Face-to-face assessment essential: NACA

Staff at the My Aged Care Gateway should carry out aged care assessment eligibility over the phone, unless the client needs additional support, however all comprehensive assessments should be undertaken face-to-face, preferably in the client’s home.

That’s the overarching message from the National Aged Care Alliance in the aged care assessment discussion paper it has produced to inform the development of a nationally consistent assessment approach.

The establishment of the gateway was a recommendation of the Productivity Commission’s 2011 inquiry and a cornerstone of the Living Longer Living Better aged care reforms, to provide a single point of information, access and assessment.

All NACA members supported the face-to-face approach for comprehensive assessments, but different aged care stakeholders preferred different delivery approaches. The paper put forward three NACA supported options:

• an independent regional assessment service;
• giving the client a choice between a regional service or an approved provider assessor; and
• a GP assessment.

Elsewhere among the paper’s nine recommendations NACA proposed that all assessment processes be culturally appropriate, carer inclusive and take a wellness and reablement approach.

In its paper NACA said it supported the introduction of the  My Aged Care Gateway and a nationally consistent assessment approach and process, but the current approach and outcomes of last year’s assessment tool trial demonstrated a better system was needed.

The current gateway, which launched in July last year, provides a single point for people to get aged care information via a national call centre and website, but is not the regionalised service allocating resources to the individual that was envisaged by the Productivity Commission.

NACA said its concerns with the 2013 Wollongong University assessment tool trial were that it did not support a wellness and reablement approach and showed more people required face-to-face assessment.

In its paper, NACA outlined a system to support access to services while promoting independence; increase the system’s capacity to provide support to older people; control and target funding; and optimise existing resources and infrastructure.

The proposal was the result of work carried out by the NACA Assessment Advisory Group, which formed in the second half of last year by bringing together other sub groups that had been independently considering assessment.

The group included aged care stakeholders representing consumers, providers, workers and health professionals.

Ian Yates, chief executive of COTA Australia, which was part of the group, said the paper brought together the current state of the discussion and was important for continuing the conversation.

“We have gone through the first phase of the gateway and people are starting to see the potential of a fully-implemented system,” he said. From the consumer’s perspective, Mr Yates said COTA supported a range of assessment options but wanted to ensure whoever did the assessment did so against a clear business model and set of protocols about how it happened.

“In the broader context of greater consumer choice, control and independence, and in the context of trying to enable greater choice, we are very conscious of provider capture. People need to be given in the assessment process a clear and independent sense about what kinds of things might be around to assist them with their needs and support.”

He said COTA had a predisposition to having an independent standalone service but it recognised that might not always be possible.

Elsewhere in the paper NACA proposed that veteran’s home services also be accessed via the gateway and ongoing review and reassessment be undertaken by service providers unless a consumer specifically requests an independent reassessment.

The paper further recommended the secure electronic client record be developed and integrated with the government’s eHealth record, systems be reoriented to support short-term periods of reablement service provision and the development of a sector-agreed comprehensive transition plan that includes training.