Recognising the difference

This Fact Sheet has been developed to assist Aboriginal and Torres Strait Islander working carers to identify some of the different care options available to support you and the person you are caring for. They range from care at home to long-term residential support.

The main purpose of this Fact sheet is to eliminate the confusion between State/Territory and Federally funded programs. It has been adapted from the booklet ‘What are the HACC and Aged Care Programs? Recognising the Difference’ by Dianne Creighton, Aboriginal and Torres Strait Islander HACC Access Co-ordinator, Casino Neighbourhood Centre, NSW. It should be read in conjunction with the Home and Community Care (HACC) and Aged Services Flowchart also developed by Dianne Creighton.

A separate Fact Sheet is available on Services for People with Disabilities.

State and Territory funding

State and Territory funding for aged and disability services is mainly used for short to long-term community-based programs. This means services support frail older people (50 years and above) and younger people with disabilities and their carers so they can stay in their own homes instead of hospital, hostel or nursing home care.

The Home and Community Care (HACC) Program


Most State funded services are provided through the Home and Community Care (HACC) program which is jointly funded by Federal, State and Territory governments and administered by the NSW Department of Ageing, Disability and Home Care (DADHC). HACC services include:

• home help
• personal care
• social support
• allied health services such as physiotherapy and podiatry
• transport
• food services
• respite care
• home maintenance and modifications
• home nursing
• community options programs
• HACC flexi services
• counselling/support, information and advocacy services

The HACC program funds a large number of organisations and agencies across NSW to provide these services. The HACC program targets Aboriginal people so services should all be friendly and flexible to meet your requirements. Some services have workers who are dedicated to the needs of Aboriginal people. They may cater for special diets or run activities appropriate for the many different cultural groups in NSW. Aboriginal Home Care provides services exclusively to Aboriginal people in some areas but these agencies are very busy.

You have the right to use all HACC services. You may be able to get encouragement and support to go to these services from an Aboriginal and Torres Strait Islander HACC Access Co-ordinator in your area.

Eligibility is usually based on need and availability of services. There is often a waiting list. The fees paid are negotiable.

The following information goes into more detail about each service:

Home Help may include doing jobs such as house cleaning, dishwashing, cooking, clothes washing and ironing and shopping.

Personal Care assists the person needing care with tasks such as showering, bathing, toileting, dressing, eating, helping them with medicine, getting in and out of bed and moving about the house.

Social Support is usually carried out in the person’s home as well as assisting the person needing care to access community services. It may mean visiting relatives, helping with telephone calls, writing letters or attending a community venue for a yarn-up. Social support may also include group activities such as:

• Arts and craft
• Knitting, crochet and needlework
• Basket weaving
• Dancing
• Timeline stories
• Fishing
• A BBQ lunch in the park

The main aim of this service is to support the person’s need for social contact.

Allied Health Services are usually provided in a Community Health Centre. Your HACC service may be funded to provide a wide range of specialist services for people needing care, including:

• Occupational therapy
• Physiotherapy
• Spinal care
• Speech pathology
• Continence advice
• Respiratory advice

Transport Services are available in two ways:

• When the HACC transport service provider has a bus or other vehicles, staff can help to transport people to a shopping centre or a group activity venue.
• When the HACC service provider arranges for other transport such as a taxi, dial-a-bus, or some other form of community transport to assist people to access basic support services such as a doctor, dentist or specialist clinic.

Food Services can vary. They may be either meals or other food services. Meals on Wheels provides prepared meals or food delivered to a person’s home. Meals at a Centre are meals that are prepared and cooked either by the staff or clients attending a HACC adult day care centre for group activities.

Other food services include HACC staff preparing meals in a client’s home, and/or a dietician providing advice on nutrition. Some services may also provide food parcels or food orders.

Respite Care gives the carer a break by having a care worker allocated from a HACC service provider look after the person for a short time. Respite care can happen:

• In a person’s home
• In another person’s home
• In a special respite or caring centre

Respite Care gives a chance for full-time carers to have a break from an often very demanding job. It also gives the person who has a disability or is frail a chance to have a holiday away from home and a break from their carers.

Home Maintenance services provide essential repairs and maintenance of a house and garden. Home maintenance includes:

• Minor repairs such as changing light bulbs, fixing taps, basic carpentry and painting
• Maintaining the garden and removing rubbish
• Minor repairs necessary to allow the person to remain independent in their home

Home Modification services provide assistance with modifications or renovations to the client’s home to help them cope with a disabling condition. Home Modifications include:

• Installing hand rails, wheelchair ramps, shower and toilet rails
• Providing other modifications to make a home more liveable and easy to get around for someone who has a disability or is frail.

Home Nursing services are provided by trained nurses in the home of the person you care for on a regular or one-off basis.

Community Options Programs (COPs) co-ordinates services if the person you are caring for has complex care needs.

HACC Flexi Services may provide goods and equipment that help the client with their mobility, communication, reading, personal care or health care. Some of the items provided may include:


• Walking frames
• Wheelchairs
• Commodes
• Bath boards or shower extensions
• Dressing aids
These items may be purchased from or loaned to the client by the HACC service provider.

Counselling/Support, Information and Advocacy services help the client and/or carer deal with the situation of caring. These services also include support to individual clients in accessing general community services (advocacy). Assistance includes:


• Dementia support and counselling
• Carer support and counselling
• One-to-one training or advice to assist with coping with a situation (eg. training a carer on safe ways to lift a person)
• Provision of information to a client or carer (eg. other services available in the area)

These services are usually provided on a one-to-one basis with the client or carer.

Other State funded programs

ComPacks
If you or the person you are caring for is coming out of hospital, there may be case-managed packages that tailor a combination of services to suit individual needs. ComPacks have been established for people who need two or more community services to ensure they can return home safely with appropriate care in place. If you are eligible, you can get care services for up to six weeks after discharge from hospital. Hospital staff members refer inpatients for ComPacks and case managers determine eligibility according to NSW Health guidelines. ComPacks are not available at all hospitals.

Federal Funding
Federal funding for aged care services is mainly used to provide permanent residential nursing and hostel care as well as short-term respite and tailored package services for people who are ageing so they can stay in their own homes.

Federally funded programs include:

• Aged Care Assessment Teams (ACATs)
• Community Aged Care Packages (CACPs)
• Extended Aged Care At Home (EACH)
• Commonwealth Carelink Centres
• Commonwealth Carer Respite Centres and services
• Veterans Home Care
• Hostel and nursing home care

The following information goes into more detail about each program.

Aged Care Assessment Teams (ACATs)
Aged Care Assessment Teams help older people and their carers work out what kind of care will best meet their needs when they are no longer able to manage at home without assistance. The team provides information on suitable care options and can help arrange access or referral to appropriate residential or community care.

Extended Aged Care At Home (EACH)
The EACH program is a small, limited program, which enables frail older people to remain in their homes by providing care at the level currently provided in high care residential aged care facilities. To access the program, the Aged Care Assessment Team must assess the person you are caring for.

Community Aged Care Packages (CACPs)
CACPs are planned and coordinated packages of community care services to help older people with complex care needs to remain living in their own home. These are designed for each individual and are based upon his or her particular needs.

The Transition Care Program
The Transition Care Program, jointly funded by Federal and State and Territory Governments, provides short-term care to help older people at the conclusion of a hospital stay. The program targets older people who require more time and support outside of hospital to recover and finalise their long-term care arrangements. It is for people who would otherwise be eligible for residential care (a nursing home or hostel).

Many people who have used the program have been able to return home, rather than going into residential care. To access the program, the Aged Care Assessment Team must assess the person you are caring for. This can be arranged at the hospital.

Commonwealth Carelink Centres
These centres assist older people and their families, people with special care needs and carers with information about community, residential and other aged care services. To find your nearest Commonwealth Carelink Centre telephone freecall 1800 052 222.

Commonwealth Carer Respite Centres and services
Commonwealth Carer Respite Centres specialise in helping carers to access community-based or residential respite services in their local area. Respite services, also funded by the Federal Government, help carers to take breaks from their caring. There is a range of services that look after the person you are caring for while you have a rest or attend to other commitments. This can happen in your own home, at day centres or activities, or in residential accommodation.

Respite is generally not available to enable you to do full-time work, but packages may assist some part-time and casual workers and those who run their own businesses. To find your nearest Commonwealth Carer Respite Centre telephone freecall1800 059 059.

Veterans' Home Care
If you are a veteran or a war widow or widower, you can access Veterans' Home Care. This is a program of the Department of Veterans' Affairs to help veterans and war widows/widowers enjoy a healthier lifestyle and remain living at home longer. The services through Veterans' Home Care are similar to HACC services and include help in the home, personal care, home maintenance and respite care. More information is available from the Department of Veterans Affairs on freecall 1800 555 254.

Hostel and nursing home care
Historically there have been two options in residential aged care accommodation – hostels and nursing homes. Residential care is available for older people who cannot live at home and who have been assessed by an Aged Care Assessment Team worker as needing this care.

• Hostels generally provide accommodation and personal assistance for those needing a low level of care

• Nursing homes generally care for people with a greater degree of frailty, often in need of continuous nursing care at a high level

How do I find these services?
HACC and aged care services are provided by many different agencies across NSW. To find the most appropriate services closest to where you live:

• Telephone your nearest Commonwealth Carelink Centre on freecall 1800 052 222
• Telephone the Commonwealth Carer Resource Centre on freecall 1800 232 636

Do I have to pay for them?
Users of HACC services may be asked to contribute to the cost of the service being delivered. If you are unable to pay you cannot be denied services on this ground. The amount of contribution may vary between service type and between State and Territory. You should check with the HACC service you intend to use or your nearest Commonwealth Carelink Centre may have information on whether there are any costs associated with receiving the services.

How do I get these services?
The HACC and aged care service systems are designed to ensure that support is received when needed. The steps for assessing the eligibility of the care receiver for ongoing supports are:

1. The Assessment
An assessment is usually undertaken at the request of the client, on the recommendation of a carer or concerned family member, or by request of the treating doctor.

The service co-ordinator or Aged Care Assessment Team worker usually conducts the assessment with the full involvement of the care receiver as well as family members or carers. The information given to an assessor will determine whether a person is eligible to receive a HACC or aged care service. Note that:

• A frail older person is eligible to receive support under either the HACC or aged care programs but not both

• A younger person with a disability is only eligible for HACC services (They may be able to get other services - see our separate Fact Sheet on Services for People with Disabilities).

The assessment will look at the care receiver’s need for assistance and their ability to undertake tasks of daily living. This may also include an Occupational Health and Safety check of the care receiver’s home for safe service delivery. Requests for support are usually prioritised according to the person’s support needs and the availability of appropriate services.

2. Case Planning/Review and Co-ordination
Case planning/review and co-ordination is the evaluation process of the ongoing needs of the care receiver. The review process is when the service co-ordinator decides what changes need to be made to the type of help that the service is providing to a person. This includes the development, monitoring and review of a person’s service plan and the level of support provided by the HACC or Aged Care service provider.

3. Case Management
Case management is the monitoring of a care receiver’s care plan after the service supports have been implemented. This process is usually undertaken by Community Options Programs (COPs) or Linkages projects. It refers to the assistance received by a person with complex care needs. The case manager co-ordinates the planning and delivery of services a client is receiving from more than one service provider.

For more information
See our Fact Sheets on Tips for Getting Services and Complaints to Services.

For more details about aged care, including Community Aged Care Packages (CACPs), the Extended Aged Care at Home (EACH) program, and what to check for in a nursing home, check the Carers NSW Fact Sheets on these topics. The following link will take you to the Carers NSW website where you can view the information. To return to the Working Carers Support Gateway, simply close the Carers NSW website window. The link is http://www.carersnsw.asn.au/  

For other services for people with disabilities, not covered here, see our Fact Sheet Services for People with Disabilities.

Working Carers Support Gateway: online news, information and support for working carers
www.workingcarers.org.au