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A presentation on how the Hong Kong Housing Society has approached senior care.

Transcript of Rubicon HKHS Presentation

  • 1. + Hong Kong Housing Societys Senior Care Facility and Business www.AsiaHealthcareBlog.com Modelwww.RubiconStrategyGroup.com

2. +Overview Hong Kong Housing Society (HKHS) History of the Organization HKHS Mission and Mandate Role of the Hong Kong Government (past, present, future) Structure of Senior-Care Market in Hong Kong Role of the Family as Caregiver Available Residential and In-Home Care Options Role of Government and Private Insurance as Payer HKHS Solution Facility Structure (Services, Amenities, Infrastructure) Payment Options (Financing, Qualification Standards) Role of Government (Land Incentives, Eldercare Regulation) What HKHS Plans to do Differently How Their Next Two Facilities will be Different How They Want to Shift Their Relationship with the Hong Kong Government 3. +Hong Kong Housing SocietyHistory of the OrganizationMission & MandateRole of the Hong Kong Government (Past, Present and Future) 4. +Hong Kong Housing Society History of the Organization Started in 1948. Play a role renovating existing properties,rebuilding distressed properties, or providinghousing for people who have lost housing due toreclamation. As of today, have built over 67,000 individualhousing units. Today, in addition to managing their ownproperties, they provide commercial propertyowners with housing management services andretail leasing as well. Mission & Mandate Help create housing initially for low-incomefamilies. As housing in Hong Kong become moreexpensive, mission migrated to address housingneeds of middle-income families also. Role of the Government Past: Government funded the HKHS. Present: Government offers incentives andsome remediation, but little direct support. Future: Government may continue to offerincentives, but HKHS sees its reliance ingovernment support dwindling. 5. +Structure of the Senior CareMarket in Hong KongRole of the Family as the CaregiverAvailable Residential and In-Home Care OptionsRole of Government and Private Insurance as PayerPublic versus Private Residential Senior-CareKey Similarities & Dissimilarities Between Hong Kong & China 6. + The Family Role of the Family as Caregiver 74.1% of the elderly population live w/ family1. 17% of elderly over 60 are receiving social security2. 55% of elderly over 65 are also receiving old age allowance3. Even with elderly parents who have dementia, families are reluctantto turn over caregiving services to outsiders.4 Studies of ex-pat Chinese and Hong Kong communities in Boston,Vancouver and Toronto show that cultural barriers to third-party caregiving continue to lower; however, strong concepts of familial pietystill govern how Hong Kong families view senior care.51Report no. 27: Life, Health and Financial Conditions of Elderly Persons and Middle-Aged Persons Census and Statistics Department 2000.2ElderlyServices in Hong Kong The Hong Kong Council of Social Service.3Ibid.4Caregivers Informational Needs on Dementia and Dementia Care, Asian Journal of Gerontology & Geriatrics, Vol 2, No 2, August 2007.5Intergenerational Family Support for Chinese Older Adults, International Journal of Social Welfare, Volume 20, Supplement 1, October 2011. 7. +The MarketHong KongGovernment Provided Community Care &Support Services District ElderlyCommunity Centers & Social Centers for theResidential CareNeighborhood Elderly ElderlyServices (RCH)CentersServices for active and healthy More involved services which RCH can be subsidized (what HKGseniors: education, socialprovide the option of either center- government calls subvented), ordevelopment, career support,based services or some minimal in- some combination of public/private.outreach, networking, basic home care. These are more involved servicescounseling, meals, referrals to servicethan social centers.providers, etc. NOTE: After this stage, the HKG government does provide limited assessment-based subsidized long- term care. As a HKG senior moves further to the right, services get more involved to reflect growing healthcare needs and typically diminished ability to pay for these services themselves. 8. +Available Residential & In-HomeCare Options Number of Facilities17% 3%RCH Hybrids15%RCH Non-Subsidised 65%EBSPrivateRCH Hybrids are combinations of subsidized (public and NGO), self-financing, contract, contract-based, etc.RCH Non-Subsidized receive no government assistance but are not self-financing. These are NGOs.EBS (also called EBPS for Enhanced Bought Place Scheme) are facilities purchased by the HKG Social Welfare Department.Private facilities are individually run, for-profit senior housing operators.NOTE: Data compiled from four databases provided by the HKG Social Welfare Department; 2 (the RCH components) updated 9/30/2011and 2 (EBS and Private) updated 11/30/2011. 9. +Available Residential & In-HomeCare OptionsRCH Openings0% 2%Hostel16%Home48%Care & Attention 34%Care & Attention PlusContinuum of CareNursing HomeThese are only openings for RCH categorized senior care facilities.The Hostel and Home categories can essentially be overlooked (2% of the total); categories not of practical analytical value.Care & Attention basic in-home services ranging from social visitation to basic medical care.Care & Attention Plus Continuum of Care more involved medical care up to hospice.NOTE: Data compiled from four databases provided by the HKG Social Welfare Department; 2 (the RCH components) updated 9/30/2011and 2 (EBS and Private) updated 11/30/2011. 10. +Available Residential & In-HomeCare OptionsNumber of FacilitiesNumber of Openings (% of Total)(% of Total)RCH Hybrids 147 (16.5%) 17,739 (17.8%)RCH Non-Subsidized29 (3.3%) 1,304 (1.3%)EBS 136 (15.3%) 21,698 (21.8%)Private 578 (64.9%)58,744 (59%)Total: 890 99,485Estimates are that there are 19,000 on the waiting list currently for the RCH Hybridized senior care.1NOTE: Data compiled from four databases provided by the HKG Social Welfare Department; 2 (the RCH components)updated 9/30/2011 and 2 (EBS and Private) updated 11/30/2011.1Who Pays for Long Term Care in Hong Kong, Laurence Wing Him Ho, Chief Executive, Hong Kong Policy ResearchInstitute. 11. +In Case You Are CuriousHow that stacks up against the need in Hong Kong Number of Seniors 65+Percentage of Population2009 913,000 13.01%20251,766,00024.01%20502,427,00039.32%Suggests Hong Kong has services in place for about 11% of seniors.Current dependency ratio is 168:1000 (seniors over 65 : workers).Projections are by 2023 this will rise to 282:1000, by 2033 to 428:1000. 12. +A Word About EBSThe Enhanced Bought Place Scheme was the outgrowth of a majorpolicy review by the Hong Kong government where they attempted todevelop solutions to the shortage of senior care facilities. With the EBS,the government purchases an existing privately owned senior care operationand upgrades them (there are two standards as shown below: EA1 offers morecare than EA2). The government saves CapEx by renovating an existing facility. EA1EA2 Per Capita Net Floor Area 9.5 m2 8 m2 Home Manager11 Registered Nurse20 Physiotherapist 0.50 Health Worker 24 Care Worker 88 Ancillary Worker86 Total 21.5 19Note: Source data from Hong Kong Social Welfare Department and Who Pays for Long Term Care in HongKong, by Laurence Wing Him Ho, Chief Executive, Hong Kong Policy Research Institute. 13. +Payer Government & Insurance How seniors in Hong Kong pay for services: 12% who are 60+ are still working in some part-time capacity. 80% are living off of savings. 17% receive social security allowance. 55% over 65 receive additional old age allowance. Private insurance plays a very small role. New efforts by the Health & Wealth Bureau are recommending arequired 2% contribution of salary to Health Protection Account foruse in retirement. 14. +HKHS SolutionFacility Structure (Services, Amenities, Infrastructure)Payment Options (Financing, Qualification Standards)Role of Government (Land Incentives, Eldercare Regulations) 15. +HKHS Solution Facility Structure Cheerful Court Jolly PlaceLocationNo. 55 Choi Ha Road, Ngau Tau Kok, Kowloon No. 2 Pui Shing Lane, Tseung Kwan ONumber of UnitsOne Bedroom Flat 254 162 Studio Flat 79 81 Total: 333 243Floor Area (sqm) One Bedroom Flat35 37 Studio Flat 23 25Carparks Private Cars48 14 Motorcycles 0 5Hospice Beds 57 40Club FacilitiesRestaurant, Convenience Store, Coffee Bar, Hair Lounge, Restaurant, Hobby Room, Multi- Salon, Music Room, Chinese Medicine Store,Purpose Hall, Garden, Games, Gymnasium, Library & Hobby Room, Indoor Swimming Pool, Reading Room Hydropool, Garden, Fitness / Rehab Room, Dancing Room 16. +HKHS Solution Facility StructureThese pictures were taken during a site visit at Cheerful Court in November 2011. They showthe one-bedroom flat in their model configuration. Kitchen to the LEFT, Dining Area to RIGHT.As pictured, this unit would sell for approximately $600,000 HKD. 17. +HKHS Solution Facility StructureThese pictures were taken during a site visit at Cheerful Court in November 2011. They showthe one-bedroom flat in their model configuration. Living Room to the LEFT, Bedroom to the RIGHT. 18. +HKHS Solution Payment Options HKHS is one of the other major policy initiatives that came from the Hong Kong municipalgovernments review of senior housing and the chronic shortage. With HKHS, the government chose to offer land incentives for development versus additionalsubsidization of those seniors who wanted to move to either Cheerful Court or Jolly Garden. Consequently, HKHS has some financial criteria that potential candidates must meet in order tomove to one of these residences: Residents must have net assets between $1-5m HKD. If less than this, the income of the children can be used to qualify. In this eventuality, the childrens income must total $29,000 HKD/month. Services for in-home care range from: Minimum of the basic management fee of $1,260 HKD/month plu