Eligibility & Assessment

Nationally Consistent Assessment - Status Update

Information about the research into comprehensive assessment for packaged care services across community care programs.

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PDF printable version of Nationally Consistent Assessment - Status Update (PDF 73 KB)

Background

In 2002, the Department of Health and Ageing initiated a review of its community care programs. Research associated with the review identified that from the consumer and carer point of view, the existing community care system was confusing, difficult to enter and required that clients be assessed multiple times in a variety of ways.

The review resulted in the development of A New Strategy for Community Care – The Way Forward. One component of The Way Forward is to develop a nationally consistent way to assess consumers for HACC and other community care services which COAG endorsed in 2006.

Information about the research and development work for an assessment process is contained in the document Nationally Consistent Assessment, Research and Initial Development on The Way Forward website.

This document provides an overview of the current status of, and work on, developing a nationally consistent assessment process.

Monthly updates are available in The Way Forward Newsletter.

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Current Status

The Australian Government, in partnership with State and Territory Governments and the community care sector, has made good progress in developing a nationally consistent screening/ assessment process. The approach encourages the 'assessor' to explore a broad range of topics to help identify a person's abilities and areas where the person has difficulties in completing tasks of daily living.

Importantly, the new process also considers the relationship between the care recipient and carer, including the carer's ability to sustain their caring role, and the most effective way to support them both.
The process encompasses two key elements: a screening/assessment questionnaire and a computer system that includes business rules to suggest priorities and referrals from the information collected through the questionnaire. These suggestions may prompt or assist the assessor in decision making. The computer system also incorporates a data base of service providers.

The information collected during the initial screening/assessment can (with client consent) be included with the referral to one or more service providers, or to more comprehensive (eg ACAT) or specialist (eg continence) assessors. This means that clients will not have to repeat the information about their circumstances over and over again.
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The ACCNA-R and the CENA-R

The Australian Community Care Needs Assessment-Revised (ACCNA-R) is a screening and eligibility questionnaire that can be used to collect and record relevant information about the needs of both the care recipient and carer. This questionnaire screens at a 'broad and shallow' level. It will be used within some of the Access Point Demonstration Projects that are operating as the first point of contact into community care services for consumers and their carers.

The Carer Eligibility and Needs Assessment-Revised (CENA-R) is a carer-specific assessment questionnaire which adds to the information about a carer to form a 'deep and narrow' view of the caring relationship and an assessment of a carer's support needs.

To minimise the demands on existing services' infrastructure and provide the most efficient way to carry out the development and evaluation of the ACCNA-R and CENA-R questionnaires, the contractor, Applied Aged Care Solutions (AACS), has embedded the questionnaires within a software platform, the Community Care Access Support System (CCASS). This platform provides the ability to apply business rules to automatically identify priorities and trigger referrals.

The CCASS application allows the ACCNA-R and CENA-R questionnaires to operate as secure internet user interfaces and removes the need for users to install software at their locations. Each user has a name and password to allow them to securely access and operate the assessment questionnaires on the web.

The CCASS application allows care recipient and/or carer information to be 'auto-populated' across both questionnaires removing the need to collect information repeatedly.

The CCASS also allows appropriate information to be 'exported' (printed, faxed, emailed) in a variety of standard formats (Doc, XML, PDF) to other relevant applications and/or 'extracted' as a file that can be sent to service providers and uploaded into their client management and information systems (i.e. ONI, SCTT, etc).

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How the ACCNA-R Works

The ACCNA-R is organised into eight modules. Each module includes a set of questions to guide the collection of information about a specific aspect of the client and/or carer situation. The information assists the assessor to identify the type and degree of a client's need. If a module does not apply to the individual client, the assessor can note there is no issue identified and move immediately to the next module.

The ACCNA-R may be easily used during a telephone interview and/or during a face-to-face interview.

The ACCNA-R:

• records demographic (contact) information
• records information about eligibility
• guides the assessment of a client's and carer's functional capabilities
• prioritises needs for service referral and/or more comprehensive (eg ACAT/ACAS) or specialised (eg continence) assessment
• identifies a carer's needs and potentially “triggers” to a detailed carer assessment (the CENA-R)
• stores and exports client information and assessment outcomes (consistent with privacy and consent provisions) to service providers 'down stream' of the assessment point (including ACAT/ACAS and service providers) reducing the need for reassess-ments of what has already been covered
• seamlessly searches a web-based service provider database that has been populated with information from the Commonwealth Carelink Centre Information System.

Detailed information about the contents of ACCNA-R is available on the website in the report Intake Assessment for Community Care - June 2008

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Workforce Support

AACS is developing a range of on-line tools (user guides and training packages) as well as establishing a telephone-based help desk support function. They are also preparing an Assessor Training Workshop and on-site support processes that may vary according to each jurisdiction's requirements.

Evaluation and Enhancement

AACS is undertaking an extended process of evaluating existing assessment approaches as well as the effectiveness of the structure (look and feel), format (sequence of questions) and operation (suitability and usability) of the ACCNA-R. This evaluation is being developed under an 'action research' approach that incorporates feedback from assessors in Access Point Demonstration Projects, selected clients and carers, selected 'down stream' service providers and other referral points. The feedback will come through interviews, surveys, focus groups and evaluation reports.

It is anticipated that the analysis of feedback will lead to recommendations and options for a nationally consistent assessment process and enhancements and improvements to the questionnaire.
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CENA-R Development

The CENA-R uses the information about the carer that has already been collected in the ACCNA-R during the 'broad and shallow' assessment. The CENA-R extends the detail of information collected to allow a user to assess a carer's needs for services in a more in-depth manner (referred to as a 'deep and narrow' assessment). The CENA-R:

• guides a detailed assessment of a carer's functional capabilities
• prioritises needs for a service referral and/or more extensive assessment for the carer
• stores and/or exports carer information and assessment outcomes (consistent with privacy and consent provisions) in electronic or paper formats to appropriate service providers to reduce the need for re-assessments of what has already been covered.

The CENA-R is a new assessment format. Although it is based on available research, it is anticipated CENA-R will undergo further refinement, testing and validation before progressing to full implementation.

A plan to conduct User Acceptance Testing (UAT) for the CENA-R has been developed and endorsed by the Eligibility and Assessment Working Group (EAWG) in October 2008. An initial workshop was held on 3 December 2008 to identify current practices for carer assessment including feedback from experienced assessors regarding interview processes, business flows and the most effective assessment processes for various users. Participants represented the following programs:

• Commonwealth Respite Carelink Centre
• Community, In-Home and Emergency Respite
• Overnight Cottage Project
• Innovative Employed Carers Initiative & Carers at Work
• National Carers Counselling Program
• Dementia Respite Services

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