Funding for dual participants

Page last updated: 13 June 2018

Until the National Disability Insurance Scheme (NDIS) has rolled out nationally, some younger people will be dual participants for aged care and NDIS purposes.

This means that aged care subsidies and supplements will continue to be claimed through aged care online claiming and the younger person will continue to pay their aged care fees, while any NDIS supports above their aged care subsidy and supplements, will be delivered through the NDIS.

More information is available in the Implications of NDIS rollout for providers of residential aged care fact sheet. 

Aged care funding

Aged care providers delivering services will continue to deliver care and services under the framework of the Aged Care Act 1997 (the Act). Providers will continue to claim aged care subsidies and supplements for their residents and consumers through the existing Aged Care Online Services system (ACOS), administered by the Department of Human Services (DHS).

Care recipients must be approved before subsidy can be paid

A subsidy cannot be paid to an approved provider for providing care to a person, unless the person is approved under the Act as a care recipient.

An Aged Care Assessment Team (ACAT) assessment is required if the care recipient needs aged care that is funded by the Commonwealth Government, such as:

  • Residential Care
  • Flexible Care in the form of Transition Care
  • Residential Respite Care
  • Home Care.

An ACAT approval is not required when the care recipient enters into flexible care other than Transition Care, such as a Multi-Purpose Service (MPS) or Innovative Care services.

Checking your claim form

Claim forms with missing or incorrect information provided to DHS will be returned to you for corrections, which may lead to delays in the DHS process. To avoid rejected claims, and reduce delays providers should double-check all details on their claim for payment forms (online or paper) before submitting.

Aged care fees and payments

Younger people living in residential care or who are receiving a home care package may be asked to continue to contribute towards the cost of their care and accommodation.  The NDIS may contribute to or pay some or all of these fees on the resident's behalf.  This will form part of the planning discussion.

Residential care

While younger people remain in aged care, they may still be asked to pay fees to contribute to accommodation costs, living expenses and care services that are not funded under the NDIS.

Basic daily fee (all)

Everyone can be asked to pay this fee. The NDIS will not assist the younger person with this fee. 

Means-tested care fee (post-1 July 2014)

The result of the younger person’s combined income and assets assessment, when they first entered your residential aged care home, determined if they needed to pay this fee. The NDIS will assist the younger person with this fee. 

Income tested fee (pre-1 July 2014) 

The result of the younger person’s income test assessment, when they first entered care, determined if they needed to pay this fee. The NDIS will assist the younger person with this fee. 

Extra and additional service fees (all)

These fees may apply if the younger person chose a higher standard of accommodation, meals or other care or services. The NDIS will not assist the younger person with this fee. 

Accommodation payments (post-1 July 2014)

The result of the younger person’s combined income and assets assessment, when they first entered your residential aged care home, determined if they received assistance with their accommodation costs or if they needed to pay for their accommodation. 

  1. Lump sum:

Refundable Accommodation Deposit (RAD) or Refundable Accommodation Contribution (RAC), the NDIS will not assist the younger person with this payment.

  1. Daily payment:

Daily Accommodation Payment (DAP), the NDIS will assist the younger person with part of this payment - up to the value of the maximum accommodation supplement your residential aged care home is eligible for. Residential aged care providers may need to assist the NDIS with working this amount out.

Note: the amount above the maximum accommodation supplement your residential aged care service is eligible for is still payable by the younger person and will not be covered in their NDIS plan.

  1. Daily Accommodation Contribution (DAC), the NDIS will assist the younger person with this payment.
  2. If the younger person pays for their accommodation as a combination of a lump sum and a daily payment, the NDIS will not assist them with their lump sum payment but they will assist them with their daily payment (as above).

Accommodation bond or charge (pre-1 July 2014) 

The result of the younger person’s asset test assessment and their level of care, when they first entered care, determined if they needed to pay for their accommodation.

  1. Accommodation Bond, the NDIS will not assist the younger person with this payment (when it is paid as a lump sum).
  2. Accommodation Charge, the NDIS will assist the younger person with this payment.

The NDIS representative will discuss how they will pay these aged care fees with the younger person when they develop their plan.

More information is available in the Younger people in residential aged care: NDIS eligibility meetings  and Providers with Younger people in residential aged care: NDIS eligibility meetings factsheets.

Home care

Younger people who commenced receiving a home care package after 1 July 2014, should visit the My Aged Care website for more information about their aged care fees.

Younger people who commenced receiving a home care package before 1 July 2014, should visit the My Aged Care website for more information about their aged care fees.

These aged care fees will remain payable while the younger person continues to receive services through a home care package.

NDIS funding

Residential care

The NDIS will provide some additional supports for participants who are younger people in residential aged care. In the roll out period, funding for the care and services you have a responsibility to deliver under the Aged Care Act 1997 will continue to be claimed through the ACOS.

The NDIS may be able to provide additional assistance to participants. For example, a Local Area Coordinator or Support Coordinator can help the participant to make contact with providers in community care settings and discuss their needs where appropriate.

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