�        Enhance employability and financial security;

�        Provide holistic and affordable healthcare and eldercare;

�        Enable ageing-in-place; and 

�        Promote active ageing. 

2.         Good progress has been made in the four identified strategic thrusts, and further initiatives will be pursued in 2008. Recommendations of the earlier Committee on Ageing Issues are also being implemented and will be included in the agenda of the MCA. The major achievements in 2007 include measures to enhance the employability and financial security of seniors, improving the affordability of healthcare, enhancing a barrier-free and accessible environment for our seniors, and facilitating seniors to be well-connected and active in society. The full report is at Attachment A.

3.         Health is key to well-being at old age. Thus, it is vital that services for seniors to help them remain healthy and prevent illness are established for their use.  A pilot Wellness Programme, announced in September 2007, aims to offer older Singaporeans with information and opportunities to lead healthy lifestyles and remain socially engaged within the community.  The Council for Third Age was also established in May 2007 to promote active ageing in Singapore. 

4.         Taking the perspective of ageing as both a challenge and opportunity, the MCA has also encouraged the development of commercially viable products and services for seniors in Singapore.  Promoting a �Silver Industry� as a business opportunity and to enhance quality living for our seniors has been made through the Silver Industry Conference and Exhibition on 10-13 January 2008.   

5.         The MCA, formed in March 2007, coordinates the efforts by the various ministries to provide a holistic approach towards addressing the challenges and opportunities of Singapore�s ageing population. It consists of several high-level ministers and is led by Minister (Prime Minister�s Office) Lim Boon Heng.

. . . . . . . . . . .

Issued by:

Ministry of Community Development, Youth and Sports

ANNEX B

Progress Update on Recommendations of the Committee on Ageing Issues

The Committee on Ageing Issues made a total of 39 recommendations, pushing for greater efforts by the Government, the private and people sectors to achieve four outcomes:

(i)                provide a range of senior-friendly housing;

(ii)              make Singapore a barrier-free society;

(iii)            provide holistic and affordable eldercare and healthcare services; and

(iv)            encourage seniors to lead active lifestyles.

All the 39 recommendations have been or are being implemented. Their respective progress updates can be found as follows:

CAI Recommendation	Progress Update
#1. The Government should consider specific measures to facilitate the development of retirement housing by the private sector, in particular, varying the length of land leases to lower land costs, to cater to seniors.	In Nov 06, URA released a residential site at Jalan Jurong Kechil under the Government Land Sale (GLS) Reserve List. The site has been offered for sale on a 30-year lease and developers will have the option to develop either retirement or normal housing on the site.
#2. HDB should work with market players to offer reverse mortgage schemes for senior HDB flat lessees at commercial terms, to provide another option for seniors to derive some income from their homes to meet expenditure in old age, without having to move out of their homes.	Since Mar 06, NTUC Income has offered a reverse mortgage scheme for elderly HDB flat owners aged 62 and above.    HDB will also implement a new Lease Buyback Scheme as another option for the elderly to monetise their flats.  This Scheme is subsidised and targeted at the lower-income elderly to help them meet retirement needs.
#3. HDB should provide for more rental housing options for seniors, by exploring the lease of vacant flats to voluntary welfare organisations (VWOs), to cater to seniors who may prefer to rent rather than buy, or who need to downgrade from their existing flats.	HDB is building more studio apartments and smaller flats to cater to the housing needs of the elderly.  HDB and MCYS will continue to review how best to meet the social and emotional needs of the low-income elderly in rental flats, and the role that VWOs can play.
#4. The Government should consider introducing guidelines for the provision of accessibility and safety features in the homes for seniors, through a review of the Code on Barrier-Free Accessibility, to create a more senior-friendly environment.	With effect from 1 Apr 07, new residential buildings (excluding landed properties) are required by BCA to meet the following conditions: (i) Each dwelling unit to have at least one toilet that is large enough to be fitted with elderly and disabled friendly features; (ii) Maximum allowable difference in level between the entrance to a residential unit and the common area, so that a short ramp can be fitted for the wheelchair-bound where needed; (iii) Specified height of switches and sockets from the finished floor level to enable wheelchair-bound persons to use them easily.   These new requirements will be legislated when the revised BFA Code comes into force on 1 Apr 08.   HDB has also introduced Universal Design (UD) features in new public housing projects tendered from Jul 06.  These features cover minimising level differences within the flat (at entrance, bathroom and service yard), ensuring doorways and internal corridors are wide enough for wheelchair access, and the provision of at least one wheelchair-accessible bathroom.  There will also be provisions for residents to add other features when the need arises, e.g. space for future installation of grab bars in the bathrooms.
#5. MCYS and HDB should work with VWOs and grassroots organisations (GROs) to provide support services and opportunities for seniors to lead an active lifestyle.	The pilot Wellness Programme, announced in Sep 07, aims to coordinate and enhance existing support services and activities provided by partners within the local community.  Besides eldercare services, the programme will emphasise on empowering older residents to lead active and healthy lifestyles.   MCYS and MOH are also reviewing services provided in the community, such as Senior Activity Centres and Neighbourhood Links.
#6. Town Councils should make all HDB precincts barrier-free as part of their estate improvement works, in a coordinated effort to make Singapore an �Accessible City� for all.	Work to ensure Barrier-Free Accessibility (BFA) is ongoing and on track to achieve Barrier-Free Accessibility in all HDB precincts by 2011. As at end Nov 07, 122 precincts were BFA.
#7. LTA should work with the Public Transport Operators to make all new public buses low-floor, step-free and wheel-chair accessible. The Government should also help to defray the additional costs involved.	All new public buses will be low-floor, step-free and wheelchair-accessible.  The older buses will be replaced with such wheel-chair accessible buses (WABs) when the former reach their statutory life-span and are replaced.  The Government has committed $21 million to help defray the additional cost involved for 3,550 buses.   There are currently 12 bus service routes where WABs are deployed. About 40% of the bus fleet will be wheelchair-accessible by 2010.
#8. LTA should expand and accelerate the upgrading and improvement of existing barrier-free measures on road facilities to enhance accessibility between destinations, hence making it easier for seniors and persons with disabilities to move about on public streets and use the public transport system.	LTA has committed $60 million to upgrade our road facilities to be barrier-free over the next 3 years.  For road facilities connecting transport nodes to residential estates, the improvement measures will be implemented in tandem with upgrading programmes set out by the Town Councils.
#9. BCA should promote Universal Design (UD) through courses and guidelines, to encourage architects and designers to develop a built environment that caters to all.	BCA published the 1st UD guide in Sep 06 to suggest how UD features can be included in these commercial buildings.  The 2nd guide was launched on 12 Oct 07 encompassing all building types.  Complementing the guide, BCA conducts courses and seminars to equip the industry with UD knowledge.   BCA has also instituted the UD Award to give recognition to building owners who incorporated UD designs in their buildings. The first award was given out in May 07.    HDB held a Public Housing Seminar on 29 Sep 06, to share the importance of UD with building consultants, contractors, and estate managers.  The HDB Universal Design Guide Book for Public Housing was launched at the seminar.  HDB has also extended the application of UD to a pilot Neighbourhood Park project in Toa Payoh, which is targeted to complete by 1Q 09.
#10. BCA should introduce guidelines to improve inter-connectivity between buildings, through a review of the Code on Barrier-Free Accessibility, so that everyone can travel between buildings, and between buildings and walkways with minimal obstruction.	For new buildings, BCA requires Qualified Persons to submit �accessible route plans� to illustrate how the building can be accessed from neighbouring buildings and public facilities by persons with mobility difficulties.   This requirement will be legislated when the revised BFA Code comes into force on 1 Apr 08.
#11. BCA should introduce new legislative measures to ensure continued compliance to the Code on Barrier-Free Accessibility and other building requirements so that building and facilities remain usable to seniors and persons with disabilities.	BCA has amended the Building Control Act to ensure that the accessibility features remain usable after construction is completed. It is expected to come into force in early 08.
#12. The Government should set up an inter-agency barrier-free accessibility coordination committee, to coordinate efforts for barrier-free accessibility, especially in the resolution of inter-connectivity issues where responsibilities for implementing accessibility provisions are not clearly established or defined.	An Inter-Agency Coordination Committee, chaired by BCA and HDB, aims to resolve inter-connectivity issues in the built environment. A list of accessible buildings is also published on the BCA�s website (www.bca.gov.sg/BFA/BarrierFree_Search.aspx).
#13. The Government should top-up Medisave accounts of less well-off Singaporeans when there are budgetary surpluses to ensure that seniors have the means to afford healthcare services.	In 2007, the Government provided total Medisave top-ups of $67 to $333 to Singaporeans aged above 50.  The top-up will be distributed over 4 years.
#14. The Government should adopt a holistic, family physician-centred approach towards the management of healthcare needs for seniors, given their close proximity to seniors in the community and ability to ensure that they receive the most appropriate level of healthcare services within the community.	Family physicians are the focus of the Chronic Disease Management Programme.  From Jan 07, elderly patients have been able to use Medisave to pay for treatment related to key chronic diseases in any of the 700 clinics registered under this programme.  The programme empowers family physicians to adopt a holistic approach to manage the healthcare needs of their patients.
#15. The Government should explore new models of primary care delivery, such as the development of one-stop primary healthcare centres, to support a network of private sector family physicians, so that they can shift the focus of chronic disease management from episodic-care to patient-centred, outcome-driven continuing care.	The Jurong Medical Centre, which started operations in Oct 06, is the one-stop primary care centre piloted by MOH.
#16. The Government should promote family physicians to provide first-line medical care for seniors in need of end-of-life care, whether within their own homes or in nursing homes, so that they can receive care in familiar surroundings with their loved ones by their side.	Training in palliative care is included in all training programmes for family physicians to empower them to take on a bigger role in the provision of end-of-life care in the community.
#17. The Government should partner the private and people sector to study and develop the range of community-based nursing services and personal care services, to enhance the range of services available in the community to allow �ageing-in-place�.	Through the pilot Wellness Programme, the Government will encourage the operator (which could be private or people sector) to identify and cater to the needs of the local community.  For example, NTUC Eldercare has started a pilot Care@Home service for Jurong GRC.   MCYS will also be reviewing the Home Help Service and Befrienders programmes to ensure that they continue to meet the needs of the elderly to �age-in-place�.
#18. The Government should set up a Caregiver Centre to support families in care-giving through provision of information resources and programmes.	A Caregivers Centre was set up in Apr 06. The Care Coordinators programme, in operation since Dec 05, also helps to provide caregiver support through public education, support groups and caregiver training.   MCYS is reviewing the framework to enhance caregiver support.
#19. MOH and MCYS should enhance the role of Community Case Management Service through closer integration with the hospital system and the community, to ensure that caregivers are linked to proper follow-up care in the community.	MOH and Integrated Care Services (ICS) are working on a proposal to expand ICS to an Agency for Integrated Care (AIC) to facilitate the care coordination and discharge management of patients. The AIC would facilitate the optimisation of medical care and a smooth transition from the hospital to the home and long-term care setting.   On the ground, the AIC will be complemented by the pilot Wellness Programme, which will also have the information and referral component and aims to help seniors find the relevant services within the local community through dedicated Wellness Coordinators.
#20. The Government should encourage all hospitals to collaborate with partner agencies such as Integrated Care Services to put in place effective discharge planning systems, so as to facilitate the smooth transition and follow-up of clients from hospitals to community-based support services.
#21. MOH and MCYS should jointly review the appropriateness of the Resident Assessment Form classification system in defining the clientele for nursing and sheltered homes, to ensure that continuity and the right level of care are provided. The Government should also study the longer term approach towards better integration of nursing homes and sheltered homes, in line with promoting a continuum of care.	MOH and MCYS are jointly exploring the feasibility of integrating sheltered homes and nursing homes, and how they should evolve so as to best meet the long-term care needs of seniors.
#22. The Government should set up a new intermediate residential care facility, to address the current service gap in intermediate residential care for seniors.	In Jul 06, MCYS set up a new residential facility located at Hong San Terrace, which provides intermediate residential care services. The intermediate care facility currently has an occupancy rate of 63%.
#23. MOH and MCYS should work together to allow integrated models of day care and day rehabilitation centres to evolve based on market-driven needs, to provide more client-centric and efficient services.	MCYS and MOH are reviewing the current service models with the aim of enhancing day care and day rehabilitation services so that each type of centre can more optimally meet the needs of seniors.
#24. The Government should streamline and reduce data requirements across service providers, so as to reduce the administrative work of agencies, freeing them to focus their energies on providing excellent services.	NCSS has gathered feedback from VWOs and implemented the alignment of data requirements with MOH and MCYS for co-funded programmes since Dec 05.
#25. MOH should review its policies to encourage private sector participation and innovation in intermediate and long-term care, and conduct regular fora with them to chart the course for the industry.	Today, the intermediate and long-term care facilities are largely run by charities.  There is potential for the private sector to expand its role, particularly in the nursing home market, to meet different needs of different population segments.   MOH will look into facilitating the entry of providers which can add value to this sector.  This will include measures to further improve market transparency, so that the market can function better.  In Oct 06, MOH published an information paper on charges in the nursing home sector.  MOH will continue to push out more information, such as on clinical and service performance.
#26. The Government should develop a holistic manpower development plan for the healthcare and eldercare sector, to ensure the supply of well-trained professionals in tandem with the ageing population.	MOH, in collaboration other agencies (e.g. MOE, MOM, WDA, NTUC and tertiary educational institutions), has ramped up our supply of doctors, nurses and allied health professions over the years.  This is done by increasing our local training intakes, active recruitment of foreign trained healthcare professionals, redesigning jobs and facilitating entry of local mid-career workers into the healthcare sector.  Such efforts to train, recruit and increase the pipeline will be ongoing to meet our evolving and expanding healthcare needs.
#27. The Government should work with stakeholders to put in place a comprehensive service quality framework for the eldercare sector, to ensure consistent and progressive standards of care nationally.	In Oct 07, WDA launched a skills development framework for community and social services sector under its Workforce Skills Qualifications system.  MCYS and NCSS are working with WDA on using the skills development framework to improve the skills of eldercare workers as part of the effort to improve service standards.
#28. MOH should review the Medisave policy to allow Medisave withdrawals for the treatment of some common chronic diseases affecting the seniors.	MOH has rolled out the Chronic Disease Management Programme from 1 Oct 06. Under this programme, Medisave can be used to pay for outpatient treatments of diabetes, hypertension, lipids disorders and stroke. Each Medisave account holder can withdraw up to $300 per year for such expenses. Altogether, about 1 million Singaporeans, many of them elderly, will benefit.
#29. MOH should review the ElderShield scheme, with the aim to improve the coverage for seniors who require long term care.	MOH has completed the review of the ElderShield Scheme. As of 1 Oct 07, there are 3 ElderShield insurers: Aviva, Great Eastern Life, and NTUC Income. The new basic ElderShield pays $400 per month in cash, for up to 6 years.  The premiums for basic ElderShield can be paid with Medisave.   Insurers can also offer ElderShield Supplements to those who prefer and can afford higher coverage. The premium for Supplements can be paid for by Medisave (subject to a withdrawal limit of $600 per insured per year).
#30. The Government should commit $10 million over five years to set up the �Golden Opportunities! Fund� (GO! Fund) to seed more programmes and activities for seniors and by seniors.	MCYS announced the launch of the GO! Fund in Apr 06, with $20 million set aside over five years.  Since Oct 07, the administration of the GO! Fund has been transferred to the Council for Third Age. Projects that have been funded under the GO! Fund include: Learn My Dialect programme by Viriya Community Services, which aims to break down language barriers between the dialect-speaking seniors and the younger generation, by recruiting bilingual seniors to conduct dialect training in schools and social service institutions; a 100-hour course covering subjects such as gerontology  health and community work for seniors by Young-at- Heart! (YAH!) Community College.
#31. The Government should build on strong family ties to ensure that the family continues to be the first line of support.	The Council for Third Age has taken over the organisation of Senior Citizens� Week and has re-branded it as Active Ageing Festival from 07 onwards.  One of the themes promoted under the Active Ageing Festival includes Grandparents� Day on 25 Nov 07.
#32. The Government should systematically inform older persons of activities. For instance, the Government could publish an active lifestyle magazine to be made readily available to older persons.	In collaboration with CPF, MCYS issued an active ageing publication in Nov 06 entitled, �Jubilee� to 20,000 seniors turning 55 years.   Since 06, SPRING Publishing, a commercial publisher, has published bi-monthly PRIME (English) and GaoFeng (Chinese) magazines targeted at persons aged 45 years and above.
#33. The Government should ensure that all public spaces in housing estates such as parks and sporting venues have facilities that cater to the whole family, including seniors, so as to make it convenient for seniors to engage in sports.	SSC is enhancing sports facilities with better signage, lightings, open space for interaction, and more rest areas, as well as upgrading existing sports facilities.    SSC and PA will work to offer a greater variety of sports courses and activities at all community clubs/centres where space and demand permits.    SSC has also built elder-friendly and disabled-friendly sports facilities at Jurong West, Choa Chu Kang, Jalan Besar and Jurong East.
#34.  HPB should implement more programmes to inform seniors of the importance and benefits of healthy living, to increase public awareness of health issues.   HPB will conduct talks and community and workplace-based outreach activities to promote healthy living.	HPB has developed and enhanced several programmes to reach out to seniors to increase their knowledge and awareness of the importance of living a healthy lifestyle and to encourage them to engage in health promoting behaviours.  These include: 1) Screening programmes for diabetes, high blood pressure and high cholesterol. 2) Those screened as abnormal will be tracked and followed up to ensure that they are treated.  They will be counselled on how to manage their disease and the lifestyle changes they need to make. 3) Healthy eating. 4) Physical activity for health benefits and exercises to increase muscle strength, improve flexibility and balance to prevent falls.
#35. The Government should provide for more public spaces within housing estates and neighbourhood parks for seniors to interact and socialise, such as ensuring that every recreational area in estates is suitable for the whole family, including seniors.	The �family playground� concept has been implemented in new HDB housing precincts.  Family playgrounds have both play equipment for children and exercise equipment for the youth, adults and elderly.  For older estates, their playgrounds are being converted to family playgrounds as part of precinct upgrading by HDB and Town Councils.  As at Apr 07, there were 136 family playgrounds in public housing estates.      Where possible, NParks, as part of its park development programme, will design parks that are universally accessible and have facilities such as exercise equipment that are senior-friendly.  Since 2004, NParks has been retrofitting parks to make them universally accessible and equipped with elder-friendly facilities.    NParks is also targeting to set up about 400 community gardening groups/plots by 2010.
#36. NVPC should work with partners to develop and promote more volunteering opportunities for seniors, to better harness their experiences and skills for the community.	Since 2006, NVPC has been increasing awareness of senior volunteerism through public education materials and events, media relations and media campaigns. These include fairs organised to promote active ageing and volunteerism and a dedicated brochure featuring volunteer opportunities for seniors. NVPC has also been actively promoting senior volunteerism to non-profit organisations (NPOs) through visits and focus group discussions involving NPO representatives.    To help facilitate recruitment and encourage retention of senior volunteers, NVPC has developed an on-line best practice guide for NPOs, �Engaging Senior Volunteers: A Guide for Non-profit Organisations�. NVPC has also acquired relevant publications on senior volunteering for its Resource Centre for public consumption.   NVPC also conducts training for NPOs to help them in managing and retaining their senior volunteers.
#37. Universities and polytechnics should provide more learning opportunities for seniors, to allow seniors the opportunity to learn and pursue their interest areas.	With support from MCYS� Golden Opportunities (GO!) Fund in 2007, YAH! College has expanded lifelong learning in the community.    In Aug 07, the Council for Third Age also signed a MOU with UniSIM to promote the General Studies Programme beginning 2008. 500 spaces have been set aside for seniors.   MCYS will continue to facilitate and open up opportunities for older Singaporeans to embark on lifelong learning opportunities.
#38. NLB should provide more large print books and audio-visual materials that appeal to seniors.	Since 2006, NLB has conducted focus group sessions to obtain end-users' inputs, which have been incorporated into the specifications outlining the collection buildup.  Today, a total of 12,000 volumes of audio books have been placed at Tampines, Woodlands and Jurong regional libraries and the Central Lending Library.  Large-font books have also been added to NLB branches.
#39. SSC and PA should introduce family passes to encourage multi-generational use of sports facilities.	The Grassroots Organisations (GROs) under the PA offer discounts and incentives for family participation in many of their activities.  PA will encourage GROs to do more where appropriate.   The SSC also launched its Senior Citizen Family Pass in 2007, which offers discounts for senior citizens and their family members to facilitate inter-generational bonding among seniors and their families through sports.