EXPLANATORY STATEMENT
Issued by the authority of the Minister for Ageing
Aged Care Act 1997
Flexible Care Subsidy 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 Flexible Care Subsidy Principles (“the Principles”) are one of the sets of Principles made under the Act.
Section 50-2 of the Act provides that the Principles may specify the kinds of care for which flexible care subsidy may be payable, and provides a range of criteria against which these kinds of care may be specified:
(a) the nature of the care;
(b) the circumstances in which the care is provided;
(c) the nature of the locations in which it is provided;
(d) the groups of people to whom it is provided;
(e) the period during which the care is provided; and
(f) any other matter.
The kinds of care included in the Principles for which flexible care subsidy may be payable include extended aged care at home services, transition care services, multi-purpose services and innovative care services.
Context of the Flexible Care Subsidy Amendment Principles 2005 (No. 2)
The effect of the Flexible Care Subsidy Amendment Principles 2005 (No. 2) (the Amending Principles) is to establish Extended Aged Care at Home – Dementia (EACH - Dementia) as a further kind of care for which flexible care subsidy may be payable, and to set down some of the requirements that must be met in order that an approved provider can receive flexible care subsidy for the provision 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 were announced in the 2005 Budget, and will 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 Flexible Care Subsidy 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 Flexible Care Subsidy Principles 1997 as set out in the Schedule.
Schedule 1: Amendments
Item 1 inserts a new heading to a new division to distinguish between extended aged care at home and extended aged care at home - dementia.
Item 2 inserts substitute words for section 15.5 and explains the purpose of Division 1. Division 1 explains what is meant by extended aged care at home.
Item 3 inserts the words “(other than care to which Division 2 applies)” in section 15.6 to ensure that flexible care includes both extended aged care at home – dementia and extended aged care at home as types of flexible care.
Item 4 inserts a new division (Division 2) extended aged care at home – dementia.
The new section 15.7 notes the purpose of the new Division under section 50-2 of the Act. The sections of the Division explain what is meant by extended aged care at home – dementia.
The new section 15.8 defines extended aged care at home – dementia. The section specifies that extended aged care at home dementia, is a form of flexible care that is provided in the home, to clients who have been assessed by and Aged Care Assessment Team (ACAT) under section 22-4 of the Act, as having complex care needs because of behavioural dysfunction associated with dementia, and would, if he or she were not receiving extended aged care at home –dementia require a high level of residential care. It also requires that the services provided are specifically directed to the care recipient’s complex care needs.
Item 5 substitutes the words in section 15.10 to include extended aged care at home –dementia as a kind of care for which flexible care subsidy may be paid to an approved provider delivering this type of flexible care.
Item 6 amends section 15.11 to include extended aged care at home and extended aged care at home – dementia under the arrangements for payment of flexible care subsidy to approved providers of flexible care.