Younger People with Disability in Residential Aged Care program
Report on the 2008–09 Minimum Data Set
May 2010

The Australian Institute of Health and Welfare is Australia’s national
health and welfare statistics and information agency. The Institute’s mission is
 better information and statistics for better health and wellbeing.
© Australian Institute of Health and Welfare 2010

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This publication is part of the Australian Institute of Health and Welfare’s Disability series. A complete list of the Institute’s publications is available from the Institute’s website <www.aihw.gov.au>. 

ISSN 1444 3589
ISBN 978 1 74249 031 1
Suggested citation 
Australian Institute of Health and Welfare 2010. Younger People with Disability in Residential Aged Care program: report on the 2008–09 Minimum Data Set. Disability series. Cat. no. DIS 57. Canberra: AIHW.
Australian Institute of Health and Welfare 
Board Chair
Hon. Peter Collins, AM, QC

Director 
Penny Allbon

Any enquiries about or comments on this publication should be directed to:
Anne Aisbett
Australian Institute of Health and Welfare
GPO Box 570
Canberra ACT 2601
Phone: (02) 6244 1208
Email: Anne.Aisbett@aihw.gov.au

Published by the Australian Institute of Health and Welfare
Printed by Bluestar Print Group
Please note that there is the potential for minor revisions of data in this report.
Please check the online version at <www.aihw.gov.au> for any amendments.

Contents
Acknowledgments	v
Abbreviations	vi
Summary	vii
1	Introduction	1
1.1	The YPIRAC program	1
1.2	Scope and definitions	2
1.3	Interpreting the data	4
2	YPIRAC service users	7
2.1	Characteristics and YPIRAC target groups	7
2.2	Residential setting	11
2.3	Disability groups	14
3	Service use	18
3.1	YPIRAC-specific services	18
3.2	Support services	25
4	New service users and service users exiting the YPIRAC program	30
4.1	New and continuing service users	30
4.2	Service users who exited the program in 2008–09	37
5	YPIRAC program 2006–07 to 2008–09	40
5.1	YPIRAC service users	40
5.2	Service use	45
5.3	YPIRAC program objectives	47
6	Target population	53
6.1	Contact with potential service users	53
6.2	Younger people in residential aged care	55
6.3	Younger people assessed under the Aged Care Assessment Program	56
7	Data quality	60
7.1	Data development	60
7.2	Data quality in the 2008–09 MDS	60
Appendixes	62
Appendix 1: Additional tables	62
Appendix 2: YPIRAC MDS collection forms	67
Appendix 3: Service type classification	68
Appendix 4: English proficiency groupings	75
Appendix 5: Residential setting definitions	78
Appendix 6: The statistical linkage key	80
References	81
List of tables	82
List of figures	85

Acknowledgments
This report was prepared by Anne Aisbett, Kirsten Trunk, Cathy Hales and Tracy Dixon. It builds on previous reports from the Australian Institute of Health and Welfare (AIHW), as well as developments in, and contributions from, all jurisdictions responsible for delivering the Younger People with Disability in Residential Aged Care (YPIRAC) program.
The AIHW project team would like to thank all state and territory YPIRAC program managers for their assistance in developing, collecting and reporting data for the 2008–09 YPIRAC Minimum Data Set:
Department of Human Services (New South Wales)	David Green	
Department of Human Services (Victoria)	Heather Thompson	
Disability Services Queensland	Greg Johnson	
Disability Services Commission (Western Australia)	Russell Brown	
Department for Families and Communities (South Australia)	Sharon Evans	
Department of Health and Human Services (Tasmania)	Lesley Mackay	
Department of Disability, Housing and Community Services (Australian Capital Territory)	Sarah King	
Department of Health and Families (Northern Territory)	Samantha Livesely	
Thanks also to Karen Fox, Cheryl Johnson and Ester Kyaw at the Australian Government Department of Families, Housing, Community Services and Indigenous Affairs, and to the staff in the Information Strategy and Development Section of the Australian Government Department of Health and Ageing. 
Special thanks go to Jaclyn Coleclough, Kelly Fogarty, Sarah Biggs, Helen Garner, Martin Higgins, Kylie West, Wing Sun Foong, Andrew Stanton, Jessie Speight, Ali Nur, Luke Drady and Noel Hanssens who made significant contributions to the data collection and cleaning processes in their jurisdictions.
Abbreviations
ACAP	Aged Care Assessment Program	
ACAT	Aged Care Assessment Team	
AIHW	Australian Institute of Health and Welfare	
APP	Accommodation Placement Panel (South Australia)	
COAG	Council of Australian Governments	
CSTDA	Commonwealth State/Territory Disability Agreement 	
EP Group	English Proficiency Group	
NDA	National Disability Agreement	
NMDS	National Minimum Data Set	
MDS	Minimum Data Set	
RA	remoteness area	
SLK	statistical linkage key	
YPIRAC	Younger People with Disability in Residential Aged Care 	
Symbols used in tables
<	less than	
—	zero, or null cells	
. .	not applicable	
n.a.	not available	
n.p.	not published	
Summary
The YPIRAC program
The Younger People with Disability in Residential Aged Care (YPIRAC) program is a 5-year program agreed on by the Council of Australian Governments. It aims to reduce the number of people with disability aged less than 65 who live in residential aged care. The 2008–09 year is the third year of the program. 
The people
In 2008–09 a total of 817 people received services funded by the YPIRAC program. This represents a 41% increase on the number of people receiving services in 2007–08.
Three-quarters of YPIRAC service users in 2008–09 were aged less than 50 years, the initial priority group for the program.
One in 10 service users was of Aboriginal or Torres Strait Islander origin and about 6% were from non-English-speaking backgrounds. 
Nearly half (47%) of all service users had a primary disability relating to acquired brain injury, and another 29% had a neurological primary disability. Many service users had high and complex needs: 1 in 10 reported having four or more disability groups, and the average number of disability groups per service user was nearly 2 (1.93).
Residential setting
Almost two-thirds (64%) of YPIRAC service users lived in residential aged care at the end of the reporting period. Of these, nearly 2 in 5 reported that their main reason for living there was because appropriate alternative accommodation was not available. 
Around 3 in 10 YPIRAC service users were to remain in residential aged care (YPIRAC target groups 3 and 4), but the great majority of these (89%) were to receive, or had received, additional disability support services.
YPIRAC services
Of all YPIRAC service users in 2008–09, nearly 3 in 10 (234) were offered alternative accommodation and, of these, over half (124) moved to alternative accommodation such as private residences, domestic-scale supported living facilities and supported accommodation. 
Nearly two-thirds of YPIRAC service users received a support services package in 2008–09, and 15% of all service users received both alternative accommodation and support services.
YPIRAC from 2006–07 to 2008–09
An estimated 947 people received services from the YPIRAC program during the first 3 years of its operation. Of these, 163 (17%) received alternative accommodation and 392 (41%) received support services packages.

1	Introduction
This report is based on data collected for the Younger People with Disability in Residential Aged Care (YPIRAC) Minimum Data Set (MDS) for the YPIRAC program in the 2008–09 financial year. It presents information on the people who were provided with support under the YPIRAC program (YPIRAC service users) and the services they accessed during the 2008–09 reporting period (1 July 2008—30 June 2009). The report examines the achievements of the YPIRAC program over the 3 years of its operation and presents information on the potential target population for the program. 
1.1	The YPIRAC program
The YPIRAC program was approved by the Council of Australian Governments (COAG) on 10 February 2006 with the aim of delivering sustained reductions in the number of younger people with disability in residential aged care (URBIS 2009). It operated under a 5‑year agreement between the Australian Government and state and territory governments, with funding of up to $122 million from the Australian Government to be matched by the states and territories. The program was funded through the states and territories and administered by the Australian Government Department of Families, Housing, Community Services and Indigenous Affairs.
The program has three main objectives:
•	to move younger people with disability currently living in residential aged care into appropriate disability supported accommodation, where it can be made available and if that is the client’s choice
•	to divert younger people with disability who are at risk of admission to residential aged care into more appropriate forms of accommodation
•	to enhance the delivery of specialist disability services to those younger people with disability who choose to remain in residential aged care or for whom residential aged care remains the only available suitable supported accommodation option.
The YPIRAC target group is people with disability aged under 65 years who live in, or are at risk of entering, residential aged care. Initial priority was to be given to those under 50 years of age. 
National Disability Agreement
On 1 January 2009, a new National Disability Agreement (NDA) was introduced, which replaced the Commonwealth State and Territory Disability Agreement (CSTDA), the financial arrangement between the Australian Government and state and territory governments for the provision of services to benefit people with disability. This change had implications for the YPIRAC program.
Bilateral agreements between the Australian Government and state and territory governments were superseded by the NDA, with the exception of program targets for years 2009 to 2011. Australian Government funding for the YPIRAC program was rolled into the disability services specific purpose payment. 
Under the NDA, jurisdictions are responsible for the provision of specialist disability services including service planning, the workforce and sector development for the services they provide. 
The Disability and Policy Research Working Group will consider future support for younger people in, or at risk of entering, residential aged care in the context of the new federal financial arrangements, the implications of the NDA and the reforms to the disability system outlined by it.
1.2	Scope and definitions
The YPIRAC MDS contains information about all people who received funding under the YPIRAC program, and the services they used during 2008–09. These people are known as ‘YPIRAC service users’. The YPIRAC MDS also collects information about program activity relating to contact with potential service users in each state and territory. 
To be considered a YPIRAC service user in 2008–09 a person must have applied to, and been found eligible for, the YPIRAC program and have received one or more YPIRAC-specific services during the 2008–09 financial year. YPIRAC-specific services include YPIRAC assessment and individual care planning, monitoring, alternative accommodation and support service packages. Box 1.1 provides more detail on these key definitions.
Information collected about YPIRAC service users includes age and sex, country of birth, Indigenous status, residential setting and the reasons for being in their current accommodation, geographical location, and primary and other significant disability groups. A statistical linkage key (SLK) is also collected. While the data are not identifiable (that is, personal identifying information is not collected), the SLK enables individual service users to be tracked across reporting periods and would facilitate potential linkage with other relevant data collections such as the CSTDA National Minimum Data Set (NMDS) (now called the Disability Services NMDS). See Appendix 6 for more information about the SLK.
Data are also collected on the range of services received by YPIRAC service users. Box 1.2 provides definitions of each of the service groups (categories of service type) in the YPIRAC MDS, and Appendix 3 provides definitions of each service type.

Box 1.1: Definitions of YPIRAC terms 2008–09
A YPIRAC service user is a person who has:
•	applied to the YPIRAC program, and
•	been found eligible for the program, and
•	received one or more YPIRAC services during the reporting period
(1 July 2008—30 June 2009).
YPIRAC services consist of the following:
•	YPIRAC assessment/individual care planning
	YPIRAC assessment includes all assessments where the aim is to determine the service user’s care needs and/or service needs for the purposes of administering the YPIRAC program, or for the purpose of designing and implementing an individual support plan. YPIRAC assessment includes the determination of the service user’s accommodation options and preferences. Individual care planning includes planning for the individual’s care and/or service needs under the YPIRAC program.
•	YPIRAC client monitoring
	This refers to contact between the YPIRAC program and service users, which occurs after an initial YPIRAC assessment. It includes both regular and one-off contact, and may be in person, by telephone or email. Purposes of this contact may include reviewing or reassessing the service user’s situation, care needs or service needs, or providing updates to service users regarding their involvement in the program. The contact should be on an individual basis. That is, activities such as letters and emails that are provided to more than one service user do not count as client monitoring.
•	Alternative accommodation
	This refers to a change of residential setting that is supported and funded by the YPIRAC program. An offer of alternative accommodation refers to a concrete offer to move to a specific new residential setting.
•	Support services packages
	Support services packages refer to disability and other support services that are funded by the YPIRAC program. This includes disability support packages and service enhancements.
YPIRAC target groups
The YPIRAC program manager allocates a target group for each service user in accordance with their objectives under the program, based on a review of the service user assessment and all available information.
Group 1 Agreed to, or has moved from, residential aged care to alternative YPIRAC-funded accommodation and support
Group 2 Deemed ‘at risk’ of entry into residential aged care
Group 3 Remain in or enter residential aged care with additional disability support services
Group 4 Remain in or enter residential aged care without additional disability support services.

Box 1.2: Definitions of service groups in the YPIRAC MDS 2008–09	
Accommodation support	Services that provide accommodation to people with disability and services that provide the support needed to enable a person to remain in his or her existing accommodation or move to a more suitable or appropriate accommodation.	
Community support	Services that provide the support needed for a person with disability to live in a non-institutional setting (not including support with the basic needs of living, such as meal preparation and dressing, which are included under accommodation support).	
Community access	Services designed to provide opportunities for people with disability to gain and use their abilities to enjoy their full potential for social independence. People who do not attend school or who are not employed full time mainly use these services.	
Respite	Respite services provide a short-term and time-limited break for families and other voluntary caregivers of people with disability, to assist in supporting and maintaining the primary caregiving relationship while providing a positive experience for the person with disability. 	
Other services	This group covers a wide range of services, including advocacy, information, referral, mutual support and self-help groups, and alternative communication formats; research, evaluation, training and development, and peak body support; assistive products and technology; modification to the design or construction of buildings; transportation services; services provided by nurses; YPIRAC assessment and individual care planning; YPIRAC client monitoring; and any other support services outside the above defined service types.	
1.3	Interpreting the data
The following should be considered when interpreting the data presented in this report.
Small cell sizes
The YPIRAC program has relatively small numbers of service users. Cell sizes for some jurisdictions and groups of service users are very small and therefore these data should be interpreted with care. 
People in the YPIRAC program who do not receive YPIRAC-specific services in a given year 
The YPIRAC MDS was established to collect information about services provided under the YPIRAC program. As described in Section 1.2, in order to be considered a YPIRAC service user and therefore included in the MDS, a person must have received one or more YPIRAC-specific services during the relevant reporting period. People who applied and were found eligible for the YPIRAC program during a previous or current reporting period, but did not receive any YPIRAC-specific services during the current period, are not included in the MDS for that period. Many of these people may receive YPIRAC services in the future and may be included in future data collections. 
Service users receiving services from more than one jurisdiction
YPIRAC service users may receive services in more than one state or territory. For instance, a service user may transfer from accommodation in one jurisdiction to alternative accommodation in another jurisdiction, and may receive services from both jurisdictions during the transfer process. These service users are likely to be identified using the SLK, but the SLK is not a unique identifier and there is a small probability that records with identical SLKs do not represent the same person. On the other hand, records for one person may have different SLKs in different jurisdictions if the linkage key information is recorded differently. (See Appendix 6 for more information on the SLK). 
In both the 2007–08 and 2008–09 YPIRAC MDSs a very small number of service users (less than five) were identified as receiving services in more than one jurisdiction. It has not been possible to use the SLK to adjust the data relating to the total number of service users accordingly without compromising confidentiality. Therefore data relating to YPIRAC service users in this report represents a very slight over-count. An explanatory note has been added to all tables to which this applies. 
Confidentiality
To maintain confidentiality it is common statistical practice to suppress cells with very small numbers, usually defined as cells representing less than five responses. When the values for these cells can be calculated from other cells, it is necessary to suppress at least one other cell within the table. This is known as consequential confidentialisation. Confidentialisation is normally achieved by replacing cell contents with ‘n.p.’ (not published).
The small number of records in the YPIRAC data collection has made confidentialisation problematic. In order to present as much information as possible without compromising confidentiality, the following practice has been adopted in this report:

Small cells	Cells with a value of less than 5 have been replaced with ‘< 5’.	
Other cells	Where necessary for consequential confidentiality, the next smallest cell in the same row or column has been replaced with ‘< x’, where x is its value rounded up to the nearest multiple of 5. So, for instance, if the next smallest cell value was 22, the cell will be reported as ‘< 25’. If this results in a number greater than the total of the cells, the total value is substituted. For example, see the data in Table 2.1 for Tasmanian service users aged less than 50 years. 	
Percentages	Percentages for small cells have been replaced with the percentage of the reported number value. For instance, if the corresponding number cell has been reported as ‘< 5’, the percentage cell will be reported as ‘< y’, where y is 5 expressed as the percentage of the total. For example, see Table 2.1, where the number of service users in Tasmania aged 50–64 is reported as ‘< 5’. As 5 is 29.4% of 17, the percentage of service users is reported as ‘< 29.4%’. 	
Exceptions	Some cells with small values have not been suppressed where confidentiality is not compromised. These include ‘not stated’ and ‘other’ data cells.	
This method is based on that documented in Movement from hospital to residential aged care (AIHW: Karmel et al. 2008).
Note: Where table cells have been confidentialised, they are generally not referred to in detail in the accompanying text. 
2	YPIRAC service users
This chapter outlines the demographic characteristics of service users and their YPIRAC target group status.
Nationally, a total of 817 people received services funded by the YPIRAC program during 2008–09 (Table 2.1). Over one-quarter of service users (223; 27%) lived in Queensland, with a further one-quarter in Victoria (210; 26%). 
Between 2007–08 and 2008–09, there was a total increase of 237 service users (41%) (Table 5.1). There were differences in the growth of the program across states and territories between 2007–08 and 2008–09, related to the different timing and implementation strategies of the jurisdictions. While numbers of service users were steady or decreased slightly in several jurisdictions, there were increases in Victoria (up 21%) and South Australia (up 71%), and numbers more than doubled in Western Australia (up 109%) and Queensland (up 110%).
2.1	Characteristics and YPIRAC target groups
The initial priority of the program is to provide services to people with disability aged less than 50 years, with services extended to those aged up to 64 years where possible. Three-quarters (75%) of YPIRAC service users were aged under 50 years in 2008–09 (Table 2.1). This was a decrease from 83% of service users in 2007–08 (AIHW 2009b). The proportion aged under 50 years ranged from 43% in the Australian Capital Territory to 83% in New South Wales. The proportions for Tasmania and the Northern Territory cannot be reported precisely for confidentiality reasons. 
Almost one-third (32%) of service users were aged 45–49 years, with a further 20% aged 50–54 years (Figure 2.1). More than half (56%) of all service users were male, and males outnumbered females in all age groups.
Table 2.1: YPIRAC service users, by age group and state and territory, 2008–09
Age group (years)	NSW	Vic	Qld	WA	SA	Tas	ACT	NT	Total	
				Number				
Less than 50	129	169	146	57	81	< 17	6	< 7	609	
50–64 	26	41	77	35	18	< 5	8	< 5	208	
Total	155	210	223	92	99	17	14	7	817	
				Per cent				
Less than 50	83.2	80.5	65.5	62.0	81.8	< 100.0	42.9	< 100.0	74.5	
50–64 	16.8	19.5	34.5	38.0	18.2	< 29.4	57.1	< 71.4	25.5	
Total	100.0	100.0	100.0	100.0	100.0	100.0	100.0	100.0	100.0	
Note: A small number of service users (< 5) may receive services in more than one jurisdiction. These may be counted more than once in the table.
Figure 2.1: YPIRAC service users, by age group and sex, 2008–09
Vertical bar chart showing, for male and female, service users (no.) on y-axis and age group (years) on x-axis.
Source: Table A1.1. 

Service users were allocated to YPIRAC target groups based on their objectives under the program. Of the 817 service users in 2008–09:
•	less than half (44%) were living in residential aged care and agreed to move or had moved to an alternative accommodation setting (target group 1) (Table 2.2)
•	one-quarter (25%) were considered ‘at risk’ of inappropriate entry to residential aged care (target group 2)
•	28% were to remain in or enter residential aged care with additional support services (target group 3)
•	3% were to remain in or enter residential aged care without additional services (target group 4). These included service users who changed their objectives or left the program during 2008–09 but had already received some services during the reporting period, and new service users who received assessment during the reporting period.
Substantial differences in program targeting can be seen among the states and territories. For example, almost all service users in New South Wales had agreed to move from a residential aged care setting (67%) or were to remain in residential aged care with additional services (30%). By contrast, in South Australia more than 2 in 5 (42%) were considered ‘at risk’ of inappropriate entry to residential aged care. 

Table 2.2: YPIRAC service users, by target group and state and territory, 2008–09
Target group	NSW	Vic	Qld	WA	SA	Tas	ACT	NT	Total	
Number	
Group 1	104	100	76	45	21	7	< 5	< 5	358	
Group 2	5	50	67	24	42	< 5	7	< 5	202	
Group 3	46	60	80	< 20	< 15	< 10	< 5	< 5	230	
Group 4	—	—	—	< 5	< 25	—	—	—	27	
Total	155	210	223	92	99	17	14	7	817	
Per cent	
Group 1	67.1	47.6	34.1	48.9	21.2	41.2	< 35.7	< 71.4	43.8	
Group 2	3.2	23.8	30.0	26.1	42.4	< 29.4	50.0	< 71.4	24.7	
Group 3	29.7	28.6	35.9	< 21.7	< 15.2	< 58.8	< 35.7	< 71.4	28.2	
Group 4	—	—	—	< 5.4	< 25.3	—	—	—	3.3	
Total	100.0	100.0	100.0	100.0	100.0	100.0	100.0	100.0	100.0	
Notes 
1.	YPIRAC target groups: 
Group 1 Agreed to or has moved from residential aged care to alternative YPIRAC-funded accommodation and support
Group 2 Deemed ‘at risk’ of entry into residential aged care
Group 3 Remain in or enter residential aged care with additional disability support services
Group 4 Remain in or enter residential aged care without additional disability support services.
2.	A small number of service users (< 5) may receive services in more than one jurisdiction. These may be counted more than once in the table.

One in 10 YPIRAC service users (10%) was Aboriginal and Torres Strait Islander in 2008–09 (Table 2.3). This was an increase from 7% in 2007–08 (AIHW 2009b). The proportion of Indigenous YPIRAC service users was higher than the proportion of Indigenous people of all ages using disability support services in Australia—4.5% in 2007–08 (AIHW 2009a). The proportion of Indigenous YPIRAC service users was higher among those aged 50–64 years than those aged under 50 (14% compared with 9%). 
The proportion of Indigenous service users varied across the states and territories, from none in Tasmania to 2 in 5 (40%) in Western Australia (Table 2.4). The proportions for Victoria, the Australian Capital Territory and the Northern Territory cannot be reported precisely for confidentiality reasons.
Table 2.3: YPIRAC service users, by age group and Indigenous status, 2008–09
	Indigenous	Non-Indigenous	Total	
Age group (years)	Number	Per cent	Number	Per cent	Number	Per cent	
Less than 50	55	9.0	554	91.0	609	100.0	
50–64	29	13.9	179	86.1	208	100.0	
Total	84	10.3	733	89.7	817	100.0	
Note: A small number of service users (< 5) may receive services in more than one jurisdiction. These may be counted more than once in the table.

Table 2.4: YPIRAC service users, by Indigenous status and state and territory, 2008–09
Indigenous status	NSW	Vic	Qld	WA	SA	Tas	ACT	NT	Total	
Number	
Indigenous	5	< 5	21	37	13	—	< 5	< 7	84	
Non-Indigenous	150	< 210	202	55	86	17	< 14	< 5	733	
Total	155	210	223	92	99	17	14	7	817	
Per cent	
Indigenous	3.2	< 2.4	9.4	40.2	13.1	—	< 35.7	< 100.0	10.3	
Non-Indigenous	96.8	< 100.0	90.6	59.8	86.9	100.0	< 100.0	< 71.4	89.7	
Total	100.0	100.0	100.0	100.0	100.0	100.0	100.0	100.0	100.0	
Note: A small number of service users (< 5) may receive services in more than one jurisdiction. These may be counted more than once in the table.

Information on country of birth can be summarised using English Proficiency groups (DIMA 2003). This classification consists of five categories—one for people born in Australia and four for those born overseas. Categories are based on the typical ability of migrants from each country to speak English. Countries with migrants most proficient in English are classified in English Proficiency Group 1 (EP1) and the least proficient in EP4. For more details see Appendix 4.
In 2008–09, 86% of service users were born in Australia (Table 2.5). This was similar to the proportion of users of CSTDA-funded disability services (83% in 2007–08) (AIHW 2009a), and higher than the proportion in the total Australian population aged under 65 years (73% in 2006) (ABS 2007). 
The proportions born in Australia were relatively similar across most states and territories, ranging from 83% to 100% of service users (Table 2.6). Of the 93 service users born overseas, around half (46) were born in EP1 countries and half (47) in other countries. One in 10 service users (10%) in New South Wales was from an EP2–4 country.
Table 2.5: YPIRAC service users, by age group and country of birth, 2008–09
Age group (years)	Born in Australia	Overseas-born—English Proficiency Group 1	Overseas-born—English Proficiency Groups 2–4	Not stated	Total	
	Number	
Less than 50	531	32	35	11	609	
50–64	175	14	12	7	208	
Total	706	46	47	18	817	
	Per cent	
Less than 50	87.2	5.3	5.7	1.8	100.0	
50–64	84.1	6.7	5.8	3.4	100.0	
Total	86.4	5.6	5.8	2.2	100.0	
Notes
1.	For information about the English Proficiency Group classification, see Appendix 4.
2.	A small number of service users may receive services in more than one jurisdiction. These may be counted more than once in the table.
Table 2.6: YPIRAC service users, by country of birth and state and territory, 2008–09
Country of birth	NSW	Vic	Qld	WA	SA	Tas	ACT	NT	Total	
Number	
Born in Australia	129	186	184	84	89	17	< 14	< 7	706	
Overseas-born—English Proficiency Group 1	10	7	14	< 5	< 10	—	< 5	< 5	46	
Overseas-born—English Proficiency Groups 2–4	16	17	7	< 5	< 5	—	—	—	47	
Not stated	—	—	18	—	—	—	—	—	18	
Total	155	210	223	92	99	17	14	7	817	
Per cent	
Born in Australia	83.2	88.6	82.5	91.3	89.9	100.0	< 100.0	< 100.0	86.4	
Overseas-born—English Proficiency Group 1	6.5	3.3	6.3	< 5.4	< 10.1	—	< 35.7	< 71.4	5.6	
Overseas-born—English Proficiency Groups 2–4	10.3	8.1	3.1	< 5.4	< 5.1	—	—	—	5.8	
Not stated	—	—	8.1	—	—	—	—	—	2.2	
Total	100.0	100.0	100.0	100.0	100.0	100.0	100.0	100.0	100.0	
Notes
1.	A small number of service users (< 5) may receive services in more than one jurisdiction. These may be counted more than once in the table.
2.	For information about the English Proficiency Group classification, see Appendix 4.

Around 63% of service users lived in Major cities, and another 5% lived in Remote or Very remote regions (Table A1.2). Western Australia and the Northern Territory had high proportions of service users living in Remote or Very remote areas (Table A1.3).
2.2	Residential setting
The YPIRAC MDS collects information about service users’ usual residential setting at the end of the reporting period. ‘Usual residential setting’ refers to the type of accommodation in which the person lives for 4 or more days per week on average. Definitions of the types of residential settings used in the MDS are in Appendix 5.
At 30 June 2009, just under two-thirds (64%) of service users lived in a residential aged care facility (Table 2.7). This proportion was slightly lower than in 2007–08 (69%) (AIHW 2009b). An additional 17% of service users lived in private residences in 2008–09.
Service users aged under 50 years were more likely than those aged 50–64 years to live in private residences (19% compared with 12%), while those aged 50–64 years were more likely to live in residential aged care (76% compared with 60%).
Most service users who had agreed to move from residential aged care had not yet done so, with 74% still in residential aged care at 30 June 2009 (Table A1.4). More than half (53%) of service users at risk of entering residential aged care lived in private residences, a further 15% lived in a supported accommodation facility and 10% lived in domestic-scale supported living facilities.
Table 2.7: YPIRAC service users, by usual residential setting and age group, 2008–09
	Less than 50 years	50–64 years	Total	
Usual residential setting	Number	Per cent	Number	Per cent	Number	Per cent	
Private residence	114	18.7	25	12.0	139	17.0	
Domestic-scale supported living facility	41	6.7	10	4.8	51	6.2	
Supported accommodation	37	6.1	12	5.8	49	6.0	
Residential aged care	368	60.4	158	76.0	526	64.4	
Hospital	< 40	< 6.6	< 5	< 2.4	36	4.4	
Other	< 15	< 2.5	< 5	< 2.4	16	2.0	
Total	609	100.0	208	100.0	817	100.0	
Notes 
1.	Usual residential setting refers to the type of accommodation in which the person was living for 4 or more days per week on average, as at 30 June 2009 or on exit from the YPIRAC program.
2.	‘Other’ residential setting includes residence within an Aboriginal/Torres Strait Islander community; independent living within a retirement village; short-term crisis, emergency or transitional accommodation; and other settings.
3.	A small number of service users (< 5) may receive services in more than one jurisdiction. These may be counted more than once in the table.

The 2008–09 YPIRAC MDS collected information on the reasons for service users’ usual residential setting as at the end of the reporting period (30 June 2009). The main reason for accommodation was defined as ‘the reason that is of most significance to the service user’ and may reflect the reason why the person had not yet changed residential setting under the YPIRAC program. Information about additional reasons for accommodation could also be recorded. 
Of the 526 service users living in residential aged care, almost 2 in 5 (38%) reported that the main reason for living in their current accommodation setting was that appropriate alternative accommodation was not available (Table 2.8). An additional 33% indicated that they were satisfied with their current accommodation, but the majority of these (136 of 175) wanted additional services in their residential aged care facility. Differences across jurisdictions may in part reflect differences in the targeting and delivery of the program.
Additional reasons for the accommodation setting of service users in residential aged care included that appropriate disability support services were unavailable (7%), alternative accommodation was unavailable (5%) and a principal carer was unavailable (5%) (Table 2.9).
More than two-thirds (202 of 291; 69%) of service users who did not live in residential aged care indicated that the main reason for their usual accommodation setting was that they were satisfied with their current accommodation, and most of these (165; 82%) stated that they were satisfied with the services they received (Table 2.8). Many of these service users had received accommodation or other services under the YPIRAC program (Table 3.3). One in 10 (10%) service users who were not in residential aged care indicated that the main reason for their usual accommodation was that appropriate alternative accommodation was not available. 

Table 2.8: YPIRAC service users, by main reason for current accommodation and state and territory, 2008–09
Main reason for current accommodation		Total	
	NSW	Vic	Qld	WA	SA	Tas	ACT	NT	No.	Per cent	
Service users in residential aged care											
Appropriate alternative accommodation unavailable	58	64	24	31	14	6	< 5	< 5	201	38.2	
Satisfied with current accommodation but needs additional services	29	11	81	< 5	7	< 5	—	< 5	136	25.9	
Satisfied with current accommodation and services	5	15	—	7	8	< 5	—	< 5	39	7.4	
Appropriate disability support services unavailable	< 5	29	< 5	< 5	—	—	< 5	< 5	37	7.0	
Waiting for YPIRAC services	—	13	6	5	10	—	—	—	34	6.5	
Principal carer unavailable	—	—	—	12	—	—	—	—	12	2.3	
Other reasons	< 5	< 5	< 10	< 5	5	—	—	—	14	2.7	
Not stated	46	< 5	—	—	—	—	< 5	< 5	53	10.1	
Total—residential aged care	141	136	119	63	44	< 17	7	< 5	526	100.0	
Service users in other types of accommodation											
Satisfied with current accommodation and services 	6	36	79	15	23	< 5	< 5	< 5	165	56.7	
Satisfied with current accommodation but needs additional services	< 5	17	6	< 5	7	< 5	—	—	37	12.7	
Appropriate alternative accommodation unavailable	< 5	8	5	7	5	—	< 5	—	30	10.3	
Waiting for YPIRAC services	< 5	< 5	5	—	12	—	—	< 5	22	7.6	
Appropriate disability support services unavailable	—	9	< 5	< 5	—	—	—	< 5	12	4.1	
Other reasons	—	< 5	< 10	< 5	8	—	—	—	17	5.8	
Not stated	2	—	—	3	—	—	1	2	8	2.7	
Total—all other accommodation types	14	74	104	29	55	< 5	7	< 5	291	100.0	
Total	155	210	223	92	99	17	14	7	817	. .	
. .	not applicable
Notes 
1.	Usual residential setting refers to the type of accommodation in which the person was living for 4 or more days per week on average, as at 30 June 2009 or on exit from the YPIRAC program.
2.	‘Other’ residential setting includes residence within an Aboriginal/Torres Strait Islander community; independent living within a retirement village; short-term crisis, emergency or transitional accommodation; and other settings.
3.	Other main reasons for current accommodation include declined accommodation offer, appropriate non-CSTDA services unavailable, cost of appropriate accommodation and support services, appropriate equipment and/or modifications unavailable, reason not elsewhere classified.
4.	A small number of service users (< 5) may receive services in more than one jurisdiction. These may be counted more than once in the table.

Table 2.9: YPIRAC service users, additional reasons for current accommodation, as at 30 June 2009
	Additional reasons for current accommodation	
Additional reasons for current accommodation	Number	Per cent	
Service users in residential aged care			
Appropriate disability support services unavailable	39	7.4	
Appropriate alternative accommodation unavailable	24	4.6	
Principal carer unavailable	24	4.6	
Waiting for YPIRAC services	16	3.0	
Satisfied with current accommodation but needs additional services	15	2.9	
Appropriate equipment and environmental modifications unavailable	15	2.9	
Cost of appropriate accommodation and support services	10	1.9	
Satisfied with current accommodation and services	5	1.0	
Other reasons	< 5	< 1.0	
Service users in other types of accommodation 			
Waiting for YPIRAC services	7	2.4	
Appropriate disability support services unavailable	6	2.1	
Principal carer unavailable	4	1.4	
Satisfied with current accommodation but needs additional services	< 5	< 1.7	
Appropriate equipment and environmental modifications unavailable	< 5	< 1.7	
Cost of appropriate accommodation and support services	< 5	< 1.7	
Notes 
1.	Usual residential setting refers to the type of accommodation in which the person lives for 4 or more days per week on average, as at 30 June 2009 or on exit from the YPIRAC program.
2.	Service users may nominate more than one additional reason for current accommodation. This item is optional and not all service users responded to this question.
3.	Other reasons include assessment not provided, appropriate non-CSTDA services not available.
4.	A small number of service users (< 5) may receive services in more than one jurisdiction. These may be counted more than once in the table.
2.3	Disability groups
The YPIRAC MDS collected information on each service user’s main, or primary, disability group, along with any ‘other significant’ disability groups. The primary disability group is the one that most clearly expresses the experience of disability by the person. It can be considered the disability group that causes the person the most difficulty in everyday life. Other significant disability groups are those that also cause difficulty for the person or express their experience of disability. Although only one primary disability group can be recorded in the MDS, multiple other significant disability groups can be recorded. 
Acquired brain injury was the primary disability group of almost half (47%) of all YPIRAC service users (Table 2.10). Around 29% had a primary disability of ‘neurological’ and 15% had a physical primary disability. These results were similar in both the under 50 and 50–64 years age groups, and were consistent with the primary disability profile of YPIRAC service users in 2007–08 (AIHW 2009b).
Table 2.10: YPIRAC service users, by primary disability group and age group, 2008–09
	Less than 50 years	50–64 years	Total	
Primary disability group	Number	Per cent	Number	Per cent	Number	Per cent	
Intellectual/autism 	45	7.4	20	9.6	65	8.0	
Physical	94	15.4	30	14.4	124	15.2	
Acquired brain injury	282	46.3	99	47.6	381	46.6	
Neurological	181	29.7	57	27.4	238	29.1	
Deafblind/vision	< 5	< 0.8	< 5	< 2.4	< 5	< 0.6	
Psychiatric	< 5	< 0.8	< 5	< 2.4	< 10	< 1.2	
Total service users	609	100.0	208	100.0	817	100.0	
Note: A small number of service users (< 5) may receive services in more than one jurisdiction. These may be counted more than once in the table.

Differences in primary disability group can be seen across different YPIRAC target groups (Table 2.11). More than half (56%) of service users who agreed to move from residential aged care accommodation (target group 1) had an acquired brain injury, and an additional one-quarter (23%) had a neurological primary disability. Service users who were to remain in or enter residential aged care were also most likely to have an acquired brain injury (42% of those in target group 3 and 48% of target group 4). Those who sought additional support services (group 3) were more likely than those who did not (group 4) to have a neurological primary disability (33% compared with 19%) and less likely to have an intellectual primary disability or autism (10% compared with 26%). However, the relatively small numbers of service users in target group 4 means that these data should be interpreted with caution.
Service users who were considered ‘at risk’ of inappropriate admission to residential aged care (target group 2) were most likely to have a neurological or acquired brain injury primary disability (37% and 36% respectively). An additional 22% of this target group had a physical primary disability.
When all reported disability groups are considered (both primary and other significant groups), service users had around two (1.93) disability groups on average (Table 2.12). This was higher than the broader population of disability service users in Australia: users of CSTDA-funded disability services had 1.7 disability groups on average in 2007–08. Around half (49%) of all YPIRAC service users had one disability group, and nearly one-quarter (24%) had two disability groups. More than 1 in 10 (10%) had four or more significant disability groups. Service users aged 25–29 years had the highest number of disability groups on average (2.39). 

Table 2.11: YPIRAC service users, by primary disability group and YPIRAC target group, 2008–09
	YPIRAC target group		
Primary disability group	Group 1	Group 2	Group 3	Group 4	Total	
	Number	
Intellectual/autism	27	7	24	7	65	
Physical	47	45	< 35	< 5	124	
Acquired brain injury	199	73	96	13	381	
Neurological	83	75	75	5	238	
Deafblind/vision	< 5	< 5	< 5	< 5	< 5	
Psychiatric	< 5	< 5	< 5	—	< 10	
Total service users	358	202	230	27	817	
	Per cent	
Intellectual/autism	7.5	3.5	10.4	25.9	8.0	
Physical	13.1	22.3	< 15.2	< 18.5	15.2	
Acquired brain injury	55.6	36.1	41.7	48.1	46.6	
Neurological	23.2	37.1	32.6	18.5	29.1	
Deafblind/vision	< 1.4	< 2.5	< 2.2	< 18.5	< 0.6	
Psychiatric	< 1.4	< 2.5	< 2.2	—	< 1.2	
Total service users	100.0	100.0	100.0	100.0	100.0	
Notes
1.	YPIRAC target groups: 
Group 1 Agreed to or has moved from residential aged care to alternative YPIRAC-funded accommodation and support
Group 2 Deemed ‘at risk’ of entry into residential aged care
Group 3 Remain in or enter residential aged care with additional disability support services
Group 4 Remain in or enter residential aged care without additional disability support services.
2.	A small number of service users (< 5) may receive services in more than one jurisdiction. These may be counted more than once in the table.

Taking into account all reported disability groups, around half (51%) of all service users had acquired brain injury and half (50%) had physical disability (Table A1.5). Two in 5 (41%) had neurological disability. 
Some disability groups were more likely to be reported as an other significant disability than as a primary disability. For example, ‘physical’ disability was a primary disability for 15% of service users, and an other significant disability for 35% of service users. There were no service users with ‘speech’ recorded as a primary disability, but 1 in 5 (20%) had speech as an other significant disability. While less than 1% of service users reported ‘vision’ or ‘psychiatric’ as their primary disability, both of these disabilities were recorded as other significant disabilities by around 8% of service users.

Table 2.12: YPIRAC service users, by age group and total number of disability groups, 2008–09
	Total number of disability groups		Average number of disability groups	
Age group 
(years)	1	2	3	4	5
or more	Total service users		
Less than 50 								
Less than 25	21	8	< 5	< 5	< 5	36	1.78	
25–29 	14	8	<10	< 10	< 5	36	2.39	
30–34	20	17	8	< 5	< 5	52	2.13	
35–39 	38	16	21	< 10	< 5	83	2.01	
40–44 	65	34	23	< 15	< 5	137	1.96	
45–49	129	64	47	< 25	< 5	265	1.90	
Total	287	147	108	49	18	609	1.97	
Per cent	47.1	24.1	17.7	8.0	3.0	100.0	. .	
50–64 								
50–54 	88	39	25	< 20	< 5	164	1.78	
55–64 	22	9	7	< 10	< 5	44	1.95	
Total	110	48	32	15	3	208	1.82	
Per cent	52.9	23.1	15.4	7.2	1.4	100.0	. .	
Total 	397	195	140	64	21	817	1.93	
Per cent	48.6	23.9	17.1	7.8	2.6	100.0	. .	
Notes
1.	‘Total number of disability groups’ includes primary disability group and other significant disability groups.
2.	A small number of service users (< 5) may receive services in more than one jurisdiction. These may be counted more than once in the table.
3	Service use
The YPIRAC MDS contains information on three broad categories of services provided under the YPIRAC program during 2008–09: 
•	YPIRAC assessment, individual care planning and client monitoring
•	alternative accommodation
•	support services packages.
For each service user, information was recorded about whether these services were offered to, accepted by or received by the service user during the collection period. Each service user received one or more of these categories of service during 2008–09. More information about the definitions of these categories is provided in Section 1.2 (see Box 1.1).
Service delivery processes vary across the state and territories. In New South Wales, potential clients may be assessed for eligibility but not receive further services under the YPIRAC program until there is sufficient capacity in the program to provide these services; these clients are not included in the MDS.
3.1	YPIRAC-specific services
Almost all service users (97%) received one or more of YPIRAC assessment, individual care planning and client monitoring services during 2008–09 (Table 3.1). Just under two-thirds (518; 63%) received a support services package, and 15% (124 service users) received alternative accommodation.
Support services packages were most commonly provided to service users in target groups 1, 2 and 3: more than half of all service users in each group received support services. Service users in target group 4 had chosen to enter or remain in residential aged care without additional services and, not surprisingly, few of these (fewer than 5) received support services. Those who did receive support services had changed from another target group during the reporting period (see Section 5.3 for more information on service users who changed target group). Service users who had moved or agreed to move from residential aged care (target group 1) were the most likely (73%) to receive a support services package during 2008–09. 
The 124 service users who were provided with alternative accommodation were in YPIRAC target groups 1 and 2. Similar proportions of each group received alternative accommodation under the YPIRAC program: 75 of 358 people (21%) who had agreed to move from residential aged care (target group 1), and 49 of 202 people (24%) who were considered at risk of inappropriate entry to residential aged care (group 2). Service users in target groups 3 and 4 had chosen to remain in residential aged care, and none of these received alternative accommodation.

Table 3.1: YPIRAC service users, by target group and YPIRAC-specific services received, 2008–09
YPIRAC target group	YPIRAC-specific services received		
	Assessment/
individual care planning/
client monitoring	Alternative accommodation	Support services package	All service users	
	Number	Per cent	Number	Per cent	Number	Per cent	Number	Per cent	
Group 1	352	98.3	75	20.9	261	72.9	358	100.0	
Group 2	188	93.1	49	24.3	136	67.3	202	100.0	
Group 3	227	98.7	. .	. .	< 120	< 52.2	230	100.0	
Group 4	27	100.0	. .	. .	< 5	< 18.5	27	100.0	
Total	794	97.2	124	15.2	518	63.4	817	100.0	
. .	not applicable
Notes
1.	Totals may not be the sum of components as service users may have accessed more than one service type during the period. 
2.	YPIRAC target groups: 
Group 1 Agreed to or has moved from residential aged care to alternative YPIRAC-funded accommodation and support
Group 2 Deemed ‘at risk’ of entry into residential aged care
Group 3 Remain in or enter residential aged care with additional disability support services
Group 4 Remain in or enter residential aged care without additional disability support services.
3.	Assessment processes in NSW differ from those in other jurisdictions. Initially, potential clients are assessed for eligibility and, if eligible, are only offered further services (including an assessment of support needs) when there is capacity to provide them. People who have only received an assessment for eligibility are excluded from the table. 
4.	NSW does not record client monitoring as a service.
5.	A small number of service users (< 5) may receive services in more than one jurisdiction. These may be counted more than once in the table.

Most service users in all states and territories received one or more of YPIRAC assessment, individual care planning and client monitoring, with the proportion in each jurisdiction ranging from 86% of those in the Northern Territory to all service users (100%) in Victoria, Queensland, South Australia and Tasmania (Table 3.2). 
Differences in the delivery of alternative accommodation and support services among states and territories may reflect differences in program targeting, as well as in the operational rules, timing and development of program delivery. The proportion of service users who received a support services package ranged from 37% in Queensland to all service users (100%) in New South Wales and Tasmania. The three states with the greatest increase in service user numbers during 2008–09—Queensland, Western Australia and South Australia—had the smallest proportions of service users who received a support services package. This may be in part due to the amount of time required to complete assessment and planning processes for new service users, and to locate or establish suitable support services.
The proportion of service users who received an alternative accommodation placement under the YPIRAC program ranged from zero in the Australian Capital Territory and the Northern Territory to 29% in Queensland. Overall, more than half (65 of 124; 52%) of those who received alternative accommodation during 2008–09 lived in Queensland. An additional 23% (29 service users) lived in Victoria. These states also had the largest number of YPIRAC service users overall.

Table 3.2: YPIRAC service users, by state and territory and YPIRAC-specific services received, 2008–09
	YPIRAC-specific services received		
State/territory	Assessment/ individual care planning/client monitoring	Alternative accommodation	Support services package	All service users	
	Number	Per cent	Number	Per cent	Number	Per cent	Number	Per cent	
New South Wales	146	94.2	< 5	< 3.2	155	100.0	155	100.0	
Victoria	210	100.0	29	13.8	161	76.7	210	100.0	
Queensland	223	100.0	65	29.1	82	36.8	223	100.0	
Western Australia	80	87.0	< 5	< 5.4	43	46.7	92	100.0	
South Australia	99	100.0	20	20.2	44	44.4	99	100.0	
Tasmania	17	100.0	< 5	< 29.4	17	100.0	17	100.0	
Australian Capital Territory	13	92.9	—	—	10	71.4	14	100.0	
Northern Territory	6	85.7	—	—	6	85.7	7	100.0	
Total	794	97.2	124	15.2	518	63.4	817	100.0	
Notes
1.	Totals may not be the sum of components as service users may have accessed more than one service type during the period. 
2.	Assessment processes in NSW differ from those in other jurisdictions. Initially, potential clients are assessed for eligibility, and if eligible, are only offered further services (including an assessment of support needs) when there is capacity to provide them. People who have only received an assessment for eligibility are excluded from the table. 
3.	NSW does not record client monitoring as a service.
4.	A small number of service users (< 5) may receive services in more than one jurisdiction. These may be counted more than once in the table.

‘Usual residential setting’ refers to the service user’s usual accommodation at the end of the reporting period (30 June 2009). An examination of usual residential setting provides information about where those who received alternative accommodation under the program were living, as at the end of the period. Of the 124 people who received an alternative accommodation placement during the period, 47 (38%) lived in private residences, 37 (30%) in a domestic-scale supported living facility and 35 (28%) in a supported accommodation facility (Table 3.3). 
When looking at differences across residential settings, service users in a domestic-scale supported living facility or a supported accommodation facility were the most likely to have received alternative accommodation during 2008–09 (73% and 70% respectively), along with one-third (34%) of those in private residences.
Service users living in a domestic-scale supported living facility, a private residence or a supported accommodation facility were the most likely to have received a support services package (92%, 85% and 80% respectively), while those in hospital were the least likely (22%). Over half (57%) of those in residential aged care received support services.

Table 3.3: YPIRAC service users, by residential setting and YPIRAC-specific services received, 2008–09
Usual residential setting	YPIRAC-specific services received	All service users	
	Assessment/ individual care planning/client monitoring	Alternative accommodation	Support services package		
	Number	Per cent	Number	Per cent	Number	Per cent	Number	Per cent	
Private residence	130	93.5	47	33.8	118	84.9	139	100.0	
Domestic-scale supported living facility	47	92.2	37	72.5	47	92.2	51	100.0	
Supported accom-modation facility	48	96.0	35	70.0	40	80.0	50	100.0	
Residential aged care	520	98.9	< 5	< 1.0	298	56.7	526	100.0	
Hospital	35	97.2	< 5	< 13.9	8	22.2	36	100.0	
Other	14	93.3	< 5	< 33.3	7	46.7	15	100.0	
Total	794	97.2	124	15.2	518	63.4	817	100.0	
Notes 
1.	Usual residential setting refers to the type of accommodation in which the person lives for 4 or more days per week on average, as at 30 June 2009 or on exit from the YPIRAC program.
2.	‘Other’ residential setting includes residence within an Aboriginal/Torres Strait Islander community; independent living within a retirement village; short-term crisis, emergency or transitional accommodation; and other settings.
3.	Assessment processes in NSW differ from those in other jurisdictions. Initially, potential clients are assessed for eligibility, and if eligible, are only offered further services (including an assessment of support needs) when there is capacity to provide them. People who have only received an assessment for eligibility are excluded from the table. 
4.	NSW does not record client monitoring as a service.
5.	Totals may not be the sum of components as service users may have accessed more than one service type during the period.
6.	A small number of service users (< 5) may receive services in more than one jurisdiction. These may be counted more than once in the table.

Service users could receive any combination of the three broad categories of services under the YPIRAC program during the reporting period. Around 37% of service users received only assessment, care planning and/or client monitoring services; more than half of these service users (169 of 299; 57%) received both assessment/care planning and client monitoring (Table 3.4). Just under half (46%) of all service users received one or more of YPIRAC assessment, care planning and/or client monitoring, along with a support services package. An additional 15% received all three broad categories of services.
There were substantial differences in the combinations of services delivered in the states and territories. The three states with large numbers of new service users in 2008–09 had the largest proportions of service users who received only assessment, care planning and/or client monitoring: 63% of service users in Queensland, 53% in Western Australia and 56% in South Australia. The proportion of service users who received assessment, care planning and/or client monitoring plus a support services package varied greatly across jurisdictions, from 8% in Queensland to 92% in New South Wales. Similarly, the proportion who received all three categories of services ranged from zero in Western Australia, the Australian Capital Territory and the Northern Territory to 29% of service users in Queensland.

Table 3.4: YPIRAC service users, by combinations of YPIRAC-specific services received and state and territory, 2008–09
YPIRAC-specific services received		Total	
	NSW	Vic	Qld	WA	SA	Tas	ACT	NT	No.	Per cent	
YPIRAC assessment and/or individual care planning and/or client monitoring only:	—	49	141	49	55	—	< 5	< 5	299	36.6	
YPIRAC assessment and/or individual care planning only	—	22	—	31	21	—	—	—	74	9.1	
YPIRAC client monitoring only	—	16	31	4	—	—	< 5	< 5	56	6.9	
YPIRAC assessment and/or individual care planning 
+ client monitoring	—	11	110	14	34	—	—	—	169	20.7	
Support services package only	< 10	—	—	< 10	—	—	< 5	< 5	< 20	< 2.4	
YPIRAC assessment and/or individual care planning and/or client monitoring:
+ support services package	142	132	17	31	24	15	9	5	375	45.9	
+ alternative accommodation + support services package	< 5	29	65	—	20	< 5	—	—	120	14.7	
Support services package and alternative accommodation	—	—	—	< 5	—	< 5	—	—	< 5	< 0.6	
Total service users	155	210	223	92	99	17	14	7	817	100.0	
Notes
1.	Assessment processes in NSW differ from those in other jurisdictions. Initially, potential clients are assessed for eligibility and, if eligible, are only offered further services (including an assessment of support needs) when there is capacity to provide them. People who have only received an assessment for eligibility are excluded from the table. 
2.	NSW does not record client monitoring as a service.
3.	A small number of service users (< 5) may receive services in more than one jurisdiction. These may be counted more than once in the table.

The number and proportions of service users who were offered, accepted and received each of the three broad categories of YPIRAC-specific services during 2008–09 are shown in tables 3.5, 3.6 and 3.7. These tables represent the progress of service users through the stages of the YPIRAC program. Some of those who accepted or received services during 2008–09 may have been offered or accepted those services during an earlier collection period. In these cases, the earlier offers and acceptances are included in the ‘offered’ and ‘received’ counts in tables 3.5, 3.6 and 3.7. 
Only YPIRAC service users are counted in these tables. People who had not received at least one of the three broad categories of services during the period are not included; for example, new service users who may have been offered or accepted assessment and planning, but who had not yet received these services. See sections 1.2 and 1.3 for further information on the scope of the MDS.
Almost all of the 817 service users were offered (98%), accepted (97%) and received (97%) YPIRAC assessment, care planning and/or monitoring during 2008–09 (Table 3.5). Proportions were similar among states and territories.

Table 3.5: YPIRAC service users, by state and territory, and status of assessment, care planning and/or client monitoring, 2008–09
	Assessment and/or individual care planning 
and/or client monitoring	All service users	
	Offered	Accepted	Received		
State/territory	Number	Per cent	Number	Per cent	Number	Per cent	Number	Per cent	
New South Wales	149	96.1	147	94.8	146	94.2	155	100.0	
Victoria	210	100.0	210	100.0	210	100.0	210	100.0	
Queensland	223	100.0	223	100.0	223	100.0	223	100.0	
Western Australia	80	87.0	80	87.0	80	87.0	92	100.0	
South Australia	99	100.0	99	100.0	99	100.0	99	100.0	
Tasmania	17	100.0	17	100.0	17	100.0	17	100.0	
Australian Capital Territory	13	92.9	13	92.9	13	92.9	14	100.0	
Northern Territory	7	100.0	7	100.0	6	85.7	7	100.0	
Total	798	97.7	796	97.4	794	97.2	817	100.0	
Notes
1.	‘Offered’ includes service users who were offered, accepted and/or received services. ‘Accepted’ includes service users who accepted and/or received services.
2.	Assessment processes in NSW differ from those in other jurisdictions. Initially, potential clients are assessed for eligibility, and if eligible, are only offered further services (including an assessment of support needs) when there is capacity to provide them. People who have only received an assessment for eligibility are excluded from the table. 
3.	NSW does not record client monitoring as a service.
4.	A small number of service users (< 5) may receive services in more than one jurisdiction. These may be counted more than once in the table.

Almost 3 in 10 service users (234 of 817; 29%) had been offered alternative accommodation by 2008–09 (Table 3.6). The proportions of service users who were offered alternative accommodation were highest in Tasmania (82%), South Australia (43%) and Western Australia (42%), and lowest in New South Wales (7%).
Of those service users in 2008–09 who had been offered alternative accommodation, most (198 of 234; 85%) had accepted the offer and over half (124; 53%) received alternative accommodation during the period. 

Table 3.6: YPIRAC service users, by state and territory and status of alternative accommodation offer, 2008–09
	Alternative accommodation		
	Offered	Accepted	Received	All service users	
State/territory	Number	Per cent	Number	Per cent	Number	Per cent	Number	Per cent	
New South Wales	11	7.1	5	3.2	< 5	< 3.2	155	100.0	
Victoria	44	21.0	43	20.5	29	13.8	210	100.0	
Queensland	78	35.0	65	29.1	65	29.1	223	100.0	
Western Australia	39	42.4	31	33.7	< 5	< 5.4	92	100.0	
South Australia	43	43.4	43	43.4	20	20.2	99	100.0	
Tasmania	14	82.4	8	47.1	< 5	< 29.4	17	100.0	
Australian Capital Territory	< 5	< 35.7	< 5	< 35.7	—	—	14	100.0	
Northern Territory	< 5	< 71.4	< 5	< 71.4	—	—	7	100.0	
Total	234	28.6	198	24.2	124	15.2	817	100.0	
Notes
1.	‘Offered’ includes service users who were offered, accepted and/or received services. ‘Accepted’ includes service users who accepted and/or received services.
2.	A small number of service users (< 5) may receive services in more than one jurisdiction. These may be counted more than once in the table.

Around 7 in 10 service users (70%) had been offered a support services package by the end of the reporting period (Table 3.7). The proportion of service users who were offered support services ranged from less than half (44%) in Queensland to all service users (100%) in New South Wales and Tasmania. In all jurisdictions, most service users in 2008–09 who had been offered support services had accepted the offer (nationally, 548 of 568; 96%) and received services (518; 91%) during the period.
Table 3.7: YPIRAC service users, by state and territory and status of support services package offer, 2008–09
	Support services package	All service users	
	Offered	Accepted	Received		
State/territory	Number	Per cent	Number	Per cent	Number	Per cent	Number	Per cent	
New South Wales	155	100.0	155	100.0	155	100.0	155	100.0	
Victoria	164	78.1	163	77.6	161	76.7	210	100.0	
Queensland	99	44.4	85	38.1	82	36.8	223	100.0	
Western Australia	66	71.7	62	67.4	43	46.7	92	100.0	
South Australia	50	50.5	49	49.5	44	44.4	99	100.0	
Tasmania	17	100.0	17	100.0	17	100.0	17	100.0	
Australian Capital Territory	11	78.6	11	78.6	10	71.4	14	100.0	
Northern Territory	6	85.7	6	85.7	6	85.7	7	100.0	
Total	568	69.5	548	67.1	518	63.4	817	100.0	
Notes
1.	‘Offered’ includes service users who were offered, accepted and/or received services. ‘Accepted’ includes service users who accepted and/or received services.
2.	A small number of service users (< 5) may receive services in more than one jurisdiction. These may be counted more than once in the table.

Of the 518 service users who received a support services package, more than half (58%) lived in a residential aged care facility at the end of the reporting period (Table 3.8). Around 23% lived in private residences. There were differences across jurisdictions; for example, most (91%) service users in New South Wales who received a support services package lived in residential aged care, compared with less than 6% of service users in Queensland.
Of the 299 service users who did not receive a support services package, around three-quarters (76%) lived in residential aged care.
Table 3.8: YPIRAC service users, by receipt of a support services package, usual residential setting and state and territory, 2008–09
	Total	
Residential setting	NSW	Vic	Qld	WA	SA	Tas	ACT	NT	No.	Per cent	
Received a support package	
Residential aged care	141	102	< 5	20	14	< 15	< 5	< 5	298	57.5	
Private residence	< 5	29	55	14	10	< 5	< 5	< 5	118	22.8	
Other residential setting	< 15	30	< 30	9	20	< 5	< 5	< 5	102	19.7	
Total	155	161	82	43	44	17	< 14	< 7	518	100.0	
Did not receive support package	
Residential aged care	—	34	118	43	30	—	< 5	< 5	228	76.3	
Private residence	—	< 5	6	< 5	9	—	< 5	—	21	7.0	
Other residential setting	—	< 15	17	< 5	16	—	–	< 5	50	16.7	
Total	—	49	141	49	55	—	< 5	< 5	299	100.0	
Total service users	155	210	223	92	99	17	14	7	817	100.0	
Notes
1.	Usual residential setting refers to the type of accommodation in which the person was living for 4 or more days per week on average, as at 30 June 2009 or on exit from the YPIRAC program.
2.	‘Other’ residential setting includes domestic-scale supported living facilities; supported accommodation facilities; hospital; residence within an Aboriginal/Torres Strait Islander community; independent living within a retirement village; short-term crisis, emergency or transitional accommodation; and other settings.
3.	A small number of service users (< 5) may receive services in more than one jurisdiction. These may be counted more than once in the table.
3.2	Support services
The three broad categories of services provided under the YPIRAC program, described in Section 3.1, can be further broken down into five service groups—accommodation support, community support, community access, respite and other services. Each of these service groups consists of between three and nine different service types. Service users may receive any combination or number of different service types. For more information and definitions for the service group and service type classification, see Section 1.2 (Box 1.2) and Appendix 3.
During 2008–09, almost all service users (802; 98%) received one or more services from the ‘other services’ category (Table 3.9). Most received YPIRAC assessment and/or individual care planning (594; 73%)  and client monitoring (696 service users; 85%). Two in 5 service users (42%) received one or more YPIRAC-specific service types, including assistive products and technology, modifications to buildings, transport services and services provided by nurses.
Around 34% of service users received community access services, 33% received community support services and 32% received accommodation support services. A small number (30 service users; 4%) received respite services under the program.
Table 3.9: YPIRAC service users, by service groups received, 2008–09
Service group	Number	Per cent of all service users	
Accommodation support	257	31.5	
Community support	271	33.2	
Community access	275	33.7	
Respite	30	3.7	
Other services	802	98.2	
YPIRAC assessment and/or individual care planning	594	72.7	
YPIRAC client monitoring	696	85.2	
YPIRAC-specific service types	342	41.9	
Advocacy and information	43	5.3	
Research and evaluation	18	2.2	
Other support services	24	2.9	
Total	817	100.0	
Notes
1.	Totals may not be the sum of components as service users may have accessed more than one service type during the period. 
2.	‘YPIRAC-specific service types’ includes 8.01 Assistive products and technology, 8.02 Modification to design or construction of buildings, 8.03 Transportation services and 8.04 Services provided by nurses. ‘Advocacy and information’ refers to 6 Advocacy, information, referral, mutual support/self help groups, alternative communication formats. ‘Research and evaluation’ refers to 7 Research, evaluation, training and development, peak bodies.
3.	Assessment processes in NSW differ from those in other jurisdictions. Initially, potential clients are assessed for eligibility, and if eligible, are only offered further services (including an assessment of support needs) when there is capacity to provide them. People who have only received an assessment for eligibility are excluded from the table. 
4.	In NSW, attendant care/personal care services and respite services are not funded under the YPIRAC program and are provided by other areas within the Department of Human Services. Client monitoring is not recorded as a service. 
5.	Respite services are not funded in South Australia under the YPIRAC program. Respite needs are addressed via other areas within Disability SA.
6.	A small number of service users (< 5) may receive services in more than one jurisdiction. These may be counted more than once in the table.

Service groups are further broken down into the complete set of service types in Table 3.10, and selected service types are given by state and territory in Table 3.11. Aside from YPIRAC assessment/care planning and client monitoring, the most commonly received service types were assistive products and technology (31% of service users), therapy support for individuals (24%), transportation services (21%) and ‘other community access’ services (21%).
Other service types that were provided to large numbers of service users during 2008–09 were attendant care/personal care (15% of service users), in-home accommodation support (15%), recreation/holiday programs (15%) and case management, local co-ordination and development (14%).
Differences in service type provision across jurisdictions can be seen in Table 3.11, particularly among the larger states. Apart from YPIRAC assessment/care planning and client monitoring, service users in New South Wales most commonly accessed assistive products and technology (79% of service users) and therapy support (48%). Service users in Victoria most commonly accessed other support services (42%) and attendant care/personal care (39%), while those in Queensland accessed assistive products and technology (28%) and in-home accommodation support (28%).
Table 3.10: YPIRAC service users, by service types received, 2008–09
Service type	Number	Per cent of all service users	
Accommodation support			
Large residential/institutions	13	1.6	
Small residential/institutions	30	3.7	
Hostels	5	0.6	
Group homes	51	6.2	
Attendant care/personal care	121	14.8	
In-home accommodation support	120	14.7	
Alternative family placement	< 5	< 0.6	
Other accommodation support	7	0.9	
Total accommodation support	257	31.5	
Community support			
Therapy support for individuals	197	24.1	
Behaviour/specialist intervention	22	2.7	
Counselling 	13	1.6	
Regional resource and support teams	—	—	
Case management, local coordination and development	117	14.3	
Other community support	27	3.3	
Total community support 	271	33.2	
Community access			
Learning and life skills development	64	7.8	
Recreation/holiday programs	119	14.6	
Other community access	172	21.1	
Total community access 	275	33.7	
Respite			
Own home respite	18	2.2	
Centre-based respite/respite homes	6	0.7	
Host family respite/peer support respite	—	—	
Flexible respite	6	0.7	
Other respite	< 5	< 0.6	
Total respite services 	30	3.7	
(continued)		

Table 3.10 (continued): YPIRAC service users by service types received, 2008–09
Service type	Number	Per cent of all service users	
Other specified services			
Advocacy, information, referral, mutual support/self help groups, alternative communication formats	43	5.3	
Research, evaluation, training and development, peak bodies	18	2.2	
Assistive products and technology	253	31.0	
Modification to design or construction of buildings	27	3.3	
Transportation services	171	20.9	
Services provided by nurses	49	6.0	
YPIRAC assessment and/or individual care planning	594	72.7	
YPIRAC client monitoring	696	85.2	
Other support services	24	2.9	
Total other services	802	98.2	
Total	817	100.0	
Notes 
1.	Totals may not be the sum of components as service users may have accessed more than one service type during the period.
2.	Assessment processes in NSW differ from those in other jurisdictions. Initially, potential clients are assessed for eligibility, and if eligible, are only offered further services (including an assessment of support needs) when there is capacity to provide them. People who have only received an assessment for eligibility are excluded from the table. 
3.	In NSW, attendant care/personal care services and respite services are not funded under the YPIRAC program and are provided by other areas within the Department of Human Services. Client monitoring is not recorded as a service. 
4.	Respite services are not funded in South Australia under the YPIRAC program. Respite needs are addressed via other areas within Disability SA.
5.	A small number of service users (< 5) may receive services in more than one jurisdiction. These may be counted more than once in the table.

Table 3.11: YPIRAC service users, by selected service types received and state and territory, 2008–09
		Total	
Selected service type	NSW	Vic	Qld	WA	SA	Tas	ACT	NT	No.	Per cent 	
Accommodation support	
Attendant care/personal care	—	81	34	< 5	—	—	< 5	< 5	121	14.8	
In-home accommodation support	< 5	26	62	15	10	< 5	—	< 5	120	14.7	
All other accommodation support	12	33	30	< 5	23	< 5	< 5	—	105	12.9	
Total accommodation support	14	98	82	20	31	5	< 10	< 5	257	31.5	
Community support	
Therapy support for individuals	74	68	48	—	—	< 10	< 5	—	197	24.1	
Other community support services	17	55	50	8	< 5	< 5	< 5	< 5	140	17.1	
Total community support	84	98	66	8	< 5	6	< 5	< 5	271	33.2	
Community access	
Total community access	90	96	29	21	15	13	< 10	< 5	275	33.7	
Respite	
Total respite services	< 5	10	17	—	—	—	< 5	—	30	3.7	
Other specified services	
Assistive products and technology	122	49	63	12	< 5	< 5	< 5	—	253	31.0	
Services by nurses	—	5	44	—	—	—	—	—	49	6.0	
YPIRAC assessment and/or individual care planning	146	140	123	71	99	6	< 10	< 5	594	72.7	
YPIRAC client monitoring	146	171	223	47	77	13	13	6	696	85.2	
All other support services	64	88	39	10	< 10	9	7	< 5	224	27.4	
Total other services	151	210	223	82	99	17	14	6	802	98.2	
Total	155	210	223	92	99	17	14	7	817	100.0	
Notes
1.	Totals may not be the sum of components as service users may have accessed more than one service type during the period.
2.	Assessment processes in NSW differ from those in other jurisdictions. Initially, potential clients are assessed for eligibility, and if eligible, are only offered further services (including an assessment of support needs) when there is capacity to provide them. People who have only received an assessment for eligibility are excluded from the table. 
3.	In NSW, attendant care/personal care services and respite services are not funded under the YPIRAC program and are provided by other areas within the Department of Human Services. Client monitoring is not recorded as a service. 
4.	Respite services are not funded in South Australia under the YPIRAC program. Respite needs are addressed via other areas within Disability SA.
5.	A small number of service users (< 5) may receive services in more than one jurisdiction. These may be counted more than once in the table.
4	New service users and service users exiting the YPIRAC program
This chapter examines the characteristics of service users who entered or exited the YPIRAC program during 2008–09. 
For the analyses in this chapter, the SLK was used to identify people who used YPIRAC-funded services during the 3 years of the program’s operation. More information on the SLK is provided in Appendix 6.
4.1	New and continuing service users 
People who accessed services under the YPIRAC program can be classified as ‘new’ or ‘continuing’ service users. New service users were those who first received services during the 2008–09 reporting period. Continuing service users were those who had also received services during an earlier period—2006–07, 2007–08—or in all 3 years. 
The 2008–09 period was the third year of the 5-year YPIRAC program, and there were some differences in the characteristics of service users entering the program compared with those who were continuing in the program. This may reflect the growth and progress of the program. Differences among states and territories also highlight differences in program targeting and development.
Overall, around 2 in 5 (40%; 328) service users first received YPIRAC-funded services during 2008–09 (Table 4.1). The proportion of new service users varied among the states and territories, ranging from around one-quarter in New South Wales (23%) and Victoria (26%) to more than half in Western Australia (59%), Queensland (55%) and South Australia (54%).
Characteristics
Table 4.1: New and continuing YPIRAC service users, by state and territory, 2008–09
New or continuing	NSW	Vic	Qld	WA	SA	Tas	ACT	NT	Total	
	Number		
Continuing	120	155	101	38	46	11	< 14	< 7	489	
New	35	55	122	54	53	6	< 5	< 5	328	
Total	155	210	223	92	99	17	14	7	817	
	Per cent		
Continuing	77.4	73.8	45.3	41.3	46.5	64.7	< 100.0	< 100.0	59.9	
New	22.6	26.2	54.7	58.7	53.5	35.3	< 35.7	< 71.4	40.1	
Total	100.0	100.0	100.0	100.0	100.0	100.0	100.0	100.0	100.0	
Note: A small number of service users (< 5) may receive services in more than one jurisdiction. These may be counted more than once in the table.

New service users were less likely than continuing service users to be in YPIRAC target group 1—that is, to have agreed to move from residential aged care to an alternative accommodation setting (31% compared with 52%) (Table 4.2). They were more likely than continuing service users to remain in or enter residential aged care with additional support services (35% compared with 23%; target group 3). New service users were also slightly more likely to be considered at risk of inappropriate entry to residential aged care (27% compared with 23%; target group 2). Service users in previous reporting periods who elected to remain in or enter residential aged care without additional services (target group 4) generally did not receive services under the YPIRAC program in 2008–09. Continuing service users in this target group in 2008–09 had changed from other target groups or received new assessments or client monitoring. It is therefore not surprising that new service users were more likely to be in target group 4 than continuing service users (6% compared with 1%).
There was no difference between new and continuing service users in the proportion of service users who were aged under 50 years. Around three-quarters of both new (74%) and continuing (75%) service users were aged less than 50 years.
Table 4.2: New and continuing YPIRAC service users, by age group and target group, 2008–09
Age group	YPIRAC target group		
	Group 1	Group 2	Group 3	Group 4	Total	
Continuing service users	
Less than 50 years	198	88	< 80	< 7	366	
50–64 years	57	25	< 40	< 5	123	
Total continuing service users	255	113	114	7	489	
Total continuing service users (%)	52.1	23.1	23.3	1.4	100.0	
New service users	
Less than 50 years	75	83	69	16	243	
50–64 years	28	6	47	4	85	
Total new service users	103	89	116	20	328	
Total new service users (%)	31.4	27.1	35.4	6.1	100.0	
All service users	358	202	230	27	817	
All service users (%)	43.8	24.7	28.2	3.3	100.0	
Notes 
1.	YPIRAC target groups: 
	Group 1 Agreed to or has moved from residential aged care to alternative YPIRAC-funded accommodation and support
	Group 2 Deemed ‘at risk’ of entry into residential aged care
	Group 3 Remain in or enter residential aged care with additional disability support services
	Group 4 Remain in or enter residential aged care without additional disability support services.
2.	A small number of service users (< 5) may receive services in more than one jurisdiction. These may be counted more than once in the table.

There was a higher proportion of Aboriginal and Torres Strait Islander people among new users (15%) than among continuing users (7%) (Table 4.3). Of the 48 new Aboriginal and Torres Strait Islander service users, more than half (29 people; 60%) were from Western Australia and 23% (11) from Queensland.

Table 4.3: New and continuing YPIRAC service users, by Indigenous status and state and territory,
2008–09
Indigenous status		Total	
	NSW	Vic	Qld	WA	SA	Tas	ACT	NT	No.	Per cent	
Continuing service users	
Indigenous	< 5	—	10	8	8	—	< 5	< 7	36	7.4	
Non-Indigenous	< 120	155	91	30	38	11	< 14	—	453	92.6	
Total—continuing	120	155	101	38	46	11	< 14	< 7	489	100.0	
New service users	
Indigenous	< 5	< 5	11	29	5	—	—	—	48	14.6	
Non-Indigenous	< 35	< 55	111	25	48	6	< 5	< 5	280	85.4	
Total—new	35	55	122	54	53	6	< 5	< 5	328	100.0	
All service users	
Indigenous	5	< 5	21	37	13	—	< 5	< 7	84	10.3	
Non-Indigenous	150	< 210	202	55	86	17	< 14	< 5	733	89.7	
Total	155	210	223	92	99	17	14	7	817	100.0	
Note: A small number of service users (< 5) may receive services in more than one jurisdiction. These may be counted more than once in the table.

There were similar proportions of new and continuing service users with each primary disability group (Table 4.4). New service users were slightly less likely than continuing service users to have a primary disability group of acquired brain injury (44% compared with 48%) or physical disability (14% compared with 16%) and more likely to have a primary disability group of intellectual disability or autism (10% compared with 6%).
Table 4.4: New and continuing YPIRAC service users, by primary disability group, 2008–09
Primary disability group	Continuing service users	New service users	All service users	
	Number	Per cent	Number	Per cent	Number	Per cent	
Intellectual/autism	31	6.3	34	10.4	65	8.0	
Physical	79	16.2	45	13.7	124	15.2	
Acquired brain injury	236	48.3	145	44.2	381	46.6	
Neurological	139	28.4	99	30.2	238	29.1	
Deafblind/vision	< 5	< 1.0	< 5	< 1.5	< 5	< 0.6	
Psychiatric	< 5	< 1.0	< 5	< 1.5	< 10	< 1.2	
Total 	489	100.0	328	100.0	817	100.0	
Note: A small number of service users (< 5) may receive services in more than one jurisdiction. These may be counted more than once in the table.

At the end of the reporting period on 30 June 2009, new service users were more likely than continuing service users to live in residential aged care (67% compared with 62%) or hospital (7% compared with 3%) (Table 4.5). Continuing service users were more likely to live in a private residence (19% compared with 14%), domestic-scale supported living facility (8% compared with 4%) or supported accommodation (7% compared with 5%). This reflects differences in target groups and the provision of YPIRAC-funded accommodation and services between new and continuing service users.
Table 4.5: New and continuing YPIRAC service users by usual residential setting, 2008–09 
Usual residential setting	Continuing service users	New service users	All service users	
	Number	Per cent	Number	Per cent	Number	Per cent	
Residential aged care	305	62.4	221	67.4	526	64.4	
Private residence	93	19.0	46	14.0	139	17.0	
Domestic-scale supported living facility	38	7.8	13	4.0	51	6.2	
Supported accommodation	34	7.0	15	4.6	49	6.0	
Hospital	12	2.5	24	7.3	36	4.4	
Other	7	1.4	9	2.7	16	2.0	
Total 	489	100.0	328	100.0	817	100.0	
Notes 
1.	Usual residential setting refers to the type of accommodation in which the person lives for 4 or more days per week on average, as at 30 June 2009 or on exit from the YPIRAC program.
2.	‘Other’ residential setting includes residence within an Aboriginal/Torres Strait Islander community; independent living within a retirement village; short-term crisis, emergency or transitional accommodation; and other settings.
3.	A small number of service users (< 5) may receive services in more than one jurisdiction. These may be counted more than once in the table.
Services used
While almost all service users received one or more of YPIRAC assessment, individual care planning and client monitoring, there were differences in the proportions of new and continuing service users who received alternative accommodation and support service packages (Table 4.6). Considerable time may be required to complete assessment and planning processes and to organise or develop appropriate services and accommodation for new service users, so it is not surprising that continuing service users were much more likely than new service users to receive both accommodation (21% compared with 7%) and support services (85% compared with 32%).

Table 4.6: New and continuing YPIRAC service users, by YPIRAC–specific services received,
2008–09
YPIRAC-specific services received	Continuing service users	New service users	All service users	
	Number	Per cent	Number	Per cent	Number	Per cent	
Assessment/individual care planning/client monitoring	471	96.3	323	98.5	794	97.2	
Alternative accommodation	101	20.7	23	7.0	124	15.2	
Support service package	414	84.7	104	31.7	518	63.4	
Total YPIRAC service users	489	100.0	328	100.0	817	100.0	
Notes
1.	A small number of service users (< 5) may receive services in more than one jurisdiction. These may be counted more than once in the table.
2.	Assessment processes in NSW differ from those in other jurisdictions. Initially, potential clients are assessed for eligibility, and if eligible, are only offered further services (including an assessment of support needs) when there is capacity to provide them. People who have only received an assessment for eligibility are excluded from the table. 
3.	NSW does not record client monitoring as a service.

These three broad categories of service can be further broken down into five service groups, each consisting of between three and nine different service types (see Section 1.2 and Appendix 3). Selected service groups and service types are shown in Table 4.7 for new and continuing service users.
Again, new service users were less likely to receive services other than assessment or individual care planning. New service users were less likely than continuing service users to receive accommodation support (16% compared with 42%), community support (14% compared with 46%), community access (13% compared with 47%) and respite (2% compared with 5%). In terms of the ‘other services’ group, new service users were much more likely to receive YPIRAC assessment and/or individual care planning (95% compared with 58%), and less likely to receive YPIRAC-specific service types including assistive products and technology, modifications to buildings, transportation services and services provided by nurses (19% compared with 57%) and client monitoring (75% compared with 92%).

Table 4.7: New and continuing YPIRAC service users, by services received, 2008–09
	Continuing service users	New service users	All service users	
Service group	Number	Per cent 	Number	Per cent	Number	Per cent	
Accommodation support	205	41.9	52	15.9	257	31.5	
Community support	226	46.2	45	13.7	271	33.2	
Community access	232	47.4	43	13.1	275	33.7	
Respite	25	5.1	5	1.5	30	3.7	
Other services	478	97.8	324	98.8	802	98.2	
Advocacy and information	38	7.8	5	1.5	43	5.3	
Research and evaluation	18	3.7	—	—	18	2.2	
YPIRAC-specific service types	279	57.1	63	19.2	342	41.9	
YPIRAC assessment and/or individual care planning	284	58.1	310	94.5	594	72.7	
YPIRAC client monitoring	451	92.2	245	74.7	696	85.2	
Other support services	22	4.5	< 5	< 1.5	24	2.9	
Total	489	100.0	328	100.0	817	100.0	
Notes
1.	Totals may not be the sum of components as service users may have accessed more than one service type during the period. 
2.	‘YPIRAC-specific service types’ include: 8.01 Assistive products and technology, 8.02 Modification to design or construction of buildings, 8.03 Transportation services and 8.04 Services provided by nurses. ‘Advocacy and information’ refers to 6 Advocacy, information, referral, mutual support/self-help groups, alternative communication formats. ‘Research and evaluation’ refers to 7 Research, evaluation, training and development, peak bodies.
3.	Assessment processes in NSW differ from those in other jurisdictions. Initially, potential clients are assessed for eligibility, and if eligible, are only offered further services (including an assessment of support needs) when there is capacity to provide them. People who have only received an assessment for eligibility are excluded from the table. 
4.	In NSW, attendant care/personal care services are not offered and respite services are not funded under the YPIRAC program. Client monitoring is not recorded as a service.
5.	Respite services are not funded in South Australia under the YPIRAC program. Respite needs are addressed via other areas within Disability SA.
6.	A small number of service users (< 5) may receive services in more than one jurisdiction. These may be counted more than once in the table.
Residential setting and provision of alternative accommodation
Of the 124 service users who received alternative accommodation during 2008–09, around 
3 in 5 (75 people; 60%) were in target group 1 (agreed to move out of residential aged care) and the remainder were in target group 2 (at risk of entry to residential aged care) (Table 4.8). Within each target group, most of those who received alternative accommodation were continuing service users—85% (64 of 75) of target group 1, and 76% (37 of 49) of target group 2.
‛Usual residential setting’ refers to the type of accommodation in which the person was living at the end of the reporting period or, for users who exited the program during the reporting period, the accommodation in which they were living on their date of exit.
Those service users who had received alternative accommodation were most likely to have a usual residential setting of private residence (38%), followed by domestic-scale supported accommodation (30%) and supported accommodation (28%). This pattern was evident for service users in both target groups.
Table 4.8: New and continuing YPIRAC service users who received alternative accommodation, by usual residential setting and target group, 2008–09
Usual residential setting	Target group 1
Target group 2	Target group 2	Total	
	Continuing	New	Total	Continuing	New	Total		
Private residence	25	4	29	13	5	18	47	
Domestic-scale supported living facility	21	3	24	8	5	13	37	
Supported accommodation	< 20	< 5	< 20	< 20	< 5	< 20	35	
Other	< 5	< 5	< 5	< 5	< 5	< 5	5	
Total	64	11	75	37	12	49	124	
Notes 
1.	Usual residential setting refers to the type of accommodation in which the person lives for 4 or more days per week on average, as at 30 June 2009 or on exit from the YPIRAC program.
2.	‘Other’ residential setting includes residential aged care; hospital; residence within an Aboriginal/Torres Strait Islander community; independent living within a retirement village; short-term crisis, emergency or transitional accommodation; and other settings.
3.	YPIRAC target groups: 
Group 1 Agreed to or has moved from residential aged care to alternative YPIRAC-funded accommodation and support
Group 2 Deemed ‘at risk’ of entry into residential aged care.
4.	A small number of service users (< 5) may receive services in more than one jurisdiction. These may be counted more than once in the table.

Factors other than the receipt of YPIRAC-funded alternative accommodation may affect where service users usually reside, such as changing health and family circumstances, the receipt of a support services package and the availability of other services. Overall, of the 410 service users living in residential aged care at the end of the 2007–08 reporting period, 296 (72%) remained in residential aged care at the end of the 2008–09 reporting period, 32 (8%) had moved to other residential settings, and 82 (20%) did not receive YPIRAC services during 2008–09 (Figure 4.1). New service users accounted for 46% of all service users in residential aged care by 30 June 2009 (221 service users).
Of the 182 service users living in other residential settings at the end of 2007–08, 152 (84%) remained in other settings, 9 (5%) had moved to residential aged care and 21 (12%) did not receive YPIRAC services during 2008–09. New service users accounted for 41% of all service users in other residential settings by 30 June 2009.

Figure 4.1: YPIRAC service users, by usual residential setting, 2007–08 to 2008–09 
Flow chart diagram
Note: Continuing service users at 30 June 2008 includes 13 service users who received services in 2006–07 and 2008–09, but not 2007–08.
See Section 1.3 for more information.
Source: AIHW analysis of YPIRAC MDS for 2006–07, 2007–08 and 2008–09.
4.2	Service users who exited the program in 
2008–09
Information about service users’ exits from the YPIRAC program was collected for the first time in the 2008–09 reporting period. For those who left the program during the period, the date at which they left and their main reason for leaving the program were collected.
Overall, of the 817 service users, 69 or 8% left the program during the reporting period (Table 4.9). South Australia had the highest proportion of exits, with around one-quarter (24%) of service users leaving the program during the period; the proportion of exits in most jurisdictions ranged from zero in the Northern Territory to around 10% in Western Australia. The numbers for Tasmania and the Australian Capital Territory are too small to report without compromising service users’ confidentiality.

Table 4.9: Service users who exited the YPIRAC program during 2008–09, by state and territory
State/territory	Service users who exited the program in 2008–09	Total service users	
	Number	Per cent	Number	Per cent	
New South Wales	4	2.6	155	100.0	
Victoria	15	7.1	210	100.0	
Queensland	13	5.8	223	100.0	
Western Australia	9	9.8	92	100.0	
South Australia	24	24.2	99	100.0	
Tasmania	< 5	< 29.4	17	100.0	
Australian Capital Territory	< 5	< 35.7	14	100.0	
Northern Territory	—	— 	7	100.0	
Total	69	8.4	817	100.0	
Note: A small number of service users (< 5) may receive services in more than one jurisdiction. These may be counted more than once in the table.

Around three-quarters (75%) of service users who left the program were aged under 50 years (Table 4.10); this was equivalent to the proportion of all service users who were aged under 50 (75%; Table 2.1). About half (52%) of those in the under 50 years age group who left the program lived in residential aged care, compared with 82% of those aged 50–64 years.
Table 4.10: Service users who exited the YPIRAC program during 2008–09, by usual residential setting and age group
Usual residential setting	Less than 50 years	50–64 years	Total	
	Number	Per cent	Number	Per cent	Number	Per cent	
Residential aged care	27	51.9	14	82.4	41	59.4	
Private residence	< 13	< 25.0	< 5	< 29.4	13	18.8	
Other	< 15	< 28.8	< 5	< 29.4	15	21.7	
Total	52	100.0	17	100.0	69	100.0	
Notes 
1.	Usual residential setting refers to the type of accommodation in which the person was living for 4 or more days per week on average, as at 30 June 2009 or on exit from the YPIRAC program.
2.	‘Other’ residential setting includes supported accommodation facility; domestic-scale supported living facility; hospital; residence within an Aboriginal/Torres Strait Islander community; independent living within a retirement village; short-term crisis, emergency or transitional accommodation; and other settings.
3.	A small number of service users (< 5) may receive services in more than one jurisdiction. These may be counted more than once in the table.

The most common reason for service users exiting the YPIRAC program during 2008–09 was that the service user had died (61% of exits; Table 4.11). This was the case for 88% of service users aged 50–64 years who left the program, compared with 52% of those under 50 years. One-quarter (25%) of those aged under 50 years who exited were no longer eligible for the program. Just seven people (10%) elected to withdraw from the program during the period.

Table 4.11: Service users who exited the YPIRAC program during 2008–09, by main reason for cessation of services and age group
Main reason for cessation of services	Less than 50 years	50–64 years	Total	
	Number	Per cent	Number	Per cent	Number	Per cent	
Service user withdrew from program	< 7	< 13.5	< 5	< 29.4	7	10.1	
Service user died	27	51.9	15	88.2	42	60.9	
Service user moved to residential aged care (without further YPIRAC support)	< 5	< 9.6	< 5	< 29.4	< 5	< 7.2	
Service user moved out of area/interstate	< 5	< 9.6	< 5	< 29.4	< 5	< 7.2	
Service user no longer eligible for the program	13	25.0	—	—	13	18.8	
Other	4	7.7	—	—	4	5.8	
Total	52	100.0	17	100.0	69	100.0	
Note: A small number of service users (< 5) may receive services in more than one jurisdiction. These may be counted more than once in the table.

The majority of service users from target groups 1 and 3 who exited the program did so because the service user had died—14 of 18 in target group 1, and most of those in target group 3 (Table 4.12). In target group 2 (at risk of entry to residential aged care) the highest proportion of service users who left the program was those who were no longer eligible.
Table 4.12: Service users who exited the YPIRAC program during 2008–09, by main reason for cessation of services and target group
Main reason for cessation of services	YPIRAC target group	Total	
	Group 1	Group 2	Group 3	Group 4	Number	Per cent	
Service user withdrew from program	< 5	—	—	< 7	7	10.1	
Service user died	14	< 10	< 20	< 5	42	60.9	
Service user no longer eligible for the program	< 5	< 13	—	—	13	18.8	
Other	< 5	< 5	< 5	< 5	7	10.1	
Total	18	22	20	9	69	100.0	
Notes 
1.	Other reasons for exiting the program include service user moved to residential aged care without further YPIRAC support, service user moved out of area or interstate, and other.
2.	YPIRAC target groups: 
	Group 1 Agreed to or has moved from residential aged care to alternative YPIRAC-funded accommodation and support
	Group 2 Deemed ‘at risk’ of entry into residential aged care
	Group 3 Remain in or enter residential aged care with additional disability support services
	Group 4 Remain in or enter residential aged care without additional disability support services.
3.	A small number of service users (< 5) may receive services in more than one jurisdiction. These may be counted more than once in
the table.

5	YPIRAC program 2006–07 to 
2008–09
The 2008–09 financial year was the third year of the 5-year YPIRAC program. It was also the third year for which data was collected in the YPIRAC MDS. These data can now be used to examine the changing characteristics of YPIRAC service users and the services they have received over the 3 years of the program’s operation. 
Data for 2006–07 should be viewed with caution. While the YPIRAC program was announced by COAG in February 2006, the bilateral agreements between the states and territories and the Commonwealth government were signed over a 6-month period between August 2006 and January 2007 (URBIS 2009) and the program start date varied across the states and territories. Arrangements to collect data relating to 2006–07 were not completed until after the reporting period, and the ability of the states and territories to provide data for this reporting period varied. After the 2006–07 reporting period the definition of ‘YPIRAC service user’ and some other data items were refined; for details see the previous report Younger People with Disability in Residential Aged Care program: Final report on the 2007–08 Minimum Data Set (AIHW 2009b). 
5.1	YPIRAC service users 
The number of people receiving services under the YPIRAC program has increased steadily since the program began, from 260 in 2006–07 to 817 in 2008–09 (Table 5.1). This is to be expected due to the considerable time required by the state and territory governments to establish the program and develop the services offered under it. The number of service users increased in most states and territories from 2006–07 to 2007–08. However, from 2007–08 to 2008–09 only Victoria, Queensland, Western Australia, South Australia and the Australian Capital Territory reported increases in service user numbers. In the Northern Territory the number of service users has reduced over the 3 years of the program (from 12 in 2006–07 to
 7 in 2008–09).
Table 5.1: YPIRAC service users, by state and territory, 2006–07 to 2008–09
Year	NSW	Vic	Qld	WA	SA	Tas	ACT	NT	Total	
2006–07	21	124	12	45	34	9	3	12	260	
2007–08	157	174	106	44	58	17	13	11	580	
2008–09	155	210	223	92	99	17	14	7	817	
Notes
1.	A small number of service users (< 5) may receive services in more than one jurisdiction. These may be counted more than once in the table.
2.	The definition of ‘YPIRAC service user’ was refined after the 2006–07 data collection. Therefore comparisons between 2006–07 and later reporting periods should be undertaken with caution.

The YPIRAC program was initially targeted at people aged less than 50 years, with those aged between 50 and 64 years to be included if and when resources were available. This, as well as the ageing of earlier entrants to the YPIRAC program, is reflected in the increasing proportion of YPIRAC service users aged 50 to 64 years old—from 14% in 2006–07 to 26% in 2008–09 (Table 5.2).
Table 5.2: YPIRAC service users, by age group, 2006–07 to 2008–09
Year	Less than 50 years	50–64 years	Total	
	Number	Per cent	Number	Per cent	Number	Per cent	
2006–07	224	86.2	36	13.8	260	100.0	
2007–08	483	83.3	97	16.7	580	100.0	
2008–09	609	74.5	208	25.5	817	100.0	
Notes
1.	A small number of service users (< 5) may receive services in more than one jurisdiction. These may be counted more than once in the table.
2.	The definition of ‘YPIRAC service user’ was refined after the 2006–07 data collection. Therefore comparisons between 2006–07 and later reporting periods should be undertaken with caution.
The proportion of service users in each of the YPIRAC target groups has changed considerably over the 3 years of the program. During the 2006–07 reporting period the majority of service users (59%) were in target group 1 (agreed to or has moved from residential aged care to alternative accommodation). By 2008–09 the proportion in this target group had decreased to 44% (Table 5.3). During the same period the proportions in target group 2 (at risk of entry into residential aged care) and 3 (remain in or enter residential aged care with additional services) increased, from 15% to 25% and from 20% to 28% of service users respectively. The proportion in target group 4 (remain in or enter residential aged care without additional services) remained low and stable (3%). 
Table 5.3: YPIRAC service users, by YPIRAC target group, 2006–07 to 2008–09
	YPIRAC target group		
Year	Group 1	Group 2	Group 3	Group 4	Not stated	Total	
	Number	
2006–07	154	38	52	8	8	260	
2007–08	296	125	134	13	12	580	
2008–09	358	202	230	27	—	817	
	Per cent	
2006–07	59.2	14.6	20.0	3.1	3.1	100.0	
2007–08	51.0	21.6	23.1	2.2	2.1	100.0	
2008–09	43.8	24.7	28.2	3.3	—	100.0	
Notes
1.	YPIRAC target groups: 
Group 1 Agreed to or has moved from residential aged care to alternative YPIRAC-funded accommodation and support
Group 2 Deemed ‘at risk’ of entry into residential aged care
Group 3 Remain in or enter residential aged care with additional disability support services
Group 4 Remain in or enter residential aged care without additional disability support services.
2.	A small number of service users (< 5) may receive services in more than one jurisdiction. These may be counted more than once in the table.
3. 	The definition of ‘YPIRAC service user’ was refined after the 2006–07 data collection. Therefore comparisons between 2006–07 and later reporting periods should be undertaken with caution.

The proportion of Aboriginal and Torres Strait Islander service users also varied over the 
3 years of the program, dropping from 14% in 2006–07 to 7% in 2007–08 before increasing to 10% in 2008–09 (Table 5.4). From 2007–08 to 2008–09 the number of Aboriginal and Torres Strait Islander service users doubled from 42 to 84. 
Table 5.4: YPIRAC service users, by Indigenous status, 2006–07 to 2008–09
	Indigenous	Non-Indigenous	Not stated	Total	
Year	Number	Per cent	Number	Per cent	Number	Per cent	Number	Per cent	
2006–07	35	13.5	222	85.4	3	1.2	260	100.0	
2007–08	42	7.2	535	92.2	3	0.5	580	100.0	
2008–09	84	10.3	733	89.7	—	—	817	100.0	
Notes
1.	A small number of service users (< 5) may receive services in more than one jurisdiction. These may be counted more than once in the table.
2.	The definition of ‘YPIRAC service user’ was refined after the 2006–07 data collection. Therefore comparisons between 2006–07 and later reporting periods should be undertaken with caution.

In contrast, the proportions of service users born in Australia and overseas have remained relatively stable over the years, with between 82% and 88% born in Australia, 4% and 6% born in EP1 countries and between 6% and 8% born in EP2–4 countries (Table 5.5). See Appendix 4 for more information on the English Proficiency Group classifications.
Table 5.5: YPIRAC service users, by English Proficiency Group, 2006–07 to 2008–09
Year	Born in Australia	Overseas-born—English Proficiency Group 1	Overseas-born—English Proficiency Groups 2–4	Not stated	Total	
	Number	
2006–07	229	11	16	4	260	
2007–08	476	27	45	32	580	
2008–09	706	46	47	18	817	
	Per cent	
2006–07	88.1	4.2	6.2	1.5	100.0	
2007–08	82.1	4.7	7.8	5.5	100.0	
2008–09	86.4	5.6	5.8	2.2	100.0	
Notes 
1.	For information about the English Proficiency Group classification, see Appendix 4.
2.	A small number of service users may receive services in more than one jurisdiction. These may be counted more than once in the table.
3.	The definition of ‘YPIRAC service user’ was refined after the 2006–07 data collection. Therefore comparisons between 2006–07 and later reporting periods should be undertaken with caution.
Residential setting
While the actual number of service users living in residential aged care has increased over the 3 years of the program, it has reduced considerably as a proportion of all service users. On 30 June 2007, 79% of service users were living in residential aged care. However, by 30 June 2009 this had dropped to 64% of service users (Table 5.6). During the same period the proportion living in private residences doubled from 8.5% to 17%. The proportions living in domestic-scale supported living facilities and supported accommodation also increased. 
Table 5.6: YPIRAC service users, by usual residential setting, 2006–07 to 2008–09
	Usual residential setting at 30 June:	
	2007	2008	2009	
Usual residential setting	Number	Per cent	Number	Per cent	Number	Per cent	
Private residence	22	8.5	81	14.0	139	17.0	
Domestic-scale supported living facility	15	5.8	35	6.0	51	6.2	
Supported accommodation facility	12	4.6	32	5.5	49	6.0	
Residential aged care	204	78.5	398	68.6	526	64.4	
Hospital	< 10	< 3.8	20	3.4	36	4.4	
Other	< 5	< 1.9	14	2.4	16	2.0	
Total	260	100.0	580	100.0	817	100.0	
Notes 
1.	Usual residential setting refers to the type of accommodation in which the person was living for 4 or more days per week on average, as at 30 June 2009 or on exit from the YPIRAC program.
2.	‘Other’ residential setting includes residence within an Aboriginal/Torres Strait Islander community; independent living within a retirement village; short-term crisis, emergency or transitional accommodation; and other settings.
3.	A small number of service users (< 5) may receive services in more than one jurisdiction. These may be counted more than once in the table.
4.	The definition of ‘YPIRAC service user’ was refined after the 2006–07 data collection. Therefore comparisons between 2006–07 and later reporting periods should be undertaken with caution.
Disability groups
The profile of YPIRAC service users by reported primary disability group has remained fairly stable over the years of the program’s operation. Acquired brain injury has consistently been the most commonly reported primary disability group, reported by just over half (54%) of all service users in 2006–07, 46% in 2007–08 and 47% in 2008–09 (Table 5.7). The second most frequently reported primary disability group was neurological, varying from 26% in 2006–07 to 29% in 2008–09. The proportion reporting a physical primary disability varied from 13% in 2006–07 to 17% in 2007–08 and 15% in 2008–09. 

Table 5.7: YPIRAC service users, by primary disability group, 2006–07 to 2008–09
	2006–07	2007–08	2008–09	
Primary disability group	Number	Per cent	Number	Per cent	Number	Per cent	
Intellectual/autism 	16	6.2	49	8.4	65	8.0	
Physical	33	12.7	96	16.6	124	15.2	
Acquired brain injury	139	53.5	269	46.4	381	46.6	
Neurological	68	26.2	155	26.7	238	29.1	
Deafblind/ vision	—	—	—	—	< 5	< 0.6	
Psychiatric	< 5	< 1.9	10	1.7	< 10	< 1.2	
Not stated	< 5	< 1.9	1	0.2	—	—	
Total service users	260	100.0	580	100.0	817	100.0	
Notes
1.	A small number of service users (< 5) may receive services in more than one jurisdiction. These may be counted more than once in the table.
2.	The definition of ‘YPIRAC service user’ was refined after the 2006–07 data collection. Therefore comparisons between 2006–07 and later reporting periods should be undertaken with caution.

The average number of disability groups per service user has increased from 1.58 in 2006–07 to 1.93 in 2008–09, reflecting the higher proportion of service users with more than one disability group in both the 2007–08 and 2008–09 reporting periods (Table 5.8).
Table 5.8: YPIRAC service users by total number of disability groups, 2006–07 to 2008–09
	Total number of disability groups	Average number of disability groups	
Year	1	2	3	4	5+	Not stated	Total service users		
	Number		
2006–07	172	40	36	7	3	2	260	1.58	
2007–08	272	140	104	48	15	1	580	1.97	
2008–09	397	195	140	64	21	—	817	1.93	
	Per cent		
2006–07	66.2	15.4	13.8	2.7	1.2	0.8	100.0	. .	
2007–08	46.9	24.1	17.9	8.3	2.6	0.2	100.0	. .	
2008–09	48.6	23.9	17.1	7.8	2.6	—	100.0	. .	
. . 	not applicable
Notes
1.	‘Total number of disability groups’ includes primary disability group and other significant disability groups.
2.	‘Average number of disability groups’ excludes service users whose primary disability group was ‘not stated’.
3.	A small number of service users (< 5) may receive services in more than one jurisdiction. These may be counted more than once in the table.
4.	The definition of ‘YPIRAC service user’ was refined after the 2006–07 data collection. Therefore comparisons between 2006–07 and later reporting periods should be undertaken with caution.
5.2	Service use
In comparing service use data across the reporting periods, it should be noted that several changes were made to the data items collected after the 2006–07 reporting period. These changes included the review and restructure of service group data items, the refinement of the definition of ‘YPIRAC assessment’ and the addition of the service type ‘YPIRAC client monitoring’.
The number of service users provided with alternative accommodation has increased markedly over each of the 3 years of the program. Only 33 service users (13% of all service users) received alternative accommodation in 2006–07, the first year of the program operation, when procedures and services were still being developed. In 2007–08 this increased to 79 service users (14%) and in 2008–09 to 124 service users (15%). The number of service users receiving support services (without alternative accommodation) has also increased, from 21 service users (8%) in 2006–07 to 190 (33%) in 2007–08 and 394 users (48%) in 2008–09 (Table 5.9). 
Table 5.9: YPIRAC service users, by combinations of YPIRAC-specific services received, 2006–07 to 2008–09
	2006–07	2007–08	2008–09	
YPIRAC-specific services received	Number	Per cent	Number	Per cent	Number	Per cent	
Alternative accommodation (with or without assessment and/or individual care planning and/or client monitoring, and with or without support services package)	33	12.7	79	13.6	124	15.2	
Support services package (without alternative accommodation; and with or without assessment and/or individual care planning and/or client monitoring)	21	8.1	190	32.8	394	48.2	
YPIRAC assessment and/or individual care planning and/or client monitoring only	206	79.2	311	53.6	299	36.6	
Total service users	260	100.0	580	100.0	817	100.0	
Notes 
1.	A small number of service users (< 5) may receive services in more than one jurisdiction. These may be counted more than once in the table.
2.	The definition of ‘YPIRAC service user’ was refined after the 2006–07 data collection. Therefore comparisons between 2006–07 and later reporting periods should be undertaken with caution.
3.	The definition of ‘YPIRAC assessment’ was refined, ‘YPIRAC client monitoring’ was added as a service type, and the data items relating to service use were refined and restructured after the 2006–07 reporting year. Therefore comparisons between 2006–07 and later reporting periods should be undertaken with caution.
4.	Assessment processes in NSW differ from those in other jurisdictions. Initially, potential clients are assessed for eligibility, and if eligible, are only offered further services (including an assessment of support needs) when there is capacity to provide them. People who have only received an assessment for eligibility are excluded from the table. 
5.	NSW does not record client monitoring as a service.
Running tally of services received under 3 years of the YPIRAC program
Another way to evaluate the achievements of the YPIRAC program is by a running tally of services received by YPIRAC service users. This tally represents the number of YPIRAC service users who have ever received a YPIRAC service, regardless of which reporting period the service was received in. The running tally method may be a more appropriate method of measuring the achievements of the YPIRAC program, given its 5-year duration and the often lengthy and complex processes that may be required to help service users achieve the program objectives. For instance, provision of alternative accommodation can require extensive planning processes and the completion of capital works.
The running tally method adjusts for the double-counting that may occur in year-by-year reporting. For instance, due to changing health, family or other circumstances, a service user may receive more than one accommodation package over the life of the program. In year-by-year reporting such as that presented in Table 5.9, these would be reported as alternative accommodation packages in each of the reporting periods in which they were provided. Similarly, support services may be received by a service user over several reporting periods, but will only be counted once using the running tally method.
Running tally data is calculated using the SLK to link service user data across reporting periods, and to adjust for service users who received services in more than one state or territory (see Section 1.3). As the SLK is not a unique identifier, some degree of false linking is possible. More information on the SLK is provided in Appendix 6.
Using the running tally method, it is estimated that 947 people had received services in the 3 years of the YPIRAC program (Table 5.10). Of these, 163 or 17% had received alternative accommodation (with or without a support services package or assessment, individual care planning and client monitoring). Another 41%, or 392 service users, had received support services packages (with or without assessment, individual care planning and client monitoring) and the remaining 41% had received assessment, individual care planning and/or client monitoring only.
Table 5.10: Estimated running tally of YPIRAC service users in receipt of YPIRAC-specific services since commencement of the program
	Number of service users who have ever received the service as at 30 June 2009	
YPIRAC-specific services received	Number	Per cent	
Alternative accommodation (with or without assessment and/or individual care planning and/or client monitoring, and with or without support services package)	163	17.2	
Support services package ((without alternative accommodation; and with or without assessment and/or individual care planning and/or client monitoring)	392	41.4	
YPIRAC assessment and/or individual care planning and/or client monitoring only	392	41.4	
Total service users	947	100.0	
Notes 
1.	Service user numbers are estimates after the use of a statistical linkage key to adjust for individuals who received services from more than one jurisdiction during the reporting period.  
2.	The definition of ‘YPIRAC service user’ was refined after the 2006–07 data collection. 
3.	The definition of ‘YPIRAC assessment’ was refined, ‘YPIRAC client monitoring’ was added as a service type, and the data items relating to service use were refined and restructured after the 2006–07 reporting year. 
4.	Assessment processes in NSW differ from those in other jurisdictions. Initially, potential clients are assessed for eligibility, and if eligible, are only offered further services (including an assessment of support needs) when there is capacity to provide them. People who have only received an assessment for eligibility are excluded from the table. 
5.	NSW does not record client monitoring as a service.

5.3	YPIRAC program objectives 
The YPIRAC program was established with three key objectives, as described in Section 1.1:
Program objective 1:	to move younger people with disability currently accommodated in residential aged care into appropriate disability supported accommodation, where it can be made available and if that is the client’s choice	
Program objective 2:	to divert younger people with disability who are at risk of admission to residential aged care into more appropriate forms of accommodation	
Program objective 3:	to enhance the delivery of specialist disability services to those younger people with disability who choose to remain in residential aged care or for whom residential aged care remains the only available suitable supported accommodation option. 	
This section examines the data from the first 3 years of the program’s operation to gain an indication of how the program is performing against each of these objectives. In interpreting this data, it is important to consider the complex nature and 5-year timeframe of the YPIRAC program, and the emphasis on individuals’ right to choose, as far as possible, the services and outcomes they want from the YPIRAC program. For instance, program objective 1 may be achieved in a variety of ways, including (but not limited to) providing alternative accommodation such as purpose-built disability accommodation, or providing support services so that the service user can return home. In addition, some service users may choose to remain in residential aged care, for instance to remain close to family and friends (URBIS 2009). Some service users may change their goals under the YPIRAC program and the YPIRAC target group to which they belong may change in consequence—see the following section on service users who changed target group between reporting periods.
Due to this complexity, several measures could be devised to measure achievements against program objectives. In this section the criteria detailed below have been used. Other criteria could be used and these may produce different results. 
Program objective 1:
	YPIRAC service users who:
•	were in YPIRAC target group 1 (agreed to move or have moved from residential aged care to alternative YPIRAC-funded accommodation and support) in their most recent entry in the MDS, and	
•	were not residing in residential aged care at the end of the reporting period, and
•	had received alternative accommodation and/or a support services package under the YPIRAC program.	
Program objective 2:	YPIRAC service users who:
•	were in target group 2 (deemed at risk of entry into residential aged care) in their most recent entry in the MDS, and
•	were not residing in residential aged care at the end of the reporting period, and
•	had received alternative accommodation and/or a support services package under the YPIRAC program.	
Program objective 3:	YPIRAC service users who:
•	were in target group 1 (agreed to move from residential aged care to alternative YPIRAC-funded accommodation and support) or in target group 3 (remain in or enter residential aged care with additional disability support services) in their most recent entry in the MDS, and
•	were residing in residential aged cared care at the end of the reporting period, and
•	had received a support services package under the YPIRAC program.
Note: Target group 1 service users are included in measures of this objective if they were still residing in residential aged care at the end of the reporting period and had received support services under the YPIRAC program, as residential aged care remained their only available suitable supported accommodation option. 	
In 2008–09, an estimated 87 service users achieved program objective 1 (relocation from residential aged care), 133 achieved program objective 2 (diversion from residential aged care), and 293 achieved program objective 3 (provided with enhanced services in residential aged care) (Table 5.11). The numbers achieving each of the program objectives increased markedly over the 3 years of the YPIRAC program.

Table 5.11: Estimated number of YPIRAC service users who have achieved program objectives, 2006–07 to 2008–09 
YPIRAC program objectives 	Estimated number of service users who achieved program objectives during:	
	2006–07	2007–08	2008–09	
Objective 1: People moving out of residential aged care to more age-appropriate supported disability accommodation.	17	43	87	
Objective 2: People at risk diverted from inappropriate admission to residential aged care 	24	89	133	
Objective 3: People provided with enhanced services within a residential aged care setting, for whom residential aged care is the only available, suitable supported accommodation option 	12	133	293	
Total YPIRAC service users in reporting period	260	580	817	
Notes
1.	A small number of service users (< 5) may receive services in more than one jurisdiction. These may be counted more than once in the table.
2.	The definition of ‘YPIRAC service user’ was refined after the 2006–07 data collection. Therefore comparisons between 2006–07 and later reporting periods should be undertaken with caution.
3.	The definition of ‘YPIRAC assessment’ was refined, ‘YPIRAC client monitoring’ was added as a service type, and the data items relating to service use were refined and restructured after the 2006–07 reporting year. Therefore comparisons between 2006–07 and later reporting periods should be undertaken with caution.
4.	Numbers do not add to the total as not all service users achieve objectives under the program, and some service users may achieve more than one objective as their circumstances or service availability change over time.
Running tally
The numbers of service users achieving YPIRAC program objectives can also be calculated using the running tally method described in Section 5.2 above. This method estimates the total number of service users who have achieved one or more program objectives in any year of the YPIRAC program. It uses the SLK to adjust for service users who have received YPIRAC services in more than one reporting period or in more than one jurisdiction. 
On a running tally basis, an estimated 92 people had achieved program objective 1, relocation from residential aged care, over the 3 years of the YPIRAC program (Table 5.12). This represents 23% of YPIRAC service users in target group 1 (agreed to move from residential aged care). An estimated 146 people had achieved program objective 2 (diversion from residential aged care), representing 67% of service users at risk of entering residential aged care (target group 2), and 311 people had achieved program objective 3 (remain in residential aged care with enhanced services), representing 55% of service users who had either agreed to remain in residential aged care with additional services or had agreed to move from residential aged care but had not yet been able to do so.

Table 5.12: Estimated running tally of YPIRAC service users who have achieved program objectives since entry to the program
	Estimated number of YPIRAC service users who have achieved program objectives to 30 June 2009	
YPIRAC service users against program objectives	Number	Per cent of service users in target group(a)	
Objective 1: People moving out of residential aged care to more age-appropriate supported disability accommodation	92	22.6	
Objective 2: People at risk diverted from inappropriate admission to residential aged care	146	66.7	
Objective 3: People provided with enhanced services within a residential aged care setting, for whom residential aged care is the only available, suitable supported accommodation option	311	54.7	
Total YPIRAC service users 	947	. .	
. .	not applicable
(a)	Percentages are calculated using the following denominators:
Objective 1: Target group 1 Agreed to or has moved from residential aged care to alternative YPIRAC-funded accommodation and support.
Objective 2: Target group 2 Deemed ‘at risk’ of entry into residential aged care.
Objective 3: Target group 1 Agreed to or has moved from residential aged care to alternative YPIRAC-funded accommodation and support but still residing in residential aged care, and Target group 3 remain in or enter residential aged care with additional disability support services. 
Notes
1.	Service user numbers are estimates after the use of a statistical linkage key to adjust for individuals who received services from more than one jurisdiction.  
2.	The definition of ‘YPIRAC service user’ was refined after the 2006–07 data collection. 
3.	The definition of ‘YPIRAC assessment’ was refined, ‘YPIRAC client monitoring’ was added as a service type, and the data items relating to service use were refined and restructured after the 2006–07 reporting year. 
4.	Service users may have received services in more than one collection period and may have had different target groups and residential settings recorded in different years. The most recently provided target group and residential setting were used to determine whether service users have achieved program objectives. 
5.	Numbers do not add to the total as not all service users achieve objectives under the program, and some service users may achieve more than one objective as their circumstances or service availability change over time.

Running tallies of program objectives achieved can also be calculated by state and territory (Table 5.13). Again, these data are indicative only, and care should be taken in its interpretation as program start dates, the broader systems of disability and accommodation services, and the policy approach taken in each state and territory vary considerably. 

Table 5.13: Estimated running tally of YPIRAC service users who have achieved program objectives since entry to the program, by state and territory
	Estimated number of YPIRAC service users who have achieved program objectives to 30 June 2009	
YPIRAC service users against program objectives	NSW	Vic	Qld	WA	SA	Tas	ACT	NT	Total	
Objective 1: People moving out of residential aged care to more age-appropriate supported disability accommodation	9	26	36	< 5	15	< 5	—	< 5	92	
Objective 2: People at risk diverted from inappropriate admission to residential aged care	< 10	37	45	21	23	< 5	7	6	146	
Objective 3: People provided with enhanced services within a residential aged care setting, for whom residential aged care is the only available, suitable supported accommodation option	141	109	< 5	19	14	19	< 5	5	311	
Total YPIRAC service users 	205	235	228	107	118	24	14	18	947	
Notes
1.	Service user numbers are estimates after the use of a statistical linkage key to adjust for individuals who received services in more than one jurisdiction. For this reason, state and territory numbers may not add to the national total. 
2.	The definition of ‘YPIRAC service user’ was refined after the 2006–07 data collection. 
3.	The definition of ‘YPIRAC assessment’ was refined, ‘YPIRAC client monitoring’ was added as a service type, and the data items relating to service use were refined and restructured after the 2006–07 reporting year.
4.	Service users may have received services in more than one collection period and may have had different target groups and residential settings recorded in different years. The most recently provided target group and residential setting were used to determine whether service users have achieved program objectives. 
5.	Numbers do not add to the total as not all service users achieve objectives under the program, and some service users may achieve more than one objective as their circumstances or service availability change over time.
Service users who changed target group 
Service users who were reported under one target group during a reporting period may fall into another target group in subsequent reporting periods, due to changing health or family circumstances, or for other reasons. 
Table 5.14 compares service users by target group in both the 2007–08 and 2008–09 reporting periods. The shaded cells represent service users who remained in the same target group in both reporting periods. Thirty service users, or 6% of those who received YPIRAC services in both reporting periods, moved from target group 1 (relocating from residential aged care) to target group 3 (remain in residential aged care with additional services) between 2007–08 and 2008–09. A further 20 service users (4%) moved from target group 3 in 2007–08 to target group 1 in 2008–09. 

Table 5.14: YPIRAC service users who received services in both 2007–08 and 2008–09, by target group in each period 
YPIRAC target group 2007–08	YPIRAC target group 2008–09		
	Group 1	Group 2	Group 3	Group 4	Total	
Group 1	219	< 5	30	< 5	255	
Group 2 	< 5	108	< 5	< 5	113	
Group 3 	20	< 5	79	< 5	100	
Group 4	—	—	< 5	< 5	< 5	
Not stated	< 5	—	< 5	—	< 10	
Total	244	111	113	7	475	
Notes
1.	YPIRAC target groups: 
Group 1 Agreed to or has moved from residential aged care to alternative YPIRAC-funded accommodation and support
Group 2 Deemed ‘at risk’ of entry into residential aged care
Group 3 Remain in or enter residential aged care with additional disability support services
Group 4 Remain in or enter residential aged care without additional disability support services.
2.	Service user numbers are estimates after the use of a statistical linkage key to adjust for individuals who received services in more than one jurisdiction. 
6	Target population
This chapter provides information about the contact made between the YPIRAC program and potential YPIRAC service users during 2008–09. It also presents some information on the potential target population for the YPIRAC program.
6.1	Contact with potential service users
State and territory program managers use a variety of approaches to identify and contact potential service users. These approaches differ in the age groups and target groups considered for entry to the program, and in how potential service users are identified and contacted. 
In Queensland, people aged 18–49 years are contacted as soon as information is received regarding possible and actual admissions to aged care, and information about the program is provided to people in the 50–64 years age group when requested. 
In South Australia, YPIRAC program managers monitor entrants to residential aged care to identify potential service users. People at risk of admission to residential aged care are referred to the Disability SA Accommodation Placement Panel (APP), and if deemed eligible by the APP, either an Aged Care Assessment Team (ACAT) assessment is requested or the person is referred directly to YPIRAC.
In the Australian Capital Territory, Expression of Interest processes are undertaken among those aged less than 55 years in residential aged care to identify those who seek alternative living arrangements or additional services. 
In some jurisdictions, YPIRAC resources are fully allocated against some or all of the program objectives, and additional service users are not identified or contacted.
During 2008–09, the YPIRAC program made first contact with 237 potential service users to provide information about the program (Table 6.1). Of these, most (88%) were to people aged less than 50 years. The largest numbers of initial contacts were made in Victoria (68), Western Australia (53) and South Australia (53). 
A total of 179 people accepted an initial contact from the YPIRAC program, and the great majority of these (93%) were also aged less than 50 years. People who accepted contact during 2008–09 may have first been contacted in a previous reporting period. Those who accept contact indicate that they would like to be considered for inclusion in the program, and some of these may have gone on to receive a YPIRAC assessment or other service under the program during 2008–09. These are included in the YPIRAC MDS as YPIRAC service users. Those who did not go on to receive YPIRAC services in 2008–09 may do so in future years. A total of 39 people declined to be involved in the YPIRAC program in 2008–09. 

Table 6.1: Number of contacts, acceptances and refusals, by age group and state and territory, 
2008–09
	Contacts made	Acceptances	Refusals	Yet to be contacted	
State/
territory	< 50	50–64	Total	< 50	50–64	Total	< 50	50–64	Total	< 50	50–64	Total	
NSW(a)	—	—	—	—	—	—	—	—	—	—	—	—	
Vic	59	9	68	52	4	56	6	2	8	7	2	9	
Qld(b)	29	6	35	19	2	21	1	—	1	—	—	—	
WA	52	1	53	33	1	34	19	—	19	—	—	—	
SA	49	4	53	49	4	53	7	3	10	2	—	2	
Tas	7	—	7	6	—	6	1	—	1	—	—	—	
ACT	6	8	14	1	1	2	—	—	—	—	—	—	
NT	7	—	7	7	—	7	—	—	—	—	—	—	
Total	209	28	237	167	12	179	34	5	39	9	2	11	
(a)	In NSW, two formal, written rounds of contact were made with potential clients early in the program, however people are free to apply for the program at any time and do not require an invitation in order to do so. The program is not open to people in the 50–64 years age group.
(b)	In Queensland, people aged 18–49 years were contacted as soon as information was received regarding possible and actual admissions to aged care. Information was provided to people in the 50–64 years age group when requested.
Notes
1.	‘Contacts made’ refers to the number of people who were contacted by the YPIRAC program regarding possible participation in the Program. 
2.	‘Acceptances’ refers to the number of people who accepted an initial contact from the YPIRAC program. 
3.	‘Refusals’ refers to the number of people who refused an initial contact from the YPIRAC Program.
4.	‘Yet to be contacted’ refers to the number of potential YPIRAC service users who have been identified, and who have not yet been contacted by the YPIRAC Program.
5.	People who accepted or refused contact may have first been contacted in a previous reporting period,

State and territory program managers identified an additional 11 potential service users who, as at 30 June 2009, were yet to be contacted. All potential service users in New South Wales were first contacted in March 2007 and no more contacts were made or accepted during 2008–09.
The 2008–09 reporting year is the third year of the YPIRAC program. Most initial contacts (1,131) were conducted in 2006–07, the first year of the program, and the numbers of contacts in subsequent years are substantially lower (Figure 6.1). Accordingly, the numbers of acceptances and refusals have also decreased over the 3 years of the program (Figure 6.2). 
Figure 6.1: Number of potential service users contacted by state and territory, 2006–07 to 2008–09
Vertical bar chart showing, for year, number contacted on y-axis and state/territory on x-axis.
Source: Table A1.6.
Figure 6.2: Summary of contact with potential YPIRAC service users, 2006–07 to 2008–09
Stacked line chart showing, for type of contact, number on y-axis and reporting period on x-axis.
Source: Table A1.6
6.2	Younger people in residential aged care 
Note: this section will be updated in the internet version of the report, following the publication of Residential aged care in Australia 2008–09.
The number of people aged less than 50 years in residential aged care reduced by 15% during the first 2 years of the YPIRAC program, from 1,007 in June 2006 to 858 in June 2008 (Table 6.2). Similarly, the number of admissions to permanent residential aged care for the same age group decreased by 26% from 2005–06 to 2007–08 (Table 6.3). 
The number of permanent aged care residents aged 50 to 64 years increased slightly (3%) from June 2006 to June 2008, while the number of permanent admissions in this age group reduced by 95 people, or 5%, from 2005–06 to 2007–08.
Table 6.2: Permanent aged care residents under 65 years, by age group, as at 30 June 2003–2008
Year	NSW	Vic	Qld	WA	SA	Tas	ACT	NT	Total	
	Less than 50 years	
2003	392	218	220	76	66	21	3	13	1,009	
2004	380	219	229	64	67	22	3	13	997	
2005	397	218	236	66	67	20	1	14	1,019	
2006	391	221	244	65	60	15	4	7	1,007	
2007	374	210	226	47	53	9	2	5	926	
2008	336	209	179	58	55	11	4	6	858	
	50–64 years	
2003	1,818	1,231	1,052	402	322	133	50	60	5,068	
2004	1,832	1,309	1,080	419	370	134	44	60	5,248	
2005	1,913	1,334	1,135	425	413	138	45	54	5,457	
2006	1,954	1,364	1,157	430	423	130	43	51	5,552	
2007	1,996	1,365	1,165	389	402	122	56	45	5,540	
2008	2,033	1,407	1,180	456	435	141	63	33	5,748	
	Total less than 65 years	
2003	2,210	1,449	1,272	478	388	154	53	73	6,077	
2004	2,212	1,528	1,309	483	437	156	47	73	6,245	
2005	2,310	1,552	1,371	491	480	158	46	68	6,476	
2006	2,345	1,585	1,401	495	483	145	47	58	6,559	
2007	2,370	1,575	1,391	436	455	131	58	50	6,466	
2008	2,369	1,616	1,359	514	490	152	67	39	6,606	
Source: AIHW analysis of the Aged and Community Care Management Information System (ACCMIS) as at October 2009.
Table 6.3: Admissions to permanent residential aged care for people aged less than 65 years, by age group and state and territory, 2004–05 to 2007–08 (first non-transfer admissions in year)
Year	NSW	Vic	Qld	WA	SA	Tas	ACT	NT	Total	
	Less than 50 years	
2004–05	126	81	84	23	31	5	0	3	353	
2005–06	97	82	58	22	27	2	3	2	293	
2006–07	98	67	53	18	17	3	1	1	258	
2007–08	84	57	29	19	18	5	3	2	217	
	50–64 years	
2004–05	630	427	381	146	193	41	19	9	1,846	
2005–06	645	426	347	162	166	37	21	16	1,820	
2006–07	610	380	323	165	151	39	20	9	1,697	
2007–08	608	380	344	150	166	50	17	10	1,725	
	Total less than 65 years	
2004–05	756	508	465	169	224	46	19	12	2,199	
2005–06	742	508	405	184	193	39	24	18	2,113	
2006–07	708	447	376	183	168	42	21	10	1,955	
2007–08	692	437	373	169	184	55	20	12	1,942	
Note: Age reported is age at admission.
Source: AIHW analysis of the Aged and Community Care Management Information System (ACCMIS) as at October 2009.
6.3	Younger people assessed under the Aged Care Assessment Program
The Aged Care Assessment Program (ACAP) is a national program jointly funded by the Australian Government and state and territory governments. Under this program, ACATs are responsible for assessing clients and making recommendations for their long-term care and support. ACATs provide assessment, information, advice and assistance to frail older people who want to remain at home with support or who are considering living in an aged care home. For the purposes of service planning, older people are regarded as those 70 years of age or over (50 years or over if Indigenous Australians). The Aged Care Act 1997 does not specify an age when a person becomes an aged person. Referral of a younger person with disability to an ACAT for assessment and approval of aged care services should only occur where it can be demonstrated that there are no other facilities or care services appropriate to meet the person’s needs. 
An ACAT assessment is essential for determining eligibility and approval for services provided under the Aged Care Act 1997, including residential aged care.
During 2007–08 a total of 745 ACAT assessments of people aged less than 50 were completed (Table 6.4). Of these, 280 or 38% recommended a long-term care setting of high-level care in residential aged care, and a further 77 (10%) recommended low-level care in residential aged care. 
Table 6.4: ACAT assessments for people aged less than 50 years at referral, recommended long-term care setting by state and territory, 2007–08
State/territory	Private residence	Other community	Residential aged care low-level care	Residential aged care high-level care	Other	Not stated/
inadequately described	Total	
New South Wales	100	8	22	88	8	1	227	
Victoria	72	< 5	23	75	< 10	—	179	
Queensland	65	6	11	50	13	—	145	
Western Australia	21	< 10	10	35	< 5	—	73	
South Australia	23	< 5	8	19	< 5	1	58	
Tasmania	< 10	—	< 5	8	—	—	19	
Australian Capital Territory	< 5	< 5	—	< 5	< 5	—	6	
Northern Territory	20	13	< 5	< 5	< 5	—	38	
Total	311	41	77	280	34	2	745	
Notes 
1.	Some clients may receive more than one ACAT assessment within a financial year. 
2.	Table excludes 54 clients with invalid age data.
Source: AIHW analysis of the Aged Care Assessment Program Minimum Dataset.
ACAT approvals remain valid for 1 year and 1 day, and are not always taken up as clients’ circumstances or service availability change. ACAT recommendations that resulted in permanent admission to residential aged care in the 2007–08 financial year are included in Table 6.3. Others may result in admissions after this period. 
Some ACAT clients may have received services under the YPIRAC program. However, data linkage between the ACAP MDS, the Aged and Community Care Management Information System and the YPIRAC MDS has not been undertaken, and the extent of overlap and movement between these programs has not been determined. 
Just over half (53%) of the 357 recommendations for long-term care in residential aged care were for people who usually resided in private residences (Table 6.5). An additional 15% lived in public or community housing. About 10% were already living in residential aged care at the time of assessment. 

Table 6.5: ACAT assessments for people aged less than 50 at referral with recommended
long-term care setting of residential aged care, usual accommodation setting, 2007–08
Usual accommodation setting	Number	Per cent	
Boarding house/rooming house/private hotel	9	2.5	
Hospital	12	3.4	
Independent in retirement village	< 5	< 1.4	
Private residence	189	52.9	
Public or community housing	52	14.6	
Public place or temporary shelter	9	2.5	
Residential aged care - high level care	16	4.5	
Residential aged care - low level care	18	5.0	
Crisis accommodation	< 5	< 1.4	
Supported community accommodation	15	4.2	
Other institutional care	13	3.6	
Other	18	5.0	
Total	357	100.0	
Notes 
1.	Some clients may receive more than one ACAT assessment within a financial year. 
2.	Table excludes 54 clients with invalid age data.
Source: AIHW analysis of the Aged Care Assessment Program Minimum Dataset.
A broad range of primary health conditions were reported by clients aged less than 50 years who were recommended for long-term care in residential aged care. The most common were diseases of the nervous system, reported by nearly one-third (116) of assessments (Table 6.6). These included Huntington disease (31 people; 9% of assessments), multiple sclerosis (30 people; 8%), cerebral palsy (7 people; 2%) and other diseases of the nervous system (48 people; 13%). Cancers were reported as the primary health condition by 42 people (12%). 

Table 6.6: ACAT assessments for people aged less than 50 at referral with recommended
long-term care setting of residential aged care, by primary health condition, 2007–08
Primary health condition	Number	Per cent	
Certain infections and parasitic diseases	< 5	< 1.4	
Neoplasms (tumours/cancers):	42	11.8	
Brain cancer	17	4.8	
Other cancers/neoplasms	25	7.0	
Diseases of the blood and immune mechanism	< 5	< 1.4	
Endocrine, nutritional and metabolic disorders	< 5	< 1.4	
Dementia	23	6.4	
Psychoses and depression/mood/affective disorders:	8	2.2	
Schizophrenia	< 8	< 2.2	
Other psychoses and mood disorders	< 5	< 1.4	
Intellectual and developmental disorders	12	3.4	
Other mental and behavioural disorders	12	3.4	
Diseases of the nervous system:	116	32.5	
Huntington disease	31	8.7	
Multiple sclerosis	30	8.4	
Cerebral palsy	7	2.0	
Other diseases of the nervous system	48	13.4	
Diseases of the eye and adnexa	< 5	< 1.4	
Heart disease	< 5	< 1.4	
Cerebrovascular disease 	27	7.6	
Other diseases of the circulatory system	< 5	< 1.4	
Diseases of the respiratory system	7	2.0	
Diseases of the liver	12	3.4	
Diseases of the musculoskeletal system	< 5	< 1.4	
Diseases of the genitourinary system	9	2.5	
Congenital malformations, deformations and chromosomal abnormalities	10	2.8	
Injury, poisoning and certain other consequences of external causes:	35	9.8	
Injuries to the head (including ear, eye, face, jaw and brain)	< 35	< 9.8	
Other injury, poisoning and external	< 5	< 1.4	
Symptoms and signs n.e.c.; other conditions n.e.c.	22	6.2	
No formal diagnosis available	< 5	< 1.4	
Total	357	100.0	
n.e.c.	Not elsewhere classified.
Notes
1.	Some clients may receive more than one ACAT assessment within a financial year. 
2.	Table excludes 54 clients with invalid age data.
3.	Primary health condition is classified according to the ACAP code list for health condition, Aged care assessment program data dictionary version 1.0 (AIHW 2002). Clients may have more than one health condition. The primary health condition is that with the greatest impact on the person’s need for assistance with activities of daily living and social participation.
Source: AIHW analysis of the Aged Care Assessment Program Minimum Dataset.
7	Data quality
7.1	Data development
Data were first collected for the YPIRAC MDS for the 2006–07 reporting year. For details on the development of the collection and data quality in previous years, see the previous report Younger People with Disability in Residential Aged Care program: Final report on the 2007–08 Minimum Data Set. 
7.2	Data quality in the 2008–09 MDS
The procedures used for the collection and compilation of the 2008–09 data collection were similar to those used for the 2007–08 collection. Two additional data items were collected in 2008–09—program exit date and main reason for cessation of services. Data were provided by all jurisdictions for these items. 
Program managers were asked to provide data for all YPIRAC service users within their jurisdiction and the Australian Institute of Health and Welfare (AIHW) was not advised of any service users who did not consent to their data being included in the collection. Therefore it is expected that all people who received YPIRAC services during the collection period are included in the YPIRAC MDS. 
All jurisdictions provided complete data in 2008–09. However, there were some variations in the ‘not stated’ rates of service user data items (Table 7.1). Most data items were very well reported. Data were provided for all service users for the linkage key items (letters of name, date of birth and sex), residential setting, Indigenous status, primary disability group and postcode. Country of birth information was not provided for 18 service users (2.2%). 
The largest proportion of ‘not stated’ responses was for the principal reason for the service user’s current accommodation setting—61 service users, or 7.5%. This was a considerable improvement over the response rate for this item in 2007–08, when 28% of service users did not provide a response for this question. 

Table 7.1: ‘Not stated’ responses for service user data items, 2007–08 and 2008–09
	2007–08	2008–09	
Data item	Number	Per cent	Number	Per cent	
Letters of surname	—	—	—	—	
Letters of given name	—	—	—	—	
Date of birth	—	—	—	—	
Sex	—	—	—	—	
Indigenous status	3	0.5	—	—	
Country of birth	32	5.5	18	2.2	
Residential setting	—	—	—	—	
Postcode	1	0.2	—	—	
Primary disability group	1	0.2	—	—	
YPIRAC target group	12	2.1	—	—	
Principal reason for accommodation setting	163	28.1	61	7.5	
Total service users	580	100.0	817	100.0	
Note: A small number of service users (< 5) may receive services in more than one jurisdiction. These may be counted more than once in the table.
Data issues
For the 2008–09 report, additional checking was carried out on the linkage keys over the 3 years of data in the MDS. As a result of this, numerous changes were made to both 2008–09 linkage key information and to the SLKs in 2006–07 and 2007–08 data (for the purposes of linking only—the 2006–07 and 2007–08 MDSs were not updated). Therefore data presented in chapters 4 and 5 of this report may differ from that in the 2007–08 report.
Appendixes
Appendix 1: Additional tables
Table A1.1: YPIRAC service users, by age group and sex, 2008–09
Age group (years)	Male	Female	Total	
	Number	Per cent	Number	Per cent	Number	Per cent	
	Less than 50 years	
Less than 25	23	5.0	13	3.7	36	4.4	
25–29 	27	5.9	9	2.5	36	4.4	
30–34	31	6.7	21	5.9	52	6.4	
35–39 	45	9.8	38	10.7	83	10.2	
40–44 	75	16.3	62	17.4	137	16.8	
45–49	139	30.2	126	35.4	265	32.4	
Total less than 50	340	73.8	269	75.6	609	74.5	
	50–64 years	
50–54 	92	20.0	72	20.2	164	20.1	
55–64 	29	6.3	15	4.2	44	5.4	
Total 50–64	121	26.2	87	24.4	208	25.5	
Total	461	100.0	356	100.0	817	100.0	
Note: A small number of service users (< 5) may receive services in more than one jurisdiction. These may be counted more than once in the table.

Table A1.2: YPIRAC service users, by remoteness area and age group, 2008–09
Age group (years)	Remoteness area	Total	
	Major cities	Inner regional	Outer regional	Remote/
Very remote		
	Number	
Less than 50	381	128	76	25	609	
50–64	131	30	29	18	208	
Total	512	158	105	43	817	
	Per cent	
Less than 50	62.5	21.0	12.4	4.1	100.0	
50–64	62.9	14.5	13.9	8.6	100.0	
Total	62.6	19.3	12.8	5.2	100.0	
Notes
1.	Remoteness Areas (RAs) are based on the Australian Standard Geographical Classification (ASGC) developed by the Australian Bureau of Statistics. This classification provides an indication of the degree of remoteness (or distance) from major cities (ABS 2006).The number of service users in each RA was estimated based on residential postcodes. Some postcode areas were split between two or more RAs. Where this was the case, the data were weighted according to the proportion of the population of the postcode area in each RA. Totals may not be the sum of the components due to rounding.
2.	A small number of service users (< 5) may receive services in more than one jurisdiction. These may be counted more than once in the table.
Table A1.3: YPIRAC service users, by remoteness area and state and territory, 2008–09 
Remoteness area	NSW	Vic	Qld	WA	SA	Tas	ACT	NT	Total	
				Number				
Major cities	106	159	133	50	50	—	14	—	512	
Inner regional	42	44	34	7	19	12	—	—	158	
Outer regional	7	6	50	11	24	< 10	—	< 5	105	
Remote/Very remote	—	—	6	24	6	< 5	—	< 7	43	
Total	155	210	223	92	99	17	14	7	817	
				Per cent				
Major cities	68.5	75.8	59.6	54.3	50.2	—	100.0	—	62.6	
Inner regional	26.8	21.2	15.1	7.7	19.3	69.7	—	—	19.3	
Outer regional	4.7	3.0	22.3	11.8	24.5	< 58.8	—	< 71.4	12.8	
Remote/Very remote	—	—	2.9	26.3	6.1	< 29.4	—	< 100.0	5.2	
Total	100.0	100.0	100.0	100.0	100.0	100.0	100.0	100.0	100.0	
Notes
1.	Remoteness Areas (RAs) are based on the Australian Standard Geographical Classification (ASGC) developed by the Australian Bureau of Statistics. This classification provides an indication of the degree of remoteness (or distance) from major cities (ABS 2006). The number of service users in each RA was estimated based on residential postcodes. Some postcode areas were split between two or more RAs. Where this was the case, the data were weighted according to the proportion of the population of the postcode area in each RA. Totals may not be the sum of the components due to rounding.
2.	A small number of service users (< 5) may receive services in more than one jurisdiction. These may be counted more than once in the table.

Table A1.4: YPIRAC service users, by usual residential setting and YPIRAC target group, 2008–09
Usual residential setting	YPIRAC target group	Total	
	Group 1	Group 2	Group 3	Group 4		
	Number	
Private residence	32	107	—	—	139	
Domestic-scale supported living facility	30	21	—	—	51	
Supported accommodation facility	19	30	—	—	49	
Residential aged care facility	266	< 5	230	< 27	526	
Hospital	< 5	< 35	—	—	36	
Other	< 10	< 10	—	< 5	16	
Total	358	202	230	27	817	
	Per cent	
Private residence	8.9	53.0	—	—	17.0	
Domestic-scale supported living facility	8.4	10.4	—	—	6.2	
Supported accommodation facility	5.3	14.9	—	—	6.0	
Residential aged care facility	74.3	< 2.5	100.0	< 100.0	64.4	
Hospital	< 1.4	< 17.3	—	—	4.4	
Other	< 2.8	< 5.0	—	< 18.5	2.0	
Total	100.0	100.0	100.0	100.0	100.0	
Notes 
1.	Usual residential setting refers to the type of accommodation in which the person lives for 4 or more days per week on average, as at 30 June 2009 or on exit from the YPIRAC program.
2.	‘Other’ residential setting includes residence within an Aboriginal/Torres Strait Islander community; independent living within a retirement village; short-term crisis, emergency or transitional accommodation; and other settings.
3.	YPIRAC target groups: 
Group 1 Agreed to or has moved from residential aged care to alternative YPIRAC-funded accommodation and support
Group 2 Deemed ‘at risk’ of entry into residential aged care
Group 3 Remain in or enter residential aged care with additional disability support services
Group 4 Remain in or enter residential aged care without additional disability support services.
4.	A small number of service users (< 5) may receive services in more than one jurisdiction. These may be counted more than once in the table.

Table A1.5: YPIRAC service users, by primary disability group and all significant disability groups, 2008–09
Disability group	Primary disability	Other significant disability	All with disability	
	Number	Per cent of all service users	Number	Per cent of all service users	Number	Per cent of all service users	
Intellectual/autism/specific learning/ADD	65	8.0	25	3.1	90	11.0	
Physical	124	15.2	283	34.6	407	49.8	
Acquired brain injury	381	46.6	36	4.4	417	51.0	
Neurological	238	29.1	98	12.0	336	41.1	
Deafblind	< 5	< 0.6	< 6	< 0.7	6	0.7	
Vision	< 5	< 0.6	< 65	< 8.0	67	8.2	
Hearing	—	—	17	2.1	17	2.1	
Speech	—	—	166	20.3	166	20.3	
Psychiatric	< 10	< 1.2	< 70	< 8.6	72	8.8	
Total	817	100.0	. .	. .	. .	. .	
. .	not applicable
Notes 
1.	‘Total number of disability groups’ includes primary disability group and other significant disability groups.
2.	A small number of service users (< 5) may receive services in more than one jurisdiction. These may be counted more than once in the table.

Table A1.6: Contacts, acceptances and refusals, by age group and state and territory, 2006–07 to 2008–09
	Contacts made	Acceptances	Refusals	Yet to be contacted	
	< 50	50–64	Total	< 50	50–64	Total	< 50	50–64	Total	< 50	50–64	Total	
	2006–07	
NSW(a)(b)	367	—	367	171	24	195	36	—	36	—	—	—	
Vic	265	14	279	133	14	147	17	—	17	—	—	—	
Qld(c)	305	32	337	102	15	117	18	—	18	—	—	—	
WA	47	17	64	37	8	45	14	5	19	5	1	6	
SA	30	4	34	30	4	34	—	—	—	55	1	56	
Tas	14	2	16	11	2	13	1	—	1	—	—	—	
ACT	2	11	13	2	3	5	4	—	4	10	3	13	
NT	12	1	13	11	1	12	1	—	1	1	12	13	
Total	1,042	81	1,123	497	71	568	91	5	96	71	17	88	
	2007–08	
NSW(b)	63	—	63	152	—	152	—	—	—	—	—	—	
Vic	65	—	65	161	25	186	34	—	34	—	—	—	
Qld(c)	63	30	93	57	23	80	1	1	2	—	—	—	
WA	9	—	9	9	—	9	—	—	—	—	—	—	
SA	26	5	31	21	5	26	5	—	5	35	5	40	
Tas	11	—	11	6	—	6	5	—	5	4	—	4	
ACT	11	12	23	10	7	17	—	1	1	1	—	1	
NT	18	1	19	17	1	18	1	—	1	—	—	—	
Total	266	48	314	433	61	494	46	2	48	40	5	45	
	2008–09	
NSW(b)	—	—	—	—	—	—	—	—	—	—	—	—	
Vic	59	9	68	52	4	56	6	2	8	7	2	9	
Qld(c)	29	6	35	19	2	21	1	—	1	—	—	—	
WA	52	1	53	33	1	34	19	—	19	—	—	—	
SA	49	4	53	49	4	53	7	3	10	2	—	2	
Tas	7	—	7	6	—	6	1	—	1	—	—	—	
ACT	6	8	14	1	1	2	—	—	—	—	—	—	
NT	7	—	7	7	—	7	—	—	—	—	—	—	
Total	209	28	237	167	12	179	34	5	39	9	2	11	
(a)	Includes 24 people in NSW aged 50–64 who spontaneously applied to the program in 2006–07.
(b)	In NSW, two formal, written rounds of contact were made with potential clients early in the program, however people are free to apply for the program at any time and do not require an invitation in order to do so. The program is not open to people in the 50–64 years age group.
(c)	In Queensland, people aged 18–49 years were contacted as soon as information was received regarding possible and actual admissions to aged care. Information was provided to people in the 50–64 years age group when requested.
Notes
1.	‘Contacts made’ refers to the number of people who were contacted regarding possible participation in the YPIRAC Program. 
2.	‘Acceptances’ refers to the number of people who accepted an initial contact from the YPIRAC program. 
3.	‘Refusals’ refers to the number of people who refused an initial contact from the YPIRAC Program.
4.	‘Yet to be contacted’ refers to the number of potential YPIRAC service users who have been identified, and who have not yet been contacted by the YPIRAC Program. 
5.	People who accepted or refused contact may have first been contacted in a previous reporting period,

Appendix 2: YPIRAC MDS collection forms
Each jurisdiction submitted two data files for the YPIRAC MDS 2008–09 collection—the service user file and the jurisdiction file. Blank templates for completion were provided by the AIHW. In addition, data forms were provided as a visual aid to assist in completing the spreadsheets. For example, when completing items with a number of code choices such as question 5 (residential setting), the forms allow the data entry operator to see the different code options at a glance.
These forms are suitable for printing and using in a hard copy format. Hard copies may be used by some jurisdictions to collect data in the first instance. However, data were submitted to the AIHW in standard spreadsheet format.

The YPIRAC forms are not included in this format. Please contact  feedback@aihw.gov.au for moreinformation.

Appendix 3: Service type classification
The following definitions are taken from the YPIRAC MDS Data guide 2008–09, available on request.
Accommodation support
Services that provide accommodation to people with a disability and services that provide support needed to enable a person with a disability to remain in their existing accommodation or to move to more suitable or appropriate accommodation.
1.01 Large residentials/institutions (> 20 places)
Large residentials/institutions are usually located on large parcels of land and provide 
24-hour residential support in a congregate setting of more than 20 beds. In some cases a range of residential and vocational/day services, and/or respite services are provided in the one site. 
1.02 Small residentials/institutions (7–20 places)
Small residentials/institutions are usually located on large parcels of land and provide 
24-hour residential support in a congregate or cluster setting of 7 to 20 beds. In some cases a range of residential and vocational/day services, and/or respite services are provided on the one site.
1.03 Hostels
Hostels provide residential support in a congregate setting of usually less than 20 beds, and may or may not provide 24-hour residential support. Many are situated in an institutional setting and also have respite beds included on the premises. In contrast to residentials/institutions (1.01 and 1.02), hostels usually do not provide segregated specialist services. 
1.04 Group homes (< 7 places)
Group homes provide combined accommodation and community based residential support to people in a residential setting. Usually no more than 6 service users are located in any one house, although this can vary. Group homes may or may not be staffed 24 hours a day. The agency being funded to provide the service must have control of the residence, that is, own, lease, hold in trust or in other ways be responsible for the residence, not just the support to enable the residents to remain in the residence. If the only service being provided is support to enable residents to remain in their existing accommodation, then see category 1.05 ‘attendant care/personal care’ or 1.06 ‘in-home accommodation support’.
1.05 Attendant care/personal care
An attendant care program provides for an attendant(s) to assist people with daily activities that they are unable to complete for themselves because of physical, intellectual or any other disability. The service is provided to people to assist them to live in the community, and to live on their own.
1.06 In-home accommodation support
Support involves individual in-home living support and/or developmental programming services for people with a disability, supplied independently of accommodation. The accommodation may be owned, rented or otherwise provided, but should be independent of the agency providing the in-home support service, otherwise see code 1.04 ‘group homes’. Where an in-home accommodation support services also provides some other limited assistance, for example help with banking once a week, then in-home accommodation should be recorded, as it is the primary focus of the support provided.
1.07 Alternative family placement
Placements of a person with disability with an alternative family who will provide care and support. Includes shared-care arrangements and host family placements.
1.08 Other accommodation support
Accommodation support services that provide short-term, one-off instances of accommodation such as:
•	accommodation provided so that individuals or families can access specialist services, or further education 
•	emergency or crisis accommodation support (for example, following the death of a parent or carer) 
•	houses or flats for holiday accommodation.
If the accommodation support is primarily for respite (that is, involves the separation of the service user from their usual support arrangements or the addition of extra support in their current environment) please refer to the relevant service type 4.01–4.05.
Community support
Services that provide the support needed for a person with disability to live in a non-institutional setting. Support with the basic needs of living, such as meal preparation, dressing, transferring, are included under accommodation support.
2.01 Therapy support for individuals
Specialised, therapeutic care services including occupational therapy, physiotherapy, speech pathology. These services are intended to improve, maintain or slow deterioration of a person’s functional performance, and/or assist in the assessment and recommendation of equipment to enable people to perform as independently as possible in their environment.
2.03 Behaviour/specialist intervention
These include the range of services relating to the management of challenging behaviours, including dangerous antisocial behaviour. Services include intensive intervention support, training and education in behaviour management, and consultancy services for other professionals. Behaviour/specialist intervention is often provided as a by-product of other services.
2.04 Counselling (individual/family/group)
Services that provide counselling to individuals, families or groups.
2.05 Regional resource and support teams
Regional resource and support teams are generally inter-disciplinary teams that provide a combination of services in the categories 2.01, 2.02 and 2.03 that cannot be broken down into the component parts. Regional resource and support teams may also assist service users to access mainstream services and/or support mainstream funded agencies. Except for early childhood intervention teams, these teams usually have an individual, rather than a family, focus.
2.06 Case management, local coordination and development
This is a broad service type category, including elements of individual- or family-focused case management and brokerage as well as coordination and development activity within a specified geographical area. Services assist people with disability to maximise their independence and participation in the community through working with the individual, family and/or carers in care planning and/or facilitating access to appropriate services. 
Case management services are targeted to individuals who require assistance, for a period of time, to access necessary supports, including help with service coordination and with assisting services to respond to their service needs. Brokerage is one method of purchasing appropriate supports for an individual and should be included in this category.
Other forms of local coordination and development generally involve working with the individual, family and/or carers and at the community level to facilitate positive changes that assist people with disability to live and participate in the community and assist families in their continued provision of care. Local coordination does not generally involve management of individuals’ funds and does not generally involve ongoing case management. However, discretionary funds are sometimes available for one-off purchases (for example respite or therapy) to enable a quick response until longer term supports can be put in place.
2.07 Other community support
Community support services other than those outlined above (that is, other than 2.01–2.06).
Community access
Services designed to provide opportunities for people with disability to gain and use their abilities to enjoy their full potential for social independence. People who do not attend school or who are not employed full-time mainly use these services.
The key features are that the services:
•	are flexible and responsive to personal needs and interests 
•	range from educational to leisure and recreational pursuits 
•	range from facility to home-based activities
•	include supervision and physical care, and models that link people into activities that are offered to the whole community 
•	range from long-term day support to time-limited and goal-oriented education that maximises personal independent functioning and may complement other community services.
3.01 Learning and life skills development
These programs provide ongoing day-to-day support for service users to gain greater access and participate in community-based activities. Programs may focus on continuing education to develop skills and independence in a variety of life areas (for example self-help, social skills, and literacy and numeracy) or enjoyment, leisure and social interaction. They are often called day programs. 
Activities under service type 3.01 may include:
•	attending courses to develop literacy and numeracy, financial and household management skills or classes such as cooking, arts and crafts, water aerobics and fitness 
•	undertaking trips to art galleries, libraries, movies, zoos, parks and nature reserves or outings that involve fishing or other recreational activities
•	undertaking tours to familiarise individuals with their local area and develop confidence in using public transport or visits to facilities such as hospitals, designed to alleviate the stress of future visits 
•	participating in volunteer programs such as helping at the RSPCA or landscaping and gardening programs 
•	attending social clubs, for example book, music or sporting clubs
•	going on shopping trips or eating out in various venues from food halls to restaurants.
3.02 Recreation/holiday programs
Recreation services and holiday programs aim to facilitate the integration and participation of people with disability in recreation and leisure activities available in the general community. These services may also enhance the capacity and responsiveness of mainstream sport and recreation agencies and community organisations to provide for people with disability.
3.03 Other community access
Community access services other than those outlined above (that is, other than 3.01–3.02)
Respite
Respite services provide a short-term and time-limited break for families and other voluntary care givers of people with disability, to assist in supporting and maintaining the primary care giving relationship, while providing a positive experience for the person with disability.
4.01 Own home respite
Respite care provided in the individual’s own home location.
4.02 Centre-based respite/respite homes
Respite care provided in community setting similar to a ‘group home’ structure and respite care provided in other centre-based settings. This service type includes respite care provided in any of the accommodation settings 1.01–1.04.
4.03 Host family respite/peer support respite
Host family respite provides a network of ‘host families’ matched to the age, interests and background of the individual and their carer. Peer support is generally targeted at children or young adults up to 25 years of age, and matches the individual with a peer of similar age and interests, usually for group activities. Usually provided on a voluntary basis.
4.04 Flexible respite
Respite services that offer any combination of own home, host family/peer support respite. Includes respite where day outings and camping trips are taken (this service type is distinguished from service type 3.02 ‘Recreation/holiday programs’ because the primary purpose is respite). Flexible respite to meet an individual’s needs may include brokerage for respite, only when the funding dollars come from respite resources.
4.05 Other respite
Respite services other than those outlined above (that is, other than 4.01–4.04), including:
•	crisis respite
•	holidays for the person with the disability where the primary intention of the service is to provide respite support (rather than primarily a holiday experience) and the service user is generally separated from their usual support arrangements such as family.
Other specified services
6 Advocacy, information and alternative forms of communication
Advocacy Services designed to enable people with disability to increase the control they have over their lives through the representation of their interests and views in the community. Examples include:
•	self-advocacy/individual advocacy 
•	citizen advocacy 
•	group advocacy 
•	system/systematic advocacy.
Information/referral Information services provide accessible information to people with disabilities, their carers, families and related professionals. This service type provides specific information about disability specific and generic services, equipment, and promotes the development of community awareness. Information includes contact by phone, print or email that recommends a person to another service.
Combined information/advocacy Services that offer both information and advocacy services to individuals where these two components cannot reasonably be separated.
Mutual support/self-help groups Focus, or special interest, groups to provide support and assistance for people with disabilities, their families and carers. These groups promote self-advocacy through the provision of information, support and assistance.Alternative formats of communication Includes alternative formats of communication for people who by reason of their disability are unable to access information provided in the standard format. May include interpreter services, radio and alternative formats of print medium, for example TTY or braille.
7 Research, evaluation, training and development, peak bodies.
Research and evaluation Research and evaluation with respect to the provision of services for people with disability. This includes the investigation of the need for new services or enhancement of existing services and the measurement of outcomes for people with disability using these services. 
Training and development Training and development services may be funded; for example, to train disability funded agencies to deliver higher quality or more appropriate services to people with disabilities or develop materials or methods that promote service system improvements.
Peak bodies Peak bodies are generally funded to support non-government disability funded agencies in achieving positive outcomes for people with disability.
8.01 Assistive products and technology
Includes products, equipment and technologies, adapted, specially designed or generally available that assist people to fulfil their daily lives according to their life goals. Included may be items for personal use in daily living, mobility, education, employment or leisure. For example continence products, prosthetic and orthotic devices, wheelchairs and vehicle adaptations, environment control mechanisms and communication assistive devices.
8.02 Modification to design or construction of buildings
Includes adaptations and modifications that enable entry and exit, routing through and around public or private buildings. For example ramps, bathroom facilities, electronic controls for entrances and exits, hand rails and lighting, textured surfaces and level door thresholds.
8.03 Transportation services
Includes services and programs aimed at moving people from one location to another, by road, path, air, rail or water by public or private transport. For example volunteer drivers, assisted taxi services and supporting companions on flights. 
8.04 Services provided by nurses
Includes all services performed by qualified nurses. The term ‘nurse’ includes all persons who were either registered or enrolled with a state or territory nursing and midwifery registration board. ‘Registered nurses’ include registered midwifes, direct entry midwives, nurse practitioners, midwife practitioners, and Division 1, 3, 4 and 5 nurses in Victoria. ‘Enrolled nurses’ include enrolled nurses (mothercraft) and Division 2 nurses in Victoria.
9.01 YPIRAC assessment
YPIRAC assessment includes all assessments where the aim is to determine the service user’s care needs and/or service needs for the purposes of administering the YPIRAC program. YPIRAC assessment includes the determination of the service user’s accommodation options and preferences. The scope and type of YPIRAC assessments conducted vary across jurisdictions. Different timeframes for assessment are available in different jurisdictions. 
Individual care planning includes planning for the individual’s care and service needs under the YPIRAC program. 
9.02 YPIRAC client monitoring
This refers to contact between the YPIRAC program and service users, which occurs after an initial YPIRAC assessment. It includes both regular and one-off contact, and may be in person, by telephone or by email. Purposes of this contact may include reviewing or reassessing the service user’s situation, care needs or service needs, or providing updates to service users regarding their involvement in the program. The contact should be on an individual basis. That is, activity such as letters and emails that are provided to more than one service user should not be included.
10 Other support services
Services that are completely outside any of the defined service types above (that is, outside service types 1.01–1.08, 2.01–2.07, 3.01–3.03, 4.01–4.05, 6, 7, 8.01–8.04 and 9.01–9.02). This service type also includes the provision of one-off funding for a defined event (for example for promotional activities) or for the purchase of aids and equipment for a community facility (not for an individual). Any support services that fall into this category should be specified.

Appendix 4: English proficiency groupings
An ‘English proficiency index’—a standard tool developed by the Bureau of Immigration, Multicultural and Population Research—was used to construct each of the English Proficiency (EP) Groups (see AIHW: Benham et al. 2000). Those countries consisting of immigrants who scored 98.5% or higher on this index and had an immigrant population of 10,000 or more were rated as EP Group 1. Because the number of usual immigrant residents has reached more than 10,000, Zimbabwe is also in EP Group 1. 
The remaining EP Groups were determined by their EP index score as follows:
•	countries with a ‘high’ level of English proficiency (84.5–98.5%, or above 98.5% but with an immigrant population of fewer than 10,000) were placed in EP Group 2
•	countries with a ‘moderate’ level of English proficiency (a rating of more than 57.5% but less than 84.5%) fell into EP Group 3
•	the remaining countries (that is, those with a rating on the EP index of less than 57.5%) were considered to have a ‘low’ level of English proficiency and placed in EP Group 4.
Table A4.1: English proficiency group classification
English 
Proficiency Group	Countries	
Group 1	Canada	South Africa	United States of America	
	Ireland 	United Kingdom	Zimbabwe	
	New Zealand			
Group 2	Americas nfd	Brunei Darussalam	Dominica	
	Andorra	Bulgaria	Dominican Republic	
	Angola	Burkina Faso	Eastern Europe nfd	
	Antigua and Barbuda	Burundi	Equatorial Guinea	
	Aruba	Cameroon	Faeroe Islands	
	At sea	Cape Verde	Falkland Islands	
	Australian ext. territories nec	Caribbean nfd	Fiji	
	Austria	Cayman Islands	Finland	
	Bahamas	Central African Republic	France	
	Bahrain	Central America nfd	French Guiana	
	Bangladesh	Chad 	French Polynesia	
	Barbados	Chilean Antarctic Territory	Gabon	
	Belgium	Comoros	Gambia	
	Belize	Congo, Democratic Republic of	Germany	
	Benin	Cook Islands	Ghana	
	Bermuda	Costa Rica	Gibraltar	
	Bhutan	Cote D’Ivoire	Greenland	
	Botswana	Czech Republic	Grenada	
	Brazil	Denmark	Guadeloupe	
	Guam	Nauru	Slovakia	
	Guatemala	Nepal 	Slovenia 	
	Guinea-Bissau 	Netherlands 	Solomon Islands 	
(continued)
Table A4.1 (continued): English proficiency group classification
English 
Proficiency Group	Countries	
Group 2 (cont.)	Guyana 	Netherlands Antilles 	South America nec	
	Haiti 	New Caledonia 	Southern and East Africa nec	
	Holy See 	Niger 	Southern and East Africa nfd 	
	Iceland 	Nigeria 	Southern and Eastern Europe nfd	
	India 	Niue 	Southern Asia nfd	
	Indonesia	Norfolk Island 	Spain 	
	Israel 	North Africa nec	Sri Lanka 	
	Jamaica 	North Africa nfd 	St Helena 	
	Kenya 	Northern America nfd 	St Kitts and Nevis 	
	Kiribati 	Northern Europe nfd 	St Lucia 	
	Latvia	Northern Mariana Islands 	St Pierre and Miquelon	
	Lesotho 	Norway 	St Vincent and the Grenadines 	
	Liberia 	Oceania and Antarctica nfd	Suriname 	
	Liechtenstein 	Oman 	Swaziland 	
	Luxembourg 	Pakistan 	Sweden 	
	Madagascar 	Palau 	Switzerland 	
	Malawi	Panama	Tajikistan 	
	Malaysia	Papua New Guinea 	Tanzania 	
	Maldives 	Philippines	Tokelau	
	Mali 	Polynesia (excludes Hawaii) nec	Tonga 	
	Malta 	Polynesia (excludes Hawaii) nfd	Trinidad and Tobago 	
	Maritime South-East Asia nfd	Puerto Rico	Tunisia	
	Marshall Islands 	Qatar 	Turks and Caicos Islands 	
	Martinique 	Reunion 	Tuvalu 	
	Mauritania 	Rwanda 	Uganda 	
	Mauritius 	Samoa	United Arab Emirates 	
	Melanesia nfd	Samoa, American	Vanuatu 	
	Mexico 	San Marino 	Venezuela 	
	Micronesia, Federated States of	Sao Tome and Principe 	Virgin Islands, British 	
	Monaco 	Saudi Arabia	Virgin Islands, United States 	
	Montserrat 	Senegal	Wallis and Futuna 	
	Morocco 	Seychelles 	Western Sahara	
	Mozambique 	Sierra Leone 	Zambia	
	Namibia 	Singapore 		
Group 3	Afghanistan 	Belarus	Chile	
	Albania 	Bolivia	China (excl. SARs and Taiwan province)	
	Algeria	Bosnia and Herzegovina	Colombia	
	Argentina 	Burma (Myanmar) 	Croatia	
	Armenia 	Central and West Africa nfd	Cuba 	
	Cyprus	Jordan	Portugal	
(continued)
Table A4.1 (continued): English proficiency group classification
English 
Proficiency Group	Countries	
Group 3 (cont.)	Djibouti	Kazakhstan	Romania 	
	Ecuador	Korea, Democratic People’s Republic of (North)	Russian Federation 	
	Egypt	Korea, Republic of (South)	Somalia	
	El Salvador 	Kuwait	South Eastern Europe nfd	
	Eritrea 	Kyrgyz Republic	South-East Asia nfd	
	Estonia	Lebanon	Sudan 	
	Ethiopia 	Libya 	Syria 	
	Former Yugoslav Republic of Macedonia (FYROM)	Lithuania 	Taiwan 	
	Gaza Strip and West Bank	Macau (SAR of China)	Thailand 	
	Georgia 	Micronesia nfd	Togo	
	Greece 	Middle East nfd	Turkmenistan	
	Honduras	Moldova 	Ukraine 	
	Hong Kong (SAR of China)	Mongolia 	Uruguay 	
	Hungary 	Nicaragua 	Uzbekistan 	
	Iran	North Africa and the Middle East nfd	Yemen 	
	Iraq	Paraguay 	Yugoslavia, Federal Republic of	
	Italy 	Peru 		
	Japan	Poland		
Group 4	Antarctica nfd	East Timor	Southern Europe nfd	
	Azerbaijan	Guinea	Turkey	
	Cambodia	Japan and the Koreas nfd	Viet Nam	
	Central Asia nfd	Laos		
	Chinese Asia (includes Mongolia) nfd	Mainland South-East Asia nfd		
Notes:
1.	nfd—not further defined.
2.	nec—not elsewhere classified.
3.	SAR—special administrative region.
Source: DIMA 2003.

Appendix 5: Residential setting definitions
YPIRAC service users may have changed their residential setting during the reporting period. For the 2008–09 YPIRAC MDS collection, data on ‘usual residential setting’ relates to the type of accommodation in which the person lives for 4 or more days per week on average, as at 30 June 2009. Service users who exited the program during the reporting period should have recorded their usual residential setting on the date they exited the program.
The following definitions are taken from the YPIRAC MDS data guide 2008–09, available on request.
1 Private residence
This refers to private residences, which include a wide range of dwelling types, such as houses, flats, units, caravans, mobile homes, boats etc. It includes public or private rental properties and those which are owned or being purchased.
2 Residence within an Aboriginal/Torres Strait Islander community
This code should be used for service users that live in this type of setting, regardless of whether the residence is a private residence or a public place/temporary shelter (codes 1 and 11).
3 Domestic-scale supported living facility
This refers to community living settings in which service users reside in a facility that provides support in some way by staff or volunteers. This category includes group homes, cluster apartments where a support worker lives on site, community residential apartments, congregate care arrangements, etc. Domestic-scale supported living settings may or may not have 24-hour supervision and care. Independent living units in retirement villages should be coded 6 and community psychiatric facilities should be coded to 8. (Service users receiving service type 1.04 ‘Group homes’ should be coded 3).
4 Supported accommodation facility
This refers to settings in which service users reside in an accommodation facility which provides board or lodging for a number of people and which has support services provided on what is usually a 24-hour basis by rostered care workers. (Service users receiving service types 1.01, 1.02 or 1.03 should be coded to 4). Supported accommodation facilities include hostels for people with disability. This code should be used for larger supported accommodation facilities (usually 7 or more people) that provide 24-hour supervision or care. Smaller supported accommodation facilities (that is, fewer than 7 people) which may or may not have 24-hour supervision or care should be coded to 3 ‘Domestic-scale supported living facility’. Aged care hostels should be coded to 7 ‘Residential aged care facility’. 
5 Boarding house/private hotel
6 Independent living within a retirement village
7 Residential aged care facility
This includes permanent residents of residential aged care services (formerly nursing homes and aged care hostels) and multi-purpose services or multi-purpose centres, who are receiving low-level or high-level care.
8 Psychiatric/mental health community care facility
This refers to community care units which provide accommodation and non-acute care and support on a temporary basis to people with mental illness or psychological disabilities.
9 Hospital
10 Short term crisis, emergency or transitional accommodation
This may include night shelters, refuges, hostels for the homeless and halfway houses.
11 Public place/temporary shelter
This includes public places such as streets and parks, as well as temporary shelters such as bus shelters or camps and accommodation outside legal tenure arrangements, such as squats.
12 Other
This includes situations such as a child under a court/guardianship order with no usual address.

Appendix 6: The statistical linkage key
The YPIRAC MDS collection includes the SLK. The SLK enables individual service users to be tracked over time.
The SLK is created from the SLK components of each service user record (questions 2a–2e and 2c of the service user file—see Appendix 1). To link service user records in different data sets, records are matched by SLK. That is, records that have matching SLKs are assumed to belong to the same service user and are linked. 
Some degree of false linking is expected. Because the SLK is not a unique identifier, there is a small probability that some of the linked records do not actually belong to the same individual and, conversely, that some records that did not link do belong to the same individual. For privacy reasons, the SLK is not personally identifiable information. The extent to which records from the same service user can be correctly matched also depends on the accuracy of the component data items. In the 2006–07, 2007–08 and 2008–09 YPIRAC MDS data collections, data were provided for all SLK components, for all service users.
The inclusion of the SLK also means that data from the YPIRAC MDS could potentially be linked with other data collections which collect the SLK, such as the CSTDA NMDS (now called the Disability Services NMDS), in the future. 

References
ABS (Australian Bureau of Statistics) 2006. Statistical geography volume 1, Australian standard geographical classification (ASGC). ABS cat. no. 1216.0. Canberra: ABS.
ABS (Australian Bureau of Statistics) 2007. 2006 Census tables. ABS cat. no. 2068.0. Canberra: ABS. Viewed 26 November 2008, <http://abs.gov.au/websitedbs/D3310114.nsf/home/Census+data>.
AIHW (Australian Institute of Health and Welfare) 2002. Aged Care Assessment Program data dictionary version 1.0. Cat. no. AGE 26. Canberra: AIHW.
AIHW 2009a. Disability support services 2007–08: national data on services provided under the Commonwealth State/Territory Disability Agreement. Disability series. Cat. no. DIS 56. Canberra: AIHW.
AIHW 2009b. Younger People with Disability in Residential Aged Care program: Final report on the 2007–08 Minimum Data Set. Disability series. Cat. no. DIS 53. Canberra: AIHW.
AIHW: Benham C, Gibson D, Holmes B & Rowland D 2000. Independence in ageing: the social and financial circumstances of older overseas-born Australians. Cat. no. AGE 15. Canberra: Department of Immigration and Multicultural Affairs & AIHW. 
AIHW: Karmel R, Lloyd J, Anderson P 2008. Movement from hospital to residential aged care. Data linkage series no. 6. Cat. no. CSI 6. Canberra: AIHW.
DIMA (Australian Government Department of Immigration and Multicultural Affairs) 2003. 2001 classification of countries into English Proficiency Groups. Statistical focus C01.2.0. Canberra: DIMA.
URBIS 2009. Mid-Term Review, Younger People in Residential Aged Care (YPIRAC) Program: prepared for Australian Government Department of Families, Housing, Community Services and Indigenous Affairs. Canberra: URBIS. 
List of tables
Table 2.1:	YPIRAC service users, by age group and state and territory, 2008–09
Table 2.2:	YPIRAC service users, by target group and state and territory, 2008–09
Table 2.3:	YPIRAC service users, by age group and Indigenous status, 2008–09
Table 2.4:	YPIRAC service users, by Indigenous status and state and territory, 2008–09
Table 2.5:	YPIRAC service users, by age group and country of birth, 2008–09
Table 2.6:	YPIRAC service users, by country of birth and state and territory, 2008–09
Table 2.7:	YPIRAC service users, by usual residential setting and age group, 2008–09
Table 2.8:	YPIRAC service users, by main reason for current accommodation and state and territory, 2008–09
Table 2.9:	YPIRAC service users, additional reasons for current accommodation, as at 
30 June 2009
Table 2.10:	YPIRAC service users, by primary disability group and age group, 2008–09
Table 2.11:	YPIRAC service users, by primary disability group and YPIRAC target group, 
2008–09
Table 2.12:	YPIRAC service users, by age group and total number of disability groups, 2008–09
Table 3.1:	YPIRAC service users, by target group and YPIRAC-specific services received, 
2008–09
Table 3.2:	YPIRAC service users, by state and territory and YPIRAC-specific services received, 
2008–09
Table 3.3:	YPIRAC service users, by residential setting and YPIRAC-specific services received, 
2008–09
Table 3.4:	YPIRAC service users, by combinations of YPIRAC-specific services received and 
state and territory, 2008–09
Table 3.5:	YPIRAC service users, by state and territory, and status of assessment and care 
planning or monitoring, 2008–09
Table 3.6:	YPIRAC service users, by state and territory and status of alternative accommodation 
offer, 2008–09
Table 3.7:	YPIRAC service users, by state and territory and status of support services package 
offer, 2008–09
Table 3.8:	YPIRAC service users, by receipt of a support services package, usual residential 
setting and state and territory, 2008–09
Table 3.9:	YPIRAC service users, by service groups received, 2008–09
Table 3.10:	YPIRAC service users, by service types received, 2008–09
Table 3.11:	YPIRAC service users, by selected service types received and state and territory, 
2008–09
Table 4.1:	New and continuing YPIRAC service users, by state and territory, 2008–09
Table 4.2:	New and continuing YPIRAC service users, by age group and target group, 2008–09
Table 4.3:	New and continuing YPIRAC service users, by Indigenous status and state and 
territory, 2008–09
Table 4.4:	New and continuing YPIRAC service users, by primary disability group, 2008–09
Table 4.5:	New and continuing YPIRAC service users by usual residential setting, 2008–09
Table 4.6:	New and continuing YPIRAC service users, by YPIRAC–specific services received, 
2008–09
Table 4.7:	New and continuing YPIRAC service users, by services received, 2008–09
Table 4.8:	New and continuing YPIRAC service users who received alternative accommodation, 
by usual residential setting and target group, 2008–09
Table 4.9:	Service users who exited the YPIRAC program during 2008–09, by state and territory
Table 4.10:	Service users who exited the YPIRAC program during 2008–09, by usual residential setting and age group
Table 4.11:	Service users who exited the YPIRAC program during 2008–09, by main reason for cessation of services and age group
Table 4.12:	Service users who exited the YPIRAC program during 2008–09, by main reason for cessation of services and target group
Table 5.1:	YPIRAC service users, by state or territory, 2006–07 to 2008–09
Table 5.2:	YPIRAC service users, by age group, 2006–07 to 2008–09
Table 5.3:	YPIRAC service users, by YPIRAC target group, 2006–07 to 2008–09
Table 5.4:	YPIRAC service users, by Indigenous status, 2006–07 to 2008–09
Table 5.5:	YPIRAC service users, by English Proficiency Group, 2006–07 to 2008–09
Table 5.6:	YPIRAC service users, by usual residential setting, 2006–07 to 2008–09
Table 5.7:	YPIRAC service users by primary disability group, 2006–07 to 2008–09
Table 5.8:	YPIRAC service users by total number of disability groups, 2006–07 to 2008–09
Table 5.9:	YPIRAC service users, by combinations of YPIRAC-specific services received, 2006–07 
to 2008–09
Table 5.10:	Estimated running tally of YPIRAC service users in receipt of YPIRAC-specific services since commencement of the program
Table 5.11:	Estimated number of YPIRAC service users who have achieved program objectives, 2006–07 to 2008–09
Table 5.12:	Estimated running tally of YPIRAC service users who have achieved program 
objectives since entry to the program
Table 5.13:	Estimated running tally of YPIRAC service users who have achieved program 
objectives since entry to the program, by state and territory
Table 5.14:	YPIRAC service users who received services in both 2007–08 and 2008–09, by target group in each period
Table 6.1:	Number of contacts, acceptances and refusals, by age group and state and territory, 
2008–09
Table 6.2:	Permanent aged care residents under 65 years, by age group, as at 30 June 2003–2008
Table 6.3:	Admissions to permanent residential aged care for people aged less than 65 years, 
by age group and state and territory, 2004–05 to 2007–08 (first non-transfer 
admissions in year)
Table 6.4:	ACAT assessments for people aged less than 50 years at referral, recommended 
long-term care setting by state and territory, 2007–08
Table 6.5:	ACAT assessments for people aged less than 50 at referral with recommended 
long-term care setting of residential aged care, usual accommodation setting, 2007–08
Table 6.6:	ACAT assessments for people aged less than 50 at referral with recommended 
long-term care setting of residential aged care, by primary health condition, 2007–08
Table 7.1:	‘Not stated’ responses for service user data items, 2007–08 and 2008–09
Table A1.1:	YPIRAC service users, by age group and sex, 2008–09
Table A1.2:	YPIRAC service users, by remoteness area and age group, 2008–09
Table A1.3:	YPIRAC service users, by remoteness area and state and territory, 2008–09
Table A1.4:	YPIRAC service users, by usual residential setting and YPIRAC target group, 2008–09
Table A1.5:	YPIRAC service users, by primary disability group and all significant disability 
groups, 2008–09
Table A1.6:	Contacts, acceptances and refusals, by age group and state and territory, 2006–07 to
2008–09
Table A4.1:	English proficiency group classification
List of figures
Figure 2.1:	YPIRAC service users, by age group and sex, 2008–09
Figure 4.1:	YPIRAC service users, by usual residential setting, 2007–08 to 2008–09
Figure 6.1:	Number of potential service users contacted by state and territory, 2006–07 to 2008–09
Figure 6.2:	Summary of contact with potential YPIRAC service users, 2006–07 to 2008–09