Aged Care (Amount of flexible care subsidy - multi-purpose services) Determination 2008 (ACA Ch. 3 No. 21/2008)

Administered by Department of Health, Disability and Ageing

Legislation au F2008L02238 Not in force Legislative Instrument

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EXPLANATORY STATEMENT

 

AGED CARE ACT 1997    SUBSECTION 52-1(1)

 

AGED CARE (AMOUNT OF FLEXIBLE CARE SUBSIDY – MULTI-PURPOSE SERVICES) DETERMINATION 2008  

(ACA Ch. 3 No. 21/2008)

 

FLEXIBLE CARE SUBSIDY – MULTI-PURPOSE SERVICES

 

 

Subsection 52-1(1) of the Aged Care Act 1997 (the Act) provides that the Minister for Ageing may determine, in writing, the amount of the flexible care subsidy or a method that must be used to work out the amount of flexible care subsidy. 

 

In accordance with paragraph 52-1(1)(b) of the Act, the Aged Care (Amount of flexible care subsidy – multi-purpose services) Determination 2008 (ACA Ch. 3 No. 21/2008) (the Determination) specifies the method for working out the amount of flexible care subsidy payable to a multi-purpose service (MPS) under section 51-1 of the Act.

 

The Determination applies from 1 July 2008 and, from that date, revokes the Aged Care (Amount of flexible care subsidy – multi-purpose services) Determination 2007 (No. 2) (ACA Ch. 3 No. 23/2007). 

 

An MPS is a flexible care service in rural locations that delivers a number of different forms of aged care, health care and community care.  An MPS is not funded on the same basis as a residential service under the Act.  An MPS is funded on a ‘cashed-out’ basis, that is, allocated places are deemed to be occupied for the purposes of funding.

 

The Determination provides for the total amount of flexible care subsidy payable for an MPS for a day.  This total amount comprises the amount payable for a day in respect of the MPS’s high, low and community care places, and the respite supplement equivalent amount.

 

The amount of subsidy payable to an MPS for high care places is based on:

 

  • a basic subsidy equivalent amount, which is a proportion of Residential Classification Scale RCS3 (currently 98 per cent) with a 7 per cent loading for the Conditional Adjustment Payment (CAP);
  • a concessional resident equivalent amount (regional rates apply);
  • a viability supplement equivalent amount, which is based on a proportion (currently 96 per cent) of the viability supplement payable for residential aged care; and
  • an adjusted subsidy reduction amount (where appropriate), which is based on a proportion (currently 98 per cent) of the adjusted subsidy reduction for residential care.

 

The amount of subsidy payable to MPS for low care places is based on:

 

  • a basic subsidy equivalent amount, which is a proportion of Residential Classification Scale RCS7 (currently 94 per cent) with a 7 per cent loading for the CAP;
  • a concessional resident equivalent amount (regional rates apply); and
  • a viability supplement equivalent amount, which is based on a proportion (currently 96 per cent) of the viability supplement payable for residential aged care.

 

The amount of subsidy payable to MPS in respect of community care places is based on a proportion of the Community Care subsidy (currently 94 per cent). 

 

Section 13 provides for an additional daily amount of community care subsidy to be paid in respect of each community care place allocated to an MPS under the Act if the MPS is in a rural or remote location that has an Accessibility/Remoteness Index of Australia (ARIA) score of more than 3.51.  The Department of Health and Ageing will verify the location of an MPS by reference to the postcode of the suburb or town in which the MPS is located.  Subsection 7(2) of the Determination provides that a moderately accessible location, a remote location and a very remote location (as those terms are defined in the Determination) all have an ARIA score of more than 3.51. 

 

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 Department of Health and Ageing.

 

The additional amount of community care subsidy, if any, payable to an MPS for a day in respect of a community care place is set out in the table in section 13 of the Determination.  The more remote the MPS’s location, the higher the MPS’s ARIA score and the higher the additional amount of community care subsidy payable to the MPS.  This approach reflects the higher costs involved in operating an MPS in rural and remote areas, including the higher costs associated with attracting and retaining staff.  If the ARIA score for an MPS that provides community care is less than 3.52 no additional daily amount of community care subsidy is payable in respect of the MPS.

 

Consultation

 

Many aged care subsidy rates are indexed on 1 July each year.  The index incorporates movements in wage costs and non-wage costs.  The wage costs component is calculated using the annualised dollar figure of the October 2006 Federal Minimum Wage decision of the Australian Fair Pay Commission expressed as a proportion of the (latest available) Average Weekly Ordinary Time Earnings at the time of the AFPC decision.  The non-wage costs index is based on the Consumer Price Index exclusive of the impact of A New Tax System consistent with a whole of government decision.

 

As the indexation of this supplement used an established formula for indexation, no specific consultation with industry was undertaken with respect to making this new determination.


ATTACHMENT

 

NOTES ON CLAUSES

 

Part 1 – Preliminary

 

Clause 1 provides that the title of the determination is the Aged Care (Amount of flexible care subsidy – multi-purpose services) Determination 2008.  It is also known as ACA Ch. 3 No. 21/2008.

 

Clause 2 provides that the determination will commence on 1 July 2008.

 

Clause 3 revokes the previous determination Aged Care (Amount of flexible care subsidy – multi-purpose services) Determination 2007 (No. 2) (ACA Ch. 3 No. 23/2007).

 

Clause 4 makes clear that this determination applies only to flexible care services that are multi-purpose services. 

 

Clause 5 defines certain types of services and categories of service, types of care places, a type of locality classification, and a payment rate.

 

Clauses 6, 7 and 8 set out the criteria for Category A, B and C services.  These criteria relate to location and the volume of beds or places.  Whether or not a multi-purpose service meets the prescribed requirements is based on a points system.

 

The criteria for a Category A service includes criteria in respect of the inability of the multi-purpose service to co-locate with another service, and the types of residents (i.e. whether they are supported, concessional or assisted residents). 

 

The criteria for a Category B or C service include a criterion in respect of the volume of special needs care recipients

 

Clauses 6, 7 and 8 each defines terms that are specific to that clause.

 

Part 2 – Amount of flexible care subsidy

 

Clause 9 sets out a formula for calculating the amount of flexible care subsidy that is payable in respect of a day.

 

Clause 10 sets out the formulae for calculating the amount of flexible care subsidy that is payable in respect of a day for a high care place, for particular types of multi-purpose service,

 

Clause 11 sets out the formula for calculating the amount of flexible care subsidy that is payable in respect of a day for a low care place.

 

Clause 12 provides a table which specifies the amount of respite supplement equivalent amount in respect of a day for the total number of high care and low care allocated.

 

Clause 13 provides a table which specifies the amount of community care subsidy in respect of a day depending on the Accessibility/Remoteness Index of Australia.

Schedule 2 – Concessional resident equivalent amounts

This schedule is provided for the purpose of clauses 10 and 11 of this determination.  The table specifies the concessional resident equivalent amounts in respect of 65 locations.  These amounts are used in calculating applicable amounts for high and low care places.

 

Schedule 3 – Adjusted subsidy reduction multi-purpose services

This schedule is provided for the purpose of clauses 5 and 10 of this determination.  The table specifies the adjusted subsidy reduction factor in respect of 21 multi-purpose service.  These factors are used in calculating applicable amounts for high care places, and in defining an adjusted subsidy reduction multi-purpose service.

 

Schedule 4Viability supplement equivalent amounts

This schedule is provided for the purpose of clauses 5, 6, 7 and 8 of this determination. 

 

Clause 1 of Schedule 4

This clause provides a table that specifies the viability supplement equivalent amounts in respect of 10 degrees of isolation.  These amounts are used for determining whether a multi-purpose service is a Category A service, and in defining a viability supplement equivalent amount.  This clause also defines terms that are used in the table.

 

Clause 2 of Schedule 4

This clause provides a table that specifies the viability supplement equivalent amounts in respect of a range of scores.  These amounts are used for determining whether a multi-purpose service is a Category B service, and in defining a viability supplement equivalent amount. 

 

Clause 3 of Schedule 4

This clause provides a table that specifies the viability supplement equivalent amounts in respect of a range of scores.  These amounts are used for determining whether a multi-purpose service is a Category C service, and in defining a viability supplement equivalent amount. 

Overview

The Aged Care (Amount of flexible care subsidy – multi-purpose services) Determination 2008 (ACA Ch. 3 No. 21/2008) was enacted to establish a method for calculating the amount of flexible care subsidy payable to multi-purpose services (MPS) under the Aged Care Act 1997. This legislation addresses the need for a specific funding method for MPS, which deliver various forms of aged, health, and community care in rural areas and are funded differently from residential services. The determination was introduced by the Commonwealth of Australia, with the primary policy objective being to ensure that the funding for MPS reflects the higher costs involved in operating these services in remote and rural areas. Effective from 1 July 2008, the determination specifies the method for calculating the total amount of flexible care subsidy payable for an MPS for a day, taking into account factors such as the type of care place, the location's Accessibility/Remoteness Index of Australia score, and the viability supplement equivalent amounts.

Scope and Application

The Aged Care (Amount of flexible care subsidy – multi-purpose services) Determination 2008 applies to multi-purpose services (MPS) under the Aged Care Act 1997. It specifically governs the calculation of the flexible care subsidy payable to these services, which are distinct from residential aged care services in that they are funded on a 'cashed-out' basis, meaning allocated places are considered occupied for funding purposes. This Determination is effective from 1 July 2008, replacing the Aged Care (Amount of flexible care subsidy – multi-purpose services) Determination 2007 (No. 2). It applies nationally across Australia, focusing on the method of calculating subsidies for different care levels within MPS, including high care, low care, and community care places, with additional considerations for the accessibility and remoteness of the service location as defined by the Accessibility/Remoteness Index of Australia (ARIA). The Determination outlines specific formulae and criteria for calculating the subsidy amounts, taking into account factors such as the Residential Classification Scale, concessional resident equivalent amounts, and viability supplements, with adjustments made for regional rates and specific service categories. This Determination does not specify exclusions, exemptions, or thresholds but provides detailed schedules for concessional resident equivalent amounts, adjusted subsidy reduction factors, and viability supplement equivalent amounts to aid in calculations.

Key Provisions

The Aged Care (Amount of Flexible Care Subsidy – Multi-Purpose Services) Determination 2008 (ACA Ch. 3 No. 21/2008) provides a method for calculating the amount of flexible care subsidy payable to a multi-purpose service (MPS) under section 51-1 of the Aged Care Act 1997. The Determination applies from 1 July 2008, replacing the 2007 version (ACA Ch. 3 No. 23/2007). It specifies how the subsidy is calculated for high care, low care, and community care places in MPS, taking into account factors like the Residential Classification Scale, concessional resident equivalent amounts, viability supplement equivalent amounts, and adjusted subsidy reductions. Additionally, it includes an adjustment for the Accessibility/Remoteness Index of Australia (ARIA) to account for the higher operational costs in more remote areas. The Act imposes several obligations on the parties it governs, including the requirement for the Department of Health and Ageing to verify the location of an MPS by reference to the postcode of the suburb or town. The Determination also mandates that multi-purpose services meet specific criteria to qualify for the subsidy, based on location and volume of care places. These criteria are detailed in Clauses 6, 7, and 8 and involve a points system to determine if a service is eligible for the subsidy. Furthermore, the Act requires that the subsidy rates be indexed annually, incorporating movements in wage costs and non-wage costs. There are no explicit offences, penalties, or civil/criminal consequences outlined in the Determination for breach. However, the failure to comply with the criteria and requirements set out in the Determination may result in the non-payment of the flexible care subsidy. This could lead to financial implications for the multi-purpose services, as they would not receive the full subsidy amount if they do not meet the specified conditions. The Determination emphasizes the importance of adhering to the prescribed criteria and processes to ensure the appropriate distribution of subsidies.

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