EXPLANATORY STATEMENT
Issued by the authority of the Minister for Ageing
AGED CARE ACT 1997
Determination under Subsection48-1(3)
Aged Care (Community Care Subsidy Amount) Determination 2009 (No. 1)
Subsection 48-1(3) of the Aged Care Act 1997 (the Act) provides that the amount of community care subsidy that is payable to an approved provider in respect of a day is the amount determined by the Minister by legislative instrument; or worked out in accordance with a method determined by the Minister by legislative instrument.
In accordance with paragraph 48-1(3)(b) of the Act, the Determination of the amount of Community Care Subsidy under subsection 48-1(3) (the Determination) specifies the method for working out the amount of community care subsidy payable under section 47-1 of the Act for a day in respect of a community care recipient.
The Determination applies from 1 July 2009 and, from that date, revokes the Determination of the amount of Community Care Subsidy under subsection 48-1(3) (ACA Ch. 3 No. 18/2008).
Clause 5 sets out the amount of Community Care Subsidy payable under section 47-1 of the Act for in respect of a community care recipient in respect of a day.
Subclause 5(a) states the amount of the basic subsidy
Subclause 5(b) provides for an additional daily amount of community care subsidy to be paid to an approved provider of community care who provides community care to a care recipient who resides in rural and remote locations, 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 community care recipient’s residential location, the higher the ARIA score for that location and the higher the amount of additional community care subsidy payable to the approved provider in respect of that care recipient. This approach reflects the higher costs involved in operating community care aged services in rural and remote areas, including the higher costs associated with attracting and retaining staff.
If the ARIA score for a community care recipient’s residential location is less than 3.52 no additional daily amount of community care subsidy is payable in respect of the care recipient and the amount of community care subsidy payable in respect of the care recipient is $35.41 (as specified in Step 2).
However, where the ARIA score for a community care recipient’s residential location is 3.52 or more, the table in Step 1 (and the Determination) sets out the additional daily amount that is payable in respect of that care recipient. The additional daily amount set out in the table in Step 1 is added to the basic daily amount of community care subsidy, which the Determination specifies is $35.41.
Approved providers who are eligible to receive an additional amount of community care subsidy in respect of a community care recipient will receive the additional amount of subsidy through Medicare Australia’s payment systems.
Consultation
As the indexation of the subsidy uses well established formula based on the Consumer Price Index and Wage Cost Index 9, and is in accordance with policy upon which extensive consultation was undertaken, no specific consultation was undertaken with respect to this instrument.
Information about the increase in the amount of the subsidy will be disseminated via print and electronic media to approved providers.
Overview
The Aged Care (Community Care Subsidy Amount) Determination 2009 (No. 1) was enacted to specify the method for calculating the amount of community care subsidy payable under the Aged Care Act 1997 for a day in respect of a community care recipient, as mandated by subsection 48-1(3) of the Act. This legislative instrument was introduced to ensure a structured approach to the payment of subsidies to approved providers of community care, reflecting the varied costs associated with providing care in different locations. The determination came into effect on 1 July 2009, replacing the previous determination issued under the same subsection.
The policy objective of this Determination is to provide a fair and equitable subsidy system that takes into account the additional costs of providing community care in rural and remote areas. This is achieved by incorporating the Accessibility/Remoteness Index of Australia (ARIA) scores, which quantify the remoteness of a care recipient's location. A higher ARIA score indicates greater remoteness and higher operating costs for providers, thus warranting a higher subsidy. The basic daily amount of community care subsidy is set at $35.41, with an additional amount payable for care recipients in locations with an ARIA score of 3.52 or more. The information about these subsidy amounts will be disseminated to approved providers through various media to ensure transparency and compliance.
Scope and Application
The Aged Care (Community Care Subsidy Amount) Determination 2009 (No. 1) applies to approved providers of community care under the Aged Care Act 1997, specifically concerning the calculation and payment of community care subsidies for care recipients. The Determination sets out the method for calculating the amount of community care subsidy payable for a day in respect of a community care recipient, effective from 1 July 2009. It revokes the previous determination and introduces a new calculation that includes a basic subsidy amount and an additional subsidy for care recipients residing in rural and remote areas, as identified by an Accessibility/Remoteness Index of Australia (ARIA) score of 3.52 or more. The Determination ensures that approved providers are compensated appropriately for the higher operational costs associated with providing community care services in less accessible locations. The amount of subsidy payable is determined through Medicare Australia’s payment systems.
Key Provisions
The main provisions of the Aged Care (Community Care Subsidy Amount) Determination 2009 (No. 1) (the Determination) establish the method for calculating the amount of community care subsidy payable under the Aged Care Act 1997 (the Act). According to subsection 48-1(3) of the Act, the Minister is responsible for determining the amount of community care subsidy payable to an approved provider in respect of a day. The Determination, under subsection 48-1(3)(b), specifies the method for calculating the amount of community care subsidy payable for a day in respect of a community care recipient. The Determination applies from 1 July 2009, revoking the previous Determination of the amount of Community Care Subsidy under subsection 48-1(3) (ACA Ch. 3 No. 18/2008).
Under clause 5 of the Determination, the amount of community care subsidy payable under section 47-1 of the Act is specified for a day in respect of a community care recipient. Subclause 5(a) details the basic daily amount of community care subsidy, which is $35.41. Subclause 5(b) provides for an additional daily amount of community care subsidy to be paid to an approved provider of community care if the care recipient resides in a rural or remote location with an Accessibility/Remoteness Index of Australia (ARIA) score of 3.52 or more. The ARIA score is used to determine the remoteness of the location, with higher scores indicating more remote areas. The additional daily amount is intended to reflect the higher costs associated with providing community care services in rural and remote areas.
The Determination imposes obligations on approved providers of community care to accurately calculate and claim the community care subsidy in accordance with the specified method. Approved providers must verify the location of the care recipient by reference to the postcode of the suburb or town in which the care recipient resides. The Department of Health and Ageing will verify the ARIA score of the care recipient’s residential location to determine the applicable subsidy amount. If the ARIA score is less than 3.52, no additional daily amount of community care subsidy is payable, and the amount of community care subsidy payable is $35.41. If the ARIA score is 3.52 or more, the additional daily amount specified in the Determination is added to the basic daily amount of community care subsidy.
Breach of the obligations and requirements under the Determination may lead to civil or criminal consequences. Although the Determination does not specify particular offences or penalties, any breach of the Aged Care Act 1997 may result in penalties under the Act. The Act provides for both civil and criminal penalties for breaches, with maximum penalties depending on the nature and severity of the breach. Approved providers who fail to accurately calculate and claim the community care subsidy may be subject to fines, corrective action, or other penalties as determined by the relevant authorities. The Act also allows for legal action to be taken against individuals or entities that breach the provisions of the Act.