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).
The ACFI was designed to link to the requirements under Schedule 1 – Care and services for residential care services and Schedule 2 – Accreditation Standards of the Quality of Care Principles 2014. The ACFI questions are selective “indicators” only, and the level of funding provided is intended to allow for the delivery of all of the legislated care and services.
To assist approved providers complete assessments for the ACFI the following resources are available:
- ACFI User Guide
- ACFI Answer Appraisal Pack
- ACFI Assessment Pack
- ACFI Application for Classification Form 2017 on the Department of Human services website.
- Aged Care Act 1997
- Aged Care (Transitional Provisions) Act 1997
- Classification Principles 2014
- Suggested Assessments for ACFI
- Calculating the residential care subsidy
- Latest payment rates, including ACFI rates, are available on the schedule of subsidies and supplements
- For information on claiming - Department of Human Services ACFI page
- ACFI request for reconsideration template
- Video program – ACFI: a guide for providers of aged care
Frequently Asked Questions (FAQS)
- ACFI appraisals - The Seven Day Rule
- ACFI 12.4 – Complex Health Care pain management
- ACFI 12.12 – Complex Health Care compression garments
Changes to ACFI
In recent years, there have been a number of changes to ACFI funding and operational arrangements announced at Budget and the Mid-Year Economic and Fiscal Outlook.
Further information on these changes can be found on the links below:
- ACFI Reviews and Reconsiderations in the My Aged Care provider portal – September 2017
- Information on strengthened compliance actions - 1 March 2017
- Adjustments to Budget 2016-17 changes (scoring and indexation pauses)– 1 January 2017
- Questions and Answers - Changes to residential aged care funding arrangements - 1 January 2017
- Summary of Changes to ACFI Resources Documents – 1 January 2017
- MYEFO 2016–17 Announcement - Supporting Older Australians
The Department routinely monitors ACFI expenditure and publishes quarterly and monthly reports on spending trends.
Access historical and current ACFI Monitoring Reports on the departments web page.
Residential Aged Care Funding Reform
Work is underway to investigate alternative approaches to determining residential care funding that delivers more stable funding arrangements and the Government is engaging with the sector for the development of this longer term reform.
Further information on residential aged care funding reform can be found on the departments web page.
Care recipient ACFI classification interdependencies
High level and low level residential care was repealed on 1 July 2014. However, a residential care service may still come across rules and programs where a care recipient’s ACFI classification will act as a proxy distinction for higher and lower care needs.
Section 7(6)(a) of the Quality of Care Principles 2014 sets out which classifications equate to a care recipient having higher care needs (note: this is also the definition of high level residential care set out in the Aged Care (Transitional Provisions) Principles 2014).
a care recipient whose classification level includes any of the following:
- high ADL domain category;
- high CHC domain category;
- high behaviour domain category;
- a medium domain category in at least 2 domains
Aged care services need to be mindful that:
- A care recipient’s ACFI classification will impact upon whether additional fees may be charged for the provision of care and services specified under Schedule 1, Part 3 of the Quality of Care Principles 2014.
- Outer regional and remote aged care services may benefit from an additional 15 points in the viability supplement calculator if they cater for more than 50 per cent of care recipients with lower level care needs.
- The Department of Veterans’ Affairs also relies on the definition above to determine whether eligible veteran care recipients in residential care may access allied health services or the Rehabilitation Appliances Program. Typically these programs are restricted to care recipients with lower level care needs.
Grandparenting of Resident Classification Scale (RCS) Subsidies
Residents initially classified using the RCS have been progressively appraised using the ACFI from 20 March 2008. Grandparenting arrangements ensure that an aged care service continues to receive at least the same subsidy for these residents as was paid under the RCS.
Once the ACFI appraisal has been submitted for existing residents previously classified using the RCS, the Department of Human Services will compare the calculated subsidy under the ACFI model with the existing RCS subsidy. If the subsidy under the ACFI model is $15 or more above the RCS amount, the ACFI subsidy amount will be payable. If not, the existing RCS amount will continue to be paid.
- 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