The ACFI is a scoring matrix that the government uses to assess the complex needs of people living in residential care. It helps the government to determine how much they will allocate, by way of a subsidy, to aged care providers so that they can provide adequate care to their residents. The ACFI comprises 12 care needs-based questions in three funding categories:
1. Activities of Daily Living (ADL)
2. Behaviour (BEH)
3. Complex Health Care (CHC)
Each resident's funding bracket within the above categories is then determined as high, medium, low or nil.
Changes made to the ACFI
In May 2016, the Federal Government announced its plan for changes to the ACFI in order to save $1.2 billion over the ensuing four years.
The plans involved cuts to the care of residential clients with CHC needs. These residents are often the frailest and most unwell, with complex needs with regard to the level and frequency of their pain treatments and medication assistance.
These changes came into effect in two stages: initially from July 1, 2016 and were update on January 1, 2017.
Changes effective from July 1, 2016
1. Funding for CHC was halved to 50 per cent 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 re-categorised from, for instance, 'high' to 'medium'.
Changes effective from January 1, 2017
1. A redesigned matrix replaced the one from July 1, 2016 and now applies to all new appraisals and reappraisals.
2. Changes were made to the scores and eligibility requirements relating to certain issues like complex pain management, with higher levels of funding reserved for residents with the most critical care needs.
What do these changes mean for residential care clients?
The ACFI changes have seen the 'downgrading' of many clients' perceived level of complex care requirements. This in turn, has meant the government is under-funding care homes – reducing 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, such as physiotherapists, 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 enable homes to charge extra to provide these much-needed programs, clients will have to rely solely on medications to treat issues such as chronic pain, rather than programs that could offer 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 receive government compensation for the level of care required by the potential client.
The proposed cuts have attracted heavy criticism from peak bodies sector-wide. 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.