Measurement Fundamentals

The measurement approach should adequately address the following specific principles as expressed in the submissions:-

 Support equity and transparency for consumers with a standardised assessment approach  Standardised data collection based on evidence based assessment tool or toolbox

 Provides robust objective data

 Based on care needed, not care provided

 Assessment undertaken independent of the service provision  Electronic data that is useful for multiple stakeholders

 Incorporates early identification e.g. supports preventative and healthy ageing models  Assesses both carer recipient and carer needs separately and co-jointly

 Process that identifies triggers areas that require further assessment

 Simpler assessment process that provides quick access to low level community services

 Assessment and care planning process that includes consumer driven choice, care coordination and care advocacy

The Measurement Model and approach operates independently of the type of Classification Model selected. The assessment outcomes however should provide an algorithm that directs the assessor to a particular program type or classification level within whatever Classification Model is preferred.

While there are a number of viable options in terms of the Classification Models, the measurement model should be based around assessments focusing on care needs, not care provided and they should assess a set of attributes that are largely context independent, allowing for the assessment to be conducted outside of the specific context of the care. To carry out this type of assessment requires knowledge across a broad range of domains, inclusive of special need groups issues, and is therefore suited to a multidisciplinary team approach.

The approach is primarily focused on a person’s attributes and need for care that could be determined from an assessment (outside the service provider context) that could then be used to determine funding

relativities. The advantage with this approach is that the assessment (primary) is then done by the most highly trained group (generally), it can be done centrally, external to the care environment and provider (context independent) and it can determine relative funding without the confounding of the care provided context (e.g. person A has assessment level 3 but in EACH Program A gets 4 hours of type X care but in EACH Program B the exact same type of person gets 2 hours of type Y care – once we fund on the basis of the type of care provided as assessed by the service provider, there is no consistency or relativity). Being completed

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at a central entry point (e.g. hub) also simplifies the accountability and validity requirements as fewer and higher skilled resources are involved in the decision making and funding determination.

The assessment would be completed using standardised assessments completed by an assessor with the highest level of skills (e.g. ACAT). However, the data collection aspect should not dictate the assessment approach e.g. a natural conversation should be supported, not interviews structured entirely on the data items only.

The assessment will need to be designed to be accurate and reliable. The first assessment level may be completed on-line (e.g. self assessment), and is also accessible by assessment from an external organisation. To manage the risk of initial access from the different pathways it should be limited to access for low

resources and with further validation of the need by the service provider. The second assessment level may be completed in either a telephone setting or face to face, and is completed by an assessor independent of the funding receivers (client and service providers). This aspect (along with the final resource determination sitting with the hub) will provide a stronger basis for equitable resource allocation.

While a face to face assessment is possible from the hub the overall approach for the second assessment outcomes needs to be accurate from the lowest denominator (e.g. telephone setting). The service provider role in client assessment is to complete a service assessment in a face to face setting and to carry out ongoing monitoring of the client’s needs. The service provider will have the opportunity to develop an ongoing relationship with the client to better determine the care provided aspects, as they are in the best position to negotiate the local circumstances and determine client (care recipient and carer) needs and wants – and take account of the local services available in the community. The hub assessment is about the basic care need assessment areas (that are important to resource use) and it does not try to cover how the care is provided. This makes for a ‘cleaner’ model as then the care provided aspects (the how the person is cared for) can be validated by an audit model assessing service plans and care outcomes.

The electronic data should be useful for multiple stakeholders as it:  Informs the consumer about their needs and available services  Builds up a history (i.e. reduces multiple assessment)

 Can be accessed between systems and organisations (e.g. health and aged systems)  Provides accurate minimum data set (MDS) for program monitoring

 Provides accurate data for assessing need and care planning

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Status changes could be addressed via:

 Regular planned reviews, the time of review should be based on the type of program  Regular planned feedback from the Service Provider

 Requested re- assessment in response to a deterioration or trauma, via the Service Provider or client/carer