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Payment Essentials December 2007
The December 2007 Payment E$$ential$ newsletter designed to keep financial officers within Residential Aged Care Services (RACS) informed of changes to all payment related forms and processes for residential aged care. It has been redesigned and renamed Aged Care Essentials.
You may download this document in PDF format:
PDF printable version of December Payment Essentials (PDF 533 KB)
Would you like to see an article on a particular topic?
Email the Editor at agedcare_essentials@health.gov.au or send a facsimile to (02) 6289 8595.Past issues can be accessed via our web page at: http://www.health.gov.au/internet/wcms/publishing.nsf/Content/ageing-rescare-payessdx.htm
Editor
Continence Aids Assistance Scheme (CAAS)
From 1 July 2007 many aged care recipients became eligible to receive free continence products up to the value of $470 per year under the Continence Aids Assistance Scheme (CAAS).To be eligible for CAAS, applicants must be five years or over, have permanent and severe incontinence caused by an eligible neurological condition such as cerebral palsy or multiple sclerosis. People whose incontinence is caused by other conditions such as dementia or prostate disease are also eligible for assistance under CAAS if they hold a Pensioner Concession Card.
CAAS clients are able to order continence products of their choice from Intouch (who administer the scheme on behalf of the Department of Health and Ageing) and these items are delivered to their door free of charge up to four times per year. Care providers are able to place orders on behalf of aged care recipients.
Recipients of Australian Government funded aged care
A person living in an Australian Government funded aged care home and receiving low level care or a Community Aged Care Package (CACP) in their home, is able to apply for CAAS, provided that they meet the CAAS eligibility criteria.Recipients of high level care in an Australian Government funded aged care home are not eligible for CAAS, as the home is required to provide appropriate continence products.
If someone is receiving an Extended Aged Care at Home (EACH) or EACH Dementia (EACHD) package while living in their own home, they will not be eligible for CAAS, as the EACH/EACHD service provider is required to provide appropriate continence products, if negotiated as part of their care plan.
A list of questions and answers for aged care homes and community care providers is available at www.bladderbowel.gov.au
CAAS application forms and further information
For more details on CAAS or to receive a CAAS application form, contact the CAAS Helpline on 1300 366 455 or visit www.intouchdirect.com.au or www.bladderbowel.gov.auFor information on other continence services that may be available, contact the National Continence Helpline on 1800 330 066.
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Last Call For Annual Aged Care Approved Provider Statements
Medicare Australia is waiting for over 400 Annual Aged Care Approved Provider statements that were due on 31 August for implementation on 1 September 2007. In July, Medicare Australia wrote to all aged care approved providers advising them of the changes to the authorised signatory process and requesting the completed statements prior to the August deadline. It is important you return your completed Annual Aged Care Approved Provider Statement as soon as possible if you have not already. If you have misplaced your provider statement, a 'fillable PDF' and helpful information is available on Medicare Australia's website at www.medicareaustralia.gov.au/aged'Fillable' PDF forms now available on medicare Australia's website
Medicare Australia has the following 'fillable' PDF forms available at www.medicareaustralia.gov.au/aged:- Annual Aged Care Approved Provider Statement
- Banking Details form
- Application for Eligible Oxygen Treatment and/or Enteral Feeding Supplement
- Appointment of a Nominee
- Resident Entry Record (RER)
- Resident Classification Scale (RCS).
Important:
- Only blank forms can be saved to your computer
- Forms cannot be submitted online—users have to print them off to sign and post them to Medicare Australia.
Update—Aged Care Funding Instrument (ACFI) training website
March 2008 will see the implementation of the new Aged Care Funding Instrument (ACFI) which will replace the existing Residential Classification Scale.The ACFI will enable users to send all ACFI related data (forms) electronically to Medicare Australia via business to business (B2B), file upload or a web form. All of these three lodgement channels require internet access (preferably broadband)—the B2B and file upload channels require software developed by a registered software vendor. To ensure secure transmission of ACFI data, by means of a web form, service providers will be required to submit an Online Claiming Authorisation form and an Annual Aged Care Approved Provider Statement to Medicare Australia, after which a User ID and Password will be issued. These forms can be downloaded from the Medicare Australia website at www.medicareaustralia.gov.au/aged
In preparation for the ACFI release, Medicare Australia launched a training website on 26 November 2007 that allows Aged Care Providers and their individual Services to:
- familiarise themselves with the Aged Care Online Claiming website
- familiarise themselves with the ACFI registration module
- test, train and practise data entry via the ACFI web form
- view the completed ACFI web form.
Important:
If you intend to use a software vendor's product (which will also provide this capability), it would be more appropriate to practice capturing ACFI data through the software vendor's product.Further information regarding ACFI, the online training environment and the training environment user guide can be found on Medicare Australia's website at www.medicareaustralia.gov.au/aged
Online Claiming Update
On Tuesday 14 August 2007, Medicare Australia received its first online Residential Claim. It was sent from Assisi Centre Aged Care using Management Advantage software and support.Assisi, who first introduced online claiming in 2005 said "we have had fantastic support from both our software provider in Management Advantage, and their staff to help iron out some of the early teething problems as well as Medicare Australia and in particular James Elliott the Business Development Manager for Victoria. They have all been there to help along the way to get release 3 and the B2B system up and running effectively. We hope to see even more benefits over the coming months as we start to realise its full potential."
Congratulations to both Management Advantage and Assisi Centre Aged Care for sending the first online claim to Medicare Australia successfully. This was a major milestone in introducing Aged Care Online Claiming functionality.
On Wednesday 12 September 2007, Cathy Argall (CEO Medicare Australia) spent the morning with Assisi Centre Aged Care in Melbourne to look at how the system works and to also congratulate the organisation on being the first service to send an online claim. Cathy Argall was extremely impressed with the functionality of the online claiming software developed by Management Advantage which has been implemented by Assisi Centre Aged Care.
Back Row L-R:
Ben Sturzaker - Operations Manager, Management Advantage, David Ribchester - Medicare Australia, Manager Victoria and Tasmania Aged Care Payments, Linda Holub - Medicare Australia, General Manager PBS and Aged Care Programs Division.Front Row L-R:
Enrico Belli - Assisi Centre Aged Care, Board President, Andy Chin - Management Advantage, IT Manager, James Elliott - Medicare Australia, Victoria Business Development Manager, Eileen Kielty - Assisi Centre Aged Care, Director of Care, Cathy Argall, Medicare Australia CEOTop of page
Draft Community Packaged Care Guidelines
By now you should have received a copy of the Draft Community Packaged Care Guidelines from the Department of Health and Ageing on a CD – ROM. These Draft Guidelines will assist you in the program management of the CACP, EACH and EACHD programs.Please remember to register to receive updates from the Department when you first upload the Draft Guidelines onto your computer. This will ensure that if the Department makes updates to the Draft Guidelines, prior to the final version being released next year, they are able to notify you. Registering for updates is simple, and details can be found in the booklet in the CD case or on the Department's website at: www.health.gov.au
At this stage, the Department is unable to update electronic copies automatically, as not all service providers have registered to receive updates. You may modify your own electronic copy by accessing the note function along the top toolbar in the Draft Guidelinesand inserting a note with the correct information.
Unfortunately, a section of the Draft Guidelines provides incorrect information and the Department asks that you update this in your copy. Details on this amendment were provided to service providers in August 2007.
The table in Part 4 Section 12.8 (page 70 in the hard copy version) regarding leave entitlements for EACH and EACHD recipients should read:
Type of leave | Recipient Leave Entitlements |
| Hospital | A care recipient may take hospital leave for up to 28 consecutive days and still retain their eligibility to receive an EACH/EACHD package upon leaving hospital. Approved providers may still continue to receive the Flexible Care Subsidy for up to 28 consecutive days only. |
| Transition Care | A care recipient is entitled to take leave from care packages to access the Transition Care Program. Approved providers may still continue to receive the Flexible Care Subsidy for up to 84 days. |
| Alternative care - e.g. respite or short term residential care or social leave | Maximum of 56 days per financial year. Approved providers may still continue to receive the Flexible Care Subsidy during this 56 days.Note:Only 28 days per financial year may be taken as social leave. |
| Extension of suspension of service | Retention of services will not be affected if fees are paid and extension is requested in writing to the approved provider. |
Remember, you still have until March 2008 to provide comments and feedback on the Draft Guidelines at the following email address: communitypackagedcareguidelinesfeedback@health.gov.au
If you did not receive a copy of the Draft Guidelines please also advise the Department via the above email address.
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Report On The Operation Of The Aged Care Act 1997 Now Available
Under the Aged Care Act 1997, the Minister for Ageing presents to Parliament a report on the operation of the Aged Care Act 1997 for every financial year. The Report for 2006-07 was tabled with Parliament recently and is now available to the public. The report contains five sections covering:- Introduction
- Access to care
- Funding for care
- Quality of care and accommodation, and
- Complaints Investigation Scheme.
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eACCR Project Update
Significant progress has been made on the electronic Aged Care Client Record (eACCR) Project since the last article in October's edition of the Payments Essentials Newsletter.As you would be aware the NSW Evaluation Unit has received their Notice of Integration from Medicare Australia which essentially confirmed the ACE system met the technical specifications required to electronically submit information to Medicare Australia. Western Australian and Victorian Evaluation Units will shortly receive their Notice of Integration and expect to begin their proof of concept phase with Swan (WA) and Heidelberg (VIC) ACATs respectively in early December 2007.
The Blacktown ACAT commenced the initial proof of concept phase on 11 September 2007. The first eACCR lodged by the Blacktown ACAT to Medicare Australia and was successfully processed in the aged care payment systems on the 26 September 2007.
We are now happy to inform you that Blacktown ACAT has successfully passed the proof of concept phase and commenced the 12 week demonstration phase on 29 October 2007. The proof of concept phase allowed a number of technical issues and procedural questions to be resolved, and demonstrate the eACCR system to be working effectively.
As at 20 November 2007, there had been 295 eACCRs successfully lodged with Medicare Australia.
Goulburn NSW ACAT is currently being prepared to commence their demonstration phase.
As more ACATs move into the demonstration phase, there will be an opportunity to qualitatively evaluate the new processes and system in terms of what works and what could be improved, and what impacts (both positive and negative) there are on the ACATs. This evaluation will also assist in determining when to proceed with a broader rollout of the eACCR.
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Frequently Asked Questions
Q: What happens to resident fee advice letters when they are redirected to family members by service providers?
Occasionally, the Department sends out general advice letters to all residents in aged care homes and to their nominees about changes to aged care arrangements. As about 55% of residents are full pensioners who are not eligible to pay income-tested care fees, the Department does not write regularly to them regarding care fees and they may not have nominee arrangements in place. Consequently, service providers often redirect mail for these residents to family members.Service providers need to be aware that Australia Post returns redirected mail to the Department, as per the return address printed on the envelopes. Therefore resident advice letters do not get through to the family members to whom they are redirected. Many residents will be visited by family members over the Christmas/New Year period. If you are requested to on-forward mail to a family member, it would be preferable that you advise them that the Department has nominee arrangements available so that they may represent the resident to the Department and receive copies of any correspondence about care fees.
The Department of Health and Ageing's Residential Aged Care Appointment of a Nominee form is for use by residents in Commonwealth funded aged care homes who wish to authorise another person to deal with the Department on their behalf. The form should also be used for residents who have a cognitive impairment and are therefore unable to administer their own affairs.
This form may be downloaded from the Department's website at: http://www.health.gov.au/internet/wcms/publishing.nsf/Content/ageing-rescare-nomform.htm
Nominee forms may also be obtained from the Aged and Community Care Information Line on 1800 500 853.
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Quarterly Review of income-tested Care fees
The latest quarterly review of income-tested fees was run on 24 November 2007 with an effective date of 1 January 2008. Review letters have been issued.Quarterly review letters are issued following the 'run date' for those residents who have a change to their:
- income-tested fee from the effective date;
- Class C (hardship) fee reduction from the effective date; or
- income-tested fee or Class C fee reduction for any past periods and therefore the residents are due a refund.
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Extra Service Status For Residential Aged Care Homes Invitation To Apply
The Department of Health and Ageing invites approved providers of residential aged care to apply for Extra Service status in 2008.Closing Date | Applications will be accepted between: |
| Friday 29 February 2008 | 15 February 2008 and 29 February 2008 |
All applications will be assessed against the criteria set out in the Aged Care Act 1997 and the Extra Service Principles 1997. Note that in some regions, applications may be assessed competitively.
All applicants must complete the approved application form. The application form and guidelines are available on the Department's internet site at: www.health.gov.au/internet/main/publishing.nsf/Content/ageing-rescare-ess-essprov.htm
It will be to an applicant's advantage to send in sufficient text and material evidence to support the claims made in the application. If the documentation cannot be downloaded from the internet, please contact the Aged Care Information Line on 1800 500 853 to obtain a copy.
The Information Line is open from 8.30am to 5pm Eastern Summer Time (Monday to Friday).
Two signed application forms with one set of clearly labelled attachments are to be sent to:
Postal Address
Extra Service Applications
Residential program management Branch
department of health and Ageing
MDP75
GPO Box 9848
CANBERRA ACT 2601
OR
Street Address
Extra Service Applications
Residential program management Branch
department of health and Ageing
MDP75
Ground Floor Reception
Alexandre Building
Furzer Street
WODEN ACT 2606
Please submit the Benchmark List section of the application form for approval of Extra Service status in electronic format as well as in hard copy to facilitate the publication of successful Extra Service packages on the Departmental website.
When sending the Benchmark List, the List should be marked with the name of the facility and its location. Commercial-in-confidence information which appears elsewhere in the application form should not be sent to the Department in electronic format. Electronic copies of the Benchmark List are to be sent to the following e-mail address: ESS.Applications.and.Inquiries@health.gov.au
Should providers approved for Extra Service status, who were not approved under the Extra Service Benchmarks, wish to have their list of approved Extra Services published on the website, they can also submit their information to the above e-mail address.
Information For Potential Extra Service Status Applicants South Coast Planning Region Of Queensland
Following the competitive assessment processes applied to applicants for Extra Service status in the South Coast Aged Care Planning Region of Queensland in the April 2007 Round, this region is now considered to be well supplied with Extra Service places. Applicants considering future applications for Extra Service approvals in the South Coast region can expect to have the supply of Extra Service in this region taken into account in the assessment process. The Department of Health and Ageing will keep the supply of Extra Service places in this planning region under review.AGED CARE INFORMATION LINE: 1800 500 853Top of page
Combining Adjacent Residential Aged Care Services
Combining residential aged care services is the administrative process whereby two or more aged care services located adjacent to each other (with all their approved places) and operated by the same approved provider, are combined into one aged care service using one of the existing RACS ids. For the purposes of combining aged care services, adjacent is taken to mean, to be on the same site or share a common boundary. A combined residential aged care service is not treated as a new service; it is a variation of an existing service.There are a number of advantages that may be achieved by combining residential aged care services. These include:
- the need to only submit one monthly claim form for Australian Government subsidy for care recipients in approved residential care
- simplifying the claim and payment process
- the need to have only one Certification assessment for a single service rather than individual assessments for more than one service
- the need to have only one Accreditation site audit over the entire service rather than audits against more than one service
- no need to discharge and re-admit residents when moving from low to high level care if they remain in the same aged care service
- no need to have new ACAT assessments completed for residents when they move from low to high level care if they remain in the same aged care service.
To fully complete the application form and better understand the combining process, approved providers need to read the document, 'Information for approved providers applying to combine Australian Government funded residential aged care services' (information document) which is available with the application form.
The application form and information document list a range of matters that approved providers need to take into account when deciding whether to seek approval to combine their residential aged care services. Providers may need to seek independent advice on the effects of combining services.
Application forms may be submitted to the Allocations Management area in the Aged Care Branch of the Department's State or Territory office where the aged care services are located.
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Aged Care Funding Instrument (ACFI) Training
The TAFE network has delivered two day training sessions about the ACFI to approximately 3300 aged care managers nationally. This training commenced in September and finished in November. ACFI appraisal training for 7000 care staff who will do ACFI appraisals of residents will be provided in February and March 2008.ACFI Appraisal Registrations
Aged care staff responsible for completing ACFI appraisals (eg, directors of nursing, registered nurses, enrolled nurses and personal carers) will be eligible to attend the training in February and March 2008.These training workshops will be available free of charge to at least two and as many as four representatives from each aged care facility – depending on the number of aged care places allocated to the facility. Facilities with fewer than 80 places may send two people free of charge; facilities with between 80 and 119 places may send three people free of charge, and facilities with 120 or more places may send four people free of charge.
ACFI Information Packs
In addition to training, other information will also be available. This includes videos on DVD, posters, fact sheets and contact numbers. Two DVDs will be distributed to all residential aged care services and approved providers.- The first DVD, distributed in November, follows up on the important aspects aged care managers learnt in their two day course.
- The second DVD will be distributed in March 2008. This DVD will examine aged care staff training, administration requirements and reminds staff about when the new system comes into place and what impacts it will have on them.
The ACFI web site
Please check the ACFI web site (www.health.gov.au/ACFI) regularly for news and updated information. In addition to the key ACFI documents the web site will contain information about the appraisal training, training resources, and answers to the most common questions arising from the manager training.Aged Care online Claiming
Please see Medicare Australia's article included in the edition, for more information on the ACFI, and in particular, the availability of an ACFI Training Environment.Top of page
Accommodation Bond Refund Interest Rates
From 1 July 2006 approved providers are required to pay interest on accommodation bond balances after the resident leaves care until it is refunded. The requirement to pay interest also applies to approved providers holding entry contributions in the event that the entry contribution balance is refunded after the time specified in the Formal Agreement. Approved providers are required to pay interest at two different rates:- at the Base Interest Rate (BIR) for the period between a resident's departure and the completion of the legislated timeframe for refunding the accommodation bond balance. It is not payable for the day of departure, but for each day after the resident has departed the service until the accommodation bond balance is refunded or the legislated timeframe expires; and
- at the Maximum Permissible Interest Rate (MPIR) for the period after the end of the legislated timeframe (or the time set out in the Formal Agreement) until the accommodation bond balance or entry contribution balance is refunded.
which BIR is payable, then the interest rate applied for the full period should be the BIR that first applied to that refund.
The Base Interest Rate
- The Base Interest Rate for residents who depart from an aged care home in the
The Maximum Permissible Interest Rate
- The Maximum Permissible Interest Rate for residents whose refunds are paid after the end of the legislated timeframe for refunding accommodation bonds in the 1 January 2008 to 31 March 2008 quarter is 11.15%.
The interest rate remains fixed at this rate until the bond or entry contribution is refunded.
For further details on the rules regarding payment of interest and examples of how the two interest rates are applied refer to the User's Guide to the regulation of approved providers holding accommodation bonds.
Previous Base Interest Rates and Maximum Permissible Interest Rates can be found on the Department's Internet site at: www.health.gov.au/internet/main/publishing.nsf/content/ageing-finance-refundrates.htm
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Schedule of Fees & Charges:
1 January 2008
Description | Old Rates (to 31 Dec 2007) | New Rates (from 1 Jan 2008) |
Maximum Basic Daily Care Fee#: | ||
| - all respite residents (pensioners and non-pensioners) | up to $31.52 | up to $31.52 |
| - other residents who receive a full or part means-tested Australian pension ## | up to $31.52 | up to $31.52 |
| - other non-pensioner residents ### | up to $39.28 | up to $39.28 |
| Residents who were receiving care in a hostel on 30 September 1997 and who are NOT currently at a home that was a nursing home before 1 October 1997. | ||
| - residents receiving full or part means-tested Australian pension## | up to $30.72 | up to $30.72 |
| - non-pensioners### | up to $38.48 | up to $38.48 |
| Residents who are currently receiving care in the same 'hostel' where they were living on 30 September 1997 and who are paying 'grandparented' variable fees | (see Residential Care Manual section 7.3.3) | |
Maximum Daily Income Tested Fee: | ||
| - residents receiving a full means-tested Australian pension | N/A | N/A |
| - residents receiving a part means-tested Australian pension | ||
| may be asked to pay | up to $24.26 | up to $24.26 |
| if they have private income per year of: (single) | $38,755 | $38,755 |
| (married - combined) | $76,677 | $76,677 |
| - non-pensioner residents | ||
| may be asked to pay | up to $55.28 | up to $55.28 |
| if they have private income per year of: (single) | $83.920 | $83,920 |
| (married - combined) | $167,007 | $167,007 |
Pensioner allowable limit for accommodation bonds: | ||
| The non-pensioner rate of basic daily care fee (above) may apply for pensioner residents whose accommodation bond is over this amount | $135,000 | $135,000 |
| Minimum assets a person must be left with when calculating the maximum Accommodation Bond | $33,500 | $33,500 |
Maximum Accommodation Charge for new entrants to your home* 20 September 2007 - 30 June 2008 | ||
| - for concessional residents and charge exempt residents | N/A | N/A |
| - for residents who first entered residential aged care from 1/7/2004 | ||
| . assisted residents, if their assets at entry are at least $51,823 | $10.04 | $10.04 |
| . assisted residents, if their assets at entry are less than $51,823 | calculated amount** | calculated amount** |
| . other residents, if their assets at entry are at least $65,529 | $17.55 | $17.55 |
| . other residents, if their assets at entry are less than $65,529 | calculated amount** | calculated amount** |
| - for residents who first entered residential aged care before 1/7/2004**** | ||
| . assisted residents, if their assets at entry are at least $47,498 | $7.67 | $7.67 |
| . assisted residents, if their assets at entry are less than $47,498 | calculated amount** | calculated amount** |
| . other residents, if assets at entry are at least $61,441 | $15.31 | $15.31 |
| . other residents, if assets at entry are less than $61,441 | calculated amount** | calculated amount** |
Asset cutoff level | ||
| - for concessional *** resident status | $33,500 | $33,500 |
| - for assisted *** resident status | $54,000 | $54,000 |
Maximum permissible interest ratefor Accommodation Payment agreements entered into | ||
| - Accommodation Bond | From 1 October 2007 to 31 December 2007 | From 1 January 2008 to 31 March 2008 |
10.37% | 11.15% | |
| - Accommodation Charge | From 20 Sept 2007 | From 1 Jan 2008 |
7% | 7% | |
| Pensioner Supplement (per day) | From 1 July 2006 to 30 June 2007 | From 1 July 2007 to 30 June 2008 |
$6.32 | $6.45 | |
| Age pension per fortnight (maximum basic rate) | $519.20 | $519.20 |
| Age pension per fortnight (maximum basic rate + GST supplement) | $537.70 | $537.70 |
## 'Pensioner' maximum rate also applies to blind pensioners & non-pensioner residents who have a dependent child
### 'Non-pensioner' maximum rate also may apply for pensioners who agree to pay a bond above the 'pensioner allowable limit'
* Rate remains unchanged for resident's stay in the one home, regardless of annual indexation of the max. rate for new entrants
** Margin of assets over $33,500 divided by 1,825 (See section 8.3.3.4 of Residential Care Manual).
*** See Residential Care Manual for additional criteria for concessional (6.3.5.1.2) and assisted (6.3.5.1.4) status.
**** Accommodation charge limited to a maximum period of five years and is fixed at date of entry.
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