The major health areas of focus include:

1. Mental Health Disorders and rehabilitation.
2. Accommodation Care of younger physically disabled veterans where there may or may not be co-existing mental illness.
3. Support for Carers.

1. Mental Health Disorders and Rehabilitation

A Government-funded, national mental health rehabilitation scheme is needed for veterans suffering with chronic mental health problems.

The scheme should be based on individual case assessment and management programs and include, where necessary, accommodation assistance options..

During 2004/2006 a DVA funded veterans' mental health project was conducted. Recommendation 5 of the Project's Report states "That DVA provides support, including financial support, for appropriate community accommodation models to meet the needs of veterans with mental health issues e.g. step-down accommodation for short term rehabilitation, care review/renewal and relapse support."

The need for such accommodation is also supported by the July 2006 report of the Council of Australian Governments (COAG).

Proposal: Early implementation of Recommendation 5: That DVA provides support, including financial support, for appropriate community accommodation models to meet the needs of veterans with mental health issues e.g. step-down accommodation for short term rehabilitation, care review/renewal and relapse support."

2.1 Health Accommodation – Younger Veterans

Within the ex-service community, a small number of veterans aged 30 to 50 are unable to live independently or with their families as a result of significant physical, medical or emotional care needs. A system is needed to ensure access to appropriate accommodation for disabled veterans who require 24-hour supported living but are too young to qualify for aged care services.

At present no agency/government department has responsibility for finding appropriate residential accommodation and associated care. This is despite the COAG meeting of 2007, at which money was allocated by all States and the Federal Government toward the construction of such a facility, that would accommodate under 50 year olds, including younger veterans. The Younger Persons in Residential Care Program has not yet delivered any significant number of places. As a result, younger people continue to be co-located in residential aged care, including in dementia units.

The need for residential accommodation must be addressed both in the short term, rehabilitation phase and also for those who require longer term supportive accommodation with mental health assistance according to a recognized care plan.

Proposal: That identified processes be established within DVA, to provide a seamless and responsive approach toward accommodating severely incapacitated young veterans.

2.2 Residential Disability Care – Younger Veterans

There are consistently reported numbers of younger veterans, most often with Gold Card entitlements, who require disability accommodation and support care.

Support for veterans in a congregate residential setting needs to be created, with DVA providing adequate capital and ongoing support for veterans who are Gold/White Card holders.

Proposal: That DVA fund the establishment of a number of services/facilities in major population centres where the bulk of the veteran population lives.

3.1 Veterans' Carers

DVA Recognition of the Role of Partners Who are Carers of Disabled Veterans

Increasing numbers of veterans are being diagnosed as high care and many of these veterans are being cared for by their spouse/partner in their own home, having no wish to be placed in a care facility, particularly if they are of a younger age.

Spouses/partners who become carers give up their employment and devote their lives to care for their disabled veteran. By no longer being employed, these partners are not able to accrue superannuation to provide for their own old age. These carers deserve support to continue their caring role. There are very few carers who do not suffer ill health and/or some disability brought about by the constant care they give to their disabled veteran

As a result, the veteran could be forced into a full care facility earlier than necessary because the caregiver is not well enough to continue in her/his caring role. Eventually, the Government may be faced with the cost of caring for two instead of one.

Proposals: *That DVA be given direct responsibility for partners who are carers of disabled veterans.

*That the Government provide a Health Plan/Program for carers of veterans to enable them to continue in their caring role.

3.2 Carer's Allowance Cut Offs:

· Currently Carer's Allowance payment is cancelled after the veteran has been hospitalised for six weeks.

· Centrelink advises they pay for 63 days in one year with an additional 63 days (a total of 126 days) if the Veteran is transferred into an approved Aged Care Facility after their hospital stay for respite or convalescent care. As soon as they are discharged, the carer must re-apply for payment.

Proposal: That the carer allowance be suspended after 126 days. Once the veteran has been discharged and is home again the Dept can then be advised to re-start the Carer allowance from that date.

3.3 Transport Plan for carers while Veteran in Hospital

· Carers who accompany a veteran to hospital are left to find their own way home when the hospitalised and does not return with them. It is unacceptable for the partner/carer to be obliged to find their own way home.

Proposal: That DVA develop a transport plan for carers returning home from accompanying their veteran to hospital.

3.4 Subsidised Accommodation

· Many carers experience great difficulty in visiting their hospitalised veterans . Their visits are vital to the recovery and well being of the veteran.

Proposal: That subsidised accommodation be provided to enable carers to be available to veterans who are hospitalised away from their home.

3.5 Inadequate Respite Care

· The effect on the mental and physical health of many partners/carers of veterans has been profound and if the condition of the veteran deteriorates the carer then has the added burden of insufficient respite care.

· A carer is allowed only 196 hours (3.76hrs per week) of respite care per annum. This is totally inadequate when a carer is providing high level, full-time care in the home.

· While palliative care in a hospice is available, those veterans who also suffer from PTSD are often not amenable to leaving their homes.

Proposals: * That respite care be monitored by DVA, with a dedicated DVA Case Manager whose role is to tap in to any other community or government department to access additional respite care.

* That respite hours be increased to 260 per annum.

4 Departmental Responsibility

Proposal: That DVA be designated as the agency to administer the support provided to the carers of veterans.