Introduction to Aged Care Assessment Program

1. Introduction to Aged Care Assessment Program << Facilitators Name>> <<Date>> Developed by Communio on behalf of the Australian Government Department of Health and Ageing Updated March 2008

2. Introductions • Who am I?

3. Welcome • The National Learning Package: Introduction to Aged Care Assessment Program has been designed to: • assist new Aged Care Assessment Team (ACAT) members • assist existing members • promote nationally consistent practice

4. Links with local orientation programs • Supplement this package with local orientation/induction: • local policy and procedures • local reporting relationships • employment logistics such as timesheets, pay days and leave processes • the physical layout of your work environment • the local health and aged care environment.

5. Presentation Contents • Generic Section • Assessors Section • Managers Section

6. Terms and Acronyms ACAP ACCR ILU EACH MDS EU ACAT RACF NRCP EACHD CACPs

7. Generic Section - Objectives In completing this section participants will develop an understanding of the: • purpose, history and future focus of ACAP • key roles and responsibilities of ACAP • key roles and responsibilities of ACAT members • when an ACAT assessment & approval is required to access services

8. Generic Section - Objectives • Understanding of the: • Relevant policy and procedures • Roles & responsibilities of all team members • Minimum Data Set and the Aged Care Client Record • Resources available • Privacy and confidentiality issues • Complaints management • OH&S issues

9. Aged Care Assessment Program - Objectives • Assessment of frail older people to determine eligibility for Australian Government funded services • Ensure equitable access to Australian Government funded services for: • Aboriginal and Torres Strait Islander people • people of culturally and linguistically diverse (CALD) backgrounds • people living in rural and remote areas • veterans, their spouses, widows and widowers • people with dementia • Ensure that access to assessment services is based on need

10. Objectives of ACAP cont’d • Prevent premature or inappropriate admission to aged care homes • Help frail older people live in the community, where that is their wish • Facilitate access to the combination of services that best meets the needs of assessed clients • Ensure that assessments of the care needs of frail older persons are comprehensive

11. Objectives of ACAP cont’d • Involve clients, their carers and other service providers in the assessment and care planning processes • Promote the co-ordination of aged care and other support services to improve the appropriateness and range of care services available to frail older people • Optimise assessment services provided within available resources.

12. Role of the Aged Care Assessment Team • The primary role of an Aged Care Assessment Team (ACAT) is to: • undertake a comprehensive assessment • determine the overall care needs • assist clients to gain access to the most appropriate types and level of care services • exercise the delegation under the Aged Care Act 1997 (the Act)

13. ACATs Role • In undertaking their primary role, ACAT members also: • focus on the needs and preferences of people being assessed • take into account the needs and preferences of the carer/advocate • have the capacity to refer to a range of services • actively encourage client and provider involvement • promote community awareness of ACATs and their role

14. ACATs Role cont’d • establish and maintain links with providers • ensure that their clients understand and are able to exercise their rights • advise health professionals and the public on aged care issues • participate in ACAP data collection processes to inform planning and policy.

15. Advocacy role of ACATs • ACATs are not formal or legal advocates for individual clients. • ACATs will need to exercise a level of advocacy for both the client and the system in undertaking their role.

16. Advocacy cont’d • Advocacy can include strategies to: • increase the older persons control over their future • overcome barriers that restrict opportunities • promote appropriate societal and service delivery responses • protect human rights • be responsive to and emphasise individual needs and wishes • promote equity for disadvantaged individuals and groups • challenge stereotypes and stigma Adapted from National Aged Care Advocacy Program accessed at http://www.agedrights.asn.au/rights/whatis.html

17. Advocacy cont’d • ACATs should only exercise advocacy within the boundaries of their role in their direct dealings with older people, services and the general community. • Formal advocacy for individuals should be done by professional, independent advocates.

18. History

19. ACAP Today • There are 116 teams – changes occasionally to adjust to demographics • All teams can be found on www.health.gov.au/acats

20. The Community Care Review: The Way Forward • The Way Forward includes a range of reform strategies in the areas of: • addressing overlap and gaps • easier access • enhanced service management • streamlining Australian Government programs • a partnership approach

21. The Way Forward • Specific projects include work on: • Eligibility criteria • A tiered Model • Access Points • Framework for assessment • National Consumer Fees Framework • Website Packaged Care Basic Care Information

22. Council of Australian Governments (COAG) • National Reform Agenda - ‘Better Health For All Australians’ • Aged Care Assessment Program (ACAP) forms part of the Agenda. • $24.1 million over four years from 2006-07 for activities to improve and strengthen the ACAP. Including: • National Review of ACATs • better analysis of ACAP data • national training initiatives and improved communication strategies • a review of the administrative framework underpinning the program

23. Legislative Basis

24. Legislative Basis • The Act and associated Principles are integral to the functioning of ACAP • All team members must know: • Where to locate the Act • Understand the contents • Know in detail the elements that pertain to their particular role

25. Guidelines • Guidelines - only provide guidance • Only the content of the Act is enforceable • Breaches of the Act can incur legal penalties

26. The Aged Population • Australia has a rapidly growing older population • In 2006 1,887,064 people were aged 70 years or over • Of those 322,879 are 85 years or older • Older people with a profound disability estimated to nearly double between 2006 to 2031 • 2006 Census - there were 55,292 Indigenous people over the age of 50 (12.15% of the total Indigenous population) Australian Bureau of Statistics 2006 Census of Population and Housing Australia (Australia) – by age. Cat. No. Lynne C Giles, Ian D Cameron and Maria Crotty. Disability in older Australians: projections for 2006–2031 MJA 2003; 179 (3): 130-133

27. Ageing • Not all old people are unhealthy • Many lead active, satisfying lives continuing to contribute to society • Many only rely on informal support from spouses, family and friends • Carers play a significant role in caring and supporting older people • Nationally ACATs completed assessments on just over 8% of the total target population in 2004-05 Aged Care Assessment Program. National Data Repository Annual Report 2004-2005, October 2006

28. Local Demographics • http://www.abs.gov.au/websitedbs/d3310114.nsf/4a256353001af3ed4b2562bb00121564/ca72fe09083c7deaca257242001c71d3!OpenDocument

29. Local Demographics – ACAT Assessments ACAT Referrals and completed assessment in target group by jurisdiction 2006 - 07

30. RESPONSIBILITIESWITHIN ACAP

31. The Australian Government • Responsible for strategic direction and policy issues • Has a small team based in the National Office in Canberra • Each State and Territory has a local office

32. State and Territory Governments • Manage the day to day operations of the ACAP • Develop an annual work plan for the Evaluation Units • Special programs and reform agenda.

33. ACAP Officials • Comprised of senior departmental representatives from Australian Government and each State/Territory Government • Oversee the operation of the ACAP • Meet regularly

34. Auspice Organisations • Various health and community organisations • Public, private, not-for-profit • Budget holder • Employ team members • Provide day to day operational governance • Teams are required to abide by the auspice organisations policies and procedures

35. Evaluation Units • Evaluation Units (EUs) in each state and territory: • Collate • Analyse, and • Report data (Minimum Data Set)

36. Evaluation Units • Data is used to: • monitor the performance of ACATs • estimate the level of need for aged care • identify gaps in service provision • assist ACATs in the collection of the Minimum Data Set (MDS) • provide data to the National Data Repository (NDR) for collation and analysis at the national level.

37. National Data Repository (NDR) • NDR for the ACAP was established 2003 • Provides a national picture of ACAT activity and practice • Located in the Lincoln Centre for Ageing and Community Care Research - Victoria • Produce the Annual Report

38. ACAP Communication and Reporting Channels • ACATs are managed locally • ACAT managers are responsible for the team • ACAT members should direct any enquiry or issue to their local manager in the first instance • The ACAT manager may then contact either their state/territory government staff for advice • There are regular managers meetings and networking opportunities

39. FUNDING • Funding is provided to each jurisdiction • Distributed to the auspice bodies for teams on an operational basis • Australian Government funding is allocated on a population basis that is indexed according to: • Aboriginality • Age • Geography • Culturally and linguistically diverse background • Socio-economic status • Additional funding e.g. COAG specific projects

40. FUNDING cont’d • The Aged Care Assessment Program Financial Guidelines – November 2004 • State and Territory Governments and local health services contribute • 2007- 08 Australian Government contribution was $63,670,095 an increase of 5.7% • Review of the financing

41. Medicare Australia • Medicare Australia administers more than $5.5 billion per year • Require a completed Aged Care Client Record (ACCR) in order to process payments • Working to improve the use of electronic systems in aged care

42. Centrelink • Assesses assets and income of clients to determine residential charges • ACATs do not, and are not to provide financial advice • Refer clients and their carers to the appropriate departments and/or independent financial advisers • The 5 Steps to Entry into Residential Aged Care • ACATs are required to give these booklets to clients

43. Department of Veterans’ Affairs (DVA) • DVA provide a range of services for older veterans and their spouses including home help and personal care • Assist in the funding of aged care places for their members • DVA specific packages or facilities • Assess the income and assets for their clients - not Centrelink • Veteran status should be noted on the ACCR • DVA clients are also still eligible for mainstream services

44. ACAT Member Roles and Responsibilities • Teams differ in size • Each team requires the certain roles to be undertaken, normally by discrete positions. • Flexibility is paramount.

45. ACAT Managers • Manager, coordinator, team leader • National Review of ACATs 2007. Of the 106 teams that responded to the survey, their managers were described as: • 45% - nurses • 4% - Medical officers • 43% - allied health professional • 10% - non-clinicians • and having: • 36% - full time management load • 41% - manage other programs in addition to ACAP • 22% - assessment load of greater than 20 hours per week.

46. Managers’ role • The manager’s role is to provide: • the day to day coordination of work & resources • a focal point for matters regarding ACAP issues

47. Managers’ role cont’d • Managers of ACATs: • ensure assessments are conducted in accordance with Legislation Guidelines • keep abreast of policy and program developments • oversee the ACAT budget • manage the human resources • manage the workload • ensure assessments occur within acceptable time frames

48. Managers’ Role cont’d Managers of ACATs: • ensure high quality • manage any complaints • establish and maintain relationships • ensure privacy and confidentiality • ensure a high client focus

49. Managers’ Role cont’d Managers of ACATs: • ensure special groups receive appropriate assessment services • liaise with state / territory and Australian Governments • ensure data is submitted on time • respond to requests for information • participate in the aged care planning activities

50. Assessors • Assessors are the pivotal members of the ACAT, their role is to: • undertake assessments • arrange client referrals to service providers • contribute to the relevant collection of data • maintain relationships with local service providers • provide education to the health and aged care staff and the general community