Younger people with disability in residential aged care
Update from the 2009–10 Minimum Data Set
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David Kalisch
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Contents
Acknowledgments
Symbols
1	Key points
2	The Younger People with Disability in Residential Aged Care (YPIRAC) program
3	YPIRAC target population
4	YPIRAC service users
5	Services received
6	YPIRAC from 2006–07 to 2009–10
7	Measuring progress towards YPIRAC objectives
8	Further information
A	Technical appendix
References

Acknowledgments
This bulletin was prepared by Anne Aisbett, Arianne Schlumpp, Sean Ackland and Libby Grant. 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 2009–10 YPIRAC Minimum Data Set.
Thanks also to Ester Kyaw, David Fuentes-Solano and Leanne Merrett at 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.
Symbols
—	nil or rounded to zero
. . 	not applicable
n.p.	not published
1	Key points 
The Younger People with Disability in Residential Aged Care (YPIRAC) program is a 5-year program agreed by the Council of Australian Governments in 2006. It aims to reduce the number of younger people, those aged less than 65 years, with disability living in residential aged care. 
The most common reason YPIRAC service users gave for living in residential aged care was ‘appropriate alternative accommodation unavailable’ (39%). A further 27% reported need of additional services and 9% indicated a possibly temporary arrangement (unavailability of principal carer or awaiting agreed YPIRAC services). However, 23% (135) were ’satisfied with current accommodation and services’. 
Over the four years of YPIRAC to 2009–10, an estimated 1,141 people aged less than 65 have been assisted with YPIRAC services. Of these:
•	an estimated 139 people achieved the first YPIRAC objective—a move out of residential aged care to more appropriate accommodation 
•	an estimated 207 people achieved the second YPIRAC objective—diversion from residential aged care 
•	an estimated 409 people achieved the third YPIRAC objective—receiving enhanced services within residential aged care, when this was the only available, suitable accommodation option
Over the same time frame, the number of people admitted to residential aged care who were aged less than 50 (the initial priority of the YPIRAC program) has fallen by 22%, and the number living in residential aged care has fallen by 29%. 
In 2009–10, the fourth year of YPIRAC, 943 people received YPIRAC services. Of these:
•	14% (131 service users) had moved from residential aged care to alternative accommodation
•	27% (253 service users) had agreed to move from residential aged care but had not yet done so
•	29% (275 service users) had elected to remain in residential aged care with additional services
•	25% (235) were receiving services to divert them from entering residential aged care. 
A total of 172 service users received alternative accommodation in 2009–10, including 98 who had previously lived in residential aged care and 74 who were diverted from entering residential aged care. Another 521 service users received support services, such as therapy support or assistive products and technology.
Other characteristics of service users in 2009–10 include:
•	nearly 50% (445 service users) reported a primary disability of ‘acquired brain injury’ and a further 30% (284) reported a ‘neurological’ primary disability
•	10%(96) were Aboriginal and Torres Strait Islander people
•	68%(639) were aged less than 50.
2	The Younger People with Disability in Residential Aged Care (YPIRAC) program
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 a disability. In response to these concerns, the YPIRAC program was agreed on by the Council of Australian Governments in February 2006. It 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, YPIRAC 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 National Disability Agreement provides the framework for the provision of government support for people with disability. Australian Government funding for YPIRAC was rolled into funding provided to the state and territory governments for the NDA; however, YPIRAC program targets remained as agreed in the previous bilateral agreements.
This bulletin reports on data collected for the Younger People with Disability in Residential Aged Care (YPIRAC) Minimum Data Set (MDS) in the 2009–10 collection period. It presents information on the people who were provided with support under YPIRAC (YPIRAC service users) and the services they received during the reporting period (1 July 2009 to 30 June 2010). This bulletin does not provide 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 on the previous collection, Younger People with Disability in Residential Aged Care program: report on the 2008–09 Minimum Data Set (AIHW 2010). 
As the YPIRAC program ceased to be funded as a separate program from 1 January 2009, the term ‘YPIRAC’ is used in this bulletin to refer to state and territory efforts to meet YPIRAC program targets.
3	YPIRAC target population
YPIRAC aims to reduce the number of younger people with disability living in residential aged care by assisting younger people with disability in residential aged care and those who are at risk of entering residential aged care. While the initial priority of YPIRAC is to achieve the objectives in relation to people with disability less than 50 years, where possible these objectives are extended to people with disability aged less than 65 years.
3.1	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:
•	6,478 people aged less than 65 years were living in residential aged care at 30 June 2010—715 of these were aged less than 50 (Table 1).
•	while the number of people aged less than 65 years living in residential aged care fell slightly (1.2%) from June 2006 to June 2010, the number of people aged less than 
50 years, the primary focus group of YPIRAC, fell by 29% (from 1,007 at 30 June 2006 to 715 at 30 June 2010), partly reflecting the success of diversionary programs (Table 1).
•	the number of people aged less than 50 years admitted annually to residential aged care has fallen by 22% since the start of YPIRAC, from 262 in 2005–06 to a low of 204 in 
2009–10 (Table 2).
•	the number of people aged 50–64 years admitted to residential aged care was lowest in 2006–07, with 1,602 people, but rose slightly in each subsequent year to 1,708 people in 2009–10. 

Table 1: Permanent aged care residents aged less than 65 years, by age group, as at 
30 June 2003–2010
Year	NSW	Vic	Qld	WA	SA	Tas	ACT	NT	Total	
	Less than 50 years	
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	
	50–64 years	
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	
	Total less than 65 years	
2006	2,343	1,586	1,400	495	483	145	47	58	6,557	
2007	2,371	1,577	1,389	512	476	144	58	50	6,577	
2008	2,371	1,615	1,357	518	490	152	67	39	6,609	
2009	2,322	1,581	1,305	541	475	163	65	51	6,503	
2010	2,363	1,528	1,288	538	475	163	69	54	6,478	
Source: AIHW analysis of the Aged and Community Care Management Information System (ACCMIS) as at December 2010.

Table 2: People admitted to permanent residential aged care aged less than 65 years, by age group and state and territory, 2004–05 to 2009–10
Year	NSW	Vic	Qld	WA	SA	Tas	ACT	NT	Total	Per cent change from previous year	
	Less than 50 years	
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	
	50–64 years	
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	
	Total less than 65 years	
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	
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 2010.

3.2	Younger people at risk of entering residential aged care
Younger people with disability at risk of entering residential aged care may receive YPIRAC services to achieve the following 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 approving them to receive Australian Government-subsidised aged care services provided under the Aged Care Act 1997, including residential aged care. An ACAT should only accept a referral of a younger person with a disability where it can be demonstrated that 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 or other support services that provide assistance to younger people with disability at risk of entering residential aged care.
During 2008–09, a total of 669 ACAT assessments of people aged less than 50 years were completed. Of these:
•	just over 40% (278 assessments) recommended a long-term care setting of high-level care in residential aged care
•	a further 8% (53 assessments) recommended low-level care in residential aged care. 
From 2006–07 to 2008–09:
•	the number of ACAT assessments for people aged less than 50 years fell by 8.0%—the number recommending a long-term care setting of high level care in residential aged care fell by 1.1% and the number recommending low-level care in residential aged care fell by 13% (Table 3). 
•	the number of ACAT assessments recommending a long-term care setting of residential aged care fell in all jurisdictions except for the Northern Territory and New South Wales. It fell most sharply in Queensland (by 17%) and Victoria (16%) (Table 4).

Table 3: ACAT assessments for people aged less than 50 years at referral, recommended long-term care setting, 2006–07 to 2008–09
Recommended long-term care setting	2006–07	2007–08	2008–09	Per cent change 2006–07 to 2008–09	
Private residence	317	311	288	–9.1	
Other community	41	41	30	–6.8	
Residential aged care—low level care	61	77	53	–13.1	
Residential aged care—high level care	281	280	278	–1.1	
Other	22	34	20	–9.1	
Not stated/inadequately described	5	2	—	–100.0	
Total	727	745	669	-8.0	
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 less than 50 years at referral with recommended 
long-term care setting of residential aged care by state and territory, 2006–07 to 2008–09
State/territory	2006–07	2007–08	2008–09	Per cent change 2006–07 to 2008–09	
New South Wales	116	110	133	14.7	
Victoria	81	98	68	–16.0	
Queensland	78	61	65	–16.7	
Western Australia	26	45	24	–7.7	
South Australia	30	27	27	–10.0	
Tasmania	7	10	6	–14.3	
Australian Capital Territory	<5	<5	<5	n.p.	
Northern Territory	<5	<5	<10	n.p.	
Total	342	357	331	-3.2	
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.

3.3	Identifying potential YPIRAC service users
The age and target groups considered for entry into YPIRAC 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 under 50 years of age residing in residential aged care. There has been no further mail-out. Some people who did not respond to the initial mail-out contacted YPIRAC at a later date, after seeing the impact of YPIRAC on fellow residents. New South Wales continues to accept all applications to YPIRAC, but does not actively recruit applicants.
In Victoria, at the commencement of the initiative, all people in residential aged care aged less than 50 years of age 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 years 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 YPIRAC is provided to people in the 50–64 years age group on request. 
In South Australia, YPIRAC program managers monitor entrants to residential aged care to identify potential service users. People with disability under 65 years of age who are at risk of admission to residential aged care are referred to the Disability SA Accommodation Placement Panel (APP), and if deemed eligible by the APP, either an ACAT assessment is requested or the person is referred directly to YPIRAC if under 50 years of age.
In the Australian Capital Territory, expression of interest processes were undertaken among those aged less than 55 years 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.
3.4	Assessment of potential YPIRAC service users
The highest number of initial contacts for assessment of need purposes with potential service users was made in 2006–07, the first year of YPIRAC, when 1,123 contacts were made. These initial contacts have declined in each subsequent year, as the initial target population for YPIRAC has been largely reached and the remaining resources have become constrained (Figure 1). Not all approaches are accepted or declined immediately, and some people may not respond until years later. As a result, although the numbers of acceptances and refusals have also declined each year since 2006–07, they have not declined as sharply as the number of contacts.
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 YPIRAC and are accepted as service users. The number of YPIRAC service users has therefore increased each year, regardless of the fall in initial contacts and acceptances. 

In 2009–10, initial contact was made with a total of 192 people. Of these, 136 people indicated that they would like to be considered for inclusion in YPIRAC, and 26 people declined to be involved. Those who did not accept or decline contact in 2009–10 may change their minds in later years. Nearly three-quarters of these initial contacts were with people aged less than 50 years.
Figure 1: Summary of contact with potential YPIRAC service users, 2006–07 to 2009–10
Line chart showing for, contacts, refusals, service users, acceptances and not yet contacted, 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 and 2009–10.

4	YPIRAC service users
In 2009–10, 943 people received YPIRAC services, the highest number since the commencement of YPIRAC in 2006–07 when there were 260 service users (see Table 9 for details).
4.1	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 include:
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 YPIRAC objectives.
In 2009–10, of the 943 people receiving YPIRAC services:
•	41% (384 service users) were in Target Group 1 (living in residential aged care and agreed to move or had moved to alternative accommodation)
•	25% (235 service users) were in Target Group 2 (at risk of inappropriate entry to residential aged care)
•	29% (275 service users) were in Target Group 3 (remain in or enter residential aged care with additional support services).
The proportions of YPIRAC service users in each target group varied across the states and territories, reflecting differences in the timing and implementation of YPIRAC in each jurisdiction (Figure 2). 
Figure 2: YPIRAC service users in target groups 1–3, by target group and state or territory 
Vertical bar chart showing, for group 1, group 2 and group 3, on the y-axis per cent and on the x-axis state/territory.
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.

The YPIRAC MDS, by definition, only includes people who received YPIRAC services during the reporting period. For this reason, there were few service users (49 or 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 YPIRAC and received services such as YPIRAC assessment or client monitoring during 2009–10, 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 YPIRAC during 2009–10 after initially receiving YPIRAC services.
4.2	Age and sex
In 2009–10, most YPIRAC service users (639 or 68%) were aged less than 50 years, and just over 300 (32%) service users were aged 50 to 64 years. The proportion of service users aged 50 to 64 years has increased over each of the four years of YPIRAC, reflecting the expansion of YPIRAC services over time beyond the primary focus group (Figure 3).
Figure 3: YPIRAC service users by age group, 2006–07 to 2009–10 
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 65 years
who were included in YPIRAC services for operational reasons.
Source: AIHW analysis of YPIRAC MDS 2006–07, 2007–08, 2008–09 and 2009–10.
The age group with the largest proportion of service users in 2009–10 was 45 to 49 years (30% or 282 service users) and a further 233 (25%) service users were aged 50 to 54 years. Slightly more than half (56% or 523) of all YPIRAC service users were male. Males outnumbered females in all age groups except for the 45 to 49 year age group (Figure 4).
Figure 4: YPIRAC service users, by age group and sex, 2009–10 
Vertical bar chart showing, for male and female, on the y-axis number and on the x-axis age group.
Note: The 55–64 year age group includes a small number of YPIRAC service users (<5) aged 65 years who were included in 
YPIRAC services for operational reasons.
Source: AIHW analysis of YPIRAC MDS 2009–10.

4.3	Aboriginal and Torres Strait Islander service users
Aboriginal and Torres Strait Islanders comprised 1 in 10 YPIRAC service users (96 or 10%) in 2009–10. This proportion is more than three times that of Aboriginal and Torres Strait Islanders aged less than 65 years in the Australian population. It is also more than double the proportion of Aboriginal and Torres Strait Islanders in this age group using disability support services in 2008–09 (Figure 5).
Figure 5: Proportion of Aboriginal and Torres Strait Islanders aged less than 65 years 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 and disability support services and Australian population.
Source: AIHW analysis of YPIRAC MDS 2009–10; AIHW 2011.
Table 5: YPIRAC service users, by Indigenous status and state and territory, 2009–10
Indigenous status	NSW	Vic	Qld	WA	SA	Tas	ACT	NT	Total	
				Number				
Indigenous	8	<5	27	35	11	<5	<5	<11	96	
Non-Indigenous	176	<257	232	59	79	<21	<27	<5	847	
Total	184	257	259	94	90	21	27	11	943	
				Per cent				
Indigenous	4.3	<1.9	10.4	37.2	12.2	<23.8	<18.5	<100.0	10.2	
Non-Indigenous	95.7	<100.0	89.6	62.8	87.8	<100.0	<100.0	<45.5	89.8	
Total	100.0	100.0	100.0	100.0	100.0	100.0	100.0	100.0	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.	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 2009–10, when compared with non-Indigenous services users, Aboriginal and Torres Strait Islander service users were more likely to:
•	be male (65% or 62 Indigenous service users, compared with 54% or 461 non-Indigenous service users)
•	be aged 50 to 64 years (37% or 35, compared with 32% or 269)
•	live in Outer regional areas (33% or 32, compared with 10% or 86) or Remote or Very remote areas (39% or 38 and 1% or 11)
•	report a primary disability group of ’acquired brain injury’ (78% or 75, compared with 44% or 370)
•	have a higher average number of disability groups (2.07 compared with 1.87).
Aboriginal and Torres Strait Islander service users were less likely to:
•	live in private residences (6% or 6, compared with 17% or 142).
4.4	Country of birth
Most YPIRAC service users in 2009–10 (87% or 820) were born in Australia, another 5% (49) were born in other predominantly English-speaking countries. A further 6% (57) were born in predominantly non-English speaking countries. A final 2% (17) did not specify their country of birth. 
4.5	Residential setting
In 2009–10, the majority of YPIRAC service users lived in residential aged care (62% or 582 service users). Those aged less than 50 years were less likely to be living in residential aged care compared with those aged 50 to 64 years (56% compared with 74%), and more likely to be living in private residences (18% compared with 11%) and other settings such as domestic-scale supported living facilities (Table 6). 
The most common reason YPIRAC service users gave for living in residential aged care was ‘appropriate alternative accommodation unavailable’ (226 or 39% of those in residential aged care), followed by ’satisfied with current accommodation and services’ at 23% (135). Nearly 20% (112) of those in residential aged care reported ‘satisfied but needs additional services’ and a further 7% (41) indicated appropriate disability support services were unavailable. Nearly 6% (34) indicated they were waiting for YPIRAC services, while the remainder specified unavailability of principal carer (15 or 3%) or other reasons, or were not stated. The majority of service users living in other types of accommodation (68%) reported that they were ‘satisfied with current accommodation and services’.

Table 6: YPIRAC service users, by usual residential setting and age group, 2009–10
	Less than 50 years	50–64 years	Total	
Usual residential setting	Number	Per cent	Number	Per cent	Number	Per cent	
Residential aged care	358	56.0	224	73.7	582	61.7	
Private residence	116	18.2	32	10.5	148	15.7	
Domestic-scale supported living facility	67	10.5	19	6.3	86	9.1	
Supported accommodation	61	9.5	24	7.9	85	9.0	
Hospital	<28	<4.4	<5	<1.6	28	3.0	
Other	<14	<2.2	<5	<1.6	14	1.5	
Total	639	100.0	304	100.0	943	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 2010 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.	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.
4.	The 50–64 year age group includes a small number of YPIRAC service users (<5) aged 65 years who were included in YPIRAC for operational reasons.
4.6	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 2009–10, nearly half (47% or 445) of YPIRAC service users reported a primary disability group of ‘acquired brain injury’. Another 30% (284) of service users reported a primary disability group of ‘neurological’ (Figure 6). Just over half (51% or 156) of YPIRAC service users aged 50 to 64 years reported one disability group, compared to less than half (46% or 296) of service users aged less than 50. Slightly less than 10% of service users in both age groups reported four or more disability groups (9% or 54 service users aged less than 50 years, and 8% or 25 of those aged 50 to 64 years) (Figure 7).

Figure 6: YPIRAC service users by primary disability group, 2009–10
Pie chart showing, intellectual/autism 8.8, physical 12.4, acquired brain injury 47.2, neurological 30.1, sensory/speech 0.7, and psychiatric 0.7.
Source: AIHW analysis of YPIRAC MDS for 2009–10. 
Figure 7: YPIRAC service users by number of disability groups and age group, 2009–10
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 year age group includes a small number of YPIRAC service users (<5) aged 65 years 
who were included in YPIRAC for operational reasons.
Source: AIHW analysis of YPIRAC MDS for 2009–10.
4.7	New service users 
People who accessed services under YPIRAC can be classified as ‘new’ or ‘continuing’ service users. New service users were those who first received services during the 2009–10 reporting period. Continuing service users were those who had also received services during one or more earlier periods. 
Overall, 20% (195) service users were new in 2009–10. The Australian Capital Territory reported the highest proportion of new service users, with 56% of service users first receiving services in this year (Table 7). 
Table 7: New and continuing YPIRAC service users, by state and territory, 2009–10
New or continuing	NSW	Vic	Qld	WA	SA	Tas	ACT	NT	Total	
	Number		
Continuing	148	200	210	80	74	<20	12	<10	748	
New	36	57	49	14	16	<10	15	<5	195	
Total	184	257	259	94	90	21	27	11	943	
	Per cent		
Continuing	80.4	77.8	81.1	85.1	82.2	<95.2	44.4	<90.9	79.3	
New	19.6	22.2	18.9	14.9	17.8	<47.6	55.6	<45.5	20.7	
Total	100.0	100.0	100.0	100.0	100.0	100.0	100.0	100.0	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.	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 in 2009–10, the fourth year of YPIRAC. These differences reflect the growth and progress of YPIRAC, 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 continuing service users to be in Target Group 4 (remain in or enter 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, 2009–10 
Vertical bar chart showing, for group 1, group 2, group 3 and group 4, on the y-axis service users (per cent) and on the x-axis continuing service users 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 2009–10.
Although the proportion of YPIRAC service users aged less than 50 has decreased over time, new service users in 2009–10 were still more likely to be aged less than 50 (142 or 73% of new service users, compared with 497 or 66% of continuing service users). They were also more likely to report a primary disability group of ‘neurological’ (68 or 35% compared with 216 or 30%) or ‘intellectual or autism’ (24 or 12% compared with 59 or 8%).
4.8	Service users who exited YPIRAC in 2009–10
There were a total of 80 exits from YPIRAC in 2009–10. Of these, 70% 
(56 service users) were aged less than 50 years and 30% (24) were aged between 50 and 64 years. The main reasons for service users leaving were ‘service user died’ (66%), followed by ‘service user withdrew from the program’ (23%) (Table 8).

Table 8: Service users who exited YPIRAC during 2009–10, by main reason for cessation of services and age group
Main reason for cessation of services	Less than 50 years	50–64 years	Total	
	Number	Per cent	Number	Per cent	Number	Per cent	
Service user withdrew from program	10	17.9	8	33.3	18	22.5	
Service user died	40	71.4	13	54.2	53	66.3	
Service user moved out of area/interstate	<5	<8.9	<5	<20.8	<5	<6.3	
Service user no longer eligible for YPIRAC	<5	<8.9	—	0.0	<5	<6.3	
Other	<5	<8.9	<5	<20.8	5	6.3	
Total	56	100.0	24	100.0	80	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 50–64 year age group includes a small number of YPIRAC service users (<5) aged 65 years who were included in YPIRAC for operational reasons.
3.	‘Other’ reasons included: the service user had received support from another program or had become eligible for compensation payments during the reporting period.
In 2009–10, the jurisdictions with the highest proportions of service users exiting were Western Australia (18%) and South Australia (14%). Most (66%) service users who exited were living in residential aged care on exit.

5	Services received
YPIRAC 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 YPIRAC 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 2009–10 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 2009–10. 
Almost all (98%) YPIRAC service users received YPIRAC assessment, individual care planning or client monitoring in 2009–10, and most (74%) received support services. A total of 172 service users (18%) received alternative accommodation; however, another 127 (13%) had been offered alternative accommodation by 2009–10, and 70 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, 2009–10 
Vertical bar chart showing, for offered, accepted and received, on the y-axis service users (number) and on the x-axis assessment/indiv. Care planning/client monitoring, alternative accommodation and support services.
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 2009–10.
Support services packages were received by the majority of service users in each of target groups 1, 2 and 3 (over 70% in each group). 
Alternative accommodation was received by service users in target groups 1 and 2 only, with 25% (98 service users) in Target Group 1 and nearly 33% (74) in Target Group 2 receiving alternative accommodation services (Figure 10).
Figure 10: YPIRAC-specific services received by target group, 2009–10 
Vertical bar chart showing, for assessment, alternative accommodation, and support services package, on the y-axis service users (per cent) and on the x-axis groups.
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 2009–10.
The Northern Territory and Queensland reported the highest proportions of service users receiving alternative accommodation (4 or 36% and 83 or 32% respectively). While the Australian Capital Territory reported the lowest proportion, this was influenced by the large number of new service users in this jurisdiction.
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 2009–10, nearly 20% of YPIRAC service users (172) received both alternative accommodation and support services, and almost all of these (168) also received assessment, individual care planning or client monitoring. A further 55% of service users (521) received support services packages and most of these (509) also received assessment, individual care planning or client monitoring. The remaining 27% (250) of service users received assessment, individual care planning or client monitoring only (Figure 11).
Figure 11: YPIRAC service users by combinations of YPIRAC specific services received, 2009–10, per cent.
Pie chart showing, assessment/care planning/monitoring only 26.5, support package only 1.3, support package and assess/planning/monitoring 54.0, and accommodation and support package 18.2.
Note: New South Wales does not record client monitoring as a service.
Source: AIHW analysis of YPIRAC MDS for 2009–10.
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 the Technical appendix.) The most commonly received service types were ‘YPIRAC client monitoring’ and ‘YPIRAC assessment and/or individual care planning’ (received by 87% or 823 and 66% or 622 of all service users respectively). Other commonly received service types included ‘other community access’ services, received by 34% (320) of service users, and ‘therapy support for individuals’, received by 31% (294) of service users (Figure 12).
Figure 12: YPIRAC service users, by service types received, 2009–10
Horizontal bar chart showing, on the y-axis service types received, and on the x-axis per cent 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 2009–10.

6	YPIRAC from 2006–07 to 2009–10
The number of service users has increased steadily over the four years of YPIRAC. 
In 2009–10 there were more than three times the number (943 compared to 260) of service users than in 2006–07, the first year of YPIRAC. The number and proportion of service users aged 
50 to 64 years has also increased steadily, from 14% to 32% (Figure 3).
In 2006–07, the majority of service users were in Target Group 1 (60% or 154) and each of target groups 2, 3 and 4 included less than one-fifth of service users. 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 2009–10 
Vertical bar chart showing, for group 1, group 2, group 3 and group 4, on the y-axis per cent of year total and on the x-axis year.
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 and 2009–10.
Differences in the timing, focus and implementation of YPIRAC across the states and territories are also evident (Table 9). While there was large growth after the first year in 
New South Wales and Queensland, there was considerable relative growth in the Australian Capital Territory and the Northern Territory in the year to 2009-10.

Table 9: YPIRAC service users, by state and territory, 2006–07 to 2009–10
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	
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 planning or accommodation support services.
The proportion of service users living in residential aged care has decreased over time, as service users are relocated from residential aged care, and there are 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 less than 50 years in residential aged care has fallen most sharply, from 79% in 2006–07 to 56% in 2009–10, while the proportion aged 50 to 64 years has remained fairly steady at around 75% (Figure 14).
Figure 14: YPIRAC service users by age group and usual residential setting, 2006–07 to 2009–10
Two vertical bar charts showing, for in residential aged care and not in residential aged care, on the y-axis per cent and on the x-axis service users aged less than 50, and service users 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 2010 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 65 years 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 and 2009–10. 
The number and combination of YPIRAC-specific services received has also changed over the four years of YPIRAC. The proportion of service users receiving alternative accommodation has increased each year, from 13% in 2006–07 to 18% in 2009–10. The proportion receiving support services but not alternative accommodation has also increased, from 8% in 2006–07 to 55% in 2009–10 (Table 10). 

Table 10: YPIRAC service users, by combinations of YPIRAC-specific services received, 2006–07 to 2009–10
	2006–07	2007–08	2008–09	2009–10	
YPIRAC-specific services received	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	
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	
YPIRAC assessment and/or individual care planning and/or client monitoring only	206	79.2	311	53.6	299	36.6	250	26.5	
Total service users	260	100.0	580	100.0	817	100.0	943	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 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 2006–07 and later reporting periods should be undertaken with caution.
4.	New South Wales does not record client monitoring as a service.

7	Measuring progress towards YPIRAC objectives
In examining how YPIRAC is performing against its objectives, it is important to consider the complex nature and 5-year timeframe of YPIRAC, as well as the emphasis on an individual’s right to choose, as far as possible, the services and outcomes they want from YPIRAC 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 service user 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 service users change their goals over the course of their involvement in YPIRAC, 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 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, and
•	were not residing in residential aged care at the end of the reporting period, and
•	had received alternative accommodation and/or a support services package under YPIRAC.	
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, and
•	were not residing in residential aged care at the end of the reporting period, and
•	had received alternative accommodation and/or a support services package under YPIRAC.	

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, and
•	were residing in residential aged cared care at the end of the reporting period, and
•	had received a support services package under YPIRAC.	

Objective 3 (cont.)	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 YPIRAC, 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 which reporting period the objective was achieved in. This is an appropriate method of measuring the achievements of YPIRAC, given its planned 5-year duration and the often lengthy and complex processes that may be required to help service users achieve its objectives. For instance, provision of alternative accommodation may require extensive planning processes and the completion of capital works.
Running tally data is 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 four years to 30 June 2010:
•	an estimated total of 1,141 people received YPIRAC services
•	an estimated 139 people achieved YPIRAC Objective 1, moving out of residential aged care to more appropriate accommodation (31% of service users in this target group)—of these, 110 (79%) were aged less than 50
•	an estimated 207 people achieved YPIRAC Objective 2, being diverted from entering residential aged care (75% of service users in this target group)—of these 184 (89%) were aged less than 50
•	an estimated 409 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 336 ( 82%) were aged less than 50
•	people aged 50 to 64 were:
–	 slightly more likely to achieve Objective 1 than those aged less than 50 years (34% compared to 30%)
–	slightly less likely to achieve Objective 2 (72% compared with 75%)
–	much less likely to achieve Objective 3 (51% compared with 69%) (Table 11). 
Table 12 provides an outline of such data by state and territory.

Table 11: Estimated running tally of YPIRAC service users who have achieved YPIRAC objectives since entry to 2009–10, by age group in year of entry 
	Estimated number of YPIRAC service users who have achieved YPIRAC objectives to 30 June 2010	
	Less than 50 years	50–64 years	Total	
YPIRAC service users against YPIRAC objectives	Number	Per cent of service users in target group(a)	Number	Per cent of service users in target group(a)	Number	Per cent of service users in target group(a)	
Objective 1: People moving out of residential aged care to more appropriate supported disability accommodation	110	30.0	29	34.1	139	30.8	
Objective 2: People at risk diverted from inappropriate admission to residential aged care	184	75.1	23	71.9	207	74.7	
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	336	68.9	73	51.4	409	64.9	
Total YPIRAC service users 	914	100.0	227	100.0	1,141	100.0	
(a)	Percentages are calculated using the following denominators:
	Objective 1: Target Group 1—Agreed to or has moved from residential aged care to alternative YPIRAC-funded accommodation and 	support
	Objective 2: Target Group 2—Deemed ‘at risk’ of entry into residential aged care
	Objective 3: Target Group 1—Agreed to or has moved from residential aged care to alternative YPIRAC-funded accommodation and 	support but still residing in residential aged care, and Target Group 3—Remain in or enter residential aged care with additional disability 	support services.
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.	Numbers do not add to the total as not all service users achieved objectives under YPIRAC, and some service users may have achieved more than one objective as their circumstances or service availability changed over time.
6. 	The 50–64 year age group includes a small number of YPIRAC service users (<5) aged 65 years 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 2010, by state and territory
	Estimated number of YPIRAC service users who have achieved YPIRAC objectives to 30 June 2010	
YPIRAC service users against YPIRAC objectives	NSW	Vic	Qld	WA	SA	Tas	ACT	NT	Total	
Objective 1: People moving out of residential aged care to more appropriate supported disability accommodation	27	37	39	9	18	<10	<5	<5	139	
Objective 2: People at risk diverted from inappropriate admission to residential aged care	13	53	62	26	35	<5	<10	<10	207	
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	155	125	41	36	25	16	5	7	409	
Total YPIRAC service users 	241	292	277	121	134	29	29	21	1,141	
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.	Numbers do not add to the total as not all service users achieved objectives under YPIRAC, 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.
8	Further information
Additional tables from the 2009–10 YPIRAC MDS are available on the AIHW website at
<http://www.aihw.gov.au>.
More information on YPIRAC 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.
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 YPIRAC, and
•	been found eligible for YPIRAC, and
•	received one or more YPIRAC services during the reporting period (1 July 2009 to 30 June 2010).
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 YPIRAC, 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 YPIRAC.
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 YPIRAC. 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 YPIRAC. 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 YPIRAC. 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 YPIRAC who do not receive YPIRAC-specific services in a given year 
The YPIRAC MDS was established to collect information about services provided under YPIRAC. 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 YPIRAC 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 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
YPIRAC 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, usually 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 7 for Continuing Tasmanian service users. 	
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 6, where the number of New service users in the Northern Territory is reported as ‘<5’. As 5 is 45.5% of 11, the percentage of service users is reported as ‘<45.5%’. 	
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
ABS (Australian Bureau of Statistics) 2006. Statistical geography volume 1, Australian standard geographical classification (ASGC). ABS cat. no. 1216.0. Canberra: ABS.
AIHW (Australian Institute of Health and Welfare) 2011. Disability support services 2008–09: report on services provided under the Commonwealth State/Territory Disability Agreement and the National Disability Agreement. Disability series. Cat. no. DIS 58. Canberra: AIHW.
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.