Younger people with disability in residential aged care
2010–11

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Australian Institute of Health and Welfare 2012. Younger people with disability in residential aged care 2010–11. Bulletin no. 103. Cat. no. AUS 155. Canberra: AIHW.
Australian Institute of Health and Welfare
Board Chair
Dr Andrew Refshauge
Director
David Kalisch
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Contents
Acknowledgments
Symbols
Summary
1	The Younger People with Disability in  Residential Aged Care (YPIRAC)  initiative
2	YPIRAC target population
3	YPIRAC service users
4	Services received
5	The YPIRAC initiative from 2006–07 to  2010–11
7	Further information
A	Technical appendix
References
List of tables
List of figures
Related publications
Acknowledgments
This bulletin was prepared by Nathan Wakefield, Glyn Prichard and Felicity Murdoch. It builds on previous reports from the AIHW, as well as developments in, and contributions from, all jurisdictions responsible for delivering Younger People with Disability in Residential Aged Care (YPIRAC) services.
The AIHW project team would like to thank all state and territory YPIRAC program managers and their staff for their assistance in collecting and reporting data for the 2010–11 YPIRAC Minimum Data Set.
Thanks also to 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.
Abbreviations
ACAP	Aged Care Assessment Program	
ACAT	Aged Care Assessment Team	
ACCMIS	Aged and Community Care Management
Information System	
AIHW	Australian Institute of Health and Welfare	
CSTDA	Commonwealth State and Territory Disability Agreement	
DS-ACAS	Disability Services—Aged Care Assessment Service	
MDS	Minimum data set	
NDA	National Disability Agreement	
SLK	statistical linkage key	
YPIRAC	Younger People with Disability in Residential Aged Care
	
Symbols
—	nil or rounded to zero	
. .	not applicable	
no.	number	
n.p.	not publishable because of small numbers, confidentiality or other concerns about the quality of the data	
Summary
The Younger People with Disability in Residential Aged Care (YPIRAC) initiative is a 5-year program agreed on by the Council of Australian Governments. It aims to reduce the number of people with disability aged under 65 who live in residential aged care. 
In 2010–11, a total of 1,087 people received services funded by the YPIRAC initiative. Of these, just under two-thirds (63%) were aged under 50; 9% were Aboriginal or Torres Strait Islander origin; 6% were from non-English-speaking backgrounds; 45% had a primary disability relating to acquired brain injury; and 30% had a neurological primary disability. 
Many younger people with disability continue to achieve YPIRAC objectives, less end up in residential aged care
Over the five years of YPIRAC to 2010–11, an estimated 1,432 people received services from the YPIRAC initiative. Of these, an estimated 250 people achieved the first YPIRAC objective (a move out of residential aged care to more appropriate accommodation); 244 people achieved the second YPIRAC objective (diversion from residential aged care); and 456 people achieved the third YPIRAC objective (receiving enhanced services within residential aged care, when this was the only available, suitable accommodation option).
Over the life of the YPIRAC initiative, the total number of permanent residents of residential aged care aged under 65 has generally decreased and, in particular, there has been a 35% drop in the number of persons under 50 living in permanent aged care since 2005–06. 
YPIRAC helps many younger people with disability find appropriate accommodation 
In 2010–11, 20% of service users had moved from residential aged care to alternative accommodation; 26% had agreed to move from residential aged care, but had not yet done so; 28% were receiving services intended to divert them from inappropriately entering residential aged care; and 31% remained in residential aged care with additional services. It is possible for service users to receive a combination of services.
Over half (53%) of YPIRAC service users received a service support package in 2010–11, and 20% of all service users received both alternative accommodation and support services.
1	The Younger People with Disability in 	Residential Aged Care (YPIRAC) 	initiative
Concerns were expressed at an the inquiry into Quality and equity in aged care, held by the Senate Community Affairs Committee in 2005, about the current system’s capacity to meet the needs of younger people with disability. In response to these concerns, the YPIRAC initiative was agreed on by the Council of Australian Governments in February 2006. YPIRAC has three main objectives:
•	to move younger people with disability living in residential aged care into appropriate supported disability 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 and suitable supported accommodation option.
To meet these objectives, the YPIRAC initiative provides three broad categories of services:
•	YPIRAC assessment, individual care planning and/or client monitoring
•	alternative accommodation
•	support services packages.
Examples of services provided include the provision of assistive products and technology, respite care, learning and skills development, therapy support (such as occupation therapy, physiotherapy and speech pathology), as well as attendant/personal care.
On 1 January 2009, the National Disability Agreement (NDA) replaced the Commonwealth State and Territory Disability Agreement (CSTDA). The NDA provides the framework for the provision of government support for people with disability. Australian Government funding for the YPIRAC initiative was rolled into funding provided to the state and territory governments for the NDA; however, YPIRAC targets remain as agreed in the previous bilateral agreements.
This bulletin reports on data collected for the YPIRAC Minimum Data Set (MDS) in the 2010–11 collection period. It presents information on the people who were provided with support under the YPIRAC initiative (YPIRAC service users) and the services they received during the reporting period (1 July 2010 to 30 June 2011). It does not include information on the assistance provided to younger people with disability in, or at risk of entering, residential aged care, separate to the YPIRAC initiative. For more information about the YPIRAC MDS, see the report Younger People with Disability in Residential Aged Care program: report on the 2008–09 Minimum Data Set (AIHW 2010).
2	YPIRAC target population
The YPIRAC initiative aims to reduce the number of younger people with disability living in residential aged. While the initial priority of the YPIRAC initiative is to achieve the objectives in relation to people with disability aged under 50, where possible these objectives are extended to people with disability under the age of 65.
2.1	Younger people in residential aged care
Younger people with disability living in residential aged care may receive YPIRAC services to achieve either one of two objectives:
•	moving out of residential aged care to more appropriate accommodation (such as supported accommodation)
•	being provided with enhanced services (such as targeted community support and access) within residential aged care.
Information on younger people admitted to, and living in, residential aged care is available from the Department of Health and Ageing’s Aged and Community Care Management Information System (ACCMIS). According to this:
•	6,381 people aged under 65 were living in residential aged care at 30 June 2011; 658 of these were  under 50 (Table 1)
•	while the number of people  under the age of 65 living in residential aged care fell slightly (3%) from June 2006 to June 2011, the number of people aged under 50, the initial primary focus group of YPIRAC, fell by 35% partly reflecting the success of diversionary programs (Table 1)
•	the number of people  under 50 admitted annually to residential aged care has generally decreased by 21% between 2005–06 and 2010–11 (Table 2).
•	the number of people aged 50–64 admitted to residential aged care was lowest in 2006–07, with 1,602 people, but rose slightly in each subsequent year to reach 1,733 people in 2010–11 (Table 2). 

Table 1: Permanent aged care residents aged under 65, by age group and state and territory, as at 30 June 2003–2011
Year	NSW	Vic	Qld	WA	SA	Tas	ACT	NT	Total	
Under 50	
2006	391	221	244	65	60	15	<5	<10	1,007	
2007	374	210	226	63	53	12	<5	<10	945	
2008	335	209	179	58	55	11	<5	<10	857	
2009	333	181	158	58	54	14	<5	<20	810	
2010	304	145	131	54	53	15	<5	<10	715	
2011	287	133	119	49	48	12	<5	<10	658	
50–64	
2006	1,952	1,365	1,156	430	423	130	43	51	5,550	
2007	1,997	1,367	1,163	449	423	132	56	45	5,632	
2008	2,036	1,406	1,178	460	435	141	63	33	5,752	
2009	1,989	1,400	1,147	483	421	149	63	41	5,693	
2010	2,059	1,383	1,157	484	422	148	65	45	5,763	
2011	2,010	1,393	1,115	447	504	137	69	48	5,723	
Total	
2006	2,343	1,586	1,400	495	483	145	<50	<70	6,557	
2007	2,371	1,577	1,389	512	476	144	<70	<60	6,577	
2008	2,371	1,615	1,357	518	490	152	<70	<50	6,609	
2009	2,322	1,581	1,305	541	475	163	<70	<70	6,503	
2010	2,363	1,528	1,288	538	475	163	<70	<60	6,478	
2011	2,297	1,526	1,234	496	552	149	<80	<60	6,381	
Note: Totals include Indigenous Australians aged 50–64 who are eligible for residential aged care services, see additional tables for totals.
Source: AIHW analysis of the Aged and Community Care Management Information System (ACCMIS) as at December 2011.

Table 2: People admitted to permanent residential aged care aged under 65, by age group and state and territory, 2004–05 to 2010–11
Year	NSW	Vic	Qld	WA	SA	Tas	ACT	NT	Total	Change from previous year
(per cent)	
Under 50	
2004–05	117	71	72	20	30	<10	—	<5	318	. .	
2005–06	89	71	49	21	25	<5	<5	<5	262	–17.6	
2006–07	90	59	48	17	17	<5	<5	—	234	–10.7	
2007–08	76	58	27	18	19	5	<5	<5	208	–11.1	
2008–09	93	59	32	18	19	6	—	5	232	11.5	
2009–10	68	47	33	22	22	8	<5 	<5	204	–12.1	
2010–11	74	56	32	17	20	<5	<5	<5	207	1.5	
50–64	
2004–05	577	393	353	134	180	38	18	7	1,700	. .	
2005–06	587	380	322	145	162	34	17	15	1,662	–2.2	
2006–07	573	363	302	151	143	40	20	10	1,602	–3.6	
2007–08	568	391	318	137	157	50	17	10	1,648	2.9	
2008–09	578	366	322	164	145	60	20	12	1,667	1.2	
2009–10	591	391	340	162	134	56	19	15	1,708	2.5	
2010–11	598	406	310	165	162	57	15	20	1,733	1.5	
Total	
2004–05	694	464	425	154	210	<50	18	<20	2,018	. .	
2005–06	676	451	371	166	187	<40	<30	<20	1,924	–4.7	
2006–07	663	422	350	168	160	<50	<30	10	1,836	–4.6	
2007–08	644	449	345	155	176	55	<30	<20	1,856	1.1	
2008–09	671	425	354	182	164	66	20	17	1,899	2.3	
2009–10	659	438	373	184	156	64	<30	<20	1,912	0.7	
2010–11	672	462	342	182	182	<70	<20	<30	1,940	1.5	
Notes:
1.	Age reported is age at admission.
2.	Data represents counts of the first non-transfer admission in the year.
Source: AIHW analysis of the Aged and Community Care Management Information System (ACCMIS) as at December 2011.

2.2	Younger people at risk of entering residential 	aged care
Younger people with disability who are at risk of entering residential aged care may receive YPIRAC services to achieve the YPIRAC objective: 
•	diversion from inappropriate admission to residential aged care to more appropriate supported and group accommodation or other arrangements.
There is limited information available on the number of younger people with disability at risk of entering residential aged care. Assessments to determine eligibility for aged care services are one possible data source, available from the Aged Care Assessment Program (ACAP) Minimum Dataset. Under the ACAP, Aged Care Assessment Teams (ACATs) are responsible for assessing clients, making recommendations for their long-term care and support, and approvals for Australian Government-subsidised aged care services provided under the Aged Care Act 1997. This includes residential aged care. An ACAT should only accept a referral of a younger person with disability where there are no other facilities or care services appropriate to meet the person’s needs. 
A decrease over time in the number of younger people referred to an ACAT may indicate that more younger people are being diverted to YPIRAC funded accommodation or other support services that provide assistance to younger people with disability at risk of entering residential aged care.
During 2009–10, a total of 790 ACAT assessments of people under the age of 50 were completed (Table 3). Of these:
•	just over 28% (225 assessments) recommended long-term, high-level care in residential aged care
•	a further 6% (48 assessments) recommended low-level care in residential aged care
•	there was a large increase in the number of people with not stated or inadequately described settings, and this was due to an increase in the number of incomplete assessments compared with previous years. 
From 2006–07 to 2009–10:
•	the number of ACAT assessments for people aged under 50 increased by 9%; however the number recommending long-term, high level care in residential aged care fell by 20% and the number recommending low level care in residential aged care fell by 21% (Table 3)
•	the number of ACAT assessments recommending a long-term care setting of residential aged care fell in all jurisdictions except for Western Australia and Tasmania. It fell most sharply in Queensland (by 41%) and Victoria (32%) (Table 4).

Table 3: ACAT assessments for people aged under 50 at referral, recommended long-term care setting, 2006–07 to 2009–10
Recommended long-term care setting	2006–07	2007–08	2008–09	2009–10	Change 2006–07 to 2009–10
(per cent)	
Private residence	317	311	288	277	–12.6	
Other community	41	<50	30	40	–2.4	
Residential aged care—low level care	61	77	53	48	–21.3	
Residential aged care—high level care	281	280	278	225	–19.9	
Other	22	34	20	58	136.6	
Not stated/inadequately described	5	<5	—	142	2,740.0	
Total	727	745	669	790	8.7	
Notes: 
1.	Some clients may receive more than one ACAT assessment within a financial year.
2.	Table excludes 54 clients in 2006–07, 54 clients in 2007–08 and 6 clients in 2008–09 with invalid age data.
Source: AIHW analysis of selected data from the Aged Care Assessment Program Minimum Dataset.
Table 4: ACAT assessments for people aged under 50 at referral with recommended 
long-term care setting of residential aged care by state and territory, 2006–07 to 2009–10
State/territory	2006–07	2007–08	2008–09	2009–10	Change 
2006–07 to 2009–10
(per cent)	
New South Wales	116	110	133	96	–17.2	
Victoria	81	98	68	55	–32.1	
Queensland	78	61	65	46	–41.0	
Western Australia	26	45	24	29	11.5	
South Australia	30	27	27	28	–6.7	
Tasmania	7	10	6	11	57.1	
Australian Capital Territory	<5	<5	<5	<5	n.p.	
Northern Territory	<5	<5	<10	<5	n.p.	
Total	342	357	331	273	-20.2	
n.p.	Not published
Notes: 
1.	Some clients may receive more than one ACAT assessment within a financial year.
2.	Table excludes 54 clients in 2006–07, 54 clients in 2007–08 and 6 clients in 2008–09 with invalid age data.
Source: AIHW analysis of selected data from the Aged Care Assessment Program Minimum Dataset.

2.3	Identifying potential YPIRAC service users
The age and target groups considered for entry into the YPIRAC initiative vary across the states and territories, as do the methods used to identify and contact potential service users. 
In New South Wales there was an initial mail-out to potential applicants aged under 50 living in residential aged care. There has been no further mail-out. Some people who did not respond to the initial mail-out contacted the YPIRAC program managers at a later date, after seeing the impact of the YPIRAC initiative on fellow residents. New South Wales continues to accept all applications to the initiative, but does not actively recruit applicants. The current YPIRAC target group in New South Wales is people under the age of 50 who are already residing in residential aged care. This is due to the high demand for services and the limitations of supports that can be provided to those in hospitals or in the community.  New South Wales will accept and register all applications received into the program.
In Victoria, at the start of the YPIRAC initiative, all people in residential aged care under the age of 50 were contacted to invite them to participate in a planning and assessment process. Under the Disability Services—Aged Care Assessment Service (DS–ACAS) protocol, people at risk of admission to residential aged care are made known to regional disability teams. At this point, client preferences and support options are explored. 
In Queensland, people aged 18–49 were initially contacted regarding possible or actual admissions to aged care. In addition, referrals may come from Disability and Community Care Services intake processes, as well as directly from external agencies. Information about the YPIRAC initiative is provided to people aged 50–64 on request. 
In South Australia, YPIRAC program managers monitor entrants to residential aged care to identify potential service users. People with disability aged under 65 who are at risk of admission to residential aged care are referred to the Disability South Australia Accommodation Placement Panel (APP), and if deemed eligible by the APP, either an ACAT assessment is requested or the person is referred directly to the YPIRAC initiative if they are aged under 50.
In the Australian Capital Territory, expression of interest processes were undertaken among those under the age of 55 living in residential aged care to identify those seeking alternative living arrangements or additional services. 
In some jurisdictions, YPIRAC resources are fully allocated against some or all of the objectives, and additional service users are not identified or contacted.
The initial commitment for the YPIRAC initiative was for five years. At their October 2011 meeting, Ministers agreed to a continued effort to meet each of the three objectives under the YPIRAC initiative.

2.4	Assessment of potential YPIRAC service users
The highest number of initial contacts with potential service users for assessment of need purposes was made in the first year of the YPIRAC initiative (1,123). Since 2006–07, the total number of contacts each year has followed a strong downward trend; however in 2010-11 there has been an increase of about 17% compared with 2009–2010. The overall downward trend in initial contacts each year is due to the initial target population for the YPIRAC initiative having been mostly reached and the remaining resources becoming constrained. Not all approaches are accepted or declined immediately, and some people may not respond until years later. As a result, although the numbers of contacts have increased in 2010–11, acceptances and refusals have continued declining but will likely increase in later years (Figure 1).
It may also take some time before people who accept contact are assessed and, if found eligible, receive YPIRAC services. In addition, some people apply directly to the YPIRAC initiative and are accepted as service users. The number of YPIRAC service users has therefore increased each year. 
In 2010–11, initial contact was made with a total of 225 people. Of these, 130 people indicated that they would like to be considered for inclusion in the YPIRAC initiative. Those who did not accept or declined contact in 2010–11 may change their minds in later years. Nearly two-thirds of these initial contacts were with people under the age of 50 (See YPIRAC additional tables: Table A6).
Figure 1: Summary of contact with potential YPIRAC service users, 2006–07 to 2010–11
Stacked line chart showing, for contacts, acceptances, refusals, not yet contacted and service users, on the y-axis number and on the x-axis reporting period.
Notes:
1.	‘Contacts made’ refers to the number of people who were contacted regarding possible participation in YPIRAC. 
2.	‘Acceptances’ refers to the number of people who accepted an initial contact from YPIRAC. 
3.	‘Refusals’ refers to the number of people who refused an initial contact from YPIRAC.
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 YPIRAC. 
5.	People who accepted or refused contact may have first been contacted in a previous reporting period.
Source: AIHW analysis of YPIRAC MDS for 2006–07, 2007–08, 2008–09, 2009–2010 and 2010–11.
3	YPIRAC service users
In 2010–11, 1,087 people received YPIRAC services, compared with 943 service users in 2009–10 and 260 service users at the commencement of the YPIRAC initiative in 2006–07 (Table 9).
3.1	YPIRAC target groups
Program managers allocate service users to YPIRAC target groups according to their objectives, their assessed needs and other relevant information. For known potential clients, the YPIRAC target groups are:
•	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.
The first three target groups relate to the three YPIRAC objectives, while the fourth includes service users who receive some YPIRAC services, such as assessment, but then elect not to receive services geared toward meeting any of the objectives.
In 2010–11, of the 1,087 people receiving YPIRAC services:
•	36% were in Target Group 1 (living in residential aged care and agreed to move or had moved to alternative accommodation); a slight decrease on 2009–10 figures
•	28% were in Target Group 2 (at risk of inappropriate entry to residential aged care); a slight increase in 2009–10 figures
•	31% were in Target Group 3 (remain in or enter residential aged care with additional support services); a slight increase in 2009–10 figures (Figure 2).
The proportions of YPIRAC service users in each target group varied across the states and territories, reflecting differences in the timing and implementation of the YPIRAC initiative in each jurisdiction (Figure 2).
Figure 2: YPIRAC service users in target groups 1–3, by target group and state or territory, 2009–10 and 2010–11 
Vertical bar chart showing, for groups 1, 2 and 3, on the y-axis per cent and on the x-axis state or territory, 2009–10 and 2010–11. 
Note: 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
Source: AIHW analysis of YPIRAC MDS 2009–10, AIHW analysis of YPIRAC MDS 2010–11.
The YPIRAC MDS, by definition, only includes people who received YPIRAC services during the reporting period. For this reason, there were few service users (5%) in Target Group 4 (remain in or enter residential aged care without additional services). Service users in this target group included those who were new entrants or had re-connected with the YPIRAC initiative and received services such as assessment or client monitoring during 2010–11, but then elected not to receive further services. This group also included some service users who changed their goals and therefore their target group, or who left the initiative during 2010–11 after initially receiving YPIRAC services.
3.2	Age and sex
In 2010–11, most YPIRAC service users (63%) were under the age of 50, and the remaining 37% were aged 50–64. The proportion of service users aged 50–64 has increased over each of the five years of the YPIRAC initiative, reflecting the expansion of YPIRAC services over time beyond the initial priority group (Figure 3). This number also incorporates a number of participants who have turned 50 while remaining in the YPIRAC initiative.
Figure 3: YPIRAC service users by age group, 2006–07 to 2010–11 
Vertical bar chart showing, for under 50 and 50-64, on the y-axis number and on the x-axis year.
Note: The 50–64 year age group includes a small number of YPIRAC service users (<5) aged 66 who were included in YPIRAC services for operational reasons.
Source: AIHW analysis of YPIRAC MDS 2006–07, 2007–08, 2008–09, 2009–10 and 2010–11.
The age groups with the largest proportion of service users in 2010–11 were the 45–49 and 50–54 age groups, both with 27% of total service users (see YPIRAC additional tables: Table A8). This differs from previous years where the majority of service users were aged 45–49 in each of those age groups. Slightly more than half (56%) of all YPIRAC service users were men. Men outnumbered women in all age groups except for the ‘under 25’ age group, and there were an equal number of men and women in the 45–49 age group (Figure 4).
Figure 4: YPIRAC service users, by age group and sex, 2010–11 
Vertical bar chart showing, for male and female, on the y-axis number and on the x-axis age group.
Note: The 55–64 age group includes a small number of YPIRAC service users (<5) aged 65 who were included in YPIRAC services for operational reasons.
Source: AIHW analysis of YPIRAC MDS 2010–11.
3.3	Aboriginal and Torres Strait Islander service users
Aboriginal and Torres Strait Islanders comprised nearly 1 in 10 YPIRAC service users (9%) in 2010–11 (Table 5). This proportion is more than three times that of Aboriginal and Torres Strait Islanders under the age of 65 in the Australian population. It is also almost double the proportion of Aboriginal and Torres Strait Islanders in this age group using specialist disability support services in 2009–10 (Figure 5).
Figure 5: Proportion of Aboriginal and Torres Straight Islanders aged under 65 receiving YPIRAC and disability support services compared with the total Australian population
Vertical bar chart showing on the y-axis Indigenous (per cent), and on the x-axis YPIRAC service users 2010-11, disability support services users 2009-10 and Australian population, 30 June 2009.
Note: Disability Support Service user data for 2010–11 not available until 2012.
Source: AIHW analysis of YPIRAC MDS for 2010–11.
Table 5: YPIRAC service users, by Indigenous status and state and territory, 2010–11
Indigenous status	NSW	Vic	Qld	WA	SA	Tas	ACT	NT	Total	
Number	
Indigenous	10	<5	36	28	11	—	—	<10	96	
Non-Indigenous	220	<290	300	57	99	<20	17	<5	991	
Total	230	284	336	85	110	<20	17	10	1,087	
Per cent	
Indigenous	4.3	<1.7	10.7	32.9	10.0	—	—	<100.0	8.8	
Non-Indigenous	95.7	<100.0	89.3	67.1	90.0	100.0	100.0	<50.0	91.2	
Total	100.0	100.0	100.0	100.0	100.0	100.0	100.0	100.0	100.0	
Note: In New South Wales, 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. Clients are not considered service users until they actually receive a YPIRAC-funded support service, such as assistive products and technology, individual care planning or accommodation support services.
In 2010–11, when compared with non-Indigenous services users, Aboriginal and Torres Strait Islander service users were more likely to:
•	be men (63% of Indigenous service users, compared with 55% of non-Indigenous service users)
•	live in Outer regional areas (32% compared with 9%) or Remote or Very remote areas (38% and 2%)
•	report a primary disability group of ’acquired brain injury’ (67% compared with 43%) 
•	have a higher average number of disability groups (1.97 compared with 1.68)
•	live in supported accommodation (16% compared with 10%) (AIHW unpublished data).
Aboriginal and Torres Strait Islander service users were less likely to:
•	live in private residences (12% compared with 19%) (AIHW unpublished data).
3.4	Country of birth
Most YPIRAC service users in 2010–11 (87%) were born in Australia; another 4% were born in other predominantly English-speaking countries. A further 6% were born in predominantly non-English speaking countries. A final 3% did not specify their country of birth (See YPIRAC additional tables: Table A12). 
3.5	Residential setting
In 2010–11, half of YPIRAC service users lived in residential aged care (50%). Those aged under 50 were less likely to be living in residential aged care compared with those aged 50–64 (46% compared with 56%), and more likely to be living in private residences (20% compared with 17%) and other settings such as domestic-scale supported living facilities (18% compared with 14%), supported accommodation (11% compared with 9%), or a hospital (4% compared with 3%) (Table 6).
The most common reason YPIRAC service users gave for remaining in residential aged care was ‘satisfied with current accommodation but needs additional services’ (31% of those in residential aged care), followed by ’satisfied with current accommodation and services’ (27%). Other reasons provided were just over one quarter (26%) reporting ‘appropriate alternative accommodation unavailable’ and a further 4% indicated appropriate disability support services were unavailable. Nearly 7% indicated they were waiting for YPIRAC services. Unavailability of principal carer and ‘other reasons’ comprised 3% of YPIRAC service users and additional 3% of service users declined an accommodation offer (see YPIRAC additional tables: Table A18).
The majority of service users living in other types of accommodation (70%) reported that they were ‘satisfied with current accommodation and services’ (see YPIRAC additional tables: Table A18).
Table 6: YPIRAC service users, by usual residential setting and age group, 2010–11
	Under 50	50–64	Total	
Usual residential setting	Number	Per cent	Number	Per cent	Number	Per cent	
Residential aged care facility	313	45.8	225	55.8	538	49.5	
Private residence	136	19.9	67	16.6	203	18.7	
Domestic-scale supported living facility	124	18.1	55	13.6	179	16.5	
Supported accommodation facility	77	11.3	37	9.2	114	10.6	
Hospital	24	3.5	10	2.5	34	3.1	
Other	10	1.5	9	2.2	19	1.7	
Total	684	100.0	403	100.0	1,087	100.0	
Notes:
1.	‘Usual residential setting’ refers to the type of physical accommodation in which the person was living for 4 or more days per week on average, as at 30 June 2011 or on exit from YPIRAC. See Younger People with Disability in Residential Aged Care program: report on the 2008–09 Minimum Data Set (AIHW 2010) for further information.
2.	‘Other’ residential setting includes independent living within a retirement village; short-term crisis, emergency or transitional accommodation; psychiatric/mental health community care facility; and other settings.
3.	The 50–64 age group includes a small number of YPIRAC service users (<5) aged 66 who were included in YPIRAC for operational reasons.
3.6	Disability group
The YPIRAC MDS collects 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 and 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. Multiple other significant disability groups can be recorded.
In 2010–11, nearly half (45%) of YPIRAC service users reported a primary disability group of ‘acquired brain injury’. Another 30% reported ‘neurological’ as their primary disability group (Figure 6). 
Over half of YPIRAC service users aged under 50 (55%) and 50–64 (61%) reported one disability group. Service users with 4 or more disability groups made up 6% of service users in both age groups (4% of service users aged under 50, and 4% of those aged 50–64) (Figure 7).
Figure 6: YPIRAC service users by primary disability group, 2010–11
Pie chart showing YPIRAC service users by primary disability group, 2010–11.
Source: AIHW analysis of YPIRAC MDS for 2010–11. 
Figure 7: YPIRAC service users by number of disability groups and age group, 2010–11
Vertical bar chart showing, for less than 50 and 50-64, on the y-axis service users (per cent) and on the x-axis number of disability groups.
Notes:
1.	‘Number of disability groups’ includes primary disability group and other significant disability groups.
2.	The 50–64 age group includes a small number of YPIRAC service users (<5) aged 66 
who were included in YPIRAC for operational reasons.
Source: AIHW analysis of YPIRAC MDS for 2010–11.
3.7	New service users 
People who accessed services under the YPIRAC initiative can be classified as ‘new’ or ‘continuing’ service users. New service users first received services during the 2010–11 reporting period. Continuing service users had also received services during one or more earlier periods. 
Overall, 27% of service users were new in 2010–11. Queensland reported the highest proportion of new service users, with 32% first receiving services in this year (Table 7). 
Table 7: New and continuing YPIRAC service users, by state and territory, 2010–11
New or continuing	NSW	Vic	Qld	WA	SA	Tas	ACT	NT	Total	
Number	
Continuing	164	223	227	67	78	15	12	10	796	
New	66	61	109	18	32	—	5	—	291	
Total	230	284	336	85	110	15	17	10	1,087	
Per cent	
Continuing	71.3	78.5	67.2	78.8	70.9	100.0	70.6	100.0	73.2	
New	28.7	21.5	32.4	21.2	29.1	—	29.4	—	26.8	
Total	100.0	100.0	100.0	100.0	100.0	100.0	100.0	100.0	100.0	
Note: In New South Wales, 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. Clients are not considered service users until they actually receive a YPIRAC-funded support service, such as assistive products and technology, individual care planning or accommodation support services.
There were some differences in the characteristics of service users entering the YPIRAC initiative in 2010–11, the initiative’s fifth year. These differences reflect the growth and progress of the initiative, as well as the variation among the states and territories in service targeting and development. New service users were more likely than continuing service users to be in Target Group 2, while continuing service users were more likely to be in Target Groups 1 and 3 (Figure 8). New service users were also more likely than those continuing service to be in Target Group 4 (remaining in or entering residential aged care without additional services); however, people in this group are by definition unlikely to continue in the YPIRAC MDS (see the ‘Target group’ section for more information). 
Figure 8: New or continuing YPIRAC service users by target group, 2010–11
Vertical bar chart showing, for groups 1, 2, 3 and 4, on the y-axis service users (per cent), and on the x-axis continuing and new service users.
Note:	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.
Source: AIHW analysis of YPIRAC MDS for 2010–11.
Although the proportion of YPIRAC service users under the age of 50 has decreased over time, new service users in 2010–11 were still more likely to be under 50 (67% of new service users, compared with 61% of continuing service users) (see YPIRAC additional tables: Table A25). They were also more likely to report a primary disability group of ‘neurological’ (35% compared with 28%) or ‘intellectual or autism’ (16% compared with 9%) (see YPIRAC additional tables: Table A27).
3.8	Service users who exited the YPIRAC initiative 	in 2010–11
There were a total of 127 exits from the YPIRAC initiative in 2010–11. Of these, 60% were under the age of 50 and 40% were aged 50–64. The main reasons for leaving were the death of the service user (37%), followed by ‘other’ (26%) (Table 8).
Table 8: Service users who exited the YPIRAC initiative during 2010–11, by main reason for cessation of services and age group
Main reason for cessation of services	Under 50	50–64	Total	
	Number	Per cent	Number	Per cent	Number	Per cent	
Service user withdrew from program	10	13.2	10	19.6	20	15.7	
Service user died	33	43.4	14	27.5	47	37.0	
Service user moved out of area/interstate	—	—	<5	<9.8	<5	<7.7	
Service user no longer eligible for YPIRAC	11	14.5	8	15.7	19	15.0	
Other	20	26.3	13	25.5	33	26.0	
Total	76	100.0	51	100.0	127	100.0	
Notes:
1. 	The 50–64 age group includes a small number of YPIRAC service users (<5) aged 65 who were included in YPIRAC for operational reasons.
2.	‘Other’ reasons included: the service user had received support from another program or had become eligible for compensation payments during the reporting period.
In 2010–11, the jurisdictions with the highest proportions of service users exiting were Australian Capital Territory (35%) and Tasmania (<33%). In 2010–11, 43% service users who exited were living in residential aged care when they left (see YPIRAC additional tables: Table A31).
4	Services received
The YPIRAC initiative provides three broad categories of services: 
•	YPIRAC assessment, individual care planning and/or client monitoring
•	alternative accommodation
•	support services packages.
YPIRAC service users may receive any combination of these three broad categories of services. Many services can take considerable time to arrange. For instance, alternative accommodation may require capital works to be completed and new support services may need to be established. Therefore, some of the service users who accepted or received services during 2010–11 may have been offered or accepted those services during an earlier reporting period. In these cases, these earlier offers and acceptances are included in the ‘offered’ and ‘received’ counts for 2010–11.
Almost all YPIRAC users (1,067 or 98%) received an assessment, individual care planning or client monitoring service in 2010–11, and most (798 or 73%) received support services. A total of 215 service users received alternative accommodation; however, another 325 had been offered alternative accommodation by 2010–11, and 282 of these had accepted these offers. This indicates that it is likely that many more service users will receive alternative accommodation in later years (Figure 9).
Figure 9: YPIRAC-specific services offered, accepted and received, 2010–11 
Vertical bar chart showing, for offered, accepted and received, on the y-axis service users (number) and on the x-axis specific services offered.
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.	New South Wales does not record client monitoring as a service.
Source: AIHW analysis of YPIRAC MDS for 2010–11.
Support services packages were received by the majority of service users in each of Target Groups 1, 2 and 3 (86%, <70% and 75% respectively) (Figure 10). 
Alternative accommodation was given primarily to service users in Target Groups 1 and 2, with 39% in Target Group 1 and <23% in Target Group 2 receiving alternative accommodation services (Figure 10). Alternative accommodation was received by <2% of service users in Target Group 3.
Figure 10: YPIRAC-specific services received by target group, 2010–11 
Vertical bar chart showing, for specific services received, on the y-axis per cent and on the x-axis groups 1, 2, 3 and 4.
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.	New South Wales does not record client monitoring as a service.
Source: AIHW analysis of YPIRAC MDS for 2010–11.
The Australian Capital Territory and the Northern Territory reported the highest proportions of service users being given alternative accommodation (77% and <50% respectively). While Queensland reported the lowest proportion, this was influenced by the large number of new service users in this jurisdiction (see YPIRAC additional tables: Table A40).
Most YPIRAC service users received a combination of services. Delivery of these services may occur at different times and over a number of years. In 2010–11, 20% of YPIRAC service users received both alternative accommodation and support services. A further 54% received support services packages. The remaining 27% of service users received only assessment, individual care planning or client monitoring (Figure 11).
Figure 11: YPIRAC service users by combinations of YPIRAC specific services received, 2010–11, per cent.
Pie chart showing YPIRAC service users by combinations of YPIRAC specific services received, 2010–11, per cent.
Note: New South Wales does not record client monitoring as a service.
Source: AIHW analysis of YPIRAC MDS for 2010–11.
More detailed information is also collected on the types of services received within these three broad categories. (For more information on service groups and service types, see ‘Technical appendix’.) The most common service types were ‘YPIRAC client monitoring’ and ‘YPIRAC assessment and/or individual care planning’ (received by 81% and 56% of all service users respectively). Other commonly received service types included ‘assistive products and technology’, received by 33% of service users; ‘other community access’ services, received by 32%; and ‘therapy support for individuals’, received by 25% (Figure 12).
Figure 12: YPIRAC service users, by service types received, 2010–11
Horizontal bar chart showing on the y-axis service types received and on the x-axis percentage of service users receiving service type.
Notes:
1.	In New South Wales, attendant care/personal care services and respite services are not funded under YPIRAC and are provided by other areas within the Department of Human Services. Client monitoring is not recorded as a service. 
2.	Respite services are not funded in South Australia under YPIRAC. Respite needs are addressed via other areas within Disability SA.
Source: AIHW analysis of YPIRAC MDS for 2010–11.
5	The YPIRAC initiative from 2006–07 to 	2010–11
The number of service users has increased steadily over the five years of the YPIRAC initiative. In 2010–11 there were more than four times the number of service users than in 2006–07, the initiative’s first year  (1,087 compared with 260)(see YPIRAC additional tables: Table A48). The number and proportion of service users aged 50–64 has also increased steadily, from 14% to 37%.
In 2006–07, the majority of service users were in Target Group 1 (59%) and each of Target Groups 2, 3 and 4 included less than one-fifth. In subsequent years the proportion of service users in Target Groups 2, 3 and 4 has increased while the proportion in Target Group 1 has decreased (Figure 13).
Figure 13: YPIRAC service users by target group, 2006–07 to 2010–11 
Vertical bar chart showing on the y-axis per cent of year total and on the x-axis groups 1, 2, 3 and 4 and not stated.
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.	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.
Source: AIHW analysis of YPIRAC MDS for 2006–07, 2007–08, 2008–09, 2009–10 and 2010–11.
Differences in the timing, focus and implementation of the YPIRAC initiative across the states and territories are also evident (Table 9). There was large growth after the first year in 
New South Wales and Queensland, and considerable relative growth in the Australian Capital Territory and the Northern Territory in the years to 2009–10. However in 2010–11 two states and both territories have experienced decreasing numbers of service users.
Table 9: YPIRAC service users, by state and territory, 2006–07 to 2010–11
Year	NSW	Vic	Qld	WA	SA	Tas	ACT	NT	Total	
2006–07	21	124	12	45	34	<10	<5	12	260	
2007–08	157	174	106	44	58	17	13	11	580	
2008–09	155	210	223	92	99	17	14	7	817	
2009–10	184	257	259	94	90	21	27	11	943	
2010–11	230	284	336	85	110	15	17	10	1,087	
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.	In New South Wales, 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. Clients are not considered service users until they actually receive a YPIRAC- funded support service, such as assistive products and technology, individual care and planning or accommodation support services
The proportion of service users living in residential aged care has decreased over time, as service users are relocated. There are also more service users in other target groups due to diversion of those at risk from entering residential aged care (Figure 14). The proportion of service users aged under 50 in residential aged care has fallen most sharply, from 79% in 2006–07 to 46% in 2010–11, the proportion aged 50–64 has also significantly dropped for the first time since 2006–07, down from 74% in 2009–10 to 56% to 2010–11 (Figure 14).
Figure 14: YPIRAC service users by age group and usual residential setting, 2006–07 to 2010–11
Two vertical bar charts showing, for in and not in residential aged care, on the y-axis per cent and on the x-axis service users aged under 50 and aged 50 to 64.
Notes:
1.	Usual residential setting refers to the type of physical accommodation in which the person was living for 4 or more days per week on average, as at 30 June 2011 or on exit from YPIRAC. See Younger People with Disability in Residential Aged Care program: report on the 2008–09 Minimum Data Set (AIHW 2010) for further information.
2.	The 50–64 year age group includes a small number of YPIRAC service users (<5) aged 66 who were included in YPIRAC for operational reasons.
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.
Source: AIHW analysis of YPIRAC MDS for 2006–07, 2007–08, 2008–09, 2009–10  and 2010–11. 
The number and combination of YPIRAC-specific services received has also changed over the five years of the YPIRAC initiative. The proportion of service users receiving alternative accommodation has increased each year, from 13% in 2006–07 to 20% in 2010–11. The proportion receiving support services but not alternative accommodation has also increased, from 8% in 2006–07 to 54% in 2010–11 (Table 10). 
Table 10: YPIRAC service users, by combinations of YPIRAC-specific services received, 2006–07 to 2010–11
YPIRAC-specific services received	2006–07	2007–08	2008–09	2009–10	2010–11	
	No.	Per  cent	No.	Per cent	No.	Per cent	No.	Per cent	No.	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	172	18.2	215	19.8	
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	521	55.2	583	53.6	
YPIRAC assessment and/or individual care planning and/or client monitoring only	206	79.2	311	53.6	299	36.6	250	26.5	289	26.6	
Total service users	260	100.0	580	100.0	817	100.0	943	100.0	1,087	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 the 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 the 2006–07 and later reporting periods should be undertaken with caution.
4.	New South Wales does not record client monitoring as a service.
6	Measuring progress towards YPIRAC objectives
In examining how the YPIRAC initiative is performing against its objectives, it is important to consider the complex nature and 5-year timeframe, as well as the emphasis on an individual’s right to choose, as far as possible, the services and outcomes they want from the initiative across jurisdictions. For instance, Objective 1 may be achieved in a variety of ways, including (but not limited to) providing alternative accommodation such as purpose-built disability support accommodation or providing support services so that the individual can return home. Many service users choose to remain in residential aged care to remain close to family and friends or for other reasons (URBIS 2009). Some change their goals over the course of their involvement in the YPIRAC initiative, and their target group may change as a result.
Due to this complexity, several measures could be devised to measure achievements against YPIRAC objectives. In this section the criteria detailed below have been used. Other criteria could also be used and these may produce different results. 
Objective 1
	YPIRAC service users who:
•	were in 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
•	were not residing in residential aged care at the end of the reporting period
•	had received alternative accommodation and/or a support services package under the YPIRAC initiative.	
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
•	were not residing in residential aged care at the end of the reporting period
•	had received alternative accommodation and/or a support services package under the YPIRAC initiative.	

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
•	were residing in residential aged cared care at the end of the reporting period
•	had received a support services package under the YPIRAC initiative.
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 initiative, as residential aged care remained their only available suitable supported accommodation option.	
The numbers of service users achieving the YPIRAC objectives have been calculated using a running tally method. The running tally represents the number of YPIRAC service users who have ever achieved an objective, regardless of when the objective was achieved. This is appropriate for measuring the YPIRAC initiative’s achievements, given its planned five-year duration and the often lengthy and complex processes involved. For instance, provision of alternative accommodation may require extensive planning processes and the completion of capital works.
Running tally data are calculated by linking service user data across reporting periods using a statistical linkage key (SLK), and adjusting for service users who received services in more than one state or territory (see the Technical appendix). As the SLK is not a unique identifier, a small degree of false linking is possible. More information on the SLK is provided in Younger People with Disability in Residential Aged Care program: report on the 2008–09 Minimum Data Set (AIHW 2010).
In the five years to 30 June 2011:
•	an estimated total of 1,432 people received YPIRAC services
•	an estimated 250 people achieved YPIRAC Objective 1 (moving out of residential aged care to more appropriate accommodation); of these, 79% were under the age of 50
•	an estimated 244 people achieved YPIRAC Objective 2 (being diverted from entering residential aged care); of these, 87% were aged under 50
•	an estimated 456 service users achieved YPIRAC Objective 3 (receiving enhanced services within a residential aged care setting, when this was the only available, suitable accommodation option); of these, 79% were aged under 50 (Table 11).
Table 12 provides the numbers by state and territory.
Table 11: Estimated running tally of YPIRAC service users who have achieved YPIRAC objectives since entry to 30 June 2011, by age group in year of entry (number)
YPIRAC service users against YPIRAC objectives	Under 50	50–64	Total	
Total YPIRAC service users5	1,109	323	1,432	
Objective 1: People moving out of residential aged care to more appropriate supported disability accommodation	197	53	250	
Objective 2: People at risk diverted from inappropriate admission to residential aged care	213	31	244	
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	358	98	456	
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 had achieved YPIRAC objectives. 
5.	Total is a running total over 5 years of the YPIRAC initiative. Numbers may not add to the total number of YPIRAC users as not all service users may have achieved objectives, and some service users may have achieved more than one objective as their circumstances or service availability changed over time.
6.	The 50–64 age group includes a small number of YPIRAC service users (<5) aged 66 who were included in YPIRAC for operational reasons.

Table 12: Estimated running tally of YPIRAC service users who have achieved YPIRAC objectives since entry to 30 June 2011, by state and territory (number)
YPIRAC service users against YPIRAC objectives	NSW	Vic	Qld	WA	SA	Tas	ACT	NT	Total	
Total YPIRAC service users6	307	353	386	139	166	29	34	21	1,432	
Objective 1: People moving out of residential aged care to more appropriate supported disability accommodation	55	72	72	20	22	7	<5	<5	250	
Objective 2: People at risk diverted from inappropriate admission to residential aged care	14	69	70	27	41	4	12	8	244	
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	177	117	71	38	22	16	10	7	456	
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 had achieved YPIRAC objectives. 
5.	Total includes service users who receive some YPIRAC services, but elect not to receive services geared toward meeting YPIRAC objectives.
6.	Total is a running total over 5 years of the YPIRAC initiative. Numbers may not add to the total number of YPIRAC users as not all service users may have achieved objectives, and some service users may have achieved more than one objective as their circumstances or service availability changed over time.
7.	In New South Wales, 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. Clients are not considered service users until they actually receive a YPIRAC-funded support service, such as assistive products and technology, individual care planning or accommodation support services.
7	Further information
Additional tables from the 2010–11 YPIRAC MDS are available on the AIHW website at
<http://www.aihw.gov.au>.
More information on the YPIRAC initiative and the YPIRAC MDS can be found in the report on the previous collection, Younger People with Disability in Residential Aged Care program: report on the 2008–09 Minimum Data Set (AIHW 2010), also available on the AIHW website. Examples of Jurisdiction service user forms, YPIRAC Service Type classifications, definitions of YPIRAC residential settings, English Proficiency Groups and information on the Statistical Linkage Key (SLK) used to link YPIRAC service users across years and services are provided. 
A	Technical appendix
A.1	Definitions of YPIRAC terms
This appendix describes some of the common terms used in the YPIRAC data collection. For more information, please see the report on the previous collection (see Further information, above). 
YPIRAC service user
A YPIRAC service user is a person who has:
•	applied to the YPIRAC initiative
•	been found eligible for the YPIRAC initiative
•	received one or more YPIRAC services during the reporting period
YPIRAC services
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 initiative, 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 initiative.
YPIRAC client monitoring
Client monitoring refers to contact between YPIRAC program managers 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. The purpose 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 YPIRAC initiative. 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
Alternative accommodation refers to a change of residential setting that is supported and funded by the YPIRAC initiative. An offer of alternative accommodation refers to a concrete offer to move to a specific new residential setting.
Support services packages
Support services packages refers to disability and other support services that are funded by the YPIRAC initiative. This includes disability support packages and service enhancements.
YPIRAC service groups 
Accommodation support
Accommodation support services provide accommodation to people with disability, and 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
Community support services 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
Community access services are 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
Other services 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
•	any other support services outside the above defined service types.
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.
A.2	Interpreting the data
The following factors should be considered when interpreting the data presented in this bulletin.
People in the YPIRAC initiative 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 initiative. In order to be considered a YPIRAC service user and therefore be 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 initiative 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 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 are linked across services, jurisdictions and years using a statistical linkage key (SLK) to identify instances of multiple service usage. The SLK is derived from portions of a client’s first names, last name and date of birth. In the YPIRAC initiative, 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. In the 2007–08, 2008–09 and 2009–10 YPIRAC MDSs a very small number of service users (less than 5) 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 bulletin represents a very slight over-count. An explanatory note has been added to all tables to which this applies.
Small cell sizes
The YPIRAC initiative has relatively small numbers of service users. Cell sizes for some jurisdictions and groups of service users are very small, meaning that these data should be interpreted with caution. 
Confidentiality
To maintain confidentiality it is common statistical practice to suppress cells with very small numbers, sometimes 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 bulletin:
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 10. So, for instance, if the next smallest cell value was 22, the cell will be reported as ‘<30’. 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 5 for YPIRAC service users, by Indigenous status and state and territory, 2010–11. 	
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 5, where the number of Indigenous and Not Stated users in Victoria is reported as ‘<5’. As 5 is 1.7% of 284, the percentage of service users is reported as ‘<1.7%’. 	
Exceptions	Some cells with small values have not been suppressed where confidentiality is not compromised. 	
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 the accompanying text. 

References
AIHW 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.
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.
Senate Community Affairs Committee. 2005. ‘Chapter Four – Young people in residential aged care facilites’ in Quality and equity in aged care. Canberra. 
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 1: Permanent aged care residents aged under 65, by age group and state and territory, as at 30 June 2003–2011
Table 2: People admitted to permanent residential aged care aged under 65, by age group and state and territory, 2004–05 to 2010–11
Table 3: ACAT assessments for people aged under 50 at referral, recommended long-term care setting, 2006–07 to 2009–10
Table 4: ACAT assessments for people aged under 50 at referral with recommended  long-term care setting of residential aged care by state and territory, 2006–07 to 2009–10
Table 5: YPIRAC service users, by Indigenous status and state and territory, 2010–11
Table 6: YPIRAC service users, by usual residential setting and age group, 2010–11
Table 7: New and continuing YPIRAC service users, by state and territory, 2010–11
Table 8: Service users who exited the YPIRAC initiative during 2010–11, by main reason for cessation of services and age group
Table 9: YPIRAC service users, by state and territory, 2006–07 to 2010–11
Table 10: YPIRAC service users, by combinations of YPIRAC-specific services received, 2006–07 to 2010–11
Table 11: Estimated running tally of YPIRAC service users who have achieved YPIRAC objectives since entry to 30 June 2011, by age group in year of entry (number)
Table 12: Estimated running tally of YPIRAC service users who have achieved YPIRAC objectives since entry to 30 June 2011, by state and territory (number)
List of figures
Figure 1: Summary of contact with potential YPIRAC service users, 2006–07 to 2010–11
Figure 2: YPIRAC service users in target groups 1–3, by target group and state or territory, 2009–10 and 2010–11
Figure 3: YPIRAC service users by age group, 2006–07 to 2010–11
Figure 4: YPIRAC service users, by age group and sex, 2010–11
Figure 5: Proportion of Aboriginal and Torres Straight Islanders aged under 65 receiving YPIRAC and disability support services compared with the total Australian population
Figure 6: YPIRAC service users by primary disability group, 2010–11
Figure 7: YPIRAC service users by number of disability groups and age group, 2010–11
Figure 8: New or continuing YPIRAC service users by target group, 2010–11
Figure 9: YPIRAC-specific services offered, accepted and received, 2010–11
Figure 10: YPIRAC-specific services received by target group, 2010–11
Figure 11: YPIRAC service users by combinations of YPIRAC specific services received, 2010–11, per cent.
Figure 12: YPIRAC service users, by service types received, 2010–11
Figure 13: YPIRAC service users by target group, 2006–07 to 2010–11
Figure 14: YPIRAC service users by age group and usual residential setting, 2006–07 to 2010–11
Related publications
Younger People with Disability in Residential Aged Care program: Update from the 2010–11 Minimum Date Set: Additional Tables.