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LCQ13: Support services for persons with disabilities and aged carers
     Following is a question by Dr Hon Fernando Cheung and a written reply by the Secretary for Labour and Welfare, Mr Matthew Cheung Kin-chung, in the Legislative Council today (November 16):
     In recent months, a number of elderly persons, who were carers of adults with intellectual disabilities, had died of attacks of illnesses or accidents at home as they were not saved in time, leaving at home those persons with intellectual disabilities who lacked self-care skills alone being unattended beside the corpses of their carers for several days before they were discovered. Some social workers have pointed out that the aforesaid tragedies show that the Government had not provided adequate support services for those families. They consider that families of elderly tripletons or elderly doubletons (i.e. families in which persons with disabilities or illnesses, who are old and/or with deteriorating functional capacities, live with their fathers and/or mothers) are high-risk groups. Hence, the Government should provide comprehensive community support services for them, including establishing a case management system and database, as well as arranging for such families visits by social workers, household cleaning and meal delivery services, social activities, etc. In this connection, will the Government inform this Council:
(1) of the existing mechanism through which families of elderly tripletons or elderly doubletons are identified; 

(2) whether it has compiled statistics on (i) the number of families of elderly tripletons or elderly doubletons, (ii) the number of persons with disabilities or patients being taken care of (broken down by the categories listed in the table below), and (iii) the number of carers aged over 65; if such information is not available, whether the Government will take measures to identify those families expeditiously so as to enhance its support for them and avoid the recurrence of the aforesaid tragedies; and
Categories of disabilities/diseases suffered by care recipients Number
Cognitive impairment  
Intellectual disabilities  
Mental illness  
Physical disability  
Deteriorating functional capacity  
Lack of self-care skills due to other reasons  

(3) whether it has any plan to establish a case management system and database for families of elderly tripletons or elderly doubletons in order to provide them with comprehensive community support services on a long-term basis?



     The Government attaches great importance to the service needs of families with aged carers and families of elderly tripletons or elderly doubletons (i.e. families in which persons with disabilities or illnesses, who are old and/or whose functional capacities are deteriorating, live with their father and/or mother).  We have been providing a range of community support services for these families to relieve their stress and help them integrate into the community.

     My reply to the questions raised by Dr Hon Fernando Cheung is as follows:

(1) and (2) The Social Welfare Department (SWD) approaches and identifies families with welfare needs (including elderly tripleton or elderly doubleton families) through various service units across the territory. These service units include 65 integrated family service centres (IFSCs), two integrated services centres (ISCs), 16 district support centres for persons with disabilities (DSCs) and over 200 government-subsidised district elderly community centres (DECCs)/neighbourhood elderly centres (NECs).
     To identify needy families which are reluctant to seek help (including elderly tripleton or elderly doubleton families) as early as possible, SWD has implemented the Family Support Programme since 2007 at a total of 86 units including IFSCs, ISCs, Family and Child Protective Services Units and Psychiatric Medical Social Service Units. Social workers will, through telephone calls, home visits and other outreaching services, contact families with social isolation problems and refer them to a host of support services. Furthermore, these service units recruit and train volunteers (including those with personal experience in overcoming family problems or crises) who will contact the aforementioned families and encourage them to receive appropriate services for building a community care and support network. As at end-September 2016, there were around 4 200 volunteers under the Family Support Programme. From 2007 to end-September 2016, the Programme successfully contacted 96 584 individuals/families and provided them with support services.
     SWD has been providing an array of subsidised community care services for persons with disabilities and their carers, including DSCs, home care service for persons with severe disabilities (HCS), integrated support service for persons with severe physical disabilities (ISS), transitional care and support centre for tetraplegic patients, day and residential respite services, social and recreational centres for the disabled, parents/relatives resource centres and community rehabilitation network. These services cover emotional support, personal and nursing care, rehabilitation training, day care, home respite service, escort service, and cash subsidies for renting respiratory support medical equipment and purchasing medical consumables. To support needy carers of persons with disabilities from low-income families, the Government launched in October 2016 a two-year Pilot Scheme on Living Allowance for Low-income Carers of Persons with Disabilities through the Community Care Fund to provide a monthly living allowance of $2,000 to each eligible carer.
     As to persons with disabilities or illnesses, who are old and/or whose functional capacities are deteriorating as well as their parents, the DECCs/NECs of SWD will provide outreaching and counselling services for hidden and vulnerable elderly persons, including families of elderly tripletons or elderly doubletons. Social workers of these elderly centres will, in the course of delivering the services, ascertain the support network for the elderly persons and their families, thereby facilitating the provision of appropriate services for them. In parallel, the Support Teams for the Elderly under the 41 DECCs across the territory will identify vulnerable elderly persons through outreaching and networking approaches. These teams will show care for the elderly persons through regular home visits and telephone contacts, provide them with information on community resources and refer them to formal services and assistance, so that needy elderly persons, including families of elderly tripletons or elderly doubletons, can have appropriate support. To meet the various needs of frail elderly persons in their daily life, SWD also provides a range of subsidised home-based community care services, including Integrated Home Care Services (IHCS) and Enhanced Home and Community Care Services (EHCCS).  At present, there are 60 IHCS teams and 34 EHCCS teams in the territory, providing on-site home-based services for needy elderly persons on a regular basis. In addition, under the second phase of the Pilot Scheme on Community Care Service Voucher for the Elderly currently underway, a total of 124 Recognised Service Providers in 18 districts provide community care services under single mode (home-based service) or mixed mode (both centre-based and home-based service), and elderly persons can choose service packages which suit their individual needs. The subject officers will, through regular home visits, assist elderly persons in reviewing their service needs and take appropriate follow-up actions.
     The Government takes care of elderly persons and persons with disabilities with financial needs through the Comprehensive Social Security Assistance (CSSA) Scheme, including providing higher standard rates, a series of supplements and special grants (such as care and attention allowance, grant to cover fees for Home Help Service/ Integrated Home Care Service, etc.). The CSSA Scheme also provides a special grant to eligible recipients for installing home emergency alarm system.
     In addition, IFSCs and ISCs provide needy families, including elderly tripleton or elderly doubleton families, with a continuum of preventive, supportive and remedial family services, including counselling service, supportive/mutual help group and family aide services. These centres also refer needy persons to community support/care services, financial assistance etc., so as to enhance the skills of family carers in handling stress and to strengthen their problem-solving capability.
     At present, SWD does not keep the breakdown of statistics on part (2) of the question regarding the number of relevant families and care recipients who are persons with disabilities or suffering from other illnesses.
(3) SWD has allocated an additional annual recurrent expenditure of $10.6 million since November 2014 for increasing the manpower of social workers at DCSs to implement case management service model with a view to enhancing support for persons with disabilities and providing suitable services. About 80 per cent of the DCSs members are persons with intellectual disabilities. SWD also implemented case management in the HCS, ISS and DSCs since 2014. Case managers co-ordinate necessary services, including personal care, rehabilitation training and nursing care services for service users, and make timely referrals for them to obtain suitable social and medical services. Together with a multi-disciplinary team comprising allied health staff, nurses and social workers, case managers draw up personal care plans with service users and/or their families. They also collaborate with social and medical service units that have taken referral cases to help service users and their families obtain appropriate services. 
     As at end-September 2016, about 5 000 persons with disabilities received case management service. Apart from SWD's service units, the Hospital Authority, special schools and non-governmental organisations could also refer persons with disabilities in need to accept the foresaid case management service.
Ends/Wednesday, November 16, 2016
Issued at HKT 14:38
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