Residential Care Subsidy Amendment Principles 2009 (No. 1)

Administered by Department of Health, Disability and Ageing

Legislation au F2009L03558 Not in force Legislative Instrument

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EXPLANATORY STATEMENT

Issued by the authority of the Minister for Ageing

Aged Care Act 1997

Residential Care Subsidy Amendment Principles 2009 (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 aged care services (approved providers) can be eligible to receive 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.  One set of Principles made under the Act is the Residential Care Subsidy Principles 1997 (the Residential Care Subsidy Principles).

The purpose of the Residential Care Subsidy Amendment Principles 2009 (No. 1) (the Amending Principles) is to make consequential amendments in line with changes made to both the Act and the Social Security Act 1997 which are due to take effect on 20 September 2009.  The Amending Principles are a legislative instrument for the purposes of the Legislative Instruments Act 2003.

On 20 September 2009, the Australian Government is increasing the rate of the basic age pension to ensure that older Australians receive enough income to keep pace with the cost of living.  People in residential aged care make a contribution to their cost of living (for example, food, cleaning and utilities) through payment of a fee to the residential aged care service provider - the standard resident contribution.  The maximum amount of standard resident contribution is set out in the Act and is directly linked to the basic age pension amount (currently 85 per cent of the basic age pension).

To enable the appropriate and equitable flow of pension increase to both the care recipient and the approved provider, amendments to the Act ensure that pensioners in aged care benefit from the increased pension, as well as providers of the residential aged care service. 

People on fixed incomes who do not benefit from the pension increase are protected from paying higher fees in aged care.  Aged care residents who are in care on 19 September 2009, and who are self funded retirees or part pensioners for whom the pension increase is less than the planned increase in the standard resident contribution, will be protected and remain on their existing fee rate until they leave care.  Newly entering residents (on or after 20 September 2009) who are self funded retirees or part pensioners who do not benefit from the new pension arrangements will be subject to a phased rate.  These residents will initially pay the same rate as protected residents.  Over four years their fees will be phased up every six months until the fees are equal to 84 per cent of the basic age pension.

In parallel with the amendments that were made to the Act, the Amending Principles make changes to the Residential Care Subsidy Principles to ensure that cross references to the basic age pension amount operate in the same manner both before and after 20 September 2009.

 

Details of the amendments to the Residential Care Subsidy Principles are listed at Attachment A.

Consultation

The changes outlined in the Amending Principles are consequential to the Pension Review which engaged in an extensive consultation process, involving a series of public forums, meetings with state and territory government officials, a call for written submissions and a series of small focus groups.

Information about the changes to the Residential Care Subsidy Principles will be disseminated via print and electronic media to approved providers.


ATTACHMENT A

NOTES ON CLAUSES

Clause 1 states that the name of the Amending Principles is the Residential Care Subsidy Amendment Principles 2009 (No. 1).

Clause 2 provides that the Amending Principles commence on 20 September 2009. 

Clause 3 states that Schedule 1 amends the Residential Care Subsidy Principles 1997.

Schedule 1 Amendments

Item 1

Item 1 changes the definition of ‘homeowner’ in subsections 21.3(2) and (3) of the Residential Care Subsidy Principles.  Currently, one of the relevant considerations for determining whether a person is an assistedor concessional resident under sections 44-7 or 44-8 of the Act is whether the person has been a homeowner for 2 years or more.  Subsections 21.3(2) and (3) of the Residential Care Subsidy Principles, provide that a homeowner does not include a person if the value of the person’s interest in the home does not exceed 2.5 times the basic age pension (for concessional resident status) or 4 times the basic age pension (for assisted resident status).

From 20 September 2009, the basic age pension will increase.  In the absence of any changes to the definition of homeowner this would mean that the threshold for assisted and concessional resident status would also change.  This amendment therefore adjusts the definition of homeowner so that the eligibility criteria remain unchanged despite the increase in the basic age pension. 

From 20 September 2009, the Principles will provide that for the purposes of determining whether a person is:

  • a concessional resident - a homeowner does not include a person if the value of the person’s interest in the home does not exceed 2.25 times the basic age pension.  This equates to 2.5 times the basic age pension as it existed immediately prior to 20 September 2009; and
  • an assisted resident - a homeowner does not include a person if the value of the person’s interest in the home does not exceed 3.61 times the basic age pension.  This equates to 4 times the basic age pension as it existed immediately prior to 20 September 2009.

Items 2 and 3

These items amend paragraphs 21.32D(2)(a) and (b) and 21.32D(3)(a) and (b) so that different multiplying factors are applied from 20 September 2009 setting the amounts to be excluded in ordinary income determinations for pre-2008 reform residents.  This ensures that the arrangements for pre-2008 reform residents remain consistent before and after 20 September 2009, despite the increase in the basic age pension amount.


Items 4 and 5

These items amend the definitions of ‘the maximum pension (P) and ‘the social security income test free threshold (T) in subsection 21.32D(4).  These changes are required to ensure that: the provisions operate in the same way before and after 20 September 2009; and the references to the Social Security Act 1991 within those definitions remain applicable despite changes to that Act that resulted from the Social Security and Other Legislation Amendment (Pension Reform and Other 2009 Budget Measures) Act 2009.

Item 6

Section 21.27 of the Residential Care Subsidy Principles sets out classes of care recipients eligible for hardship supplement.  One of these classes is pre-2008 reform residents who do not receive an income support payment but have ordinary fortnightly income within a certain range.  This range is defined by reference to a formula.  Item 6 amends sub-subparagraph 21.37(1)(c)(iii)(B) to substitute the formula with a fixed upper fortnightly income limit of $1774.42.  This ensures that those people who are currently part of the defined class (and are therefore eligible for hardship supplement) remain eligible after the 20 September 2009 changes.

Overview

The Residential Care Subsidy Amendment Principles 2009 (No. 1) were enacted to address consequential amendments required due to changes in the Aged Care Act 1997 and the Social Security Act 1997, effective from 20 September 2009. These amendments were necessary to ensure the equitable distribution of the increase in the basic age pension, aligning the residential care subsidy with the new pension rates while protecting those on fixed incomes from increased fees. This legislative instrument was introduced by the Minister for Ageing and is intended to maintain consistency and fairness in the aged care subsidy system post-pension increase. The policy objective is to safeguard the financial interests of aged care residents and providers, ensuring that pensioners in aged care benefit from the increased pension, and that those on fixed incomes are not adversely affected by the changes. The principles were developed following extensive consultation and are intended to provide clear guidance on the application of the subsidy in line with the legislative reforms.

Scope and Application

The Residential Care Subsidy Amendment Principles 2009 (No. 1) applies to approved providers of aged care services who are eligible to receive subsidy payments under the Aged Care Act 1997. The Amending Principles primarily aim to make consequential amendments in line with changes to the Aged Care Act 1997 and the Social Security Act 1997, which took effect on 20 September 2009. These amendments ensure that the flow of the pension increase to both care recipients and approved providers is appropriate and equitable. The changes also protect individuals on fixed incomes who do not benefit from the pension increase from paying higher fees in aged care. The geographic reach of the Act is national, as it pertains to Commonwealth legislation. The Amending Principles extend the application of the Residential Care Subsidy Principles to ensure consistency before and after the 20 September 2009 changes.

Key Provisions

The Residential Care Subsidy Amendment Principles 2009 (No. 1) (the Amending Principles) makes several amendments to the Residential Care Subsidy Principles 1997 to align them with changes to the Aged Care Act 1997 and the Social Security Act 1997, which took effect on 20 September 2009. The primary objective of these amendments is to ensure that the increased rate of the basic age pension is appropriately and equitably distributed between care recipients and approved residential aged care providers. The Amending Principles are a legislative instrument for the purposes of the Legislative Instruments Act 2003. Under the Aged Care Act 1997, approved providers of aged care services can receive subsidy payments for the care they provide to approved care recipients. The Act requires that the Minister for Ageing make Principles that provide for various matters required or permitted by a Part or section of the Act. The Residential Care Subsidy Principles 1997 are one such set of Principles. The Amending Principles make consequential amendments to these Principles to ensure that references to the basic age pension amount operate consistently before and after the pension increase on 20 September 2009. These amendments include changes to the definition of ‘homeowner’ (Schedule 1, Item 1), adjustments to the multiplying factors for excluding amounts in ordinary income determinations (Schedule 1, Items 2 and 3), and modifications to the definitions of ‘the maximum pension’ and ‘the social security income test free threshold’ (Schedule 1, Items 4 and 5). Additionally, the Amending Principles ensure that pre-2008 reform residents who do not receive an income support payment but have ordinary fortnightly income within a specified range remain eligible for hardship supplement by substituting a fixed upper fortnightly income limit (Schedule 1, Item 6). The obligations and requirements imposed by the Amending Principles on the parties and entities they govern are primarily aimed at ensuring the appropriate and equitable distribution of the increased basic age pension rate. Approved residential aged care providers must ensure that their fee structures are aligned with the new subsidy arrangements to protect care recipients on fixed incomes from higher fees. For instance, self-funded retirees or part pensioners who do not benefit from the pension increase are protected from paying higher fees in aged care. Newly entering residents who are self-funded retirees or part pensioners and do not benefit from the new pension arrangements will be subject to a phased rate, with their fees gradually increasing over four years until they reach 84 per cent of the basic age pension. The Amending Principles also impose obligations on the Minister for Ageing and other relevant authorities to ensure that the changes are implemented effectively. This includes ensuring that the updated Principles are disseminated to approved providers and that the new fee structures are properly enforced. The Minister must also ensure that the amendments to the Residential Care Subsidy Principles are consistent with the changes to the Aged Care Act 1997 and the Social Security Act 1997. Failure to comply with the provisions of the Amending Principles and the Residential Care Subsidy Principles may result in civil or criminal consequences. While the Amending Principles themselves do not specify penalties, breaches of the Aged Care Act 1997 or the Residential Care Subsidy Principles 1997 can result in significant penalties. For example, under section 127 of the Aged Care Act 1997, a person who contravenes the Act can be subject to a civil penalty of up to $11,000 for each contravention, while corporations can face penalties of up to $55,000 for each contravention. Additionally, under section 128 of the Act, a person who contravenes the Act can be subject to criminal penalties, including fines of up to $66,000 for individuals and $330,000 for corporations, as well as imprisonment for up to two years. These penalties are intended to ensure compliance with the Act and the Principles, thereby protecting the interests of care recipients and ensuring the appropriate distribution of the increased basic age pension rate.

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Elder Law
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