Residential Care Subsidy Amendment Principles 2011 (No. 3)1
Aged Care Act 1997
I, MARK BUTLER, Minister for Mental Health and Ageing, make these Principles under subsection 96-1 (1) of the Aged Care Act 1997.
Dated 15th August 2011
MARK BUTLER
Minister for Mental Health and Ageing
1 Name of Principles
These Principles are the Residential Care Subsidy Amendment Principles 2011 (No. 3).
2 Commencement
These Principles are taken to have commenced on 1 July 2011.
3 Amendment of Residential Care Subsidy Principles 1997
Schedule 1 amends the Residential Care Subsidy Principles 1997.
Schedule 1 Amendments
(section 3)
[1] Section 21.35C
substitute
(1) A residential care service meets the requirements of this subsection if, on or after 1 January 2005, the service:
(a) is not a 1997 scheme service or a 2001 scheme service; and
(b) scores at least 50 points, worked out as follows:
Viability supplement points calculator
Step 1.
Work out the number of points (if any) applicable to the service in respect of its location under subsection (3).
Step 2.
Add an additional 15 points if more than 50% of care recipients of the service (other than care recipients receiving respite care) require a low level of residential care and the service is in a very remote location, a remote location or a moderately accessible location.
Step 3.
Add the number of points (if any) applicable to the service in respect of targeting care for homeless people, people from an Aboriginal and Torres Strait Islander community, or both, under subsection (4).
Step 4.
If the total of Steps 1, 2 and 3 is more than 65, then reduce the total to 65 points.
Step 5.
Add the number of points (if any) applicable to the service in respect of its number of places under subsection (5).
Step 6.
Add an additional 5 points if more than 50% of care recipients are *people with special needs (other than people who are people with special needs only because they live in rural or remote areas or are financially or socially disadvantaged).
(2) In this section:
accessible location has the meaning given by subsection 21.35B (2).
ARIA has the meaning given by subsection 21.35B (2).
ARIA score has the meaning given by subsection 21.35B (2).
highly accessible location has the meaning given by subsection 21.35B (2).
low level of residential care has the meaning given by section 9.3 of the Classification Principles 1997.
moderately accessible location has the meaning given by subsection 21.35B (2).
remote location has the meaning given by subsection 21.35B (2).
very remote location has the meaning given by subsection 21.35B (2).
(3) For the purposes of Step 1 of the viability supplement points calculator in subsection (1), the number of points applicable to the service in respect of its location is calculated using the scoring system in the following table:
Criterion
Points
Location:
(a) very remote location
65
(b) remote location
55
(c) moderately accessible location
40
(d) accessible location
30
(e) highly accessible location
0
(4) For the purposes of Step 3 of the viability supplement points calculator in subsection (1), the service scores 60 points if more than 50% of care recipients of the service (other than care recipients receiving respite care) have been appraised using either Appraisal tool A or Appraisal tool B in Schedule 2 as demonstrating complex behavioural needs and social disadvantage associated with their background as a homeless person or their background as a person from an Aboriginal or Torres Strait Islander community, or both, and:
(a) the places allocated in respect of the residential aged care service are subject to a condition of allocation under subsection 14-5 of the Act relating to the care of people with a background as homeless persons or persons from an Aboriginal or Torres Strait Islander community; or
(b) the approved provider of the residential care service or its key personnel have demonstrated experience in providing, or the capacity to provide, specialist services for such persons, including:
(i) programs and interventions to manage complex behavioural needs;
(ii) programs to promote social engagement and participation; or
(iii) any other relevant services that the Secretary considers appropriate.
(5) For the purposes of Step 5 of the viability supplement points calculator in subsection (1), the number of points applicable to the service in respect of its number of places is calculated using the scoring system in the following table:
Criterion
Points
Places:
(a) fewer than 20
30
(b) more than 19 but fewer than 25
25
(c) more than 24 but fewer than 30
20
(d) more than 29 but fewer than 35
15
(e) more than 34 but fewer than 40
10
(f) more than 39 but fewer than 45
5
(6) A residential care service meets the requirements of this subsection if the service meets the requirements of subsection 21.35A (1) (that is, for a 1997 scheme 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 amount of viability supplement payable under the Amount Determination for a day in respect of a care recipient to whom care is provided through the service as a 2005 scheme service is the same as or greater than the amount of viability supplement payable in respect of the care recipient for the day if the service were treated as a 1997 scheme service.
(7) A residential care service meets the requirements of this subsection if the service meets the requirements of subsection 21.35B (1) or (3) (that is, for a 2001 scheme 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 amount of viability supplement payable under the Amount Determination for a day in respect of a care recipient to whom care is provided through the service as a 2005 scheme service is the same as or greater than the amount of viability supplement payable in respect of the care recipient for the day if the service were treated as a 2001 scheme service.
[2] After Schedule 1 Building Requirements
insert
Schedule 2 Appraisal procedures for targeting care for homeless people or people from Aboriginal and Torres Strait Islander communities
(paragraph 21.35C (4))
1.1 Appraisal procedures
(1) Appraisal of whether a person demonstrates complex behavioural needs and social disadvantage associated with their background as a homeless person or their background as a person from an Aboriginal or Torres Strait Islander community must be undertaken using either appraisal tool A or appraisal tool B in Item 1.3 of this Schedule.
(2) Where a person is both a homeless person and a person from an Aboriginal or Torres Strait Islander community then both appraisal tool A and appraisal tool B are completed.
1.2 Time for completion of appraisal procedures
(1) For a care recipient who enters residential care on or after 1 September 2011, the appraisal must be completed by the approved provider within the period for the appraisal of the level of care needed by the resident under section 25-3 of the Act.
(2) For a resident who entered residential care prior to 1 September 2011, the appraisal must be completed within two months of the making of this Schedule.
1.3 Appraisal tools
APPRAISAL TOOL A – HOMELESSNESS: ADDITIONAL SPECIAL NEEDS
The care recipient must demonstrate complex behavioural and/or needs and social support needs. They must meet EACH of the following four criteria:
Tick if YES
1. Homelessness background
a.
The person has a history of homelessness or is at severe risk of homelessness, including people who immediately prior to entering care at the current or a previous residential aged care home:
i) Were living in a public place or temporary shelter; short-term crisis, emergency or transitional accommodation; boarding house, rooming house or private hotel; or supported community accommodation; and/or
ii) Had no recent housing address; and/or
iii) Had a long history of unsuccessful tenancies/ unstable housing arrangements.
£i
£ii
£iii
2. Financial Status
The person is eligible for the maximum basic rate of social security pension or benefit as defined in the Social Security Act 1991 or service pension or disability pension as defined in the Veterans Entitlement Act 1986.
£2
3. Relevant behavioural diagnosis
The person has mental and behavioural diagnosis associated with one of the following disorders (ACAP codes shown in brackets). This checklist aligns with the range of conditions recognised by the Mental and Behavioural Diagnoses section of the ACFI :
i) Dementia, Alzheimer’s disease including early onset, late onset, atypical or mixed type or specified.(ACAP code 500)
ii) Vascular dementia e.g. multi-infarct, subcortical, mixed (ACAP code 510)
iii) Dementia in other diseases, e.g. Pick’s Disease, Creulzfeldt-Jakob, Huntington’s, Parkinson’s, HIV (ACAP code 520)
iv) Other dementia, e.g. Lewy Body, alcoholic dementia, unspecified (ACAP code 530)
v) Delirium (ACAP code 540)
vi) Depression, mood affective disorders, Bi- Polar (ACAP code 550A)
vii) Psychoses e.g. schizophrenia, paranoid states (ACAP code 550B)
viii) Neurotic, stress related, anxiety, somatoform disorders e.g. post traumatic stress disorder, phobic and anxiety disorders, nervous tension/stress, obsessive–compulsive disorder (ACAP code 560)
ix) Intellectual and developmental disorders e.g. intellectual disability or disorder, autism, Rhet’s syndrome, Asperger’s syndrome etc.(ACAP code 570)
x) Other mental and behavioural disorders e.g. due to alcohol or psychoactive substances (includes alcoholism, Korsakov’s psychosis), adult personality and behavioural disorders (ACAP code 580)
For the purposes of the checklist, the diagnosis can be made by any health professional acting within their approved scope of practice.
£i
£ii
£iii
£iv
£v
£vi
£vii
£viii
£ix
£x
4. Challenging behaviours and/or need for intensive social support
a.
The person displays challenging behaviours which require ongoing management and prevention including:
i) Episodic catastrophic behaviours such as severe physical and verbal abuse, violent mood swings, aggression; and/or
ii) Is considered at high risk of leaving without warning with ongoing staff intervention required to prevent this from occurring.
£i
£ii
AND/OR
b.
The person requires intensive social support or intensive assistance with continuing to perform activities of daily living themselves including initiation of and assistance with:
i) Personal care and hygiene matters (for example, shows aversion to showering and washing hands, has problems with toileting and dressing, requires assistance or guidance with meals) ; and/or
ii) Social and recreational activities, with significant one-on-one staff intervention necessary to enable the client to participate in community activities.
£i
£ii
APPRAISAL TOOL B - INDIGENOUS AUSTRALIANS: ADDITIONAL SPECIAL NEEDS
The care recipient must demonstrate complex behavioural and/or needs and social support needs. They must meet EACH of the following four criteria:
Tick if YES
1. Indigenous status
Is the person of Aboriginal or Torres Islander origin?
£1
2. Financial Status
The person is eligible for the maximum basic rate of social security pension or benefit as defined in the Social Security Act 1991 or service pension or disability pension as defined in the Veterans Entitlement Act 1986.
£2
3. Relevant behavioural diagnosis
The person has mental and behavioural diagnosis associated with one of the following disorders (ACAP codes shown in brackets). This checklist aligns with the range of conditions recognised by the Mental and Behavioural Diagnoses section of the ACFI :
i) Dementia, Alzheimer’s disease including early onset, late onset, atypical or mixed type or specified.(ACAP code 500)
ii) Vascular dementia e.g. multi-infarct, subcortical, mixed (ACAP code 510)
iii) Dementia in other diseases, e.g. Pick’s Disease, Creulzfeldt-Jakob, Huntington’s, Parkinson’s, HIV (ACAP code 520)
iv) Other dementia, e.g. Lewy Body, alcoholic dementia, unspecified (ACAP code 530)
v) Delirium (ACAP code 540)
vi) Depression, mood affective disorders, Bi- Polar (ACAP code 550A)
vii) Psychoses e.g. schizophrenia, paranoid states (ACAP code 550B)
viii) Neurotic, stress related, anxiety, somatoform disorders e.g. post traumatic stress disorder, phobic and anxiety disorders, nervous tension/stress, obsessive–compulsive disorder (ACAP code 560)
ix) Intellectual and developmental disorders e.g. intellectual disability or disorder, autism, Rhet’s syndrome, Asperger’s syndrome etc.(ACAP code 570)
x) Other mental and behavioural disorders e.g. due to alcohol or psychoactive substances (includes alcoholism, Korsakov’s psychosis), adult personality and behavioural disorders (ACAP code 580)
For the purposes of the checklist, the diagnosis can be made by any health professional acting within their approved scope of practice.
£i
£ii
£iii
£iv
£v
£vi
£vii
£viii
£ix
£x
4. Challenging behaviours and/or need for intensive social support
a.
The person displays challenging behaviours which require ongoing management and prevention including:
i) Episodic catastrophic behaviours such as severe physical and verbal abuse, violent mood swings, aggression; and/or
ii) Is considered at high risk of leaving without warning with ongoing staff intervention required to prevent this from occurring.
£i
£ii
AND/OR
b.
The person requires intensive social support or intensive assistance with continuing to perform activities of daily living themselves including initiation of and assistance with:
i) Personal care and hygiene matters (for example, shows aversion to showering and washing hands, has problems with toileting and dressing, requires assistance or guidance with meals) ; and/or
ii) Social and recreational activities, with significant one-on-one staff intervention necessary to enable the client to participate in community activities.
£i
£ii
Note
1. All legislative instruments and compilations are registered on the Federal Register of Legislative Instruments kept under the Legislative Instruments Act 2003. See http://www.frli.gov.au.
