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Types of Care Situations

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Last amended: 1 July 2014

Who is considered to be “In Care”?

    

A person is considered to be in care, if they are:

  • an aged care resident,
  • in non government subsidised care
  • in a multi purpose service
  • a nursing home patient in a hospital
  • in respite care[glossary:,:]    
  • receiving community based care
  • personally providing community based care.
  • receiving Home Care and Veterans Home Care.
Who is considered to be an aged care resident?

    

An aged care resident is a person who is receiving residential care conducted by an approved provider, for at least 14 consecutive days, and the care recipient has been approved for that care under the Aged Care Act 1997 legislation. The person must be occupying an “approved bed”, that is the approved facility must be receiving a subsidy in respect of the person, for the definition of aged care resident to be met.

A person in respite care is not regarded as an aged care resident under the VEA.

Note: Advice from the Department of Social Services (DSS) may be needed to confirm whether an approved care facility is receiving a subsidy in respect of the person. Where there is conflicting information, the advice from DSS is to be given greater weight than advice from the approved care provider.

Non government subsidised care

A person is considered to be in Non-Government Subsidised Care if no Australian Government subsidy is payable to the facility in respect of their care and/or accommodation. This generally means that such pensioners are paying the full cost of their accommodation and any care they may receive.

Multi Purpose Service (MPS)

Multi-Purpose Services (MPS) are designed specifically for rural and regional areas, to bring together a range of health and aged care services under one management structure, where traditional styles of services may not usually be viable. However, unlike residential aged care facilities, care recipients are not required to be ACAT assessed and MPS facilities do not receive Australian Government funding for individual residents. Therefore recipients residing in MPS facilities may be eligible to receive rent assistance on the amount of rent they pay to their MPS service provider.

Nursing home patient in a hospital (NHTP)

A patient may be classed as a nursing home type patient (NHTP) in a hospital bed either awaiting placement to an approved facility or there long term as there is no appropriate local facility (eg. a remote locality). Any patient who has been in hospital for more than 35 days in a 12 month period, and for whom a doctor has not certified the need for acute care is also a NHTP.

Costs and subsidies for NHTP

A NHTP cannot be fully covered for hospital costs by a person's health fund and therefore the person must contribute to their stay in hospital. The State Governments set the NHTP contribution. The National Health Act 1953 does not allow health funds to insure for this part of the cost. These persons are not in approved residential care and are eligible for rent assistance in respect of any money paid for their accommodation.

Note: This should not be confused with an aged care resident going to hospital (as an in-patient) to receive treatment. Government aged care subsidy continues to be paid for residents during periods of hospital leave, so rent assistance is not payable.

Respite care

    

Residential respite care is a form of short-term care provided in aged care facilities for the purposes of giving a carer, or care recipient, a short break from their usual caring arrangement.     

Receiving community-based care

    

A person is considered to be receiving community-based care, if the person needs, and has been receiving or is likely to receive, a substantial level of care in a private residence for at least 14 consecutive days. A private residence includes all private accommodation arrangements, including Supported Residential Services     

Providing community-based care

    

A person is considered to be providing community-based care, if the person is personally:

  • providing a substantial level of care needed by the other person in a private residence; and
  • providing, or is likely to provide, that level of care for at least 14 consecutive days.
Pension assessment rules for community-based care

A person receiving or providing community-based care is considered to be “in-care” and therefore the assessment rules contained in the 9.2.4/In Care Assessment Rules apply. The term “community-based care” is specifically for pension purposes to ensure those who leave their principal home to receive or provide care in these situations, have access to the home exemption rules and rent assistance, subject to other relevant criteria being met.  The residential situations are defined in terms of a substantial level of care being received or provided in a private residence, for at least 14 consecutive days. There is no requirement or linkage to any ACAT assessment.

Home Care packages and Veterans' Home Care

Home Care is comprised of various services that are designed to help people to stay at home. Veterans' Home Care (VHC) provides services to assist eligible veterans and war widows/widowers with low level care needs to remain independent in their homes.     

Receiving care through a home care package or VHC is not a change of residential situation.  Fees payable are not considered rent for rent assistance purposes.     


Respite care is care provided for one member of a couple in a nursing home or hostel on a temporary basis so that their partner can have a break from providing care.  For care to be recognised as respite care under the VEA, it must be Government subsidised care provided under the Aged Care Act 1997.

A pensioner receiving such care, and their partner (a respite care couple), are entitled to be paid the single rate of pension.

For the full definition of respite care, refer to subsection 5NC(8) of the VEA.

 

 

Non-Government Subsidised care applies to the following groups:

  • pensioners residing in nursing homes or hostels that are not approved facility;
  • pensioners who are residing in a nursing home or hostel but who are not approved care recipients. For instance, a person may be residing in a nursing home or hostel to be near to their partner who is receiving care (known as co-habitees) or a person may be in a multi purpose service (MPS) unit; and
  • pensioners residing in an approved facility but who receive accommodation only, require no care and therefore are not receiving Commonwealth Government subsidised care.

No Commonwealth Government subsidy, including pensioner supplement, is payable to the facility in respect of their places.

 

 

Aged Care Assessment Team.

Assessment with a member of an Aged Care Assessment Team is required for a person needing the following;

  • access to aged care services through any type of Home Care Package
  • receive services through the Transition Care Program
  • receive certain respite services
  • enter into an government subsidised aged care home

An ACAT will discuss the person's current situation and work out if they are eligible to receive government subsidised aged care services.

If a person can receive aged care services, an ACAT assessment will assist in accessing the right services for the care that is required.

An ACAT assessment is not required for aged care services that are not subsidised by the government. Examples might be services offered by volunteer groups and charitable organisations.

ACAT assessment is not necessary to receive aged care services through some government funded programs such as Home and Community Care, Day Therapy Centres and the National Respite for Carers Program as these organisations deliver these services that have their own, less formal, assessment procedures.

Note: An Aged Care Assessment Team is referred to as an Aged Care Assessment Service (ACAS) in Victoria. Where there is reference to the term ACAT, it intends the Victorian term ACAS to be interchangeable.

Rent Assistance is an allowance, which may be paid to a service pensioner or income support supplement (ISS) recipient to assist in meeting the cost of rental accommodation.

To receive rent assistance, a pensioner must be paying rent (other than Government rent) for accommodation in Australia, and the amount paid must exceed a certain threshold.

An approved facility under the Aged Care Act 1997 is one that has been assessed to meet certain standards of care and accommodation.

Note: Nursing homes and nursing home beds that are fully funded by a State Government do not come under the Aged Care Act 1997.

To determine whether a care receiver requires and is receiving a substantial level of care, they should meet one or more of the following criteria:

  • Carer Allowance is being paid to a care provider in respect of the care receiver; or
  • Carer Payment is being paid to a care provider in respect of the care receiver; or
  • Care receiver is in receipt of Disability Support Pension or Invalidity Service Pension and because of their condition require assistance; or
  • Care receiver is over pension age and regarded as frail; or
  • Care receiver can provide medical evidence stating they left their home due to illness; or
  • Care receiver can provide evidence that on their recent discharge from hospital they require assistance; or
  • Care receiver has been assessed by ACAT and is awaiting institutional admission or has been accepted for approved respite care.

 

 

To determine whether a care receiver requires and is receiving a substantial level of care, they should meet one or more of the following criteria:

  • Carer Allowance is being paid to a care provider in respect of the care receiver; or
  • Carer Payment is being paid to a care provider in respect of the care receiver; or
  • Care receiver is in receipt of Disability Support Pension or Invalidity Service Pension and because of their condition require assistance; or
  • Care receiver is over pension age and regarded as frail; or
  • Care receiver can provide medical evidence stating they left their home due to illness; or
  • Care receiver can provide evidence that on their recent discharge from hospital they require assistance; or
  • Care receiver has been assessed by ACAT and is awaiting institutional admission or has been accepted for approved respite care.