1. Commonwealth Aged Care Reforms

2. <insert title of presentation and who the audience is> <insert name of presenter> <insert date of presentation>

3. 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.

4. 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.

5. 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

6. 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

7. My Aged Care Gateway MyAgedCare National Contact Centre
National Contact Centre
8am-8pm (Monday to Friday)
10am-2pm (Saturdays)

8. What is My Aged Care?
My Aged Care is a national gateway commencing from 1 July 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.

9. 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

10. 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

11. 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

12. 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.

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

14. 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 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).

15. 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

16. 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.

17. 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.

18. 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.

19. 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

20. 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.

21. Further Information - DSS
My Aged Care
Website:
Commonwealth Home Support Programme
Website:
Home Care Packages
Website:
Quality Indicators- Pilot in residential care
KPMG – Free call
General Aged Care Information
DSS Website:
Information:

22. 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:
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 HTMs and ACCS to advise when the any content gets updated or added.