DISCLOSURE LOG - FOI 24/25-0642 DOCUMENT 1
Practice Guide Younger People in Residential Aged Care
Practice Guide
Contents
Practice Guide Younger People in Residential Aged Care …………………………………………….. 1 For use by YPIRAC trained Planners and Delegates only. …………………………………………… 1 Introduction …………………………………………………………………………………………………………… 3 Audience ……………………………………………………………………………………………………………… 4 Access …………………………………………………………………………………………………………………. 5
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Introduction
The purpose of this Practice Guide is to support YPIRAC trained planners and/or delegates to understand and facilitate the transition of Younger People in Residential Aged Care (YPIRAC) to the National Disability Insurance Scheme (NDIS) and to support the development of their NDIS plan.
Younger people (aged under 65) may be living in a residential aged care facility (RACF) if they have been unable to access alternative age-appropriate accommodation and care due to their high-level care needs. Younger people in residential aged care are scheduled to transition to the NDIS in line with agreed geographic or aged based phasing arrangements for each state or territory.
There are approximately 6,100 younger people in residential aged care nationally and it is anticipated the majority of this cohort will be eligible for the NDIS.
The National Disability Insurance Agency (NDIA), the Department of Health (DoH) and the Department of Social Services (DSS) have agreed on the service delivery model and funding arrangements that will enable the transition of younger people in residential aged care to the NDIS.
DoH are the policy owners of the Aged Care Act 1997 (Aged Care Act), however the Commonwealth Department of Human Services (DHS) are responsible for conducting income and assets assessments. DoH is responsible for setting the fees and charges payable for people accessing Aged Care services.
The Aged Care Act applies to all people living in RACFs who have been approved as eligible under the Act for residential aged care, no matter how they are funded. Therefore, the structure of fees and charges payable by people in RACFs, and the subsidies and supplements payable by the Australian Government by DoH apply to NDIS participants who are permanent residents of a RACF.
Under the funding arrangements, the NDIS pays DoH for the subsidies and supplements it pays the RACF for the care, support and accommodation of a participant who is residing in an RACF on a permanent basis. This is made through a cross billing arrangement. The NDIS will also fund some of the fees and charges that a participant permanently residing in a RACF is required to pay. The name of the fees and charges may differ depending on when the participant entered the aged care facility. The fees and charges that are reimbursable to the participant are:
- Income Tested Care Fees (before 1 July 2014), or Means Tested Care Fees (after 1 July 2014), and
- Up to a specified limit - Daily Accommodation Payments, or Accommodation Charge (before 1 July 2014) or Daily Accommodation Contribution (after 1 July 2014), if applicable.
To support the transition to the NDIS, the NDIA receives individualised data under Section 55 of the NDIS Act for every younger person under the aged of 65 residing in an RACF on a permanent basis. The information is received from DoH on a quarterly basis and uploaded to
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the NDIS Business System (System). Once uploaded, contact can be made with the relevant RACF by the local YPIRAC planner/Business Support Officer. This is in preparation of scheduling a time to meet with the potential participant to establish if the person would like to request access to the NDIS. The National Access and Workload Management (NAWM) Branch will determine the eligibility decision of the potential participant against the access requirements.
This Practice Guide relates to participants who reside in a Commonwealth registered RACF on a permanent basis and who have been approved under the Aged Care Act for residential aged care.
This Practice Guide does not apply to participants who are:
- in receipt of respite at a RACF
- occupying a place in a facility operating as part of the National Aboriginal and Torres Strait Islander Flexible Aged Care Program
- in a Multi-Purpose Service
- residing in a Commonwealth registered RACF but who have not been approved under the Aged Care Act for residential aged care.
If the participant does not meet the YPIRAC criteria, do not use the YPIRAC planning process. For guidance regarding planning for these participants, refer to Practice Guide – Determine Reasonable and Necessary Supports in a Plan.
A participant who resides in a Commonwealth registered RACF on a permanent basis and has been approved under the Aged Care Act for residential care should have the following documentation:
- A Department of Human Services (DHS) Residential Aged Care Advice letter
- Last six months of itemised RACF tax invoices for the participant
The RACF must be a Commonwealth registered RACF. This can be checked using the YPIRAC Fee Calculator, services tab. Refer to Standard Operating Procedure – Using the YPIRAC Fee Calculator.
When deciding to include any support in a participant’s plan, the NDIA must have regard to a range of matters set out in the NDIS Act 2013, including the participant’s statement of goals and aspirations. Specifically, the NDIA must be satisfied that each support meets each of the reasonable and necessary criteria outlined in section 34(1)(a)-(f) of the NDIS Act and the Supports for Participants Rules (see deciding to include supports in a participant’s plan).
Audience
This document is to support:
- NDIA Planners
- Staff involved in YPIRAC planning
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Note: YPIRAC access and planning tasks should only be completed by planners who have received YPRIAC training.
Access
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Engaging with the NDIS
To ensure a nationally consistent approach to support younger people in residential aged care to access the NDIS, an access sub process has been developed. This process involves the planner undertaking face-to-face access and planning with the participant. The planner has a key role in the collection of information in order to complete an access request form (ARF).
This process is designed to improve capacity to respond to the specific needs of younger people in residential aged care, in particular ensuring that multiple contacts are not made with the same RACF, and that important representatives are not left out of the access request process. It also ensures access requests are not unnecessarily delayed through double handling of information and that preparation for plan development can begin in a timely manner.
During the access process, plan developers must request a copy of relevant documents from the participant, see list below, that will provide the evidence of fees and charges the resident is currently paying to the RACF.
Please refer to Work Practice – Access – Younger People in Residential Aged Care (YPIRAC) when determining a participant’s access to the NDIS.
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Supporting material
- NDIS Act 2013
- NDIS Rules 2013, 2014 and 2016
- NDIS Operational Guidelines
- Work Practice — Access Sub Process — Younger People in Residential Aged Care
- Compensation Information
- Standard Operating Procedure — Add Plan Management and Financial Administration Line Items
- Practice Guide — Assistive Technology
- Work Instruction — Complete Risk Assessment
- Standard Operating Procedure — Record Bank Details
Feedback
If you have any feedback about this Practice Guide please email Planning Support. In your email remember to include the title of the product you are referring to and to describe your suggestion or issue concisely.
Version change control
| Version No | Amended by | Brief Description of Change: | Status | Date |
|---|---|---|---|---|
| 13.0 | JS0082 | CLASS 1 Approval | APPROVED | 2019-02-01 |
| 13.1 | KP0035 | Update to referral process for compensation to the Compensation Recoveries Team instead of TAT | DRAFT | 2019-02-15 |
| 14.0 | SMQ398 | Class 1 Approval (not published) | APPROVED | 2019-02-25 |
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| Version No | Amended by | Brief Description of Change: | Status | Date |
|---|---|---|---|---|
| 14.1 | MG0023 | redacted: s22(1)(a)(ii) - irrelevant material |
DRAFT | 2019-02-26 |
| 14.2 | CF0034 | Review by Aged Care team and approved | DRAFT | 2019-04-30 |
| 14.3 | MG0023 | Minor word changes to ensure participant centred language | DRAFT | 2019-04-31 |
| 15.0 | ZWECKM | Review and Class 2 approval | APPROVED | 2019-05-02 |