ANSWER
MINISTER OF STATE FOR SOCIAL JUSTICE AND EMPOWERMENT
(SUSHRI PRATIMA BHOUMIK)
(a) to (c): Yes, sir. As per the Longitudinal Ageing Study in India (LASI) report, the population of senior citizens will be more than 150 million by 2025. As per the report longetivity is more in respect of female senior citizens.
Ministry of Social Justice and Empowerment, being the Nodal Ministry for welfare of senior citizens, has launched an Umbrella Scheme namely Atal Vayo Abhyuday Yojana (AVYAY) w.e.f. 01.04.2021. Previous schemes namely Integrated Programme for Senior Citizens (IPSrC), State Action Plan for Senior Citizens (SAPSrC) and Rashtriya Vayoshri Yojana (RVY) have been brought under AVYAY. Apart from these, the following new Schemes have been started under AVYAY:-
(i) Poshan Abhiyan for Elderly
(ii) Livelihood and Skilling Initiatives for Senior Citizens
(iii) Promoting silver economy
(iv) Channelizing CSR funds for Elderly care
(v) Awareness Generation and Capacity Building for welfare of Senior Citizens
Apart from Ministry of Social Justice and Empowerment the Government of India is implementing schemes and programmes through other Ministries/ Departments, too.
The details of the steps taken in the Schemes/Programmes by the Government of India in the Senior Care Sector are at Annexure.
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ANNEXURE
[Reply to Part (a) to (c) of Lok Sabha Unstarred Question No. 263 for 20.07.2021 regarding ‘Care of Senior Citizens’ raised by Hon’ble M.P., SHRIMATI NAVNEET RAVI RANA]
Details of Schemes and Programmes being implemented by Government of India in Care of Senior Citizens Sector:
Department of Social Justice and Empowerment:
Atal Vayo Abhyudaya Yojana (AVYAY):
AVYAY brings together articulation of each of the current schemes, future plans, strategies and targets and maps it with schemes/programmes, accountabilities, financials and clear outcomes. This Plan takes care of the top four needs of the senior citizens viz financial security, food, health care and human interaction /life of dignity. It also includes the facets of safety/protection and general wellbeing of the elderly beginning from awareness generation and sensitization of the society.
2. AVYAY is an umbrella scheme, effective since 1st April 2021, has following schemes under it, namely:
• Scheme of Integrated Programme for Senior Citizens (IPSrC): Setting up of Homes to improve the quality of life of the Senior Citizens, especially indigent senior citizens by providing basic amenities like shelter, food, medical care and entertainment opportunities and by encouraging productive and active ageing.
• State Action Plan for Senior Citizens (SAPSrC): The Government of India perceives a major and critical role of all State Governments in partnering and implementing this Action Plan for welfare of senior citizens. Each State/UT is expected to plan and strategize taking into account their local considerations and frame their own State Action Plans for the welfare of their senior citizens.
• Rashtriya Vayoshri Yojana’ (RVY): A scheme for providing physical Aids and Assisted living devices to Senior Citizens
• Poshan Abhiyan for Elderly
• Livelihood and Skilling Initiatives for Senior Citizens - Senior Able Citizens for Re-Employment in Dignity (SACRED); Action Groups Aimed at Social Reconstruction (AGRASR Groups):Elderly Self Help groups
• Promoting silver economy
• Channelizing CSR funds for Elderly care
• Scheme for Awareness Generation and Capacity Building for welfare of Senior Citizens – Training, Awareness, Sensitization, Setting up of National Helpline for Senior Citizens.
3. Under the Scheme of Integrated Programme for Senior Citizens (IPSrC), grants upto 100% of project cost are given for running and maintenance the following projects:-
(i) Senior Citizens'' Homes for 25 destitute Senior Citizens to provide food, care and shelter.
(ii) Senior Citizens'' Homes for 50 Elderly Women including those under Sansad Adarsh Gram Yojana (SAGY) to provide food, care and shelter.
(iii) Continuous Care Homes and Homes for senior citizens afflicted with Alzheimer''s disease/ Dementia for a minimum of 20 Senior Citizens who are seriously ill requiring continuous nursing care and respite or those who are afflicted with Alzheimer''s disease/ Dementia.
(iv) Mobile Medicare Units to provide medical care to the Senior Citizens living in rural, isolated and backward areas.
(v) Physiotherapy Clinics for Senior Citizens for a minimum of 50 Senior Citizens per month.
(vi) Regional Resource and Training Centres (RRTCs) monitors and provides technical support, advocacy, networking, training and capacity building for effective delivery of service by the Centres for Senior Citizens, funded by the Ministry.
4. Under the Scheme, assistance is sanctioned to the following agencies subject to the terms and conditions laid down by this Ministry:-
• Priority to be given to the State Governments / UT Administrations for supporting the projects under the Scheme of IPSrC through Registered Societies/ Panchayati Raj Institutions (PRIs) / Local bodies, in the vicinity of Hospitals, as far as possible;
• Non-Governmental/Voluntary Organizations;
• Institutions or Organizations set up by Government as autonomous/ subordinate bodies;
• Government Recognized Educational Institutions, Charitable Hospitals/ Nursing Homes, and recognized youth organizations such as Nehru Yuva Kendra Sangathan (NYKS)
5. Under State Action Plan for Senior Citizens (SAPSrC), the Government of India perceives a major and critical role of all State Governments in partnering and implementing the Action Plan for welfare of senior citizens. Appreciating the critical and significant role of States/UTs, each State/UT is expected to plan and strategize taking into account their local considerations and frame their own State Action Plans for the welfare of their senior citizens. This State Action Plan may comprise a long-term strategy for five years as well as Annual Action Plans and this Department shall release funds to the States/UTs for formulation and implementation of their State Action Plans.
6. Rashtriya Vayoshri Yojana (RVY): Scheme for providing Physical Aids and Assisted-Living Devices for Senior Citizens
The Scheme of Rashtriya Vayoshri Yojana (RVY) has been formulated by Ministry of Social Justice and Empowerment with an objective to provide aids and assisted living devices viz. walking sticks, elbow crutches, walkers/crutches, tripods/quadpods, hearing aids, wheelchairs, artificial dentures and spectacles, free of cost to senior citizens belonging to BPL category who suffer from age related disabilities/infirmities such as low vision, hearing impairment, loss of teeth and loco-motor disabilities. The Scheme has been revised w.e.f. F.Y. 2020-21. Under the revised Scheme, the criteria of selection of beneficiaries have been extended to include not only those senior citizens belonging to BPL category but also senior citizens with monthly income not more than Rs. 15000/- and who suffer from age related disabilities/infirmities as mentioned above.
Under the revised Scheme of RVY, the number of devices hitherto provided has been increased. At present, following are the items that have been included for distribution:
(a) Generic Items: (1)Walking sticks (2) Elbow crutches (3) Walkers/Crutches,
(4) Tripods/Quadpods (5) Hearing Aids (6) Artificial Dentures, and
(7) Spectacles.
(b) Special Items: (1) Wheelchairs, (2) Wheel Chairs with Commode, (3) Chair/Stool with Commode, (4) Silicon Foam Cushion, (5) Knee Brace, (6) Spinal Support, (7) Cervical Collar, (8) Lumbosacral Belt (LS), (9) Walker/Roalator with Brakes, (10) Walking Stick with Seat,
(11) Foot Care Kit:- (i) Flexi Gel Socks, (ii) Socks Cusion Sandal, (iii) Silicon Insole (Complete Foot/Ankle) and (iv) Insole with Pressure Point Relief.
7. Poshan Abhiyan for the Elderly: This is a new Scheme to address the nutritional deficiencies in the senior citizens, especially indigent elderly. The objective of the Scheme is to provide one nutritious, hot and cooked meal during the day (mid-day), through Gram Panchayats and Urban Municipalities.
8. Livelihood and Skilling Initiatives for Senior Citizens- A new scheme with following two components:-
(i) Senior Able Citizens for Re-Employment in Dignity (SACRED)- Many senior citizens have experience, time and energy which can be used by the business enterprises looking for stable employees with experience. The Human resources cells of many private enterprises seek experienced but stable persons in certain positions. The portal allows bringing these people together by virtual matching of preferences.
(ii) Action Groups Aimed at Social Reconstruction (AGRASR Groups): Elderly Self Help groups - The Senior Citizens are encouraged to form Self-Help Groups (SHGs), which will provide them with a platform to share the time constructively with each other. To attain financial assistance under the scheme SHGs will function as ‘Action Groups Aimed at Social Reconstruction (AGRASR Groups)’. Assistance under this Scheme to any SHG will be independent of assistance under any other scheme of the Ministry and an SHG can choose to avail assistance under any one or more Scheme(s).
9. Promoting Silver Economy – This is also a new scheme launched with an objective to encourage the entrepreneurs for to think about the problems of the elderly and come out with innovative solutions The Government aims to achieve the objective by providing upto Rs. 1 crore as financial assistance through equity participation, through an open invitation on a portal namely Seniorcare Ageing Growth Engine (SAGE).
10. Channelizing CSR funds for Elderly care- This is also a new scheme with an objective to channelize the CSR funds in an appropriate manner for elderly care projects. Under Schedule VII of Section 135 of the Companies Act, setting up old age homes, day care centres and such facilities for Senior Citizens is an approved item for CSR funding.
11. Scheme for Awareness Generation and Capacity Building for welfare of Senior Citizens- Components like the National Helpline for Senior Citizens, Research, awareness, sensitization etc. for the welfare of senior citizens, spreading awareness and sensitizing the youth and other sections of the society towards the issues related to the elderly.
Other Initiatives of D/o Social Justice and Empowerment:
1. National Policy on Older Persons (NPOP), 1999: National Policy on Older Persons (NPOP) had been announced in January 1999 to reaffirm the commitment to ensure the well-being of the older persons. The Policy envisaged State support to ensure financial and food security, health care, shelter and other needs of older persons, equitable share in development, protection against abuse and exploitation, and availability of services to improve the quality of their lives. The primary objectives were to encourage individuals to make provision for their own as well as their spouse''s old age; to encourage families to take care of their older family members; to enable and support voluntary and non-governmental organizations to supplement the care provided by the family; to provide care and protection to the vulnerable elderly people; to provide adequate healthcare facility to the elderly; to promote research and training facilities to train geriatric care givers and organizers of services for the elderly; and to create awareness regarding elderly persons to help them lead productive and independent live.
2. The Maintenance and Welfare of Parents and Senior Citizens (MWPSC) Act, 2007: The MWPSC Act, 2007 had been enacted in December 2007 to ensure need based maintenance for parents and senior citizens and their welfare. The Act provides for Maintenance of Parents/ senior citizens by children/ relatives made obligatory and justiciable through Tribunals, Revocation of transfer of property by senior citizens in case of neglect by relatives, Penal provision for abandonment of senior citizens, Establishment of Old Age Homes for Indigent Senior Citizens, Adequate medical facilities and security for Senior Citizens.
In order to make the Maintenance and Welfare of Parents and Senior Citizens (MWPSC) Act, 2007 more contemporary to the needs of senior citizens at large, amendments, such as, adoption of uniform age criteria to define a ‘senior citizens’, registration and prescribing minimum standards of service, infrastructure, manpower etc. in Senior Citizens Care Homes/Multi-service Day Care Centres, rating of agencies providing Home Care services to senior citizens etc. have been proposed. The Maintenance and Welfare of Parents and Senior Citizens (Amendment) Bill, 2019 has been introduced in the Lok Sabha on 11.12.2019.
3. Senior Citizens'' Welfare Fund (SCWF): In pursuance of the Budget Announcement, 2015-16, a "Senior Citizens'' Welfare Fund" has been created to be utilized for such schemes, for promoting financial security of senior citizens, healthcare and nutrition of senior citizens, welfare of elderly widows, schemes relating to Old Age Homes, Short Stay Homes and Day Care of senior citizens etc. , for the promotion of the welfare of senior citizens. The Fund comprises of the unclaimed amounts transferred by every institution holding such fund in the Schemes including Small Savings and other Saving Schemes of the Central Government such as Post Office Savings Accounts, Post Office Recurring Deposits Accounts etc., Accounts of Public Provident Funds and Accounts of Employees Provident Fund, that remain unclaimed for a period of seven years from the date of the account being declared as inoperative account.
4. National Council for Senior Citizens (NCSrC): In pursuance of the National Policy for Older Persons (NPOP), 1999, a National Council for Older Persons (NCOP) was constituted in 1999 to oversee implementation of the Policy and to advise the Government in the formulation and implementation of policy and programmes for the aged. The National Council for Older Persons (NCOP) has been reconstituted and renamed as National Council of Senior Citizens (NCSrC) in 2012. The mandate of NCSrC is to advise Central and State Governments on the entire gamut of issues related to welfare of senior citizens and enhancement of their quality of life. The Hon’ble Minister, Social Justice and Empowerment, is the Chairperson of the Council.
5. National Award ‘Vayoshreshtha Samman’: Every year, this Ministry confers National Award ‘Vayoshreshtha Samman’ to eminent senior citizens and institutions in recognition of their contribution to the society. This is in order to showcase the Government’s concern for senior citizens and its commitment towards senior citizens with the aim of strengthening their legitimate place in the society. The Vayoshrestha Samman award started since 2005, which was upgraded to the status of National Award in 2013. The Awards are given under thirteen categories. Mementos, certificates and cash awards are presented to the awardees.
6. Observance of International Day of Older Persons (IDOP): On 1st October every year, this Ministry observes International Day for Older Persons by conferring National Award ‘Vayoshreshtha Samman’ to eminine senior citizens and institutions involved in rendering distinguished services for the cause of elderly persons, especially indigent senior citizens. Further, Health Camps, Inter-generational walkathons etc. are organised in different States with active participation of Senior Citizens, Youth, Celebrities and Media-persons etc.
Schemes, Programmes, Concession and Benefits provided by other Ministries/Department in Care of Senior Citizens:
1. Ministry of Rural Development:
National Social Assistance Programme (NSAP) is a Centrally Sponsored Scheme of Ministry of Rural Development. NSAP is a social security/social welfare programme applicable to old aged, widows, disabled persons and bereaved families on death of primary bread winner, belonging to below poverty line household. Old age pension is provided under Indira Gandhi National Old Age Pension Scheme (IGNOAPS) to aged persons belonging to below poverty line (BPL) household. Central assistance of Rs. 200/- per month is provided to the persons of 60-79 years of age and Rs. 500/- per month to the persons of age of 80 years or more. This Scheme is implemented by the States/UTs. Identification of beneficiaries, sanction and disbursement of benefit under the schemes is done by the States/UTs. A total of 221 lakh is the targeted beneficiaries under IGNOAPS. The Scheme is implemented in all States/ UTs in rural as well as urban areas.
2. Ministry of Health and Family Welfare:
“National Programme for the Health Care of Elderly” (NPHCE) launched during 2010-11 is State oriented program with the basic thrust to provide comprehensive and dedicated health care facilities to the elderly persons above 60 year of age at various level of primary, secondary and tertiary health care.
I. Primary & Secondary Geriatric Care Services : The program commenced with 100 districts in the 11 thplan period. In the 12 thplan period 421 districts and in 2019-2020, 114 districts were additionally sanctioned to provide dedicated geriatric OPD, IPD, Physiotherapy and lab services. Presently all 713 Health districts have been sanctioned for geriatric primary & secondary care services of OPD, 10 bedded Geriatric Ward, Physiotherapy and laboratory services.
II. Tertiary level activities of NPHCE : renamed as ‘RashtriyaVaristh Jan Swasthya Yojana’ in 2016-17. As on date, 19 Regional Geriatric Centres (RGCs) in selected Medical Colleges of 18 States, are sanctioned for tertiary care service delivery under NPHCE in the form of specialized OPD’s, 30 bedded wards in RGC including earmarking beds in various specialties like urology, orthopedics, ophthalmology etc, manpower development & research activities. Presently OPD services are being provided through 18 RGCs, inpatient services in 16 RGC’s, Physiotherapy in 14 centers & laboratory services in 13 centers.
Two National Centre for Ageing (NCA) has also been developed as centre of Excellence for Geriatric Care services. 200 bedded NCA at Madras Medical College, Chennai has been developed and operational for Covid ward and another NCA at AIIMS, New Delhi is in advance state of Construction.OPD services are expected to initiate by October 2021. A 250 Bedded Geriatric Care and Rehabilitation Centre is sanctioned at PGI chandigarh.
Progress in Operationalization of the Programme activities 2020-21
(As per Progress Report- April to December, 2020)
S.
No
Institutions
Sanctioned Operational
OPD Indoor
wards Physiotherapy services Laboratory services
1 RGCs 19 18 16 14 13
2 District hospitals 718 584 507 445 539
3 CHCs 4869 3111 - 1131 2408
4 PHCs 18407 10180 - - -
5 SCs providing home based care & supportive
appliances
90719
14201
Daily Geriatric OPD services are being provided in 584 DH, 3111 CHCs and 10180 PHCs along with special OPDs in 18 RGCs. Inpatient services are being provided in 507 DH, along with 16 RGCs. Physiotherapy services are being provided in 445 DH, 1131 CHCs along with 14 RGCs. Laboratory services are being provided in 539 DHs, 2408 CHCs, along with 13 RGCs.
Geriatric care service provision in 2019-20
(As per Annual Progress Report- April 2019- March 2020)
S.
N. Services RGCs Distt. Hospitals CHCs PHCs SCs Total
1 OPD care services 133545 7567744 7016670 9032922 2843211 2,65,94,092
2 In-door
admissions 9992 688966 269286 9,68,244
3 Physiotherapy care 34637 754186 744964 15,33,787
4 Lab Tests 230749 4215883 2348922 2275600 90,71,154
5 No of Elderly
Screened & given Health card
599908
719021
526754
273850
21,19,533
6 No of Elderly
Provided Home care services
11157
92657
68674
68783
2,41,271
7 No of Elderly Provided
supportive devices
4820
18006
7256
17502
47,584
8 Cases referred 32017 59202 65057 64119 2,20,395
9 Cases died in
hospitals 17026 2156 384 19,566
Overall 265 lakhs elderly have been provided OPD, 9.68 lakhs Indoor admissions, 15.33 lakhs Rehabilitation and 90.71 lakhs Leb. services respectively by all the operational District Hospitals and below.
V. Training Modules: Three sets of Training modules for Medical Officers, Nurses and Community based workers to deliver Comprehensive Geriatric care has been developed. State level Training of Trainers of Medical Officers for Comprehensive Geriatric Care has been conducted at Chhattisgarh, Meghalaya, Haryana, Punjab Tamil Nadu & Maharashtra generating approx 236 States level Master Trainers and 85 National Master Trainers: 27 for Medical Officer Module, 26 for Staff Nurses Module and 32 for module developed to train Community based workers.
VI. NPHCE Website: - An interactive and dynamic website cum MIS of the NPHCE program has been initiated through Center for Health Informatics (CHI) to provide comprehensive information along with data regarding Geriatric facilities and services available through-out the country. www.nphce.nhp.gov.in
VII. IEC: Audio/Video spots on different topics of elder care, print material-folder, posters etc. have been developed. The regional language version of IEC material is being developed. https://nphce.nhp.gov.in/video-spot/
3. MINISTRY OF FINANCE:
Ministry of Finance has launched a scheme namely ‘Pradhan Mantri Vaya Vandana Yojana’ (PMVVY) to provide social security during old age and to protect elderly persons aged 60 and above against a future fall in their interest income due to uncertain market conditions. The Scheme enables old age income security for senior citizens through provision of assured pension/ return linked to the subscription amount based on Government guarantee to Life Insurance Corporation of India (LIC).
2. PMVVY is open for subscription upto 31st March 2023 and offers an assured rate of return of 7.40% per annum for the year 2020-21 for policy duration of 10 years. In subsequent years, while the Scheme is in operation full month 2023, there will be annual reset of assured rate of return with effect from April 1st of the financial year in line with applicable rate of return of Senior Citizens Saving Scheme (SCSS) upto a ceiling of 7.75% with fresh appraisal of the scheme on breach of this threshold at any point.
3. The differential return, i.e. the difference between return generated by LIC and the assured returns would be borne by Government of India as subsidy on an annual basis. Pension is payable at the end of each period during the policy tenure of 10 years as per the frequency of monthly/ quarterly/ half-yearly as chosen by the subscriber at the time of purchase. Minimum purchase price under the scheme is Rs. 1,62,162/- for a minimum pension of Rs. 1,000/- per month and the maximum purchase price is Rs. 15 lakh per senior citizen for getting a pension amount of Rs. 9,250/-.
4. The Scheme is being implemented through Life Insurance Corporation of India (LIC). A total number of 5,83,208 subscribers are being benefited under the scheme as on 31st December, 2020.
GST Rates on Elder Care Services:
The phrase “elder care services” has not been defined in GST as such, there are services which are related to care of elders. For instance – “Services by an old age home run by Central Government, State Government or by an entity registered under section 12AA of the Income-tax Act, 1961 (43 of 1961) to its residents (aged 60 years or more) against consideration upto twenty-five thousand rupees per month per member, provided that the consideration charged is inclusive of charges for boarding, lodging and maintenance” is exempt from GST vide S.No. 9D of notification No. 12/2017-CTR dated 28.06.2017.
• Few more services which may cover care of elders as well are also exempt-
(i) Services provided by rehabilitation professionals recognised under the Rehabilitation Council of India Act, 1992 (34 of 1992) by way of rehabilitation, therapy or counselling and such other activity as covered by the said Act at medical establishments, educational institutions, rehabilitation centers established by Central Government, State Government or Union territory or an entity registered under section 12AA of the Income-tax Act, 1961 (43 of 1961) vide S.No. 74A of notification No. 12/2017-CTR dated 28.06.2017.
(ii) Health care services by a clinical establishment, an authorised medical practitioner or para-medics vide S.No. 74(a) of notification No. 12/2017-CTR dated 28.06.2017.
4. MINISTRY OF HOUSING AND URBAN AFFAIRS:
Ministry of Housing and Urban Affairs, Department of Urban Development has issued the Model Building Bye Laws, 2016 (MBBL) prescribing standards for creation of elder friendly barrier free environment with reference to buildings, toilets etc. Urban Local Bodies shall implement the Policy by adopting the Model Building Bye Laws, 2016. Further, under Urban Bus Specification-II issued in 2013, the emphasis on buses financed by the Department of Urban Development is on procurement of low floor buses with proper ramps for easy access of the passengers and proper space for wheelchair to be placed in the bus for the benefit of disabled persons and senior citizens. All metro rail projects implemented/under implementation in the country are having disabled and elder friendly infrastructure such as proper ramps/lifts to the stations. There is a provision for reservation of seats in metro rail coaches for differently-abled persons and senior citizens. Further, Housing for All Mission/Pradhan Mantri Awas Yojana Guidelines have been circulated to State/UTs to meet the demand of housing in their States/UTs, which interalia incorporates that ‘while making the allotment, families with senior citizens should be given priority for allotment on ground floor or lower floors’.
Ministry of Housing & Urban Affairs is implementing the Deendayal Antyodaya Yojana-National Urban Livelihoods Mission (DAY-NULM) with the aim to reduce poverty andvulnerability of urban poor households on sustainable basis. The Mission, inter-alia, aims at providing permanent shelter equipped with essential services to the urban homeless in a phased manner under the component of Shelters for Urban Homeless, irrespective of age.
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