DESK REVIEWS | 03.02.01.06. How are long-term care budgets allocated and dispersed, across program areas?

DESK REVIEW | 03.02.01.06. How are long-term care budgets allocated and dispersed, across program areas?

Using the budget allocated by the Federal government, states and municipalities then decide how to prioritise or to create program areas that require investment. We have no detailed information on the details of how this budget is spent locally.

The Lump Sum Grant is the key means of subvention for LTC services. It was introduced in 2000-2001 for voluntary adoption by NGOs. The Social Welfare Department no longer imposes rigid input controls on NGOs’ staffing and salary structures or on individual items of expenditure. Recurrent funding is granted to NGOs in a lump sum and NGOs are given greater autonomy and flexibility to deploy resources and re-engineer their services to meet changing social needs. As of August 2018, 164 out of 169 funded NGOs have joined the Lump Sum Grant system and the subvention for these NGOs represents over 99% of the total recurrent subvention for 2017-18 (Social Welfare Department, 2019b). Some NGOs receive heavy subsidies from the Government, covering almost full operating expenses, capital costs, and the provision of premises. Some NGOs and private providers operate on a self-financing basis. Government also has a programme to subsidise residents to stay in privately run facilities, known as the “Enhanced Bought Place Scheme” (Yuen, 2014).

In addition, the Government has from time to time applied for funds from the Lotteries Fund to finance the development of elderly services. These include funds for the construction and setting-up of contract residential care homes for the elderly (RCHEs) and for the implementation of various welfare projects/schemes for the elderly (e.g., Pilot Scheme on Community Care Service Voucher for the Elderly). NGOs may also apply for grants to meet the capital costs of projects in connection with elderly services provided (Audit Commission, 2014, October).

References:

Audit Commission. (2014, October). Provision of long-term care services for the elderly.  Retrieved from https://www.aud.gov.hk/pdf_e/e63ch01.pdf

Social Welfare Department. (2019b, 28 January 2019). Lump Sum Grant (LSG) Subvention System. Retrieved from https://www.swd.gov.hk/en/index/site_ngo/page_subventions/sub_modesofsub/id_lsgmanualc/

Yuen, P. P. (2014). Financing Health Care and Long-term Care in a Rapidly Ageing Context: Assessing Hong Kong’s Readiness. Public Policy and Administration, 17(1), 56-64.

The funding is allocated to state federals and to the respective programmes and schemes initiated as part of the budgets.

No repository listing all program areas related to long-term care in Indonesia was found. However, a specific program called ASLUT (Program Asistensi Sosial Penduduk Lanjut Usia Terlantar) is available for neglected or poor elderly individuals. The criteria for eligibility are:

  1. aged 60 years and above
  2. having physical ailments that forbid performing daily activities
  3. not having a source of income
  4. being neglected and in poverty
  5. not being a recipient of the Keluarga Harapan Program.

The budget for the ASLUT program is derived from the social assistance funds of the Ministry of Social Affairs. ASLUT program is managed by the Directorate of Elderly’ Social Rehabilitation, the Director General of Social Rehabilitation, and the Ministry of Social Affairs. In 2017, the budget allocation for beneficiaries of the ASLUT program was at IDR 60 billion. This budget is fully allocated as a grant of Rp. 200,000 per person per month to 30,000 ASLUT beneficiaries (TNP2K, 2018, p.132).

References:

Tim Nasional Percepatan Penanggulangan Kemiskinan (TNP2K). (2018) The Future of the social protection system in Indonesia, Jakarta Pusat: Office of the Vice President of the Republic of Indonesia. https://www.developmentpathways.co.uk/wp-content/uploads/2018/11/44293181123-SP-ReportFinal-ENG-web.pdf

There is no funding specifically for long-term care services.

There are no long-term care programs in the federal or local public administrations and, therefore, no budgets are allocated and dispersed for this.

Budget allocations across programme areas continue to be based on historical budgeting processes (i.e., funding cycles continue to allocate funds to programmes funded the previous cycle/historically) (EMERALD, 2017). Unless a budget bid is tabled to lodge an investment case, budget allocations will follow historical trends (EMERALD, 2017).

References:

EMERALD. (2017). Moving towards Universal Health Coverage for Mental Disorders in South Africa.