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LCQ20: Statistics about private residential care homes for the elderly
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     Following is a question by the Hon Tang Ka-piu and a written reply by the Secretary for Labour and Welfare, Mr Matthew Cheung Kin-chung, in the Legislative Council today (January 8):

Question:

     It has been reported earlier in the press that a staff member of a private residential care home for the elderly (PRCHE) was dismissed for reporting the abuse of an elderly resident of that PRCHE by another staff member, and the elderly abuse case has also given rise to public concern about the service quality of PRCHEs.  In this connection, will the Government inform this Council:

(1) in respect of subsidised residential care homes for the elderly and PRCHEs respectively, (i) of the number of cases received by the authorities about the abuse of elderly residents, and (ii) among them, the number of cases in which the abusers were convicted, and (iii) the number of staff members of residential care homes who were dismissed for reporting incidents of abuse, in the past five years;

(2) of the existing number of elderly persons residing in PRCHEs and a breakdown by (i) District Council district where the PRCHEs concerned are located, (ii) their level of disability (i.e. in need of constant attendance, 100% disabled and able-bodied/50% disabled), (iii) the age group to which they belong, (iv) the number of children they have and (v) their marital status;

(3) of the number of elderly persons currently residing in PRCHEs who received, in each of the past five years, assessments for ascertaining their service needs under the "Standardised Care Need Assessment" and, among them, the respective numbers and percentages of those (i) who were assessed to have different levels of disability, (ii) who were assessed as having had a significant change in health conditions, and (iii) who were allocated a place in a subsidised residential care home subsequently;

(4) of the existing number of elderly persons residing in PRCHEs who are recipients of Comprehensive Social Security Assistance (CSSA) and, among them, of the number of those who started receiving CSSA only after admission to PRCHEs; the respective average amounts of CSSA payments received by residents of PRCHEs who have different levels of disability and are receiving CSSA;

(5) of the number of elderly CSSA recipients currently residing in PRCHEs who were given supplements and special grants last year, as well as the average amounts they were given, and a breakdown by the level of disability;

(6) among the elderly persons residing in PRCHEs, of (i) the respective numbers and percentages of those receiving CSSA of different standard rates according to their levels of disability, and (ii) the number and percentage of those who were allocated a place in a subsidised residential care home, in the past five years;

(7) of the number of elderly CSSA recipients residing in PRCHEs who passed away in each of the past five years and, among them, of the number of those who were waiting for admission to a subsidised residential care home when they passed away;

(8) of the number of cases, in each of the past five years into which the authorities conducted investigations, concerning elderly CSSA recipients residing in PRCHEs did not report the fact that their family members had paid part of the home fees for them, and the number of prosecutions instituted in respect of such cases;

(9) of the respective numbers of PRCHEs charging minimum home fees higher than the CSSA payments received by elderly residents of the relevant levels of disability; and

(10) whether the Social Welfare Department will consider granting, apart from Residential Care Supplement, additional allowance to CSSA recipients residing in PRCHEs, so as to make up for the differences between the CSSA payments and the home fees charged by PRCHEs; if so, of the details; if not, the reasons for that; and whether it has studied the feasibility of allowing family members of CSSA recipients residing in PRCHEs to pay part of the home fees for them without deducting their CSSA payments?

Reply:

President,

     We do not tolerate any act of elderly abuse.  The Social Welfare Department (SWD) will handle any suspected elderly abuse incidents in residential care homes for the elderly (RCHEs) seriously.  Apart from referring the cases concerned to the Police for criminal investigation, SWD will collaborate with different disciplines of professionals to investigate and handle the cases in accordance with the "Procedural Guidelines for Handling Elder Abuse Cases" as well as to provide suitable support services for the elderly persons concerned.  Furthermore, depending on the nature and seriousness of the cases involved, the Licensing Office of Residential Care Homes for the Elderly (LORCHE) of SWD will issue advices, warnings or directives to the RCHEs concerned.  LORCHE will also conduct more frequent inspections of the RCHEs concerned and monitor if remedial measures have been implemented by the RCHEs concerned.

     As regards the questions raised by the Hon Tang Ka-piu, my reply is as follows:

(1) LORCHE only keeps records of elderly abuse incidents since 2010.  From 2010 to end-September 2013, there were nine elderly abuse incidents involving seven private RCHEs and two subsidised/self-financing RCHEs.  All of the seven elderly abuse incidents in private RCHEs were referred to the Police for follow-up action. Among these cases, the abuser in one case was prosecuted after police investigation and subsequently convicted by the Court.  The other two elderly abuse cases which occurred in subsidised/self-financing RCHEs were also followed up by the Police.  The abuser of one of these cases was prosecuted after police investigation and convicted by the Court.  SWD does not keep record on the number of dismissal of RCHE staff members for reporting elderly abuse incidents.

(2) According to the records of LORCHE [Note 1], as at September 2013, the numbers of elderly residents in private RCHEs (including the places provided by private RCHEs under the Enhanced Bought Place Scheme) are as follows:

                        Numbers of elderly residents
District                    in private RCHEs
----------------------------------------------------
Central and                         1 832
Western District
Southern District                   1 500
Eastern District                    3 443
Wan Chai                              620
Kwun Tong                           2 373
Wong Tai Sin                        1 826
Kowloon City                        4 359
Sham Shui Po                        3 272
Yau Tsim Mong                       2 326
Islands                               335
Sai Kung                              135
Northern District                   2 005
Tai Po                              1 895
Sha Tin                             1 533
Kwai Tsing                          3 482
Tsuen Wan                           2 403
Tuen Mun                            2 481
Yuen Long                           3 292
----------------------------------------------------
Total                              39 112

Note 1: The information is extracted from the database in the record system of SWD LORCHE during the said period.  There is no breakdown of information in the database on the level of disability, age, number of children and marital status of these elderly residents.

     Among the over 39 000 elderly residents in private RCHEs, around 32 000 were living in non-subsidised residential care places.

(3) SWD does not keep statistics on the number of elderly persons in private RCHEs who have been assessed by the Standardised Care Need Assessment Mechanism for the Elderly Services (SCNAMES).  However, according to the accommodation status provided by the elderly applicants on the Central Waiting List (CWL) for subsidised long-term care (LTC) services, as at end-September 2013, some 10 000 applicants living in private RCHEs were being assessed as having LTC needs.

     Furthermore, under the existing arrangement, once the applicants have met the age requirement and have been assessed by SCNAMES with proven residential care needs, SWD will allocate subsidised services to these eligible applicants in accordance with the priority of their application dates and their preferences for RCHEs.  Applicants' accommodation status is not part of the application criteria and will not affect the priority of service allocation.  Hence, SWD does not keep statistics on the number of elderly residents in private RCHEs based on their assessment results, health conditions and placements for subsidised residential care places.

(4),(5) and (6) The numbers of elderly persons aged 60 or above residing in non-subsidised residential care places who are Comprehensive Social Security Assistance (CSSA) recipients in the past five years are set out below:

As at end of the year     Numbers of CSSA recipients
---------------------     --------------------------
        2009                       25 210
        2010                       25 307
        2011                       25 050
        2012                       24 947
  End-September 2013               26 007

     The statistics on elderly singletons aged 60 or above residing in non-subsidised care places and receiving CSSA of different standard rates according to their levels of disabilities are as follows:

                                Average monthly CSSA
                                   payments for the
                                     period from
 Levels of     No. of cases as     October 2012 to
Disabilities  at September 2013  September 2013 ($)
------------  -----------------  -------------------
Elderly
singletons
who are             2 405               4,927
able-bodied/
50% disabled

Elderly
singletons          8 696               5,941
who are
100% disabled

Elderly
singletons
who are            13 037               7,693
in need of
constant
attendance
----------------------------------------------------
Total              24 138               6,759

     SWD does not keep record on the number of elderly persons who apply for CSSA after being admitted to private RCHEs.

     As at end-September 2013, among the some 29 000 applicants on CWL for subsidised LTC services, more than 8 250 applicants were elderly CSSA recipients living in non-subsidised residential care places.  SWD will allocate services to eligible applicants in accordance with the priority of their application dates and their preferences for RCHEs.  When allocating subsidised residential care places to CWL applicants, SWD would not keep record on whether the applicants concerned are living in private RCHEs and receiving CSSA payments.

(7) SWD does not keep statistics on the number of elderly CSSA recipients living in private RCHEs who passed away every year and the number of them who were waiting for subsidised residential care places.  

(8) As regards the statistics on reports and prosecutions of CSSA fraud cases, SWD does not keep a breakdown of cases related to elderly CSSA recipients who failed to report that their family members had paid part of the home fees of private RCHEs for them.

(9) According to the information above, the average monthly CSSA payment granted to an elderly singleton who is able-bodied/50% disabled was $4,927.  According to the record of LORCHE, as at end-September 2013, there were 568 private RCHEs in Hong Kong.  Among them, the minimum home fees of 214 private RCHEs were higher than the aforementioned average monthly CSSA payment.  The average monthly CSSA payment granted to an elderly singleton who is 100% disabled was $5,941.  The minimum home fees of 55 out of the 568 private RCHEs were higher than this average monthly CSSA payment.  The average monthly CSSA payment granted to an elderly singleton who is in need of constant attendance was $7,693.  The minimum home fees of 10 out of the 568 private RCHEs were higher than this average monthly CSSA payment.  

(10) The CSSA Scheme is designed to support persons with financial hardship owing to various reasons, such as old age, disability, illness, unemployment and low income, etc., to meet their basic needs.

     Under the CSSA Scheme, elderly persons enjoy a more relaxed level of asset limit and higher standard rates when compared with able-bodied adults.  A number of special grants and supplements (such as long-term supplement, special diet allowance and grants to cover costs of medical/rehabilitation/surgical/hygienic items) are also available to cater for special needs of elderly persons.  The amounts will also be adjusted on a regular basis to maintain their purchasing power.

     Furthermore, to relieve the financial burden of the elderly persons who are living in non-subsidised residential care places, SWD has, since June 2012, introduced a monthly Residential Care Supplement of $275 for all CSSA recipients aged 60 or above who are living in non-subsidised residential care places.  The Supplement also covers CSSA recipients who are disabled or in ill-health and living in non-subsidised residential care places.

     Elderly persons can flexibly use the CSSA payments and choose suitable RCHEs that meet their individual needs.

     As the objective of CSSA Scheme is to provide support for needy people to meet their basic needs, the Administration will first ascertain the recognised needs of the applicant and then verify his/her deployable resources, including financial support from family members.  The shortfall between the recognised needs and deployable resource would be met by CSSA.

Ends/Wednesday, January 8, 2014
Issued at HKT 14:35

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