8.4.5 Residential care for MRCA treatment card holders

Last updated 2 May 2011

Residential care such as might be provided in a nursing home or hostel is provided for in Part 10 of the MRCA Treatment Principles.  Where a person is a MRCA Treatment cardholder and is in high-level residential care solely because of their accepted MRCA injury or condition, (i.e. not because of a requirement for aged care) the Department pays the residential care subsidy instead of the Department of Health and Ageing and may also, in exceptional circumstances cover the 'residential care amount'.

The MRCA TPs definition of the 'residential care amount' equates to the 'maximu — m daily amount of resident fees' as defined in Section 58-2 of the Aged Care Act 1997.  This includes:

• the basic daily care fee;
• the income-tested fee; and
• the accommodation charge.

Exceptional circumstances exist where the person:

• is in high level residential care solely because of his or her service injury or disease; and
• has one or more dependants as defined in section 15 of the MRCA; and
• would be financially disadvantaged by having to pay the components of the 'residential care amount'.

The financially disadvantaged test will always be met if the person has dependants and is required to maintain a home for their dependants at the same time as paying the 'residential care amount'.

Obtaining Approval

Where exceptional circumstances exist, the Delegate is to:

• obtain written approval, to pay the 'residential care amount', from the Deputy Commissioner for their location; and
• copy the National Manager, Rehabilitation and Entitlements Policy Group, and the National Manager, Rehabilitation, Compensation and Systems Support Group into the approval request.

This will assist in providing updated information regarding the management and assistance for these severely injured persons and their families to senior management.

Approved cases

Following approval the Delegate is to:

• advise the Department's Medical Expenses Personally Incurred (MEPI) team, so that the authority to pay/reimburse is noted on the client's file (in VIEW);
• inform the persons' residential care facility that the fees and charges that make up the 'residential care amount' can be covered under the client's MRCA Treatment card arrangements; and
• inform the client and or their carer of the decision, to allow them to claim from the Department any reimbursement of fees and charges they may have previously paid in relation to their residential care placement.  They can claim reimbursement through the Department's MEPI process.