Residential Aged Care Services fees

Public sector Residential Aged Care Service (RACS) fees (funding and resident contributions) are determined by the Commonwealth under the Aged Care Act 1997

These fees are issued and available from the Commonwealth only. Current information related to fees for residents before and after 1 July 2014 are detailed  at residential care fees charges and payments.

If public sector RACS require any information on Commonwealth-regulated fees, they should contact the respective Commonwealth officer who administers their RACS claims.

The State provides additional funding for selected public sector RACS through an Agency's SAMS agreement.

Community health services

Hospitals which provide community health services funded by the Community Health Program are required to comply with the Community Health Program Fees Policy which specifies principles, fee levels, and exemptions. DH Funding for Community Health Services assume revenue from client fees. The policy and further information is available at Community Health.

Transition Care Program

The Transition Care Program (TCP) is jointly funded by the Commonwealth, State and Territory Governments. The Commonwealth Government subsidy component is paid based on occupancy and requires health services to submit a monthly claim form to Medicare Australia (Australian Government Department of Human Services). The State subsidy component is paid directly to the health service and is based on full operational capacity. A single national Commonwealth subsidy rate applies to TCP places operational nationally. 

Daily care fees for recipients of the TCP are determined by the Commonwealth under the Aged Care Act 1997. The State Government subsidy is detailed annually in the Victorian Policy and Funding Guidelines, Volume 2, Chapter 2.

Maximum care fee charges must not exceed 85 per cent of the basic single age pension for care delivered in a bed-based setting and 17.5 per cent of the basic single age pension for care delivered in a home based setting. Such fees may be adjusted twice yearly (March and September) in line with the Consumer Price Index (CPI), which also affects the age pension payment. 

Further information regarding the TCP is available through the Victorian Government Department of Health and Human Services Transition Care Program and the Australian Government Department of Health's Ageing and Aged Care site. 

Victorian Patient Transport Assistance Scheme

The Victorian Patient Transport Assistance Scheme (VPTAS) aims to improve accessibility of specialist medical and oral health services for rural Victorian residents by reducing the financial disadvantage of patients living in rural areas who require specialist services.

VPTAS provides partial reimbursement to assist with travel and accommodation costs incurred by rural patients and, if appropriate, their escorts when travelling long distances or staying away from home to receive specialist medical treatment.

The Victorian Policy and Funding Guidelines (Volume 2, Chapter 1) sets out the eligibility criteria, reimbursement rates and conditions under which the scheme operates at: Victorian Patient Transport Assistance Scheme (VPTAS).

Provision of aids and equipment and domiciliary oxygen

This information is provided to clarify responsibilities of public hospitals in the provision of aids, equipment and domiciliary oxygen for patients being discharged from hospital.

Note: This supersedes and replaces circular 24/1995.

Public hospital responsibility

Hospitals have a responsibility to provide aids and equipment including domiciliary oxygen and continence aids required by patients for safe and effective discharge. The aids, equipment and domiciliary oxygen may be defined as that equipment which is necessary for recuperation and, if not provided, would result in either continued hospitalisation or readmission to hospital.

For admitted patients being discharged who do not meet the access requirements for support through the National Disability Insurance Scheme (NDIS), hospitals must provide any aids or equipment necessary to enable discharge for as long as these are required. This shall be at no cost to the patient for a period of 30 days unless, at the hospital discretion, a refundable deposit is required. 

Hospitals may charge fees for these aids and equipment after the expiry of the 30 day post-discharge period. Alternatively, patients may choose to make their own arrangements. The NDIS will not provide assistance to an NDIS participant if the participant requires equipment or services that are not related to the person’s disability.

The Victorian Aids and Equipment Program  will continue to provide equipment including domiciliary oxygen to a patient on discharge if they are a pre-existing Aids and Equipment Program client prior to admission to hospital, and require equipment related to the same condition.

Hospitals are responsible for assessment of the patient’s needs and consideration of appropriate discharge options including services and supports available within the community. As part of the discharge planning process, hospitals should identify ongoing equipment requirements and discuss options with patients. 

Hospitals can make referrals to appropriate health and community services for follow-up assessment of the patient’s ongoing equipment needs. Alternatively, hospitals may wish to complete an equipment assessment or prescription and submit these to the relevant community equipment program. These include the Victorian Aids and Equipment Program, compensable providers (where applicable) and Commonwealth programs such as the NDIS and My Aged Care. Note: equipment provision during the 30 day post-discharge period remains the responsibility of the discharging hospital. 

Where patients require oxygen equipment, the discharging public hospital is responsible for arranging relevant testing 30 days post discharge prior to lodgement of the required prescription form with the State-wide Equipment Program (SWEP).

Assisting patients who have long-term aids and equipment needs

With the introduction of the NDIS and the expansion of the Commonwealth's role in supporting older Australians, patients who have an ongoing need for aids and equipment will need to be directed to the appropriate service provider.

Supports funded by the Home and Community Care Program

Younger persons home care, for individuals aged 55 or less,  is the responsibility of the State Government. Older persons home care is the responsibility of the Commonwealth.
 
Clients may be eligible for some aids and equipment following assessments under the program, particularly through the Linkages program. For more information on these programs please contact your service provider. More information can be found at Victorian Home and Community Care program manual 2013.

Commonwealth Home Support Programme

The Commonwealth Home Support Programme provides a range of entry-level aged care services for older people who need assistance to keep living independently at home and in their community.

The program is for people aged 65 years and over (50 years and over for Aboriginal and Torres Strait Islander people).

The program also includes support services for prematurely aged people on a low income who are 50 years or over (45 years or over for Aboriginal and Torres Strait Islander people) and are homeless or at risk of homelessness.

While Commonwealth Home Support care packages are not intended to be an aids and equipment scheme, some aids and equipment, including custom-made aids, can be provided when they are identified in a package recipient’s care plan and the item can be provided within the budget available for the package.

Package funds can also be used towards a motorised wheelchair or motorised scooter. However, given the high cost of these items, it is expected they would be leased rather than bought.

The package funds are capped. Where possible, the cost of any aids and equipment must be met within the package funds. If there are not enough funds in the package, the recipient will need to pay any additional costs.

My Aged Care home care packages – aids and equipment

Home care packages funded by the Commonwealth are not intended to be an aids and equipment scheme. However, some aids and equipment, including custom made aids, can be provided when they are identified in a person’s care plan and the item can be provided within the budget available for the package.

Package funds can also be used towards a motorised wheelchair or motorised scooter. However, given the high cost of these items, it is expected they would be leased rather than bought.

The package funds are capped. Where possible, the cost of any aids and equipment must be met within the package funds. If there are not enough funds in the package, the client will need to pay any additional costs.

If package funds are used to buy, or contribute towards the cost of, aids and equipment such as a motorised wheelchair or scooter, there needs to be clear documentation between the client and the service provider as to:

  • whether it is leased or who owns the item
  • what will happen to it when you leave the package
  • who is responsible for ongoing maintenance and repair costs.

The agreed responsibilities must be written down and included in the client's home care agreement.

Find out more about My Aged Care home care packages.

Victorian Aids and Equipment Program

The Victorian Government will continue to have responsibility for the provision of aids and equipment for people:

  • under 65 years of age who have a health-related aid or equipment need – this can include NDIS participants
  • people aged over 65 with ageing or health related equipment needs.

To ensure a smooth transition of the patient from hospital, applications for the Victorian Aids and Equipment Program may be lodged during the 30-day post discharge period for Victorians who meet the eligibility criteria.

There is high demand for the Victorian Aids and Equipment Program and every effort is made to provide equipment as soon as possible. Applications are processed in date order of receipt and in accordance with priority of urgency criteria. However, when the number of applications exceeds the funds available, applications will be waitlisted for all programs except the Domiciliary Oxygen Program.

State-wide Equipment Program

The State-wide Equipment Program (SWEP) managed by Ballarat Health Services is the main aids and equipment service provider for the Department of Health and Human Services Aids and Equipment Program. SWEP administers the following Victorian aids and equipment programs and schemes:

  • Aids and Equipment Program
  • Domiciliary Oxygen Program
  • Continence Aids
  • Vehicle Modification Subsidy Scheme.

SWEP can be contacted on 1300 PH SWEP or (1300 74 7937)

Domiciliary oxygen

Domiciliary oxygen therapy includes the provision of oxygen gas through equipment which is necessary for recuperation and, if not provided, would result in either continued hospitalisation or readmission.

Hospitals are responsible for the provision of oxygen gas and associated equipment (oxygen therapy) for a period of 30 days post discharge to new patients requiring domiciliary oxygen equipment. 

Existing SWEP Domiciliary Oxygen Program clients will continue to have their oxygen therapy funded on discharge by the SWEP Domiciliary Oxygen Program (that is, the 30 day rule does not apply).

Where a patient may require ongoing oxygen therapy, hospitals should arrange the appropriate tests, completion and submission of an application to the SWEP Domiciliary Oxygen Program so that there is no disruption to the supply of the patient’s oxygen equipment.  Please note that the subsidy through the SWEP Domiciliary Oxygen Program will only be approved if the test results meet with the Thoracic Society Australia & New Zealand (TSANZ) guidelines for domiciliary oxygen.

Continence aids

Hospitals are responsible for the provision of continence equipment to new patients for a period of 30 days post-discharge. This equipment includes catheters, condoms and associated drainage systems which are necessary to facilitate discharge and, if not provided, would result in either continued hospitalisation or readmission.

Where a patient may require ongoing continence equipment, hospitals should consider arranging submission of an application to the Continence Aids Payment Scheme (Australian Government) if their patient is eligible, and/or the SWEP Continence Aids program pre-discharge. If the patient is an NDIS participant and their continence management requirements are not related to a health issue, hospitals should suggest the patient contacts their NDIS care planner to discuss their need for continence products.

Current clients of the SWEP Continence Aids program will continue to have their continence equipment funded on discharge by the SWEP Continence Aids program (that is, the 30 day rule does not apply).

Compensable patients (including TAC, WorkCover and DVA)

During the hospital stay, compensable patients are treated the same as public patients. Hospitals have a responsibility to provide aids and equipment including domiciliary oxygen therapy required by compensable patients for safe discharge up to 30 days post hospital stay. Hospitals should liaise with the compensable provider to arrange on-going services following the 30 days post discharge.

Hospitals should invoice the compensable provider for any aids or equipment, including domiciliary oxygen therapy, for any hire fee after the 30 day discharge period and for any equipment which is not returned. Hospitals may be required to provide proof of effort of recovery. 

Hospitals have a responsibility to provide aids and equipment, including domiciliary oxygen, for Department of Veterans Affairs (DVA) patients who hold a Gold Card, or a White Card where the aid is required for a related accepted condition. Hospitals should liaise with DVA for entitled persons who hold a Gold Card, or a White Card where the aid is required for a related accepted condition, to determine if DVA will arrange alternative provision or continuation of current hire arrangements of these aids. Hospitals should invoice DVA for any hire fee charged after the 30 day post-discharge period expires and for the replacement cost of any equipment not returned. Hospitals may be required to provide proof of effort of recovery.

Where the patient has been in receipt of aids or equipment from their compensable provider prior to the hospital stay, the supply of these items should re-commence on discharge.

Where compensable patients have been using customised aids or equipment prior to admission, these should continue to be used during the hospital stay. Where customised aids or equipment will be required post discharge for ongoing use (for example, wheelchairs), hospitals should contact the compensable provider early to commence the process of providing these post discharge to the patient. These customised items are not subject to the 30 day rule.

Compensable providers are responsible for approving and funding appropriate home modifications for their clients. Where the hospital arranges a home assessment for a compensable patient and the need for a home modification is identified for more than 30 days post discharge, the hospital should liaise with the compensable provider.

Non-compensable spinal cord patients

Patients aged under 65 who have a spinal cord injury with a diagnosis of any form of quadriplegia or paraplegia and are non-compensable, may be eligible for support through the NDIS. An application to the National Disability Insurance Agency (NDIA) should be submitted prior to the patient being discharged from the hospital or rehabilitation service. 

For those aged over 65, SWEP will continue to provide aids and equipment. In order for an application for subsidy assistance through the Aids and Equipment Program to be approved, the patient will need to have a completed discharge plan including an expected date of discharge, and meet the eligibility requirements of the Aids and Equipment Program. To facilitate the application process, hospitals and rehabilitation services will need to provide as much advance notice of the patient’s discharge date as possible. 

Submitting an application to the Aids and Equipment Program does not necessarily guarantee availability of equipment or subsidy. Applications may also be waitlisted should there be insufficient funds available at the time the application is submitted.

Prisoners

Health services are not permitted to raise additional fees or charges for pharmaceuticals or other items for prisoners receiving admitted, emergency department or specialist clinic services in Victorian public hospitals. 

See Victorian Policy and Funding Guidelines, Volume 2, Chapter 2: Compensable patients.