The ACFI - What You Need To Know
Heather Campbell April 08
The AMA committee on Care of Older People has developed a fact sheet on the Aged Care Funding Instrument (ACFI), which came into effect from 20 March 2008.
On 20 March 2008 the ACFI replaced the Resident Classification Scale (RCS) as the method of determining Australian Government funding to residential aged care facilities (ACFs). From that date new residents will need an ACFI assessment completed within two months of entering residential aged care. ACFI will apply to existing residents only as their annual reviews fall due over the next 12 months.
ACFI measures key care needs for funding requirements, but is not a holistic assessment for resident care.
What will be the impact on medical practitioners?
There will be no significant impact.
Are Comprehensive Medical Assessments (CMAs) required for the ACFI?
No, a CMA is not a mandatory requirement of ACFI, but information gathered during a CMA may be used as evidence by ACFs to support ACFI responses.
A key benefit of the CMA is to provide the GP with a sound clinical basis from which to develop care plans for the resident.
When is a diagnosis from a medical practitioner required for ACFI funding?
The ACFI consists of 12 questions about assessed care needs. Each question has four ratings: A - D, and two diagnostic sections: Mental and Behavioural and Medical.
There are four cases where a medical diagnosis is required to support a claim by the ACF for higher funding supplements. The AMA agrees it is appropriate that only a medical practitioner should confirm medical diagnoses in these cases:
- For an Aged Care Facility to receive the highest level of Behaviour Supplement for a resident, a dementia diagnosis, provisional dementia diagnosis, psychiatric diagnosis or behavioural diagnosis is required. For diagnosis covering depression, psychotic and neurotic disorders, the diagnosis (provisional or reconfirmed) must have been completed within the past 12 months.
- ACFI 10 – Depression: the rating would default to a B, unless there is a medical diagnosis on file, or a commitment to obtain a medical diagnosis.
- ACFI 11 – Medication: a copy of an appropriately authorized medication chart related to the appraisal period must be included to receive a rating of B, C or D.
- ACFI 12 – Complex Health Care: some complex health care procedures/care needs can only be claimed where there is a medical directive. For others, a medical directive is only one of the options.
Is a doctor's note in the progress notes sufficient for a diagnosis, when all it has is the doctor's signature?
Yes. It must be dated and signed by the medical practitioner who confirmed the diagnoses, in either the resident's progress notes or in the resident's CMA documents.
Medical practitioners should direct any inquiries to: ACFI business rules and funding acfi@health.gov.au or call 1800 500 853.
This article is available online at http://bddgp.org.au/article/2008/04/acfi-faqs
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