Preliminary findings from the community care voucher pilot program in Hong Kong

Abstract

Hong Kong’s population is aging rapidly. Although only about 14% of the population are 65 years or older in 2014, the figure is projected to increase to about 1/3 of the total population in 2041. Hong Kong also has a very high nursing home utilization rate as about 7% of all elderly are living in nursing homes. There is another 2.5% of the elderly population on the waiting list for nursing home care. To lower the demand for nursing home care, the HK Government has implemented a pilot community care voucher program in Hong Kong since September of 2013. The program allows older people with certified nursing home needs to receive a voucher valued at HK$2,500 to HK$ 4,500 per month (US$320 to US$577 per month) to purchase community support services from designated service providers. Individuals on the waiting list were invited to participate in the pilot project according on their tenure on the waiting list for nursing home care. The goals of this presentation are to present the basic program structure of the community care voucher program in Hong Kong and to share findings from a formative evaluation of the pilot project. Data came from 497 individuals who participated in the voucher pilot project and 4,199 people who rejected the invitation. We will share the similarities and differences in the demographic characteristics, family structures, economic status, and caregiving arrangements of older people in these two groups. We will also share their reasons of participating and not 23 participating in the pilot program. We will also report findings from focus groups with care managers and service providers of the voucher program. We found that older people who participate in the voucher program were more likely living with spouse only or living with an adult child only; owned their own apartment, more educated and had more care needs. Those who did not participated were more likely living alone or living with child only, living in low income public rental housing, less educated, and had less care needs. Among those who participated, they cited 'advice from social worker' and geographic accessibility of services as the major reasons for participating. Most care managers and services providers were positive about the voucher pilot program. Many saw voucher program as a way to increase options for service users. However, many also complained a huge increase in workload after the implementation of the voucher program, particularly on explaining the voucher program to potential participants.