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Classification Principles 2014

Authoritative Version
  • - F2014L00805
  • In force - Superseded Version
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Principles as made
These principles deal with the classification of care recipients, specifically the procedures for determining classification levels for care recipients receiving residential care or residential care provided as respite care, care recipients that do not require classification (care recipients in a multi-purpose service), the classification levels for care recipients being provided with residential care or respite care, appraisals of the level of care needed for care recipients,how if an approved provider has been suspended from undertaking appraisals the provider may make an application for the lifting of the suspension, and the date of effect, expiry and renewal of classifications.
Administered by: Health
Made 20 Jun 2014
Registered 24 Jun 2014
Tabled HR 26 Jun 2014
Tabled Senate 26 Jun 2014

 

Classification Principles 2014

I, Mitch Fifield, Assistant Minister for Social Services, make the following principles.

Dated 20 June 2014

Mitch Fifield

Assistant Minister for Social Services

 

  

  

  


Contents

Part 1—Preliminary                                                                                                                                        1

1............ Name of principles........................................................................................................ 1

2............ Commencement............................................................................................................. 1

3............ Authority....................................................................................................................... 1

4............ Definitions..................................................................................................................... 1

Part 2—Classification of care recipients                                                                                            3

5............ Purpose of this Part....................................................................................................... 3

6............ Procedure for determining classification level—residential care other than respite care. 3

7............ Procedure for determining classification level—respite care.......................................... 4

Part 3—Classes of care recipients excluded from classification                                          5

8............ Purpose of this Part....................................................................................................... 5

9............ Exclusion of class of care recipients.............................................................................. 5

Part 4—Classification levels                                                                                                                       6

10.......... Purpose of this Part....................................................................................................... 6

11.......... Classification levels....................................................................................................... 6

12.......... Lowest applicable classification level—care other than respite care............................... 6

Part 5—Appraisals of the level of care needed                                                                              7

13.......... Purpose of this Part....................................................................................................... 7

14.......... Circumstance and alternative period.............................................................................. 7

15.......... Appraisal procedure...................................................................................................... 7

Part 6—Suspending approved providers from making appraisals and reappraisals      8

16.......... Purpose of this Part....................................................................................................... 8

17.......... Requirements for applications for the lifting of suspensions......................................... 8

Part 7—When respite care classifications take effect                                                                 9

18.......... Purpose of this Part....................................................................................................... 9

19.......... Day of effect.................................................................................................................. 9

Part 8—Expiry and renewal of classifications                                                                              10

20.......... Purpose of this Part..................................................................................................... 10

21.......... Different expiry dates.................................................................................................. 10

22.......... Circumstances in which care needs are taken to have changed significantly................ 10

23.......... Procedure for determining renewal of classification.................................................... 11

Schedule 1—Scores for question ratings                                                                        12

Part 1—ADL domain                                                                                                                                   12

1............ Scores.......................................................................................................................... 12

Part 2—Behaviour domain                                                                                                                       13

2............ Scores.......................................................................................................................... 13

Part 3—CHC domain                                                                                                                                  14

3............ Scores.......................................................................................................................... 14

Schedule 2—Domain categories                                                                                              15

Part 1—ADL domain                                                                                                                                   15

1............ Domain categories....................................................................................................... 15

Part 2—Behaviour domain                                                                                                                       16

2............ Domain categories....................................................................................................... 16

Part 3—CHC domain                                                                                                                                  17

3............ Domain categories....................................................................................................... 17

 


Part 1Preliminary

  

1  Name of principles

                   These principles are the Classification Principles 2014.

2  Commencement

                   These principles commence on 1 July 2014.

3  Authority

                   These principles are made under section 96‑1 of the Aged Care Act 1997.

4  Definitions

                   In these principles:

Act means the Aged Care Act 1997.

ADL domain means the domain relating to activities of daily living.

Answer Appraisal Pack means the Aged Care Funding Instrument (ACFI) Answer Appraisal Pack published by the Department, as it exists on 1 July 2014.

Note:          In 2014, the Answer Appraisal Pack was accessible at http://www.dss.gov.au.

application for classification means an application completed in accordance with section 15 for classification of a care recipient under section 25‑1 of the Act.

Assessment Pack means the Aged Care Funding Instrument (ACFI) Assessment Pack published by the Department, as it exists on 1 July 2014.

Note:          In 2014, the Assessment Pack was accessible at http://www.dss.gov.au.

behaviour domain means the domain relating to behaviour.

CHC domain means the domain relating to complex health care.

domain means a group of questions in the Answer Appraisal Pack relating to one of the following:

                     (a)  activities of daily living;

                     (b)  behaviour;

                     (c)  complex health care.

domain aggregate range has the meaning given by subsection 6(2).

domain category means a domain category mentioned in a table in Schedule 2.

multi‑purpose service has the meaning given by section 104 of the Subsidy Principles 2014.

User Guide means the Aged Care Funding Instrument (ACFI) User Guide published by the Department, as it exists on 1 July 2014.

Note 1:       In 2014, the User Guide was accessible at http://www.dss.gov.au.

Note 2:       A number of expressions used in these principles are defined in the Act, including:

(a)    classification level; and

(b)    lowest applicable classification level.

Part 2Classification of care recipients

  

5  Purpose of this Part

                   For subsection 25‑1(2) of the Act, this Part specifies the procedure the Secretary must follow in determining the appropriate classification level for a care recipient being provided with residential care.

6  Procedure for determining classification level—residential care other than respite care

             (1)  The procedure set out in subsection (2) is specified for determining the appropriate classification level for a care recipient being provided with residential care (other than respite care).

             (2)  The Secretary must take the following steps, using the application for classification completed in respect of the care recipient.

Procedure for determining classification level

Step 1.   For the ADL domain and the behaviour domain in the completed application, the Secretary must:

               (a)     use the tables in Parts 1 and 2 of Schedule 1 to identify the score for the rating for each question in each domain; and

              (b)     add up the scores to work out an aggregate figure for each domain (the domain aggregate); and

               (c)     use the tables in Parts 1 and 2 of Schedule 2 to identify, for each domain:

                        (i)      the range within which the domain aggregate falls (the domain aggregate range); and

                       (ii)      the domain category that applies to that domain aggregate range.

Step 2.   If:

               (a)     the domain category identified for the behaviour domain is the high behaviour category; and

              (b)     the completed application does not include a mental and behavioural diagnosis code;

              the Secretary must reduce the domain category to the medium behaviour category.

Step 3.   For the CHC domain in the completed application, the Secretary must:

               (a)     use the matrix in Part 3 of Schedule 1, which combines ratings for the questions in the domain, to work out the overall score for the domain; and

              (b)     identify the domain category mentioned in the table in Part 3 of Schedule 2 that applies to that score.

Step 4.   The Secretary must determine that the appropriate classification level for the care recipient consists of the domain categories identified for each domain.

Note 1:       For the classification level for a care recipient being provided with residential care (other than respite care), see subsection 11(1).

Note 2:       The procedure set out in this subsection also applies in relation to a renewal of the classification level for a care recipient being provided with residential care (other than respite care). See section 23.

7  Procedure for determining classification level—respite care

             (1)  The procedure set out in subsection (2) is specified for determining the appropriate classification level for a care recipient being provided with residential care as respite care.

             (2)  The Secretary must determine the appropriate classification level for the care recipient according to the limitation of the care recipient’s approval under the Approval of Care Recipients Principles 2014.

Note:          For the classification levels for care recipients being provided with residential care as respite care, see subsection 11(2).

Part 3Classes of care recipients excluded from classification

  

8  Purpose of this Part

                   For subsection 25‑1(5) of the Act, this Part specifies:

                     (a)  a class of care recipients excluded from classification under Part 2.4 of the Act; and

                     (b)  the period for which that class is excluded.

9  Exclusion of class of care recipients

             (1)  The class of care recipients who receive flexible care provided through a multi‑purpose service is excluded from classification.

             (2)  An indefinite period is specified in relation to the class mentioned in subsection (1).

Part 4Classification levels

  

10  Purpose of this Part

                   For section 25‑2 of the Act, this Part sets out classification levels for care recipients being provided with residential care.

11  Classification levels

Care other than respite care

             (1)  For subsection 25‑2(1) of the Act, the classification level for care recipients being provided with residential care (other than respite care) consists of a domain category for each domain.

Respite care

             (2)  For subsection 25‑2(1) of the Act, the classification levels for care recipients being provided with residential care as respite care are:

                     (a)  low level residential respite care; and

                     (b)  high level residential respite care.

12  Lowest applicable classification level—care other than respite care

                   For subsection 25‑2(3) of the Act, the lowest applicable classification level for a care recipient being provided with residential care (other than respite care) consists of the following domain categories:

                     (a)  nil ADL category;

                     (b)  nil behaviour category;

                     (c)  nil CHC category.

Part 5Appraisals of the level of care needed

  

13  Purpose of this Part

                   For section 25‑3 of the Act, this Part specifies:

                     (a)  a circumstance in which subsection 25‑3(2) of the Act does not apply in relation to an appraisal of the level of care needed by a care recipient being provided with residential care, relative to the needs of other care recipients; and

                     (b)  an alternative period during which the appraisal may be made; and

                     (c)  procedures for making the appraisal.

14  Circumstance and alternative period

                   For subsection 25‑3(2A) of the Act:

                     (a)  subsection 25‑3(2) of the Act does not apply in relation to the appraisal if the care recipient leaves the residential care service through which the care is provided within 7 days after the day the approved provider began providing the care; and

                     (b)  if paragraph (a) applies, the appraisal may be:

                              (i)  made during the period in which the care recipient was provided with the care; and

                             (ii)  given to the Secretary within 28 days after the day the provider began providing the care.

15  Appraisal procedure

             (1)  For subsection 25‑3(3) of the Act, the procedure set out in subsection (2) is specified for the appraisal.

             (2)  The person making the appraisal must:

                     (a)  complete an Answer Appraisal Pack in accordance with the User Guide, using:

                              (i)  accurate and reliable information; and

                             (ii)  if required by the Answer Appraisal Pack—the assessment tools in the Assessment Pack; and

                     (b)  complete an application for classification using the completed Answer Appraisal Pack.

Part 6Suspending approved providers from making appraisals and reappraisals

  

16  Purpose of this Part

                   For paragraph 25‑4C(3)(b) of the Act, this Part specifies requirements that must be met by an application for the lifting of a suspension of an approved provider from making appraisals and reappraisals.

17  Requirements for applications for the lifting of suspensions

                   The application must include information about:

                     (a)  action the approved provider has taken to correct false, misleading or inaccurate information given in appraisals or reappraisals made by the approved provider; and

                     (b)  consultations (if any) held by the approved provider with staff, care recipients or the relatives of care recipients in relation to the giving of the false, misleading or inaccurate information; and

                     (c)  action the approved provider proposes to take to ensure that false, misleading or inaccurate information is not given in future appraisals or reappraisals made by the approved provider.

Part 7When respite care classifications take effect

  

18  Purpose of this Part

                   For section 26‑3 of the Act, this Part specifies the day when a classification of a care recipient in relation to care provided as respite care takes effect.

19  Day of effect

                   The classification takes effect on the first day the care recipient enters respite care.

Part 8Expiry and renewal of classifications

  

20  Purpose of this Part

                   For sections 27‑2, 27‑4 and 27‑6 of the Act, this Part specifies the following:

                     (a)  different expiry dates in relation to certain classifications;

                     (b)  circumstances in which the care needs of a care recipient are taken to have changed significantly;

                     (c)  procedures the Secretary must follow in determining the appropriate classification level for a care recipient when renewing the care recipient’s classification.

21  Different expiry dates

Care recipient being provided with respite care

             (1)  For paragraph 27‑2(6)(a) of the Act, the expiry date for the classification of a care recipient to whom the circumstance mentioned in item 7 of the table in subsection 27‑2(1) of the Act applies is the first day after the earlier of the following:

                     (a)  the day in a financial year on which the number of days on which the care recipient has been provided with residential care as respite care in the financial year equals the number of days specified in paragraph 23(1)(c) of the Subsidy Principles 2014;

                     (b)  the day the care recipient’s approval as a care recipient ceases to have effect.

Note:          For when a care recipient’s approval as a care recipient ceases to have effect, see Division 23 of the Act.

Care recipient eligible for dementia and severe behaviours supplement

             (2)  For paragraph 27‑2(6)(a) of the Act:

                     (a)  the expiry date for the classification of a care recipient being provided with residential care whose classification has been renewed because the care recipient became eligible for a dementia and severe behaviours supplement under the Subsidy Principles 2014 is the day immediately after the period of 28 days starting on the day the care recipient ceases being provided with residential care (other than because the care recipient is on leave); and

                     (b)  the expiry date specified in item 5 of the table in subsection 27‑2(1) of the Act does not apply in relation to the classification.

22  Circumstances in which care needs are taken to have changed significantly

                   For subsection 27‑4(4) of the Act, the care needs of a care recipient being provided with residential care are taken to have changed significantly if the care recipient:

                     (a)  becomes eligible for a dementia and severe behaviours supplement under the Subsidy Principles 2014; or

                     (b)  experiences an event likely to increase the level of care needed by the care recipient by:

                              (i)  2 or more domain categories within a domain; or

                             (ii)  at least one domain category within 2 or more domains; or

                     (c)  for a care recipient whose classification level includes the high ADL category and the medium CHC category—experiences an event likely to change the level of complex health care needed by the care recipient to the high CHC category.

23  Procedure for determining renewal of classification

                   For subsection 27‑6(2) of the Act, in determining the appropriate classification level for a care recipient, the procedure mentioned in subsection 6(2) of these principles is specified.


Schedule 1Scores for question ratings

Note:       See section 6.

Part 1ADL domain

  

1  Scores

                   The following table sets out the score for each rating for each question in the ADL domain.

 

ADL domain

Question

Rating

Score

1 Nutrition

A

0

B

6.69

C

13.39

D

20.09

2 Mobility

A

0

B

6.88

C

13.76

D

20.65

3 Personal hygiene

A

0

B

6.88

C

13.76

D

20.65

4 Toileting

A

0

B

6.11

C

12.21

D

18.31

5 Continence

A

0

B

5.79

C

11.53

D

17.31

Part 2Behaviour domain

  

2  Scores

                   The following table sets out the score for each rating for each question in the behaviour domain.

 

Behaviour domain

Question

Rating

Score

6 Cognitive skills

A

0

B

6.98

C

13.91

D

20.88

7 Wandering

A

0

B

5.91

C

11.82

D

17.72

8 Verbal behaviour

A

0

B

7.04

C

14.10

D

21.14

9 Physical behaviour

A

0

B

7.70

C

15.40

D

23.11

10 Depression

A

0

B

5.71

C

11.43

D

17.15

Part 3CHC domain

  

3  Scores

                   The following matrix sets out the score for each combination of ratings in the CHC domain.

 

CHC domain

Matrix

 

 

Question 12 Complex health care

 

Rating

A

B

C

D

Question 11 Medication

A

0

0

2

2

B

0

1

2

3

C

1

1

2

3

D

1

2

3

3

Schedule 2Domain categories

Note:       See section 6.

Part 1ADL domain

  

1  Domain categories

                   The following table sets out the domain category that applies to each domain aggregate range for the ADL domain.

 

ADL domain

Item

Domain aggregate range

Domain category

1

0–17.99

Nil ADL category

2

18–61.99

Low ADL category

3

62–87.99

Medium ADL category

4

88–100

High ADL category

Part 2Behaviour domain

  

2  Domain categories

                   The following table sets out the domain category that applies to each domain aggregate range for the behaviour domain.

 

Behaviour domain

Item

Domain aggregate range

Domain category

5

0–12.99

Nil behaviour category

6

13–29.99

Low behaviour category

7

30–49.99

Medium behaviour category

8

50–100

High behaviour category

Part 3CHC domain

  

3  Domain categories

                   The following table sets out the domain category that applies to each overall score for the CHC domain.

 

CHC domain

Item

Score

Domain category

9

0

Nil CHC category

10

1

Low CHC category

11

2

Medium CHC category

12

3

High CHC category