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Approval of Care Recipients Principles 2014

Authoritative Version
Principles as amended, taking into account amendments up to Aged Care Legislation Amendment (Increasing Consumer Choice) Principles 2016
Administered by: Health
Registered 27 Feb 2017
Start Date 27 Feb 2017

Approval of Care Recipients Principles 2014

made under the

Aged Care Act 1997

Compilation No. 2

Compilation date:                              27 February 2017

Includes amendments up to:            F2016L01492

Registered:                                         27 February 2017

 

About this compilation

This compilation

This is a compilation of the Approval of Care Recipients Principles 2014 that shows the text of the law as amended and in force on 27 February 2017 (the compilation date).

The notes at the end of this compilation (the endnotes) include information about amending laws and the amendment history of provisions of the compiled law.

Uncommenced amendments

The effect of uncommenced amendments is not shown in the text of the compiled law. Any uncommenced amendments affecting the law are accessible on the Legislation Register (www.legislation.gov.au). The details of amendments made up to, but not commenced at, the compilation date are underlined in the endnotes. For more information on any uncommenced amendments, see the series page on the Legislation Register for the compiled law.

Application, saving and transitional provisions for provisions and amendments

If the operation of a provision or amendment of the compiled law is affected by an application, saving or transitional provision that is not included in this compilation, details are included in the endnotes.

Editorial changes

For more information about any editorial changes made in this compilation, see the endnotes.

Modifications

If the compiled law is modified by another law, the compiled law operates as modified but the modification does not amend the text of the law. Accordingly, this compilation does not show the text of the compiled law as modified. For more information on any modifications, see the series page on the Legislation Register for the compiled law.

Self‑repealing provisions

If a provision of the compiled law has been repealed in accordance with a provision of the law, details are included in the endnotes.

  

  

  


Contents

Part 1—Preliminary                                                                                                                                        1

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

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

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

Part 2—Eligibility to receive care                                                                                                           2

5............ Purpose of this Part....................................................................................................... 2

6............ Residential care.............................................................................................................. 2

7............ Home care..................................................................................................................... 2

8............ Flexible care—transition care........................................................................................ 4

8A......... Flexible care—short‑term restorative care..................................................................... 4

Part 3—Limitation of approvals                                                                                                             5

9............ Purpose of this Part....................................................................................................... 5

10.......... Residential care provided as respite care........................................................................ 5

11.......... Home care..................................................................................................................... 5

Part 4—Date of effect of approval                                                                                                        6

12.......... Purpose of this Part....................................................................................................... 6

13.......... Care provided in emergency circumstances................................................................... 6

Part 5—Lapsing of approval                                                                                                                     7

14.......... Purpose of this Part....................................................................................................... 7

15.......... Entry period................................................................................................................... 7

16.......... Circumstances in which approval lapses....................................................................... 7

Part 6—Transitional provisions                                                                                                               9

17.......... Residential care started before 1 July 2014 but approval given on or after that date...... 9

18.......... Transitional provisions relating to the Aged Care Legislation Amendment (Increasing Consumer Choice) Principles 2016............................................................................................................. 9

Endnotes                                                                                                                                                               11

Endnote 1—About the endnotes                                                                                                      11

Endnote 2—Abbreviation key                                                                                                          12

Endnote 3—Legislation history                                                                                                       13

Endnote 4—Amendment history                                                                                                     14

 


Part 1Preliminary

  

1  Name of principles

                   These principles are the Approval of Care Recipients Principles 2014.

3  Authority

                   These principles are made under the Aged Care Act 1997.

4  Definitions

                   In these principles:

Act means the Aged Care Act 1997.

Commonwealth home care package means a package of care and services in respect of which home care subsidy is payable.

episode of short‑term restorative care has the meaning given by section 4 of the Subsidy Principles 2014.

in‑patient hospital episode has the meaning given by section 4 of the Subsidy Principles 2014.

multi‑purpose service has the meaning given by section 4 of the Subsidy Principles 2014.

short‑term restorative care has the meaning given by section 4 of the Subsidy Principles 2014.

transition care has the meaning given by section 4 of the Subsidy Principles 2014.

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

(a)    flexible care;

(b)    home care;

(c)    respite care.

Part 2Eligibility to receive care

  

5  Purpose of this Part

                   For sections 21‑2, 21‑3 and 21‑4 of the Act, this Part specifies additional criteria that a person must meet to be eligible to receive residential care, home care or flexible care.

6  Residential care

             (1)  For paragraph 21‑2(c) of the Act, a person is eligible to receive residential care only if:

                     (a)  the person is assessed as:

                              (i)  having a condition of frailty or disability requiring continuing personal care; and

                             (ii)  being incapable of living in the community without support; and

                     (b)  for a person who is not an aged person—there are no other care facilities or care services more appropriate to meet the person’s needs.

             (2)  In deciding if a person meets the criteria mentioned in subsection (1), the Secretary must consider the person’s medical, physical, psychological and social circumstances, including (if relevant) the following:

                     (a)  evidence of a medical condition, as decided by a suitably qualified medical practitioner;

                     (b)  evidence of absence or loss of physical functions, as established by assessment of capacity to perform daily living tasks;

                     (c)  evidence of absence or loss of cognitive functioning, as established by:

                              (i)  a medical diagnosis of dementia or other condition; or

                             (ii)  assessment of capacity to perform daily living tasks; or

                            (iii)  evidence of behavioural dysfunction;

                     (d)  evidence of absence or loss of social functioning, as established by:

                              (i)  information provided by the person, a carer, family, friends or others; or

                             (ii)  assessment of capacity to perform daily living tasks;

                     (e)  evidence that the person’s life or health would be at significant risk if the person did not receive residential care.

7  Home care

Home care—level 1

             (1)  For paragraph 21‑3(c) of the Act, a person is eligible to be approved as a recipient of home care at level 1 only if:

                     (a)  the person is assessed as having needs that can only be met by a coordinated package of care services; and

                     (b)  the person is assessed as requiring a basic level of home care; and

                     (c)  the person prefers to remain living at home; and

                     (d)  the person is assessed as being able to live at home with the support of home care at level 1; and

                     (e)  for a person who is not an aged person—there are no other care facilities or care services more appropriate to meet the person’s needs.

Home care—level 2

             (2)  For paragraph 21‑3(c) of the Act, a person is eligible to be approved as a recipient of home care at level 2 only if:

                     (a)  the person is assessed as having needs that can only be met by a coordinated package of care services; and

                     (b)  the person is assessed as requiring a low level of home care; and

                     (c)  the person prefers to remain living at home; and

                     (d)  the person is assessed as being able to live at home with the support of home care at level 2; and

                     (e)  for a person who is not an aged person—there are no other care facilities or care services more appropriate to meet the person’s needs.

Home care—level 3

             (3)  For paragraph 21‑3(c) of the Act, a person is eligible to be approved as a recipient of home care at level 3 only if:

                     (a)  the person is assessed as having needs that can only be met by a coordinated package of care services; and

                     (b)  the person is assessed as requiring an intermediate level of home care; and

                     (c)  the person prefers to remain living at home; and

                     (d)  the person is assessed as being able to live at home with the support of home care at level 3; and

                     (e)  for a person who is not an aged person—there are no other care facilities or care services more appropriate to meet the person’s needs.

Home care—level 4

             (4)  For paragraph 21‑3(c) of the Act, a person is eligible to be approved as a recipient of home care at level 4 only if:

                     (a)  the person is assessed as having needs that can only be met by a coordinated package of care services; and

                     (b)  the person is assessed as requiring a high level of home care; and

                     (c)  the person prefers to remain living at home; and

                     (d)  the person is assessed as being able to live at home with the support of home care at level 4; and

                     (e)  for a person who is not an aged person—there are no other care facilities or care services more appropriate to meet the person’s needs.

8  Flexible care—transition care

                   For paragraph 21‑4(c) of the Act, a person is eligible to receive flexible care in the form of transition care only if the person:

                     (a)  is assessed as satisfying all of the following requirements:

                              (i)  the person is in the concluding stage of an in‑patient hospital episode;

                             (ii)  the person is medically stable;

                            (iii)  the person has the potential to benefit from transition care; and

                     (b)  is in hospital at the time the assessment is undertaken; and

                     (c)  would be assessed as eligible to receive residential care if the person applied for residential care.

8A  Flexible care—short‑term restorative care

                   For paragraph 21‑4(c) of the Act, a person is eligible to receive flexible care in the form of a single episode of short‑term restorative care (the proposed episode) only if:

                     (a)  the person is assessed as experiencing functional decline that is likely to be reversed or slowed through short‑term restorative care; and

                     (b)  the person is at risk of losing independence to such a degree that, without short‑term restorative care, it is likely that the person will require home care, residential care or flexible care provided through a multi‑purpose service; and

                     (c)  the person is not receiving residential care, home care through a Commonwealth home care package or flexible care in the form of transition care; and

                     (d)  the person is not on leave from a residential care service or a flexible care service through which the person is receiving flexible care in the form of transition care; and

                     (e)  the person would not be assessed as eligible to receive flexible care in the form of transition care if the person applied for flexible care in the form of transition care; and

                      (f)  the person has not, at any time during the 6 months before the date of assessment, received flexible care in the form of transition care; and

                     (g)  the person has not, at any time during the 3 months before the date of assessment, been hospitalised for a condition related to the functional decline mentioned in paragraph (a); and

                     (h)  the person is not receiving end of life care; and

                      (i)  in receiving the proposed episode, the person will not have received more than 2 episodes of short‑term restorative care in any 12 month period.

Part 3Limitation of approvals

  

9  Purpose of this Part

                   For section 22‑2 of the Act, this Part specifies matters and circumstances to which approval of a person as a care recipient of one or more types of aged care may be limited.

10  Residential care provided as respite care

             (1)  Approval of a person as a recipient of residential care may be limited to respite care if respite care is appropriate to the needs of the person, the person’s carer or both.

             (2)  If a person’s approval is limited to residential care provided as respite care, the approval may be limited to:

                     (a)  low level residential respite care; or

                     (b)  high level residential respite care.

             (3)  However, if the person is approved as a recipient of high level residential respite care, the limitation of the approval does not prevent the person receiving low level residential respite care.

11  Home care

             (1)  Approval of a person as a recipient of home care may be limited to one of the following levels of home care:

                     (a)  level 1;

                     (b)  level 2;

                     (c)  level 3;

                     (d)  level 4;

where level 4 is the highest level of home care and level 1 is the lowest.

             (2)  However, if a person is approved as a recipient of a particular level of home care, the limitation of approval to that level does not prevent the person receiving home care at a lower level.

Part 4Date of effect of approval

  

12  Purpose of this Part

                   For paragraph 22‑5(2)(b) of the Act, this Part sets out the circumstances in which the Secretary may be satisfied that a person who was provided with care before being approved as a recipient of that type of care urgently needed the care when it started.

13  Care provided in emergency circumstances

                   The Secretary may be satisfied that the person urgently needed the care when the care started if the Secretary is satisfied that an emergency existed when the care started.

Part 5Lapsing of approval

  

14  Purpose of this Part

                   For section 23‑3 of the Act, this Part specifies:

                     (a)  the entry period for flexible care in the form of transition care and flexible care in the form of short‑term restorative care; and

                     (b)  circumstances in which a person’s approval as a recipient of flexible care in the form of transition care, or flexible care in the form of short‑term restorative care, lapses.

15  Entry period

             (1)  For paragraph 23‑3(1)(a) of the Act, the entry period for a person who is approved as a recipient of flexible care in the form of transition care is 4 weeks beginning on the day after the approval is given under subsection 22‑1(2) of the Act.

             (2)  For paragraph 23‑3(1)(a) of the Act, the entry period for a person who is approved as a recipient of flexible care in the form of an episode of short‑term restorative care is 6 months beginning on the day after the approval is given under subsection 22‑1(2) of the Act.

16  Circumstances in which approval lapses

             (1)  For subsection 23‑3(3) of the Act, the approval of a person as a recipient of flexible care in the form of transition care lapses if the person is not provided, for a period of at least 1 day after the entry period for the person’s approval ends, with the care in respect of which the person is approved.

             (2)  For subsection 23‑3(3) of the Act, the approval of a person as a recipient of flexible care in the form of an episode of short‑term restorative care lapses if:

                     (a)  the episode of short‑term restorative care ends; or

                     (b)  both of the following apply:

                              (i)  for a period (the non‑care period) of at least 1 day after the entry period for the person’s approval ends, the person is not provided with the care in respect of which the person is approved;

                             (ii)  the provision of care to the person was not suspended in accordance with subsections 111C(3) to (5) of the Subsidy Principles 2014 for each day in the non‑care period.

             (3)  In this section:

entry period, for a person’s approval, means:

                     (a)  if the person is approved as a recipient of flexible care in the form of transition care—the entry period specified in subsection 15(1); or

                     (b)  if the person is approved as a recipient of flexible care in the form of short‑term restorative care—the entry period specified in subsection 15(2).

Part 6Transitional provisions

  

17  Residential care started before 1 July 2014 but approval given on or after that date

             (1)  This section applies to a person:

                     (a)  who started to be provided with residential care (other than residential care provided as respite care) before 1 July 2014; and

                     (b)  who is approved as a recipient of residential care under section 22‑1 of the Act on or after 1 July 2014; and

                     (c)  whose approval as a recipient of residential care is taken to have had effect from the day on which the care started because of subsection 22‑5(2) of the Act.

             (2)  The approval may be limited to a high level of residential care or a low level of residential care.

             (3)  However, if the person is approved as a recipient of a high level of residential care, the limitation of the approval does not prevent the person receiving residential care at any classification level.

             (4)  In this section:

high level of residential care has the meaning given by section 9.3 of the Classification Principles 1997 as in force immediately before 1 July 2014.

low level of residential care has the meaning given by section 9.3 of the Classification Principles 1997 as in force immediately before 1 July 2014.

18  Transitional provisions relating to the Aged Care Legislation Amendment (Increasing Consumer Choice) Principles 2016

             (1)  If:

                     (a)  immediately before the commencement of this section, a person met the criteria in paragraphs 7(1)(b) and (d) of the old principles; and

                     (b)  the person did so as a result of an assessment of the person made at any time before the commencement of this section;

on and after the commencement of this section the person is taken, for the purposes of paragraphs 7(2)(b) and (d) of the new principles, to have been assessed as a result of that assessment as:

                     (c)  requiring a low level of home care; and

                     (d)  being able to live at home with the support of home care at level 2.

             (2)  If:

                     (a)  immediately before the commencement of this section, a person met the criteria in paragraphs 7(2)(b) and (d) of the old principles; and

                     (b)  the person did so as a result of an assessment of the person made at any time before the commencement of this section;

on and after the commencement of this section the person is taken, for the purposes of paragraphs (7)(4)(b) and (d) of the new principles, to have been assessed as a result of that assessment as:

                     (c)  requiring a high level of home care; and

                     (d)  being able to live at home with the support of home care at level 4.

             (3)  In this section:

new principles means these principles as in force on the day this section commences.

old principles means these principles as in force immediately before the day this section commences.


Endnotes

Endnote 1—About the endnotes

The endnotes provide information about this compilation and the compiled law.

The following endnotes are included in every compilation:

Endnote 1—About the endnotes

Endnote 2—Abbreviation key

Endnote 3—Legislation history

Endnote 4—Amendment history

Abbreviation key—Endnote 2

The abbreviation key sets out abbreviations that may be used in the endnotes.

Legislation history and amendment history—Endnotes 3 and 4

Amending laws are annotated in the legislation history and amendment history.

The legislation history in endnote 3 provides information about each law that has amended (or will amend) the compiled law. The information includes commencement details for amending laws and details of any application, saving or transitional provisions that are not included in this compilation.

The amendment history in endnote 4 provides information about amendments at the provision (generally section or equivalent) level. It also includes information about any provision of the compiled law that has been repealed in accordance with a provision of the law.

Editorial changes

The Legislation Act 2003 authorises First Parliamentary Counsel to make editorial and presentational changes to a compiled law in preparing a compilation of the law for registration. The changes must not change the effect of the law. Editorial changes take effect from the compilation registration date.

If the compilation includes editorial changes, the endnotes include a brief outline of the changes in general terms. Full details of any changes can be obtained from the Office of Parliamentary Counsel.

Misdescribed amendments

A misdescribed amendment is an amendment that does not accurately describe the amendment to be made. If, despite the misdescription, the amendment can be given effect as intended, the amendment is incorporated into the compiled law and the abbreviation “(md)” added to the details of the amendment included in the amendment history.

If a misdescribed amendment cannot be given effect as intended, the abbreviation “(md not incorp)” is added to the details of the amendment included in the amendment history.

Endnote 2—Abbreviation key

 

ad = added or inserted

o = order(s)

am = amended

Ord = Ordinance

amdt = amendment

orig = original

c = clause(s)

par = paragraph(s)/subparagraph(s)

C[x] = Compilation No. x

    /sub‑subparagraph(s)

Ch = Chapter(s)

pres = present

def = definition(s)

prev = previous

Dict = Dictionary

(prev…) = previously

disallowed = disallowed by Parliament

Pt = Part(s)

Div = Division(s)

r = regulation(s)/rule(s)

ed = editorial change

reloc = relocated

exp = expires/expired or ceases/ceased to have

renum = renumbered

    effect

rep = repealed

F = Federal Register of Legislation

rs = repealed and substituted

gaz = gazette

s = section(s)/subsection(s)

LA = Legislation Act 2003

Sch = Schedule(s)

LIA = Legislative Instruments Act 2003

Sdiv = Subdivision(s)

(md) = misdescribed amendment can be given

SLI = Select Legislative Instrument

    effect

SR = Statutory Rules

(md not incorp) = misdescribed amendment

Sub‑Ch = Sub‑Chapter(s)

    cannot be given effect

SubPt = Subpart(s)

mod = modified/modification

underlining = whole or part not

No. = Number(s)

    commenced or to be commenced

 

Endnote 3—Legislation history

 

Name

Registration

Commencement

Application, saving and transitional provisions

Approval of Care Recipients Principles 2014

24 June 2014 (F2014L00804)

1 July 2014 (s 2)

 

Aged Care Legislation Amendment (Short‑term Restorative Care) Principles 2016

5 May 2016 (F2016L00670)

Sch 1 (items 9–15):
6 May 2016 (s 2(1) item 1)

Aged Care Legislation Amendment (Increasing Consumer Choice) Principles 2016

23 Sept 2016 (F2016L01492)

Sch 1 (items 26, 27): 27 Feb 2017 (s 2(1) item 3)

 

Endnote 4—Amendment history

 

Provision affected

How affected

Part 1

 

s 2.............................................

rep LA s 48D

s 4.............................................

am F2016L00670

Part 2

 

s 7.............................................

rs F2016L01492

s 8A..........................................

ad F2016L00670

Part 5

 

s 14...........................................

am F2016L00670

s 15...........................................

am F2016L00670

s 16...........................................

am F2016L00670

Part 6

 

s 18...........................................

ad F2016L01492