009 AGM to create two categories of provider membership: Full members who are certificated to the Home and Community Support Sector Standard (NZS 8158:2003), and Associate members, who are not certificated.    The Affiliate membership category also remains.

The second motion was to limit the lifespan of the Associate category to 30 June 2012.  This means that from 1 July 2012 only provider organisations who are certificated to the Home and Community Support Sector Standard may apply for or retain membership of the Association.  The majority of Association members are currently certificated, the 'grandparenting' arrangement allows all members to gain certification by that date.

The Association has shown leadership in strongly advocating for mandatory standards in home and community support.  Only by having such standards can funder and provider organisations ensure greater consistency and quality in the delivery of services to clients.

Association members in Christchurch report that they had a frantically busy weekend, making sure that all clients were safe, and endeavouring to manage rosters.  This has been made all the more stressful because of access problems due to the state of the roads, and, this week, because of the closure of schools (many support workers have school aged children).  One provider reports that a staff member has lost her home.

NZHHA has extended its empathy and messages of support to Christchurch provider members at this very stressful time.

MEDIA RELEASE: NEW ZEALAND HOME HEALTH ASSOCIATION
2 September 2010

EXPERT ADVOCATES FRESH APPROACH TO AGED CARE

New Zealand is being urged to take a fresh look at the way it cares for the elderly to eliminate loneliness, helplessness and boredom.

These three things account for the bulk of suffering amongst older people, according to an Australian aged care consultant.  Joanne Hope-Murray, a nursing lecturer and Vice Chair of Eden in Australia and New Zealand, was addressing delegates to the New Zealand Home Health Association (NZHHA) conference in Wellington today.

The three day conference, themed Dollars & Sense, is looking at the future of aged and disability care in New Zealand against a backdrop of an ageing population and rising healthcare costs.

Ms Hope-Murray represents The Eden Alternative™ a new philosophy she says is revolutionising aged care around the world and reducing costs because it leads to happier, healthier clients and lower staff turnover.

The Eden Alternative™ is based on 10 principles aimed at making environments in which elderly people are cared for much more vibrant and interactive and their lives and activities more meaningful.  Some of the principles include having continuing contact with plants, animals and children, less emphasis on structured routines and the opportunity to give as well as receive care, such as looking after pets.

“Current funding models are based on a silo approach which is not consistent with a continuum of care for the elderly from assistance in the home to residential care.  The Eden Alternative™ is about normalising everyday living, fostering lifelong learning and incorporating a community spirit by addressing the plagues of loneliness, helplessness and boredom.”

Ms Hope-Murray told delegates that real change requires a paradigm shift in the way we currently think about how we deliver services in the community and residential care.

“Our culture is so focussed on the young. We need to start valuing the wisdom and experience of our older citizens like some traditional cultures do.”

The Eden Alternative™, which was founded in America, has been operating in selected aged care facilities in Australia for a decade. New Zealand has nine facilities practising the philosophy.

Ms Hope-Murray told conference delegates, representing New Zealand home health care providers, that The Eden Alternative™ is equally applicable to the care of elderly living in the community.

“What it requires is a workplace culture change to replace ageist attitudes and policies with a more elder-centred approach that honours and values older people and supports them to live rich and interesting lives.”

For all media inquiries or information about the conference please contact conference media advisor Liz Price 0276 957 744, 04 527 3290.

MEDIA RELEASE
NEW ZEALAND HOME HEALTH ASSOCIATION

For immediate use
1 September 2010

HOME HEALTH CONFERENCE FOCUSSES ON ECONOMIC CHALLENGES
 
The challenge of providing care for the sick, elderly and disabled in a tight economy with rocketing health costs will occupy the minds of delegates attending a conference of home health providers in Auckland this week.

The conference, themed, Dollars & Sense, is being hosted by the New Zealand Home Health Association, which represents 64 organisations that provide health care, personal care and support for people living in their own homes. Members include both private and not-for-profit organisations across New Zealand.

The three-day conference is being opened by Associate Health Minister Jonathan Coleman who is expected to address issues such as low pay rates for home support workers and industry demands for mandatory minimum standards.

Keynote speakers include Australian nursing academic, Joanne Hope-Murray, who will talk about how loneliness, helplessness and boredom can be problems for home-based elderly. Economist Brian Easton will look at who should bear the burden of the rising costs of aged care and disability services; while journalist and commentator Rod Oram will consider how communities can contribute to the care of the elderly.

NZHHA Chief Executive, Julie Haggie, says how to fund increasing demands for home-based services is a major issue for the industry and for government. She says that members’ businesses are stretched to breaking point, and several have gone out of business.   

“Our member organisations are doing their best to find innovative solutions but sustainable funding models are needed to allow providers to maintain their current level of safe service and to cater for increasing demands.”
 
Ms Haggie says low rates of pay for home support workers continue to threaten and frustrate the industry. She says the ability for many New Zealanders to remain safely in their home relies on regular visits from home support workers, many of whom are on the minimum wage despite being asked to deliver increasingly complex care.

“These unsung heroes are saving the health system money by assisting people - whether elderly or in recovery or with complex health needs - to retain their independence in their homes for longer, reducing the length of hospital stays, and helping people stay more connected to their communities. 

“That contribution is undervalued and undermined by funding decisions that push provider businesses to, and beyond, breaking point. Provider members of the New Zealand Home Health Association have developed cost-efficient models of support that, when piloted, have delivered impressive outcomes in terms of improved client health.  They have much to offer those making strategic decisions on public health funding.”

Ms Haggie says she doesn’t expect the conference to come up with all the answers but believes it will provide a forum to discuss a way forward and focus attention on a sector that plays a crucial role in improving the quality of life of thousands of New Zealanders.

Media are invited to attend the whole or any part of the conference. For all media inquiries or information about the conference please contact conference media advisor Liz Price 0276 957 744, 04 527 3290.