Assessment

Before accessing services, an eligible older person will have to complete an assessment to check what services are most suitable for their needs and preferences.

[Chapter 2 – Part 2 – Division 2]

The Act sets up a new, consistent framework for assessing what services will meet someone’s care needs. This is called the single assessment system.

Note: ‘Single assessment’ means there is one team and a consistent approach to assess someone’s needs. It doesn’t mean a one-step process for the older person.

Through this system, older people don’t have to go to different assessment organisations to get access to different services. Assessment organisations can assess someone for all government-funded clinical and non-clinical services. This framework is more flexible, allowing older people to move between services more easily based on their needs at the time.

Needs assessment process

An approved needs assessor must carry out the assessment. They work for an assessment organisation and need to be trained and qualified to do the assessment. When doing an aged care needs assessment, the assessor must:

• consider the older person’s rights to independence, choice and control over their lives
• talk to the older person about what their assessment has shown about the services they may need
• talk to the older person about what their preferences and goals are. 

The aged care needs assessor must involve the older person’s carer, family member, advocate or other person in their assessment, if that’s the older person’s preference.

The assessor uses the Integrated Assessment Tool (IAT). The IAT assesses someone’s need for all funded aged care services at one time.

The assessor summarises the outcomes of the assessment in a report. The report includes information on the service groups and specific services the older person needs. It also includes the classification type for the services that the assessor considers should be approved for the older person, which is used in the classification assessment. 

Approval 

[Chapter 2 – Part 2 – Division 3, Division 4]

The assessor submits their report to an assessment delegate for approval. A delegate is someone who has been granted power by the department to decide which services someone can access. They make this decision based on the assessor’s report.

What the delegate can approve depends on the setting:

• If the older person is to receive the services in a home or in a community setting, the approval will be for access to specific service types or services.
• If the older person is to receive services in an approved residential care home, the approval will be for access to the residential care service group as a whole – not specific services. The provider is then responsible for delivering the care, based on the older person’s needs, preferences and goals.

Notice of the decision

Once the delegate makes an approval decision, they have to notify the older person within 14 days after the decision is made. This notice must include information such as: 

• what the decision is
• the reasons for the decision
• if the decision is to approve access, the day the approval starts (sometimes referred to as when the approval ‘takes effect’)
• which services have been approved, including service types and service groups
• which classification type(s) are approved for the service group
• any conditions included in approval, such as if they need to give any extra information to their provider regarding their needs
• how the older person may apply for a review of the decision if they feel it doesn’t meet their needs.

Revoking and reviewing approval

Older people can only access services after they have been approved. The approval continues until either:

• the department revokes – cancels – it
• the older person is reassessed, and a new approval decision is made. 

The department can cancel someone’s approval if it finds the person gave information or a document relating to their approval that was false or misleading.

If someone is not approved, or their approval is cancelled, they can ask the department to review the decision. This is because approving and cancelling access to services are reviewable decisions, under Part 2 of Chapter 8 of the Act. 

Reassessment

[Chapter 2 – Part 2 – Division 2]

An older person who is already accessing funded aged care services can ask for their needs to be reassessed. For example, if there is a change to their circumstances or needs. Their registered supporter can also ask for the reassessment. If it’s a significant change, the older person might need a completely new needs assessment. In other cases, they might not need a full reassessment. The older person, their provider or a health professional can instead give information to the department about what has changed.