December 5, 2023

dementia-and-cognition-supplement

A Services Australia payment for people with a Home Care Package

Cognitive impairment can arise from dementia, but it can also be caused by such things as a stroke or traumatic brain injury.

If your loved one is the recipient of a Home Care Package and has a cognitive impairment, they may be eligible for the dementia and cognition supplement.

The dementia and cognition supplement was introduced on August 1st, 2013, to provide extra funding to meet the additional care needs of people living with a moderate to severe cognitive impairment.

A diagnosis of dementia does not automatically qualify a person for this supplement because the level of cognitive impairment can vary.

The person’s eligibility is assessed with the prescribed screening tools as dictated by the Department of Health and Aged Care. These screening tools are the Psychogeriatric Assessment Scale (PAS), the Rowland Universal Dementia Assessment Scale (RUDAS) or the Kimberly Indigenous Cognitive Assessment (KICA-cog).

The only approved health care professionals who can screen for eligibility for this supplement are Registered Nurses, Clinical Psychologists and GPs. Occupational Therapists cannot screen for the Dementia and Cognition Supplement.

The amount of funding that a person would receive if they were eligible for this supplement is a percentage of the level of home care package they are receiving.

From July 1st 2023, the daily supplements are as follows:

A level 1 HCP recipient would receive a daily supplement of $3.24.
A level 2 HCP recipient would receive a daily supplement of $5.69.
A level 3 HCP recipient would receive a daily supplement of $12.39.
A level 4 HCP recipient would receive a daily supplement of $18.78.

The screening tests are not time consuming to administer and, when approved, the supplement is backdated to the date of completion of the application document.

Unfortunately there is much misunderstanding about this supplement and many people miss out on receiving it because they're given the wrong information, either by their home care package provider or their GP.

If a provider has a Registered Nurse on staff, it is more likely this provider will be familiar with the screening process and the person more likely to be approved for the additional funding.

PAS (Psychogeriatric Assessment Scale)

What we hear, consistently from people is that their provider has told them to go to the GP and have the PAS completed.

The PAS, being one of the screening tools is the Psychogeriatric Assessment Scale and is not one of the more commonly used screening tools we, as clinicians use with people who have cognitive impairment. In fact, when I left the public sector and moved into the aged care sector and the coordinator for a provider asked me to do the PAS for someone for the supplement, I had to find out what the PAS was. I had not heard of the PAS in my 30 year career as a Registered Nurse. I was used to using other tools MMSE, MOCA and RUDAS.

Some things to know:

  • Many GPs have no idea what the PAS is either, and their practice nurses are often unaware of what it is too. So the GP or practice nurse will instead use a different screening tool which Services Australia will decline. 
  • Or the GP thinks screening for the Dementia and Cognition Supplement is aligned with diagnosing dementia and tells the person they need to see a Geriatrician to have the screening completed.
  • But many Geriatricians also don't realise they cannot deviate from the Department's prescribed screening tools and they too use different screening tools and then Services Australia declines that application also.
  • Sometimes GPs and Geriatricians tell people they need to have a diagnosis of dementia to be eligible. But this is wrong too.

As a result the person misses out on this vitally needed extra funding.

Don't miss out you just need a Registered Nurse to complete an assessment

Where we find so many people miss out on receiving this additional funding though, is when their provider is a self-managed provider.

Self-management means the provider is the conduit for receiving and approving expenditure from the package and you as the person supporting an older loved one with dementia or cognitive impairment, sources your own carers, support workers and contractors.

Self-managed providers tell people to go to the GP to have the PAS completed not realising GPs don't know how to complete the screening.

People who are declined by Services Australia in applying for the supplement then think their loved one is ineligible. But they are not. This is a scenario we see very week.

If your loved one is not receiving the supplement and the provider doesn't have a registered nurse available to complete the eligibility screening, contact us to see if we can help you out.

We can complete this screening and the application form on behalf of providers, via a telehealth consultation, and the cost is fully claimable from the Home Care Package funding

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