Commonwealth Aged Care Reforms

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Contents Drivers for Commonwealth Aged Care Reforms My Aged Care and Regional Assessment Services (RAS) – from 1 July 2015 Commonwealth Home and Community Care (HACC) Transition to Commonwealth Home Support Programme (CHSP) NSW ACATs transition to My Aged Care by the end of 2015 Aged Care reforms - Commonwealth HACC service provision to those over the age of 65 yrs will transition to CHSP from 1 July 2015. NDIS reforms - NSW CCSP (HACC) service provision to those under 65 yrs will gradually be transitioned to the NDIS by 1 July 2018. Note: The focus today will be on information around the immediate changes occurring under the CHSP with the introduction of My Aged Care and the transition of HACC to CHSP from 1 July 2015. Information about CCSP (under 65 yrs) and transition to NDIS is not covered in this presentation.

Drivers for Commonwealth Aged Care reforms Increasing demands on aged care system & workforce Increased demands from people with complex needs Increased number of people living with chronic diseases Growing and ageing population Increasingly fragmented, complex system Expansion in separately funded home support programs Societal changes Rising consumer expectations There are a lot of different reasons that demands on the aged care system are growing – these are just a few. Rising consumer expectations… including a greater desire for independent living and culturally relevant care – giving consumers what they want as well as need – is a key driver for change. The current system is fragmented, based on funding programmes rather than matching individuals to services that address their needs and wants.

Commonwealth objectives Australian Government vision is that by 2022 Australia’s aged care system will: Be sustainable and affordable, long into the future Provide diverse and rewarding career options Encourage aged care businesses to invest and grow Offer greater choice, with control in the hands of consumers Support people to stay at home, and part of their communities, for as long as possible Over 65s will represent ~20% of the population in 2030 compared to 14% in 2006 Healthcare expenditure for over 65s is two to three times higher than under 65s The NSW population is expected to grow by about 1% per annum The National Aged Care reforms offer the framework within which to build a better and more sustainable aged and community care system NSW Health is working with the Commonwealth to implement Aged Care reforms, organising aged and community care services for older people that better meet their changing needs

Timeline of HACC/CCSP transition > 65years 2012 2013 2014 2015 2016 2017 2018 NDIS Full implementation 1 Jul 2018 NSW CCSP funding extended by AHDC Hunter Pilot site transition complete and their NSW CCSP funding ceases 30 Jun 2016 CHSP contracts end Transition of Commonwealth HACC Program to CHSP Full functionality rollout of My Aged Care Gateway 1 Jul 2015 NSW CCSP transition to NDIS complete 30 Jun 2018 30 Jun 2017 HACC program ceased Commonwealth HACC Program 65+ commenced 1 Jul 2012 Contracts for Commonwealth HACC devolved to LHDs Hunter Pilot site transition to NDIS commences 1 Jan 2014 1 Jul 2013 HACC/CHSP $80M approx. 1 Nov 2015 New CHSP Contracts 1 Jul 2012 HACC Program ceased; NSW CCSP <65 commenced NSW CCSP contracts devolved to LHDs The timeline illustrates the key milestones that have occurred since the 1 July 2012 when HACC was split into two separate programs under the National Health Reform Agreement with the Commonwealth having policy and funding responsibility for >65s and the state having the corresponding responsibilities for those under 65. You will note that key milestones relating to Commonwealth HACC and service provision to those over the age of 65 are represented above the timeline, while service provision and transition to NDIS for those under the age of 65 are displayed under the timeline. There are two parallel reform processes affecting HACC/CHSP programs in the LHDs: the Commonwealth aged care reforms and the NDIS. Clients under 65 will gradually be transitioned to the NDIS, with care continuing under HACC grandfathering arrangements until full implementation on 1 July 2018. The focus today will be on changes occurring under the CHSP with the introduction of My Aged Care. CCSP/NDIS $20M approx. < 65years

My Aged Care Gateway MyAgedCare National Contact Centre http://www.myagedcare.gov.au/ National Contact Centre 1800 200 422 8am-8pm (Monday to Friday) 10am-2pm (Saturdays)

What is My Aged Care? My Aged Care is a national gateway commencing from 1 July 2015. It will provide a single entry point for access to Commonwealth funded aged care services My Aged Care has 3 online portals: for clients and carers, assessors and service providers My Aged Care aims to: Provide a standardised national approach from screening through to comprehensive aged care assessments Centralise all registration and screening Introduce and maintain a central Client Record Simplify and streamline client assessment Match and refer clients for appropriate services From 1 July 2015 the new My Aged Care Regional Assessment Service (RAS) will be responsible for providing assessment services. The My Aged Care approach to assessment will help ensure that the allocation of services is based on the needs of older people, and is not limited by the scope of services a particular provider has to offer. Assessment will be face-to-face, and focused on holistic, person-centred, goal-oriented support planning. Existing clients do not need to be assessed by My Aged Care to continue receiving the services they currently receive. The system and referral pathways are illustrated on a later slide.

My Aged Care benefits for clients Identifiable entry point providing timely and reliable information on aged care A central client record, accessible by assessors, service providers and clients Simplified and standardised aged care needs assessment Support to locate and access appropriate services My Aged Care Website My Aged Care Contact Centre National Screening & Assessment Form Action/ Support Plan Client Record Regional Assessment Services (RAS) ACATs National Screening & Assessment Form Action/ Support Plan Service Finders Electronic Referrals

My Aged Care impacts for NSW Health What will change for NSW Health front-line staff? New clients referred through My Aged Care Different referral pathways Maintenance of the central Client Record Determine My Aged Care or existing referral pathways for clients Service provision to clients should for the most part remain the same. What will change is the business process around how NSW Health staff refer in to the My Aged Care system, as well as how referrals for new client are received by CHSP services. Central Client Record: the MAC client record and National Screening and Assessment Form (NSAF) will be populated by MAC Contact Centre staff and RAS/ACATs. Service Providers will only need to enter a minimal amount of new data fields– to ensure the client record maintained across the pathway, while maintaining scheduling and contact information in the existing system. The Commonwealth will be releasing access to the service provider portal in early May and further detail will be provided after this, around MAC data entry requirements for staff. For new clients over the age of 65, the majority of these should be referred to the My Aged Care contact centre for registration and screening, to determine higher or entry-level home support services. Exceptions to this would be for services that are not Commonwealth aged care services, such as Compacks. Determining My Aged Care or existing referral pathways? e.g. for community nursing. MoH is working with LHDs to develop decision pathways which will be distributed to each LHD shortly

My Aged Care Assessment & Service Referral Pathways MATCH & REFER TO SERVICES Inbound Referral My Aged Care Contact Centre Registration Screening Service Planning & Delivery Regional Assessment Service (RAS) – Home Support Assessment Home Support Program Basic level / Low intensity home support services Wellness / reablement focus Residential Aged Care Permanent placement Respite placement (low/high) Complex multiple needs Home Care Packages Complex multiple care needs Levels 1 and 2 Levels 3 and 4 Transitional Aged Care Aged Care Assessment Team (ACAT) – Comprehensive Assessment Currently My Aged Care operates only as an information and referral service. From 1 July 2015, My Aged Care will become fully operational and will be the central intake point for access to the aged care system – that is residential aged care, Home Care Packages, CHSP, ACATS and Regional Assessment Services. This diagram illustrates a simple overview of the assessment and service referral pathways. The solid orange lines indicate usual pathways and the dotted lines indicate exception pathways i.e. the Contact Centre can refer a client directly to a basic service Decision Support A set of business rules has been developed to support decision making capabilities of trained My Aged Care contact centre staff and assessors as they undertake Screening, Home Support Assessment and Comprehensive Assessment. These rules have been developed based on best practice from across the jurisdictions, and will align with the design of the Commonwealth Home Support Programme and eligibility for services under the Aged Care Act 1997. This enables a nationally consistent set of rules to be applied to Screening and Assessment, but does not enforce mandatory decision making Decision support will either assist by: Presenting the My Aged Care contact centre staff or assessor with a recommended action or outcome Presenting identifying issues to guide the user in making their own decision

National Screening and Assessment Form (NSAF) Commenced by My Aged Care contact centre during registration and screening Holistic Restorative philosophy underpins assessment Assessment building on information collected at screening, with appropriate questions at each level of assessment Previously collected information displayed so clients do not have to repeat their story Built in algorithms will assist to identify client needs, goals & preferences in a support plan The NSAF is an electronic assessment form built into My Aged Care that will ensure people are assessed consistently so those with similar needs are able to access similar aged care services across the country. The form has inbuilt algorithms to direct decision pathways, and has been developed based on an appraisal of existing best practice assessment processes from around Australia. NSAFs will be completed by the MAC contact centre staff, RAS and ACATs.

NSAF Structured but also allows free form text e.g. Q.42 or the story in eACCR. Can make attachments to NSAF

Assessment and Referral Pathways (RAS and ACATs) A single referral pathway through My Aged Care by 31 December 2015: Regional Assessment Services (RAS) to commence 1 July 2015 ACAT referral and assessment services to transition on 2 November 2015 Some LHD referral pathways will remain unchanged i.e. Compacks, post-acute nursing, CCSP LHDs will no longer be able to directly refer to their own existing CHSP (HACC) service – all referrals first through My Aged Care for screening, assessment, then referral to LHDs CHSP RAS home support assessment -> match & refer for Home Support Services (CHSP) In client’s home, uses National Screening and Assessment Form (NSAF), links clients to services provided under CHSP Focuses on client wellness and reablement, rather than pairing with specific programs or care types ACAT comprehensive assessment - > match & refer for Aged Care Services ACAT referral and assessment services will transition on 2 November 2015. Until this date ACATs will use the Accept/Reject functionality of MAC for some referrals that come through electronically, but will not be required to utilise the rest of the MAC functionality (ie. NSAF and Client Record).

What is the Regional Assessment Service (RAS)? A national assessment workforce, operating regionally across Australia (except Vic and WA) NSW Health one of 13 agencies operating RAS Face-to-face assessment of clients with reablement focus Matching and referral of assessed clients to appropriate CHSP service Benefit: streamlined referrals process. One assessment for multiple client services

Commonwealth Home Support Programme (CHSP) The Commonwealth Home Support Programme (CHSP) will bring together the following programs: HACC National Respite for Carers Program Day Therapy Centres Program Assistance with Care and Housing for the Aged Program Introduction of a nationally-consistent fees policy Underpinned by a restorative care approach (wellness and reablement) and consumer directed care Sector support and development – with operational guidance from NSW Health A nationally-consistent fees policy is being introduced, with clients who can afford to, paying fees to access CHSP services. A Commonwealth Fees Policy Consultation paper has been released for sector feedback. MoH is coordinating a response from LHDs to provide feedback to DSS and will also work with LHDs in supporting the implementation of a consistent fees policy. Wellness and reablement are key philosophies behind the CHSP, and a focus on client independence and autonomy will be embedded in the approach to all CHSP service delivery. Reclassification of existing sector support and development activities that are more appropriately identified as service delivery. Funding contracts will be extended to 31 October 2015 while arrangements are reviewed by the Commonwealth. MoH will provide further guidance as it comes to hand.

HACC transition to CHSP Community and Home Support Objective To provide entry-level support services to assist older people to live independently at home and in the community Target Group Frail, older people aged 65 years and over (or 50 years and over for Aboriginal and Torres Strait Islander people) who need assistance with daily living to remain living independently at home and in the community Service types funded Meals Other food services Transport Domestic assistance Personal care Home maintenance Home modifications Social support – individual Social support – group (formerly Centre-Based Day Care) Nursing Allied Health and Therapy Services Goods, Equipment and Assistive technology The CHSP is structured around four main sub-programmes based on target groups. Community and Home Support Care Relationships and Carer Support Assistance with Care and Housing Service System Development HACC will transition to services under the Community and Home Support target group illustrated in this slide.

CHSP impacts for NSW Health What will change for NSW Health front-line staff? Referrals for your service will now come through My Aged Care electronically Service provision will continue, except for case management, assessment, and care coordination services Regional Assessment Services (RAS) will now provide short term case management, assessment and care coordination services. What will continue for LHDs? Continued delivery of services under CHSP Funding continuity until 30 June 2017 Clients will continue to receive the same services and should not notice any changes in their continuity of care.

Timeline of RAS/ACAT transition to My Aged Care 2 Nov 2015 NSW ACATs use full functionality of My Aged Care 2013 2014 2015 2016 2017 2018 Full functionality rollout of RAS and My Aged Care 1 Jul 2015 1 July 2013 Current RAS contract ceases My Aged Care website and contact centre established 30 Jun 2016 Current ACAP contract ceases NSW ACATs use accept/reject process in My Aged Care

ACAT transition to My Aged Care Key Transition Steps for ACATs ACAT Activity My Aged Care – Accept /Reject Process starts 1 July 2015 Continue business as usual Inbound referrals accepted from My Aged Care as well as other referral sources My Aged Care – Full Functionality will commence by the end of 2015 All clients will be referred through My Aged Care ACATs will commence using full My Aged Care functionality ACATs will follow an ‘Accept/Reject’ process from 1 July, accepting appropriate referrals through the online portal, or rejecting inappropriate referrals through this source. Ministry of Health will support LHDs in developing new referral pathways by the end of 2015 to ensure all referral for the ACAT go through My Aged Care for screening, assessment and referral. The MoH will also closely monitor the experience of the Victorian Demonstration Project in Kingston ACAS, to learn from their experiences during their early implementation of the My Aged Care system.

Further Information - DSS My Aged Care Website: www.dss.gov.au/myagedcare Email: GPO@dss.gov.au Commonwealth Home Support Programme Website: www.dss.gov.au/chsp Email: CHSP@dss.gov.au Home Care Packages Website: www.dss.gov.au/homecarepackages Email: homecarepackages@dss.gov.au Quality Indicators- Pilot in residential care KPMG – Free call 1800 881 436 Email: AU-FMACQIS@kpmg.com.au General Aged Care Information DSS Website: www.dss.gov.au/agedcare Information: AgedCareReformEnquiries@dss.gov.au

Further Information – NSW Health The NSW Ministry of Health (MoH) is working closely with LHDs to support and prepare for the implementation of My Aged Care and the transition to the CHSP on 1 July 2015 A new NSW Health Aged Care website will be updated frequently with information on the Aged Care changes, impacts for LHDs, FAQs, DSS fact sheets, tools and resources. Check the ‘What’s New’ tab for updates: www.health.nsw.gov.au/agedcare For information on local implementation and processes in your LHD contact your HACC Transition Manager or Aged Care Contact – available on the NSW Health website Encourage staff to visit NSW Health Aged Care website for updated information & fact sheets relevant to their needs and to save the link for future reference. MoH will email HTMs and ACCS to advise when the any content gets updated or added.