Aged Care (Flexible Care Subsidy Amount - Multi-Purpose Services) Determination 2013 (No. 2)
Part 2Amount of flexible care subsidy
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Turn the raw legal text into a practical explanation grounded in Aged Care (Flexible Care Subsidy Amount - Multi-Purpose Services) Determination 2013 (No. 2).
This determination is the Aged Care (Flexible Care Subsidy Amount—Multi‑Purpose Services) Determination 2013 (No. 2).
3 Authority
This determination is made under the Aged Care Act 1997.
5 Definitions
In this determination:
Act means the Aged Care Act 1997.
adjusted subsidy reduction multi‑purpose service means a multi‑purpose service mentioned in Schedule 2.
Aged Care Workforce Supplement Guidelines means the document with that title published by the Department, as it exists on 1 August 2013.
Note: The document is available through the Department’s website (www.health.gov.au).
Category A service means a multi‑purpose service that:
(a) meets the requirements of subsection 6(1); and
(b) does not meet the requirements of subsection 8(3).
Category B service means a multi‑purpose service that:
(a) meets the requirements of subsection 7(1) or (3); and
(b) does not meet the requirements of subsection 8(4).
Category C service means a multi‑purpose service that meets the requirements of subsection 8(1), (3) or (4).
high care place means a place allocated in respect of a multi‑purpose service for the provision of care equivalent to a high level of residential care.
home care place means a place allocated in respect of a multi‑purpose service for the provision of care equivalent to home care.
low care place means a place allocated in respect of a multi‑purpose service for the provision of care equivalent to a low level of residential care.
multi‑purpose service has the meaning given by section 15.3 of the Flexible Care Subsidy Principles 1997.
region has the meaning given by Schedule 1 to the Aged Care Act 1997.
reviewable decision has the meaning given by section 18.
RRMA Classification means the ‘Rural, Remote and Metropolitan Area Classification’, 1991 Census Edition, published by the Australian Government Publishing Service, November 1994.
viability supplement equivalent amount, for a multi‑purpose service for a day, means:
(a) for a multi‑purpose service that is a Category A service, a Category B service or a Category C service—the amount that is specified in Schedule 3 in respect of a care recipient to whom care is provided through the service on that day; and
(b) for a multi‑purpose service that is not a Category A service, a Category B service or a Category C service—$0.
6 Category A services
(1) A multi‑purpose service meets the requirements of this subsection if:
(a) the service was in operation on 31 December 2004, and, on that date, the point score of the service would have been at least 60 points, under the scoring system set out in the following table; and
(b) on 1 January 2005, either:
(i) the point score of the service was less than 50 points, under the scoring system set out in the table in subsection 8(1); or
(ii) the point score of the service was at least 50 points, under that scoring system, and the viability supplement equivalent amount specified in Schedule 3 for a day in respect of the service as a Category A service was more than the viability supplement equivalent amount so specified in respect of the service as a Category C service.
Item
Criterion
Points
1
Location:
2
(a) remote zone
40
3
(b) other rural area
30
4
(c) small rural centre
20
5
(d) large rural centre
10
6
Beds:
7
(a) less than 30
20
8
(b) less than 16
30
9
Service not co‑located with another service and unable to co‑locate
20
10
Supported residents, concessional residents or assisted residents:
11
(a) over 70%
20
12
(b) 50% to 70%
10
13
Caters largely for special groups, including Aboriginal and Torres Strait Islander groups
10
(2) For subsection (1):
(a) a location of a particular kind is a statistical local area of that kind defined in the RRMA Classification; and
(b) a service is taken to be unable to co‑locate with another service if it is:
(i) not on the same site as, or on an adjoining site to, another multi‑purpose service or residential care service; or
(ii) on the same site as, or an adjoining site to, another multi‑purpose service or residential care service, but the total of the residential places and non‑acute beds on the same or adjacent sites is less than 45; or
(iii) more than 25 kilometres from the nearest residential care service; or
(iv) not more than 25 kilometres from the nearest residential care service, but the total number of places in both services is:
(A) for a service in a remote zone—less than 30 beds; or
(B) for a service not in a remote zone—less than 16 beds; and
(c) points may be scored under only 1 paragraph in an item that has paragraphs.
7 Category B services
(1) A multi‑purpose service meets the requirements of this subsection if:
(a) the service was in operation on 31 December 2004, and, on that date, the point score of the service would have been at least 40 points, under the scoring system set out in the following table; and
(b) on 1 January 2005, either:
(i) the point score of the service was less than 50 points, under the scoring system set out in the table in subsection 8(1); or
(ii) the point score of the service was at least 50 points, under that scoring system, and the viability supplement equivalent amount specified in Schedule 3 for a day in respect of the service as a Category B service was more than the viability supplement equivalent amount so specified in respect of the service as a Category C service.
Item
Criterion
Points
1
Location:
2
(a) very remote location
60
3
(b) remote location
50
4
(c) moderately accessible location
40
5
(d) accessible location
30
6
(e) highly accessible location
0
7
Places:
8
(a) less than 20
30
9
(b) more than 19 but less than 30
20
10
(c) more than 29 but less than 45
10
11
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 they are financially or socially disadvantaged)
10
(2) In this section:
accessible location means a location that has an ARIA value of more than 1.84, but not more than 3.51.
ARIA value, in relation to a location, means the value given to that location in accordance with the methodology set out in the document titled Measuring Remoteness: Accessibility/Remoteness Index of Australia (ARIA), Occasional Papers: New Series Number 14, published by the Department in October 2001, as the document exists on 1 July 2013.
Note: The document is available through the Department’s website (www.health.gov.au).
highly accessible location means a location that has an ARIA value of not more than 1.84.
moderately accessible location means a location that has an ARIA value of more than 3.51, but not more than 5.8.
remote location means a location that has an ARIA value of more than 5.8, but not more than 9.08.
very remote location means a location that has an ARIA value of more than 9.08, but not more than 12.
(3) A multi‑purpose service meets the requirements of this subsection if:
(a) the service commenced operating on or after 1 January 2005 and before 1 July 2005; and
(b) on the day that the service commenced operating:
(i) the point score of the service was at least 40 points, under the scoring system set out in subsection (1); and
(ii) either:
(A) the point score of the service was less than 50 points, under the scoring system set out in the table in subsection 8(1); or
(B) the point score of the service was at least 50 points, under that scoring system, and the viability supplement equivalent amount specified in Schedule 3 for a day in respect of the service as a Category B service was more than the viability supplement equivalent amount so specified in respect of the service as a Category C service.
8 Category C services
(1) A multi‑purpose service meets the requirements of this subsection if, on or after 1 January 2005, the service:
(a) is not a Category A service or a Category B service; and
(b) scores at least 50 points, under the scoring system set out in the following table.
Item
Criterion
Points
1
Location:
2
(a) very remote location
65
3
(b) remote location
55
4
(c) moderately accessible location
40
5
(d) accessible location
30
6
(e) highly accessible location
0
7
Places:
8
(a) less than 20
30
9
(b) more than 19 but less than 25
25
10
(c) more than 24 but less than 30
20
11
(d) more than 29 but less than 35
15
12
(e) more than 34 but less than 40
10
13
(f) more than 39 but less than 45
5
14
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 they are financially or socially disadvantaged)
5
(2) In this section:
accessible location has the meaning given by subsection 7(2).
ARIA value has the meaning given by subsection 7(2).
highly accessible location has the meaning given by subsection 7(2).
moderately accessible location has the meaning given by subsection 7(2).
remote location has the meaning given by subsection 7(2).
very remote location has the meaning given by subsection 7(2).
(3) A multi‑purpose service meets the requirements of this subsection if the service meets the requirements of subsection 6(1) (that is, for a Category A service) and, on at least 1 day on or after 1 January 2005:
(a) the service scores at least 50 points, under the scoring system set out in the table in subsection (1); and
(b) the viability supplement equivalent amount specified in Schedule 3 for a day in respect of the service as a Category C service is the same as or greater than the viability supplement equivalent amount so specified in respect of the service as a Category A service.
(4) A multi‑purpose service meets the requirements of this subsection if the service meets the requirements of subsection 7(1) or (3) (that is, for a Category B service) and, on at least 1 day on or after 1 January 2005:
(a) the service scores at least 50 points, under the scoring system set out in the table in subsection (1); and
(b) the viability supplement equivalent amount specified in Schedule 3 for a day in respect of the service as a Category C service is the same as or greater than the viability supplement equivalent amount so specified in respect of the service as a Category B service.
Part 2—Amount of flexible care subsidy
Division 2.1—Amount of flexible care subsidy
9 Amount of flexible care subsidy
The amount of flexible care subsidy that is payable in respect of a day in respect of a multi‑purpose service is worked out in accordance with the following method.
HCA + LCA + HMA + RSEA + WSA + DEA + VEA + DVEA + HMAA
where:
HCA is the amount worked out by multiplying:
(a) the amount that applies under Division 2.2 in respect of the day for a high care place allocated in respect of the service; and
(b) the number of high care places allocated in respect of the service.
LCA is the amount worked out by multiplying:
(a) the amount that applies under Division 2.3 in respect of the day for a low care place; and
(b) the number of low care places allocated in respect of the service.
HMA is the amount worked out by multiplying:
(a) $35.14; and
(b) the number of home care places allocated in respect of the service.
RSEA is the respite supplement equivalent amount for the service in respect of the day under Division 2.4.
WSA is the workforce supplement (if applicable) worked out under Division 2.5.
DEA is the amount worked out by multiplying:
(a) the dementia and severe behaviours supplement equivalent amount specified in subsection 21(1); and
(b) the number of high care places and low care places allocated in respect of the service.
VEA is the amount worked out by multiplying:
(c) the veterans’ supplement equivalent amount specified in subsection 21(2); and
(d) the number of high care places and low care places allocated in respect of the service.
DVEA is the amount worked out by multiplying:
(a) the dementia and cognitive supplement and veterans’ supplement equivalent amount specified in subsection 21(3); and
(b) the number of home care places allocated in respect of the service.
HMAA is the amount worked out by multiplying:
(a) the amount that applies under Division 2.7 in respect of a day for a home care place; and
(b) the number of home care places allocated in respect of the service.
Division 2.2—Applicable amount for high care places
10 Applicable amount—high care places
(1) For a multi‑purpose service that is not an adjusted subsidy reduction multi‑purpose service, the amount that applies in respect of a day for a high care place allocated in respect of the service is worked out in accordance with the following method.
B + C + V
(2) For an adjusted subsidy reduction multi‑purpose service, the amount that applies in respect of a day for a high care place allocated in respect of the service is worked out in accordance with the following method.
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(3) In subsections (1) and (2):
B is $116.49
C is the concessional resident equivalent amount specified in Schedule 1 for the region in which the service is located.
V is the viability supplement equivalent amount for the service for the day.
(4) In subsection (2):
R is $11.74
F is the number of places mentioned in column 3 of Schedule 2 for the service.
H is the number of high care places allocated in respect of the service for the day.
Division 2.3—Applicable amount for low care places
11 Applicable amount—low care places
The amount that applies in respect of a day for a low care place is worked out in accordance with the following method.
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where:
B is $30.61
C is the concessional resident equivalent amount specified in Schedule 1 for the region in which the multi‑purpose service in respect of which the place is allocated is located.
V is the viability supplement equivalent amount for the service for the day.
Division 2.4—Respite supplement equivalent amount
12 Respite supplement equivalent amount
The respite supplement equivalent amount for a multi‑purpose service in respect of a day is the amount mentioned in the following table for the total number of high care places and low care places allocated in respect of the service.
Item
Total number of high care places and low care places
Respite supplement equivalent amount ($)
1
Less than 11
$47.55
2
More than 10 but less than 21
$76.08
3
More than 20 but less than 31
$85.58
4
More than 30 but less than 41
$95.10
5
More than 40
$104.61
Division 2.6—Dementia and veterans’ supplement equivalent amounts
21 Dementia and veterans’ supplement equivalent amounts
(1) The dementia and severe behaviours supplement equivalent amount for a multi‑purpose service in respect of a day for each high care place and low care place allocated to the service is $0.18.
(2) The veterans’ supplement equivalent amount for a multi‑purpose service in respect of a day for each high care place and low care place allocated to the service is $0.08.
(3) The dementia and cognition supplement and veterans’ supplement equivalent amount for a multi‑purpose service in respect of a day for each home care place allocated to the service is $1.10.
Division 2.7—Additional amount of home care subsidy
22 Additional amount of home care subsidy
(1) The amount that applies in respect of a day for a home care place is the amount (if any) that corresponds to the ARIA value for the location of the multi‑purpose service, as set out in the following table:
Item
ARIA value for location of multi‑purpose service
Additional daily amount of home care subsidy
1
ARIA value of 0 to 3.51 inclusive
$0.00
2
ARIA value of 3.52 to 4.66 inclusive
$4.21
3
ARIA value of 4.67 to 5.80 inclusive
$5.06
4
ARIA value of 5.81 to 7.44 inclusive
$7.08
5
ARIA value of 7.45 to 9.08 inclusive
$8.50
6
ARIA value of 9.09 to 10.54 inclusive
$11.89
7
ARIA value of 10.55 to 12.00 inclusive
$14.27
(2) In this section, ARIA value has the meaning given by subsection 7(2).
Part Part 2 - Aged Care (Flexible Care Subsidy Amount - Multi-Purpose Services) Determination 2013 (No. 2) - Amount of flexible care subsidy | Zoe