Why aged care assessments for allied health have “gone backwards”

Barriers to allied health delivery are allegedly limiting the Commonwealth Home Support Program (CHSP)’s ability to provide reablement services to clients.

Jennene Buckley, Director of Enkindle Consulting and former CEO of Feros Care, told The Weekly SOURCE that the Integrated Assessment Tool (IAT) is only approving specific allied health disciplines instead of broader allied health, preventing the delivery of multi-disciplinary care.

For example, the IAT might approve physiotherapy, but the physiotherapist identifies the person needs occupational therapy and podiatry – but they have not been approved through the assessment.

Providers then have to submit a support plan review request and months waiting for these approvals, Jennene said.

Similarly, clients approved for Assistive Technology and Home Modifications (AT-HM) have not been approved for an OT to assess which modifications are required.

The IAT was introduced on 1 July 2024 as part of the Single Assessment System (SAS) to streamline assessment of need for Government-funded aged care services.

Because the IAT’s allied health approvals are so narrow, CHSP providers are being forced to seek further approvals in order for their clients to receive the allied health discipline they need, said Jennene.

“Many providers voiced that with the new SAS processes, we have gone backwards,” Jennene said.

The allied health concerns come amid other issues with the SAS, with around 100,000 waiting to be assessed and some reassessments delivering bizarre outcomes.

What's needed?

To address concerns, Jennene recommends the IAT should approve allied health allowing multi-disciplinary care, not simply individual disciplines.  

Allied health should also be approved alongside AT-HM approvals. “They go hand in hand,” Jennene said. 

Barriers to reablement

Allied health is of the most common services delivered under the CHSP’s wellness and reablement approach to care.

This month, the Government published its ‘Outcomes from the 2024 Wellness and Reablement Report’ for the CHSP, which looks at how providers are progressing embedding wellness and reablement into their services.

The report shows nearly half of providers – 41% (a 10 percentage point increase on 2022-23) – have more than 75% client participation in wellness and reablement.

However, it also found providers face significant barriers to delivering reablement.

Only 36% were funded to deliver Allied Health and Therapy Services in 2023-24.

The barriers include:

• insufficient funding
• staff shortages, particularly experienced staff
• providers already “at or over” capacity
• long waitlists
• transport barriers, particularly in regional, rural, and remote areas
• client reluctance to participate
• financial hardship
• cognitive decline
• cultural and language barriers

Funding a major issue

Jennene agreed funding shortfalls are a major issue. “Many CHSP Providers voice that their funding is at capacity,” she said.

Some providers have not had ‘growth funding’ for years.

The last round of growth funding focused on funding for “new providers, instead of ensuring existing providers have adequate growth funding to meet demand”.

Growth funding for current CHSP providers should be a priority, Jennene added.