EXPLANATORY STATEMENT
STATUTORY RULES 1982 NO. 285
ISSUED BY AUTHORITY OF THE MINISTER FOR HEALTH
NURSING HOMES ASSISTANCE REGULATIONS (AMENDMENT)
Section 37 of the Nursing Homes Assistance Act 1974 (the Act) provides that the Governor-General may make regulations prescribing all matters required or permitted by the Act to be prescribed or which are necessary or convenient to be prescribed for carrying out or giving effect to the Act.
Sub-section 12(1) of the Act provides that the Commonwealth and the proprietor of a nursing home approved under the Act may enter into an agreement under which the Commonwealth meets any approved operating deficit incurred by the home in a financial year or other period. Paragraph 13(1)(a) of the Act provides that any such agreement between the Commonwealth and the proprietor of a nursing home is to include a provision under which the proprietor is to charge a fee of $32 per week or such other amount as is prescribed for nursing home patients other than certain specified classes of patients. Such an amount is prescribed in Regulation 5A of the Nursing Homes Assistance Regulations (the Regulations) which is consistent with Government policy that the amount
of minimum financial contribution towards the cost of their nursing home care by patients should be equivalent to 87½% of pension entitlement, including supplementary assistance, under the Social Services Act 1947. An increase in pension rates with effect from 4 November 1982 has made it necessary to increase the amount of the prescribed fee from that date to maintain this relativity. The regulations accordingly amend Regulation 5A to increase the amount of the prescribed fee for the purposes of paragraph 13(1)(a) from $71.75 to $76.30.
Paragraph 13(1)(d) of the Act provides for the prescription of the fees to be charged to nursing home patients in nursing homes approved under the Act where the patient has received, has established his right to receive, or may be entitled to receive, a payment by way of compensation or damages under a law of a State or Territory. Fees for the purposes of paragraph 13(1)(d) are prescribed in Regulation 6 of the Regulations in respect of “extensive care patients” and “ordinary care patients”. These fees are based on the sum of the fee prescribed under paragraph 13(1)(a) of the Act and the amounts of Commonwealth nursing home benefit prescribed in the National Health Regulations in respect of each
State or Territory for the purposes of sub-section 47(1) of the National Health Act 1953. Increases, therefore, in both the fee prescribed under paragraph 13(1) (a) of the Act, and Commonwealth nursing home benefits, with effect from 4 November 1982, require corresponding increases in the weekly fees prescribed under paragraph 13(1)(d) of the Act from that date. Accordingly, the regulations amend Regulation 6 to increase the fees prescribed therein by amounts ranging from $76.30 in Victoria to $26.25 in Western Australia, to reflect these other increases.
The terms “extensive care patient” and “ordinary care patient”, as used in Regulation 6 of the Regulations, are defined in Regulation 3 of the Regulations. An “ordinary care patient” is defined as a qualified nursing home patient who is not an “extensive care patient” in relation to the relevant nursing home. “Extensive care patient” was defined by reference to a qualified nursing home patient approved by the Permanent Head as requiring “extensive care” under former section 13A of the Act which was, however, repealed by section 80 of the Health Acts Amendment Act 1981. The proposed regulations amend Regulation 3 by the substitution of a new definition of
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of “extensive care patient”. This new definition defines “an extensive care patient” to mean, in general terms, a qualified nursing home patient who requires and is receiving nursing home care of the kind required by a person who, by virtue of being bedridden, virtually bedridden or through undergoing treatment, is wholly or substantially dependent on nursing care. These criteria are similar to those provided for in section 40AF of the National Health Act 1953 in respect of “extensive care patients” in nursing homes approved under that Act.
The regulations came into operation on 4 November 1982.
Overview
The Nursing Homes Assistance Regulations (Amendment) were issued under Section 37 of the Nursing Homes Assistance Act 1974, granting the Governor-General the authority to make regulations necessary for implementing the Act. These regulations were necessitated by the increase in pension rates effective from 4 November 1982, which required adjustments to the prescribed fees for nursing home care. The amendments were made to ensure the relativity between the nursing home fees and pension entitlements was maintained, as per the government's policy outlined in the Social Services Act 1947. The primary objective was to increase the weekly fee for nursing home patients from $71.75 to $76.30, and to adjust the fees for extensive and ordinary care patients to reflect the changes in Commonwealth nursing home benefits. This amendment aimed to align the fees with the updated pension rates and maintain the financial contribution of patients towards their nursing home care.
Scope and Application
The Nursing Homes Assistance Regulations (Amendment) issued under the Nursing Homes Assistance Act 1974 applies to approved nursing homes and their proprietors within the Commonwealth of Australia. These regulations are designed to facilitate agreements between the Commonwealth and nursing home proprietors, ensuring that the Commonwealth meets any approved operating deficit incurred by the nursing homes in a financial year or other period. This is achieved through the provision of fees charged to nursing home patients, which must align with the government's policy that the minimum financial contribution towards the cost of nursing home care by patients should be equivalent to 87½% of pension entitlement under the Social Services Act 1947. The amendment to the regulations, which came into effect on 4 November 1982, primarily involves adjusting the prescribed fee for nursing home patients from $71.75 to $76.30 to account for the increase in pension rates. Furthermore, the regulations also address the fees for patients who are entitled to receive compensation or damages, adjusting these fees to reflect the increases in both the prescribed fee and Commonwealth nursing home benefits. The definitions of "extensive care patient" and "ordinary care patient" have also been updated to align with the criteria for "extensive care patients" under the National Health Act 1953.
Key Provisions
The Nursing Homes Assistance Regulations (Amendment) Statutory Rules 1982 No. 285, issued under the authority of the Minister for Health, amend the Nursing Homes Assistance Regulations to reflect changes in pension rates and Commonwealth nursing home benefits, effective from 4 November 1982. Regulation 5A is amended to increase the prescribed weekly fee for nursing home patients from $71.75 to $76.30, aligning with Government policy that the patient's financial contribution should be equivalent to 87.5% of their pension entitlement, including supplementary assistance, as defined in the Social Services Act 1947. Regulation 6 is also amended to adjust the fees for extensive care and ordinary care patients in various states and territories, ranging from $76.30 in Victoria to $26.25 in Western Australia.
These amendments impose obligations on the Commonwealth and nursing home proprietors to adjust their agreements to reflect the new fee structures, ensuring that the financial contributions from patients are updated accordingly. Nursing home proprietors must ensure that the correct fees are charged to patients based on their care category, whether extensive or ordinary care, and the applicable state or territory regulations. The Commonwealth, in turn, must be prepared to meet any approved operating deficit under the terms of their agreements with the proprietors.
Failure to comply with these amended regulations may result in legal consequences for both the nursing home proprietors and the Commonwealth. While the Act does not explicitly outline specific penalties for non-compliance, breaches of such regulations could potentially lead to disputes, financial discrepancies, or legal challenges regarding the validity of the agreements between the Commonwealth and the nursing home proprietors. It is essential that both parties adhere to these updated fee structures to maintain the integrity of the funding arrangements and to ensure that patients receive the appropriate level of care commensurate with their financial contributions.