Budget Paper No. 2 - Part 2: Expense Measures Health and Ageing

Health and Ageing

COAG Mental Health

The Australian Government will provide $1.9 billion over five years for substantial reform of the mental health system in Australia as part of the Council of Australian Governments' mental health initiative.

This significant Australian Government commitment provides additional investment in clinical and health services as well as non-clinical and respite services for people with mental illness and their families. The package will also strengthen the mental health workforce and improve community awareness of the link between illicit drugs and mental illness.

The package comprehensively addresses current gaps in services for which the Australian Government has responsibility, particularly access to clinical and primary care services for people with mental illness. In this area, the Australian Government will restructure the Medicare Benefits Schedule to improve early detection treatment and management of mental illness through increased access to general practitioners, psychiatrists, and psychologists. Additionally, the Australian Government will provide funding to general practitioners and psychiatrists to employ mental health nurses in their practices to enable a team-based approach to managing people with mental illness, as well as providing more funding for mental health nurses and allied health services in rural and remote areas.

Recognising the link between illicit drug use and mental illness, drug and alcohol treatment services will be provided with funding to improve services for people with both mental illness and a substance abuse problem.

New non-clinical services will also be provided through the non-government sector including personal helpers and mentors as well as a range of programmes that will improve the economic and social participation of people suffering from mental illness. With significant increases in respite services for carers and new early intervention programmes for young people, this represents a substantial increase in services available in the community.

Mental health workforce issues are also being addressed in the package, with increased funding for mental health nursing and psychology places, as well as initiatives to improve the capacity of the Indigenous health workforce to meet the demand for services in Indigenous communities.

Table 9: COAG Mental Health
	2006-07 $m	2007-08 $m	2008-09 $m	2009-10 $m	Total $m
REVENUE MEASURES
EDUCATION, SCIENCE AND TRAINING
Department of Education, Science and Training
COAG Mental Health
- additional education places, scholarships and clinical training in mental health	-	-	0.1	0.3	0.4
Sub Total	-	-	0.1	0.3	0.4
Total Revenue measures	-	-	0.1	0.3	0.4
EXPENSE MEASURES
EDUCATION, SCIENCE AND TRAINING
COAG Mental Health
- helping young people stay in education	6.6	12.9	13.1	13.4	45.9
- additional education places, scholarships and clinical training in mental health	6.5	12.0	15.2	17.7	51.4
Sub Total	13.1	24.9	28.3	31.0	97.3
EMPLOYMENT AND WORKPLACE RELATIONS
Department of Employment and Workplace Relations
COAG Mental Health
- helping people with a mental illness enter and remain in employment	6.7	8.3	9.3	7.3	31.6
Sub Total	6.7	8.3	9.3	7.3	31.6
FAMILIES, COMMUNITY SERVICES AND INDIGENOUS AFFAIRS
Department of Families, Community Services and Indigenous Affairs
COAG Mental Health
- new personal helpers and mentors	5.1	37.6	73.9	83.6	200.2
- more respite care places to help families and carers	13.4	44.1	63.5	52.1	173.0
- community based programmes to help families coping with mental illness	3.2	11.2	11.1	11.1	36.6
Sub Total	21.7	92.8	148.5	146.8	409.8
HEALTH AND AGEING
Department of Health and Ageing
COAG Mental Health
- better access to psychiatrists, psychologists and general practitioners through the Medicare Benefits Schedule	49.8	92.0	108.6	130.2	380.5
- new funding for mental health nurses	1.4	23.9	37.7	54.6	117.6
- improved services for people with drug and alcohol problems and mental illness	3.2	19.4	23.7	24.4	70.7
- expanding suicide prevention programmes	9.6	10.9	12.3	13.7	46.5
- funding for telephone counselling, self help and web-based support programmes	6.6	11.9	12.3	12.8	43.7
- mental health services in rural and remote areas	4.9	9.4	10.7	12.4	37.4
- support for day-to-day living in the community	5.0	9.6	10.0	10.3	35.0
- additional education places, scholarships and clinical training in mental health	2.9	6.3	8.3	8.6	26.1
- new early intervention services for parents, children and young people	1.6	2.5	5.7	7.0	16.8
COAG Mental Health
- alerting the community to links between illicit drugs and mental illness	2.7	8.9	9.0	0.7	21.3
- improving the capacity of health workers in Indigenous communities	2.0	5.8	4.5	4.4	16.7
- mental health in tertiary curricula	1.1	1.2	1.1	1.1	4.5
- increased funding for the Mental Health Council of Australia	0.2	0.2	0.2	0.2	0.8
Medicare Australia
COAG Mental Health
- better access to psychiatrists, psychologists and general practitioners through the Medicare Benefits Schedule	0.4	..	..	..	0.3
- new funding for mental health nurses	0.2	0.1	0.2	0.2	0.8
Sub Total	91.7	202.1	244.3	280.6	818.7
Total Expense measures	133.1	328.2	430.3	465.7	1,357.4
CAPITAL MEASURES
EMPLOYMENT AND WORKPLACE RELATIONS
Department of Employment and Workplace Relations
COAG Mental Health
- helping people with a mental illness enter and remain in employment	0.2	-	-	-	0.2
Sub Total	0.2	-	-	-	0.2
HEALTH AND AGEING
Department of Health and Ageing
COAG Mental Health
- better access to psychiatrists, psychologists and general practitioners through the Medicare Benefits Schedule	0.9	-	-	-	0.9
- new funding for mental health nurses	0.4	-	-	-	0.4
- improved services for people with drug and alcohol problems and mental illness	0.4	-	-	-	0.4
- expanding suicide prevention programmes	0.7	-	-	-	0.7
- funding for telephone counselling, self help and web-based support programmes	0.4	-	-	-	0.4
- mental health services in rural and remote areas	0.4	-	-	-	0.4
- support for day-to-day living in the community	0.4	-	-	-	0.4
- additional education places, scholarships and clinical training in mental health	0.3	-	-	-	0.3
- new early intervention services for parents, children and young people	0.3	-	-	-	0.3
- alerting the community to links between illicit drugs and mental illness	0.3	-	-	-	0.3
- improving the capacity of health workers in Indigenous communities	0.1	-	-	-	0.1
- mental health in tertiary curricula	0.2	-	-	-	0.2
Medicare Australia
COAG Mental Health
- better access to psychiatrists, psychologists and general practitioners through the Medicare Benefits Schedule	0.2	-	-	-	0.2
Sub Total	4.9	-	-	-	4.9
Total Capital measures	5.1	-	-	-	5.1
SUMMARY OF EXPENDITURE
Total expense measures	133.1	328.2	430.3	465.7	1,357.4
Total capital measures	5.1	-	-	-	5.1
Total expenditure	138.3	328.2	430.3	465.7	1,362.5
Total revenue measures	-	..	0.1	0.3	0.4
Net additional expenditure	138.3	328.2	430.2	465.5	1,362.2

COAG Mental Health — better access to psychiatrists, psychologists and general practitioners through the Medicare Benefits Schedule

Expense ($m)
	2006-07	2007-08	2008-09	2009-10
Department of Health and Ageing	49.8	92.0	108.6	130.2
Medicare Australia	0.4	..	..	..
Total	50.2	91.9	108.5	130.1
Related capital ($m)
Department of Health and Ageing	0.9	-	-	-
Medicare Australia	0.2	-	-	-
Total	1.1	-	-	-

The Government will provide $538.0 million over five years (including $156.1 million in 2010-11) to improve early detection, treatment and management of mental illness in the community through increased access to psychiatrists, psychologists and general practitioners (GPs) and encouraging health professionals to work together. Reforms will be made to the Medicare Benefits Schedule (MBS) to:

Allow private psychiatrists to see more new patients and refer on those patients who could be more effectively treated by appropriately trained psychologists and GPs;
Encourage more GPs to participate in early intervention, assessment and management of people with a mental illness; and
Increase access to appropriately trained psychologists and allied health professionals on referral from a GP with appropriate training.

Training will also be provided for the primary care workforce to help improve recognition and treatment of mental illness. This measure complements the budget measure COAG Mental Health — mental health services in rural and remote areas.

Funding will be provided to Medicare Australia to process claims. This measure includes $0.9 million in capital funding in 2006-07 for building fit-out costs for the Department of Health and Ageing.

This measure forms part of the Government's contribution to the COAG Mental Health package, announced on 5 April 2006. Further information can be found in the press release issued by the Prime Minister.

COAG Mental Health — new personal helpers and mentors

Expense ($m)
	2006-07	2007-08	2008-09	2009-10
Department of Families, Community Services and Indigenous Affairs	5.1	37.6	73.9	83.6

The Government will provide $284.8 million over five years (including $84.6 million in 2010-11) to engage 900 personal helpers and mentors to assist people with a mental illness who are living in the community to better manage their daily activities. People with a severe mental illness will be assisted in accessing the range of treatment, income support, employment and accommodation services they need. Funding will be provided to the non-government sector to provide these services.

COAG Mental Health — more respite care places to help families and carers

Expense ($m)
	2006-07	2007-08	2008-09	2009-10
Department of Families, Community Services and Indigenous Affairs	13.4	44.1	63.5	52.1

The Government will provide $224.7 million over five years (including $51.7 million in 2010-11) to enhance respite care. The funding will provide approximately 650 new respite care places to help families and carers of people with mental illness or an intellectual disability.

This measure will provide overnight respite and day respite services for up to 15,000 families a year. Priority access to these places will be given to elderly parents who live with and care for a son or daughter with a severe mental illness or an intellectual disability. The additional places will be provided by the non-government sector.

COAG Mental Health — new funding for mental health nurses

Expense ($m)
	2006-07	2007-08	2008-09	2009-10
Department of Health and Ageing	1.4	23.9	37.7	54.6
Medicare Australia	0.2	0.1	0.2	0.2
Total	1.6	24.0	37.9	54.9
Related capital ($m)
Department of Health and Ageing	0.4	-	-	-

The Government will provide $191.6 million over five years (including $72.7 million in 2010-11) to assist people with severe mental illness to receive better coordinated treatment and care. Funding will be provided for mental health nurses in private psychiatry practice, general practice and other appropriate organisations including Indigenous health services. These mental health nurses will work closely with the patient's psychiatrist or general practitioner and will provide services such as home visits, medication monitoring and management, and improving links to other health professionals. This measure includes $0.4 million in capital funding in 2006-07 for building fit-out costs for the Department of Health and Ageing.

COAG Mental Health — improved services for people with drug and alcohol problems and mental illness

Expense ($m)
	2006-07	2007-08	2008-09	2009-10
Department of Health and Ageing	3.2	19.4	23.7	24.4
Related capital ($m)
Department of Health and Ageing	0.4	-	-	-

The Government will provide $73.9 million over five years (including $2.8 million in 2010-11) to improve services for people with drug and alcohol problems who also experience mental illness.

The funding will be provided to the non-government sector to provide extra training for the drug and alcohol workforce to enable them to better assist clients who also have mental health problems. The funding will also be used to identify and implement best practice models for intervention for clients with substance use and mental health co-morbidities. This measure includes $0.4 million in capital funding in 2006-07 for building fit-out costs for the Department of Health and Ageing.

COAG Mental Health — expanding suicide prevention programmes

Expense ($m)
	2006-07	2007-08	2008-09	2009-10
Department of Health and Ageing	9.6	10.9	12.3	13.7
Related capital ($m)
Department of Health and Ageing	0.7	-	-	-

The Government will provide $62.4 million over five years (including $15.2 million in 2010-11) to expand and enhance current suicide prevention efforts. Funding will be provided under the National Suicide Prevention Strategy for national and community-based projects. This funding will also allow for further national research and development to increase the understanding of suicide and its prevention. This measure includes $0.7 million in capital funding in 2006-07 for building fit-out costs for the Department of Health and Ageing.

COAG Mental Health — helping young people stay in education

Expense ($m)
	2006-07	2007-08	2008-09	2009-10
Department of Education, Science and Training	6.6	12.9	13.1	13.4

The Government will provide $59.5 million over five years (including $13.6 million in 2010-11) to help approximately 6000 young people a year experiencing mental health problems who are at risk of dropping out of school. This measure increases the capacity of the existing Youth Pathways programme, and provides one-on-one assistance to identify services and professional support to help individual young people with their specific needs. Through this initiative young people will be linked into appropriate services, which may include counselling and support to find housing or remain at home.

COAG Mental Health — funding for telephone counselling, self-help and web-based support programmes

Expense ($m)
	2006-07	2007-08	2008-09	2009-10
Department of Health and Ageing	6.6	11.9	12.3	12.8
Related capital ($m)
Department of Health and Ageing	0.4	-	-	-

The Government will provide $56.9 million over five years (including $12.9 million in 2010-11) for increased telephone and web-based counselling services and self-help resources targeting individuals with common mental illnesses. Non-government organisations such as Kids Help Line and Lifeline Australia will be funded to provide these services. This measure includes $0.4 million in capital funding in 2006-07 for building fit-out costs for the Department of Health and Ageing.

COAG Mental Health — mental health services in rural and remote areas

Expense ($m)
	2006-07	2007-08	2008-09	2009-10
Department of Health and Ageing	4.9	9.4	10.7	12.4
Related capital ($m)
Department of Health and Ageing	0.4	-	-	-

The Government will provide $51.7 million over five years (including $13.9 million in 2010-11) to improve access to mental health services for people in rural and remote areas. Funding will be provided to increase access to treatment services provided by workers such as psychologists, social workers and mental health nurses in rural and remote areas. This measure complements the Budget measure COAG Mental Health — better access to psychiatrists, psychologists and general practitioners through the Medicare Benefits Schedule. This measure includes $0.4 million in capital funding for building fit-out costs for the Department of Health and Ageing.

COAG Mental Health — support for day-to-day living in the community

Expense ($m)
	2006-07	2007-08	2008-09	2009-10
Department of Health and Ageing	5.0	9.6	10.0	10.3
Related capital ($m)
Department of Health and Ageing	0.4	-	-	-

The Government will provide $46.0 million over five years (including $10.6 million in 2010-2011) for approximately 7,000 additional places in programmes designed to assist people with severe mental illness. These programmes will provide people with access to structured activities such as cooking, shopping and social outings, helping to improve their social participation by providing independent living skills and social rehabilitation activities. This measure includes $0.4 million in capital funding in 2006-07 for building fit-out costs for the Department of Health and Ageing.

COAG Mental Health — community based programmes to help families coping with mental illness

Expense ($m)
	2006-07	2007-08	2008-09	2009-10
Department of Families, Community Services and Indigenous Affairs	3.2	11.2	11.1	11.1

The Government will provide $45.2 million over five years (including $8.6 million in 2010-11) to fund local, community-based projects that support families, children and young people affected by mental illness.

This measure will support projects targeted at prevention and early intervention, with a particular focus on Indigenous families and those from a culturally and linguistically diverse background. Non-government sector and community-based organisations will be able to apply for project funding.

COAG Mental Health — helping people with a mental illness enter and remain in employment

Expense ($m)
	2006-07	2007-08	2008-09	2009-10
Department of Employment and Workplace Relations	6.7	8.3	9.3	7.3
Related capital ($m)
Department of Employment and Workplace Relations	0.2	-	-	-

The Government will provide $39.8 million over five years (including $8.0 million in 2010-11) to help people with a mental illness enter and remain in employment.

This funding will provide 2,500 additional places in the Personal Support Programme to help people with a mental illness who are not yet ready to benefit from the Job Network. The funding will also provide more support for people with mental illness who are at risk of losing or leaving their jobs because of their condition.

In addition, funds will be available for projects to evaluate the most effective ways of providing employment assistance for people with mental illness. The online information and advice service will be expanded to include information on effective employment assistance for employers, service providers and jobseekers.

This measure includes $0.2 million in capital funding in 2006-07 for computer system enhancements.

COAG Mental Health — additional education places, scholarships and clinical training in mental health

Expense ($m)
	2006-07	2007-08	2008-09	2009-10
Department of Education, Science and Training	6.5	12.0	15.2	17.7
Department of Health and Ageing	2.9	6.3	8.3	8.6
Total	9.4	18.3	23.5	26.2
Related capital ($m)
Department of Health and Ageing	0.3	-	-	-
Related revenue ($m)
Department of Education, Science and Training	-	..	0.1	0.3

The Government will provide $103.5 million over five years (including $26.2 million in 2010-11) to increase the supply and quality of the mental health workforce. The number of tertiary sector places in mental health nursing will increase by 420 and in post-graduate psychology by 200 each year, growing to 1,148 nursing places by 2010 and 400 post-graduate psychology places by 2008. It will also provide 25 full-time and 50 part-time post-graduate scholarships to nurses and psychologists. This measure includes $0.3 million in capital funding in 2006-07 for building fit-out costs for the Department of Health and Ageing.

Amounts loaned under the Higher Education Loans Programme (HELP) for students taking up these places are treated as financial assets and therefore do not impact on the fiscal balance. Payments by students of the indexation component of their HELP loan are treated as interest revenue. These payments will impact on the fiscal balance from 2007-08. The additional public debt interest incurred by the Commonwealth in financing the loans is separately accounted for in the budget papers.

COAG Mental Health — new early intervention services for parents, children and young people

Expense ($m)
	2006-07	2007-08	2008-09	2009-10
Department of Health and Ageing	1.6	2.5	5.7	7.0
Related capital ($m)
Department of Health and Ageing	0.3	-	-	-

The Government will provide $28.1 million over five years (including $11.0 million in 2010-11) to assist parents and schools to better identify children at risk of mental illness and to offer early referral for appropriate treatment. This funding will provide resources, information and training for parents and schools to promote the availability of new mental health services for children and young people with complex mental health conditions, including those due to substance abuse. This measure will help to prevent the progression of early symptoms of mental illness into more serious disorders. This measure includes $0.3 million in capital funding in 2006-07 for building fit-out costs for the Department of Health and Ageing.

COAG Mental Health — alerting the community to links between illicit drugs and mental illness

Expense ($m)
	2006-07	2007-08	2008-09	2009-10
Department of Health and Ageing	2.7	8.9	9.0	0.7
Related capital ($m)
Department of Health and Ageing	0.3	-	-	-

The Government will provide $21.6 million over four years to help people better understand the links between drug use and the development of mental illness. This measure will involve public information and education activities targeting the general population to promote a better understanding of the link between illicit drugs and mental illness to prevent the onset of drug-induced mental illness. This measure includes $0.3 million in capital funding in 2006-07 for building fit-out costs for the Department of Health and Ageing.

COAG Mental Health — improving the capacity of health workers in Indigenous communities

Expense ($m)
	2006-07	2007-08	2008-09	2009-10
Department of Health and Ageing	2.0	5.8	4.5	4.4
Related capital ($m)
Department of Health and Ageing	0.1	-	-	-

The Government will provide $20.8 million over five years (including $3.9 million in 2010-11) to improve the capacity of the Indigenous mental health workforce. This will be achieved by providing five new scholarships each year for Indigenous students undertaking studies in a mental health discipline under the Puggy Hunter Memorial Scholarship Scheme, as well as creating 10 additional mental health worker positions in Indigenous communities. Additionally, a range of mental health training programmes and resources will be provided for the existing Indigenous health workforce to enable them to better identify mental illness and assist people to access appropriate treatment. This measure includes $0.1 million in capital funding in 2006-07 for building fit-out costs for the Department of Health and Ageing.

COAG Mental Health — mental health in tertiary curricula

Expense ($m)
	2006-07	2007-08	2008-09	2009-10
Department of Health and Ageing	1.1	1.2	1.1	1.1
Related capital ($m)
Department of Health and Ageing	0.2	-	-	-

The Government will provide $5.6 million over five years (including $1.0 million in 2010-11) to increase the mental health content in tertiary curricula. This measure will develop mental health training modules for registered nurses, including the culturally appropriate management of Indigenous patients, and provide students with clinical training in multi-disciplinary teams that include allied health, medical and nursing students. This measure includes $0.2 million in capital funding in 2006-07 for building fit-out costs for the Department of Health and Ageing.

COAG Mental Health — increased funding for the Mental Health Council of Australia

Expense ($m)
	2006-07	2007-08	2008-09	2009-10
Department of Health and Ageing	0.2	0.2	0.2	0.2

The Government will provide an additional $1.0 million over five years (including $0.2 million in 2010-11) to increase funding for the Mental Health Council of Australia (the Council). This will increase the secretariat funding for the Council to assist it to respond to an increased focus on mental health issues in the broader community.

Other measures in the Health and Ageing portfolio

Adult Stem Cell Research Centre — contribution

Expense ($m)
	2006-07	2007-08	2008-09	2009-10
Department of Health and Ageing	5.0	5.0	5.0	5.0

The Government will provide $20.0 million over four years to fund the operational costs of the National Adult Stem Cell Research Centre (the Centre). The Centre brings together stem cell researchers from around Australia to conduct research using adult stem cells. Research involving adult stem cells has great potential to provide benefits in an increasing number of fields in health and medicine. The Centre will have a particular focus on applying adult stem cell research to brain diseases such as Parkinson's disease.

See also the related expense measure Medical research facilities — grants for development and expansion in the Health and Ageing portfolio.

Further information can be found in the press release of 2 May 2006 issued by the Minister for Health and Ageing.

Aged care — Community Visitors Scheme additional funding

Expense ($m)
	2006-07	2007-08	2008-09	2009-10
Department of Health and Ageing	1.3	1.6	1.8	-

The Government will provide $4.7 million over three years to expand the reach of the Community Visitors Scheme (CVS) to cover all residential aged care homes. The funding will also ensure ongoing viability and sustainability of the scheme by increasing the overall rate of funding provided to support existing volunteers who visit aged care homes. This measure builds on existing funding of $27.9 million over four years already allocated to the Scheme.

The provision of funding to 2008-09 will align the funding and planned review of this programme with that of the CVS funded under the 2005-06 Budget measure Ensuring Quality Care for Older Australians — maintain funding.

Aged care — continued capital assistance for rural and remote providers

Expense ($m)
	2006-07	2007-08	2008-09	2009-10
Department of Health and Ageing	-	-	-	-

The Government will provide $134.2 million over four years to continue capital assistance to aged care providers in rural and remote Australia. The funding will facilitate the building, rebuilding, upgrading and extension of residential aged care infrastructure in rural and remote Australia to ensure these facilities conform to building and care standards.

This measure involves funding of $37.5 million in 2006-07, $39.0 million in 2007-08, $28.8 million in 2008-09 and $28.8 million in 2009-10. Provision for this funding has already been included in the forward estimates.

Aged care — encouraging best practice

Expense ($m)
	2006-07	2007-08	2008-09	2009-10
Department of Health and Ageing	3.2	6.3	5.6	6.4

The Government will provide $21.6 million over four years in competitive financial incentives for residential aged care providers to work with clinical educators, researchers and research institutions to develop and implement best practice in clinical care.

The programme will allow an opportunity for aged care providers to develop and enhance their knowledge and skills, develop national clinical guides and evidence summaries, and support staff to access and use the best available evidence in everyday practice. This will include areas such as clinical assessment, medication management, wound management, infection control and falls prevention and will result in wide dissemination of findings highlighting strategies developed to foster best practice.

Aged Care — increased spot checks of residential aged care homes

Expense ($m)
	2006-07	2007-08	2008-09	2009-10
Department of Health and Ageing	2.0	2.1	2.2	2.3

The Government will provide $8.6 million over four years to increase the number of unannounced site visits (spot checks) to residential aged care homes undertaken by the Aged Care Standards Accreditation Agency as part of its role in monitoring the homes' compliance with quality care standards. Under this measure each residential aged care home will have at least one unannounced site visit annually. The Aged Care Standards Accreditation Agency will now undertake an average of 1.75 visits per home per year, up from 1.25 visits per home per year previously undertaken.

Further information can be found in the press release of 10 April 2006 issued by the Minister for Ageing.

Aged care — police checks for Community Visitors Scheme volunteers

Expense ($m)
	2006-07	2007-08	2008-09	2009-10
Department of Health and Ageing	0.6	0.4	0.4	0.4

The Government will provide $1.8 million over four years to meet the costs of mandatory police checks for all volunteer visitors to aged care homes under the Community Visitors Scheme. Mandatory police checks will also be required for all staff in Australian Government subsidised aged care services. Approved providers will now be required under the Aged Care Act 1997 to ensure that all staff employed by them, or engaged through an agency, have been police-checked and assessed as to their suitability to work in aged care.

Further information can be found in the press release of 10 April 2006 issued by the Minister for Ageing.

Aged care and pensions — further harmonisation

Expense ($m)
	2006-07	2007-08	2008-09	2009-10
Department of Veterans' Affairs	0.1	..	..	..
Department of Health and Ageing	-4.8	-15.5	-22.9	-28.8
Total	-4.7	-15.5	-22.9	-28.8
Related capital ($m)
Department of Veterans' Affairs	0.1	-	-	-

The Government will bring the treatment of income and assets for aged care purposes into line with their treatment for pension purposes in relation to limits on the gifting of assets and the concessional treatment of complying income streams.

In determining whether a resident may be subject to accommodation payments, any gifts made by a prospective resident totalling more than $10,000 in any financial year, or $30,000 over five years, will be deemed to still be in the possession of the resident for the purposes of the aged care assets test. This will apply to any gifts made by prospective residents from 10 May 2006. For complying income streams, only 50 per cent of the purchase cost of an income stream purchased after 20 September 2004 will qualify for an exemption from the assets test.

As the Aged Care Assets test only applies on entry to an aged care home, existing residents will not be affected while they remain in the same aged care home.

This measure is expected to lead to savings of $73.5 million over four years and will cost $1.8 million over five years (including capital funding of $0.2 million over two years from 2005-06 and $0.1 million in expense funding in 2005-06 for the Department of Veterans' Affairs). This will lead to net savings of $71.7 million over five years.

Aged Care Assessment Programme — continue age related growth indexation

Expense ($m)
	2006-07	2007-08	2008-09	2009-10
Department of Health and Ageing	-	-	-	-

The Government will provide $20.1 million over four years to continue the age related growth funding for Aged Care Assessment Teams. This will ensure that funding keeps pace with increasing demand for assessment services associated with the ageing of Australia's population.

This measure involves funding of $2.0 million in 2006-07, $3.9 million in 2007-08, $6.1 million in 2008-09 and $8.2 million in 2009-10. Provision for this funding has already been included in the forward estimates.

Aged care income test — additional funding

Expense ($m)
	2006-07	2007-08	2008-09	2009-10
Department of Health and Ageing	1.0	1.1	1.1	1.2

The Government will provide additional funding of $5.2 million over five years (including $0.9 million in 2005-06) to the Department of Health and Ageing to ensure the continuation of high quality income testing of individuals who may face residential aged care fees.

Income testing is undertaken by Centrelink on behalf of the Department of Health and Ageing in order to determine the amount of fees that residents are required to contribute towards the cost of their daily residential care costs. The additional funding will ensure that residents continue to have access to the full range of services provided by Centrelink including access to Financial Information Services.

Aged care income test — continuation of 28 day grace period

Expense ($m)
	2006-07	2007-08	2008-09	2009-10
Department of Health and Ageing	-	-	-	-

The Government will provide $23.8 million over four years to continue to allow a 28 day period of grace for new residents of aged care facilities before they commence paying the income-tested component of their daily fees. This period of grace allows sufficient time for an income assessment to be finalised for most residents.

This measure involves funding of $5.4 million in 2006-07, $5.8 million in 2007-08, $6.1 million in 2008-09 and $6.5 million in 2009-10. Provision for this funding has already been included in the forward estimates.

Aged Care Nursing Scholarship Programme — continue funding

Expense ($m)
	2006-07	2007-08	2008-09	2009-10
Department of Health and Ageing	-	-	-	-

The Government will provide $36.0 million over four years to continue the Aged Care Nursing Scholarship Programme which aims to encourage more people to take up aged care nursing and to improve retention of aged care nurses by enhancing career pathways. This measure provides for up to 250 aged care nursing scholarships (valued at up to $10,000 per annum) each year with preference given to people in rural and regional areas.

This measure will involve funding of $8.7 million in 2006-07, $8.9 million in 2007-08, $9.1 million in 2008-09 and $9.3 million in 2009-10. Provision for this funding has already been included in the forward estimates.

Aged care workers' support — continue funding

Expense ($m)
	2006-07	2007-08	2008-09	2009-10
Department of Health and Ageing	-	-	-	-

The Government will provide $30.0 million over four years to continue to provide support for aged care workers. This programme will increase the skills of personal care workers by providing support for training in smaller aged care homes through flexible or distance training programmes.

This measure involves funding of $7.3 million in 2006-07, $7.4 million in 2007-08, $7.6 million in 2008-09 and $7.7 million in 2009-10. Provision for this funding has already been included in the forward estimates.

Arthritis and osteoporosis care — continue funding

Expense ($m)
	2006-07	2007-08	2008-09	2009-10
Department of Health and Ageing	-	-	-	-

The Government will provide $14.8 million over four years to continue to fund awareness and educational strategies promoting effective management and self-management of arthritis and osteoporosis. These activities will be supplemented by the development and implementation of clinical guidelines and a national data and monitoring programme.

This measure involves funding of $3.6 million in 2006-07, $3.7 million in 2007-08, $3.7 million in 2008-09 and $3.8 million in 2009-10. Provision for this funding has already been included in the forward estimates.

Australian Childhood Immunisation Register — redevelopment scoping study

Expense ($m)
	2006-07	2007-08	2008-09	2009-10
Department of Health and Ageing	0.7	0.6	-	-

The Government will provide $1.2 million over two years to fund a scoping study to consider the benefits, risks, required functions and costs associated with redeveloping the Australian Childhood Immunisation Register (ACIR) as a whole-of-life immunisation register. This funding will also allow the investigation of alternatives to the current practice of building and maintaining stand-alone population health registers. The review will also look into ways of improving ACIR's capacity to add vaccines that are recommended by the Pharmaceutical Benefits Advisory Committee and approved by Government, as well as potentially linking to other existing health registers.

Better Access to Radiation Oncology — continue funding

Expense ($m)
	2006-07	2007-08	2008-09	2009-10
Medicare Australia	-	-	-	-
Department of Health and Ageing	-15.7	-6.1	9.3	6.5
Total	-15.7	-6.1	9.3	6.5

The Government will continue the work of the Better Treatment for Cancer Patients programme, providing $90.3 million over four years to improve access to radiotherapy services for Australians with cancer. This will involve funding of $7.0 million in 2006-07, $19.3 million in 2007-08, $35.3 million in 2008-09 and $28.7 million in 2009-10.

This measure will benefit patients in Darwin for Northern Australian communities and non-metropolitan areas, through expanding the radiation oncology workforce, improving quality systems and expanding capital infrastructure.

Funding of $96.3 million over four years has already been included in the forward estimates. This measure will result in reduced costs, compared with the forward estimates, of $6.0 million over the four years. The figures appearing in the expense table show the impact of re-profiling the forward estimates to reflect the time taken to initiate new capital works.

Cervical screening incentives for general practitioners — continue funding

Expense ($m)
	2006-07	2007-08	2008-09	2009-10
Department of Health and Ageing	-	-	-	-
Medicare Australia	-	-	-	-
Department of Veterans' Affairs	-	-	-	-
Total	-	-	-	-

The Government will provide $97.2 million over four years (including funding for administering payments through Medicare Australia) to continue incentives for general practitioners to increase rates of participation in the National Cervical Screening Programme. Greater participation in screening will improve the chance of early detection of cervical abnormalities, thereby reducing mortality from cervical cancer.

This measure is targeted at unscreened or under-screened women, including women in rural and remote areas, and women from culturally and linguistically diverse backgrounds. It also continues funding for a population-based incentive that rewards general practices reaching an overall screening target.

This measure involves funding of $24.7 million in 2006-07, $23.2 million in 2007-08, $24.4 million in 2008-09 and $24.9 million in 2009-10. Provision for this funding has already been included in the forward estimates.

COAG Health Services — aligning services in rural and remote areas

Expense ($m)
	2006-07	2007-08	2008-09	2009-10
Department of Health and Ageing	2.0	1.7	1.9	2.1

The Government will provide $7.6 million over four years to address the specific health challenges in rural and remote Australia by consolidating and streamlining rural health service delivery programmes in conjunction with the States and Territories.

The Government will work with the State and Territories to ensure that programmes are more focused on the needs of rural and remote communities, with both levels of government to agree on the existing services to be streamlined, funding arrangements, workforce recruitment and retention strategies, and sites for priority development.

This measure forms part of the Government's contribution to the COAG Health Services package, announced on 10 February 2006.

See the related expense measures COAG Health Services in the Health and Ageing, Family, Community Services and Indigenous Affairs, and Education, Science and Training portfolios.

Further information can be found in the Council of Australian Governments' Meeting Communiqué.

COAG Health Services — establishing the foundations for a national electronic health records system

Expense ($m)
	2006-07	2007-08	2008-09	2009-10
Department of Health and Ageing	27.9	20.6	21.7	nfp

The Government will provide $70.2 million over three years towards the establishment of core national infrastructure to link information systems across the health sector. The new infrastructure will involve three key elements — an individual health identifier, a health provider identifier and an agreed set of clinical terminologies to standardise communications between clinicians and across the health system. This will help improve safety for patients and efficiency in health care by building capacity to link information across the health sector so that the information needed to make the right clinical decisions is readily available.

This measure is part of the Government's e-health agenda, and will be administered by the National Electronic Health Transition Authority, a joint Australian and States and Territories government body.

Additional funding for this measure for 2009-10 has been included in the Contingency Reserve and will be released once funding shares are agreed with the States and Territories.

This measure forms part of the Government's contribution to the COAG Health Services package, announced on 10 February 2006.

See the related expense measures COAG Health Services in the Health and Ageing, Family, Community Services and Indigenous Affairs, and Education, Science and Training portfolios.

Further information can be found in the Council of Australian Governments' Meeting Communiqué.

COAG Health Services — improving access to primary care services in rural and remote areas

Expense ($m)
	2006-07	2007-08	2008-09	2009-10
Department of Health and Ageing	0.7	0.4	0.4	0.3
Medicare Australia	0.1	0.1	0.2	0.2
Total	0.8	0.5	0.6	0.5

The Government will allow primary health care services provided in small rural hospitals and health services in areas of workforce shortages to be billed to the Medicare Benefits Schedule through special exemptions. This will improve access to primary care services in rural and remote areas where State-salaried medical officers in a public hospital setting are used to provide general practice services normally provided in the private sector. Funding for this purpose has been included in the Contingency Reserve and will be released when agreements on eligible areas are reached with the States and Territories.

The Government will also provide funding of $3.0 million over five years (including $0.5 million in 2005-06) for the Department of Health and Ageing and Medicare Australia to give effect to this measure.

As part of the proposal, the States and Territories will also be required to commit to maintaining health facilities and providing support for primary health care services.

This measure forms part of the Government's contribution to the COAG Health Services package, announced on 10 February 2006.

See the related expense measures COAG Health Services in the Health and Ageing, Family, Community Services and Indigenous Affairs, and Education, Science and Training portfolios.

Further information can be found in the Council of Australian Governments' Meeting Communiqué.

COAG Health Services — improving arrangements for aged care assessments and access to Home and Community Care services

Expense ($m)
	2006-07	2007-08	2008-09	2009-10
Department of Health and Ageing	7.4	6.1	5.2	5.3

The Government will provide funding of $24.2 million over five years (including $0.1 million in 2005-06) to simplify access to aged care services for the elderly through more timely, consistent and quality assessments by Aged Care Assessment teams.

The Australian Government and the States and Territories will work together to ensure consistency and the continuing high quality of assessments for older Australians requiring access to aged care services. This will include improvements to the administration and performance of the Aged Care Assessment Programme. It will also include streamlining eligibility and assessment processes for the Home and Community Care programme to simplify access to care services for the elderly, people with disabilities and people leaving hospital.

This measure forms part of the Government's contribution to the COAG Health Services package, announced on 10 February 2006.

See the related expense measures COAG Health Services in the Health and Ageing, Family, Community Services and Indigenous Affairs, and Education, Science and Training portfolios.

Further information can be found in the Council of Australian Governments' Meeting Communiqué.

COAG Health Services — improving care for older patients in public hospitals

Expense ($m)
	2006-07	2007-08	2008-09	2009-10
Department of Health and Ageing	38.5	37.8	37.8	38.1

The Government will provide $152.7 million over five years (including $0.5 million in 2005-06) to improve care for older patients in public hospitals by enhancing in-patient services and the transitions to appropriate long-term care, avoiding re-admission to hospital and improving care services when people stay long term in smaller rural hospitals

This measure forms part of the Government's contribution to the COAG Health Services package, announced on 10 February 2006.

See the related expense measures COAG Health Services in the Health and Ageing, Family, Community Services and Indigenous Affairs, and Education, Science and Training portfolios.

Further information can be found in the Council of Australian Governments' Meeting Communiqué.

COAG Health Services — National Health Call Centre Network

Expense ($m)
	2006-07	2007-08	2008-09	2009-10
Department of Health and Ageing	11.8	21.1	39.1	34.6

The Government will provide $110.9 million over five years (including $4.3 million in 2005-06) towards the establishment of the National Health Call Centre Network (NHCCN), a joint initiative of the Australian Government and the State and Territory Governments. The NHCCN will enable the public to access nurse-based telephone health advice and information, including in relation to the location of relevant health services, around the clock.

The funding will also provide for the creation of a web site to support the call centre by providing relevant health information. Existing statewide health call centres in the Australian Capital Territory, Northern Territory and Western Australia are expected to be absorbed into the NHCCN. National coverage will be provided by July 2011.

The NHCCN will provide access to health care advice for all Australians to help improve people's ability to make informed decisions about their health care needs and ease the pressure on general practitioners and hospital emergency rooms.

This measure includes funding of $10.0 million over four years as the Australian Government's contribution towards the delivery of mental health services as an integral element of the NHCCN. This funding will provide for mental health nurses and psychologists to answer mental health related calls.

This measure forms part of the Government's contribution to the COAG Health Services package, announced on 10 February 2006.

See also the related expense measures COAG Health Services in the Health and Ageing, Family, Community Services and Indigenous Affairs, and Education, Science and Training portfolios.

Further information can be found in the Council of Australian Governments' Meeting Communiqué.

COAG Health Services — promoting good health, prevention and early intervention

Expense ($m)
	2006-07	2007-08	2008-09	2009-10
Department of Health and Ageing	43.4	66.8	69.9	65.7
Department of Veterans' Affairs	0.4	0.6	0.7	0.7
Medicare Australia	0.3	0.3	0.5	0.3
Total	44.1	67.8	71.1	66.7

The Government will provide $250.0 million over five years (including $0.4 million in 2005-06) as its contribution to a shared initiative with State and Territory Governments to promote good health and reduce the burden of chronic disease in Australia.

The package will fund a range of initiatives including health check and multidisciplinary cancer case conferencing Medicare items, counselling and education services on lifestyle modification to be delivered by nurses and allied health workers, and professional development for general practitioners and other health professionals on chronic disease self management for patients.

The funding will also provide for information and training packages for primary care providers to improve the quality of advice regarding lifestyle risks, as well as establishing a health promotion fund to provide ongoing national media campaigns targeting chronic disease risk factors.

Funding is provided to Medicare Australia for administrative costs for the health checks and multidisciplinary cancer case conferencing Medicare items, and to the Department of Veterans' Affairs for the veterans' health scheme payments for these items.

This measure forms part of the Government's contribution to the COAG Health Services package, announced on 10 February 2006.

See the related expense measures COAG Health Services in the Health and Ageing, Family, Community Services and Indigenous Affairs, and Education, Science and Training portfolios.

Further information can be found in the Council of Australian Governments' Meeting Communiqué.

Community aged care — viability supplement in rural and remote areas

Expense ($m)
	2006-07	2007-08	2008-09	2009-10
Department of Health and Ageing	2.8	5.1	5.4	5.6
Related capital ($m)
Department of Health and Ageing	0.3	-	-	-

The Government will provide $19.4 million over four years (including $0.3 million in capital funding) for a viability supplement for Australian Government community care programmes, such as Community Aged Care Packages and Extended Aged Care at Home Packages, in rural and remote areas. The supplement recognises cost pressures faced by providers outside of metropolitan areas, including higher costs for goods and services and difficulties in attracting and training staff. Subsidies will be paid on a weighted scale according to remoteness of service recipients, size of service and number of special needs recipients.

Community aged care services in retirement villages — continue funding

Expense ($m)
	2006-07	2007-08	2008-09	2009-10
Department of Health and Ageing	-	-	-	-

The Government will provide $24.2 million over four years to improve access to community aged care services to better enable residents of retirement villages to remain living in their homes, and to defer the need to move to a residential aged care facility as their care needs increase. The focus will be on ensuring that residents of retirement villages have equitable access to Community Aged Care Packages and Extended Aged Care at Home packages as are used in the wider community.

This measure involves funding of $5.9 million in 2006-07, $6.0 million in 2007-08, $6.1 million in 2008-09 and $6.2 million in 2009-10. Provision for this funding has already been included in the forward estimates.

Further information can be found in the press release of 3 May 2006 issued by the Minister for Ageing.

Community aged care workforce — additional training

Expense ($m)
	2006-07	2007-08	2008-09	2009-10
Department of Health and Ageing	2.6	4.5	4.1	2.2

The Government will provide funding of $13.4 million over four years to provide additional training for 2,700 direct care workers involved in the delivery of Community Aged Care Packages (CACPs) and Extended Aged Care at Home (EACH) Packages. Funding will be directed to qualifications offered within the Australian Qualifications Framework to ensure that it is high quality training linked to industry developed standards, and qualifications which are recognised nationally and portable between employers.

As part of this measure, the Government will also provide funding for a community aged care workforce census and survey planned for 2007 to improve understanding of the composition of the aged care workforce.

Counsellors on university campuses — establishment

Expense ($m)
	2006-07	2007-08	2008-09	2009-10
Department of Health and Ageing	2.4	5.5	5.9	6.0

The Government will provide $19.8 million over four years to establish a network of counsellors on university campuses to focus on the needs of people with substance abuse problems, including identifying the early onset of psychosis. The counsellors will also provide family support services, including for sole parents, and arrange referrals to appropriate specialist and mainstream community services. This measure involves an awareness campaign in universities on the links between mental illness and substance abuse.

This measure will help to improve early identification and referral to appropriate treatment for young people with a mental illness and substance abuse problems, as well as assisting those in crisis.

Creutzfeldt-Jakob Disease — increased funding for surveillance

Expense ($m)
	2006-07	2007-08	2008-09	2009-10
Department of Health and Ageing	..	..	0.1	..

The Government will provide an additional $0.2 million over four years to further support the continued surveillance of Creutzfeldt-Jakob Disease (CJD). This funding will provide for updates to the infection control guidelines and the CJD database.

This measure will extend the existing funding of $0.3 million in 2006-07, $0.3 million in 2007-08, $0.3 million in 2008-09 and $0.3 million in 2009-10. Already included in the forward estimates, this funding provides for the ongoing operation of the Australian National CJD Case Registry at the University of Melbourne. The Registry investigates CJD cases, performs testing and autopsies, and undertakes scientific research.

Croc Festivals — additional funding

Expense ($m)
	2006-07	2007-08	2008-09	2009-10
Department of Health and Ageing	-	-	-	-

The Government will provide an additional $2.2 million in 2005-06 to further support the 'Croc Festivals' in 2006 by its sponsorship of a series of community-based events. The 'Croc Festivals' for Indigenous and non-Indigenous young people in rural and remote areas promote healthy, positive lifestyles and aim to improve educational and employment outcomes.

This funding is additional to the $1.2 million over four years provided for the Croc Festivals under the 2002-03 Budget measure — Croc Festivals, and the annual contributions from a range of agencies.

See also the related expense measure Community festivals for health promotion — additional funding in the Education, Science and Training portfolio.

DrinkWise Australia — contribution

Expense ($m)
	2006-07	2007-08	2008-09	2009-10
Department of Health and Ageing	-	-	-	-

The Government will provide $5.0 million in 2005-06 to DrinkWise Australia to contribute to responsible drinking education programmes. DrinkWise Australia was established by the alcohol beverage sector and is a collaboration between industry and the community. DrinkWise Australia aims to bring about a healthier drinking culture by focusing on initiatives that minimise the harm associated with alcohol in the community.

Further information can be found in the press release of 26 April 2006 issued by the Parliamentary Secretary to the Minister for Health and Ageing.

Drug and alcohol treatment services — infrastructure grants for non-government organisations

Expense ($m)
	2006-07	2007-08	2008-09	2009-10
Department of Health and Ageing	-	-	-	-

The Government will provide $0.9 million in 2005-06 in infrastructure grants for drug and alcohol treatment services provided by non-government organisations. Funding comprises:

$50,000 for the Karralika Therapeutic Community, Australian Capital Territory;
$50,000 for the Salvation Army — Canberra Recovery Service, Australian Capital Territory;
$50,000 for the Salvation Army — OASIS Youth Service, New South Wales;
$50,000 for the Ted Noffs Foundation, New South Wales;
$50,000 for We Help Ourselves (WHOS), New South Wales;
$50,000 for Banyan House, Northern Territory;
$50,000 for the Drug & Alcohol Services Association, Northern Territory;
$50,000 for the Gold Coast Drug Council (Mirakai), Queensland;
$50,000 for Goorie Recovery House, Queensland;
$50,000 for the Aboriginal Sobriety Group, South Australia;
$50,000 for the Uniting Care — Wesley Mission Kuitpo Program, South Australia;
$50,000 for the Missiondale Recovery Centre, Tasmania;
$50,000 for The Link Youth Health Service, Tasmania;
$50,000 for Odyssey House, Victoria;
$50,000 for the Windana Society Therapeutic Community, Victoria;
$50,000 for Cyrenian House, Western Australia; and
$50,000 for the Palmerston Association, Western Australia.

Further information can be found in the press release of 19 April 2006 issued by the Treasurer.

Food regulation — streamlining processes

Expense ($m)
	2006-07	2007-08	2008-09	2009-10
Food Standards Australian New Zealand	1.1	0.7	-	-
Department of Health and Ageing	0.5	0.5	-	-
Total	1.7	1.2	-	-

The Government will provide $2.9 million over two years to Food Standards Australia New Zealand and the Department of Health and Ageing, to streamline the food standards setting process including by developing a priority system for applicants and removing regulatory impediments to the efficiency and innovation of the food industry.

Health and Medical Research — additional funding

Expense ($m)
	2006-07	2007-08	2008-09	2009-10
Department of Health and Ageing	21.0	87.0	158.0	234.0

The Government will provide $500.0 million over four years to increase investment in health and medical research. This funding will enable the provision of additional research grants through the National Health and Medical Research Council.

This commitment follows the Government's announcement of its decision to sell Medibank Private Limited, and completes the Government's response to the 2004 Investment Review of Health and Medical Research (the Grant Review).

Health and Medical Research — establishment of a research fellowship scheme

Expense ($m)
	2006-07	2007-08	2008-09	2009-10
Department of Health and Ageing	8.0	14.4	20.9	27.4

The Government will provide $170.0 million over nine years (including $99.3 million from 2010-11 to 2014-15) to establish an Australian Health and Medical Research Fellowship Scheme to attract and retain leading researchers, through the National Health and Medical Research Council.

This is a long-term commitment from the Government to develop and enhance research capacity and maintain Australia's world class reputation. This commitment follows the Government's announcement of its decision to sell Medibank Private Limited, and completes the Government's response to the 2004 Investment Review of Health and Medical Research (the Grant Review).

Hospital safety — continue funding

Expense ($m)
	2006-07	2007-08	2008-09	2009-10
Department of Health and Ageing	-	-	-	-

The Government will provide up to $6.9 million in 2006-07 as its contribution to the Australian Commission on Safety and Quality in Health Care (the Commission). The Commission is a joint Australian Government and State and Territory Government body, and superseded the Australian Council for Safety and Quality in Health Care in early 2006. It will focus on quality improvements in primary care and the private sector, which are central to the national safety and quality improvements agenda.

Provision for funding of $6.9 million in 2006-07 has already been included in the forward estimates. Funding beyond 2006-07 is to be considered in the 2007-08 Budget, once the cost of the operation of the new Commission has been fully determined.

Illicit drug use — combating emerging trends

Expense ($m)
	2006-07	2007-08	2008-09	2009-10
Department of Health and Ageing	7.3	8.6	9.7	8.8

The Government will provide $34.4 million over four years to combat emerging trends in illicit drug use.

Funding of $23.7 million will provide for a third phase of the National Illicit Drugs Campaign to communicate drug prevention messages to discourage illicit drug use and increase community awareness of the harm cause