Contents
Chapter 1—Preliminary 1
Part 1—Preliminary 1
1............ Name of principles........................................................................................................ 1
3............ Authority....................................................................................................................... 1
4............ Definitions..................................................................................................................... 1
4A......... Meaning of compounding factors................................................................................. 4
Chapter 2—Classification of care recipients under Part 2.4 of the Act before 1 October 2022 6
Part 2—Classification of care recipients 6
5............ Purpose of this Part....................................................................................................... 6
6............ Procedure for determining classification level—residential care other than respite care. 6
7............ Procedure for determining classification level—respite care.......................................... 7
Part 3—Classes of care recipients excluded from classification 8
8............ Purpose of this Part....................................................................................................... 8
9............ Exclusion of class of care recipients.............................................................................. 8
Part 4—Classification levels 9
10.......... Purpose of this Part....................................................................................................... 9
11.......... Classification levels....................................................................................................... 9
12.......... Lowest applicable classification level—care other than respite care............................... 9
Part 5—Appraisals of the level of care needed 10
13.......... Purpose of this Part..................................................................................................... 10
14.......... Circumstance and alternative period............................................................................ 10
15.......... Appraisal procedure.................................................................................................... 10
Part 6—Suspending approved providers from making appraisals and reappraisals 12
16.......... Purpose of this Part..................................................................................................... 12
16A....... Stay of suspension agreements—class of persons excluded from being appointed as advisers 12
16B....... Stay of suspension agreements—matters to be taken into account in specifying period for appointing advisers 12
17.......... Requirements for applications for the lifting of suspensions....................................... 12
Part 7—When respite care classifications take effect 14
18.......... Purpose of this Part..................................................................................................... 14
19.......... Day of effect................................................................................................................ 14
Part 8—Expiry and renewal of classifications 15
20.......... Purpose of this Part..................................................................................................... 15
21.......... Different expiry dates.................................................................................................. 15
22.......... Circumstances in which care needs are taken to have changed significantly................ 15
23.......... Procedure for determining renewal of classification.................................................... 16
Part 9—Changing classifications 17
24.......... Purpose of this Part..................................................................................................... 17
25.......... Changing classifications.............................................................................................. 17
Part 10—Application fees for reconsideration of decisions to change classification of care recipients 18
26.......... Purpose of this Part..................................................................................................... 18
27.......... Application fees........................................................................................................... 18
28.......... Waiver of application fees........................................................................................... 18
29.......... Refund of application fees........................................................................................... 18
Chapter 3—Classification of care recipients under Part 2.4A of the Act on or after 1 October 2022 19
Part 11—Classification of care recipients 19
30.......... Purpose of this Part..................................................................................................... 19
31.......... Procedure for determining appropriate classification level—respite care..................... 19
32.......... Procedure for determining appropriate classification level—non‑respite care.............. 19
Part 11A—When classifications take effect 22
33.......... Purpose of this Part..................................................................................................... 22
33A....... Classification made and in effect before 1 October 2022............................................. 22
33B....... Classification made on or after 1 October 2022—entry for residential care as non‑respite care before that day 22
33C....... Classification made on or after 1 October 2022—entry for residential care as non‑respite care on or after that day 22
33D....... Classification made on or after 1 October 2022—entry for residential care as respite care on or after that day 23
33E........ Reclassification of care recipient.................................................................................. 23
Part 12—Assessments of the level of care needed 24
34.......... Purpose of this Part..................................................................................................... 24
34A....... Where the Secretary may make an assessment............................................................ 24
35.......... Assessment procedure—respite care........................................................................... 24
36.......... Assessment procedure—non‑respite care.................................................................... 24
37.......... Circumstances in which recipients of respite care are taken to have been assessed..... 25
Part 13—Classification levels 26
38.......... Purpose of this Part..................................................................................................... 26
39.......... Classification levels—respite care............................................................................... 26
40.......... Classification levels—non‑respite care........................................................................ 26
Part 14—Reclassification of care recipients 27
41.......... Purpose of this Part..................................................................................................... 27
42.......... Circumstances in which care needs are taken to have changed significantly—respite care 27
43.......... Circumstances in which care needs are taken to have changed significantly—non‑respite care 27
Part 15—Criteria for delegates 28
44.......... Purpose of this Part..................................................................................................... 28
45.......... Criteria for persons to whom assessment powers may be delegated........................... 28
Chapter 4—Application, transitional and saving provisions 29
46.......... Conversion of classification for respite care made under Part 2.4 of the Act before 1 October 2022 29
Schedule 1—Scores for question ratings 30
Part 1—ADL domain 30
1............ Scores.......................................................................................................................... 30
Part 2—Behaviour domain 31
2............ Scores.......................................................................................................................... 31
Part 3—CHC domain 32
3............ Scores.......................................................................................................................... 32
Schedule 2—Domain categories 33
Part 1—ADL domain 33
1............ Domain categories....................................................................................................... 33
Part 2—Behaviour domain 34
2............ Domain categories....................................................................................................... 34
Part 3—CHC domain 35
3............ Domain categories....................................................................................................... 35
Endnotes 36
Endnote 1—About the endnotes 36
Endnote 2—Abbreviation key 37
Endnote 3—Legislation history 38
Endnote 4—Amendment history 39
Chapter 1—Preliminary
Part 1—Preliminary
1 Name of principles
These principles are the Classification Principles 2014.
3 Authority
These principles are made under section 96‑1 of the Aged Care Act 1997.
4 Definitions
Note: A number of expressions used in this instrument are defined in the Act, including the following:
(a) classification level;
(b) disqualified individual;
(c) lowest applicable classification level.
In these principles:
Act means the Aged Care Act 1997.
ADL domain means the domain relating to activities of daily living.
AFM assessment item means the Australian Modified Functional Independence Measure assessment item of the AN‑ACC Assessment Tool.
AFM cognition score, for a care recipient, means the care recipient’s total score for communication and social cognition on the AFM assessment item.
AFM communication score, for a care recipient, means the care recipient’s total score for communication on the AFM assessment item.
AFM eating score, for a care recipient, means the care recipient’s score for eating on the AFM assessment item.
AFM motor score, for a care recipient, means the care recipient’s total score for self‑care, sphincter control, transfers and locomotion on the AFM assessment item.
AFM social cognition score, for a care recipient, means the care recipient’s total score for social cognition on the AFM assessment item.
AFM transfers score, for a care recipient, means the care recipient’s total score for transfers on the AFM assessment item.
agitation score, for a care recipient, means the care recipient’s score for physically aggressive or inappropriate behaviour on the Behaviour Resource Utilisation Assessment assessment item of the AN‑ACC Assessment Tool.
AKPS assessment item means the Australia‑modified Karnofsky Performance Status assessment item of the AN‑ACC Assessment Tool.
AKPS score, for a care recipient, means the care recipient’s score on the AKPS assessment item.
AN‑ACC Assessment Tool means the Australian National Aged Care Classification Assessment Tool, published by the Department, as existing on 1 April 2021.
Note: The AN‑ACC Assessment Tool could in 2021 be viewed on the Department’s website (https://www.health.gov.au).
AN‑ACC Reference Manual means the Australian National Aged Care Classification Reference Manual, published by the Department, as existing on 1 April 2021.
Note: The AN‑ACC Reference Manual could in 2021 be viewed on the Department’s website (https://www.health.gov.au).
Answer Appraisal Pack means the version of the Aged Care Funding Instrument (ACFI) Answer Appraisal Pack published by the Department in December 2016, as it exists on 9 December 2016.
Note: In 2016, the Answer Appraisal Pack was accessible at http://www.agedcare.health.gov.au.
applicable day for a classification means:
(a) if the classification was made before 1 October 2022—the day the classification was made; or
(b) if the classification is made on or after 1 October 2022—the day the classification takes effect.
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 version of the Aged Care Funding Instrument (ACFI) Assessment Pack published by the Department in December 2016, as it exists on 9 December 2016.
Note: In 2016, the Assessment Pack was accessible at http://www.agedcare.health.gov.au.
behaviour domain means the domain relating to behaviour.
Braden activity score, for a care recipient, means the care recipient’s score for activity on the Braden Scale assessment item of the AN‑ACC Assessment Tool.
Braden total score, for a care recipient, means the care recipient’s total score on the Braden Scale assessment item of the AN‑ACC Assessment Tool.
break period for a care recipient has the meaning given by subsection 33C(3).
CHC domain means the domain relating to complex health care.
compounding factors has the meaning given by section 4A.
DEMMI score, for a care recipient, means the care recipient’s total score on the De Morton Mobility Index assessment item.
De Morton Mobility Index assessment item means the De Morton Mobility Index assessment item of the AN‑ACC Assessment Tool.
disruptiveness score, for a care recipient, means the care recipient’s score for verbally disruptive or noisy behaviour on the Behaviour Resource Utilisation Assessment assessment item of the AN‑ACC Assessment Tool.
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.
higher cognitive ability: a care recipient who is mobile only with assistance has higher cognitive ability if the care recipient’s AFM cognition score is 22 or more.
higher function: a care recipient who is not mobile has higher function if the care recipient’s RUG total score is 16 or less.
higher pressure sore risk: a care recipient who is not mobile has higher pressure sore risk if the care recipient’s Braden total score is 13 or less.
independently mobile: a care recipient is independently mobile if the care recipient’s DEMMI score is 13 or more.
lower cognitive ability: a care recipient who is mobile only with assistance has lower cognitive ability if the care recipient’s AFM cognition score is 10 or less.
lower function: a care recipient who is not mobile has lower function if the care recipient’s RUG total score is 17 or more.
lower pressure sore risk: a care recipient who is not mobile has lower pressure sore risk if the care recipient’s Braden total score is 14 or more.
medium cognitive ability: a care recipient who is mobile only with assistance has medium cognitive ability if the care recipient’s AFM cognition score is between 11 and 21 (inclusive).
mobile only with assistance: a care recipient is mobile only with assistance if the care recipient’s DEMMI score is between 4 and 12 (inclusive).
multi‑purpose service has the meaning given by section 104 of the Subsidy Principles 2014.
National Law has the same meaning as in the My Health Records Act 2012.
not mobile: a care recipient is not mobile if the care recipient’s DEMMI score is 3 or less.
occupational therapist means a person who holds a general registration under the National Law in the occupational therapy profession as an occupational therapist.
physiotherapist means a person who holds a general registration under the National Law in the physiotherapy profession as a physiotherapist.
police certificate, for a person, means a report about a person’s criminal conviction record prepared by:
(a) the Australian Federal Police; or
(b) the Australian Criminal Intelligence Commission; or
(c) an agency accredited by the Australian Criminal Intelligence Commission; or
(d) the police force or police service of a State or Territory.
registered nurse means a person who holds a general registration under the National Law in the nursing profession as a registered nurse.
Rockwood frailty score, for a care recipient, means the care recipient’s score on the Rockwood Frailty Score assessment item of the AN‑ACC Assessment Tool.
RUG total score, for a care recipient, means the care recipient’s total score on the Resource Utilisation Group ‑ Activities of Daily Living assessment item of the AN‑ACC Assessment Tool.
serious offence conviction has the same meaning as in the Aged Care Quality and Safety Commission Rules 2018.
significant: a care recipient mentioned in an item of the table in section 4A has significant compounding factors if the compounding factors for the care recipient, considered together, indicate that the care recipient has significantly higher care needs relative to the needs of other care recipients mentioned in that item.
User Guide means the version of the Aged Care Funding Instrument (ACFI) User Guide published by the Department in December 2016, as it exists on 9 December 2016.
Note: In 2016, the User Guide was accessible at http://www.agedcare.health.gov.au.
4A Meaning of compounding factors
The following table sets out the compounding factors for care recipients.
| Compounding factors for care recipients |
| Item | Column 1
For a care recipient who ... | Column 2
the compounding factors are the following ... |
| 1 | is independently mobile | (a) the care recipient’s AFM cognition score; (b) the care recipient’s agitation score; (c) the care recipient’s AKPS score; (d) the care recipient’s RUG total score; (e) whether the care recipient requires daily injections. |
| 2 | is mobile only with assistance and has higher cognitive ability | (a) the care recipient’s AFM motor score; (b) the care recipient’s AFM social cognition score; (c) the care recipient’s AKPS score; (d) the care recipient’s Braden activity score; (e) whether the care recipient has fallen in the last 12 months; (f) whether the care recipient requires daily injections. |
| 3 | is mobile only with assistance and has medium cognitive ability | (a) the care recipient’s AFM communication score; (b) the care recipient’s disruptiveness score; (c) the care recipient’s Rockwood Frailty Score; (d) the care recipient’s RUG total score; (e) whether the care recipient requires complex wound management; (f) whether the care recipient requires daily injections. |
| 4 | is not mobile and has higher function | (a) the care recipient’s AFM transfers score; (b) the care recipient’s Braden total score; (c) the care recipient’s disruptiveness score; (d) whether the care recipient requires complex wound management; (e) whether the care recipient requires daily injections. |
| 5 | is not mobile and has lower function and higher pressure sore risk | (a) the care recipient’s AFM eating score; (b) the care recipient’s disruptiveness score; (c) whether the care recipient has fallen in the last 12 months; (d) whether the care recipient has lost more than 10% of their body weight in the last 12 months; (e) whether the care recipient requires daily injections. |
Chapter 2—Classification of care recipients under Part 2.4 of the Act before 1 October 2022
Part 2—Classification 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 on a day before 1 October 2022.
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 3—Classes 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 4—Classification 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 on a day before 1 October 2022.
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 5—Appraisals 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 on a day before 1 October 2022, 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 requirements mentioned in subsection (3); and
(b) complete an application for classification using the completed Answer Appraisal Pack.
(3) For the purposes of paragraph (2)(a), the requirements are that:
(a) the Answer Appraisal Pack must be completed 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) if the User Guide requires a directive from a health care practitioner as evidence in respect of care mentioned in a question or part of a question in the Answer Appraisal Pack, the care may be taken into account only if:
(i) a directive has been given for the care by the kind of health care practitioner mentioned in the User Guide in respect of that care; and
(ii) the directive states the manner in which the care is to be provided and the qualifications of the person who is to provide the care; and
(iii) the care was, is or is to be provided in the manner, and by a person with the qualifications, stated in the directive.
Part 6—Suspending approved providers from making appraisals and reappraisals
16 Purpose of this Part
For the purposes of sections 25‑4A and 25‑4C of the Act, this Part:
(a) excludes a class of persons from being appointed as advisers under stay of suspension agreements; and
(b) specifies matters that the Secretary must take into account in specifying the period within which an adviser must be appointed under a stay of suspension agreement; and
(c) specifies requirements that must be met by an application for the lifting of a suspension of an approved provider from making appraisals and reappraisals.
16A Stay of suspension agreements—class of persons excluded from being appointed as advisers
For the purposes of subsection 25‑4A(4) of the Act, a disqualified individual is excluded from being appointed as an adviser.
Note: For the meaning of disqualified individual, see section 10A‑1 of the Act.
16B Stay of suspension agreements—matters to be taken into account in specifying period for appointing advisers
For the purposes of subsection 25‑4A(5) of the Act, in specifying, in a stay of suspension agreement, the period within which an approved provider must appoint an adviser, the Secretary must take into account:
(a) the location of each aged care service to which the proposed suspension under subsection 25‑4(1) of the Act relates; and
(b) the number of classifications to which the proposed suspension relates; and
(c) the extent to which the information to which the proposed suspension relates is false, misleading or inaccurate.
17 Requirements for applications for the lifting of suspensions
For the purposes of paragraph 25‑4C(3)(b) of the Act, an application for the lifting of a suspension of an approved provider from making appraisals and reappraisals 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 7—When 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 on a day before 1 October 2022 as respite care takes effect.
19 Day of effect
The classification takes effect on the first day the care recipient enters respite care.
Part 8—Expiry 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.
Part 9—Changing classifications
24 Purpose of this Part
For the purposes of paragraph 29‑1(3)(b) of the Act, this Part specifies matters that the Secretary must have regard to in reviewing the classification of a care recipient being provided with residential care on a day before 1 October 2022.
25 Changing classifications
For the purposes of paragraph 29‑1(3)(b) of the Act, if care mentioned in paragraph 15(3)(b) (care covered by a directive) was taken into account in making the appraisal in respect of the care recipient that was taken into account in classifying the care recipient, the Secretary must have regard to whether that care was, is or is to be provided in the manner, and by a person with the qualifications, stated in the directive.
Part 10—Application fees for reconsideration of decisions to change classification of care recipients
26 Purpose of this Part
For the purposes of section 85‑6 of the Act, this Part:
(a) specifies the application fee for a request made under subsection 85‑5(1) of the Act for reconsideration of a reviewable decision made under subsection 29‑1(1) of the Act (a decision to change the classification of a care recipient); and
(b) deals with the circumstances in which the Secretary may waive the fee; and
(c) deals with the circumstances in which the fee may be refunded.
27 Application fees
(1) For the purposes of subsection 85‑6(1) of the Act, the application fee for a request is the sum of $375 for each question in the Answer Appraisal Pack that the request relates to.
(2) A request relates to a question if the request relates to the change of the rating for that question.
28 Waiver of application fees
For the purposes of paragraph 85‑6(3)(a) of the Act, the Secretary may waive the application fee for a request if the Secretary is satisfied that there are exceptional circumstances that justify the waiver.
29 Refund of application fees
For the purposes of paragraph 85‑6(3)(c) of the Act, the application fee for a request may be refunded if:
(a) the whole or a part of the decision to which the request relates is varied or set aside; and
(b) the decision or part of the decision relates to the change of the rating for one or more questions in the Answer Appraisal Pack; and
(c) as a result of the varying or setting aside of the decision or part of the decision, the classification of the care recipient to which the decision relates is changed back to the classification that applied to the care recipient before the decision took effect; and
(d) the request did not include any material or information that was not available to the Secretary for the purposes of the review of the classification under subsection 29‑1(3) of the Act.
Chapter 3—Classification of care recipients under Part 2.4A of the Act on or after 1 October 2022
Part 11—Classification of care recipients
30 Purpose of this Part
For the purposes of subsection 29C‑2(3) of the Act, this Part specifies the procedure the Secretary must follow in determining the appropriate classification level for a care recipient for respite care or non‑respite care.
31 Procedure for determining appropriate classification level—respite care
(1) For the purposes of subsection 29C‑2(3) of the Act, the procedure set out in subsection (2) of this section is specified for determining the appropriate classification level for a care recipient for respite care.
(2) The Secretary must take the following steps, using the assessment of the care needs of the care recipient made under section 29C‑3 of the Act for the purposes of classifying the care recipient.
Step 1. Work out whether the care recipient is independently mobile, is mobile only with assistance or is not mobile.
Step 2. Determine that the appropriate classification level for the care recipient is as follows:
(a) if the care recipient is independently mobile—Respite Class 1;
(b) if the care recipient is mobile only with assistance—Respite Class 2;
(c) if the care recipient is not mobile—Respite Class 3.
32 Procedure for determining appropriate classification level—non‑respite care
(1) For the purposes of subsection 29C‑2(3) of the Act, the procedure set out in subsection (2) of this section is specified for determining the appropriate classification level for a care recipient for non‑respite care.
(2) The Secretary must take the following steps, using the assessment of the care needs of the care recipient made under section 29C‑3 of the Act for the purposes of classifying the care recipient.
Step 1. If the Secretary has assessed the care recipient as having palliative care status, steps 2 to 5 do not apply to the care recipient.
Step 2. Work out whether the care recipient is independently mobile, is mobile only with assistance or is not mobile.
Step 3. If the care recipient is mobile only with assistance, work out whether the care recipient has higher cognitive ability, medium cognitive ability or lower cognitive ability.
Step 4. If the care recipient is not mobile:
(a) work out whether the care recipient has higher function or lower function; and
(b) if the care recipient has lower function—work out whether the care recipient has higher pressure sore risk or lower pressure sore risk.
Step 5. If the care recipient:
(a) is independently mobile; or
(b) is mobile only with assistance and has higher cognitive ability or medium cognitive ability; or
(c) is not mobile and has higher function; or
(d) is not mobile, has lower function and has higher pressure sore risk;
determine whether the care recipient has significant compounding factors.
Step 6. Determine the appropriate classification level for the care recipient in accordance with the table in subsection (3).
(3) The following table sets out the classification levels for care recipients for the purposes of step 6 in subsection (2).
| Classification levels for care recipients |
| Item | Column 1
If the care recipient ... | Column 2
the appropriate classification level for the care recipient is ... |
| 1 | has been assessed as having palliative care status | Class 1. |
| 2 | (a) is independently mobile; and (b) does not have significant compounding factors | Class 2. |
| 3 | (a) is independently mobile; and (b) has significant compounding factors | Class 3. |
| 4 | (a) is mobile only with assistance; and (b) has higher cognitive ability; and (c) does not have significant compounding factors | Class 4. |
| 5 | (a) is mobile only with assistance; and (b) has higher cognitive ability; and (c) has significant compounding factors | Class 5. |
| 6 | (a) is mobile only with assistance; and (b) has medium cognitive ability; and (c) does not have significant compounding factors | Class 6. |
| 7 | (a) is mobile only with assistance; and (b) has medium cognitive ability; and (c) has significant compounding factors | Class 7. |
| 8 | (a) is mobile only with assistance; and (b) has lower cognitive ability | Class 8. |
| 9 | (a) is not mobile; and (b) has higher function; and (c) does not have significant compounding factors | Class 9. |
| 10 | (a) is not mobile; and (b) has higher function; and (c) has significant compounding factors | Class 10. |
| 11 | (a) is not mobile; and (b) has lower function; and (c) has lower pressure sore risk | Class 11. |
| 12 | (a) is not mobile; and (b) has lower function; and (c) has higher pressure sore risk; and (d) does not have significant compounding factors | Class 12. |
| 13 | (a) is not mobile; and (b) has lower function; and (c) has higher pressure sore risk; and (d) has significant compounding factors | Class 13. |
Part 11A—When classifications take effect
33 Purpose of this Part
For the purposes of subsection 29C‑2(6) of the Act, this Part specifies the day on which classifications of care recipients under Part 2.4A of the Act take effect.
Note: Classifications under Part 2.4A of the Act affect an amount of subsidy payable on or after 1 October 2022.
33A Classification made and in effect before 1 October 2022
If:
(a) a classification of a care recipient for respite care or non‑respite care under Part 2.4A of the Act was made before 1 October 2022; and
(b) the classification was in effect immediately before 1 October 2022;
the classification takes effect on 1 October 2022.
33B Classification made on or after 1 October 2022—entry for residential care as non‑respite care before that day
If:
(a) a care recipient entered a residential care service to be provided with residential care as non‑respite care before 1 October 2022; and
(b) the recipient is classified for non‑respite care under Part 2.4A of the Act on or after 1 October 2022;
the classification takes effect on 1 October 2022.
33C Classification made on or after 1 October 2022—entry for residential care as non‑respite care on or after that day
(1) If:
(a) a care recipient enters a residential care service to be provided with residential care as non‑respite care on or after 1 October 2022; and
(b) the recipient is classified for non‑respite care under Part 2.4A of the Act on or after 1 October 2022;
the classification takes effect on the day the recipient first enters a residential care service to be provided with residential care as non‑respite care on or after 1 October 2022.
(2) However, if the care recipient has a break period of more than 28 days before the recipient is classified for non‑respite care, the classification takes effect on the day the break period for the recipient ends.
(3) A break period for a care recipient:
(a) begins on the day on which the recipient ceases to be provided with residential care as non‑respite care through a residential care service (other than because the recipient is on leave from the service); and
(b) ends on the day on which the recipient next enters a residential care service to be provided with residential care as non‑respite care.
33D Classification made on or after 1 October 2022—entry for residential care as respite care on or after that day
If:
(a) a care recipient enters a residential care service to be provided with residential care as respite care on or after 1 October 2022; and
(b) the recipient is classified for respite care under Part 2.4A of the Act on or after 1 October 2022;
the classification takes effect on the day the recipient first enters a residential care service to be provided with residential care as respite care on or after 1 October 2022.
33E Reclassification of care recipient
Reclassification requested before 1 October 2022
(1) If:
(a) before 1 October 2022, an approved provider or a care recipient requests that the Secretary reclassify the recipient under subsection 29D‑1(1) of the Act; and
(b) the Secretary decides to reclassify the recipient under that subsection; and
(c) as a result, the recipient is classified under Part 2.4A of the Act on or after 1 October;
the classification takes effect on 1 October 2022.
Reclassification requested on or after 1 October 2022
(2) If:
(a) on or after 1 October 2022, an approved provider or a care recipient requests that the Secretary reclassify the recipient under subsection 29D‑1(1) of the Act; and
(b) the Secretary decides to reclassify the recipient under that subsection; and
(c) as a result, the recipient is classified under Part 2.4A of the Act on or after 1 October;
the classification takes effect on the day the request was made.
Part 12—Assessments of the level of care needed
34 Purpose of this Part
For the purposes of section 29C‑3 of the Act, this Part specifies:
(a) where the Secretary may assess the level of care needed by a care recipient; and
(aa) procedures that the Secretary must follow in making such an assessment; and
(b) the circumstances in which recipients of respite care are taken to have been assessed.
34A Where the Secretary may make an assessment
For the purposes of paragraph 29C‑3(2)(a) of the Act, the Secretary may assess the level of care needed by a care recipient at a residential care service or any other place (as appropriate).
35 Assessment procedure—respite care
(1) For the purposes of paragraph 29C-3(2)(b) of the Act, the procedure set out in subsection (2) of this section is specified for a care recipient being provided with respite care.
(2) The Secretary must complete the De Morton Mobility Index assessment item in accordance with the part of the AN‑ACC Reference Manual that relates to that item.
36 Assessment procedure—non‑respite care
(1) For the purposes of paragraph 29C-3(2)(b) of the Act, the procedure set out in subsections (2) and (3) of this section is specified for a care recipient being provided with non‑respite care through a residential care service.
(2) If:
(a) a document was given to the Secretary in relation to the care recipient in accordance with section 27 of the Accountability Principles 2014; and
(b) according to the document, the care recipient had:
(i) a prognosis of a life expectancy of 3 months or less on the day the care recipient entered the residential care service to be provided with non‑respite care in the form of palliative care; and
(ii) an AKPS score of 40 or less;
the Secretary must assess the care recipient as having palliative care status.
(3) If the Secretary does not assess the care recipient as having palliative care status under subsection (2), the Secretary must complete the AN‑ACC Assessment Tool in accordance with the AN‑ACC Reference Manual in relation to the care recipient.
37 Circumstances in which recipients of respite care are taken to have been assessed
For the purposes of subsection 29C‑3(3) of the Act, the circumstances are that the assessment of the care recipient’s care needs mentioned in paragraph 29C‑3(3)(a) of the Act was completed using the De Morton Mobility Index assessment item in accordance with the part of the AN‑ACC Reference Manual that relates to that item.
Part 13—Classification levels
38 Purpose of this Part
For the purposes of section 29C‑5 of the Act, this Part sets out classification levels for classifications of care recipients.
39 Classification levels—respite care
For the purposes of subsection 29C‑5(1) of the Act, the following are the classification levels for classifications for respite care:
(a) Respite Class 1;
(b) Respite Class 2;
(c) Respite Class 3.
40 Classification levels—non‑respite care
For the purposes of subsection 29C‑5(1) of the Act, the following are the classification levels for classifications for non‑respite care:
(a) Class 1;
(b) Class 2;
(c) Class 3;
(d) Class 4;
(e) Class 5;
(f) Class 6;
(g) Class 7;
(h) Class 8;
(i) Class 9;
(j) Class 10;
(k) Class 11;
(l) Class 12;
(m) Class 13.
Part 14—Reclassification of care recipients
41 Purpose of this Part
For the purposes of subsection 29D‑1(3) of the Act, this Part specifies the circumstances in which the care needs of a care recipient are taken to have changed significantly.
42 Circumstances in which care needs are taken to have changed significantly—respite care
For the purposes of a reclassification of a care recipient for respite care, the care needs of the care recipient are taken to have changed significantly if, since the applicable day for the existing classification of the care recipient, the condition of the care recipient has changed from:
(a) the care recipient being independently mobile to being mobile only with assistance; or
(b) the care recipient being independently mobile to being not mobile; or
(c) the care recipient being mobile only with assistance to being not mobile.
43 Circumstances in which care needs are taken to have changed significantly—non‑respite care
For the purposes of a reclassification of a care recipient for non‑respite care, the care needs of the care recipient are taken to have changed significantly if, since the applicable day for the existing classification of the care recipient:
(a) there has been a change in the care recipient’s cognitive ability, compounding factors, function, mobility or pressure sore risk; or
(b) the care recipient has been an in‑patient of a hospital for a total of at least 5 days; or
(c) the care recipient has been an in‑patient of a hospital for a total of at least 2 days and was administered general anaesthetic while an in‑patient; or
(d) for a care recipient with an existing classification level of Class 9, Class 10, Class 11, Class 12 or Class 13—at least 6 months have passed; or
(e) for a care recipient with an existing classification level of Class 2, Class 3, Class 4, Class 5, Class 6, Class 7 or Class 8—at least 12 months have passed; or
(f) the care recipient has:
(i) ceased to be provided with residential care through a residential care service; and
(ii) subsequently entered a residential care service to be provided with non‑respite care in the form of palliative care.
Part 15—Criteria for delegates
44 Purpose of this Part
For the purposes of subsection 96‑2(15) of the Act, this Part specifies the criteria for persons to whom the Secretary’s powers and functions under section 29C‑3 of the Act may be delegated.
45 Criteria for persons to whom assessment powers may be delegated
The following criteria are specified:
(a) the person is a registered nurse, occupational therapist or physiotherapist;
(b) the person has at least 5 years of clinical experience in the delivery of aged care services or related health services as a registered nurse, occupational therapist or physiotherapist (as the case requires);
(c) a police certificate issued for the person within the last 2 years does not record that the person has a serious offence conviction in Australia;
(d) if, at any time after turning 16, the person has been a citizen or permanent resident of a country other than Australia—the person has made a statutory declaration that the person does not have a serious offence conviction in that country.
Chapter 4—Application, transitional and saving provisions
46 Conversion of classification for respite care made under Part 2.4 of the Act before 1 October 2022
(1) This section applies if:
(a) a classification (the original classification) of a care recipient for respite care has been made under Part 2.4 of the Act before 1 October 2022; and
(b) immediately before that day, both of the following apply:
(i) the original classification is in effect;
(ii) the recipient has not been classified for respite care under Part 2.4A of the Act.
(2) The original classification of the care recipient is taken, on and after 1 October 2022, to be a classification (the new classification) for respite care under Part 2.4A of the Act.
(3) If the classification level for the care recipient for the original classification was low level residential respite care, the classification level for the recipient for the new classification is taken, on and after 1 October 2022, to be Respite Class 1.
(4) If the classification level for the care recipient for the original classification was high level residential respite care, the classification level for the recipient for the new classification is taken, on and after 1 October 2022, to be Respite Class 2.
(5) To avoid doubt, the new classification of the care recipient may, on and after 1 October 2022, be dealt with under Part 2.4A of the Act as a classification for respite care.