Aged Care Funding Instrument
Changes to the Aged Care Funding Instrument from 1 February 2013
Questions and Answers
- From 1 February 2013, changes will be made to the Aged Care Funding Instrument (ACFI) for all appraisals completed on or after that date.
- The changes will be made through amendments to the ACFI User Guide and ACFI Answer Appraisal Pack.
- The changes have been developed in consultation with sector representatives through the ACFI Monitoring Group and its sub-group the ACFI Technical Reference Group.
Why are changes being made to the ACFI?
- The aim of these changes is to strengthen the evidence requirements within the ACFI and reinforce the original intent of the ACFI.
- These changes will provide clarity for providers on issues which are frequently raised during validation, and will assist validators.
- These changes reflect good practice. We are aware that many providers will already be meeting the new requirements.
What are the changes?
Activities of Daily Living Domain - Questions 1-4:
Three changes have been made to the ACFI User Guide and Answer Appraisal Pack.
1. The ACFI User Guide and ACFI Answer Appraisal Pack will be revised to include the words “assessed need” into the guidelines for questions 1-4.
Description- Questions 1-4 of the ACFI refer to a range of activities for which supervision or physical assistance may be provided to a resident.
- It has always been a requirement that these items are only claimable where a resident has a need for the level of assistance being provided.
- As described in the ACFI User Guide, ACFI assessments need to accurately portray the “related day-to-day high frequency need for care” at the time of assessment rather than what the person’s needs may be in the future.
- This change will reinforce this requirement within the ACFI User Guide and Answer Appraisal Pack
From 1 February all new appraisals (for new residents and re-appraisals for existing residents) must be based on the completion of an evidence based assessment of the resident’s needs. The completed assessment must be stored within the ACFI Answer Appraisal Pack with resident’s records – either paper or electronic - and must be available if required for validation.
This change will have minimal practical impact on how providers complete ACFI appraisals. The intent of this change is to improve the clarity of what is required when claiming within questions 1-4. Providers sometimes report lack of clarity in relation to some aspects of the instruments.
2. The ACFI User Guide and ACFI Answer Appraisal Pack will restate the wording on page five of the ACFI User Guide that makes it clear that physical assistance refers to assistance throughout the specified activity.
Description- It is already a requirement that a claim for physical assistance should relate to a need for physical assistance throughout the specified activity.
- The change to the ACFI User Guide and Answer Appraisal Pack is intended to reinforce this requirement for providers when making claims.
This change will have minimal practical impact on how providers complete ACFI appraisals. The intent of this change is to improve the clarity of what is required when claiming within questions 1-4 as providers have previously reported a lack of clarity in relation to some aspects of the instruments.
3. The ACFI User Guide will be revised to require providers to record the outcomes of evidence based assessments used to support completion of checklists with the claiming documentation held at the service, and produce these assessments as required for validation purposes.
Description- Providers are already required to base their claims in questions 1 to 4 on a contemporaneous assessment or assessment conducted in the previous six months (see page nine of the User Guide).
- This change will require providers to include this information within the completed ACFI Answer Appraisal Pack with resident’s records – either paper or electronic. It should be immediately available with other claiming documentation at time of review.
- Specific assessment tools will not be mandated. However, the Department will make available information about recommended assessments that may be used.
From 1 February 2013, providers must complete relevant evidence based assessment(s) to support their claims for questions 1-4. This information must be stored within the ACFI Answer appraisal pack with resident’s records – either paper or electronic - and produced, if requested, at validation.
For example: A provider completes an assessment on Mrs Jones using the Barthell Index. A copy of the completed assessment form is scanned and included within her electronic appraisal pack as part of the resident record.
Complex Health Care – Pain Management
1. The ACFI User Guide will be revised to change the frequency requirement for complex pain management under question 12-4b from “at least four times per week” to “at least four days per week”
Description- It has always been the intention of the ACFI that funding for the complex pain management question 12-4b should recognise complex pain management sessions conducted over four days per week.
- However, the Department has become aware that in some circumstances claims have been made where four sessions occur on three or fewer days.
- This change will align the payment of complex pain management sessions to its original intent.
From 1 February 2013, if a claim for funding under question 12-4b is made, the resident must receive treatment on at least four separate days per week.
2. Question 12.4b: The ACFI User Guide and Answer Appraisal Pack will be revised to clarify the requirement that consistent ongoing treatment must be provided as required by the resident.
Description- The intention of claims under question 12.4b is to provide treatment to residents with conditions which require ongoing intervention to manage their pain, supported by a pain assessment.
- This is already reflected on page 36 of the User Guide which states that question 12 relates to the assessed need for ongoing complex health care procedures and activities.
- It is not intended for use with residents with transient episodes of pain requiring treatment. This change will reinforce the intent of this question.
From 1 February 2013, if a claim of funding under 12-4b is made, the provider must provide evidence at validation to support the requirement for consistent ongoing treatment. A completed pain assessment is one example of possible evidence.
Where can I find a copy of the revised ACFI User Guide and Answer Appraisal Pack?
An updated ACFI User Guide and ACFI Answer Appraisal Pack will be available to download from the ACFI webpage in January 2013.What is different when I complete an ACFI appraisal for a new resident or a re- appraisal for an existing resident after 1 February 2012?
There will be very little practical difference when completing an ACFI appraisal. From 1 February 2013, providers will need to be aware of the revisions to the user guide and answer appraisal pack for question 1-4 and question 12.4b, and ensure the relevant completed assessment documents are stored within the ACFI Answer Appraisal Pack within the resident’s records. These changes are designed to strengthen the evidence requirements and reinforce the original intent of the Aged Care Funding Instrument. As such, many providers will already be meeting the new requirements.Where can I find assessment tools?
The National Framework for Documenting Care in Residential Aged Care services (NATFRAME) was developed to assist age care providers with a suite of tools which supports evidence - based process and professional care practice.The assessment tools included in the NATFRAME are considered to be best practice, the majority of which have been validated by research. The assessment tools cover five specific domains: social, cultural and spiritual; physical; functional; communication; and cognitive and mental.
The NATFRAME can be accessed at the NATFRAME webpage or by visiting the Department of Health and Ageing website and searching for NATFRAME.
How will aged care providers be informed about these changes?
In December 2012, the Department will provide a fact sheet to all providers though a mail fax (bulk information distribution service). Information will also be available at ACFI webpage.In January 2013, the Department will remind all providers of the changes.
My organisation has an appraisal visit due in February. What changes do I need to make to ensure compliance?
The changes which will be implemented on 1 February 2013 focus on the use of evidence based assessment to measure the needs of residents and the retention of those appraisals as evidence if validation is required. Many providers already have systems in place to record the outcomes of resident assessment which support their ACFI claims.From 1 February 2013, providers will need to ensure that any new appraisals (either for new or existing residents) are supported by a completed assessment and a record of this assessment is stored – either on paper or electronically – within the ACFI Answer Appraisal Pack in the resident’s records.
How can I get more information?
Further information can be found by visiting the ACFI webpage or by calling 1800 200 422Top of page
