Carer Specialist Assessment Team (CSAT) referrals for Carer Payment (CP) (child) 009-04070060

Has the claim previously been referred to CSAT, and returned?

• Yes, see Table 3 > Step 3
• No, go to Step 2

Does carer meet all other qualification criteria for Carer Payment (child) such as income, assets, residence, or a Treating Health Professional (THP) score of 'greater than zero'?

• Yes, go to Step 3
• No, reject the claim. Procedure ends here

Has a validation trigger been identified on a new claim?

• Yes, go to Step 5
• No, go to Step 4

There will be specific triggers identified by the Service Officer indicating the need for manual referral to a CSAT social worker to investigate additional evidence relating to the accuracy of care load requirements in the identified claim(s).

• Automatic referral to CSAT is triggered by the 'total score' calculated from information entered on the Care Needs Assessment (CNA) as part of the new claim for CP (child), see Table 2 > Step 1. The Service Officer will be alerted that there is an automated referral trigger, and has the option to decide whether the automatic referral is required or not
• Referrals to the CSAT must be made prior to finalising the claim

The Resources page contains a list of referral reason codes.

The CLVL screen will be presented when there are discrepancies between the responses provided in the THP report and the CNA form, and a validation is required.

A claim may just miss the total required qualifying rating when there is a qualifying score for CP (child) on the THP report for care load required but the score on the 'care load provided' within the CNA, just misses out on a qualifying score.

Trigger 1 will occur when either:

• The completed CNA total score for a single carer of a single child is:
• 70-84.9 for a child aged less than three years, or
• 80-84.9 for a child aged three years to less than 16 years, or
• The completed CNA total score for two or more carers of a single child is:
• 70-84.9 for a child aged less than three years, or
• 80-84.9 for a child aged three years to less than 16 years
• The completed CNA scores for two children of a single carer (combined care), or one or two children of a single carer plus a lower ADAT score adult (multiple care) are 80-84.9 for any child less than 16 years

Did any of the above occur, resulting in an automatic referral being created?

• Yes, and the Service Officer determines that the referral:
• is not required, process the claim, with or without rejection of payment. See Table 3 > Step 4
• is required, see Table 3 > Step 1
• No, go to Step 2

Where the system is unable to deliver a determination (for example, in exchanged care cases with more than one former spouse) as the case may be of a complexity that requires specialist assessment by the CSAT social workers to clarify the care arrangements and to confirm that the arrangements are consistent with the constant care criteria.

Is the case difficult or complex?

• Yes, see Table 3 > Step 1
• No, go to Step 3

Are the circumstances identified by the CNA or the Service Officer as unusual, unique or extreme, where the consequence of not referring could lead to an inappropriate outcome?

• Yes, see Table 3 > Step 1
• No, referral to the CSAT is not required update the Carers CSAT Referrals (CLCRF) screen code 'N' in the Referral Required field. Procedure ends here

It is not the role of the CSAT social worker to provide counselling, support or other social work interventions. If ongoing counselling, support and/or practical assistance are required, the CSAT social worker is to refer the carer to the relevant Service Officer, to a Centrelink Social Worker, Financial Information Service (FIS) or appropriate community support services.

Carer Payment Claims

When a CSAT referral is required for a CP new claim assessment, the referral option within Process Direct must be used to create the referral.

• Place the claim on hold until the assessment and recommendation by CSAT have been completed
• Do not create a referral if the claim would otherwise be rejected for other qualification reasons such as income, assets, residence or where the THP score is 0 or less

Cancellation

• If a referral needs to be cancelled, the Service Officer (a APS5 or above) is required to separately DOC the referral cancellation (with the relevant keyword 'CANCSAT'), and finalise the referral activity
• If the referral has already been started (that is, already assigned a keyword of 'TOCSAT'), the Service Officer must enter the outcome reason of 'Not required' within the referral activity, and choose not to accept the recommendation

Returned report

When the report is returned by CSAT, go to Step 2.

Was the CSAT social worker able to complete the referral?

• Yes, go to Step 3
• No, if the carer did not return the Q164 within 21 days of the date the letter being issued, refer the CP claim back to the Service Officer processing the claim and assess it based on the information provided

Were any changes to the responses for the CNA recommended by the CSAT?

• Yes, go to Step 4
• No, go to Step 5

Review the recommendations in the CSAT social worker report:

• The Service Officer can choose to accept the recommendations in the report. If the Service Officer chooses not to accept the recommendations, they can process the claim, with or without rejection of payment. The Service Officer is to use the reason 'Not required' to complete the referral activity. Note: the 'Type of assessment' is not needed when the outcome is 'Not required'. Go to Step 5
• Changes recommended by the CSAT social worker to any of the carer's responses in the CNA can be updated using the appropriate screens with a source code of 'CST'. Change the 'Information Source' from 'CUS' to 'CST'. Overstrike the relevant responses(s) with the new responses and change the Action to 'I'
• After [Enter] is pressed, a new page will be presented with the latest data displayed and the Information Source of 'CST'. The previous page will display the data sourced from 'CUS'

This process is to apply for changes to provisional or confirmed data.

The Effect Date and Date Signed should not be changed as the CSAT recommendations should apply from the effect date of the CNA.

Before completing the referral activity, make sure the following details are coded on the CLCRF screen

• CSAT recommendation
• outcome date
• recommendation accepted

Finalise the claim and record details on a DOC.

For referrals to CSAT for child terminal reviews, see Terminal illness reviews for Carer Payment (CP) child. Procedure ends here.

Has a referral to CSAT already been made, and returned?

• Yes, see Table 2 > Step 3
• No, go to Step 2

Does carer meet all other qualification criteria for Carer Payment (child) including a Treating Health Professional (THP) score of 'greater than zero'?

• Yes, go to Step 3
• No, continue with the review. Procedure ends here

Specific triggers indicate the need for a referral to a CSAT social worker.

Referrals to the CSAT must be made prior to the decision to cancel CP (child).

Consider whether:

• The CNA score just misses the qualifying rating including where:
• The completed CNA total score for a single carer of a single child is:
  - 70-84.9 for a child aged less than three years, or
  - 80-84.9 for a child aged three years to less than 16 years, or
• The completed CNA total score for two or more carers of a single child is:
  - 70-84.9 for a child aged less than three years, or
  - 80-84.9 for a child aged three years to less than 16 years
• The completed CNA scores for two children of a single carer (combined care), or one or two children of a single carer plus a lower ADAT score adult (multiple care) are 80-84.9 for any child less than 16 years
• The case is difficult or complex
  For example, where the application of the Disability Care Load Assessment (DCLA) is unable to deliver a determination such as exchanged care cases with more than one former partner
• There are circumstances identified as unusual, unique or extreme, where the consequence of not referring could lead to an inappropriate outcome

Is a referral to CSAT social worker required?

• Yes, see Table 2 > Step 1
• No, continue with the review. Procedure ends here

When a CSAT referral is needed for a CP review, the referral option in Customer First must be used to create the referral. Select:

• the Social Work guided procedure
• referral reason - CSAT Processing Team - Specialist Assessment
• referral details - CSAT for care receiver (child)

Place the review on hold to user (HTU) for 28 days awaiting the CSAT recommendation

When the report is returned by CSAT, go to Step 2

Was the CSAT social worker able to complete the referral?

• Yes, go to Step 3
• No, refer back to processing staff to assess based on the information provided

Review the recommendations in the CSAT social worker report. Service Officers can choose to accept the recommendations in the report.

If the Service Officer accepts the recommendations, update the carer's responses in the CNA. Overstrike the relevant response(s) with the new responses.

Finalise the review and record details on a DOC.