The delegate's dilemma: ACAT re-assessment in hostels.
The provision for 'ageing in place' in the Aged Care Act of 1997 has provided an opportunity for hostel facilities to broaden their scope of care for older people. Aged Care Assessment Teams (ACATs) are required to provide assessments to give approval for high or low level entry to these facilities, and to provide approval for reclassification from low to high care. However, guidelines for ACAT assessments are contradictory with respect to the Resident Classification Scale (RCS) which provides the facility funding formula, thus creating gatekeeping compared with advocacy difficulties for the ACAT. If the facility can support a claim of high care need for a resident via the RCS but the ACAT (using different and less in-depth criteria) does not agree with that claim, then the care of that resident might be compromised due to inadequate funding. Recommendations made to solve this dilemma include conferring the right of the hostel staff to reclassify residents when necessary, with the responsibility for confirmation of that classification to remain with the trained validation officers from the Commonwealth Department of Health and Family Services, not the ACAT.
Royal North Shore Hospital and Community Health Services, Sydney.
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Poole
D000203:Activities of Daily Living / Q000145:classification*; D000368:Aged; D001315:Australia; D015577:Geriatric Assessment / Q000145:classification*; D017408:Guidelines as Topic; D016852:Housing for the Elderly / Q000331:legislation & jurisprudence / Q000592:standards* / Q000706:statistics & numerical data; D006801:Humans; D010348:Patient Care Team