National Health Reform

National Health Reform Agreement

Schedule F – Aged Care and Disability Services

F1. This schedule clarifies the roles and responsibilities of governments in relation to basic community care services currently delivered through the Home and Community Care (HACC) program, Commonwealth funded and managed community and residential aged care, and certain specialist disability services provided under the National Disability Agreement and managed by States.

F2. These changes to roles and responsibilities will enable the creation of a national aged care system and national disability services system and should be read together with the broader roles and responsibilities of governments detailed in the National Disability Agreement.

F3. It is not intended that the split of responsibilities according to the age of clients be carried through into programs outside those mentioned in this Schedule.

F4. Until otherwise agreed, the changes outlined below to roles and responsibilities for basic community care, aged care and disability services and the reconciliation arrangements referred to in clause F21 do not apply to Victoria and Western Australia. In these States, basic community care services will continue to be delivered under HACC as a joint Commonwealth-State funded program. The Commonwealth and these States will maintain bilateral agreements for that purpose. The review to be conducted in 2012 under existing agreements will deal only with business processes.

Commonwealth Responsibilities

F5. The Commonwealth will take full funding, policy, management and delivery responsibility for a consistent and unified aged care system covering basic home care through to residential care.

F6. Specifically, the Commonwealth will be responsible for:

1. regulating packaged community and residential aged care delivered under Commonwealth aged care programs;


2. funding packaged community and residential aged care delivered under Commonwealth aged care programs for people aged 65 years and over (50 years and over for Indigenous Australians);


3. funding and regulating basic community care services for people aged 65 years and over (50 years and over for Indigenous Australians); and


4. funding specialist disability services delivered by the States in accordance with their responsibilities under the National Disability Agreement for people aged 65 years and over (50 years and over for Indigenous Australians).

F7. In giving effect to these responsibilities, the Commonwealth will assume:

1. from 1 July 2011, funding and policy responsibility, and from 1 July 2012, operational responsibility for basic community care services for people aged 65 years and over (50 years and over for Indigenous Australians); and


2. funding responsibility from 1 July 2011 for specialist disability services delivered by the States in accordance with their responsibilities under the National Disability Agreement for people aged 65 years and over (50 years and over for Indigenous Australians).

F8. The Commonwealth will continue to contribute funding to States for specialist disability services through the National Disability SPP and support effective national leadership in disability policy through the National Disability Agreement.

F9. Current arrangements for access to Commonwealth aged care services for people under the age of 65 years will remain unchanged.
State Responsibilities

F10. States will be responsible for:

1. regulating specialist disability services delivered under the National Disability Agreement;


2. funding and regulating basic community care services for people under the age of 65 years in line with their principal responsibility for delivery of other disability services by the States in accordance with their responsibilities under the National Disability Agreement, except Indigenous Australians aged 50 years and over for whom the cost of care will be met by the Commonwealth; and


3. funding packaged community and residential aged care delivered under Commonwealth aged care programs for people under the age of 65 years, except Indigenous Australians aged 50 years and over.

F11. In giving effect to these responsibilities, the States will assume:

1. funding and program responsibility from 1 July 2011 for basic community care services for people under the age of 65 years (under the age of 50 for Indigenous Australians); and


2. funding responsibility from 1 July 2011 for packaged community care and residential care delivered through the Commonwealth aged care program to people under the age of 65 years (under the age of 50 years for Indigenous Australians).

F12. Current arrangements for access to disability services by States in accordance with their responsibilities under the National Disability Agreement for people 65 years and over (50 years and over for Indigenous Australians) will remain unchanged.

F13. The roles and responsibilities, performance indicators and annual reporting provisions of the National Disability Agreement will reflect the changes to roles and responsibilities under this Agreement, including coverage of former HACC services for people under the age of 65 years (under the age of 50 years for Indigenous Australians).

Shared Responsibilities

F14. The Commonwealth and States will share responsibility for providing continuity of care across health services, aged care and disability services to ensure smooth client transitions.

F15. Each level of government will continue to deliver basic community care services for the client groups under its responsibility.

F16. The Commonwealth and States will share program responsibility for community care and residential care services for Indigenous Australian clients aged 50 to 64 years, who will be eligible to receive services from an appropriate provider under programs of either level of government. This will ensure that there will be no 'wrong door' for Indigenous Australians in this age group seeking community or residential care services. Where care services are provided under a State funded program to an Indigenous person aged 50 years or older the Commonwealth will meet the cost of the service.

Transition Arrangements

F17. The implementation of the new arrangements for basic community care maintenance and support services will be carefully managed to ensure continuity of care for clients.

F18. It is expected that basic level community care services will continue to be delivered through a mix of local government, State agency and non-government providers, and that individual providers will continue to be able to deliver both community disability and community aged care services during the implementation period and beyond.

F19. The changes in roles and responsibilities for the provision of aged care and disability services detailed in this schedule will be budget neutral over the period 2011-12 to 2013-14. Budget neutrality will be achieved through adjustments to the National Disability SPP.

1. Beyond 2013-14 an adjustment will continue to be made to the National Disability SPP held constant as a per capita share of the National Disability SPP based on the adjustment made in 2013-14.

F20. The Commonwealth will work with States to effect the new funding arrangements with a smooth transfer to Commonwealth operational responsibility for HACC aged care services from 1 July 2012. The Commonwealth will fund service providers no earlier than 1 July 2012, and will not substantially alter service delivery mechanisms before 1 July 2015. There is no requirement for services to be delivered under competitive tender processes.

F21. The process for reconciliation of State funding of packaged community and residential aged care services to people under the age of 65 years (under 50 years for Indigenous Australians), and Commonwealth funding of specialist disability services by States in accordance with their responsibilities under the National Disability Agreement for people 65 years and over (50 years and over for Indigenous Australians) will, during the transition period, involve transfers of resources between levels of government. These arrangements will have little or no direct impact on service providers and clients.