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What is ACFI

What is ACFI

The ACFI is a scoring matrix - a tool that the government uses to assess the complex needs of people living in residential care. It helps them determine how much they'll allocate, by way of a subsidy, to aged care providers so that they can provide adequate care to their residents. The ACFI is made up of 12 care needs-based questions across three funding categories: 

  • Activities of Daily Living (ADL)
  • Behaviour (BEH) 
  • Complex Health Care (CHC)

Each resident's funding bracket within the above categories is then determined as high, medium, low or nil.  

What changes are being made to the ACFI? 

In May 2016, the Federal Government announced it was making changes to the ACFI, in a bid to save $1.2 billion over the next four years. 

Specifically, cuts are being made in relation to the care of residential clients with CHC needs. These residents are often the frailest and most unwell, with complex needs in terms of the level and frequency of their pain treatments and medication assistance. 

These changes came into effect in two stages: initially from 1 July 2016 and then updated from 1 January 2017. 

Changes effective from 1 July 2016 

  1. Funding for CHC was halved to 50% of the rate that would have normally applied for the 2016-17 financial year. 
  2. An updated scoring matrix was put in place for new appraisals and reappraisals. This reduced funding as some residents' requirements were recategorised from, for example, 'high' to 'medium'.

Changes effective from 1 January 2017 

  1. A redesigned matrix replaced the one in place from 1 July 2016 and will apply to all new appraisals and reappraisals. 
  2. Changes were made to the scores and eligibility requirements related to certain issues like complex pain management, with higher levels of funding reserved for residents with the most critical care needs. 

What do the ACFI changes mean for residential care clients?

In effect, the ACFI changes has seen 'downgrading' of many clients' perceived level of complex care requirements. This in turn has meant that the government is underfunding care homes - decreasing funds while the homes are expected to provide the same level of care. 

So what could this mean for potential and current clients? 

A blow for the holistic approach to care 

Residential care homes help to keep elderly clients healthier, maintain their abilities and independence. Part of this means relying on complex care services from allied health professionals like physios, occupational therapists and massage therapists. 

With budget cuts, no government incentives in the ACFI funding structure to provide these programs, and no allowance from the government to let homes charge extra to provide these much-needed programs, clients will have to rely solely on medications to treat issues like chronic pain, instead of programs that could give them a better quality of life. 

Those most in need could be turned away 

Homes may be forced to turn away potential residents with complex care needs as they won't be compensated by the government for the level of care the potential new client will need. 

The proposed cuts have been heavily criticised by peak bodies from across the sector. With increasing numbers of elderly Australians, many of whom have complex care requirements, their quality of care may be compromised to make way for sustainable aged-care expenditure over the long term.