Aged Care Act 2024

Individuals can apply to the System Governor for access to funded aged care services and are assessed against a set of eligibility criteria. An individual with care needs who is age 65 or over (or age 50 or over and an Aboriginal or Torres Strait Islander person or homeless or at risk of homelessness) is eligible to undergo an aged care needs assessment by an approved needs assessor.

A report of the results of an aged care needs assessment is given to the System Governor who decides what funded aged care services are approved for the individual.

The approval may be in relation to all services in a service group, for example, as is the case for residential care where individuals generally need access to all the services in the group. For some service groups, such as home support, the approval may be limited to particular service types, or to particular services, in the service group. This reflects the wide range of different services available and varying needs of individuals accessing services in this group.

If an individual’s circumstances change significantly, an application for reassessment can be made and a new approval decision is made, either on the basis of a new aged care needs assessment or information provided to the System Governor.

A classification assessment is generally undertaken at the same time as the aged care needs assessment (except in certain cases such as for ongoing residential care where it is undertaken once a registered provider has started delivering funded aged care services to the individual in an approved residential care home).

A classification decision is made by the System Governor in relation to any classification type (ongoing, short‑term or hospital transition) for a service group the individual has been approved for. The classification decision generally affects the level of funding available under Chapter 4 to deliver funded aged care services to the individual. An individual may be approved and given a classification level for multiple service groups or multiple classification types in a service group, however, the individual can only have one classification level in effect for a classification type for a day, and there are rules about which classification types can be in effect on the same day.

For the service groups home support or residential care, a decision about the individual’s priority category for that service group is made by the System Governor (where required). This decision may affect when the individual can access services in that service group. Individuals (or in certain circumstances the registered provider) must be allocated a place to access funded aged care services in these groups. The allocation is done on the basis of considerations such as the individual’s priority category and when the individual’s access approval was given.

Alternative allocation arrangements apply in relation to individuals accessing funded aged care services under specialist aged care programs.