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Aged Care Assessment Teams

Aged Care Assessment Team¹
Delegations Policy

Relevant policies for the Aged Care Assessment Program (ACAP) developed in consultation with the Commonwealth and State / Territory Governments.

You may download this document in PDF format:

PDF printable version of the Delegations Policy (PDF 52 KB)

Aged Care Assessment Teams Delegation Proforma to be completed for all newly recommended delegates.

Under the Aged Care Act 1997, the Secretary to the Department of Health and Ageing (DoHA) has the power to approve eligibility as a care recipient for entry to residential aged care facilities, community care, residential respite care and flexible care. This power is delegated to specific Aged Care Assessment Team (ACAT) position numbers and may only be exercised by the occupants of the designated position numbers, referred to as ‘delegates’.

ACAT delegates play a very important role in ensuring that assessments of older people are conducted to a high standard, and that the care services recommended produce the optimum outcome for the person assessed.

Purpose

The purpose of this policy is to provide clear guidance to assist in the appropriate selection of delegates and the process that should be followed to nominate and recommend new delegates.
This policy document includes:

• The principles of delegation.
• Selection criteria that delegates should meet.
• The proforma to nominate new delegates.

Background

ACAT positions are recommended to receive delegation through twice yearly delegation updates during which the Secretary revokes existing delegate positions on an exception basis and considers the newly proposed delegate positions. If satisfied, the Secretary approves the positions as delegates.

The Delegations Framework was developed in 2002 to describe the policies and processes for a nationally consistent approach to delegating the authority to ACATs. The framework has been used by state and territory governments to select delegates and ensure that care recipients are approved for aged care services by delegates with the appropriate skills and experience.

In May 2004 it was agreed that the framework would be reviewed to strengthen the delegate selection process. It was recognised that the adoption of common approaches would assist in improving national consistency and provide a more robust process to ensure that ACAT delegates are suitably qualified and have a good understanding of their roles and responsibilities. It was also recognised that whilst a nationally consistent approach was desirable, some flexibility in the selection criteria may be required for exceptional circumstances, such as in small rural or remote teams.

The new selection criteria and processes were implemented from May 2005 and were reviewed in November 2006. The review was favourable with 84% of all delegates meeting all criteria and feedback indicating that the process was generally working well. It was recommended that the selection criteria and process continue to be utilised with some minor amendments to the principles of delegation, the selection criteria and the process.

Principles of Delegation

The following principles of delegation underpin the delegation framework:

• Delegation is a responsibility which can relate to dramatic changes to a person’s life circumstances and must be enacted with a commensurate responsibility and robust accountability.
• The composition of delegates within any one team should reflect the multidisciplinary approach and should include a mix of disciplines drawn from the core assessment professions.
• Wherever possible the approving delegate should not be the same person as the assessor, even though the assessor may also be a delegate.
• In approving a care recipient to receive Australian Government subsidised care, the delegate must be satisfied that the person is not only eligible for the type of care approved, but that this outcome is the optimum for the care recipient. The delegate must be satisfied that the ACAT has:
  • conducted the assessment in accordance with relevant legislation and guidelines.
  • conducted an holistic assessment, including assessment of the person’s usual living arrangements.
  • ensured that a multidisciplinary approach was taken and involved the disciplines required to assess different aspects of a person’s care needs.
  • recommended the care type for which the person is eligible and that is most suitable to meet their care needs and wishes.
  • involved the client (and/or family as appropriate) in the assessment process.
collected adequate verbal or written assessment information, sufficient to address any queries the delegate may have.

Where the delegate is not satisfied, the delegate is responsible for obtaining the additional information required to make a fully informed judgment.

• The delegate should ensure that the Aged Care Client Record has been completed without errors, contradictions or omissions before signing.
• Delegates must comply with all applicable Australian Government and state or territory laws which include, but are not limited to:
  • The Aged Care Act 1997 and associated Principles.
  • The Privacy Act 1988.
• Delegation to positions will be subject to the continued operation of the ACAT according to Commonwealth guidelines, funding conditions and any directions issued by the Secretary to the Secretary’s delegates.

Selection Criteria

A review of nominees against the agreed selection criteria assists in the appropriate selection of individuals to occupy delegate positions. ACAT Managers should nominate to their state or territory government new delegates who meet the following criteria:

1. Employed 0.5 FTE or greater on the ACAT program.
2. An employee on the ACAT program for at least 12 months.
3. Routinely engaged in the full spectrum of ACAT work including community assessments.
4. One of the core disciplines for the ACAT.
5. Successfully completed National Delegation Training.

In some circumstances a new delegate may not fully meet all criteria. This situation may arise in small or rural and remote teams. In these cases, state and territory governments are able to exercise some flexibility, although it must be demonstrated that the person has the necessary skills and knowledge to undertake the role; and that a delegate position is necessary for the effective operation of the team.

The most common criteria not fully met are Criterion 1 and 2. These criteria are included to ensure that ACAT members had appropriate levels of experience, knowledge and skills to competently undertake the delegate role. Further, the 0.5 FTE was designed to ensure that delegates had enough time to be able to attend appropriate training, and keep abreast of communication and changes. Therefore, any relaxation of these requirements should be treated with a degree of caution.

For Criterion 3, the Delegate needs to maintain their practical assessment experience to complement completion of the theoretical component of the National Delegation Training, in line with the ACAP National Training Strategy. This practical component should include being routinely involved in all aspects of ACAT work, including the clinical assessment of older people in the community and in hospital.

Not all ACAT members require delegation. In most instances, no more than 65% of team members would need delegation, although there may be cases, for example in very small teams, where a higher proportion would be necessary.

Conflict of Interest

In accordance with state or territory government regulations, delegates should disclose, and take reasonable steps to avoid, any conflict of interest (real or apparent). Types of interest and relationships that may need to be disclosed include shareholdings, gifts, employment, voluntary work, company directorships or partnerships that could or could be seen to impact upon the delegate’s decision-making powers.

Nomination of new delegates

In order to nominate a new delegate, ACAT managers must complete a proforma for all newly recommended delegates (Attachment A) to indicate whether the proposed delegate meets all the selection criteria. The completed proforma should be sent (by mail, facsimile or email) to the relevant state or territory government.

Where all criteria are not met, the ACAT manager must include sufficient information and justification as to why the ACAT member should receive delegation. This should identify any relevant operational issues; the ACAT member’s relevant skills and experience; and their suitability to perform as a delegate.

If the state or territory government supports the nomination, the proforma and recommendation is sent to DoHA who will discuss and clarify any issues with the state or territory government.

Revocation of delegates

Individuals occupying a delegate position are subject to ongoing review, conditional upon the individual:

• continuing to meet the selection criteria; and
• operating in accordance with relevant legislation, policy and guidelines.

As complaints and appeals are managed by state and territory governments and DoHA respectively, there may be times when the poor performance of a particular delegate becomes apparent through a number of avenues, including an increase in the number of complaints or appeals. On these occasions the issues should be fully discussed and investigated cooperatively between the ACAT Manager and by both levels of government, following the principles of natural justice to ensure that decision-making is fair and reasonable. Any recommendation for the revocation of delegation should be jointly agreed between the state or territory government and DoHA.

Where changes to delegates are due to long service leave, resignations or restructuring of business processes within teams, the relevant state or territory government must notify DoHA to enable Medicare Australia to update their records and revoke delegate positions if required.

1. Or ‘Aged Care Assessment Service’ in Victoria.

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