Annual health assessments

Key facts

People with intellectual disability often find it hard to explain if they are in pain or feeling sick. People often suffer in silence! Or their behaviour changes and other people do not know why. So, it is usually important for a person with intellectual disability to have a thorough health assessment each year. Medicare pays for these assessments which often show up health problems that no-one knew about, eg sight and hearing problems, reflux, side effects from medications and cancers.

In NSW, the disability department (ADHC) has told all funded supported accommodation services that they have to organise annual health assessments for their residents. The assessments feed into a health care plan for each resident.

Medicare health assessments

Medicare pays for GPs to do annual assessments of adults and children with intellectual disability. Medicare item 701 is for a brief assessment (up to 30 minutes), 703 standard (up to 45 minutes), 705 long (up to 60 minutes) and 707 for a prolonged assessment. Medicare says that a person with intellectual disability may need a long or prolonged assessment because of the communication barriers between doctor and patient.

Organising the assessment

Make an appointment with the GP. Say you want an assessment under Medicare and ask for a long appointment. See if the doctor has a practice nurse who can help with the assessment. Check that the doctor bulk bills.

Someone who knows the person well should go with them to the appointment. For people in supported accommodation, workers should discuss this with the person’s family or advocate. It will often make sense for both a parent and a support worker to attend.

Take the person’s health records, personal profile and current medications to the appointment.
If it will be hard for the doctor to assess the person in the surgery, you can ask the doctor to come to the person’s home.

At the appointment

The GP will check things like the person’s teeth, hearing, eye sight, nutrition, any swallowing problems, immunisations and so on. And then, the GP will advise on preventative health care, treatment and any other medical tests that are needed.

If the person has a chronic medical condition and complex care needs, then the GP may decide to follow up with Chronic Disease Management Medicare items. These can allow other health professionals to be paid for by Medicare, for example speech pathologists, physiotherapists and occupational therapists.

Using the CHAP tool

The CHAP is a tool that can be used to carry out the annual health assessment. CHAP stands for Comprehensive Health Assessment Program. There is a questionnaire for the family, advocate or support worker to fill in with the person. This gives the doctor lots of information about the person’s health. The doctor then fills in the second part of the CHAP at the appointment and works out a health action plan with the person and other people present.

The CHAP is used by the disability departments in NSW, Victoria, Queensland and Western Australia.

Health action plan

It is important that the actions recommended by the doctor are followed up. One person should take responsibility for supporting the person with disability through the necessary actions – eg arranging blood tests and making appointments with specialists and therapists. If you have trouble with this follow through, contact the GP for advice.

The annual assessment can also feed into an in individual health care plan. In NSW, each resident of the accommodation services run by ADHC must have a health care plan. The plan covers things like a healthy lifestyle, follow through on annual assessments and ongoing support with health problems.

Follow up

Ask the GP about a follow up appointment to talk about the results of any tests and other assessments. The doctor may use these results to give more advice about treatment or monitoring.

For more information

The Medicare assessment items for people with intellectual disability – See the Medicare fact sheet and more detailed question and answer sheet
www.health.gov.au/internet/main/publishing.nsf/Content/mbsprimarycare_mbsitem_intellectual_disability
www.health.gov.au/internet/main/publishing.nsf/Content/mbsprimarycare-qandaintelldisability

CHAP tool
www.som.uq.edu.au/research/qcidd/files/chap.pdf

Health care policy and procedures ADHC NSW
www.adhc.nsw.gov.au/__data/assets/file/0007/228094/Health_Care_Policy_Sept_2010.pdf

You might be interested in these fact sheets
Going to the doctor – tips and tricks
Personal health records
Helping the doctor understand the person
Getting the most out of Medicare

This fact sheet was updated in July 2011.

The fact sheet contains general information only and does not take into account individual circumstances. It should not be relied on for medical advice. We encourage you to look at the information in this fact sheet carefully with your health professional to decide whether the information is right for you.