Federal Register of Legislation - Australian Government

Primary content

Principles as made
This instrument amends the Subsidy Principles 2014 in relation to the viability supplement points calculator to determine eligibility for residential care subsidy and the eligibility requirements for the viability supplement in home care subsidy.
Administered by: Health
Registered 16 Dec 2016
Tabling HistoryDate
Tabled HR07-Feb-2017
Tabled Senate07-Feb-2017
Date of repeal 02 Jan 2017
Repealed by Division 1 of Part 3 of Chapter 3 of the Legislation Act 2003
Table of contents.

 

Subsidy Amendment (Viability Supplement) Principles 2016

I, Sussan Ley, Minister for Health and Aged Care, make the following principles.

Dated   13 December 2016

Sussan Ley

Minister for Health and Aged Care

 

 

  

  


Contents

1............ Name............................................................................................................................. 1

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

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

4............ Schedules...................................................................................................................... 1

Schedule 1—Amendments                                                                                                                          2

Subsidy Principles 2014                                                                                                                       2

 


1  Name

                   This instrument is the Subsidy Amendment (Viability Supplement) Principles 2016.

2  Commencement

             (1)  Each provision of this instrument specified in column 1 of the table commences, or is taken to have commenced, in accordance with column 2 of the table. Any other statement in column 2 has effect according to its terms.

 

Commencement information

Column 1

Column 2

Column 3

Provisions

Commencement

Date/Details

1.  The whole of this instrument

1 January 2017.

1 January 2017

Note:          This table relates only to the provisions of this instrument as originally made. It will not be amended to deal with any later amendments of this instrument.

             (2)  Any information in column 3 of the table is not part of this instrument. Information may be inserted in this column, or information in it may be edited, in any published version of this instrument.

3  Authority

                   This instrument is made under the Aged Care Act 1997.

4  Schedules

                   Each instrument that is specified in a Schedule to this instrument is amended or repealed as set out in the applicable items in the Schedule concerned, and any other item in a Schedule to this instrument has effect according to its terms.

Schedule 1Amendments

  

Subsidy Principles 2014

1  Section 4

Insert:

2017 scheme service: see section 66A.

domain has the same meaning as in the Classification Principles 2014.

domain category has the same meaning as in the Classification Principles 2014.

Modified Monash Model classification:

                     (a)  for a street address—means the classification given to that street address in accordance with the Modified Monash Model classification system; and

                     (b)  for a suburb or locality—means the classification for that suburb or locality set out in, or worked out in accordance with the method set out in, the document published by the Health Department titled Modified Monash Model Suburb and Locality Classification—Home Care Subsidy, as that document exists on 1 January 2017.

Note 1:       In 2017, the Modified Monash Model classification for a street address was available at http://www.doctorconnect.gov.au. This is relevant for residential care subsidy and flexible care subsidy.

Note 2:       In 2017, the document referred to in paragraph (b) was available at http://www.health.gov.au. This is relevant for home care subsidy.

Modified Monash Model classification system means the Modified Monash Model geographical classification system developed by the Health Department for categorising metropolitan, regional, rural and remote locations according to both geographical remoteness and population size, based on population data published by the Australian Bureau of Statistics, as that system exists on 1 January 2017.

2  Subparagraph 63(b)(iii)

Omit “service; and”, substitute “service; or”.

3  At the end of paragraph 63(b)

Add:

                            (iv)  a 2017 scheme service; and

4  Paragraph 64(1)(b)

After “subsection 66(6)”, insert “or 66A(6)”.

5  Paragraph 65(1)(b)

After “subsection 66(7)”, insert “or 66A(7)”.

6  Subsection 66(1)

Repeal the subsection, substitute:

             (1)  A residential care service is a 2005 scheme service on a day if, on that day, the service:

                     (a)  meets the requirements of subsection (2), (6) or (7); and

                     (b)  does not meet the requirements of subsection 66A(8).

7  Subsection 66(2) (method statement, steps 2 and 3)

Repeal the steps, substitute:

Step 2.   Add an additional 15 points if the service is in a very remote location, a remote location or a moderately accessible location, and more than 50% of care recipients of the service (other than care recipients receiving respite care) are classified at a classification level that does not include any of the following:

               (a)     high ADL domain category;

              (b)     high CHC domain category;

               (c)     high behaviour domain category;

              (d)     a medium domain category in at least 2 domains.

Step 3.   Add an additional 60 points if subsection (4) applies to the service (care for homeless people, people from Aboriginal and Torres Strait Islander communities, or both).

8  Subsection 66(2) (method statement, step 5)

Repeal the step, substitute:

Step 5.   Add the number of points (if any) applicable to the service in respect of its number of places that are occupied under subsection (5).

9  Subsection 66(4)

Omit “the service scores 60 points”, substitute “this subsection applies to the service”.

10  Subsection 66(5)

After “places”, insert “that are occupied”.

11  Subsection 66(5) (table, headings)

Repeal the headings, substitute:

 

2005 scheme service—occupied places

Item

Occupied places

Points

 

12  At the end of Subdivision C of Division 5 of Part 3

Add:

66A  Meaning of 2017 scheme service

             (1)  A residential care service is a 2017 scheme service on a day if, on that day, the service meets the requirements of subsection (2), (6), (7) or (8).

             (2)  A residential care service meets the requirements of this subsection if, on or after 1 January 2017, the service:

                     (a)  is not a 1997 scheme service, a 2001 scheme service or a 2005 scheme service; and

                     (b)  scores at least 50 points, worked out as follows:

2017 scheme service points calculator

Step 1.   Work out the number of points (if any) applicable to the service in respect of its street address under subsection (3).

Step 2.   Add an additional 15 points if the classification for the street address of the service is MMM 5, MMM 6 or MMM 7, and more than 50% of care recipients of the service (other than care recipients receiving respite care) are classified at a classification level that does not include any of the following domain categories:

               (a)     high ADL domain category;

              (b)     high CHC domain category;

               (c)     high behaviour domain category;

              (d)     a medium domain category in at least 2 domains.

Step 3.   Add an additional 60 points if subsection (4) applies to the service (care for homeless people, people from Aboriginal and Torres Strait Islander communities, or both).

Step 4.   If the total of steps 1, 2 and 3 is more than 65, reduce the total to 65 points.

Step 5.   Add the number of points (if any) applicable to the service in respect of its number of places that are occupied under subsection (5).

Step 6.   Add an additional 5 points if more than 50% of care recipients are people with special needs (other than people who are people with special needs only because they live in rural or remote areas or are financially or socially disadvantaged).

The result is the points score for the 2017 scheme service.

 

Note 1:       In 2017, the Modified Monash Model classification for a street address was available at http://www.doctorconnect.gov.au.

Note 2:       For the classification of care recipients mentioned in step 2, see the Classification Principles.

             (3)  For step 1 of the points calculator in subsection (2), the number of points applicable to the service in respect of its street address is calculated using the scoring system in the following table:

 

2017 scheme services—street addresses

Item

Modified Monash Model classification

Points

1

MMM 1

0

2

MMM 2

0

3

MMM 3

0

4

MMM 4

30

5

MMM 5

40

6

MMM 6

55

7

MMM 7

65

 

Note:          In 2017, the Modified Monash Model classification for a street address was available at http://www.doctorconnect.gov.au.

             (4)  For step 3 of the points calculator in subsection (2), this subsection applies to the service if more than 50% of care recipients of the service (other than care recipients receiving respite care) have been appraised using either appraisal tool A or appraisal tool B in Schedule 2 as demonstrating complex behavioural needs and social disadvantage associated with their background as a homeless person or their background as a person from an Aboriginal or Torres Strait Islander community, or both, and:

                     (a)  the places allocated in respect of the residential care service are subject to a condition of allocation under section 14‑5 of the Act relating to the care of people with a background as homeless persons or persons from an Aboriginal or Torres Strait Islander community; or

                     (b)  the approved provider of the residential care service or its key personnel have demonstrated experience in providing, or the capacity to provide, specialist services for such persons, including:

                              (i)  programs and interventions to manage complex behavioural needs; or

                             (ii)  programs to promote social engagement and participation; or

                            (iii)  any other relevant services that the Secretary considers appropriate.

             (5)  For step 5 of the points calculator in subsection (2), the number of points applicable to the service in respect of its number of places that are occupied is calculated using the scoring system in the following table:

 

2017 scheme service—occupied places

Item

Occupied places

Points

1

Less than 20

30

2

More than 19 but less than 25

25

3

More than 24 but less than 30

20

4

More than 29 but less than 35

15

5

More than 34 but less than 40

10

6

More than 39 but less than 45

5

 

             (6)  A residential care service meets the requirements of this subsection if the service was a 1997 scheme service and, on at least 1 day on or after 1 January 2017:

                     (a)  the service scores at least 50 points under the scoring system set out in the points calculator in subsection (2); and

                     (b)  the amount of viability supplement payable in accordance with a determination made under subsection 44‑27(3) of the Act, for a day in respect of a care recipient to whom care is provided through the service as a 2017 scheme service is the same as or greater than the amount of viability supplement payable in respect of the care recipient for the day if the service was taken to be a 1997 scheme service.

             (7)  A residential care service meets the requirements of this subsection if the service was a 2001 scheme service and, on at least 1 day on or after 1 January 2017:

                     (a)  the service scores at least 50 points under the scoring system set out in the points calculator in subsection (2); and

                     (b)  the amount of viability supplement payable in accordance with a determination made under subsection 44‑27(3) of the Act, for a day in respect of a care recipient to whom care is provided through the service as a 2017 scheme service is the same as or greater than the amount of viability supplement payable in respect of the care recipient for the day if the service was taken to be a 2001 scheme service.

             (8)  A residential care service meets the requirements of this subsection if the service was a 2005 scheme service and, on at least 1 day on or after 1 January 2017:

                     (a)  the service scores at least 50 points under the scoring system set out in the points calculator in subsection (2); and

                     (b)  the amount of viability supplement payable in accordance with a determination made under subsection 44‑27(3) of the Act, for a day in respect of a care recipient to whom care is provided through the service as a 2017 scheme service is the same as or greater than the amount of viability supplement payable in respect of the care recipient for the day if the service was taken to be a 2005 scheme service.

13  Paragraph 70(a)

Omit “at least 50%”, substitute “more than 50%”.

14  Sections 98 and 99

Repeal the sections, substitute:

98  Viability supplement

          (1A)  Viability supplement for a care recipient in respect of a payment period is a supplement for the purposes of paragraph 48‑9(1)(b) of the Act.

             (1)  The viability supplement for a care recipient in respect of a payment period is the sum of all the viability supplements for the days during the period on which:

                     (a)  there was in force a home care agreement under which the care recipient was to be provided with home care through the home care service in question (whether or not home care was provided); and

                     (b)  the service meets the eligibility requirements under section 99.

99  Eligibility for viability supplement

MMM classification system eligibility—care recipients who were not provided with home care in a particular location before 1 January 2017

             (1)  A home care service meets the eligibility requirements for a viability supplement on a particular day if, on that day:

                     (a)  home care is provided through the home care service to the care recipient in a suburb or locality that has a Modified Monash Model classification of MMM 4 or greater; and

                     (b)  before 1 January 2017, home care had not been provided through a home care service to the care recipient in that suburb or locality.

Note:          Modified Monash Model classification is defined in section 4.

MMM classification system eligibility—care recipients who were provided with home care in the same suburb or locality before 1 January 2017

             (2)  A home care service meets the eligibility requirements for a viability supplement on a particular day if, on that day:

                     (a)  home care is provided through the home care service to the care recipient in a suburb or locality that has a Modified Monash Model classification of MMM 4 or greater; and

                     (b)  before 1 January 2017, home care had been provided through a home care service to the care recipient in that suburb or locality; and

                     (c)  on or after 1 January 2017, home care has not been provided by a home care service to the care recipient in another suburb or locality.

Note:          Modified Monash Model classification is defined in section 4.

ARIA value eligibility—care recipients who were provided with home care before 1 January 2017

             (3)  A home care service meets the eligibility requirements for a viability supplement on a particular day if:

                     (a)  on that day, the home care service does not meet the eligibility requirements under subsection (1) or (2); and

                     (b)  on that day, home care is provided through the home care service to the care recipient in a location that has an ARIA value of 3.52 or greater; and

                     (c)  immediately before 1 January 2017, home care was provided through a home care service to the care recipient in that location; and

                     (d)  on or after 1 January 2017, home care has not been provided by a home care service to the care recipient in another location.

Note:          ARIA value is defined in section 4.

15  Schedule 2 (note to heading)

Repeal the note, substitute:

Note:       See subsections 66(4) and 66A(4), and paragraph 70(a).

16  Subclauses 1(5) and (6) of Schedule 2

Repeal the subclauses, substitute:

             (5)  If:

                     (a)  the appraisal is for the purposes of subsection 66(4) or 66A(4); and

                     (b)  notification of the outcome of the appraisal is received by the Secretary before the end of the period specified in subclause (3);

any points that may be added under:

                     (c)  subsection 66(4) (for the purposes of step 3 of the 2005 scheme service points calculator in subsection 66(2)); or

                     (d)  subsection 66A(4) (for the purposes of step 3 of the 2017 scheme service points calculator in subsection 66A(2));

as a result of the outcome of the appraisal take effect on the care recipient’s entry day.

             (6)  If:

                     (a)  the appraisal is for the purposes of subsection 66(4) or 66A(4); and

                     (b)  notification of the outcome of the appraisal is received by the Secretary after the end of the period specified in subclause (3);

any points that may be added under:

                     (c)  subsection 66(4) (for the purposes of step 3 of the 2005 scheme service points calculator in subsection 66(2)); or

                     (d)  subsection 66A(4) (for the purposes of step 3 of the 2017 scheme service points calculator in subsection 66A(2));

as a result of the outcome of the appraisal take effect on the day the notification of the outcome of the appraisal is received by the Secretary.