list each service; and

describe each service; and

specify the service type that the service is in; and

specify the service group that the service type is in; and

specify, for the service groups home support, assistive technology and home modifications, that all service types in those service groups must be delivered in a home or community setting; and

specify, for the service group residential care, that all service types in the service group must be delivered in a residential care home; and

specify, for each service that is in a service type (other than a service type referred to in paragraph (i)) that is specified as a service type that is in the service group home support, assistive technology or home modifications:

the means testing category for the service; and

the subsidy basis for the service; and

if the subsidy basis for the service is efficient price or unit price—the base efficient price or base unit price for the service; and

the loading type (if any) that applies to the service; and

specify any specialist aged care program under which a service type can be delivered; and

specify any service type that can only be delivered under a specialist aged care program; and

specify each provider registration category under which a service type can be delivered.

home support;

residential care;

assistive technology;

home modifications.

clinical supports;

independence;

everyday living.

Matters that must be considered before prescribing services

services for the care of persons who are experiencing sickness;

services incidental or conducive to the care of persons who are experiencing sickness.

the individual makes an application for access to funded aged care services under section 56; and

the System Governor makes an eligibility determination for the individual and that determination is in effect; and

the individual undergoes an aged care needs assessment; and

(d) an access approval that covers the service is in effect for the individual; and

if the individual is accessing the service other than under a specialist aged care program:

a classification decision establishing a classification level in a classification type for the service group is in effect for the individual; and

if a priority category decision is required under section 86 for the classification type for the service group—such a decision under section 86 has been made for the individual for the classification type for the service group; and

if the classification type or classification level is one for which the System Governor may allocate the individual a place under section 92—a place has been allocated to the individual under that section for that classification type or classification level and is in effect; and

if the individual is accessing the service under a specialist aged care program:

a classification decision establishing a classification level in a classification type for the service group has been made for the individual; and

if the System Governor may allocate the registered provider a place under section 95—a place has been allocated to the registered provider under that section and is in effect.

an approved residential care home; or

a home or community setting.

Residential care home

is the place of residence of individuals who, by reason of sickness, have a continuing need for aged care services, including nursing services; and

is fitted, furnished and staffed for the purpose of providing those services.

a place within, or co-located with, a hospital or other health service that is covered by an agreement with the Commonwealth to deliver aged care services alongside health services as a part of an integrated service arrangement;

a place within a retirement village that is a place described by subsection (2);

a place which is a complex of buildings;

any other place prescribed by the rules.

a private home;

a retirement village (other than a place referred to in paragraph (3)(b));

(c) a facility for which a declaration under subsection 121-5(6) of the Private Health Insurance Act 2007 is in force (other than a place referred to in paragraph (3)(a));

a hospice or facility that primarily provides palliative care;

any other place prescribed by the rules.

circumstances where a place is taken to be 2 or more separate places; and

circumstances where 2 or more separate places are taken to be a single place.

Home or community setting

a group home funded under the National Disability Insurance Scheme;

a hospital;

a psychiatric facility;

a prison or detention centre;

a hospice or facility that primarily provides palliative care;

any other place prescribed by the rules.

the registration period has not ended; and

the registration has not been revoked under a provision of Part 3 of Chapter 3.

the residential care category; and

(b) any other category prescribed by the rules.

Aged care workers

an individual employed or otherwise engaged (including as a volunteer) by the registered provider to deliver funded aged care services; or

an individual who:

is employed or otherwise engaged (including as a volunteer) by an associated provider of the registered provider; and

is engaging in conduct under the associated provider’s arrangement with the registered provider relating to the registered provider’s delivery of funded aged care services; or

an individual who is a registered provider.

the service is included on the list referred to in subsection 8(1); and

the service was scheduled to be delivered by the registered provider to the individual on a day; and

had the service been delivered as scheduled, the individual could have accessed the service through a service group as referred to in subsection 9(2); and

subsection (3) applies to the service.

both:

the service was scheduled to be delivered by the registered provider to the individual on the day at an agreed time and place; and

the only reason that the service was not delivered was because the individual cancelled the delivery of the service within the period, before that day, that is prescribed by the rules; or

the circumstances prescribed by the rules apply.

a reference in this Act to the number of hours or units of the service delivered to the individual on a day is taken to be a reference to the number of hours or units that were scheduled to be delivered to the individual on the day; and

a reference in this Act to the service delivery branch through which the service was delivered is taken to be a reference to the service delivery branch through which the service was scheduled to be delivered.

in circumstances prescribed by the rules; or

for the purposes of a provision of this Act prescribed by the rules.

Certain reimbursements taken to be delivery of funded aged care services

an individual incurs costs in acquiring a service that is included on the list referred to in subsection 8(1); and

the registered provider reimburses, in accordance with any requirements prescribed by the rules, the individual for the whole or a part of the costs; and

had the service been delivered to the individual by the registered provider, the individual could have accessed the service through a service group as referred to in subsection 9(2); and

any other circumstances prescribed by the rules in relation to the individual, the acquisition or the service apply;

the reimbursement is taken, for the purposes of this Act, to be the delivery of the service by the registered provider to the individual.

in circumstances prescribed by the rules; or

for the purposes of a provision of this Act prescribed by the rules.

if the registered provider is not a government entity—any person who is responsible for the executive decisions of the registered provider;

if the registered provider is not a government entity—any other person who has authority or responsibility for (or significant influence over) planning, directing or controlling the activities of the registered provider;

for any registered provider (including a government entity)—if the registered provider delivers, or proposes to deliver, a funded aged care service:

any person who has responsibility for overall management of the nursing services delivered by the registered provider, or overall management of the nursing services delivered at an approved residential care home of the registered provider, and who is a registered nurse; and

any person who is responsible for the day-to-day operations of an approved residential care home or service delivery branch of the registered provider.

the individual’s experience in providing, at any time, funded aged care services or other similar services;

whether a banning order against the individual is, or has at any time been, in force;

whether an NDIS banning order against the individual is, or has at any time been, in force;

whether the individual has at any time been convicted of an indictable offence;

whether a civil penalty order against the individual has been made at any time;

whether the individual is, or has at any time been, an insolvent under administration;

whether the individual is, or has at any time been, the subject of adverse findings or enforcement action by any of the following:

a Department of the Commonwealth or of a State or Territory;

the Australian Securities and Investments Commission;

the Australian Charities and Not-for-profits Commission;

the Australian Competition and Consumer Commission;

the Australian Prudential Regulation Authority;

the Australian Crime Commission;

(vii) AUSTRAC (within the meaning of the Anti-Money Laundering and Counter-Terrorism Financing Act 2006);

the Australian Health Practitioner Regulation Agency;

another body established for a public purpose by or under a law of the Commonwealth;

a State or Territory authority (including, but not limited to, a body that is equivalent to a body mentioned in subparagraphs (ii) to (viii));

a local government authority;

a body responsible for maintaining standards of conduct in a profession that is involved in the delivery of funded aged care services;

whether the individual:

is, or has at any time been, the subject of any findings or judgment in relation to fraud, misrepresentation or dishonesty in any administrative, civil or criminal proceedings; or

is currently party to any proceedings that may result in the individual being the subject of such findings or judgment;

(i) whether the individual is, or has at any time been, disqualified from managing corporations under Corporations Act 2001;Part 2D.6 of the

if circumstances prescribed by the rules apply in relation to the individual—the individual is a person in respect of whom the worker screening requirements prescribed for the purposes of section 152 are met;

any other matter prescribed by the rules.

how registered providers must treat, and engage with, individuals seeking to access, or accessing, funded aged care services;

how registered providers must deliver funded aged care services, including governance arrangements and arrangements for planning and delivery of palliative care;

the physical environments in which funded aged care services are required to be delivered;

how registered providers must deliver quality and safe clinical care to individuals, including infection prevention and control procedures and arrangements;

how registered providers must deliver food and drink to meet the nutritional needs and preferences of individuals;

how registered providers must support individuals accessing funded aged care services in approved residential care homes;

how registered providers must manage and respond to feedback and complaints;

how registered providers must monitor and drive improvements to their delivery of funded aged care services.

all registered providers;

registered providers in specified provider registration categories;

specified kinds of registered providers.

Periodic reviews of operation of Aged Care Quality Standards

unreasonable use of force against the individual;

unlawful sexual contact, or inappropriate sexual conduct, inflicted on the individual;

psychological or emotional abuse of the individual;

unexpected death of the individual;

stealing from, or financial coercion of, the individual by an aged care worker of the provider;

neglect of the individual;

use of a restrictive practice in relation to the individual (other than in accordance with any requirements prescribed by the rules);

unexplained absence of the individual in the course of the delivery of funded aged care services to the individual.

(a) that a specified act, omission or event involving an individual to whom a registered provider is delivering funded aged care services is a reportable incident; or

(b) that a specified act, omission or event involving an individual to whom a registered provider is delivering funded aged care services is not a reportable incident.

require that a restrictive practice in relation to the individual is used only:

as a last resort to prevent harm to the individual or other persons; and

after consideration of the likely impact of the use of the practice on the individual; and

require that, to the extent possible, alternative strategies are used before a restrictive practice in relation to the individual is used; and

require that alternative strategies that have been considered or used in relation to the individual are documented; and

require that a restrictive practice in relation to the individual is used only to the extent that it is necessary and in proportion to the risk of harm to the individual or other persons; and

require that, if a restrictive practice in relation to the individual is used, it is used in the least restrictive form, and for the shortest time, necessary to prevent harm to the individual or other persons; and

require that informed consent is given to the use of a restrictive practice in relation to the individual; and

make provision for, or in relation to, the monitoring and review of the use of a restrictive practice in relation to the individual.

(a) the number of times the provider’s or responsible person’s conduct has not complied with a provision of this Act (the relevant contraventions);

the period over which the relevant contraventions occurred;

the number of individuals affected by the relevant contraventions;

the provider’s or responsible person’s response, or failure to respond, to any complaints about the relevant contraventions.

the adult:

is legally responsible (whether alone or jointly with another individual) for the day-to-day care, welfare and development of the young person; or

is under a legal obligation to provide financial support in respect of the young person; and

in a subparagraph (a)(ii) case—the adult is not included in a class of persons prescribed by the rules; and

the young person is not:

in full-time employment; or

(ii) in receipt of a social security pension (within the meaning of the Social Security Act 1991) or a social security benefit (within the meaning of that Act); or

included in a class of persons prescribed by the rules.

an individual under 16 years of age;

an individual who:

has reached 16 years of age, but is under 25 years of age; and

is receiving full-time education at a school, college or university;

an individual included in a class of persons prescribed by the rules.

exercise choice and make decisions that affect the individual’s life, including in relation to the following:

(i) the funded aged care services the individual has been approved to access;

how, when and by whom those services are delivered to the individual;

the individual’s financial affairs and personal possessions; and

be supported (if necessary) to make those decisions, and have those decisions respected; and

take personal risks, including in pursuit of the individual’s quality of life, social participation and intimate and sexual relationships.

Equitable access

have the individual’s need for funded aged care services assessed, or reassessed, in a manner which is:

culturally safe, culturally appropriate, trauma-aware and healing-informed; and

accessible and suitable for individuals living with dementia or other cognitive impairment; and

palliative care and end-of-life care when required.

Quality and safe funded aged care services

be treated with dignity and respect; and

safe, fair, equitable and non-discriminatory treatment; and

have the individual’s identity, culture, spirituality and diversity valued and supported; and

funded aged care services being delivered to the individual:

in a way that is culturally safe, culturally appropriate, trauma-aware and healing-informed; and

in an accessible manner; and

by aged care workers of registered providers who have appropriate qualifications, skills and experience.

be free from all forms of violence, degrading or inhumane treatment, exploitation, neglect, coercion, abuse or sexual misconduct; and

have quality and safe funded aged care services delivered consistently with the requirements imposed on registered providers under this Act.

Respect for privacy and information

personal privacy respected; and

personal information protected.

be informed, in a way the individual understands, about the funded aged care services the individual accesses; and

express opinions about the funded aged care services the individual accesses and be heard.

open communication and support from registered providers when issues arise in the delivery of funded aged care services; and

make complaints using an accessible mechanism, without fear of reprisal, about the delivery of funded aged care services to the individual; and

have the individual’s complaints dealt with fairly and promptly.

Advocates, significant persons and social connections

significant persons in the individual’s life and pets, including through safe visitation by family members, friends, volunteers or other visitors where the individual lives and visits to family members or friends; and

the individual’s community, including by participating in public life and leisure, cultural, spiritual and lifestyle activities; and

if the individual is an Aboriginal or Torres Strait Islander person—community, Country and Island Home.

competing or conflicting rights;

the rights and freedoms of other individuals, including aged care workers of the registered provider and other individuals accessing funded aged care services;

(c) compliance with other laws of the Commonwealth, or of a State or Territory, including the Work Health and Safety Act 2011.

puts older people first; and

treats older people as unique individuals; and

(c) recognises the rights of individuals under the Statement of Rights.

be able to reside at the individual’s home (if the individual so chooses) or, if that is not possible, in a setting that is appropriate given the individual’s circumstances, needs and preferences; and

exercise individual responsibility and make decisions that enable the individual to lead an active and fulfilling life, including by engaging in the community and maintaining relationships with people (if the individual so chooses); and

be active and informed in decision-making, or be supported (if necessary) to make or communicate decisions, about the funded aged care services the individual accesses to ensure the individual’s will and preferences are respected; and

maintain or improve the individual’s physical, mental, cognitive and communication capabilities to the extent possible (if the individual so chooses), except where it is the individual’s choice to access palliative care and end-of-life care; and

be aware of, understand and be empowered to exercise, their rights under the Statement of Rights when accessing, or seeking to access, funded aged care services; and

engage with, and be supported by, independent aged care advocates (if the individual so chooses), including through receiving information, education and advocacy in relation to accessing, or seeking to access, funded aged care services.

are Aboriginal or Torres Strait Islander persons, including those from stolen generations; or

are veterans or war widows; or

are from culturally, ethnically and linguistically diverse backgrounds; or

are financially or socially disadvantaged; or

are experiencing homelessness or at risk of experiencing homelessness; or

are parents and children who are separated by forced adoption or removal; or

are adult survivors of institutional child sexual abuse; or

are care-leavers, including Forgotten Australians and former child migrants placed in out of home care; or

are lesbian, gay, bisexual, trans/transgender or intersex or other sexual orientations or are gender diverse or bodily diverse; or

are an individual with disability or mental ill-health; or

are neurodivergent; or

are deaf, deafblind, vision impaired or hard of hearing; or

live in rural, remote or very remote areas.

continuity of funded aged care services; and

access to integrated services, including strong linkages with the health, mental health, veterans, disability and community services sectors.

An aged care system that values workers and carers

supports funded aged care services being delivered by a diverse, trained and appropriately skilled workforce who are valued and respected; and

supports aged care workers of registered providers being empowered, including through access to relevant information, to:

provide feedback, suggest measures and take actions that support innovation, continuous improvement and the delivery of high quality care; and

participate in governance and accountability mechanisms related to the delivery of funded aged care services; and

recognises and supports the important role of advocates, carers, volunteers and visitors in improving individuals’ experiences of the Commonwealth aged care system.

it is sustainable and resilient; and

the Commonwealth’s investment in the system represents value for money, including by ensuring that public resources are used in the most efficient, effective, ethical and economic manner.

An aged care system that continues to improve

promotes innovation, continuous improvement and contemporary evidence-based best practice in the Commonwealth aged care system; and

is responsive and proportionate to risk, with a focus on prevention and timely action; and

focusses on the safety, health, wellbeing and quality of life of individuals, and prioritises the areas of highest risk to individuals; and

promotes the provision of high quality care; and

strives for regulatory alignment (if appropriate) with other care and support sectors; and

is undertaken in collaboration with older people.

has guardianship of the individual under a law of the Commonwealth, a State or a Territory; or

is appointed by a court, tribunal, board or panel (however described) under a law of the Commonwealth, a State or a Territory, and has power to make decisions for the individual; or

holds an enduring power of attorney or like power granted by the individual; or

is included in a class of persons prescribed by the rules.

if the individual has consented to information or documents being given to a supporter of the individual—that supporter;

regardless of whether the individual has consented—to a supporter of the individual if the supporter is a person covered by subsection 28(2).

under, or for the purposes of, this Act; and

if the person is a person covered by subsection 28(2)—in a manner that is consistent with the person’s duties and obligations as such a person.

the duties set out in:

subsection (2); and

section 31 (duty to inform of matters affecting ability or capacity to act as supporter); and

the duty to act honestly, diligently and in good faith in discharging the supporter’s other duties; and

the duty to avoid or manage any conflict of interest in relation to the supporter and the individual, and to inform the System Governor of any such conflict as it arises; and

any duty prescribed by the rules.

act in a manner that promotes the will, preferences and personal, cultural and social wellbeing of the individual; and

act honestly, diligently and in good faith; and

support the individual only to the extent necessary for the individual to do the thing, applying the supporter’s best endeavours to maintain the ability of the individual to make the individual’s own decisions.

either:

an event or change of circumstances happens; or

the supporter becomes aware that an event or change of circumstances is likely to happen; and

the event or change of circumstances is likely to affect:

the ability or capacity of the supporter to act as a supporter of the individual, including complying with the duties of supporters referred to in subsection 30(1); or

the ability of the System Governor to contact the supporter for the purposes of this Act; or

the ability or capacity of the supporter to comply with notices given to, and imposing requirements on, the supporter by the System Governor under, or for the purposes of, this Act.

acts, omissions, matters and things outside Australia, whether or not in a foreign country; and

all persons, irrespective of their nationality or citizenship.

the person is a supporter of an individual accessing, or seeking to access, funded aged care services; and

the person:

exercises any influence that the person has in their capacity as a supporter of the individual; or

engages in any conduct when doing a thing under section 27 in the person’s capacity as a supporter of the individual; or

uses any information that the person obtained in the person’s capacity as a supporter of the individual; and

the person does so with the intention of:

dishonestly obtaining a benefit for the person or any other person; or

dishonestly causing a detriment to another person.

the person has ceased to be a supporter of an individual accessing, or seeking to access, funded aged care services; and

the person obtained information in the person’s capacity as a supporter of the individual; and

the person uses the information with the intention of:

dishonestly obtaining a benefit for the person or any other person; or

dishonestly causing a detriment to another person.

dishonest according to the standards of ordinary people; and

known by the defendant to be dishonest according to the standards of ordinary people.

register one person as a supporter of the individual; or

register 2 or more persons, jointly and severally, as supporters of the individual.

there is such a person in relation to the individual; and

the person makes a request to be registered as a supporter of the individual.

(a) the System Governor is satisfied that the person is able to comply with the duties of supporters referred to in paragraphs 30(1)(a) to (c) and (e); and

one of the following applies:

if the registration is made on the request of the person who is a person covered by subsection 28(2)—the person has given consent to the registration;

if the registration is made on the request of the person who is not a person covered by subsection 28(2)—both the person and the individual have given consent to the registration; and

the System Governor has taken into consideration any other matters prescribed by the rules.

any person who, or body which, made a request to the System Governor to register the person; and

the individual.

be given as soon as practicable after the decision is made; and

include the reasons for the decision and how a person may apply for reconsideration of the decision.

the supporter;

the individual.

include the information specified in section 40; and

be given as soon as practicable after the System Governor registers the supporter.

the name and contact details of the supporter registered in relation to an individual;

the reasons for the decision to register the supporter;

how a person may apply for reconsideration of that decision.

(a) that the registration takes effect on a specified day;

that the registration remains in effect until a specified day.

at the time specified by the System Governor in relation to the registration; or

if the System Governor does not specify a time for the purposes of paragraph (a)—at the time the registration is made under section 37.

the registration is cancelled under Division 5;

the individual dies;

the supporter dies;

if the notice of registration given to the supporter under section 39 specifies that the registration remains in effect until a specified day—that day.

(a) the System Governor reasonably believes that the supporter has caused, or is likely to cause, physical, sexual, financial, psychological or emotional abuse or neglect to the individual; or

the System Governor reasonably believes that the supporter has used information provided to the supporter under subsection 29(1) other than under, or for the purposes of, this Act; or

the System Governor reasonably believes that the supporter has not complied with, or is not able to comply with a duty of supporters referred to in subsection 30(1) that applies to the supporter; or

a circumstance set out in subsection (2) or (3) exists; or

another circumstance prescribed by the rules exists in relation to the supporter.

the supporter informs the System Governor under section 31 that:

an event or change of circumstances has happened or is likely to happen; and

the event or change of circumstances is likely to have an effect as described in paragraph 31(1)(b); and

the System Governor reasonably believes that the event or change of circumstances is likely to affect:

the ability or capacity of the supporter to act as a supporter of the individual, including complying with the duties referred to in subsection 30(1) that apply to the supporter; or

the ability of the System Governor to contact the supporter for the purposes of this Act; or

the ability or capacity of the supporter to comply with notices given to, and imposing requirements on, the supporter by the System Governor under, or for the purposes of, this Act.

the suspended person;

the individual.

include the reasons for the decision to suspend the registration; and

provide that the suspended person and individual may give the System Governor, within 28 days after the day the notice is given, a statement setting out the reasons why the person’s registration should not be cancelled.

revoke the suspension of the person’s registration; and

give written notice of the System Governor’s decision not to cancel the registration to the person and individual to whom notice was given under subsection 50(1).

if the supporter is not a person covered by subsection 28(2)—to cancel the registration; and

if the supporter is a person covered by subsection 28(2)—whether to cancel the registration.

be given as soon as practicable after the request is received by the System Governor; and

provide that the supporter may give the System Governor, within 28 days after the day the notice is given, a statement setting out the reasons why the person’s registration as a supporter of the individual should not be cancelled.

if the supporter is given a notice under subsection (2) and gives the System Governor a statement referred to in paragraph (3)(b) within the 28-day period—14 days after receiving the statement; or

if the supporter is given a notice under subsection (2) but does not give the System Governor a statement referred to in paragraph (3)(b) within the 28-day period—14 days after the end of that 28-day period; or

otherwise—28 days after receiving the request.

be given as soon as practicable after the System Governor decides not to cancel the registration; and

include:

the reasons for the decision; and

how the individual may apply for reconsideration of the decision.

the person whose registration has been cancelled;

the individual.

be given as soon as practicable after the registration is cancelled; and

include:

the reasons for the cancellation; and

if the registration was cancelled under subsection 51(1) or (2)—how a person may apply for reconsideration of the decision to cancel the registration.

the reasons for the decision; and

a statement that the effect of the decision is that the individual’s application for access to funded aged care services is taken to be withdrawn; and

how the individual may apply for reconsideration of the decision.

an eligibility determination for an aged care needs assessment is made for the individual; or

the System Governor decides that a reassessment of the individual’s need for funded aged care services is required to be undertaken by an approved needs assessor in accordance with paragraph 64(2)(a).

an eligibility determination for an aged care needs assessment is not in effect for the individual; or

the System Governor is satisfied it is not reasonably possible for an approved needs assessor to undertake the assessment.

a discussion with the individual about what the assessment has identified in terms of funded aged care services the individual may require access to and may assist the individual to maintain the individual’s independence; and

a discussion with the individual about the individual’s preferences and goals, the next steps in terms of the individual’s application for funded aged care services and how the individual will be informed of the outcome of the application; and

any other thing prescribed by the rules.

consider the individual’s rights mentioned in subsection 23(1) (independence, autonomy, empowerment and freedom of choice); and

to the extent possible, make the individual aware of, support them to understand, and empower them to exercise, the individual’s rights under the Statement of Rights; and

involve the individual’s carer, family member, advocate or other person in the discussions mentioned in subsection (2), if that is the individual’s will and preference.

the funded aged care services the assessor considers the individual needs in order to meet the individual’s care needs; and

any service groups the assessor considers should be approved under subsection 65(2) for the individual; and

any service types the assessor considers should be approved under subparagraph 65(2)(b)(i) for the individual; and

any funded aged care services the assessor considers should be approved under subparagraph 65(2)(b)(ii) for the individual; and

whether the individual’s approval for a particular service group should be for any or all of the classification types short-term, ongoing or hospital transition.

an eligibility determination for an aged care needs assessment is in effect for the individual; and

the individual makes an application for the reassessment in an approved form; and

either:

the System Governor is satisfied that a significant change in circumstances prescribed by the rules applies in relation to the individual; or

other circumstances prescribed by the rules apply in relation to the individual.

if subparagraph (1)(c)(i) applies—arrange for a new assessment of the individual’s need for funded aged care services to be undertaken by an approved needs assessor in accordance with section 61; or

if subparagraph (1)(c)(ii) applies—make the reassessment on the basis of information of a kind prescribed by the rules being provided in relation to the individual.

the reasons for the decision; and

how the individual may apply for reconsideration of the decision.

whether to approve one or more service groups for the individual and the classification types for the service groups; and

if the service group is home support, assistive technology or home modifications and the individual is not an Aboriginal or Torres Strait Islander person:

whether to approve one or more service types in that group for the individual; and

if the service type is prescribed by the rules for the purposes of this paragraph—whether to approve one or more funded aged care services in that type for the individual.

section 66, 67 or 68 applies in relation to the individual and the service group, service type or service; and

any eligibility requirements prescribed by the rules for the service group, or the service group in which the service type or service are included, are met.

Exceptional circumstances

the System Governor is satisfied that there are exceptional circumstances that justify making the decision without an assessment; and

the individual, or a registered provider on behalf of the individual, makes an application to the System Governor in the approved form; and

any circumstances prescribed by the rules do not apply.

Timing of decisions

the individual has a long-term physical, mental, sensory or intellectual impairment and the impairment may hinder the individual’s participation in society on an equal basis with others as a result of the impairment’s interaction with various barriers; and

any of the following apply:

each of the funded aged care services in the service type, or the funded aged care service, is an in-home, residential or other community support service and access to the funded aged care services in the service type, or the funded aged care service, is necessary to support the individual to live and be included in the community, and to prevent isolation or segregation of the individual from the community;

access to the funded aged care services in the service type, or the funded aged care service, will facilitate personal mobility of the individual in the manner and at the time of the individual’s choice;

the funded aged care services in the service type each involve, or the funded aged care service involves, a mobility aid or device, or assistive technology, live assistance or intermediaries that will facilitate personal mobility of the individual;

the funded aged care services in the service type are each, or the funded aged care service is, a health service that the individual needs because of the individual’s impairment or because of the interaction of the individual’s impairment with various barriers;

the funded aged care services in the service type are each, or the funded aged care service is, a habilitation or rehabilitation service;

the funded aged care services in the service type are each, or the funded aged care service is, a service that will assist the individual to access a service mentioned in subparagraph (iv) or (v);

the funded aged care services in the service type, or the funded aged care service, will minimise the prospects of the individual acquiring a further impairment or prevent the individual from acquiring a further impairment.

that the individual must provide to a registered provider that will deliver funded aged care services in the service type, or the funded aged care service, information of a kind prescribed by the rules;

that the individual can only access the funded aged care services in the service type, or the funded aged care service, through a registered provider of a kind prescribed by the rules;

that a person of a kind prescribed by the rules has confirmed, in accordance with any requirements prescribed by the rules, that the individual requires access to the funded aged care services in the service type, or the funded aged care service.

the reasons for the decision; and

how the individual may apply for reconsideration of the decision; and

for a decision under subsection 65(2), all of the following:

the day the access approval takes effect (see subsection 71(1));

any service groups approved under subsection 65(2) for the individual and the classification types approved for those service groups;

any service types approved under subparagraph 65(2)(b)(i) for the individual;

any funded aged care services approved under subparagraph 65(2)(b)(ii) for the individual;

any conditions included, under section 69, on an approval referred to in subparagraph (iii) or (iv) of this paragraph.

the individual’s eligibility determination for an aged care needs assessment, or the access approval, is revoked under section 73 or 74;

another decision is made for the individual under subsections 65(1) and (2).

Alternative entry

the individual makes an application, in the approved form, within the period referred to in subsection (3); and

the System Governor is satisfied that any of the circumstances set out in subsection (4) apply in relation to the individual; and

the day is no earlier than the first day a funded aged care service was delivered to the individual.

the period of 5 days after the first day an aged care service covered by the approval was delivered to the individual; or

if circumstances prescribed by the rules apply—the period prescribed by the rules; or

if the System Governor determines a period for the individual under subsection (6)—that period.

the individual urgently needed access to funded aged care services and there was a significant risk of harm to the individual if those services were not delivered to the individual before the approval was given; or

the individual is an Aboriginal or Torres Strait Islander person and at the time the individual was seeking to access funded aged care services there was a lack of availability of an approved needs assessor to undertake a culturally safe aged care needs assessment for the individual; or

the individual commenced accessing funded aged care services under a specialist aged care program before the approval was given and at the time the individual was seeking to access funded aged care services there was a significant delay in the availability of an approved needs assessor to undertake an aged care needs assessment for the individual.

determine the longer period for the individual; or

reject the application.

be given as soon as practicable after the decision is made; and

include the reasons for the decision and how a person may apply for reconsideration of the decision.

the individual gave information, or a document, in relation to the application for access to funded aged care services to which the determination or access approval relates; and

either:

the information or document (as the case may be) was false or misleading; or

the information omitted any matter or thing without which the information is misleading.

set out the reasons why the System Governor is considering making the decision; and

invite the applicant to make submissions, in writing, to the System Governor in relation to the matter within 14 days after receiving the notice, or such longer period as is specified in the notice; and

inform the individual that the System Governor may, after considering any submissions made by the individual, make the decision.

the decision;

the reasons for the decision;

how the individual may apply for reconsideration of the decision.

during an aged care needs assessment for the individual under section 62, the approved needs assessor considers the classification type for the service group should be approved for the individual under subsection 65(2); or

an application for a classification reassessment for the classification type for the service group is made by the individual, or a registered provider on behalf of the individual, under section 82.

the individual’s access approval should include the classification type ongoing for the service group residential care; or

both of the following apply:

the individual’s access approval should include the short-term classification type for the service group residential care;

it is not reasonably practicable to undertake the classification assessment for that classification type for that service group at the same time as the aged care needs assessment.

after the aged care needs assessment; and

on or after the start date included in a start notification for delivering funded aged care services to the individual under that classification type at an approved residential care home of a registered provider.

circumstances prescribed by the rules apply; or

the individual’s access approval for the classification type for the service group is revoked; or

if the classification assessment is for the classification type ongoing for the service group residential care—either of the following apply:

a cessation notification for the individual is given to the System Governor by the registered provider referred to in subsection (3) or subsection 82(2);

a start notification is given to the System Governor by the registered provider, or another registered provider, to deliver funded aged care services in another approved residential care home to the individual.

for a classification assessment required under paragraph 75(1)(a) or subsection 75(2):

unless subparagraph (ii) applies—by an approved needs assessor using an assessment tool prescribed by the rules for the classification type for the service group and in accordance with any other requirements prescribed by the rules; or

if circumstances prescribed by the rules apply for the classification type for the service group and information of a kind prescribed by the rules for the classification type for the service group is given to the System Governor—by the System Governor in accordance with any requirements prescribed by the rules; or

for a classification assessment required under paragraph 75(1)(b):

unless subparagraph (ii) applies—by an approved needs assessor using an assessment tool prescribed by the rules for the classification type for the service group and in accordance with any other requirements prescribed by the rules; or

if circumstances prescribed by the rules apply for the classification type for the service group and information of a kind prescribed by the rules for the classification type for the service group is given to the System Governor—by the System Governor in accordance with any requirements prescribed by the rules.

have the skills and qualifications prescribed by the rules; and

comply with any other requirements prescribed by the rules.

the System Governor is given a report of a classification assessment for the individual for the classification type for the service group under section 77; or

information is given to the System Governor as referred to in subparagraph 76(1)(a)(ii) or (b)(ii); or

the System Governor makes an access decision for an individual under section 65 to approve a classification type for a service group for which the classification assessment will be undertaken in accordance with subsection 75(2).

the classification level for the classification type for the service group; and

details about when the classification decision did, or will, come into effect; and

how the individual may apply for reconsideration of the decision.

that the first day of the period is a day before or after the classification decision was made for the individual under section 78; and

circumstances in which a classification level that has ceased being in effect resumes being in effect for a period; and

circumstances in which a classification level is not in effect on a day because:

another classification level in the same classification type for the service group is in effect on the day; or

another classification level in a different classification type for the service group or any other service group is in effect on the day.

(a) the day the individual’s access approval for the classification type for the service group is revoked;

the day another classification decision made for the individual for the classification type for the service group under section 78 comes into effect.

set out different classification levels for different classification types for different service groups; and

set out criteria for each classification level that are to be used in establishing the classification level of an individual for a classification type for a service group; and

set out for each service group which classification levels are in each classification type.

set out compounding factors (based on results against relevant assessment items mentioned in subsection 77(2)) that will be used to establish an individual’s classification level; and

prescribe the scientific population study that will be used by the System Governor to derive a method for establishing when these compounding factors, taken together, are significant because they indicate the individual has significantly higher care needs relative to the needs of other individuals.

the individual has the classification type ongoing or short-term for the service group in effect; and

the individual considers a different classification level in the classification type for the service group should be approved for the individual; and

the funded aged care services are not being delivered under a specialist aged care program; and

the System Governor considers circumstances (if any) prescribed by the rules apply.

Short-term funded aged care services delivered through service group home modifications

the individual has the classification type short-term for the service group in effect; and

the individual considers a different classification level in the classification type for the service group should be approved for the individual; and

the funded aged care services are not being delivered under a specialist aged care program; and

the System Governor considers circumstances (if any) prescribed by the rules apply.

Ongoing funded aged care services delivered through the service group residential care

the registered provider is delivering ongoing funded aged care services to the individual through the service group in an approved residential care home; and

the registered provider or the individual considers a different classification level in the classification type for the service group should be approved for the individual; and

the funded aged care services are not being delivered under a specialist aged care program; and

either of the following apply:

if the rules prescribe a time period—not more than the number of applications prescribed by the rules have been made for the individual under this subsection in that time period;

the System Governor considers circumstances (if any) prescribed by the rules apply.

Short-term funded aged care services delivered through the service group residential care

the registered provider or the individual considers a different classification level in the classification type for the service group should be approved for the individual; and

an access approval is in effect for the individual for the classification type for the service group; and

if the application is made by the registered provider:

the registered provider is delivering short-term funded aged care services through the residential care service group to the individual in an approved residential care home; and

those funded aged care services are not being delivered under a specialist aged care program; and

either of the following apply:

if the rules prescribe a time period—not more than the number of applications prescribed by the rules have been made for the individual under this subsection in that time period;

the System Governor considers circumstances (if any) prescribed by the rules apply.

Hospital transition funded aged care services delivered through any service group

the registered provider is delivering hospital transition funded aged care services to the individual through the service group; and

the registered provider or the individual considers that an extension of the period of effect for the classification level that is in effect for the individual for the classification type for the service group should be approved for the individual.

Requirements for applications

be in an approved form; and

be accompanied by the application fee (if any) prescribed by the rules.

the classification assessment for the original decision (see section 76) was incorrect or inaccurate; or

the original decision was, for any other reason, incorrect.

any material on which the original decision was based that the System Governor considers relevant; and

any matters prescribed by the rules as matters to which the System Governor must have regard; and

any other material or information that the System Governor considers relevant (including material or information that has become available since the original decision was made).

the change takes effect on the same day that the original decision took effect; and

the System Governor must notify the individual for whom the original decision was made, and any registered provider that is providing funded aged care services to the individual, in writing, of the change.

the number of places available at that time to be allocated to individuals for each service group;

how many of the places mentioned in paragraph (a) for a service group are for allocation for a particular classification type (other than hospital transition) for the service group;

how many of the places mentioned in paragraph (b) for a particular classification type for a service group are for allocation for a particular classification level in the classification type;

if the service group is home support—how many of the places mentioned in paragraph (b) or (c) are for allocation as interim places or full places for the classification type or classification level.

forecast demand for funded aged care services at the time and the forecast cost of those services at that time;

the appropriation for the financial year and how much of that appropriation is left at the time;

target average wait times for individuals with access approvals for a classification type for a service group who are seeking to access funded aged care services through the service group.

a number of places equal to, or greater than, the guaranteed (tranche 1) number, for allocation to individuals for the service group home support by the end of 31 December 2025; and

at least an additional 43,000 places, for allocation to individuals for the service group home support by the end of 30 June 2026.

40,000; less

the following:

(i) if the difference between the number of home care packages immediately before the commencement of the Aged Care Act 2024 and the number of home care packages immediately before the transition time is greater than or equal to 40,000—40,000;

(ii) if the difference between the number of home care packages immediately before the commencement of the Aged Care Act 2024 and the number of home care packages immediately before the transition time is greater than zero but less than 40,000—that difference;

otherwise—zero.

number of home care packages, at a time, means the number of home care packages under the Australian Government framework known as the National Priority System that were available and released to recipients at that time in accordance with determinations under subsection 23B-1(1) of the Aged Care Act 1997.

transition time means the beginning of the day after the Aged Care and Other Legislation Amendment Act 2025 receives the Royal Assent.

if the place is for a classification type for a service group for which an individual is required to have a priority category under subsection 86(1):

(i) if the System Governor considers, in accordance with paragraph 91(2)(a), that the place is for a particular classification type or particular classification level in a classification type for the service group—has been determined to have a priority category under subsection 86(1) for the classification type for the service group; or

otherwise—has been determined to have a priority category under subsection 86(1) for any classification type for the service group; or

if the place is for a classification type (other than hospital transition) for a service group for which an individual is not required to have a priority category under subsection 86(1)—has an access approval that includes the classification type for the service group.

the classification type for the service group is ongoing for home support; and

the circumstances prescribed by the rules apply.

the classification type for the service group for which the individual has been allocated a place; and

if the service group is residential care—the day the place is allocated; and

if the service group is home support, assistive technology or home modifications:

information about when the place takes effect or is taken to be withdrawn in accordance with section 92A; and

for the service group home support—whether the place is an interim place or a full place.

a number of places equal to, or greater than, the guaranteed (tranche 1) number (31 December 2025; andwithin the meaning of section 91) are allocated to individuals for the service group home support by the end of

at least an additional 43,000 places are allocated to individuals for the service group home support by the end of 30 June 2026.

for a failure to comply with paragraph (5)(a)—31 December 2025; or

for a failure to comply with paragraph (5)(b)—30 June 2026.

does not take effect; and

is taken to be withdrawn.

the place allocated to the individual is a full place for a classification type for the service group home support; and

an interim place is in effect for the individual for the classification type for the service group;

the full place takes effect on the day the System Governor gives notice to the individual of the allocation of the place under subsection 92(3).

the individual’s priority category (if any) for the classification type;

the day the individual’s access approval for the classification type was given;

whether the individual has an interim place in effect for the classification type or the classification level;

the individual’s wait time for the allocation of a place for the classification type or the classification level;

whether the individual has informed the System Governor that the individual is not seeking access to funded aged care services for a specified period.

for the Transition Care Program:

the number of places available to be allocated to entities for delivering funded aged care services through a service group under the program; and

how many of those places must be used to deliver funded aged care services in a specified State or Territory; and

for the Multi-Purpose Service Program:

the number of places available to be allocated to entities for delivering funded aged care services through a service group under the program; and

how many of those places are for a residential care home or home or community setting.

relative community needs across the States and Territories; and

any other matters prescribed by the rules.

Western Australia—those places are available to also be allocated for use within Christmas Island and the Territory of Cocos (Keeling) Islands; or

Queensland—those places are available to also be allocated for use within Norfolk Island.

for the allocation of a place for the Transition Care Program:

the allocation of the place is consistent with the terms and conditions of the specialist aged care program agreement under section 247 with the State or Territory in which the funded aged care services will be delivered under the place; and

any other requirements prescribed by the rules are met;

for the allocation of a place for the Multi-Purpose Service Program:

if the place is for delivering funded aged care services through the service group residential care at a specified location—the total number of beds at the location is equal to or greater than the number of places; and

any other requirements prescribed by the rules are met;

for the allocation of any place—the allocation of the place is likely to contribute to quality and safe funded aged care services being delivered to individuals.

the objectives of the specialist aged care program that the place is for and how many places are available under section 94 for allocation for that program; and

the community needs in locations where individuals are expected to be able to access funded aged care services using the place; and

the Statement of Principles; and

any information or documents given by the entity in relation to the allocation of the place.

the specialist aged care program and service groups for which the entity has been allocated a place;

any condition on the allocation of the place;

details about when the place takes effect;

any other information prescribed by the rules.

a place to have a period of effect that is not continuous; and

circumstances in which a place ceases to have effect and cannot ever resume to have effect.

the place must only be used by the entity once the entity has become a registered provider and the entity’s registration is in effect and covers any funded aged care service delivered under the place;

the place must only be used by the entity to deliver a funded aged care service to an individual when the place is in effect;

the place must only be used by the entity to deliver a funded aged care service to an individual with an access approval in effect that:

for the Transition Care Program—includes the classification type hospital transition for the service group in which the service is included and for which the place is allocated; or

for the Multi-Purpose Service Program—includes the classification type ongoing or short-term for the service group in which the service is included and for which the place is allocated;

the place must only be used by the entity to deliver a funded aged care service to an individual in the State or Territory for which the place was allocated (if applicable);

any conditions determined by the System Governor under subsection (2);

any condition prescribed by the rules.

on the day the System Governor gives notice of a decision, under subsection 95(1) to allocate the place; or

on a later day.

on the day the notice is given to the registered provider; or

if the System Governor specifies a later day in the notice as the day the determination takes effect—that day.

the day the variation is proposed to take effect;

the condition the entity is seeking to vary;

any other requirements prescribed by the rules.

any matters prescribed by the rules as matters to which the System Governor must have regard; and

any other material or information that the System Governor considers relevant.

details of the System Governor’s decision about whether to vary the condition; and

the reasons for the decision.

on the day notice of the decision is given; or

if the System Governor specifies a later day the decision takes effect in the notice under subsection (1)—that day.

be in an approved form; and

be accompanied by the application fee (if any) prescribed by the rules.

each provider registration category that the entity is applying to be registered in; and

(b) each service type (the intended service types) that the funded aged care services which the entity intends to deliver are in; and