A Post-Implementation Update

1. ACFI Aged Care Funding Instrument A Post-Implementation Update

2. A quick re-cap The ACFI - • Introduced on 20 March 2008 • A new process to allocate care subsidies • A new structure for the subsidies • New business rules – focus on red tape reduction • Increased ability to claim and manage subsidy and supplement funding electronically Aged Care Funding Instrument

3. A better system Designed to: • better and more objectively match funding to care needs • reduce the excessive documentation for funding • improved agreement on classifications during validation/audit Aged Care Funding Instrument

4. March R C S A C F I 2008 Where are we at ? ACFI replaced the RCS for classifying residents Aged Care Funding Instrument

5. High Medium Low High Medium Low High Medium Low • Mental & Behavioural • Medical Used for minimum data set, support of other ratings, and Behaviour Supplement Diagnoses The Funding Instrument The Funding Model Score Each question’s A, B, C, or D has a SCORE The total score determines the LEVEL • Nutrition • Mobility • Personal Hygiene • Toileting • Continence ADLs • Cognitive Skills • Wandering • Verbal Behaviour • Physical Behaviour • Depression Each question’s A, B, C, or D has a SCORE The total score determines theLEVEL Behaviour A, B, C, or D applied to a MATRIX determines the LEVEL ComplexHealthCare • Medication • Complex Health Care

6. support for ACFI implementation • Financial support for transition to ACFI • “grandparenting” • Additional funding for residents with the highest care needs • A training and information strategy • KPMG will provide independent business advice Aged Care Funding Instrument

7. Progress report - • as at 12 May, Medicare Australia had received nearly 7,000 ACFI Applications for Classification • over 30% of these were submitted electronically • 585 of 1,684 services submitted ACFI applications through online claiming • estimate that 20,000 ACFIs will be submitted by end of June – sufficient for meaningful analysis Aged Care Funding Instrument

8. Some Common Issues • Diagnoses • Assessments and Records • ACCRs for long term residents • Application for Classification forms and process • “It’s not the RCS – it’s different!” Aged Care Funding Instrument

9. The Theory No change to ACAT process ACCR a source document for ACFI appraisals Once in residential care, a new definition of high care and low care Some changes to re-assessment requirements The Reality Any change has potential for impact beyond the scope of the change itself diagnoses assessment tools re-assessments eligibility e.g. respite waiting list requirements Impact on ACA Program Aged Care Funding Instrument

10. high care / low care • ACATs still determine access to residential care and whetherthis is limited to low care • once in residential care a new definition applies • High vs. low care ratio unchanged • Upon entry, and • In total population OR OR Aged Care Funding Instrument

11. high / low restrictions • Where the ACAT approval is for low care, the rate of subsidy paid cannot exceed a specified amount. • This will apply until either: • a new ACAT assessment has been completed • the resident “ages in place” (i.e. a valid reappraisal or a major change in classification is accepted) • a CNO classifies the resident at an ACFI level equivalent to a high level of care following a review Aged Care Funding Instrument

12. An RCS Classified Resident The resident’s funding classification expires on departure from care They will require an appropriate and current approval to enter care in another service, or to return to the same service ACATs may be asked to reassess for high care where the resident has aged in place in the original home An ACFI Classified Resident The resident’s funding classification does not expire if the enter care of a service within 28 days of leaving care. An ACAT reassessment is not required for transfers (even for residents who have aged in place) BUT – a resident whose initial approval was limited to low care will require a reassessment if the resident wishes to pay an accommodation charge to the new service Transfers – the 28 day provision Aged Care Funding Instrument

13. bond or charge? • rules governing payment of bond or charge did not change with ACFI • Department of Health and Ageing wrote to peak bodies to confirm current policy • ACAT (ACAS) should continue to assess based upon Program Guidelines Aged Care Funding Instrument

14. Q & As • Dealing with specific questions in writing • for consistency • record of advice given • Address: acfi@health.gov.au • Number: • Aged Care Information Line 1800 500 852 • Feedback from assessment teams • via your, and then our state offices Aged Care Funding Instrument

15. key documents • ACFI User Guide • ACFI Assessments • ACFI Answer Appraisal Pack • ACFI Scores and Categories • ACFI Subsidy Rates • ACFI Administration Quick Guide available from: www.health.gov.au/acfi Aged Care Funding Instrument

16. Questions ? Aged Care Funding Instrument