3.6.9 Adult Disability Assessment Tool (ADAT)
This section details the application of the ADAT (1.1.A.78) for CA (adult) and CP for adult care receivers.
The ADAT is contained in the Secretary's Determination known as the Adult Disability Assessment Determination 2018 (1.1.A.75), which is a disallowable instrument. The disallowable instrument contains the minimum qualifying score for CP (adult) and CA (adult).
The instrument includes authority for the Secretary to request a replacement professional questionnaire to be completed by another THP (1.1.T.170), if the Secretary is not satisfied that the original questionnaire is an accurate reflection of the person's disability, emotional state, behaviour and special care needs.
Note: If the THP is a close relative (parent, child, sibling or grandparent) of the carer or care receiver, there may be a conflict of interest because a relative may benefit financially from the THP assessment. Discretion should be exercised in determining whether the Secretary's delegate accepts that the assessment is an accurate reflection of the person with the disability's care needs.
The instrument also includes authority for the Secretary's delegate to approve an individual health professional as an approved THP on a case by case basis. This discretion should only be used where a questionnaire has been completed by a professional from the approved list of THP and the delegate is satisfied they could not provide adequate information. They should also be satisfied the person completing the questionnaire is qualified to provide an assessment of the care receiver's condition and care needs.
Note: The delegate does not have the authority to approve the addition of a class of persons to the approved list of THP, such as psychologists. This must be authorised by the Secretary.
Example 1: Abdul receives CP and CA for his wife Ayisha, who has a mental health condition. As a result of a review, Abdul submits the professional questionnaire completed by their GP, which does not achieve a qualifying score and Abdul's CP and CA are cancelled. Abdul lodges an appeal with Services Australia and submits a new professional questionnaire completed by Ayisha's psychologist, who, despite not being on the approved list of THP, is the health professional they most frequently connect with and who understands the care and support Ayisha requires. The assessor establishes the psychologist is a qualified medical professional with the knowledge to complete the professional questionnaire. As the delegate has the authority to approve a qualified individual on a case by case basis, the professional questionnaire is accepted and Abdul's CP and CA is reinstated.
Example 2: Amelia lodges a claim for CP and CA for her daughter Lotus, with the professional questionnaire completed by their naturopath, who is not on the list of approved THP. The assessor advises Amelia that she is required to have the questionnaire completed by a professional from one of the classes of persons included on the list of approved THP. Amelia has another professional questionnaire completed, this time by Lotus's GP. CP and CA are rejected as the professional questionnaire does not achieve a qualifying score. After discussion with Amelia, and after reviewing the additional information provided by the naturopath, if the assessor is not satisfied the naturopath's additional evidence determines that a qualifying level of care is being provided, CP and/or CA should be rejected.
An assessment against the ADAT is current for 2 years. However, if the condition is permanent and non-improving and an ADAT score of 40 or more is achieved the care receiver is not required to undergo another assessment for CA or CP purposes.
If the care receiver has a current ADAT score for either CP or CA and the carer makes a claim for the other payment the current assessment may be used to assess their new claim.
The ADAT enables a weighted score to be calculated that is used to determine that the care receiver is a person with a disability or severe medical condition which results in the need for a significant level of care and therefore meets the definition of a disabled adult (1.1.A.79) under SSAct section 954 for CA (adult) or SSAct section 198 for CP for adult care receivers.
What is the ADAT
The ADAT contains 2 questionnaires that together measure the amount of help the care receiver needs to undertake basic activities of daily living such as mobility, communication, hygiene, eating and management in a range of cognitive and behavioural areas. This may include supervising and prompting the care receiver to undertake these daily activities. The carer is required to complete the claimant questionnaire (Schedule 1 Part 1) of the ADAT and a THP must complete the HPA component (Schedule 1 Part 2). A minimum qualifying score must be achieved on the THP component as well as a minimum qualifying total ADAT score.
The responses from the questionnaires are used to calculate a score indicating the level of care needed because of a physical, intellectual and/or psychiatric disability.
Warning: The order and numbering of questions in the HPA does not follow the same format as the disallowable instrument, which is the order used in the SS Guide.
The one ADAT score be used for both CA & CP
When a person receiving CP applies for CA, the ADAT score that already exists for CP may be used for the CA claim. Similarly, when a person receiving CA applies for CP, the ADAT score that already exists for CA may be used for the CP claim. The legislation requiring a care receiver to be assessed and rated against the ADAT does not specify that the assessment is exclusive to a specific CA or CP claim.
If the previous ADAT score is 40 or more and the condition is permanent and not improving, the ADAT would not be subject to review on the current payment and should therefore not be reviewed as part of the claim process. If the current ADAT score is less than 40 and not permanent etc., then provided that the normal review procedures have been followed (i.e. 2 yearly review), the ADAT score would be less than 2 years old and therefore current.
The only instances where the previous ADAT may need to be reviewed is where the 2 yearly review has not been conducted, where the ADAT is being used for a CA claim from a non co-resident carer and the assessor has concerns about whether the care being provided is required under the ADAT or where the ADAT used for a previous CP claim did not achieve a qualifying score for a new CA claim, as the CP minimum qualifying score is 25, with a minimum THP score of 10 while the CA minimum qualifying score is 30 with a minimum THP score of 12. In the latter case the carer should be advised that a new ADAT will be required to assess eligibility for CA.
Act reference: SSAct section 954A Qualification for CA-caring for a disabled adult in a private home not shared by the adult and carer
Policy reference: SS Guide 126.96.36.199 Carer Allowance (CA) - Description, 188.8.131.52 Carer payment (CP) - description, 184.108.40.206 CP - Reviews (Adult with a Disability), 220.127.116.11 CA - Reviews (Adult with a Disability)