EXPLANATORY STATEMENT

Issued by the Authority of the Minister for Ageing

Aged Care Act 1997

Approval of Care Recipients Amendment Principles 2005 (No. 1)

The Aged Care Act 1997 (“the Act”) provides for the funding of aged care services.  Persons who are approved under the Act to provide flexible aged care services are eligible to receive flexible care subsidy payments in respect of the care they provide to approved care recipients.

The purpose of the Approval of Care Recipients Amendment Principles 2005 (No. 1) is to establish eligibility criteria, assessment and approval processes for transition care (a new form of flexible care), as well as circumstances for lapsing of approval. 

Principles made under the Aged Care Act 1997

Subsection 96-1(1) of the Act allows the Minister to make Principles providing for various matters required or permitted by a Part or section of the Act.

Subsection 96-1(2) of the Act provides that any Principles made under subsection 96-1(1) of the Act are disallowable instruments.

The Approval of Care Recipients Principles 1997 (“the Approval of Care Recipients Principles”) is one of the sets of Principles made under the Act.

Context of the Approval of Care Recipients Amendment Principles 2005 (No. 1)

This amendment is to give effect to the commitment by the Government in the 2004-05 Budget to provide up to 2,000 transition care places over three years to help older people make the transition from hospital care, under a new cost-shared model of care with the states and territories.

In this context, transition care refers to a kind of flexible care that is provided to a care recipient at the conclusion of an in-patient hospital episode (after the provision of any necessary acute and subacute care) and in the form of services that are goal-oriented, time-limited and therapy focussed.  The services provided will be those necessary to complete the care recipient’s restorative process, optimise the care recipient’s functional capacity and assist the care recipient, family and carer to make appropriate long-term care arrangements.  It can be provided in either a residential or community setting, and must be in a non-hospital, more home like environment.

A person can be approved under subsection 22-1(1) to receive one of three kinds of care: residential care; community care; or flexible care.

Under section 20-1 of the Act, subsidy can only be paid for the provision of services to approved care recipients.  Under subsection 96-2(5) of the Act, the Secretary may delegate the power to approve a person to receive care under section 22-1 of the Act to members of Aged Care Assessment Teams (ACATs), who are employed by State and Territory governments.  Assessments and approvals for flexible care in the form of transition care will be carried out by Aged Care Assessment Teams (ACATs) in consultation, where necessary, with the hospital geriatric rehabilitation service or members of the multidisciplinary team treating the patient.

Under section 50-1 of the Act, subsidy can only be paid to approved providers who are eligible for flexible care subsidy.  While subparagraph 50-1(b)(ii) refers to a class of people who, under the Flexible Care Subsidy Principles 1997 (“the Flexible Care Subsidy Principles”), do not require approval under Part 2.3 of the Act, no such class of people is specified under the Flexible Care Subsidy Principles for recipients of flexible care in the form of transition care (refer to the Flexible Care Subsidy Amendment Principles 2005 (No. 1)).

Section 21-1 of the Act provides that a person is eligible for approval as a care recipient of flexible care if the person is eligible to receive flexible care according to the requirements of section 21-4 of the Act.  Section 21-4 includes the requirement that, to be eligible, a person must meet any criteria specified in the Approval of Care Recipients Principles. 

The Approval of Care Recipients Amendment Principles 2005 (No. 1) extends the Approval of Care Recipient Principles to include the eligibility criteria for transition care, as well as to specify the entry period for transition care and the conditions under which an approval for transition care would lapse.

Consultation

The parameters of transition care have been developed through a consultation process with State and Territory Government representatives.  All States and Territories were included in a Transition Care Task Group, along with appropriate clinical representatives.   

Regulation impact statement

The Office of Regulation Review (ORR) assessed the proposed amendments and determined that the preparation of a Regulation Impact Statement was not required (ORR ID number 7225).

ATTACHMENT

NOTES ON CLAUSES

Clause 1 provides that the Amending Principles are to be cited as the Approval of Care Recipients Amendment Principles 2005 (No. 1).

Clause 2 provides that the Principles commence on the day that they are registered.

Clause 3 amends the Approval of Care Recipients Principles 1997 as set out in the Schedule.

Schedule 1: Amendments

Item 1 amends the heading of section 5.3 to the plural form “Definitions”.

Item 2 amends section 5.3 to insert definitions of “in-patient hospital episode” and “transition care”. 

“In-patient hospital episode” is defined as having the meaning as given by new section 15.3 of the Flexible Care Subsidy Principles 1997 (“the Flexible Care Subsidy Principles”), as inserted by the Flexible Care Subsidy Amendment Principles 2005 (No. 1). 

“Transition care” has the meaning as set out under new section 15.28 of the Flexible Care Subsidy Principles (as inserted by the Flexible Care Amendment Principles 2005 (No. 1)).

Item 3 inserts a new section (5.7A) into Part 2 of the Approval of Care Recipients Principles dealing with the eligibility of a person to receive flexible care in the form of transition care.

New section 5.7A allows that a person will be eligible for transition care only if assessed under section 22-4 of the Act as satisfying a number of requirements.  These include that the person must be in hospital when assessed and in the concluding stage of an in-patient hospital episode (as defined in section 5.3), which means that the person must be in the concluding stage of any necessary acute and sub-acute care.  Also, the person must be medically stable and have the potential to benefit from the services provided by transition care. 

New section 5.7A also requires that, to be eligible, the person also must have care requirements at least equivalent to those required for a person to be eligible to receive residential care at the low level of care.

Item 4 amends section 5.12 which specifies the purpose of Part 5, Lapsing of approval, to include transition care.  The purpose of Part 5 is now to specify the entry period (the period, following a care recipient’s approval to receive care, within which the recipient must commence receiving care), and circumstances under which a person’s approval lapses for residential care, respite care provided as residential care, and flexible care in the form of transition care.

Item 5 amends section 5.13.  New paragraph 5.13(a) maintains the existing entry period of 12 months, for residential care or respite care provided as residential care (as previously provided by section 5.13).  New paragraph 5.13(b) provides that the entry period for flexible care in the form of transition care is 4 weeks beginning on the day after the person is approved to receive flexible care. 

Item 6 amends subsection 5.14(1) to remove the apparent ambiguity of the current provision and to express the intent behind the provision more clearly.