Approval of Care Recipients Amendment Principles 2005 (No. 2)

Administered by Department of Health, Disability and Ageing

Legislation au F2005L03477 Not in force Legislative Instrument

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EXPLANATORY STATEMENT

 

Issued by the authority of the Minister for Ageing

 

Aged Care Act 1997

 

Approval of Care Recipients Principles 1997.

 

 

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 can be eligible to receive flexible care subsidy payments in respect of the care they provide to approved care recipients.

 

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 (“the Principles”) are one of the sets of Principles made under the Act.

 

Section 21-4 of the Act provides that a person is eligible to receive flexible care if:

(a) the person has physical, social or psychological needs that require the provision of care;

(b) those needs can be met appropriately through flexible care services; and

(c) the person meets the criteria specified in the Approval of Care Recipients Principles.

 

Context of the Approval of Care Recipient Amendment Principles 2005 (No. 2)

 

The effect of the Approval of Care Recipient Amendment Principles 2005 (No. 2) (the Amending Principles) is to establish eligibility criteria to be used in the assessment of people requiring Extended Aged Care at Home – Dementia.

 

A person is only eligible to receive flexible care in the form of extended aged care at home – dementia, if the person:

(a) is assessed as having behavioural dysfunction associated with dementia;

(b) has complex care needs because of behavioural dysfunction associated with

     Dementia;

(c) is assessed under section 22-4 of the Act as requiring a high level of residential care;

(d) prefers to receive extended aged care at home – dementia; and

(e) is able to live at home with the support of extended aged care at home – dementia.

 

The Australian Government introduced the Extended Aged Care at Home (EACH) program, to provide high level care at home and to prevent people from unnecessarily entering residential care.  The EACH Dementia places announced in the 2005 Budget provide 2000 new EACH places dedicated to helping people with dementia.  Currently around 185,000 Australian are affected by dementia. These new places will enable many more Australians with dementia to remain in familiar surroundings at home and in their community.

The amendments will allow the 2000 EACH Dementia places to be implemented and delivered.  EACH provides high level care comparable to nursing home care, but delivered to people in their own home.  Care is coordinated and tailored to meet the individual needs of each person.  About one third of existing EACH clients have dementia.  These Principles will allow approved aged care providers to deliver dementia specific care to people in their own homes and providers will receive a subsidy in payment for the EACH Dementia services provided.  This expansion of EACH will allow many more people with dementia to stay at home in familiar surroundings rather than entering an aged care home.

 

In determining eligibility for services Aged Care Assessment Teams (ACATs) consider an individual’s medical history, through observation, carers input, possible consultation with the client’s GP and the application of appropriate tools.  Within their current operational framework ACAT assessors have the necessary skills and training to identify a person presenting with the signs and symptoms, including behavioural dysfunction associated with dementia.  ACATs will act as the gatekeeper in identifying care recipients who are eligible to receive EACH Dementia packages.  A person will have to be assessed by an ACAT as requiring both flexible care and a high level of residential care under section 22-4 of the Act.  The amendments allow for a person to receive flexible care in the form of EACH Dementia providing they have been assessed under section 22-4 of the Act and have met the other criteria detailed in the amendments.

 

Consultation

 

The Department has consulted with the Minister’s Dementia Implementation Task Force.  In addition, feedback from the National Dementia Research Workshop held in Melbourne on   29 August 2005, attended by 140 academics and researchers was considered in developing the amendments. The advice and feedback received from these experts considered that EACH Dementia packages are best targeted to people with behaviour dysfunction associated with dementia, as this is often a level of need that requires additional care and service strategies for appropriate management.

 

The Office of Regulation Review has advised that no Regulation Impact Statement is required for the Amending Principles.

 

The Amending Principles are a “legislative instrument” for the purpose of the Legislative Instrument Act 2003.

 

Details of the Amending Principles are set out in the Attachment.

 


                                                                                                                                  Attachment

 

NOTES ON CLAUSES

 

Clause 1 provides that the Amending Principles are to be cited as the Approval of Care Recipient Amendment Principles 2005 (No. 2).

 

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

 

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

      

Schedule 2 Amendments

 

Item 1 inserts in section 5.7AA (1) the words in section “(other than care to which section 5.7AA applies)” to emphasise that extended aged care at home - dementia is another type of flexible care that eligible care recipients are able to access.

 

Item 2 inserts a new section 5.7AA (1) and (2) and describes the eligibility criteria for a person to received extended aged care at home – dementia care.

 

Section 5.7AA (1) identifies the eligibility criteria for a person to receive “extended aged care at home – dementia.”  The criteria requires that a person be assessed as having behavioural dysfunction associated with dementia and is assessed under 22-4 of the Act as requiring a high level of residential care.  The person must also have complex care needs because of behavioural dysfunction associated with dementia, and prefers to receive care in the home.

 

The new section 5.7AA(2) provides a reference to section 5.6(2) of these Principles which defines the meaning of complex care needs and to section 15.8  of the Flexible Care Subsidy Principles 1997 which provides the definition of EACH Dementia.

 

 

 

Overview

The Approval of Care Recipient Amendment Principles 2005 (No. 2) was enacted to address the need for additional care and service strategies for individuals with dementia, particularly those experiencing behavioural dysfunction. This legislative instrument amends the Approval of Care Recipients Principles under the Aged Care Act 1997, establishing specific eligibility criteria for individuals requiring extended aged care at home specifically tailored for dementia care. The policy objective of the amendment is to provide high-level care at home, preventing unnecessary residential care placements and enabling more Australians with dementia to remain in their homes. The Australian Government introduced the Extended Aged Care at Home (EACH) program, with a focus on dementia care, allocating 2000 new places dedicated to this purpose. Aged Care Assessment Teams (ACATs) will assess eligibility based on an individual’s medical history and the necessity for high-level residential care, ensuring that those who qualify can receive tailored dementia care in their own homes. This amendment reflects the government’s commitment to addressing the growing need for dementia care services within the community.

Scope and Application

The Aged Care Act 1997 and its accompanying Approval of Care Recipients Principles 1997 establish the framework for the funding and provision of aged care services in Australia, with specific provisions for flexible care services. The Act applies to individuals and entities providing or receiving aged care services, particularly those eligible for flexible care subsidy payments under the Act. The geographic reach of the Act is national, as it is a Commonwealth Act. The Approval of Care Recipient Amendment Principles 2005 (No. 2) further refine eligibility criteria for receiving extended aged care at home for individuals with dementia, detailing specific conditions such as the need for a high level of residential care and the presence of behavioural dysfunction associated with dementia. These amendments are designed to expand the Extended Aged Care at Home (EACH) program, specifically targeting individuals with dementia to enable them to receive high-level care in their own homes, thus preventing unnecessary admissions to residential care facilities. The Act allows for further specification and expansion of its provisions through subordinate instruments, such as the Amending Principles, which are subject to disallowance by Parliament.

Key Provisions

The Approval of Care Recipient Amendment Principles 2005 (No. 2) introduces specific criteria for eligibility to receive extended aged care at home – dementia under the Aged Care Act 1997 (the Act). The Act itself, particularly section 21-4, states that a person is eligible for flexible care if they have physical, social, or psychological needs that require care, these needs can be met appropriately through flexible care services, and the person meets the criteria specified in the Approval of Care Recipients Principles. The Amending Principles, as outlined in the Schedule, set out the criteria for extended aged care at home – dementia. These include being assessed as having behavioural dysfunction associated with dementia, having complex care needs due to this dysfunction, requiring a high level of residential care as per section 22-4 of the Act, preferring to receive care at home, and being able to live at home with the support of extended aged care at home – dementia. The obligations under these Amending Principles are specific to the provision of extended aged care at home – dementia. Aged Care Assessment Teams (ACATs) are responsible for assessing individuals based on the criteria specified in the Principles. This involves evaluating medical history, observing the individual, gathering input from carers, consulting with the individual's GP, and applying appropriate assessment tools. ACATs act as gatekeepers, ensuring that only those who meet the eligibility criteria under section 5.7AA of the Amending Principles are approved for the services. The approved aged care providers are then required to deliver the dementia-specific care as per the assessment and receive a subsidy payment for the services provided. The Amending Principles establish specific consequences for breaches related to the eligibility criteria and the provision of extended aged care at home – dementia. While the explanatory statement does not explicitly detail penalties for non-compliance, it is reasonable to infer that breaches of the Act’s provisions, such as providing services to ineligible individuals, could result in civil or criminal penalties. The Aged Care Act 1997 provides for enforcement actions, including fines and other penalties, for non-compliance with the Act’s requirements. The specifics of penalties are not detailed in the explanatory statement but would be in line with the general enforcement mechanisms provided by the Act.

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