Limiting the number of elderly people who receive community services and the amount of support they receive could save the Otago District Health Board about $6.6 million a year, the board's planning and funding team says.
In a report to be considered by the disability support advisory committee today - which proposes reducing use of services over three years - the team says Otago and Southland boards provide support to the elderly, which is above national averages.
Otago spends $79.4 million, about $10 million above the national average, while Southland's budget of $40.1 million is $4.5 million above average.
To fall in line with national averages, the 8303 Otago people receiving services would have to be cut by more than a quarter (2333).
The most dramatic reduction would be in those receiving housework support, which would be cut by 1248 from the existing annual level of 4157.
Changes proposed could result in a reduction in service for some people already receiving home services, carer support and respite services when their support is next reassessed or reviewed.
Those already in rest-homes, dementia units and long-stay hospitals would not be affected.
The report suggests that managing the costs by reducing the price paid for services or limiting future price increases would reduce quality and make services unsustainable.
Instead, the report focuses on ways of limiting the number of people receiving services and the support each eligible person will receive.
By doing this, it could save about two-thirds of the board's over-spending.
It would not be possible to reduce spending by the full amounts because there would be some expense in providing alternative replacement services, the report states.
"For example, apparent savings in rest-home level care will be partially offset by increased community support services."
The team also shows the largest growth in the past two years has been for home-based personal care, followed by hospital-level care.
The report proposes that the use of services could be progressively brought down over three years to bring them into line with national averages.
To do this it would enter into an agreement with each board's needs assessment co-ordinators setting target numbers of people who would receive support.
Strategies to make this work could include making it harder to get services, reducing service for a given level of need for new and existing clients, removing services for existing clients who have relative low needs, having stricter access criteria and applying criteria more stringently.
In the firing line
Annual "over-delivery" of services to Otago elderly includes:
• $2.7 million of home-based personal care and housework support
• $6.3 million rest-home and dementia level care
• $300,000 respite care
• $600,000 carer support
Source: ODHB planning & funding team report
