Integration of Health and Social Services to Support Seniors

1.     Minister for Finance Mr Heng Swee Keat announced three structural changes in his Budget Statement to better integrate health and social support services for seniors in the community.

2.     The changes will take place on 1 April 2018. Together, they will strengthen our system of community care services to enable our seniors to age healthily and confidently in place.

(I) Nationwide Expansion of Community Networks for Seniors (CNS)

3.     The Community Networks for Seniors programme will be progressively expanded to achieve nationwide coverage by 2020. Overseen by the Ministry of Health (MOH) and its Agency for Integrated Care (AIC), the CNS brings together different stakeholders in a community – voluntary welfare organisations (VWOs), People’s Association’s (PA) grassroots organisations, regional health systems and government agencies – to jointly engage and support our seniors. The objectives are to promote active ageing among seniors to keep them well, extend befriending services to seniors living alone, and sew up health and social support for seniors with needs.

4.     The expansion of the CNS follows encouraging results at the pilot sites at Tampines, Marine Parade and Chua Chu Kang since 2016. At these sites, the CNS has activated more than 70 Residents’ Committees (RCs) to hold regular preventive health and active ageing activities for more than 70,000 seniors. More than 1,500 seniors are now attending these activities on a weekly basis. The CNS has also matched more than 600 seniors to befrienders and assisted about 800 seniors with complex health and social needs. Please refer to Annex A for more information on CNS.

5.     Work has already started to initiate the CNS expansion to various other locations, such as the East Coast, Ang Mo Kio, Nee Soon, Tanjong Pagar and Jurong areas.

(II) Formation of Silver Generation Office (SGO)

6.     The Pioneer Generation Office (PGO) will be renamed the Silver Generation Office and merged into the Agency for Integrated Care (AIC). PGO was formed in 2014 to reach out to Pioneer Generation Singaporeans to explain key government policies such as the Pioneer Generation Package and MediShield Life. PGO has since trained 3,000 PG Ambassadors and engaged three in four seniors aged 65 years and above.

7.     The repositioning will better reflect the PGO’s expanded mandate to outreach to all Singaporeans aged 65 years and above, as announced by the Prime Minister on 9 July 2016. Apart from explaining government policies, Silver Generation Ambassadors will proactively identify seniors who are in need and connect them to active ageing, befriending and aged care services in the community.

(III) Further Consolidation of Planning and Policy Oversight of Health and Social Support Services

8.     The Ministry of Social and Family Development (MSF) will transfer its oversight of Senior Cluster Networks which include Senior Activity Centres (SACs), Cluster Support, Caring Assistance from Neighbours (CAN) Carers and other programmes including befriending services to MOH. MSF will retain oversight of Senior Group Homes and Sheltered Homes, which are in line with its core role of looking after low-income and vulnerable Singaporeans. Please refer to Annex B for information on the services currently under MSF.

9.     The transfer follows an earlier exercise in 2013, where oversight of social care services for frail seniors (i.e. social day care, home-based personal care, meals delivery and escort and transport services) were transferred from MSF to MOH. It will further enable MOH to integrate planning and policy-setting for health and social support services for seniors, such as planning for SAC services in close coordination with the healthcare sector’s preventive health and aged care services.

Overall Benefits

10.     Taken together, the changes will strengthen our system of community care services for our seniors. They will enable the Government, through MOH, to plan and develop health and social support services for seniors more holistically.

11.     Seniors will benefit from more holistic care and support in the community. SGO will reach out to seniors and connect them to active ageing, befriending and aged care services provided by government and community-based organisations. Seniors and their caregivers can also approach AIC as the single agency to coordinate aged care services across both the health and social domains. Seniors under the care or services provided by affected organisations will continue to be served. There will be no disruption to their service.

12.     Aged care providers can now work with MOH’s AIC as the single agency to coordinate the delivery of aged care services and to enhance service development and capability-building across both the health and social domains. The moves also create opportunities for further improvements in the expansion and coordination in outreach, scheme application, service referrals and care transitions on the ground. We thank our partners in both the health and social sectors for their continued strong support to help seniors to age successfully. Together, we can build a stronger community of care for seniors, marshalling government and community resources together as part of the SG Cares movement.

MINISTRY OF FINANCE

MINISTRY OF HEALTH

MINISTER OF SOCIAL AND FAMILY DEVELOPMENT

19 FEBRUARY 2018

ANNEX A

COMMUNITY NETWORKS FOR SENIORS

1.     The Community Networks for Seniors (CNS) aims to develop a strong community-based support system to complement family-based support to keep seniors well and help them age in place. The pilots for CNS started in Tampines, Marine Parade and Chua Chu Kang in 2016. 

2.     The CNS team works with community stakeholders and government agencies to support seniors through the “A, B, C” of ageing well.

i) Active Ageing

CNS planners and coordinators work with community-based organisations such as Senior Activity Centres (SACs) and the People’s Association (PA) to introduce preventive health and active ageing activities to encourage seniors to step out of their homes and engage in these activities regularly. This keeps the seniors active and healthy and reduces social isolation. The activities include exercises, health education, health screening and coaching as well as social interest groups.

ii) Befriending

CNS planners and coordinators work with PA to identify and train neighbours who volunteer to keep an eye on seniors who are living alone near them. In addition, local community-based organisations are activated to recruit, train and deploy befrienders to support seniors who are at higher risk of social isolation.

ii) Care and Support

Through its systematic outreach, Pioneer Generation Ambassadors identify seniors with care needs and refer them to CNS planners and coordinators. Government agencies such as Social Service Offices (SSOs) and voluntary welfare organisations (VWOs) are then activated to coordinate different assistance and support services for these vulnerable seniors.

3.     Since April 2016, CNS has activated more than 70 Residents’ Committees (RCs) to hold regular preventive health and active ageing activities for more than 70,000 seniors. More than 1,500 seniors are now attending these activities on a weekly basis. The CNS has also matched more than 600 seniors to befrienders and assisted about 800 seniors with complex health and social needs. We have seen seniors who stepped out of social isolation and engaged in active ageing programmes, as well as seniors who became stronger and healthier after joining exercise programmes.

ANNEX B

INFORMATION ON ELDERCARE SERVICES UNDER MSF

1.     Senior Cluster Network (SCN)

There are 19 Senior Cluster Networks operated by 8 VWOs appointed by MSF as Cluster Operators to provide a range of community-based social services for vulnerable seniors. The SCN seeks to reach out to and support vulnerable seniors to stay engaged in the community and receive coordinated care to enable ageing in place. The SCN services comprise: (i) Senior Activity Centres (Rental); (ii) Senior Activity Centres (Cluster Support) teams and Caring Assistance from Neighbours (CAN) Carers; and (iii) Senior Group Homes.

i. Senior Activity Centres (Rental) [69 SAC(R)]

The SAC(R) is a drop-in centre that provides information and referral as well as activities to support and engage vulnerable and socially-isolated seniors living in the HDB rental flats.

ii. Senior Activity Centres (Cluster Support) [19 SAC(CS) teams]

The SAC(CS) teams comprise social service practitioners who carry out case management, coordination and monitoring services for vulnerable seniors living in the community with no or low family support and complex care needs. The teams may receive referrals from the Senior Activity Centres, Senior Group Homes, grassroots, Family Service Centres (FSCs), hospitals, polyclinics, General Practitioners (GPs) and other community touchpoints. The teams also recruit volunteers for the CAN Carers, to monitor the well-being of its clients. CAN Carers are typically semi-retirees/retirees or housewives, who conduct regular home visits to vulnerable seniors.

iii. Senior Group Homes (SGHs) [14 SGHs]

SGHs provide assisted living support for lower income and frail seniors aged 60 and above, who have minimal/no family support and have some care and supervision needs not amounting to need for 24/7 care. SGHs facilitate mutual support among seniors living together in HDB rental flats and promote independence. They also seek to prevent premature institutionalisation and support frail seniors to age-in-place in the community. The seniors in SGHs are also supported with case management services by the social workers in SAC(CS).

2.    Senior Activity Centres (Studio Apartments) [52 SAC(SA)]

The SAC(SA) is set up at HDB Studio Apartment (SA) developments to provide the following services:

i. Monitoring and emergency response via an Alert Alarm System for SA residents;

ii. Assisting seniors in obtaining relevant information and services through an Information and Referral Counter for walk-in clients; and

iii. Managing a social communal space within the facility to facilitate socio-recreational activities amongst seniors in the area.

In addition, the SAC(SA) commercial operator runs chargeable services to meet the diverse needs of seniors in the community.  These could include healthcare services, wellness activities as well as social care and support services.

3.     Befriending Service [2 Befriending Services: Lions Befrienders (LB) and AMKFSC Community Services (COMNET)]

The programme recruits and trains volunteers (including healthy seniors) to befriend and provide support to isolated and vulnerable seniors aged 65 and above. These include seniors who may be homebound, lack family or social support, or are at risk due to physical, health, social and/or psycho-emotional reasons. The volunteers visit these seniors on a regular basis and help them in simple household chores, running of errands, escort them for medical appointments, and accompany these seniors to attend group outings or social and recreational activities.

4.     Gero-Counselling Service [1 Gero-counselling Programme by SAGE Counselling Centre]

This service improves the psycho-emotional well-being of persons aged 50 and above, and their caregivers by allowing them to voice their concerns and problems. The service includes face-to-face counselling as well as information and referral assistance.

5.      The Seniors Helpline [1 Seniors Helpline by SAGE Counselling Centre]

The tele-counselling service aims to support seniors aged 50 and above and their caregivers by providing a listening ear and information and referral services. The Helpline is run by staff and trained volunteers from the SAGE Counselling Centre.

6.     Sheltered Homes (SHs) [15 SHs]

The SHs are licensed residential facilities under the Homes for the Aged Act that cater to the needs of fairly ambulant seniors aged 60 and above, who have no alternative means of accommodation. These homes provide support services and social/exercise programmes to engage the seniors and maintain their independence within the community.