Aged care assessment teams have been cautioned not to compensate for home care wait times by approving older people for the highest level of care, federal bureaucrats have revealed.
In response to questions from Greens Senator Rachel Siewert, the Department of Health said it was concerned some “well meaning” assessors had been approving seniors for a higher level of care to avoid a reassessment at a later date.
“We have reaffirmed with ACATs that under their agreement with the Commonwealth our expectation is that people should be assessed for their current care needs,” the department’s Fiona Buffinton told a Senate estimates hearing last night.
She said the department has been working with the state-run assessment services to provide training and guidance in this area.
“We do have methods for reassessment if someone has increased frailty, which doesn’t have to be a full reassessment. It can be a desktop assessment where we can take into account the opinions of GPs,” Ms Buffinton said.
According to the latest home care data report released in December, the most common home care approval was for Level 4, accounting for 40 per cent of approvals.
Home care wait times
The department told the Senate committee it continued to advise older people with a medium priority that the wait time for a high-level package was in excess of 12 months and six to nine months for Level 1 and 2 packages.
Officials told the hearing the health department was unable to determine from its data how many of the 80,000 packages assigned between 27 February and 30 September 2017 had not been taken up by consumers. Currently the only figure it reports is the number of consumers in care, which was 71, 423 at 30 June 2017.
The department also provided the most recent data on the distribution of filled packages, which showed two thirds of packages in the system (66 per cent) were still Level 2s.
At 30 June 2017, there were:
- 1,168 Level 1 packages (2 per cent)
- 47,268 Level 2 packages (66 per cent)
- 6,750 Level 3 packages (9 per cent)
- 16,237 Level 4 packages (23 per cent).
However, this data does not reflect the conversion of 17,825 Level 1 and 2 packages into 6,000 high level ones by the Turnbull Government in September.
Changing the mix of available home care packages to better meet demand for high-level care was a recommendation of the Tune Review.
At the hearing, the department said it had delivered its advice and options to the Minister for Aged Care Ken Wyatt for responding to both the Carnell-Paterson and Tune reports.
Next data report
Ms Buffinton said she expected the release of the next quarterly home care data report to be released within the next two weeks.
Elsewhere during the hearing, South Australian Senator Stirling Griff from the Nick Xenophon Team raised concerns about the lack of auditing of providers over the return of unspent home care funds to the Commonwealth after a person permanently leaves the program.
As an ACAS who only approves at the level the client is eligible for at the time of assessment and at the correct priority, we would like to see the government address the ACAS/ACAT directly who are not doing this rather than blame all ACAS/ACAT
ACAT assessor are qualified health professionals who comprehensively assess eligibility for programs within the context of legislative requirements, guidelines and tools developed by the Department of Health, and validated assessment tools. ACATs are a skilled professional workforce and to blame and generalise the workforce is demeaning.
One of the terms that gets bandied around is ‘future planning’. Couples that were managing well at home and only needed some domestic assistance were given approval for Level 1 or 2 HCP’s stating ‘future planning’. The case management component of these lower level packages eats into the service provision component and as part of a Commonwealth Home Support Program provider it was clear that a large number of people did not need the case management and are better served by staying with the CHSP.. Case management should be provided if a complex care client is finding it difficult to access services, coordinate services and has little or no family support, or in this day and age family are unable to provide support. The ACAT’s are assessing clients at a higher level than current need and are also using the option of referral codes because they are too inundated with work due to teething problems with the new MAC system. it’s easier to do this than to have to do Support Plan Reviews. I am only speaking from a Victorian point of view.
With a condition such as dementia a lot can change in the 12 months plus someone is waiting to receive services. Could require 1 or 2 reassessments before they even get a service!