NSW Health Home and Community Care (HACC) Minimum Data Set (MDS) V2 Train the Trainer Workshop

NSW HealthNSW HealthHome and Community Care (HACC)Home and Community Care (HACC)

Minimum Data Set (MDS) V2Minimum Data Set (MDS) V2

Train the Trainer WorkshopTrain the Trainer Workshop

John HallettJohn Hallett

Demand & Performance Evaluation Demand & Performance Evaluation BranchBranch

Stefanie WilliamsStefanie Williams

Primary Health & Community Primary Health & Community Partnerships BranchPartnerships Branch

WelcomeWelcomeandand

IntroductionIntroduction

9:30am – 10:00am Morning tea

10:00am - 10:30am Welcome, introduction to the NSW Health HACC MDS and Summary of changes

10:30am - 12:00pm HACC Agency, Clients & Inward referrals

12:00pm - 12:30pm Lunch

12:30pm - 3:00pm HACC Service Episode, Carer and Service Event

3:00pm - 3:15pm Afternoon tea

3:15pm - 4:00pm HACC Goods and equipment, Functional Assessment and Outward referrals

4:00pm Close

HACC MDS v2 – Overview of the day

For the Workshop today

you have been provided with:

• Orientation Work Book

• Workshop CD

HACC MDS v2 – Overview of the day

Learning OutcomesLearning Outcomes

Learning Outcomes for Trainers

On completion of the NSW Health HACC MDS v2 Train the Trainer Workshop participants will:

• understand the reporting categories and elements of the NSW Health HACC MDS v2; and

• be able to lead a training workshop for AHS staff on the NSW Health HACC MDS v2.

Learning Outcomes

On completion of the NSW Health HACC MDS v2 training workshops participants will:

• understand the reporting categories and elements of the NSW Health HACC MDS v2; and

• be able to work through examples of typical situations encountered in providing HACC services.

HACC ProgramHACC Program

What is theWhat is the

HACC Program?HACC Program?

What is the HACC Program?

• The HACC Program is a joint Commonwealth/State initiative providing community care services for:

• frail older people;• young people with disability; and• their carers.

• HACC services support clients whose capacity for independent living is at risk or who are at risk of premature or inappropriate admission to long term residential care.


• State/Territory governments are responsible for the day-to-day administration of the HACC Program.

• The lead agency within NSW is the Department of Ageing, Disability and Home Care.

• The NSW Department of Health is a joint administrator responsible for AHS and AHS-brokered (NGO) HACC-funded services.


• Services provided by HACC include domestic assistance, social support, community nursing, community allied health, personal care, centre-based day care, meals, other food services, respite care, case management, home maintenance and modification, formal linen service, community transport and counselling/support, information and advocacy (for clients and carers).

• The main HACC services provided by NSW Health are community nursing, community allied health and centre based day care.

NSW HealthNSW HealthHACC MDS v2HACC MDS v2

IntroductionIntroduction

What is theWhat is the

NSW HealthNSW HealthHACC MDS v2?HACC MDS v2?

The NSW Health HACC MDS v2:• is a standardised and nationally-consistent

data collection about the characteristics of and the HACC-funded services provided to HACC-eligible clients and/or their carers; and

• facilitates consistency and comparability between HACC and other aged, community care and health data collections.

What is the NSW Health HACC MDS v2?

The NSW Health HACC MDSv2:• includes HACC National MDS v2 data

elements;

• includes NSW (DADHC) HACC MDS v2 data elements; and

• is integrated with other relevant NSW Health data collections.

What is the NSW Health HACC MDS v2?

Why collect theWhy collect the


• HACC funding is provided for the provision of service outputs by specific service types within specific geographic regions or for specific projects.

• Collection and reporting of NSW Health HACC MDS v2 is a condition of Commonwealth funding (approximately 60% of all HACC funding).

• Financial penalties may be imposed for reporting non-compliance and/or for poor data quality.

Why collect the NSW Health HACC MDS v2?

HACC MDS data is also essential for:• DoH, AHS and Service Managers:

– strategic planning, allocation of funding and service enhancements

– performance monitoring against agreed outputs – facilitation of improvements in HACC-funded

service delivery and community health services

• HACC service providers:– provision of high quality service to their clients– performance monitoring against agreed outputs– providing feedback on HACC regional planning

Why collect the NSW Health HACC MDS v2?

Summary of Changes -Summary of Changes -


Please refer to your NSW Health

HACC MDS v2Orientation Workbook

- pages 10 to 16 -for more detailed information

Summary of Changes – NSW Health HACC MDS v2

Data element(NSW Health HACC MDS v1)


Newdata

element

DADHCdata

element

Data element

modified

New data

domain

Data domain modified

Data element deleted

Establishment (Agency) data elements

Agency code Establishment identifier (Agency code)



Newdata

element

DADHCdata

element

Data element

modified

New data

domain



Client data elements

Client identifier (Client code)

Client name type flag

Family name/surname Client family name/surname

First given name Client first given name

Date of birth Client date of birth

Client date of birth status

Sex Client sex

Indigenous status Client Aboriginal and Torres Strait Islander origin

Country of Birth Client country of birth

Client CALD status

Main language spoken at home

Client preferred language spoken at home

Client interpreter services required




Newdata

element

DADHCdata

element

Data element

modified



Service Episode data elements

Service Episode identifier (Episode ID)

Date of entry into HACC service episode

Date of Commencement of Service Episode

Reason for HACC client status

Letters of Name of Client Statistical Linkage Key Flag

Letters of name Letters of Name of Client Statistical Linkage Key

DVA card type of Client

DVA file number of Client

Medicare number of Client

Government pension/benefit status Government pension/benefit status of Client

Living arrangements Usual living arrangements of Client

Accommodation setting Usual accommodation of Client

Building/property name and component name and number of usual Client residence

Floor/level type and number of usual Client residence

Street name, suffix, type and number of usual Client residence




Newdata

element

DADHCdata

element

Data element

modified



Service Episode data elements (continued)

Suburb/town/locality Suburb/town/locality name of usual Client residence

Area of residence State abbreviation of usual Client residence

Postcode Postcode of usual Client residence

Country of usual Client residence

Carer – existence of Client – existence of Carer

Date of last assessment

Date of exit from HACC service episode Date of Cessation of Service Episode

Main reason for cessation of services Main reason for Cessation of Service Episode

Accommodation setting after Cessation of services




Newdata

element

DADHCdata

element

Data element

modified



Carer data elements

Carer identifier (Carer code)

Carer family name/surname

Carer first given name

Letters of Name of Carer Statistical Linkage KeyFlag

Letters of Name of Carer Statistical Linkage Key

Carer date of birth

Carer date of birth status

Carer sex

Carer Aboriginal and Torres Strait Islanderorigin

Carer country of birth

Carer CALD status

Carer preferred language spoken at home

Carer interpreter services required




Newdata

element

DADHCdata

element

Data element

modified



Carer data elements (continued)

Carer residency status Carer residency status

Building/property name and component name and number ofUsual Carer residence

Floor/level type and number of usual Carer residence

Street name, suffix, type and number of usual Carer residence

Suburb/town/locality name of usual Carer residence

State abbreviation of usual Carer residence

Postcode of usual Carer residence

Country of usual Carer residence

Relationship of carer tocare recipient

Relationship of Carer to Client

Carer for more than one person




Newdata

element

DADHCdata

element

Data element

modified



Inward referral data elements

Source of referral Source of referral

Date of referral in

Date referral received



Newdata

element

DADHCdata

element

Data element

modified



Outward referral data elements

Target of referral

Date of referral out




Newdata

element

DADHCdata

element

Data element

modified



Service Event data elements

Service Event identifier (Event ID)

Date of receipt of assistance Date of Service Event

Funding source category HACC Program funding flag

Primary type of assistance received Primary type of assistance received

Family name/surname of attending service provider

First given name of attending service provider

Discipline of attending service provider

Service delivery setting Service delivery setting

Suburb/town/locality name of Service Event

State abbreviation of Service Event

Postcode of Service Event

Service Event indicator

Service Event mode

Attendance status




Newdata

element

DADHCdata

element

Data element

modified



Service Event data elements (continued)

Service Event start time

Service Event end time

Amount of assistance received (time) Amount of assistance received (time)

Total amount of type of assistance received (time)

Amount of assistance received (quantity)


Total amount of type of assistance received (quantity)

Transport mode

Transport purpose

Amount of assistance received (cost) Amount of assistance received (cost)

Total amount of type of assistance received (cost)



Newdata

element

DADHCdata

element

Data element

modified



Goods and equipment data elements

Assistance with goods and equipment received

Type of assistance with goods and equipment received

Total assistance with goods and equipment received

Amount of assistance with goods and equipment received




Newdata

element

DADHCdata

element

Data element

modified



Functional Assessment data elements

Date of Client functional assessment

Client functional status - housework

Client functional status - transport

Client functional status - shopping

Client functional status - medication

Client functional status - money

Client functional status - communication

Client functional status - dressing

Client functional status - eating

Client functional status - toileting

Client functional status - getting out of bed/moving around

Client functional status - walking

Client functional status - bathing/showering

Client functional status - memory problems/confusion

Client functional status - behavioural problems

Client functional status - transport classification


AHS NSW DoH

DADHC

DoHA

Monthly

Quarterly

Quarterly

Agencies

Monthly

Reporting frequency


• Provides increased opportunities for the identification of issues in relation to:

– reporting compliance– data completeness– data quality

• Provides greater opportunities and improved timeliness in the rectification of any issues identified.

• Is consistent with other NSW Health data collections (eg. DoHRS and CHOCIP).

Benefits of monthly reporting


Who needs to collect theWho needs to collect the


Who needs to collect the NSW Health HACC MDS v2?

• HACC Program funding is provided for service outputs by specific service types within specific geographical regions or by specific projects.

• Funding is not provided for individual service provider positions.

• All persons (staff and volunteers) who provide HACC services are required to collect the NSW Health HACC MDS.

Who needs to collect the NSW Health HACC MDS v2?


Concepts andConcepts andData ElementsData Elements

HACC MDS reporting categories:• Agency• Client• Carer• Service Episode• Service Event• Goods and equipment• Functional assessment

Concepts and Data elements

HACCHACC

Establishment Establishment (Agency)(Agency)

HACC Establishment (Agency)

• A HACC Establishment Identifier (Agency Code) will be issued to each unique team providing one or more HACC-funded service types within the specified geographical regions (or projects).

• A unique team is a team of one or more persons operating as a single unit.

• A unique team may be uni-disciplinary or multi-disciplinary.

• A unique team will generally be based at a single facility (eg. a CHC, MPS or CDC) and provide services within the local region, although some may provide cluster/sector or AHS-wide services.


• All HACC MDS data will be reported by the Agency against this HACC Agency Code.

• Examples of a HACC Agency Code:» 11G5338» 11L5168» 12B8515» 13B5239» 13D5317


• On occasion a HACC-funded agency may contract out or broker the assistance required by their clients to other agencies (HACC or non-HACC funded).

• The HACC agency paying for the assistance to clients is responsible for that assistance and is required to report NSW Health HACC MDS data for those clients.


HACCHACC

ClientClient

HACC Client

Only those persons aged 65 years of age and over are HACC-eligible.

WRONG!WRONG!

HACC Client

Any person who:• lives in the Australian community; and

• has difficulty in performing every-day tasks (eg. dressing, preparing meals, house cleaning); and

• without basic maintenance and support services, would be at risk of premature or inappropriate long term residential care.

HACC Client

These include:• older and frail persons

– frail persons aged 65 years and over– frail Aboriginal and Torres Strait Islanders aged 45

years and over

• persons of any age with moderate, severe or profound disabilities.

Please completeActivity 1

in yourNSW Health


- page 25

HACC Client

HACCHACC

ClientClientData ElementsData Elements

HACC Client data elements

• Client data elements only need to be collected ONCE as part of client registration(refer Client Registration Standard PD2007_094 and Client Registration Guidelines

GL2007_024).

• In most cases this information will only need to be checked at initial Client presentation to ensure that the information is current.

HACC Client data elementsClient privacy and confidentiality issues:• It is important that clients (and their carer/s) understand the nature

of the data collection and are comfortable with their data being used for statistical analysis.

• Your Agency is required to provide an information leaflet to clients to inform them about what information is collected, by whom, how it will be used, and their rights in relation to it. This should be provided irrespective of whether the information was collected from a third party or directly from the client.

• Use this as an opportunity to remind clients how their data is handled to safeguard their privacy as well as ensure that their recorded information is up to date.

HACC Client data elementsClients who raise privacy concerns:

For those clients who are concerned about their personal data being recorded and/or being reported to DADHC and the Commonwealth, there are three options available to them:

1. The client may choose to provide their personal information to NSW Health only, but not be reported to DADHC or the Commonwealth;

2. The client may choose to be registered using an alias;

3. The client may choose to be registered anonymously.


For clients who do not consent to potentially identifiable information being reported to DADHC or the Commonwealth:

• Register the Client and set the Statistical Linkage Key Flag at the Service Episode level (to be covered later).


Alias Clients

• In some instances, a client’s identity may require protection or suppression, or they may have a preference to be registered under an alias.

• If a client chooses to be registered under an alias:– The Surname and First Given Name will be recorded as that

provided by the person as their Alias; and– The Name Type Flag will be set to “Alias”.


Anonymous Clients

• Clients should be informed of the implications of being registered anonymously (eg, reduced availability of information for continuity of treatment).

• Where a Client chooses to register anonymously:– The surname will be recorded as “UNKNOWN”; – The first given name will be recorded as “UNKNOWN”; and– The Name Type Flag will be set to “Alias”.


Sample confidentiality statement:• Please note that <Agency name> may release information about HACC

clients (without identifying you by full name or address) to DADHC, and to the National Data Repository.

• This will enable the collection of information about HACC services and their consumers.

• The information will be kept confidential. We follow strict rules and policies regarding the secure storage of personal information in all formats in order to protect your information from unauthorised access, loss or other misuse.

• This information is to be used for statistical purposes only and will not be used to affect your entitlements to, or your access to services.

HACC Client data elementsConfidentiality statement:

Consider the consent form your agency

currently uses.

Does this form adequately address the

confidentiality issues we have discussed?

If not, what amendments are required?

Refer to your

NSW Health HACC MDS v2

Orientation Workbook

- pages 27 to 32

Client registration within ACE



Client Name and Identifier data elements• Client code• Family name/Surname• First given name• Name type• Client Statistical Linkage Key flag


Client code

• System-derived in most cases.

• A unique identifier for the Client (at an Agency or AHS level).

• Will be the Client MRN or AHS UPI (in most cases).


Client family name/surnameClient first given name

• The Client’s legal name (where it has been recorded) will be extracted to the NSW Health HACC MDS v2.

• Record the Client’s name as it would appear on legal or formal documents, such as Aged Pension card, Medicare card or other official documents.


Client family name/surnameClient first given name

• Be careful with the spelling.

• Be mindful of the cultural form of the Client’s name. For example, a Client may traditionally place their family name before their given name when writing their full name.

• The Client may have more than one name (eg, nickname, maiden name, tribal or cultural name).

• All currently used names (and previous names) should be recorded.


Client name type

• A flag is recorded against each Client name to indicate whether the name is a legal name, alias name or preferred name.

• The Client’s legal name (where it has been recorded) will be extracted to the NSW Health HACC MDS v2.

• If the Client chooses to be identified by a name other than their legal name, this should be recorded as their preferred name. Only one name can be registered as the Client’s preferred name.

• Multiple alias names may be recorded for the Client, where they exist.


Client Statistical Linkage Key flag

• The object of the Statistical Linkage Key (SLK) is to allow the linkage of different records to the same client for statistical purposes, whilst retaining the client’s anonymity.

• Although the Client’s name is not reported to DADHC, selected letters of the name (2nd, 3rd and 5th letters of the Family name/Surname and 2nd and 3rd letters of the first given name) are reported to DADHC by NSW Health in combination with the Client’s date of birth and sex (if consent is provided by the Client).

• A flag is recorded (for each Service Episode) to indicate whether the Client has consented to this information being forwarded to DADHC for statistical record linkage at a State and/or National level.


Client Statistical Linkage Key flag

• Consent need not be provided in writing.

• Consent may be:– implied by the Client;– expressly provided by either the Client or their Carer; or– refused.

• Where consent is not provided, the following default values are populated:

Letters of Name SLK: 22222 Date of birth 01/01/1800 Sex: 9 (Not stated)


Client characteristics data elements• Date of birth• Date of birth status• Sex• Aboriginal and Torres Strait Islander origin• Country of birth• Preferred language spoken at home• Interpreter services required


Date of birth

• Record in the format DDMMYYYY– eg, 5th January 1912 is recorded as 05011912

• Where the exact date of birth is not known, record as much of the date of birth as possible.

• Record 01 for each instance where the day or month is not known.

• Where no part of the date of birth is known, and the year of birth cannot be derived from the Client’s age, record the date of birth as 01011800.


Date of birth status

• A flag to indicate whether the Client’s date of birth is known (Not estimated) or has been estimated in whole or in part.

Code Description

1 Estimated

2 Not estimated


Sex

• The biological sex of the Client.

Code Description

1 Male

2 Female

9 Not stated/unknown


Aboriginal and Torres Strait Islander origin• The Client’s self-assessment of Australian Aboriginal and/or Torres

Strait Islander origin or descent.

• Aboriginal and/or Torres Strait Islander origin should not be assumed, either by appearance or name.

• Whilst sensitivities exist with the asking of this question, the question is asked because it is known that people of Aboriginal and/or Torres Strait Islander origin have in general, poorer health and greater health service needs, and the need to rectify the situation is urgent.


Country of birth

• The country in which the Client was born.

Preferred language spoken at home

• The language (including sign language) most preferred by the Client for communication in his/her home with other residents and regular visitors. This may be a language other than English, even where the person can speak fluent English.

Interpreter services required• An indicator of whether an approved interpreter service is required by

or for the Client.


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HACCHACC

Inward referralInward referral

HACC Inward referral

Any inward referral is defined as any referral for HACC services received by your Agency on behalf of a Client and/or their Carer.

A Client/Carer may have multiple inward referrals – each inward referral should be registered.

HACC Inward referralswithin ACE


HACC Inward referral data elements• Source of referral• Date of referral in• Date referral received

Source of referral

• The individual or organisation that referred (in) the Client and/or their Carer to the Agency.

• The referral may be formal, that is a written or telephone referral from an individual service provider or organisation, or

• The referral may be informal, that is not a written or phone referral from an individual service provider or organisation but either a self referral or a referral from a family member/friend/significant other.

• For clarification, ask the Client and/or Carer: ‘Where, or from whom, did you hear about this service?’

HACC Inward referral data elements

Date of referral inDate referral received

HACC Inward referral data elements

Referral type Date of referral in Date referral received

Written(from individual service provider

or organisation)Date on referral letter

Date referral letter received

Phone(from individual service provider

or organisation)Date of phone call Date of phone call

00 Self referralOR

99 Referral by Family member/ friend/significant other

Date of first presentation for service

Date of first presentation for service


In your small group, discuss your Agency’s most common sources of referral.

Refer to your NSW Health HACC MDS v2 Orientation Workbook - pages 46 to 48.


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HACCHACC

Service EpisodeService Episode

HACC Service Episode

A period of time:• with a defined commencement date;

• with a defined cessation date;

• during which a Client and/or their Carer receives assistance (as per list of primary assistance types – to be covered later) from a HACC Agency; and

• where there has been no unplanned interval of no contact greater than 6 weeks.

HACC Service Episode

HACC Service Episodewithin ACE

HACCHACC

Service EpisodeService Episodedata elementsdata elements

HACC Service Episodedata elements

• HACC Service Episode data elements only need to be collected ONCE at commencement or cessation of the Service Episode.

• In most cases, this information will only need to be checked at regular intervals (eg. 6 weekly) to ensure that the information is current.

HACC Service Episode - Client identification/benefit data elements• Service Episode identifier• Date of Commencement of Service Episode• DVA card type of Client• DVA file number of Client• Medicare number of Client• Government pension/benefit status of Client• Date of Cessation of Service Episode• Main reason for Cessation of Service Episode

HACC Service Episode data elements

Service Episode identifier• A unique identifier for the Service Episode (at an Agency or AHS

level).

• System-derived.


Date of Commencement of Service Episode


• A Client and/or Carer is identified as commencing a Service Episode if one or more of the following conditions apply:

– The Client/Carer is new to the HACC Agency; or– The Client/Carer is re-commencing assistance after having had no

contact with the service provider for 6 weeks or more.

• The date of the first Service Event when the Client is identified as HACC-eligible, assessment (including intake) occurs and/or assistance is provided.


DVA card type of Client

• Whether or not the Client is in receipt of a Department of Veterans’ Affairs entitlement, and the level of entitlement held by the Client defined by the colour of the DVA card.

• DVA card holders are usually eligible for HACC-like services funded by DVA.

• DVA card holders however are also eligible for HACC-funded services and may elect to be provided with a HACC-funded service, rather than a DVA service.

DVA file number of Client

• The DVA file number of the Client, as an eligible veteran, veteran’s spouse or dependent child.


Medicare number of Client

• The Client’s Medicare number as noted on their Medicare card.

• Collection of the Medicare number is required under the Client Registration Standard and therefore has been included in the NSW Health MDS v2 for consistency.

• Clients not in possession of a Medicare card may still be eligible for HACC services and importantly the rules relating to Client contribution still apply.


Government pension/benefit status of Client

• Whether or not the Client is in receipt of an income support payment from the Commonwealth government in the form of a government pension or benefit.

• Where the Client receives a government pension or benefit as a supplement to other income (eg. wages, superannuation, etc), they should still be regarded as receiving a pension/benefit.

• Where the Client receives no government pension or benefit, record their primary source of income.


Government pension/benefit status of ClientCode Description

01 Aged Pension

02 Veterans’ Affairs Pension

03 Disability Support Pension

04 Carer Payment (Pension)

05 Unemployment-related benefit

06 Student allowance

07 Other government pension or benefit

08 Full-time employment

09 Part-time employment

10 Retirement fund

11 Dependent on others

12 No income

98 Other

99 Not stated/not known/inadequately described


Date of Cessation of Service Episode


• A Client and/or Carer is identified as ceasing a Service Episode if one or more of the following conditions apply:

– The treatment plan/HACC service provision is completed;– The need for HACC assistance has ended;– There has been no contact with the service provider for 6 weeks or

more, and there is no plan for further contact; or– HACC assistance has ceased for other reasons (eg. left against advice,

transferred to another service provider, imprisoned, died).

• The date of the last Service Event between the service provider and the Client and/or Carer, whichever is the latter.


Main reason for Cessation of Service Episode• The main reason that the Service Episode ceased.


Code Description

01 Service completed – improved Client status

02 Transferred/referred to another service – improved Client status

03 Agency cannot or will no longer provide assistance – Client needs unchanged

04 Client terminated service by mutual agreement – Client needs unchanged

05 Transferred/referred to residential aged care – Client needs changed

06 Transferred/referred to other institutional setting – Client needs changed

07 Transferred/referred to other community-based service – Client needs changed

08 Client moved out of area

09 Client left without notice

10 Client left against advice

11 Client deceased

98 Other

99 Not stated/inadequately described


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HACC Service Episode -Client usual living arrangements data elements• Usual living arrangements of Client• Usual accommodation of Client• Address of usual Client residence• Client – existence of Carer


Usual living arrangements of Client

• Whether the Client usually resides alone or with other related or unrelated persons.

• Where the Client lives in a retirement village/aged care facility, record ‘Other’ unless the Client is sharing their own private space/room with a significant other (eg. spouse/partner).

• Where the Client lives only with two or more children – at least one of which is dependent and at least one of which is non-dependent, record ‘With child(ren) (dependent)’.

Usual accommodation of Client

• The setting in which the Client usually resides.


Address of usual Client residence

• The address of the residence in which the Client usually resides.

• Retrieved from the AHS/Agency PAS in the majority of cases.

• Do not record post office box addresses.

• RMB addresses may be recorded.

• Where the address is unknown and no further information is available, record the values for ‘Unknown/NFIA’, as appropriate.

• Where the Client has no fixed address or is homeless, record the values for ‘No fixed address/NFA’, as appropriate.



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Client – existence of Carer

• Identifies whether the Client receives regular and sustained informal assistance from another person (eg. family, friends, neighbour).

• Derived through the existence of Carer information recorded, or used as a flag to record Carer information (depending on your information system).

• A Client may have multiple informal carers – this data element does not record the number, only whether a Carer exists.


HACCHACC

CarerCarer

HACC Carer

Any person providing care to a person, including paid carers.

WRONG!WRONG!

HACC Carer

A Carer is defined as any person who:• provides regular and sustained care and

assistance to a HACC-eligible person; and

• receives no payment for the provision of care, other than a pension or benefit.

A Client may have multiple informal carers – each person should be registered.

• Carers are a national priority• Carers are a NSW Health priority:

– NSW Carers Action Plan 2007-2012– Carers - a vital source of support for those they care

for– Carers are also vital partners in care for AHSs– Carer data is useful for AHS service planning and

provision of support to clients and their carers.– Collecting carer information provides an opportunity

to assess carer needs and make appropriate referrals.

HACC Carer

Please completeActivity 6in your

NSW HealthHACC MDS v2

Orientation Workbook- page 73

HACC Carer

HACCHACC

CarerCarerdata elementsdata elements

HACC Carer data elementsCarer registration within ACE

HACC Carer data elementsCarer privacy and confidentiality issues:• It is important that clients (and their carer/s) understand the nature

of the data collection and are comfortable with their data being used for statistical analysis.

• Clients can provide information about their Carer to the Agency as long as the Client has no reason to expect that their Carer would object to this.

• If you are aware that a Client’s Carer would object to their information being provided by the Client to Agency, you should collect this information directly from the Carer.

HACC Carer data elementsCarer privacy and confidentiality issues:

• Is advisable that a Carer Privacy Leaflet, similar to the Patient Privacy Leaflet, be provided to carers. NSW Health is currently developing a proforma leaflet for AHSs to use in developing their own Carer Privacy Leaflet.

• Where some or all elements of Carer information are not available for any reason, the value for ‘Not stated/not known/inadequately described’ should be selected for the respective data elements. The ‘Client – existence of Carer’ data element should not be set to ‘2’ – ‘Has no Carer’.

HACC Carer data elements• Carer Name and Identifier data elements

– Carer code– Family name/surname– First given name– Letters of Name Carer Statistical Linkage Key flag

• The rules for collection of these data elements are the same as for the Client.

HACC Carer data elements• Carer characteristics data elements

– Date of birth– Date of birth status– Sex– Aboriginal and Torres Strait Islander origin– Country of birth– Preferred language spoken at home– Interpreter services required

• The rules for collection of these data elements are the same as for the Client.

• Carer usual living arrangements, residency, relationship and assistance data elements– Carer residency status– Address of usual Carer residence– Relationship of Carer to Client– Carer for more than one person

HACC Carer data elements

Carer residency status• Whether or not the Carer lives with the Client.


Code Description

1 Co-resident Carer

2 Non-resident Carer


Address of usual Carer residence

• The address of the residence in which the Carer usually resides.

• Derived where the Carer is a co-resident of the Client.

• Do not record post office box addresses.

• RMB addresses may be recorded.

• Where the address is unknown and no further information is available, record the values for ‘Unknown/NFIA’, as appropriate.

• Where the Carer has no fixed address or is homeless, record the values for ‘No fixed address/NFA’, as appropriate.


Relationship of Carer to Client• The relationship of the Carer to the Client.


Code Description

1 Spouse/partner

2 Parent

3 Son or daughter

4 Son-in-law or daughter-in-law

5 Other relative

6 Friend/neighbour


Carer for more than one person• Whether or not the Carer is providing assistance on a regular and

sustained basis to one or more persons in addition to the Client.

Code Description

1 Yes, one other person

2 Yes, two other persons

3 Yes, three or more other persons

4 No



Please completeActivity 7in your

NSW HealthHACC MDS v2

Orientation Workbook- page 80



In your small group, discuss yourbusiness processes for identifyingthe existence of a Carer and inobtaining and recording Carer information.

What opportunities does this provide indeveloping/enhancing referral processes tosupport carers?

HACCHACC

Service EventService Event

HACC Service Event

An occasion of assistance by a HACC Agency that:• results in a dated entry being made in the clinical

record; and• was received by a Client and/or their Carer; or• was booked for a Client and/or their Carer, but did not

occur due to prior cancellation or by the Client and/or Carer failing to attend.

HACC Service Event

• A Service Event is recorded against each person associated with the occasion of assistance – the Client and/or Carer and each service provider.

• A single Service Event cannot be longer than 24 hours, but may span midnight.

• When the assistance is funded and reported against a MDS specific to another Health Program (eg. ACAP), then it should not also be reported against the NSW Health HACC MDS.

HACCHACC

Service EventService Eventdata elementsdata elements

HACC Service Event data elements• Service Event identifier• Date of Service Event• HACC Program funding flag• Primary type of assistance received• Family name/surname of attending service provider• First given name of attending service provider• Discipline of attending service provider• Service delivery setting• Location of Service Event• Service Event indicator• Service Event mode• Attendance status

HACC Service Event data elements• Service Event start time• Service Event end time• Amount of assistance received (time)• Amount of assistance received (quantity)• Transport mode• Transport purpose• Amount of assistance received (cost)

Service Event identifier

• System-derived.

• A unique identifier for the Service Event (at an Agency or AHS level).

HACC Service Event data elements

Date of Service Event

• The date of an occasion of assistance by a service provider of a HACC Agency that:– results in a dated entry being made in the clinical record, and– was received by a Client and/or their Carer, or– was booked for a Client and/or their Carer, but did not occur due to prior

cancellation or by the Client and/or Carer failing to attend.


HACC Program funding flag

• An indication of whether HACC Program funds or other funds were used for the delivery of assistance.

• Derived in some instances (depending on your information system).


Code Description

1 HACC funds

4 Transport for Health funds

5 Ministry of Transport Community Transport Program funds

6 Ministry of Transport Area Assistance Program funds

8 Other funds only

Primary type of assistance received

• The primary type of assistance that the Client/Carer received.

• There may be many activities and types of assistance provided during a Service Event, however only the primary purpose or focus of the Service Event is recorded.

• To some extent, the type of Agency, and/or the specified purposes for which an Agency is funded, will determine the primary type of assistance received by a person attending that Agency – eg. in taking a client to a medical appointment, both transport and social support may be provided: – for a Community Transport service, this would appropriately be recorded as

‘95’ – ‘Transport-Client’;– for a Neighbour Aid service, this may be more appropriately recorded as part

of ‘42’ – ‘Social support/dementia monitoring’.




Code Description Comments

01Assessment (including screening)-Client

>=30 minutes in duration for a single Service Event(else record the appropriate assistance type applicable to the main focus of theservice provided)

10 Case managementOnly to be recorded by Community Options services(else record ’21’ – ‘Client care co-ordination-Client’ or ’31’ – ‘Counselling/support, information, referral and advocacy-Client’ or ’42’ – ‘Social support/dementia monitoring’)

42Social support/dementia monitoring

< 30 minutes in duration for a single Service Event(else record ’21’ – ‘Client care co-ordination-Client’ or ’31’ – ‘Counselling/support, information, referral and advocacy-Client’ or other appropriate assistance type applicable to the main focus of the service provided)

45 Centre-based day careGroup activities provided in a centre-based setting(the Client is the care recipient) (includes group excursions/activities conducted by centre staff, but held away from the centre)

46 Respite care Respite care provided (one-on-one) in the Client’s/Carer’s home(the Carer of the Client is the care recipient)

Notes

Activities provided by a diversional therapist within a centre day care are recorded as ’68’ – ‘Diversional therapy’ (not ’45’ – ‘Centre-based day care’), even if the diversional therapist is a staff member of the centre day care

When an occupational therapist undertakes a home modification assessment, this is recorded as ’01’ – ‘Assessment (including screening)-Client’ (not ’89’ – ‘Home modification’)

When an occupational therapist co-ordinates home modification work to be carried out, liaises with tradespersons, etc, this is recorded as ’21’ – ‘Client care co-ordination-Client’ (not ’89’ – ‘Home modification’)


In your small group, discuss your Agency’s most common primary assistance types.

Are there any problems that you may encounter in attempting to establish the primary assistance type?




In your small group, discuss the similarities and differences of the definitions between each primary assistance type.



Family name/surname of attending service providerFirst given name of attending service provider

• Derived from the User Login ID of the attending service provider (depending on your information system).

• Not required where the primary type of assistance has been recorded as one of the following:

'81' - 'Meals‘ '85' - 'Formal linen service'

'88' - 'Home maintenance' '89' - 'Home modifications'

'90' - 'Provision of goods and equipment'

'95' - 'Transport-Client' and where Transport Mode has not been recorded as

'11' - 'Ambulance-owned by Agency/service provider', '21' - 'Bus-owned by Agency/service provider', '31 - 'Car-owned by Agency/service provider', '32' - 'Car-owned by the Client/Carer' or ‘51’ - ‘Aircraft-owned by Agency/service provider'

'96' - 'Transport-Carer' and where Transport Mode has not been recorded as

'11' - 'Ambulance-owned by Agency/service provider', '21' - 'Bus-owned by Agency/service provider', '31' - 'Car-owned by Agency/service provider', '32' - 'Car-owned by the Client/Carer' or ‘51’ - ‘Aircraft-owned by Agency/service provider'


Discipline of attending service provider

• Derived from the User Login ID of the attending service provider (depending on your information system).

• The discipline of attending service provider should be recorded as that within the job description of the position, irrespective of what specific qualifications the person in the position has – eg. a nurse who is providing a counselling service would be recorded as ‘counsellor’ not ‘nurse’.

• Trainee staff working under the supervision of a qualified practitioner are to be coded to the discipline of the individual service provider supervising them.

• Where a volunteer has provided the primary type of assistance, record that most applicable to the discipline of a paid employee providing the same primary type of assistance.


Service delivery setting

• The setting in which the service provider performed the primary type of assistance that the Client/Carer received.

• Where the primary type of assistance was ‘95’ – ‘Transport-Client’ or ’96’ – ‘Transport-Carer’, the setting of the point of origin is to be recorded.

• Where the primary type of assistance was provided by telephone or Telehealth (including Telemedicine and video-conferencing), the setting most applicable to the physical location of the Client/Carer should be recorded.


Service delivery setting

In your small group, discuss the settings in which your Agency most commonly provides assistance.



Location of Service Event

• The location (Suburb, State, Postcode) at which the service provider performed the primary type of assistance that the Client/Carer received.

• Derived in some instances (depending on your information system).

• Where the primary type of assistance was ‘95’ – ‘Transport-Client’ or ’96’ – ‘Transport-Carer’, the location of the destination is to be recorded.

• Where the primary type of assistance was provided by telephone or Telehealth (including Telemedicine and video-conferencing), the setting most applicable to the physical location of the Client/Carer should be recorded.



in yourNSW Health


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Service Event indicator

• An indicator of whether the delivery of assistance to the Client and/or Carer was on an individual basis or in conjunction with other persons as part of a group.

– ‘1’ - Individual (one-to-one) service – to be used where assistance is provided to a Client and/or their Carer by a service provider.

– ‘2’ - Group service – to be used where assistance is provided to a Client and/or their Carer by a service provider as part of a group with other clients and/or their carers.


Service Event mode

• The mode of delivery of assistance to the Client and/or Carer.


Code Description

1 Face-to-face

2 Telephone

3 Telehealth

8 Other

Attendance status

• An indication of whether:– the Client and/or Carer attended; and– the service provider attended; and– the service was provided; OR– the Service Event was cancelled/postponed.


HACC Service Event – Recording primary assistance types within ACE

HACC Service Eventdata elements

HACC Service Event – Recording assistance provided within ACE

HACC Service Eventdata elements

Service Event start timeService Event end timeAmount of assistance received (time)

• Recorded for a Service Event where the primary type of assistance requires its collection.

• Time is recorded in 24-hour time format from 00:00 through to 23:59. Seconds are not included.

• A single Service Event may not span more than a 24 hour period, but may span midnight.

• The intended start time and end time are recorded for ‘unplanned’ cancelled/deferred Service Events.

• ‘00:00’ is recorded for ‘planned’ cancelled/deferred Service Events.


Primary assistance types measured in time

Assessment (including screening)-Client or Carer Case management

Client care co-ordination-Client or Carer Counselling/support, information, referral and advocacy-Client or Carer

Domestic assistance Social support/dementia monitoring

Personal care Centre-based day care

Respite care Continence care

Dementia nursing Palliative care generalist nursing

Wound management Foot care

Podiatry Hearing assessment

Occupational therapy Physiotherapy

Diversional therapy Speech pathology

Dietetics/nutrition Social work

General and other nursing support Other support by Allied Health professional

Other food services Home maintenance



• Recorded for a Service Event where the primary type of assistance requires its collection.

Primary assistance types measured in quantity

Meals

Formal linen service.


Transport mode

• Recorded for a Service Event where the primary type of assistance has been recorded as ‘95’ – ‘Transport-Client’ or ’96’ – ‘Transport-Carer’.

• The means of a one-way transport service provided to the Client and/or their Carer.

Transport purpose

• Recorded for a Service Event where the primary type of assistance has been recorded as ‘95’ – ‘Transport-Client’ or ’96’ – ‘Transport-Carer’.

• The purpose (destination setting) of a one-way transport service provided to the Client and/or their Carer.


Amount of assistance received (cost)

• Recorded in whole Australian dollars for a Service Event where the primary type of assistance requires its collection.

Primary assistance type measured in cost

Home modification.



in yourNSW Health


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HACCHACC

Goods and equipmentGoods and equipment

HACC Goods and equipmentAny goods and equipment provided(by purchase or loan) to the Clientduring a Service Event.

A Client may be provided with multiple types of goods and equipment – each type and quantity should be recorded.

When the assistance is funded and reported against a MDS specific to another Health Program (eg. PADP), then it need not also be reported against the NSW Health HACC MDS.

HACCHACC

Goods and equipmentGoods and equipmentdata elementsdata elements

HACC Goods and equipmentdata elements

• Type of assistance with goods and equipment received

• Amount of assistance with goods and equipment received

Type of assistance with goods and equipmentreceived

• Recorded for a Service Event where the primary type of assistance has been recorded as ‘90’ – ‘Provision of goods and equipment’.

• The type of goods and equipment received by the Client during a Service Event.


Amount of assistance with goods and equipmentreceived

• Recorded for a Service Event where the primary type of assistance has been recorded as ‘90’ – ‘Provision of goods and equipment’.

• The amount of each type of goods and equipment received by the Client during a Service Event.



in yourNSW Health


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HACCHACC

Functional Functional AssessmentAssessment

HACC Functional Assessment

Records the extent to which the Client:– is able to perform selected activities of

daily living;– has memory or behavioural problems;– requires transport assistance.

The HACC Functional assessment aims to identify areas in which the Client requires assistance with daily living and quantify their level of need.


• Rate what the Client is capable of doing rather than what they do.

• Rate the person’s functional status with current aids and appliances in place.

• The Client’s functional status should be rated at the start of a Service Episode (either at intake, as part of or immediately following initial assessment) and re-assessed either when the Client’s circumstances change or when there is an indication that the Client’s need for assistance has changed.

HACC Functional Assessmentwithin ACE


HACCHACC

Functional Functional AssessmentAssessment

data elementsdata elements

HACC Functional Assessmentdata elements

• Date of Client functional assessment• Client functional status – housework• Client functional status – transport• Client functional status – shopping• Client functional status – medication• Client functional status – money• Client functional status – communication• Client functional status – dressing• Client functional status – eating• Client functional status – toileting• Client functional status – getting out of bed/moving around• Client functional status – walking• Client functional status – bathing/showering• Client functional status – memory problems/confusion• Client functional status – behavioural problems• Client functional status – transport classification

Date of Client functional assessment

• The date on which the functional assessment/re-assessment was performed.

• A corresponding Service Event record must exist for the same date as the functional assessment/re-assessment. The primary type of assistance for the Service Event will be recorded as ’01’ – ‘Assessment (including screening)-Client’.

• A functional assessment/re-assessment of the Client may be performed face-to-face, by telephone or by Telehealth service delivery mode.

HACC Functional Assessment data elements

Client functional status – houseworkClient functional status – transportClient functional status – shoppingClient functional status – medicationClient functional status – money

• Not relevant for children or adolescents (persons aged <18 years) and should have the response defaulted to ‘0’ – ‘Not collected’.


Code Description

0 Not collected

1 No

2 Yes, sometimes

3 Yes, always


Client functional status – communicationClient functional status – dressingClient functional status – eatingClient functional status – toiletingClient functional status – getting out of bed/moving aroundClient functional status – walkingClient functional status – bathing/showering


Code Description

1 No

2 Yes, sometimes

3 Yes, always


Client functional status – memory problems/confusionClient functional status – behavioural problems

• Not to be asked directly of the Client.

• Ratings should be based on other information, including interview/observation of the Client, clinical notes, referral letter and information from a Carer, friends, relatives and referring services.


Code Description

1 Yes

2 No


Client functional status – transport classification

• The transport assistance requirements of the Client.

• Not to be asked directly of the Client.

• Ratings should be based on other information, including interview/observation of the Client, clinical notes, referral letter and information from a Carer, friends, relatives and referring services.


Code Description

1 Very High level Transport for Health services required

2 High level Transport for Health services required

3 Medium level Transport for Health services required

4 Low level Transport for Health services required

5 No Transport for Health services required



in yourNSW Health


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HACCHACC

Outward referralOutward referral

HACC Outward referral

Any outward referral of the Client and/or their Carer from your Agency during or at cessation of the Service Episode.

A Client/Carer may have multiple outward referrals – each outward referral should be registered.

HACC Outward referrals withinACE


HACCHACC

Outward referralOutward referraldata elementsdata elements

HACC Outward referral data elements• Target of referral• Date of referral out

Target of referral

• The individual or organisation to which the Client and/or their Carer was referred (out) by the Agency.

• The referral may be interpreted informally (ie. not requiring a written or phone referral).

• If the Client and/or their Carer was not referred (out) by the Agency during or at cessation of the Service Episode, record that there was no referral made – ’99’ – ‘No referral’.

HACC Outward referral data elements

Date of referral out

• The date on which the Client and/or their Carer was referred (out) by the Agency.

• For written referrals, the date on the referral letter should be recorded.

• For informal and verbal referrals, the date on which information was provided to the Client and/or their Carer about the Agency to which they were referred should be recorded.

• If the Client and/or their Carer was not referred (out) by the Agency during or at cessation of the Service Episode, the date on which the Client/Carer last presented for service should be recorded.

HACC Outward referral data elements


In your small group, discuss your Agency’s most common targets of referral.

What business processes does your Agency have for referrals?


HACCHACC

Are there any Are there any questions about the questions about the


HACCHACC

ConclusionConclusion

HACC Conclusion

Review of the NSW Health HACC MDSv2 workshop learning outcomes:– How has the workshop enhanced your understanding of the reporting

categories and data elements of the NSW Health HACC MDS v2?

– How can this knowledge be used to improve the timeliness and accuracy of NSW Health HACC MDS v2 reporting?

HACCHACC

Useful informationUseful information

NSW Health HACC Data Collection Co-ordinatorJohn Hallett

• Phone: 9391 9308• E-mail: [email protected]

NSW Health HACC web site• Intranet: http://internal.health.nsw.gov.au/im/ims/hacc• Internet: http://www.health.nsw.gov.au/data/hacc

HACC Useful information

HACCHACC

Thank youThank youfor your participationfor your participation

Documents

NSW Health Home and Community Care (HACC) Minimum Data Set (MDS) V2 Train the Trainer Workshop