Commonwealth Consolidated Acts Commonwealth Consolidated ActsThe Governor - General may make regulations prescribing matters:
(a) required or permitted by this Act to be prescribed; or
(b) necessary or convenient to be prescribed for carrying out or giving effect to this Act.
Before the Commonwealth can pay a * subsidy to an approved provider of * aged care, a number of approvals and similar decisions may need to have been made. These relate to:
• the * aged care service in question--for residential care services and flexible care services, * places must have been allocated in respect of the service (see Part 2.2). In addition, decisions can be made under Part 2.5 allowing places in a residential care service to become * extra service places (enabling higher fees to be charged for those places);
• the recipient of the care--the recipient must (in most cases) be approved in respect of the type of * aged care provided (see Part 2.3). In the case of home care, the recipient must be a * prioritised home care recipient (see Part 2.3A). In the case of residential care or some kinds of flexible care, the recipient can be classified in respect of the level of care that is required (see Parts 2.4 and 2.4A).
A precondition to a provider of * aged care receiving a * subsidy under this Act for the provision of care is that the provider is an approved provider.
For the obligations that arise from being an approved provider, see Division 9 of this Part.
Division 10A of this Part deals with the * key personnel of approved providers and sets out when remedial orders may be obtained.
The Commonwealth pays * subsidies under this Chapter to approved providers for * aged care that has been provided. These subsidies are:
• * residential care subsidy (see Part 3.1);
• * home care subsidy (see Part 3.2);
• * flexible care subsidy (see Part 3.3).
A number of approvals and other decisions may need to have been made under Chapter 2 before a particular kind of payment can be made (see section 5 - 2). For example, an approved provider can only receive subsidy for providing residential care or flexible care in respect of which a * place has been allocated. Receipt of payments under this Chapter gives rise to certain responsibilities, that are dealt with in Chapter 4.
Residential care subsidy calculator
Step 1. Work out the basic subsidy amount using Subdivision 44 - B.
Step 2. Add to this amount the amounts of any primary supplements worked out using Subdivision 44 - C.
Step 3. Subtract the amounts of any reductions in subsidy worked out using Subdivision 44 - D.
Step 4. Add the amounts of any other supplements worked out using Subdivision 44 - F.
The result is the amount of residential care subsidy for the care recipient in respect of the payment period.
Care subsidy reduction calculator
Step 1. Work out the means tested amount for the care recipient (see section 44 - 22).
Step 2. Subtract the maximum accommodation supplement amount for the day (see subsection (6)) from the means tested amount.
Step 3. If the amount worked out under step 2 does not exceed zero, the care subsidy reduction is zero.
Step 4. If the amount worked out under step 2 exceeds zero but not the sum of the following, the care subsidy reduction is the amount worked out under step 2:
(a) the adjusted basic subsidy amount for the care recipient for the day (see subsection (6A));
(b) any primary supplement amounts for the care recipient for the day.
Step 5. If the amount worked out under step 2 exceeds the sum of the following, the care subsidy reduction is that sum:
(a) the adjusted basic subsidy amount for the care recipient for the day (see subsection (6A));
(b) any primary supplement amounts for the care recipient for the day.
Means tested amount calculator
Work out the income tested amount using steps 1 to 4:
Step 1. Work out the care recipient's * total assessable income on a yearly basis using section 44 - 24.
Step 2. Work out the care recipient's * total assessable income free area using section 44 - 26.
Step 3. If the care recipient's total assessable income does not exceed the care recipient's total assessable income free area, the income tested amount is zero.
Step 4. If the care recipient's * total assessable income exceeds the care recipient's total assessable income free area, the income tested amount is 50% of that excess divided by 364.
Work out the per day asset tested amount using steps 5 to 10:
Step 5. Work out the value of the care recipient's assets using section 44 - 26A.
Step 6. If the value of the care recipient's assets does not exceed the asset free area , the asset tested amount is zero.
Step 7. If the value of the care recipient's assets exceeds the asset free area but not the first asset threshold , the asset tested amount is 17.5% of the excess.
Step 8. If the value of the care recipient's assets exceeds the first asset threshold but not the second asset threshold , the asset tested amount is the sum of the following:
(a) 1% of the excess;
(b) 17.5% of the difference between the asset free area and the first asset threshold.
Step 9. If the value of the care recipient's assets exceeds the second asset threshold, the asset tested amount is the sum of the following:
(a) 2% of the excess;
(b) 1% of the difference between the first asset threshold and the second asset threshold;
(c) 17.5% of the difference between the asset free area and the first asset threshold.
Step 10. The per day asset tested amount is the asset tested amount divided by 364.
The means tested amount is the sum of the income tested amount and the per day asset tested amount.
Home care subsidy calculator
Step 1. Work out the Commonwealth contribution amount using section 48 - 1A.
Step 2. Work out the shortfall amount using section 48 - 13.
Step 3. If subsection (3) does not apply, work out, using section 48 - 17, the home care account balance in the care recipient's * home care account immediately before the approved provider gives to the Secretary, under section 47 - 4, a claim in respect of the * payment period.
Step 4. Identify:
(a) if subsection (3) applies--the Commonwealth contribution amount; or
(b) otherwise--the sum of the Commonwealth contribution amount and the home care account balance.
This is the maximum contribution amount .
Step 5. Identify the lesser of the following amounts (or either amount if they are the same):
(a) the shortfall amount;
(b) the maximum contribution amount.
Commonwealth contribution amount calculator
Step 1. Work out the basic subsidy amount using section 48 - 2.
Step 2. Add to this amount the amounts of any primary supplements worked out using section 48 - 3.
Step 3. Subtract the amounts of any reductions in subsidy worked out using section 48 - 4.
Step 4. Add the amounts of any other supplements worked out using section 48 - 9.
The result is the Commonwealth contribution amount for the care recipient in respect of the * payment period.
Care subsidy reduction calculator
Step 1. Work out the care recipient's total assessable income on a yearly basis using section 44 - 24.
Step 2. Work out the care recipient's total assessable income free area using section 44 - 26.
Step 3. If the care recipient's total assessable income does not exceed the care recipient's total assessable income free area, the care subsidy reduction is zero.
Step 4. If the care recipient's total assessable income exceeds the care recipient's total assessable income free area but not the income threshold , the care subsidy reduction is equal to the lowest of the following:
(a) the sum of the basic subsidy amount for the care recipient and all primary supplements for the care recipient;
(b) 50% of the amount by which the care recipient's total assessable income exceeds the income free area (worked out on a per day basis);
(c) the amount (the first cap ) determined by the Minister by legislative instrument for the purposes of this paragraph.
Step 5. If the care recipient's total assessable income exceeds the income threshold , the care subsidy reduction is equal to the lowest of the following:
(a) the sum of the basic subsidy amount for the care recipient and all primary supplements for the care recipient;
(b) 50% of the amount by which the care recipient's total assessable income exceeds the income threshold (worked out on a per day basis) plus the amount specified in paragraph (c) of step 4;
(c) the amount (the second cap ) determined by the Minister by legislative instrument for the purposes of this paragraph.
Shortfall amount calculator
Step 1. Work out, in accordance with the Subsidy Principles, the price for the home care provided during the * payment period to the care recipient by the approved provider.
Step 1A. If, in accordance with the User Rights Principles, the approved provider elects to return the * Commonwealth portion of the care recipient's * unspent home care amount to the Commonwealth, reduce the price by the amount of the Commonwealth portion available at the end of the previous * payment period, up to 100% of the price.
Step 2. Subtract the care recipient contribution amount (if any) specified in, or worked out in accordance with, the Subsidy Principles.
The result is the shortfall amount for the care recipient in respect of the * payment period. However, if the result does not exceed zero, the shortfall amount is zero.
Care recipients contribute to the cost of their care by paying resident fees or home care fees (see Part 3A.1).
Care recipients may pay for, or contribute to the cost of, accommodation provided with residential care or eligible flexible care by paying an * accommodation payment or an * accommodation contribution (see Part 3A.2).
Accommodation payments or accommodation contributions may be paid by:
• * daily payments; or
• * refundable deposit; or
• a combination of refundable deposit and daily payments.
Rules for managing refundable deposits, * accommodation bonds and * entry contributions are set out in Part 3A.3. Accommodation bonds and entry contributions are paid under the Aged Care (Transitional Provisions) Act 1997 .
Resident fee calculator
Step 1. Work out the * standard resident contribution for the care recipient using section 52C - 4.
Step 2. Add the compensation payment fee (if any) for the care recipient for the day in question (see subsection (2)).
Step 3. Add the means tested care fee (if any) for the care recipient for that day (see subsection (3)).
Step 4. Subtract the amount of any hardship supplement applicable to the care recipient for the day in question under section 44 - 30.
Step 5. Add any other amounts agreed between the care recipient and the approved provider in accordance with the Fees and Payments Principles.
Step 6. If, on the day in question, the * place in respect of which residential care is provided to the care recipient has * extra service status, add the extra service fee in respect of the place.
The result is the maximum daily amount of resident fees for the care recipient.
Home care fee calculator
Step 1. Work out the basic daily care fee using section 52D - 3.
Step 2. Add the compensation payment fee (if any) for the care recipient for the day in question (see subsection (2)).
Step 3. Add the income tested care fee (if any) for the care recipient for the day in question (see subsection (3)).
Step 4. Subtract the amount of any hardship supplement applicable to the care recipient for the day in question under section 48 - 10.
Step 5. Add any other amounts agreed between the care recipient and the approved provider in accordance with the Fees and Payments Principles.
The result is the maximum daily amount of home care fees for the care recipient.
Care recipients may pay for, or contribute to the cost of, accommodation provided with residential care or eligible flexible care by paying an * accommodation payment or an * accommodation contribution.
Accommodation payments or accommodation contributions may be paid by:
• * daily payments; or
• * refundable deposit; or
• a combination of refundable deposit and daily payments.
* Accommodation payments and * accommodation contributions may be charged only in accordance with this Division.
Rules about * daily payments and * refundable deposits are set out in Divisions 52H and 52J.
Approved providers have responsibilities in relation to * aged care they provide through their * aged care services. These responsibilities relate to:
• the quality of care they provide (see Part 4.1);
• user rights for the people to whom the care is provided (see Part 4.2);
• accountability for the care that is provided, and the suitability of their * key personnel (see Part 4.3).
Sanctions may be imposed under Part 7B of the * Quality and Safety Commission Act on approved providers who do not meet their responsibilities.
The Commonwealth makes grants to contribute to costs associated with the establishment or enhancement of * aged care services and with support services related to the provision of aged care. These grants are:
• * residential care grants (see Part 5.1);
• * advocacy grants (see Part 5.5);
• * community visitors grants (see Part 5.6);
• other grants (see Part 5.7).
Grants are (in most cases) payable under agreements with the recipients of the grants, and may be subject to conditions.
This Chapter deals with the following matters relating to the administration of this Act:
(a) reconsideration and administrative review of decisions (see Part 6.1);
(b) protection of information (see Part 6.2);
(c) record - keeping obligations of approved providers (see Part 6.3);
(d) the compliance and enforcement powers (see Part 6.4);
(e) recovery of overpayments by the Commonwealth (see Part 6.5);
(i) home care assurance reviews (see Part 6.8).
An APS employee in the Department may be appointed as an * authorised officer.
An authorised officer may enter premises with consent of the occupier and exercise * search powers there for the purposes of the Secretary:
(a) making a decision on an application made under this Act or the Aged Care (Transitional Provisions) Act 1997 ; or
(b) determining whether the conditions to which a grant under Chapter 5 of this Act is subject have been complied with.
An authorised officer may enter premises under a warrant or with consent of the occupier and exercise monitoring powers there under Part 2 of the * Regulatory Powers Act, for the purposes of determining:
(a) whether section 25 - 3 (which deals with the appraisal of the level of care needed by care recipients) or sections 27 - 3 and 27 - 5 (which deal with the reappraisal of the level of care needed by care recipients) of this Act have been complied with; or
(b) whether information given in compliance, or purported compliance, with a provision of Chapter 3 of this Act or a provision of Chapter 3 of the Aged Care (Transitional Provisions) Act 1997 (which both deal with * subsidies) is correct.
An authorised officer may, under Part 3 of the Regulatory Powers Act, gather material that relates to the contravention of a * civil penalty provision in this Act (other than a civil penalty provision in Division 54).
Parts 2 and 3 of the Regulatory Powers Act are applied by this Part with suitable modifications.
The Secretary may require a person in certain circumstances to attend before
an authorised officer to answer questions or provider information or
documents.