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Aged Care Assessment Teams

ACAT Chat - June 2012

Volume 35 of ACAT Chat - Information for ACATs

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Welcome to the ACAT Chat

As you would be aware, on 20 April 2012 the Prime Minister and Minister Butler unveiled a comprehensive 10 year package to reshape aged care. The Living Longer Living Better aged care reform package will build a better, fairer, sustainable and nationally consistent aged care system to meet the social and economic challenges of the nation’s ageing population.

The Government recognises the need for fundamental reform of the aged care system in order to ensure that it continues to provide high quality care and can respond to future challenges. The aged care reform package was substantially informed by the Productivity Commission’s inquiry Caring for Older Australians and the extensive community and stakeholder consultations that followed the release of the Commission’s final report.

The Living Longer Living Better aged care reform package provides $3.7 billion over five years. It encompasses a reform program to create a flexible and seamless system that provides older Australians with more choice, control and easier access to a full range of services, where they want it and when they need it. The reforms will be implemented in stages. This will enable consumers and providers to gain early benefits from key changes, while ensuring they have time to adapt and plan ahead for further reform.

The reforms give priority to providing more support and care in the home, better access to residential care, more support for those with dementia and strengthening the aged care workforce.

We hope you enjoy this edition of ACAT Chat.

In this issue:
Living Longer Living Better The Australian Government aged care reform package
2012 National Aged Care Conference
Carer Visas
Requests to Correct an Aged Care Client Record
Extending Online Access to the Electronic Aged Care Client Record
The National Relay Service
Frequently Asked Questions
Aged Care Publications
Seeking ACAT Chat Articles
Useful contacts for ACATs

Living Longer Living Better The Australian Government aged care reform package

The Living Longer Living Better aged care reform package will build a better, fairer, sustainable and nationally consistent aged care system to meet the social and economic challenges of the nation’s ageing population. Top of page

Key components of the reforms include:

• additional support and care to help older people remain living at home;
• additional help for carers to access respite and other support;
• delivering better residential aged care;
• strengthening the aged care workforce;
• supporting consumers and research;
• better health connections;
• tackling the nation’s dementia epidemic;
• supporting Australians from diverse backgrounds;
• an Implementation Council to drive the reform package;
• establishing an Aged Care Financing Authority;
• establishing a Gateway to services to assist older Australians in finding information and to better navigate the aged care system;
• streamlining quality regulation; and
• improved powers to handle consumer complaints.

Staying at Home

The Australian Government is expanding and improving the support and care options available for older people who want to stay in their own homes. There are currently more than 58,000 Government-subsided community and flexible packages. Demand for these packages far outstrips supply, leaving many people forced to wait a long time for care. From 1 July 2013, the Government will be introducing two new levels of packages, one for people with intermediate care needs and one for people with basic care needs. These will complement the current packages and together be known as Home Care packages. The Government will more than double the number of Home Care packages available across Australia over the next 10 years – more than 80,000 new packages by 2021-22. The Government is committing $880.1 million over the next five years to expand care in the home, reducing the emphasis on residential care.

On 1 July 2015, the Home and Community Care Program, the National Respite for Carers Program, Day Therapy Centres and the Assistance with Care and Housing for the Aged Program will be consolidated under a new Home Support Program.

Further information on the Staying at Home component of the aged care reform package is available at www.agedcareaustralia.gov.au

Tackling Dementia

Dementia is predicted to become the leading cause of disability in Australia by 2016. The prevalence of dementia is growing and will increase from around 257,000 people in 2010 to just over 981,000 in 2050, with the growth rate expected to peak between 2021 and 2030 as the baby boomers age.

The Government will expand the Dementia Behaviour Management Advisory Services into acute and primary care settings with a particular focus on support for older Australians from culturally and linguistically diverse backgrounds and Aboriginal and Torres Strait Islanders. This will help workers and health professionals to better care for people with behavioural and psychological symptoms of dementia. It will enable individuals with dementia to be cared for at home for a longer period of time.

Around 52 per cent of all aged care recipients have some form of dementia. The Government is providing $123.3 million for a new Dementia Supplement for eligible Home Care package recipients that will increase funding by 10 per cent to recognise the higher costs of caring for people with dementia.

Further information on the Tackling Dementia component of the aged care reform package is available at www.health.gov.au

Building a Gateway to Aged Care Services

Information about aged care services is not readily available or reliable, and assessment processes are often repetitive and inconsistent. The Government is providing $198.2  million over five years to progressively establish a Gateway to aged care services to address these problems. A new My Aged Care website will be established to provide clear and reliable information. For the first time, people will know where to go to access information. Over time, the website will publish a rating system of aged care homes so that people can make the most informed choice about their care by comparing services in their area. A national call centre will also be established to improve the timeliness and consistency of information provided.

The My Aged Care website and call centre will be the main entry point into the aged care system and over time will provide a comprehensive system of information enabling Australians to find the information they need. Work is also underway on the development of an assessment framework for aged care to be incorporated into the Gateway to improve and standardise assessments for older Australians.

Strengthening Residential Aged Care

Through the aged care reform package, the Australian Government will strengthen residential aged care by encouraging greater investment in residential aged care, strengthening the sustainability of the sector, and providing consumers with more choice and greater protections. To enable all people who need it to continue to access aged care, the Government is providing $486.9 million to increase the accommodation supplement the Government pays on behalf of residents who cannot meet all or some of their own accommodation costs. This will ensure that aged care homes continue to be built and refurbished.

In general, it is more expensive to construct and deliver aged care services in non-urban areas, compared to urban areas. The Government is providing $108.0 million in viability supplements to providers operating in remote locations or who provide services to Indigenous Australians and older people who are homeless. Existing aged care capital grants programs will be combined through the Rural, Regional and Other Special Needs Building Fund providing around $51 million in capital grants each year

From 1 July 2014, the maximum accommodation supplement will increase, new means testing arrangements will commence for residents entering care from that date, and all residents entering residential care will have the choice of how to pay for their accommodation.

Further information on the Strengthening Residential Aged Care component of the aged care reform package is available at www.health.gov.au

Older Australians from Diverse Backgrounds

Older people seeking to access aged care services are increasingly from diverse backgrounds and the needs and preferences of these people can be very different. Aged care services need to be sensitive to the diverse needs and backgrounds of individuals when delivering care and support. As part of the aged care reform package, the Government is expanding support for people with diverse needs to enable them to better access information and support from aged care providers who are more aware of and responsive to their needs.

There are currently 675 places in the National Aboriginal and Torres Strait Islander Flexible Aged Care program. The aged care reform package provides $43.1 million to expand this program by an additional 200 aged care places to allow more Aboriginal and Torres Strait Islander people with complex high care needs to stay close to their home and country in culturally appropriate care.

The Government will provide $24.4 million to assist older Australians with diverse needs, their families and carers to access information and aged care services that are sensitive to their backgrounds. People who will be supported include those from culturally and linguistically diverse backgrounds; people who are homeless or at risk of being homeless; people who are care leavers; and people from the lesbian, gay, bisexual, transgender and intersex community.

Older homeless people and people at risk of homelessness can need additional support to link them to housing support and care services. The Government will provide $7.3 million to expand the Assistance with Care and Housing for the Aged initiative to better link older Australians at risk of being homeless or who are homeless with suitable accommodation and care services.

The Government will provide $114.8 million for better services to veterans receiving home care packages, residential aged care and community based places within flexible aged care programs as well as additional financial assistance to deliver more appropriate care to veterans who have an accepted mental health condition.

Further information about older Australian’s from Diverse Backgrounds can be found at www.health.gov.au

Supporting Carers

The Australian Government is funding more respite care and counselling support for carers. An additional 6,500 carers will benefit in 2012-13, rising to nearly 16,000 additional carers by 2015-16. Additional funding for respite and carer counselling services will be provided from 1 July 2012. In 2013-14, the Department will conduct an open, competitive process to establish a network of Carer Support Centres.

Further information about Supporting Carers is available at www.health.gov.au

Workforce

Aged care services continue to find it difficult to attract and retain sufficient numbers of skilled and trained workers. With a 25 per cent turnover rate, a rate much higher than other sectors, there is an impact on productivity and higher training costs due to the need to continually train new staff. There is a lack of career development within the sector. Qualifications, competency standards and skill sets need to be updated. A career in aged care needs to be promoted as a career of choice to allow the workforce to grow from 304,000 in 2010 to the estimated 827,100 aged care workers by 2050, the number needed to care for an ageing population.

The Government is developing and implementing an Aged Care Workforce productivity strategy in collaboration with the sector to ensure a skilled workforce is attracted and retained to meet growing demand. A new Workforce Compact, between government, unions and aged care providers, will improve the capacity of the aged care sector to attract and retain staff through:

• higher wages;
• improved career structures;
• enhanced training and education opportunities;
• improved career development and workforce planning; and
• better work practices.

Further information about the Workforce Compact is available at www.health.gov.au

Consumer Support and Research

Through the aged care reform package, the Government will provide $39.8 million over five years for better consumer support and to improve research. As part of the aged care reform package, the Government will also provide $30.8 million over five years to:

• increase the capacity of the National Aged Care Advocacy Program; and
• expand the Community Visitors Scheme to provide more social support to older Australians.

Further information about Consumer Support and Research is available at www.health.gov.au

2012 National Aged Care Conference

The 2012 National Aged Care Conference will be held on 6-7 August at the Adelaide Convention Centre. The Hon Minister for Mental Health and Ageing, Mark Butler will open the Conference. The first day of the Conference will showcase the Living Longer Living Better aged care reform package. The second day of the Conference will focus on aged care assessment in the reform context.

The content on the first day of the Conference will be most suited to representatives from aged care peak bodies, managers and senior staff of aged care providers. The content on the second day of the Conference will be suited to aged care assessors including Aged Care Assessment Team clinicians, Home and Community Care assessors and staff that conduct assessments for the National Respite for Carers Program.

Further information about the Conference will be sent to aged care service providers shortly.

Carer Visas

The Department of Health and Ageing understands that it can be difficult for ACATs to know how to respond to referrals they receive from people who are seeking an ACAT assessment to support their application for a Carer visa. The referral may be from the Carer visa applicant, a family member, a friend, or from a Migration Agent. Migration Agents advise on immigration matters, help applicants to prepare and lodge their application and deal with the Department of Immigration and Citizenship on an applicant's behalf, usually for a fee.Top of page

ACATs have reported that often Carer visa applicants or their Migration Agent are of the understanding that an Aged Care Client Record is a compulsory piece of evidence to submit with their Carer visa application. This is incorrect.

The Department of Health and Ageing has had discussions with the Department of Immigration and Citizenship to clarify the role of ACATs in relation to responding to requests from Carer visa applicants for an ACAT assessment.

The Department of Immigration and Citizenship has engaged Ipsos Social Research Institute to evaluate the Carer visa program. The evaluation will focus on the program as a whole and will look at how effectively it meets the policy intent.

More information on Carer visas is available on the Department of Immigration and Citizenship's website at www.immi.gov.au

Requests to Correct an Aged Care Client Record

In early April 2012 the email address on the Aged Care Assessment Team (ACAT) Request to Correct an electronic Aged Care Client Record (eACCR) form was changed to eAACR.NSW@health.gov.au Please ensure that the revised version of the form used is for all new requests. If you are submitting a request to make a correction to an ACCR, please ensure you clearly explain in your email the reason a correction is required.

Extending Online Access to the Electronic Aged Care Client Record

The Department of Health and Ageing has provided funding to the Department of Human Services (Medicare) to extend access to the electronic Aged Care Client Record (eACCR). The project has two main aims:

• To strengthen eACCR security measures; and
• To provide access to a wider group of aged care providers.

Phase 1: Strengthening SecurityTop of page

On 10 December 2011, Medicare implemented the first phase of the project to strengthen security controls when accessing a client’s eACCR through Aged Care Online Claiming. This was done to prevent people from ‘fishing’ and better manage the risk of inappropriate (browsing) access to a client’s personal information, which is classified as ‘Protected
Information’ under the Aged Care Act 1997, misuse of which can incur criminal penalties.

The following details are now required to access a client's ACCR data when using Aged Care Online Claiming for clients who are not under a provider’s care:

• the client’s surname
• given name
• date of birth
• sex
• Medicare number and individual reference number
• a reason for accessing the client’s aged care approval information

The picture below shows where to find the Medicare card number and individual reference number (to the left of the client’s name on their Medicare card).





The system will only display a client’s ACCR data if all the above information is supplied and can be verified. There are no changes to the procedure of accessing ACCR data for a client already under a service provider’s care.

If a client is unable to provide a Medicare Card Number (ie. the client may have forgotten their card or do not have a Medicare card) and they also do not have a copy of the ACCR, provisions have been in put in place to assist the service provider in retrieving the ACCR data from Medicare.

For more information on how to do this, call the Medicare Aged Care Online Claiming helpdesk on 1800 195 206 (then select Option 1).

It is recommended that service providers establish and document their business process to ensure the Medicare Card Number and Individual Reference Number are collected.

Phase 2: Extending Online Access – Part one implemented

In the second phase of this project, Medicare were extending access in two parts. Part one has been implemented and the following providers can now register for, or amend their existing access to Aged Care Online Claiming:

• Extended Aged Care at Home (EACH)
• EACH Dementia
• Transition Care
• Multi-Purpose Services

Providers already registered in Aged Care Online Claiming, (e.g. providers of residential aged care and community care) will already be able to access eACCRs for clients.

The form for providers to register or amend access to Aged Care Online Claiming can be found on Medicare’s website www.medicareaustralia.gov.au

The National Relay Service

The National Relay Service (NRS) makes a huge difference, every day, to the lives of
thousands of Australians living with a hearing or speech impediment. Many people lose their hearing as they get older and many older people who suffer disease or stroke also have impaired speech. They either use the phone less, or depend on friends and relatives to make calls for them. Sometimes they start to lose contact with the outside world. They are isolated and have trouble doing ordinary things, like phoning relatives or friends, contacting the bank, ringing the doctor or organising a plumber. These people can use the National Relay Service to make phone calls to their friends and family and services — any time of the day or night from anywhere in Australia. The service is an Australian Government initiative funded by a levy on telecommunication companies.Top of page

The NRS:

• is simple to use — thousands of people use the
• service every week;
• costs about the same as a local phone call;
• is staffed by professional relay officers who
• help the calls go smoothly;
• is available to anyone, 24 hours a day;
• guarantees confidentiality for callers by law.

How it works

When someone rings the National Relay Service to start a call, a ‘relay officer’ acts as
facilitator by relaying all or part of the call—from voice to text or text to voice. The relay officer is there to make sure the call goes smoothly.

In an emergency

The NRS also provides an emergency phone relay service with direct access to police, fire brigade and ambulance. The relay officer helps callers connect to the appropriate services and stays on the line during the call.

The NRS works with health professionals

Health professionals are respected by people with hearing or speech impediments and can:

• provide up-to-date and comprehensive information about relay calls to their clients, and
• show how the NRS can help many clients have good phone conversations and retain their independence and privacy.

Many people only find out about relay calls through their health professionals. The NRS is therefore developing an exciting new online learning module designed to raise awareness and understanding of the service among these key intermediaries. The module will be available later this year. Awareness of the NRS among professionals, however, remains low so the NRS is surveying as many health professionals as possible to find out:

• their levels of awareness and understanding of the NRS, and
• how the NRS can better support them in referring clients to the service.

The survey can be accessed any time up to 6 July 2012 at www.relayservice.com.au

Frequently Asked Questions

Extensions to respite approvals

If a client has used their 63 days of residential respite entitlement, can repeated 21 day extensions be approved if the client has been offered a permanent place in a facility?

The purpose of residential respite care is to provide a short-term alternative care arrangement, to give a carer or care recipient a short term break from their usual care arrangement. 

Residential respite care places should be made available to appropriate clients on a planned or emergency basis to help with carer stress, illness, holidays or the unavailability of the carer for any reason. Care recipients are entitled to 63 days of respite per financial year. Beyond this, it may be necessary for a client’s care needs to be re-assessed. On the occasion that a care recipient has been offered a permanent place in a residential care facility, it is not appropriate to approve a 21 day extension. The client needs to make a decision as to whether or not they accept an offer of permanent care.

Respite approvals for clients already in permanent care

A client who occupies a permanent low care residential place is admitted to hospital. The client's care needs have changed so they are reassessed by an ACAT and receive an approval for high level residential care. It is not appropriate for the client to return to their previous low care residential place. Can an ACAT approve a client for residential respite care if the client has a permanent low care residential place?

Yes. A client can be approved for residential respite care when they have a permanent place. However, they cannot receive respite care while they are still technically occupying the permanent place. The client will only be eligible to receive residential respite care once they are discharged from their low level residential place.

Convalescent care and respite

If the Department of Veterans Affairs (DVA) approves a client for convalescent care should an ACAT approval for respite care automatically follow?

No. A DVA approval for convalescent care does not mean an ACAT should automatically approve the client for respite unless there is a genuine need for respite.Top of page

Respite care is defined in the Aged Care Act 1997, as ‘residential or flexible care (as the case requires) provided as an alternative care arrangement with the primary purpose of giving the carer or care recipient a short term break from their usual care arrangement’.

Respite care is not intended for rehabilitation following a post-acute episode nor is it to be used as a waiting facility for people seeking a permanent bed. The true value of respite in supporting frail older people to remain in the community cannot be maintained if pressure is placed on the respite care system by other systems.

Hospital approvals and respite

Is residential respite care appropriate for a client who is assessed in hospital and is awaiting a permanent placement to residential care?

No. Respite approval is not appropriate for a client who is assessed in hospital and awaiting
permanent placement. Respite may be used on a planned or emergency basis and can be offered to a person who is leaving hospital, as long as the intention of the respite is not to provide transition care while awaiting admission to a permanent place or rehabilitative care following discharge from hospital.

Respite is not to be approved for clients awaiting a permanent bed as it limits the access to respite beds for those who require genuine respite. Also there is no security of tenure for the person in the respite bed and they may be asked to leave the facility if they decide not to offer a permanent bed.

Aged Care Publications

5 Steps to Entry into Residential Aged Care Pack (5 Steps Pack)

The 5 Steps Pack can be found at www.health.gov.au

5 Steps Pack

The 5 Steps Pack now consists of the 5 Steps booklet, Application for Entry into Respite of Permanent Care and the Checklist. This pack should be given to all prospective residents.

Aged Care Assets Assessment Kit

The Aged Care Assets Assessment Kit should be supplied to residents who require an assets assessment only. The Kit consists of the Request for an Assets Assessment Application form and Information Booklet.

Appointment of a Nominee Form

The Department of Health and Ageing will send an Appointment of a Nominee form to all residents with their initial fee advice letter when they enter care. ACATs are no longer required to distribute this form.

Impact for ACATs

Each of the above items will need to be ordered separately from National Mailing and Marketing. If an old order form is used, you may not get the correct stock. Please ensure that the new order form is used.

The current stock order limit of 200 continues to apply for the 5 Steps Pack and Assets Assessment Kit. The nominee form should be ordered.

All these publications and the order form can be downloaded and printed from the Department’s website at www.health.gov.auTop of page

Seeking ACAT CHAT Articles

ACAT CHAT provides updates on the Aged Care Assessment Program from a national perspective. We encourage readers to share information of interest from their local area. Informative articles give ACATs opportunities to learn more about initiatives across the country.

We welcome feedback, contributions and suggestions for articles. Please forward any contributions to acats@health.gov.au

ACAT Information Sheets

The Department has recently printed updated versions of the Aged Care Information Sheets. These sheets are available at cpcguidelines@health.gov.au

The ACAT Information Sheet - ‘How ACATs can help you’ - is now available in 18 different languages and can be downloaded from www.health.gov.au

The languages include:

• Arabic
• Chinese
• Dutch
• Hungarian
• Maltese
• Serbian
• French
• Croatian
• German
• Italian
• Polish
• Spanish
• Vietnamese
• Tagalog
• Greek
• Macedonian
• Russian

Your feedback on these translated documents would be greatly appreciated, especially if you find any discrepancies with the actual translations. Please contact acats@health.gov.au to provide feedback.

General enquiries about aged care: Phone: 1800 200 422

Useful Contacts

Website: www.agedcareaustralia.gov.au
ACAT specific information: Website: www.health.gov.au/acats
Medicare Aged Care Online Claiming: Helpdesk:1800 195 206
Website: www.medicareaustralia.gov.auTop of page