EXPLANATORY STATEMENT
AGED CARE ACT 1997
SUBSECTION 52-1(1)
Determination of the amount of Flexible Care Subsidy for flexible care provided in the form of Extended Aged Care at Home - Dementia (EACHD) (ACA Ch. 3 No. 3/2007).
Extended Aged Care at Home - Dementia (EACHD) is a flexible care program in respect of which flexible care subsidy is payable. EACHD provides nursing and personal care services and dementia specific strategies to an aged care recipient in the care recipient’s home where the care recipient would otherwise be eligible for high level residential care.
Subsection 52-1(1) of the Aged Care Act 1997 (the Act) provides that the amount of flexible care subsidy that is payable in respect of a day is the amount:
(a) determined by the Minister in writing; or
(b) worked out in accordance with a method determined by the Minister in writing.
In accordance with paragraph 52-1(1)(b) of the Act, the Determination under subsection 52-1(1) of the amount of flexible care subsidy for flexible care provided in the form of Extended Aged Care at Home - Dementia (ACA Ch. 3 No. (ACA Ch. 3 No. 3/2007) (the Determination) specifies the method for working out the amount of flexible care subsidy payable under section 51-1 of the Act for a day in respect of an EACHD care recipient.
The Determination applies from 1 January 2007 and, from that date, revokes the Determination made under section 52-1 for flexible care subsidy in respect of Extended Aged Care at Home - Dementia (ACA Ch. 3 No. 14/2006) which was made on 28 June 2006.
Steps 1 to 3 of the Determination require an EACHD care recipient to be treated as if he or she were a residential care recipient for the purposes of working out the base amount of flexible care subsidy payable for a day in respect of the EACHD care recipient. Step 1 of the Determination states that the base amount of flexible care subsidy payable for a day in respect of an EACHD care recipient is an amount equal to the amount of residential care subsidy payable for a care recipient who is classified at the Category 1 Level in the Resident Classification Scale (classification level RCS 1), assuming that the residential care is not respite care.
Steps 2 and 3 of the Determination provide that if the oxygen supplement payable under section 44-13 and/or the enteral feeding supplement payable under section 44-14 would have been payable in respect of the EACHD care recipient if he or she was receiving residential care, an amount equivalent to each applicable supplement is added to the amount calculated under Step 1.
This method of working out the base amount of flexible care subsidy payable for a day in respect of an EACHD care recipient has been in place since EACHD was established as a flexible care program and has been clarified, but has not been substantially altered, the Determination.
Step 4 of the Determination is a new provision. Step 4 provides for an additional daily amount of flexible care subsidy to be paid to an approved provider who provides EACHD to a care recipient in rural and remote location, provided that location has an Accessibility/Remoteness Index of Australia (ARIA) score of 3.52 or more.
Under the ARIA, each suburb and town in Australia is allocated an ARIA score based on its accessibility and remoteness. ARIA scores for all Australian locations are contained in the document entitled Viability Funding — ARIA scores for locations as at 30 July 1999, published by the Commonwealth Department of Health and Ageing. The Department will verify the location of a care recipient by reference to the postcode of the suburb or town in which the care recipient resides.
The more remote the EACHD care recipient’s residential location, the higher the ARIA score for that location and the higher the amount of the additional flexible care subsidy payable to the approved provider in respect of that care recipient. This approach reflects the higher costs involved in operating EACHD care services in rural and remote areas, including the higher costs associated with attracting and retaining staff.
If the ARIA score for an EACHD care recipient’s residential location is less than 3.52 no additional daily amount of flexible care subsidy is payable in respect of the EACHD care recipient. However, where the ARIA score for an EACHD care recipient’s residential location is 3.52 or more, the table in Step 4 of the Determination sets out the additional daily amount that is payable in respect of that care recipient.
Approved providers who are eligible to receive an additional amount of flexible care subsidy in respect of an EACHD care recipient will receive the additional amount through Medicare Australia’s payment systems.
The amount of flexible care subsidy payable in respect of EACHD is indexed on 1 July each year. As part of this process, the additional amount of flexible care subsidy payable in respect of an EACHD care recipient will also be indexed.
The Determination is a “legislative instrument” for the purposes of the Legislative Instruments Act 2003. As the Determination clarifies the current method of calculating the flexible care subsidy payable in respect of an EACHD care recipient and provides a new and additional amount of flexible care subsidy to providers of EACHD in rural and remote areas, it does not adversely affect the rights of, or impose liabilities on, any person. As such, the Determination does not contravene the rule against retrospectivity in subsection 12(2) of the Legislative Instruments Act 2003.
Consultation
In relation to the additional amount of flexible care subsidy for EACHD, an external reference group consisting of representatives from five peak body organizations, that deliver rural and remote aged care programs was established. Consultation with this reference group was integral to the development of the eligibility criteria for the payment of the additional amount of flexible care subsidy for EACHD and the additional amounts payable.
No other consultation with industry was undertaken in relation to the remainder of the Determination because the remainder of the Determination is substantially the same as determination ACA Ch. 3 No. 14/2006, which is replaced by the Determination.