Community care is care consisting of individually tailored packages of personal care services and other personal assistance provided to frail older people with complex care needs, who wish to continue living in their own homes. The packages are called Community Aged Care Packages (CACPs). They consist of low care services such as assistance with showering and personal hygiene, assistance with mobility and dressing, preparation of meals, administration of medication, laundry, gardening, emotional support and supervision, and transport to medical appointments, shopping or social activities (Part 3.2 AC Act; s.12.5 Community Care Subsidy Principles 1997).
An ACAS must assess and approve a person for a CACP. To be approved a person must have physical, social or psychological needs requiring the provision of care that can be met appropriately through non-residential care services (Part 2.3 AC Act; s.5.6 Approval of Care Recipients Principles).
The Department's Community Packaged Care Guidelines 2011 sets out the responsibilities of providers under the AC Act and the Principles not only in relation to CACPs, but also in relation to Extended Aged Care at Home (EACH) and Extended Aged Care at Home Dementia (EACHD) packages (see: "Flexible care", below). The Guidelines are available on the Department’s website at www.health.gov.au.
Providers of community care must meet obligations such as providing:
- quality care (ss.54-1 & 54-4 AC Act);
- security of place for the care recipient (s.56-2(d) AC Act; Part 3, Div. 1 User Rights Principles);
- protection of personal information (s.56-2(f) & Div. 62 AC Act);
- access to advocates for care recipients (s.56-2(h) AC Act; Part 3, Div. 2 User Rights Principles); and
- a complaints resolution mechanism (ss.56-2(g) & 56-4 AC Act).
There are specific requirements in relation to fees. For example, the provider cannot charge a single person any more than:
- if the care recipient's income does not exceed the maximum basic rate of pension – 17.5% of the amount of the pension; or
- if the care recipient's income does exceed the maximum basic rate of pension – 17.5% of the amount of the pension plus 50% of the amount by which the care recipient's income exceeds the amount of the pension (Div. 60 AC Act; Part 7 User Rights Principles).
A community care agreement must be offered to a prospective care recipient before a date for commencing services is agreed and the provider must assist the care recipient to understand the terms and effect of the agreement (s.56-2(e) AC Act; s.23.94 User Rights Principles). The agreement must set out or provide for matters such as:
- community care the care recipient has been assessed as requiring;
- charges payable and method of calculation;
- rights of the care recipient;
- giving of financial information to the care recipient;
- that the care recipient is entitled to make, without fear of reprisal, any complaint about the care and the mechanisms for doing this; and
- conditions under which the care may be suspended or the agreement may be terminated (Div. 61 AC Act; Part 8 User Rights Principles).
Providers of community care must comply with the Community Care Common Standards which comprise three Standards and 18 expected outcomes relating to those standards (ss.54-1(1)(f) & 54-5 AC Act: Part 5 & Schedule 5 of the Quality of Care Principles).
The rights and responsibilities of community care recipients include those in the Charter of Rights and Responsibilities for Community Care set out in Schedule 2 of the User Rights Principles (s.56-2 AC Act: Part 3, Div.3 User Rights Principles). These rights include the right of each care recipient to:
- be treated and accepted as an individual and have his or her individual preferences respected;
- choose the care and services that best meet his or her assessed needs;
- receive reliable, coordinated, safe, quality care and services;
- be given a written plan of the proposed care and services;
- receive care that takes account of his or her lifestyle and cultural, linguistic and religious preferences; and
- complain about the care and services, without fear of losing the care or being disadvantaged in any other way.
Flexible care is care provided in a residential or community setting through an aged care service that addresses the needs of care recipients in alternative ways to the care provided through residential care services and community care services (Part 3.3 AC Act; Flexible Care Subsidy Principles 1997 ("Flexible Care Subsidy Principles")).
Flexible care services have the scope to meet a broad range of care needs (whether in a residential or community care setting) and provide opportunities for people with special needs and those in rural and remote communities to receive care. Specific services include multi-purpose services, transition care following a hospital stay and care in the home for people with high level care needs.
Providers of flexible care have responsibilities similar to providers of other aged care services in relation to:
- the quality of care they provide;
- compliance with, and respect for, the rights of care recipients;
- accountability for the care that is provided, and the basic suitability of their key personnel (s.3-4 & Chapter 4 AC Act).
All flexible care providers must comply with the requirements for matters such as security of place, an internal complaints resolution mechanism, protection of information and access to advocates by care recipients (ss.54-1, 56-3, 56-4 & Div. 62 AC Act; Flexible Care Subsidy Principles).
There are two kinds of flexible care that are provided to people in their homes: EACH and EACHD. They comprise individually tailored and managed packages of care for people who have high level care needs who are able to be cared for in their homes. EACHD packages are specifically designed for people assessed as having complex care needs because of behavioural and psychological symptoms associated with their dementia. Both packages are flexible and coordinated to suit a recipient's particular needs (Chapter 2, Part 1 Flexible Care Subsidy Principles).
EACH and EACHD packages include the provision of technical and complex nursing services, personal assistance and social support. Care planning and review is undertaken by appropriately trained professionals, usually registered nurses.
A person must be approved for EACH or EACHD by an ACAS (Part 2.3 AC Act; ss.5.7 & 5.7AA Approval of Care Recipients Principles ). If a person is approved as an EACH recipient, the person is also eligible for a CACP as an alternative to EACH. If a person is approved as an EACHD recipient, the person is also eligible for EACH or a CACP as an alternative to EACHD (Part 3 Approval of Care Recipient Principles).
Providers of EACH and EACHD have similar obligations to those of community care providers (ss.54-1, 54-5, 56-3, 56-4 & Div. 62 AC Act: Part 3A User Rights Principles, Part 6 Quality of Care Principles). Additional provider responsibilities, and many of the rights of care recipients, are set out in EACH and EACHD Payment Agreements made between the Commonwealth and the provider under the Flexible Care Subsidy Principles. Schedules to the Payment Agreements set out the Specified Care and Services that are available to care recipients. The Payment Agreements and the Schedules are available on the Department's website at www.health.gov.au.
The rights and responsibilities of EACH and EACHD recipients include those in the Charter of Rights and Responsibilities for Community Care set out in Schedule 2 of the User Rights Principles (s.56-3 AC Act: Part 3A User Rights Principles). EACH and EACHD providers must also comply with the Community Care Common Standards (ss.54-1(1)(g) & 54-5 AC Act: Part 6 & Schedule 5 of the Quality of Care Principles).
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OTHER AUSTRALIAN GOVERNMENT-SUBSIDISED AGED CARE SERVICES :: Last updated: Thu Jul 1st 2010