Basic Subsidy Amount (Aged Care Funding Instrument)
The basic care subsidy is based on the appraised care needs of a resident by applying the Aged Care Funding Instrument (ACFI). The ACFI consists of questions about assessed care needs, some of which are supported by specified assessment tools and two diagnostic sections. The ACFI consists of 12 questions which are rated by the aged care home on a scale of A, B, C, or D then used to determine an individual’s ‘ACFI rating’.
The ACFI has three funding categories or domains: Activities of Daily Living (ADL), Behaviour (BEH) and Complex Health Care (CHC). Funding in each of these domains is provided at four levels, namely high, medium, low or nil. The subsidy paid for a resident is made up of the sum of the amounts payable for the three care domains (ADL + BEH + CHC).
Streamlining the ACFI Review and Reconsideration Process through the My Aged Care Portal
In September 2017, improvements to the My Aged Care provider portal will be made to enable providers to streamline functionality of the ACFI Reviews and Reconsiderations.
The changes are part of the Department’s continued investment in the delivery of system and process improvements to My Aged Care, and will strengthen the positioning of the system as the single source of truth for aged care service information.
Further information regarding these changes can be found on the ACFI Reviews and Reconsiderations in the My Aged Care provider portal page.
Amendments to the ACFI Classification Principles - 1 March 2017
Following consultation with the sector, the government is implementing changes to the ACFI announced in the 2015‑16 MYEFO measure, Aged Care Provider Funding – improved compliance.
To implement some of the changes, the following amendments have been made to the Classification Principles 2014 (the Principles), effective from 1 March 2017:
- If the User Guide requires a directive from a health care practitioner as evidence in respect of care mentioned in a question or part of a question in the Answer Appraisal Pack, the care may be taken into account only if:
i. a directive has been given for the care by the kind of health care practitioner mentioned in the User Guide in respect of that care; and
ii. the directive states the manner in which the care is to be provided and the qualifications of the person who is to provide the care; and
iii. the care was, is or is to be provided in the manner, and by a person with the qualifications, stated in the directive.
- A fee of $375 (GST exclusive) per ACFI question will be charged for a request for reconsideration of an ACFI review decision.
The government will consult further with the sector on the amendments to the Principles requiring re-appraisal where an ACFI review has identified that a care recipient’s care needs have significantly decreased.
From 1 March 2017, the department will no longer routinely seek additional information to verify ACFI subsidy claims after the ACFI review visit is completed. Approved providers will continue to be able to submit additional information for 48 hours (i.e. two working days) following the completion of an ACFI review visit.
Changes to the 2016-17 Budget measures for residential aged care funding
The government has announced a revised package of aged care funding changes originally announced in the 2016-17 Budget.
The package retains elements of the Budget such as addressing perverse incentives to take longer to deliver medication and reducing the scoring for some less complex procedures.
The government has recognised the concerns of the sector by:
- reducing the additional requirement to receive maximum funding for complex pain management down to 80 minutes per week (from 120 minutes), and
- not proceeding with other changes that had been proposed to complex pain management (reducing scoring from 6 to 4 points and 3 to 2 points for certain procedures).
In place of these changes a one year indexation pause for all domains of the ACFI in 2017-18 and an additional 50 per cent indexation pause for the Complex Health Care domain in 2018-19.
The changes to the tool will take effect from 1 January 2017. The indexation pause to all domains will apply from 1 July 2017 to 30 June 2018, and the 50% indexation pause to the Complex Health Care domain will apply from 1 July 2018 to 30 June 2019.
The government has also announced a further increase in the Viability Supplement for eligible rural and remote providers as part of this package.
Further information on the revised package of changes can be found in the Fact Sheet Changes to residential aged care funding arrangements – 1 January 2017.
The ACFI Reports include:
- Annual ACFI Reports – these reports provide the breakdown of days spent in each ACFI classification by state in that year. These reports are completed each financial year starting 2011-2012.
- Quarterly Reports – these reports detail the transition from RCS to ACFI. These reports are as at the end of each quarter from June 2009 to December 2012.
- ACFI Monthly Monitoring Reports.
For ACFI appraisals or reappraisals with a date of effect on or after 1 January 2017, the following resources apply:
- ACFI User Guide 2017
- ACFI Answer Appraisal Pack 2017
- ACFI Assessment Pack 2017
- ACFI Application for Classification Form 2017 (on Medicare website)
For ACFI appraisals and reappraisals with a date of effect before 1 January 2017, the following versions apply:
- ACFI User Guide
- Answer Appraisal Pack
- Assessment Pack
- Psychogeriatric Assessment Scales (PAS) User Guide
- Cognitive Impairment Scale
- Suggested Assessments for ACFI questions 1 to 4
- ACFI Application for Classification Form
These Frequently Asked Questions (FAQS) about the Aged Care Funding Instrument will help aged care providers to clarify the requirements.
- ACFI 12.4 – Complex Health Care pain management
- ACFI 12.12 – Complex Health Care compression garments
Basic subsidy amounts (ACFI rates)
- ACFI payments (Medicare Australia): 1800 195 206
- ACFI online claiming and eBusiness (Medicare Australia): 1800 700 199
- ACFI business rules and funding queries email: ACFI@health.gov.au
or phone My Aged Care: 1800 200 422