Seq No. Metadata item Obligation Max occurs - Home and Community Care (HACC) assistance received (quantity) cluster Mandatory 1 - Home and Community Care (HACC) assistance received (time) cluster Mandatory 1 - Home and Community Care (HACC) functional status cluster Mandatory 1 - Home and Community Care (HACC) goods and equipment received cluster Mandatory 1 - Home and Community Care (HACC) total assistance received (cost) cluster Mandatory 1 - Date—estimate indicator, code N Mandatory 1 - Informal carer—co-residency status, code N Conditional obligation:
Recorded if the HACC client has a carer (see Person—informal carer existence indicator, code N ).DSS specific information:
The data element Carer residency status helps to establish a profile of the characteristics of informal carers assisted either directly or indirectly by the HACC program. As such it increases our knowledge about the dynamics and patterning of the provision of informal care to and by clients of the HACC program. In particular, whether the Carer lives with the person for whom they care or not is one indication of the level of informal support available to HACC clients and of the intensity of care provided by the Carer. Future developments of the HACC MDS will include more information about the level and type of assistance provided by carers.
A co-resident carer is a person who provides care and assistance on a regular and sustained basis to a person who lives in the same household. A non-resident or visiting carer is a person who provides care and assistance on a regular and sustained basis to someone who lives in a different household.
The process of identifying a single person who provides the most significant care and assistance is similar to that used by the Australian Bureau of Statistics in the 2003 Survey of Disability, Ageing and Carers to identify ‘principal carers’. However, reliable comparisons of ABS ‘principal carers’ and carers identified in the HACC MDS cannot be made without the inclusion of additional information in the HACC MDS about the types of assistance needed by care recipients and provided by carers. Future developments in the HACC MDS will take this issue into consideration.
Verification rules:
A value for this data element should be present in any client record with a value of 1 in Carer—existence of.
A record with the value 1 in this data element should not have a value of 1 in the data element Living arrangements.
The agency should record this data element at the beginning of each HACC service episode for any care recipient who has a carer (i.e. Carer—existence of code 1).
The agency should assess the currency of this information at subsequent assessments/re-assessments within any given HACC service episode and should update the agency’s record of Carer residency status if necessary.
Reporting requirements:
This data element is required for reporting within the HACC MDS collection for any HACC client who has a Carer (i.e. Carer—existence of code 1).
Agencies are required to report the most recent Carer residency status that the agency has recorded for the client. This information is to be related to the same person to which the data element Relationship of carer to care recipient relates.
Information provided by the agency about Carer residency status will be considered to be at least as up to date as the Date of last update reported for the person. This is in line with the request that agencies assess and update the information they have about Carer residency status at the beginning of each HACC service episode as well as at subsequent assessments/re-assessments within any given HACC service episode.
If the agency’s system or records do not provide sufficient information to accurately report on this data element, the agency should use code 9 Not stated/inadequately described.
Mandatory 1 - Informal carer—multiple care recipient status, code N Conditional obligation:
Recorded if the HACC client has a carer (see Person—informal carer existence indicator, code N ).
DSS specific information:
Collection methods: The agency should record this data element at the beginning of each HACC service episode where a carer has been identified (i.e. code 1 recorded for Carer—existence of).
The agency should also assess the currency of this information at subsequent assessments/re-assessments and update the agency’s record if necessary.
Reporting requirements:
This data element is required for reporting in the HACC MDS collection in those circumstances where a carer has been identified (i.e. Carer—existence of code 1).
If the agency’s system or records do not provide sufficient information to accurately report on this data element, the agency should use code 9 Not stated/inadequately described.
This element is similar to the DE Informal carer – number of care recipients (NRCP), code N[N], collected in the NRCP MDS (#308603). Rather than a Yes/No item, that DE collects the number of recipients in the ranges 1,2,3+. It also recommends a further list of required items for collection.
Related data:
Is related to the data elements Carer residency status, Relationship of carer to care recipient, and Date of last update.
Is related to the data element concept Carer.
Mandatory 1 - Informal carer—relationship to care recipient, code N Conditional obligation:
Recorded if the HACC client has a carer (see Person—informal carer existence indicator, code N ).DSS specific information:
Information about the relationship the carer has to the person for whom they care assists in establishing a profile of informal caring relationships and the assistance provided by the HACC program to maintain and support those relationships. As such it increases our knowledge about the dynamics of caring and provides an insight into the gender and inter-generational patterns of informal caregiving in the community. The inclusion of this information in the HACC MDS enables useful comparisons between caring relationships supported by the HACC program and those reported in the national population data from the ABS Survey of Disability, Ageing and Carers.
The agency should record this data element at the beginning of each HACC service episode for any client who has a carer (i.e. Carer's existence of code 1).
The agency should also assess the currency of this information at subsequent assessments/re-assessments within a HACC service episode and should update the agency's record of the Carer for more than one person if necessary.
Reporting requirements:
This data element is required for reporting within the HACC MDS collection for any HACC client who has a carer (i.e. Carer's existence of code 1).
Agencies are required to report the most recent information about caring for more than one person that the agency has recorded for the person.
Information provided by the agency about the Carer for more than one person will be considered to be at least as up to date as the Date of last update reported for the person. This is in line with the request that agencies assess and update the information they have about the Carer at the beginning of each HACC service episode as well as at subsequent assessments/re-assessments within any given HACC service episode.
If the agency's system or records do not provide sufficient information to accurately report on this data element, the agency should use code 99 Not stated/inadequately described.
A HACC client may have more than one family member or friend providing them with care and assistance. In such circumstances, the data element Relationship of Carer to care recipient relates to the carer who is identified as providing the most significant amount and type of care and assistance.
The process of identifying a single person who provides the most significant care and assistance is similar to that used by the Australian Bureau of Statistics in the 2003 Survey of Disability, Ageing and Carers to identify ‘principal carers’. However, reliable comparisons of ABS ‘principal carers’ and Carers identified in the HACC MDS cannot be made without the inclusion of additional information in the HACC MDS about the types of assistance needed by care recipients and provided by Carers. Future developments in the HACC MDS will take this issue into consideration.
Mandatory 1 - Person (address)—Australian postcode, code (Postcode datafile) {NNNN} DSS specific information:
In the Home and Community Care MDS, this data element refers to the postal code for the geographic location of the person's residence whilst receiving HACC services.
In conjunction with the data element Suburb/town/locality name, the data element Postcode is included in the HACC MDS as a means of reporting information about the geographic location of the residence of a HACC client. The preferred standard for reporting this information is by using a statistical local area (SLA) in conjunction with a state/territory code (see Australian state/territory identifier). However, as some HACC agencies may have difficulty allocating SLA codes to the residential locations of their clients without more computerised assistance than is currently available to them, agencies are given the option of reporting this information by using the lesser standard of Postcode plus Suburb/town/locality name.
The agency should record the postcode for the address at which the person resides while receiving services from the agency. The postcode should not relate to a postal address different from the physical address at which the person is residing.
The Australia Post postcode book is updated more than once a year as postcodes are constantly changing. Agencies should use the most up-to-date postcode book available for the HACC MDS reporting period.
This data element should be recorded for all HACC care recipients at the beginning of each HACC service episode. The agency should also assess the currency of this information at subsequent assessments/re-assessments within any given HACC service episode and should update the agency's record of the client's postcode if necessary.
Reporting requirements:
This data element is an alternative within the HACC MDS collection to reporting the Statistical Local Area (SLA) of the client's residence.
The agency should report the most recent postcode recorded for the client. Information provided by the agency about the client's postcode will be considered to be at least as recent as the Date of last update reported for the person. This is in line with the request that agencies assess and update the information they have about a person's postcode at the beginning of each HACC service episode as well as at subsequent assessments/re-assessments within each HACC service episode.
The HACC MDS Version 2.0 does not include all data elements for full Address information. A complete implementation of Address, including the related data elements, is currently under development in coordination with Standards Australia, ABS, the National Health Data Committee and the National Community Services Data Committee. Once national standards are developed, the HACC MDS will take these standards into account for future versions of the HACC MDS.
Mandatory 1 - Person (address)—suburb/town/locality name, text A[A(49)] DSS specific information:
In the Home and Community Care MDS, this data element refers to the full name of the suburb/town/locality in which the Care Recipient lives whilst receiving HACC services.
In conjunction with the data element Postcode, the data element Suburb/town/locality name is included in the HACC MDS as an alternative means of reporting information about the geographic location of the residence of a HACC client. The preferred standard for reporting this information is by using a statistical local area (SLA) in conjunction with a state/territory code (see Australian state/territory identifier ). However, as some HACC agencies may have difficulty allocating SLA codes to the residential locations of their clients without more computerised assistance than is currently available to them, agencies are given the option of reporting this information by using the alternative standard of Postcode plus Suburb/town/locality name .
The agency should report the most recent Suburb/town/locality name recorded for the client.
Information provided by the agency about the client’s Suburb/town/locality name will be considered to be at least as recent as the Date of last update reported for the person. This is in line with the request that agencies assess and update the information they have about a person’s Suburb/town/locality name at the beginning of each HACC service episode as well as at subsequent assessments/re-assessments within each HACC service episode.
Mandatory 1 - Person (name)—family name, text X[X(39)] DSS specific information:
The HACC client’s full name is not required for HACC MDS reporting purposes. However, selected letters of the Family Name/Surname (2nd, 3rd and 5th), in combination with selected letters of the First Given Name, Date of Birth and Sex, are required for record linkage for statistical purposes only (see data element concept Record Linkage).
Context: The HACC client’s full name is not required for HACC MDS reporting purposes. However, agencies are required to record this information on their information systems in order to provide the specific letters of the person’s surname which are required. Selected letters of the Family Name/Surname (2nd, 3rd and 5th), in combination with selected letters of the First Given Name, Date of Birth and Sex, are required for record linkage for statistical purposes only (see data element concept Record Linkage).
Comments: No national standards currently exist for appellations. Standards Australia is proposing to develop such standards although no time frame for this development is known as yet.
Mandatory 2 - Person (name)—given name, text X[X(39)] DSS specific information:
The HACC client’s full name is not required for HACC MDS reporting purposes. However, selected letters of the First Given Name (2nd and 3rd), in combination with selected letters of the Family Name/Surname, Date of Birth and Sex are required for record linkage for statistical purposes only (see data element concept Record Linkage).
Comments: No national standards currently exist for appellations. Standards Australia is proposing to develop such standards although no time frame for this development is known as yet.
Mandatory 2 - Person—Australian state/territory identifier, code N DSS specific information:
Australian State/Territory identifier is important in the analysis of the spatial distribution of HACC care recipients and the services they receive. The data element allows for the comparison of HACC client groups with the HACC target population by geographic area and assists with establishing service provision targets for HACC regions. It also identifies HACC clients living outside the HACC funding region of the agency.
Mandatory 1 - Person—Commonwealth government payment type, code N Mandatory 1 - Person—country of birth, code (SACC 2008) NNNN DSS specific information:
The three data elements included in Version 2.0 of the HACC MDS that are considered relevant to measuring cultural diversity are Country of birth, Main language spoken at home and Indigenous status.
Mandatory 1 - Person—date of birth, DDMMYYYY Mandatory 1 - Person—Department of Veterans’ Affairs entitlement status, health care card, code N DSS specific information:
This data element helps to identify sub-groups of particular policy interest, such as veterans and people with disabilities.
Code 4 should be used for care recipients who are not formally recognised by DVA as having any form of DVA entitlement, including those receiving the Aged Pension.
One of the values 1, 2 or 3 in this data element should be present in any client record with a value of 2 in Government pension/benefit status.
This data element should be recorded for all HACC care recipients at the beginning of each HACC service episode. The agency should also assess the currency of this information at subsequent assessments/re-assessments within a HACC service episode and should update the agency’s record of the person’s DVA entitlement if necessary.
This data element is required for reporting in the HACC MDS collection. Agencies are required to report the most recent DVA entitlement status that the agency has recorded for the person.
Information provided by the agency about the person’s DVA entitlement status will be considered to be at least as up to date as the Date of last update reported for the person. This is in line with the request that agencies assess and update the information they have about a person’s pension/benefit status at the beginning of each HACC service episode as well as at subsequent assessments/re-assessments within a HACC service episode.
If the agency’s system or records do not provide sufficient information to accurately report on this data element, the agency should use code 9 Not stated/inadequately described.
Mandatory 1 - Person—Indigenous status, code N Mandatory 1 - Person—informal carer existence indicator, code N DSS specific information:
This data element should be recorded at the beginning of each HACC service episode. The agency should also assess the currency of this information at subsequent assessments/re-assessments within any given HACC service episode and should update the agency’s record of the client’s Informal carer availability if necessary.
Reporting requirements:
Agencies are required to report the most recent Informal carer availability that the agency has recorded for the client.
Information provided by the agency about the person’s Informal carer availability will be considered to be at least as up to date as the Date of last update reported for the person. This is in line with the request that agencies assess and update the information they have about the client’s Informal carer availability at the beginning of each HACC service episode as well as at subsequent assessments/re-assessments within any given HACC service episode.
If the agency’s system or records do not provide sufficient information to accurately report on this data element, the agency should use code 9 Not stated/inadequately described.
The data element Informal carer availability, uses the same categories as the NCSDD V3, 2005.
The National Health Data Dictionary (NHDD) includes a data element named Carer Availability which is used within the Community Nursing Minimum Data Set (CNMDSA). However, there are significant differences in the CNMDSA data element and the HACC MDS data element of the same name. These differences relate to differences in the information needed (and considered appropriate for collection) by community nurses and that needed (and considered appropriate for collection) by the broader range of HACC-funded agencies. There are also differences in the scope of information collected through this data element in both data sets. The HACC MDS includes a separate data element Carer residency status which provides information about whether the person identified as the main or primary Carer lives with the person with whom they care or not. This information is included within the classification used by the CNMDSA Carer Availability data element.
The CNMDSA data element is also intended to relate more directly to the agency’s assessment process. As such, it relies on the service provider’s assessment as to whether a client is in need of a Carer, and the service provider’s assessment as to whether a ‘potential’ Carer is capable or willing to undertake the caring role. While this may be appropriate to a community nursing context, it is considered inappropriate to apply these same assumptions and expectations to the broader HACC field.
Future developments in the HACC MDS and the CNMDSA may need to see the data elements converge more; or may require a much clearer distinction between the two given their distinct and largely incompatible intentions (i.e. client reported availability versus a service provider assessment of availability, need and adequacy).
The resolution of these inconsistencies will be a priority for future developments of the HACC MDS and the CNMDSA. The resolution of such inconsistencies is particularly important as the HACC program is a major source of funding for many community nursing agencies and these agencies are required to report on the data elements included in the HACC MDS.
Mandatory 1 - Person—letters of given and family name, text XXXXX DSS specific information:
This data element is required for reporting within the HACC MDS collection. Agencies are required to report Letters of Name for all clients for whom the agency submits a HACC MDS record. Once the record linkage process is completed, the letters of the client’s name will be replaced by an encrypted code.
The person's full name is not required for HACC MDS reporting purposes. However, agencies are required to report selected letters of the person's Family Name/Surname and First Given Name. These will be used in combination with the person's Date of Birth and Sex in order to link client records across HACC agencies and across HACC MDS reporting periods for statistical purposes
The names from which Letters of Name are derived should be recorded by the agency in line with the specifications detailed in the data elements Family Name/Surname and First Given Name.
The provision of letters of a person's name can be a sensitive issue because of privacy and confidentiality concerns. The use of this information will be in accordance with the Information Privacy Principles contained in the Commonwealth Privacy Act and letters from the person's name will only be used for linking records for statistical purposes. Moreover, once the records are linked, these letters will be replaced by an encrypted code.
Mandatory 1 - Person—living arrangement, code N Mandatory 1 - Person—main language other than English spoken at home, code (ASCL 2005) NN{NN} DSS specific information:
Mandatory 1 - Person—residential setting, code N DSS specific information:
In the classification of settings included in the National Classification of Community Services Version 1.0, aged care hostels are included in Class 205 (Supported accommodation facility) and nursing homes are included in Class 402 (Special-purpose residential facility). For the purposes of the HACC MDS, nursing homes and aged care hostels have been grouped together as Residential Aged Care Facilities under Class 402. This is in line with the recent Commonwealth government restructuring of aged care services which combines nursing homes and aged care hostels into a single category called Residential Aged Care Facility. The Australian Institute of Health and Welfare has been informed of this decision in the HACC MDS and is aware of the need to review the classification to accommodate recent aged care policy developments.
The value domain for this element is mappable to the National Community Services Data Dictionary data element Type of Usual Accommodation. However, there remains some discrepancy between the use of ‘usual’ in the NCSDD and the use of ‘while receiving services’ in the HACC MDS.
Mandatory 1 - Person—sex, code N Mandatory 1 - Record—last update date, DDMMYYYY Mandatory 1 - Record—statistical linkage key information missing flag, code N Mandatory 1 - Referral—referral source, code N[.N] Mandatory 1 - Service episode—episode end date, DDMMYYYY DSS specific information:
Date of exit (in conjunction with Date of entry) gives some indication of length of stay of clients in the HACC program and of the intensity of service provision. The data element Date of exit also locates information about the client’s Main reason for cessation of services in time. In conjunction with the data element Date of entry, it can also be used to identify the number of HACC clients as at the end of the HACC MDS reporting period.
The Date of exit need not relate to the same HACC service episode as the Date of entry reported for the client. This is because a client may have exited from a HACC service episode during a HACC MDS reporting period and then re-entered during the same reporting period and remains a client at the end of the reporting period. That is, at the end of a HACC MDS reporting period, the client is in the middle of an incomplete HACC service episode . Where the Date of exit reported for the client is before the Date of entry reported for the client, the person will be counted as a client at the end of the reporting period.
Date of exit is defined in terms of an episode of assistance funded by the HACC program. This is essential in terms of program accountability to provide an indication of the intensity of services provided by the HACC program and the length of stay within the program for HACC clients. However, because the data generated on length of stay and intensity of service provision is specific to the HACC program, this imposes a limitation on the use of the data in terms of overall patterns of services consumed by individuals (which may be funded through several sources). This is not only unavoidable but an intrinsic part of the HACC MDS. However, it does mean that considerable further developments will be required in both HACC and related service systems before the dedicated aim of client-centred service and client-centred information systems can be achieved.
Mandatory 1 - Service episode—episode start date, DDMMYYYY DSS specific information:
The date on which a period of delivery of HACC-funded assistance to the person begins.
Date of entry (in conjunction with Date of exit) gives some indication of length of stay of clients in the HACC program and of the intensity of service provision. The data element Date of entry also locates information about the client’s Source of referral in time. In conjunction with the data element Date of exit , it can also be used to identify the number of HACC clients at the end of the HACC MDS reporting period.
Future developments in HACC MDS reporting may require HACC agencies to report on the services received by their clients within each HACC service episode rather than within the HACC MDS reporting period. Thus, this data element is likely to have extended uses in the future.
Valid date
This data element should always be recorded as an 8-digit valid date comprising day, month, and year. Year should always be recorded in its full 4-digit format. For days and months with a numeric value of less than 10, agencies should use zeros to ensure that the date contains the required 8-digits. For example, for a person who received their first HACC-funded assistance from the agency on July 1, 2005 the Date of entry should be recorded as 01/07/2005.
Generally, the Date of entry is the earliest date on which the care recipient or carer received services for the current service episode. Report as follows:
For on-going clients, there is no need to re-enter the date, the system will use the existing Date of entry.
For new clients in the reporting period, report the first Assistance received date
For clients who exited from a service episode and entered a new service episode during the same reporting period, report the Assistance received date for the new service episode.
For any client whose assistance from the agency is fully-funded through the HACC program, the Date of entry is the first date on which the person received from the agency any of the types of assistance listed under the data element Type of assistance/support, within a HACC service episode. For any client whose assistance from the agency is not fully funded through the HACC program (i.e. funded in part from a source other than the HACC program), the Date of entry is the first date on which the assistance they received from the agency, within the HACC Service Episode, was funded by the HACC program, i.e. the Date of entry will be the same date as the first HACC-funded Assistance received date recorded.
At times, an agency may only provide the client with one-off assistance. For example, a client may only require assistance with minor home maintenance that is provided on one day. Alternatively, a client may have only received an assessment from an agency but has not gone on to receive any further assistance. In these circumstances (and provided the client is not receiving other on-going services), the Date of entry will be the same as the Date of exit. Furthermore, both dates will be the same as the Assistance received date recorded by the agency for that HACC service event. Despite being the same date, the agency should record the date in every relevant role that it plays in relation to the client’s involvement with the agency (e.g. Date of entry, Date of exit, Assistance received date).
Reporting requirements:
This data element is required for reporting in the HACC MDS collection. Over a period of time a client may have entered and exited an agency on more than one occasion. Agencies are required to report the latest Date of entry into HACC service episode that the agency has recorded for the client.
The data element Source of referral will be analysed in conjunction with the data element Date of entry. The agency should ensures that the Source of referral reported for the client relates to the beginning of the same HACC service episode as the Date of entry reported for the client.
Mandatory 1 - Service episode—service cessation reason (HACC), code N[N] Mandatory 1
