Approval of Care Recipients Principles 1997

Approval of Care Recipients Principles 1997

as amended

made under subsection 96-1(1) of the

Aged Care Act 1997

Compilation start date:   1 August 2013

Includes amendments up to: Approval of Care Recipients Amendment (Home Care) Principle 2013

About this compilation

The compiled Act

This is a compilation of the Approval of Care Recipients Principles 1997 as amended and in force on 1 August 2013. It includes any amendment affecting the compiled Act to that date.

This compilation was prepared on 1 August 2013.

The notes at the end of this compilation (the endnotes) include information about amending Acts and instruments and the amendment history of each amended provision.

Uncommenced provisions and amendments

If a provision of the compiled Act is affected by an uncommenced amendment, the text of the uncommenced amendment is set out in the endnotes.

Application, saving and transitional provisions for amendments

If the operation of an amendment is affected by an application, saving or transitional provision, the provision is identified in the endnotes.

Modifications

If a provision of the compiled Act is affected by a textual modification that is in force, the text of the modifying provision is set out in the endnotes.

Provisions ceasing to have effect

If a provision of the compiled Act has expired or otherwise ceased to have effect in accordance with a provision of the Act, details of the provision are set out in the endnotes.

Contents

Part 1—Preliminary

5.1 Citation

5.2 Commencement

5.3 Definitions

Part 2—Eligibility to receive care

5.4 Purpose of Part (Act, ss 21‑2, 21‑3 and 21‑4)

5.5 Residential care

5.6 Home care—levels 1 and 2

5.7 Home care—levels 3 and 4

5.7A Flexible care—transition care

Part 3—Limitation of approvals

5.8 Purpose of Part (Act, s 22‑2)

5.9 Residential care

5.9A Home care

Part 4—Date of effect of approval

5.10 Purpose of Part (Act, s 22‑5)

5.11 The Secretary’s satisfaction

Part 5—Lapsing of approval

5.12 Purpose of Part (Act s 23‑3)

5.13 Entry period—flexible care in the form of transition care

5.13A Entry period—home care

5.14 Circumstances

Part 6—Transitional provisions

5.15 Definitions for Part 6

5.16 Approval to receive flexible care

5.17 Approval to receive community care

Endnotes

Endnote 1—Legislation history

Endnote 2—Amendment history

Endnote 3—Uncommenced amendments [none]

Endnote 4—Misdescribed amendments [none]

Note:  Part 2.3 of the Aged Care Act 1997

Part 1—Preliminary

5.1  Citation

  These Principles may be cited as the Approval of Care Recipients Principles 1997.

5.2  Commencement

  These Principles commence on 1 October 1997.

5.3  Definitions

  In these Principles:

Act means the Aged Care Act 1997.

in‑patient hospital episode has the meaning given by section 15.3 of the Flexible Care Subsidy Principles 1997.

lapsing period, for an approval of a person as a recipient of aged care, means the period that applies to the person’s approval under subsection 23‑3 (1) of the Act.

transition care has the meaning given by section 15.28 of the Flexible Care Subsidy Principles 1997.

Note: A number of expressions used in these Principles are defined in the Act, including the following:

(a) flexible care;

(b) high level of residential care;

(c) home care;

(d) low level of residential care;

(e) respite care.

Part 2—Eligibility to receive care

5.5  Residential care

 (1) A person is eligible to receive residential care only if:

 (a) the person is assessed as:

 (i) having a condition of frailty or disability requiring at least low level continuing personal care; and

 (ii) being incapable of living in the community without support; and

 (iii) meeting any other eligibility criteria for the level of care assessed for the person that are set out in the classification level applicable under the Classification Principles 1997; and

 (b) for a person who is not an aged person—there are no other care facilities or care services more appropriate to meet the person’s needs.

 (2) In deciding if the criteria mentioned in subsection (1) are met, the Secretary must consider the person’s medical, physical, psychological and social circumstances, including (if relevant):

 (a) evidence of medical condition, as decided by suitably qualified medical personnel;

 (b) evidence of absence or loss of physical functions, as established by assessment of capacity to perform daily living tasks;

 (c) evidence of absence or loss of cognitive functioning, as established by:

 (i) a medical diagnosis of dementia or other condition; or

 (ii) assessment of capacity to perform daily living tasks; or

 (iii) evidence of behavioural dysfunction;

 (d) evidence of absence or loss of social functioning, as established by:

 (i) using information provided by the person, a carer, family, friends and others; or

 (ii) assessment of capacity to perform daily living tasks;

 (e) evidence that the person’s life or health would be at significant risk if the person did not receive residential care.

5.6  Home care—levels 1 and 2

  A person is eligible to receive home care at level 1 or level 2 only if the person:

 (a) is assessed as having needs that can only be met by a coordinated package of care services; and

 (b) would be assessed, if the person applied for residential care, as eligible to receive at least a low level of residential care; and

 (c) prefers to remain living at home; and

 (d) is able to live at home with the support of home care at level 1 or level 2.

5.7  Home care—levels 3 and 4

  A person is eligible to receive home care at level 3 or level 4 only if the person:

 (a) is assessed as having needs that can only be met by a coordinated package of care services; and

 (b) would be assessed, if the person applied for residential care, as eligible to receive residential care that is not limited to a low level of residential care; and

 (c) prefers to remain living at home; and

 (d) is able to live at home with the support of home care at level 3 or level 4.

5.7A  Flexible care—transition care

  A person is eligible to receive flexible care in the form of transition care only if the person:

 (a) is assessed under section 22‑4 of the Act as satisfying the following requirements:

 (i) the person is in the concluding stage of an in‑patient hospital episode;

 (ii) the person is medically stable;

 (iii) the person has the potential to benefit from transition care; and

 (b) is in hospital at the time the assessment is undertaken; and

 (c) would be assessed, if the person applied for residential care, as eligible to receive residential care at least at a low level of residential care.

Part 3—Limitation of approvals

5.9  Residential care

 (1) Approval may be limited to receipt of a high or low level of residential care for a person as a recipient of:

 (a) residential care that does not include respite care provided as residential care; or

 (b) residential care and respite care provided as residential care; or

 (c) respite care provided as residential care.

 (2) However, if the person is approved as a recipient of a high level of residential care, the limitation of the approval does not prevent the person receiving residential care at any classification level.

 (3) Approval of a person as a recipient of residential care may be limited to respite care if respite care is appropriate to the needs of the person, the person’s carer or both.

5.9A  Home care

 (1) Approval may be limited to one of the following levels of home care:

 (a) level 1 (basic care package);

 (b) level 2 (low care package);

 (c) level 3 (intermediate care package);

 (d) level 4 (high care package);

where level 4 is the highest level of home care and level 1 is the lowest.

 (2) However, if a person is approved as a recipient of a particular level of home care, the limitation of approval to that level does not prevent the person receiving home care at a lower level.

Part 4—Date of effect of approval

5.11  The Secretary’s satisfaction

  The Secretary may be satisfied that a person urgently needed the care when it started if an emergency existed at that time.

Part 5—Lapsing of approval

5.13  Entry period—flexible care in the form of transition care

  For paragraph 23‑3(1)(a) of the Act, the entry period for an approval of a person as a recipient of flexible care in the form of transition care is 4 weeks beginning on the day after the approval is given under subsection 22‑1(2) of the Act.

5.13A  Entry period—home care

  For paragraph 23‑3(1)(a) of the Act, the entry period for a person who is approved as a recipient of home care under subsection 22‑1(2) of the Act is 2 years and one day beginning on the day after the approval was given.

5.14  Circumstances

 (1) For subsection 23‑3(3) of the Act, an approval of a person as a recipient of residential care that is limited to a low level of residential care or flexible care in the form of transition care lapses if the person is not provided, for a period of at least 1 day after the lapsing period for the person’s approval ends, with the care to which the person’s approval relates.

 (2) For subsection (1), if a care recipient:

 (a) ceases being provided with residential care (other than because the care recipient is on leave); and

 (b) enters a residential care service within the period of 28 days after the day on which the care recipient ceased being provided with care as mentioned in paragraph (a);

any day within that period is to be disregarded.

Note: For a person who is on leave from a residential care service, see subsection 23‑3(4) of the Act.

Part 6—Transitional provisions

5.15  Definitions for Part 6

  In this Part:

extended aged care at home has the meaning given by section 15.6 of the Flexible Care Subsidy Principles 1997 as in force immediately before 1 August 2013.

extended aged care at home—dementia has the meaning given by section 15.8 of the Flexible Care Subsidy Principles 1997 as in force immediately before 1 August 2013.

5.16  Approval to receive flexible care

 (1) For subitem 198(2) of Schedule 1 to the Aged Care (Living Longer Living Better) Act 2013 the following kinds of approval to receive flexible care are specified:

 (a) approval to receive extended aged care at home;

 (b) approval to receive extended aged care at home—dementia.

 (2) For subitem 198(3) of Schedule 1 to the Aged Care (Living Longer Living Better) Act 2013, an approval to receive extended aged care at home or extended aged care at home—dementia that is taken to be an approval to receive home care under subitem 198(2) of that Act, is taken to be an approval to receive home care at level 4.

 (3) However, an approval for a person to receive home care at level 4 under subsection (2) does not prevent the person receiving home care at a lower level.

5.17  Approval to receive community care

 (1) For subitem 198(3) of Schedule 1 to the Aged Care (Living Longer Living Better) Act 2013, an approval to receive community care that is taken to be an approval to receive home care under subitem 198(1) of Schedule 1 to that Act, is taken to be limited to an approval to receive home care at level 2.

 (2) However, an approval for a person to receive home care at level 2 under subsection (1) does not prevent the person receiving home care at level 1.

Endnotes

Endnote 1—Legislation history

This endnote sets out details of the legislation history of the Approval of Care Recipients Principles 1997.

Endnote 2—Amendment history

This endnote sets out the amendment history of the Approval of Care Recipients Principles 1997.

Endnote 3—Uncommenced amendments [none]

There are no uncommenced amendments.

Endnote 4—Misdescribed amendments [none]

There are no misdescribed amendments.