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Aged Care Assessment Teams

National Guiding Principles for the Referral and Assessment of Younger People with Disability

Information on National Guiding Principles for assessment and coordination of specialist disability accommodation and support services.

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Between state and territory disability services and Aged Care Assessment Teams

Introduction

These national guiding principles have been developed between the Commonwealth and the states and territories for the referral of younger people with disability for assessment and coordination of their specialist disability accommodation and support services.

It is acknowledged that the various disability services programs and the Aged Care Assessment Program are organised differently across jurisdictions, and different disability legislation applies. Notwithstanding this, the operation of all Aged Care Assessment Teams is regulated by the Aged Care Act 1997 and associated principles, while the Commonwealth State Territory Disability Agreement provides the national framework for government support for the provision of specialist disability accommodation and support services.

The Commonwealth and state and territory governments have jointly developed the national guiding principles for the appropriate referral of younger people with disability for assessment and coordination of specialist disability accommodation and support services between the various disability services agencies and Aged Care Assessment Teams.

COAG younger people with disability in residential aged care initiative

From July 2006, the Commonwealth and state and territory governments are providing new, matched funding of up to $244 million to jointly establish this capped, five-year initiative. The states and territories have day to day management and administrative responsibility for delivering the new initiative, including the responsibility for the conduct of assessments.

While this initiative will operate separately from the Commonwealth State Territory Disability Agreement, it recognises the separation of responsibilities agreed to by the Commonwealth and the states and territories through the Agreement.

Under the Commonwealth State Territory Disability Agreement, the states and territories have agreed that they have ‘responsibility for the planning, policy setting and management of specialist disability services’ except employment services. Accordingly, each state or territory government is responsible for accommodation support, community support, community access and respite services for people with disability.

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Access to residential aged care by younger people with disability

Under the Aged Care Act 1997, access to Commonwealth subsidised aged care services, including residential aged care (permanent and respite), community and flexible care, requires approval by the Secretary to the Department of Health and Ageing, or a person delegated this power. Some members of Aged Care Assessment Teams are delegated this power. A person may be approved as a care recipient if the eligibility criteria set out in the Aged Care Act 1997 and associated principles are met.

Under the Approval of Care Recipients Principles 1997 a younger person with disability is eligible to receive residential care only if they meet the eligibility criteria for aged care services and 'where there are no other care facilities or care services more appropriate to meet the person's needs'.

Assessment of younger people with disability

The role of Aged Care Assessment Teams is to comprehensively assess the needs of frail older people to facilitate access to available aged care services appropriate to their needs. Aged Care Assessment Teams may not have the skills or experience to assess younger people with disability or have an understanding of the range of specialist disability accommodation and support services available.

In accordance with the Aged Care Act and associated Principles, referral of a younger person with disability to an Aged Care Assessment Team for assessment and approval of aged care services should only occur where it can be demonstrated that 'there are no other care facilities or care services more appropriate to meet the person's needs'.

It is the responsibility of the relevant state or territory disability services agency to assess younger people with disability and ensure they are referred to the most appropriate care service available.

These principles are based on the premise that all options for specialist disability accommodation and support services have fully explored and utilised prior to acceptance by an Aged Care Assessment Team for assessment and approval of aged care services.

Where, following an assessment by a state or territory disability services agency or authorised assessment provider and discussion with the younger person with disability and their family, it is determined that there are no other care facilities or care services more appropriate to meet the needs of the younger person with disability, including under the COAG initiative, referral to an Aged Care Assessment Team may be considered.

The disability assessor should remain involved and provide assistance during the Aged Care Assessment Team assessment, including the timely provision of referral documentation. Disability services, with assistance from Aged Care Assessment Teams where appropriate, should continue to provide support until an appropriate service is accessed.

Where an assessment results in a move to alternate accommodation, the person may require assistance during the transition period. In particular, state or territory disability services should assess and discuss with the younger person (and/or their representative) the appropriateness of providing additional disability services to the person where they enter a residential aged care facility.

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Developing state or territory protocols consistent with National Guiding Principles

In the interests of working together to achieve the best outcome possible for younger people with disability, each state or territory should establish a collaborative, localised protocol between the relevant disability services agency and Aged Care Assessment Teams. The objectives of such a protocol are to:

• Clarify the respective roles and responsibilities between the disability services agency and the Aged Care Assessment Team within each state or territory;
• Identify clear client management procedures between Aged Care Assessment Team and the disability services agency including referral processes that are consistent with these National Guiding Principles; and
• Outline respective roles and responsibilities in relation to younger people with disability who move into residential aged care.

National Guiding Principles

While state and territory protocols may differ in accordance with the local legislative and regulatory environment, all protocols should be consistent with the COAG initiative arrangements and the following National Guiding Principles:

• Residential aged care services are designed specifically to meet the needs of frail older people, and are not oriented to provide for the needs of younger people with disability.
• The most appropriate outcome for younger people with disability is to access specialist disability accommodation and support services and age appropriate services, rather than aged care services.
• Younger people with disability, living in residential aged care or who are at risk of entering residential aged care, should have access to specialist disability accommodation and support services that are appropriate to their needs.
• Referral of younger people with disability to Aged Care Assessment Teams for assessment and approval for aged care services from disability services should only occur where it can be demonstrated that all disability service options have been exhausted and there are no other services more appropriate to meet the person’s needs are available. Documentation should be provided to this effect.
• To minimise duplication in the assessment process, with the client’s consent, any information from the assessment carried out by the disability services assessor must be provided to the Aged Care Assessment Team as part of the referral
• An aged care service provider has the right to determine whether they will accept placement of a younger person with disability, based on their capacity to meet their individual needs. If there is no likelihood that a residential aged care facility are willing to accept a younger person with disability, an Aged Care Assessment Team assessment would not be appropriate or in the best interests of the person.



Younger People with Disability in Residential Aged Care reviews

Wherever possible, and consistent with the COAG initiative and other support arrangements, younger people with disability who remain living in, or enter a residential aged care facility, will receive enhanced specialist disability support services to provide them with opportunities for community access, to maintain family and social relationships and to live a more age appropriate lifestyle.

If a younger person with disability enters a residential aged care facility, a review mechanism should be negotiated between all parties. This should be regular, and involve the younger person with disability, and their family and/or support network

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