Aged care financial hardship assistance - assessment 065-05030010

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This document outlines the process to assess claims for aged care financial hardship (hardship) assistance.

Eligibility

Aged care recipients can apply for hardship assistance if they are in financial hardship. If approved, the Australian Government will pay for some or all of their aged care fees and charges. This supplement is paid to the aged care provider on behalf of the care recipient.

Care recipients can apply for help with:

for Home Care Packages – the basic daily fee and the income-tested care fee
for Residential Respite Care – the basic daily fee
for Residential Aged Care – the basic daily fee, the means-tested care fee, daily accommodation payments and daily accommodation contributions.

For eligibility and enquiries please see Aged care financial hardship assistance - overview

Pre entry hardship assessments

Pre entry hardship assessments are valid for 120 days from the date the assessment is completed.

If the care recipient does not start home or residential care within 120 days of the hardship assessment's completion, the hardship assessment expires and is no longer valid. See Aged care financial hardship assistance - overview.

Applying the hardship reduction (fee type)

Hardship assistance form and fee type hierarchy

Hardship forms before version (SA462.2103) asked the person completing the form to select a fee type to apply hardship against. The Process page contains information where a previous version of the form is received, and the fee type selected differs from the current hierarchy.

Post 1 July 2014 fee type hierarchy

Home care

Care recipients must have the fee reduction applied in the following order:

Basic Daily Fee (BDF)
Income Tested Care Fee (ITCF)

Residential care

Care recipients assessed as low means must have the fee reduction applied in the following order:

BDF
Means Tested Care Fee (MTCF) - if applicable
Accommodation Contribution (AC):

Care recipients assessed as not low means must have the fee reduction applied in the following order:

BDF
Means Tested Care Fee (MTCF)
Refundable Accommodation Deposit (RAD)/Daily Accommodation Payment (DAP):

a partial hardship reduction can apply to RAD/DAP

Current RAD/DAP financial hardship assistance process

From 1 August 2022, RAD/DAP hardship:

is coded in Aged Care Staff Portal (ACSP)
is coded from the start date
payments are automatic from 1 August 2022 onwards
is paid as a manual adjustment for any period before 1 August 2022
includes care recipients with existing and new RAD/DAP financial hardship assistance

Historical RAD/DAP financial hardship assistance process

Before1 August 2022, RAD/DAP hardship:

was unable to be coded in SPARC
payments were made by a monthly manual adjustment
was maintained manually through a spreadsheet

Pre 1 July 2014 - fee type hierarchy

Home care:

Care recipients assessed under a pre 1 July 2014 assessment scheme are not eligible for hardship assistance

Residential care:

Care recipients assessed under a pre 1 July 2014 assessment scheme must have the fee reduction applied in the following order:

Basic Daily Fee (BDF)
Income Tested Fee (ITF)

Accommodation costs are assessed separately

Duration of hardship and setting a review

Duration

Hardship is granted for a period of 3 years unless the circumstances are temporary. The 3 year period:

commences from the date of a new grant or date of the completed assessment, whichever is the later, and
is in addition to any eligible backdated periods

For example, where the start date is in the past, hardship is backdated to the start date and the end date is 3 years from the date the assessment is completed.

When the circumstances causing financial hardship are temporary, hardship may be granted for periods of 12 months or less. For example, if the situation is likely to improve within 12 months and/or if the care recipient is in respite care.

Reviews

Annual reviews are an opportunity to check the care recipient's circumstances and confirm ongoing eligibility for hardship assistance.

Quality assurance process

Aged care hardship assessments include a quality assurance process. The aim of the quality assurance process is to make sure of correct and consistent assessment outcomes:

Hardship processing does not include an activity in Customer First or Process Direct
The quality assurance process:

is manual
aligns with the Quality On Line (QOL) quality assurance program
is undertaken by a hardship subject matter expert (SME) nominated by Heath Service Delivery Division (HSDD)

The Resources page contains a link to the Hardship Quality Checking procedure.

Temporary Covid-19 policy

The Resources page contains information on the assessment of assets that could not be sold or borrowed against during the restrictions in place in 2020 and 2021.

Historical SPARC process

The System for the Payment of Aged Residential Care (SPARC) is the legacy aged care payment system for residential care. SPARC was a view only system from 11 August 2022 and decommissioned in 2023.

To view the legacy SPARC process, see the historical version.

The Resources page contains:

The Aged Care Fee calculator
The quality checking task card
Links to the Services Australia website, external websites, forms and letters
Aged Care processing contacts - (RCA) codes
A FAQ table
A hardship reductions and fee types table
An assessable income and assets for hardship claims table
An allowable and non-allowable essential expenses information table
A list of allowable expenses table
A List of assets that cannot be sold or borrowed against table
An Accommodation payment for residential care table
A Financial hardship current and historical thresholds table
A Temporary COVID-19 policy about assessment of assets that could not be sold or borrowed against table

Operational Information