EXPLANATORY STATEMENT
Issued by the authority of the Minister for Ageing
Aged Care Act 1997
Aged Care (Residential care subsidy – amount of
accommodation charge top-up supplement) Determination 2008
The Aged Care Act 1997 (the Act) provides for the funding of aged care services. Persons who are approved under the Act to provide residential aged care services (approved providers) can be eligible to receive residential care subsidy payments in respect of the care they provide to approved care recipients.
Subsection 44-16(1) of the Act provides that the Residential Care Subsidy Principles 1997 (the Principles) may provide for additional primary supplements.
Section 21.25D of the Principles describes the ‘accommodation charge top-up supplement (ACTUS), which is an additional primary supplement. The section also describes the circumstances in which the ACTUS is payable.
Certain residents who receive an income support payment have their accommodation charges capped under subsection 23.81P(6) of the User Rights Principles 1997 at a lower rate than that for residents who do not receive an income support payment.
These residents are post-2008 reform residents who entered care (or re-entered care with a break in residential care as defined in subsection 44-5D(2) of the Act of more than 28 days) after 19 March 2008 and before 20 September 2008. For those residents who are re-entering care after 19 March 2008, they must also have first entered a residential care service for the provision of residential care (other than respite care) after 30 June 2004.
These residents are paying less in accommodation charges than the applicable maximum rate set out in step 1 in section 4 of the Aged Care (Residential care subsidy – amount of accommodation supplement) Determination 2008. Depending on the resident’s assets, the accommodation supplement will go some way (and in some cases, all the way) towards making up this gap. However, in some cases the accommodation supplement will not equal the gap between the applicable maximum rate and the maximum daily accommodation charge that can be paid by the resident. The ACTUS seeks to remove any potential disadvantage to approved providers who are providing care to these residents by paying the provider the ACTUS.
Subsection 44-16(3) of the Act provides that the Minister may determine in writing the amount of additional primary supplements or the way in which the amount of the supplement is to be worked out.
The ACTUS is equal to the applicable maximum rate, less the amount of accommodation supplement paid for the care recipient for the day, less $19.56 (which is the maximum daily accommodation charge set out in subsection 23.81P(6) of the User Rights Principles 1997). In many cases, because of the assets of the care recipient, this amount will be negative. In this case, subsection 4(2) of the Determination provides that the ACTUS will be $0.00. In the remainder, the ACTUS, when added to the maximum daily accommodation charge payable by the resident and the accommodation supplement, will equal the applicable maximum rate.
This Determination is a legislative instrument for the purposes of the Legislative Instruments Act 2003.
Overview
The Aged Care (Residential care subsidy – amount of accommodation charge top-up supplement) Determination 2008 was enacted to address a gap identified within the Aged Care Act 1997. Specifically, it targets the issue of providing equitable funding to approved providers who are responsible for the care of certain residents whose accommodation charges are capped at a lower rate due to their receipt of income support payments. The problem this legislation addresses is the potential financial disadvantage to providers caused by the lower accommodation charges for these residents, which can result in a shortfall when compared to the applicable maximum rates set out in the Act.
The Aged Care (Residential care subsidy – amount of accommodation charge top-up supplement) Determination 2008 was issued under the authority of the Minister for Ageing, aiming to ensure that approved providers do not face a financial disadvantage when providing care to residents whose accommodation charges are capped. The policy objective, as stated, is to provide an additional primary supplement, known as the accommodation charge top-up supplement (ACTUS), to cover the difference between the applicable maximum rate and the amount paid by the resident, thereby maintaining the financial viability of residential care services. This legislative instrument was created in accordance with the Legislative Instruments Act 2003.
Scope and Application
The Aged Care (Residential Care Subsidy – Amount of Accommodation Charge Top-Up Supplement) Determination 2008 applies under the Aged Care Act 1997 to approved providers who are delivering residential aged care services, and is concerned with the payment of the accommodation charge top-up supplement (ACTUS) to these providers. The ACTUS is intended to compensate approved providers for the shortfall in accommodation charges paid by certain post-2008 reform residents who receive an income support payment and whose accommodation charges are capped at a lower rate. The Determination outlines the formula for calculating the ACTUS, which is based on the applicable maximum rate, less the accommodation supplement, less the maximum daily accommodation charge. The ACTUS is applicable nationally across Australia as it is a legislative instrument made under the Legislative Instruments Act 2003. The Determination provides specific exclusions and thresholds, such as the requirement for residents to have entered or re-entered care after specific dates, and the stipulation that the ACTUS will be $0.00 if the calculation results in a negative amount. The application and interpretation of this Determination may be further refined through subordinate instruments as authorised by the Act.
Key Provisions
The Aged Care (Residential Care Subsidy – Amount of Accommodation Charge Top-Up Supplement) Determination 2008 outlines specific provisions concerning the accommodation charge top-up supplement (ACTUS) under the Aged Care Act 1997. The determination, which is made under subsection 44-16(3) of the Act, defines the ACTUS as a financial supplement intended to ensure that approved residential care providers do not suffer any financial disadvantage when providing care to certain residents. These residents include those who have their accommodation charges capped at a lower rate than other residents due to receiving income support payments. Specifically, they are post-2008 reform residents who entered care between 19 March 2008 and 20 September 2008, or who re-entered care after 19 March 2008 with a break of more than 28 days. This group also includes those who first entered care after 30 June 2004.
The ACTUS is calculated to be equal to the applicable maximum rate, less the amount of accommodation supplement paid for the care recipient for the day, minus $19.56, which is the maximum daily accommodation charge set out in the User Rights Principles 1997. However, if this calculation results in a negative amount, the ACTUS is set to $0.00, as specified in subsection 4(2) of the Determination. The purpose of this supplement is to ensure that the total amount paid to the provider, when combined with the maximum daily accommodation charge and the accommodation supplement, equals the applicable maximum rate. This helps maintain the financial viability of residential care services for these specific residents.
Under this Act, approved providers who offer residential aged care services have certain obligations. They must adhere to the prescribed calculation method for the ACTUS to ensure they receive the correct amount of financial support for the care they provide. Furthermore, they must comply with the determination's stipulations regarding the payment of the accommodation charge top-up supplement, ensuring that it is correctly factored into their subsidy payments. Failure to comply with these provisions could result in discrepancies in the funding they receive for the care provided to eligible residents.
There are no explicit offences, penalties, or consequences mentioned in the Determination for non-compliance with the provisions concerning the ACTUS. However, the overarching Aged Care Act 1997 does provide for various penalties for breaches of its provisions. For example, approved providers who fail to comply with the Act's requirements could face administrative penalties, financial penalties, or even the suspension or cancellation of their approval to provide residential care services. The specific penalties would depend on the nature and severity of the breach, as outlined in the broader legislative framework.