Commonwealth Home

Support Programme

Program Manual 2022-2023

ISBN 978-1-925007-87-9
Copyright notice — 2015

This document – Commonwealth Home Support Programme – Program Manual 2022-24 - is

licensed under the Creative Commons Attribution 4.0 International Licence
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contact: Communication Branch Department of Health and Aged Care. Phone: (02) 6289
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The Department reserves the right to review and amend this Manual as deemed necessary and
will provide reasonable notice of any amendments.
The Commonwealth Home Support Programme – Program Manual 2022-24 is the eighth
version of the Manual since its inception in July 2015 and supersedes all previous versions.
Last updated: November 2022
Table of contents
Table of contents ..................................................................................................................... ii
Part A – The program............................................................................................................... 1
Chapter 1 – Overview of the Commonwealth Home Support Programme (CHSP).................. 1
1.1 What is the purpose of the program manual? ...................................................... 1
1.2 The Commonwealth Home Support Programme ................................................. 1
1.2.1 What is the Commonwealth Home Support Programme?.................................................. 1
1.2.2 Entry-level support .............................................................................................................. 1
1.2.3 History of the Commonwealth Home Support Programme ................................................ 2
1.2.4 Position in the Australian Government’s end-to-end aged care system ............................. 3
1.2.5 Objectives ........................................................................................................................... 4
1.2.6 Outcomes ............................................................................................................................ 5
1.2.7 Key features ........................................................................................................................ 5
1.2.8 Service delivery principles .................................................................................................. 6
1.2.9 Target groups ...................................................................................................................... 7
1.2.10 Carers ................................................................................................................................. 8
1.2.11 Older people with diverse needs ........................................................................................ 8
1.2.12 What services are funded under the Commonwealth Home Support Programme? ........ 11
1.2.13 What Commonwealth Home Support Programme funding must not be used for ............ 13
1.2.14 Where will Commonwealth Home Support Programme services not be provided? ......... 14
Chapter 2 – Supporting independence.................................................................................. 15
2.1 Introduction........................................................................................................ 15
2.2 Why Wellness and Reablement? ....................................................................... 15
2.2.1 Understanding the ageing journey .......................................................................................... 15
2.3 Benefits of a wellness and reablement approach ............................................... 16
2.3.1 Benefits for consumers ........................................................................................................... 16
2.3.2 Benefits for service provider organisations ............................................................................. 16
2.3.3. Benefits for families and carers ............................................................................................. 17
2.3.4 Empowering older Australians to remain independent for longer........................................... 17
2.4 Principles of wellness and reablement ............................................................... 18
2.4.1 Time limited support ............................................................................................................... 18
2.5 Wellness and reablement obligations and supports ..................................................... 19
2.5.1 Strategies to assist embedding wellness and reablement ..................................................... 20
2.5.2 Assessment and support planning ......................................................................................... 21
2.5.3 Reporting requirements .......................................................................................................... 23
Chapter 3 – Sub-Programs: Eligibility and Services .............................................................. 24
3.1 Program framework – Commonwealth Home Support Programme ................... 24

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 Program Framework – Commonwealth Home Support Programme............................................... 25
3.2 2022-23 CHSP national unit price ranges .......................................................... 26
3.3 CHSP Sub-Programs – objectives, target populations, eligibility and services ... 27
3.3.1 Community and Home Support Sub-Program .................................................................. 27
3.3.2 Care Relationships and Carer Support Sub-Program ...................................................... 48
3.3.3 Assistance with Care and Housing (ACH) – Hoarding and Squalor Sub-Program .......... 52
3.3.4 Sector Support and Development Sub-Program .............................................................. 55
Chapter 4 – Access and interactions..................................................................................... 60
4.1 Interaction between the Commonwealth Home Support Programme and other
programs ........................................................................................................... 60
4.1.1 Interaction with specific programs and services ............................................................... 60
4.1.2 Transition Arrangements for Existing Clients.................................................................... 64
4.2 Equity of access ................................................................................................ 66
4.3 Prioritisation of referral ...................................................................................... 66
4.4 Assessment for entry to the Commonwealth Home Support Programme .......... 66
4.4.1 Assessment functions undertaken by My Aged Care ....................................................... 66
4.4.2 Service provider requirements for interacting with My Aged Care ................................... 71
4.4.3 Assessment functions undertaken by CHSP service providers........................................ 72
4.4.4 My Aged Care interactions................................................................................................ 72
Chapter 5 – Client contribution framework ............................................................................ 74
5.1 Operation of the framework ............................................................................... 74
5.2 Exclusions from the framework .......................................................................... 74
5.3 Framework objectives........................................................................................ 74
5.4 Client contribution principles .............................................................................. 74
5.5 Guide to the framework ..................................................................................... 75
5.6 CHSP reasonable client contributions................................................................ 75
Part B – Administration of the Commonwealth Home Support Programme...................... 76
Chapter 6 - Service provider and Departmental responsibilities ............................................ 76
6.1 Service provider responsibilities ........................................................................ 76
6.1.1 Quality arrangements for service delivery ........................................................................ 77
6.1.2 Client rights and responsibilities ....................................................................................... 78
6.1.3 Police checks .................................................................................................................... 79
6.1.4 Staffing and training .......................................................................................................... 79
6.1.5 Work Health and Safety .................................................................................................... 80
6.1.6 Client not responding to a scheduled visit or service ....................................................... 80
6.1.7 Complaints mechanism..................................................................................................... 80
6.1.8 Service continuity .............................................................................................................. 81
6.1.9 Acknowledging the funding ............................................................................................... 83

December 2022 – iii

 6.1.10 Subcontracting .................................................................................................................. 83
6.1.11 Responsibilities during a national or state emergency ..................................................... 83
6.1.12 COVID-19 Vaccination Reporting ..................................................................................... 83
6.1.13 Spending the grant ............................................................................................................ 84
6.1.14 Assets ............................................................................................................................... 84
6.1.15 Code of Conduct Aged Care ............................................................................................. 84
6.2 Serious Incident Response Scheme (SIRS) responsibilities .............................. 84
6.3 Service provider reporting.................................................................................. 92
6.3.1 Overview ........................................................................................................................... 92
6.3.2 Accounting for the grant .................................................................................................... 93
6.3.3 Managing performance ..................................................................................................... 94
6.3.4 Activity reporting ............................................................................................................... 97
6.3.5 Aged Care Workforce Census .......................................................................................... 98
6.4 IT and system requirements .............................................................................. 99
6.4.1 System requirements ........................................................................................................ 99
6.5 Government responsibilities .............................................................................. 99
6.5.1 Planning framework .......................................................................................................... 99
6.5.2 Government reporting ....................................................................................................... 99
Appendix A – Useful resources ...........................................................................................100
Publications .........................................................................................................................100
Aged Care Quality Standards ..............................................................................................100
Carers..................................................................................................................................100
Interpreting support for service providers .............................................................................100
Dementia Support ................................................................................................................100
Continence Support .............................................................................................................101
National Elder Abuse Support ..............................................................................................101
Meals on Wheels National Meal Guidelines .........................................................................101
The National Public Toilet Map ............................................................................................101
Resources relating to My Aged Care ...................................................................................101
Resources relating to the DSS Data Exchange and CHSP Performance Reporting.............101
Resources relating to support for people with disability ........................................................102
Appendix B – Policy and Guidelines resources .................................................................103
Appendix C – State Funding Arrangement Managers for the Commonwealth Home
Support Programme Contacts .............................................................................................104
Northern Territory ................................................................................................................104
NSW and ACT .....................................................................................................................104
Queensland .........................................................................................................................104
South Australia ....................................................................................................................104

December 2022 – iv
 Tasmania .............................................................................................................................104
Victoria ................................................................................................................................104
Western Australia ................................................................................................................104
Appendix D – Commonwealth Home Support Programme Police Certificate Guidelines
...............................................................................................................................................105
1 Introduction ...............................................................................................................105
2 Your obligations ........................................................................................................105
3 Police certificates ......................................................................................................105
3.1 Police certificates and police checks.................................................................105
3.2 Police certificate requirements ..........................................................................105
3.3 Australian Criminal Intelligence Commission checks ........................................106
3.4 Statutory declarations .......................................................................................106
4 Staff, volunteers and executive decision makers .......................................................106
4.1 Staff, volunteers and executive decision makers ..............................................106
4.2 Definition of a staff member ..............................................................................106
4.3 Definition of non-staff members ........................................................................107
4.4 Definition of a volunteer ....................................................................................107
4.5 Definition of unsupervised interaction ...............................................................107
4.6 Definition of an executive decision maker .........................................................108
4.7 New staff ..........................................................................................................108
4.8 Staff, volunteers and executive decision makers who have resided overseas ..108
5 Assessing a police certificate ....................................................................................109
5.1 Police certificate format ....................................................................................109
5.2 Purpose of a police certificate ...........................................................................109
5.3 Police certificate disclosure ..............................................................................109
5.4 Assessing information obtained from a police certificate for staff and volunteers
.........................................................................................................................109
A risk assessment approach .......................................................................................................... 109
5.5 Assessing information obtained from a police certificate for executive decision
makers .............................................................................................................110
5.6 Committing an offence during the police certificate period ................................111
5.7 Refusing or terminating employment on the basis of a criminal record .............111
5.8 Spent convictions .............................................................................................111
6 Police Check Administration ......................................................................................111
6.1 Record keeping responsibilities ........................................................................111
6.2 Sighting and storing police certificates ..............................................................112
6.3 Cost of police certificates ..................................................................................112

December 2022 – v
 6.4 Obtaining certificates on behalf of staff, volunteers or executive decision makers
.........................................................................................................................112
6.5 Police certificate expiry .....................................................................................112
6.6 Documenting decisions ....................................................................................112
6.7 Monitoring compliance with police check requirements ....................................113
Appendix D Attachment 3a – Police Service contact details for Police Checks ..............114
Appendix D Attachment 3b – Statutory declaration form ..................................................114
Glossary ................................................................................................................................115

December 2022 – vi
Part A – The program
Chapter 1 – Overview of the Commonwealth Home Support
Programme (CHSP)
1.1 What is the purpose of the program manual?
The Department of Health and Aged Care has designed this manual for use by CHSP service
providers. The manual forms part of the CHSP Grant Agreement and outlines the operation of
the program.
Part A – The program provides an overview of the CHSP, including funded service types and
their requirements.
Part B – Administration of the CHSP outlines the responsibilities of the service provider and
the Department, including funding and reporting requirements.
The CHSP program manual 2022-23 replaces the previous versions of this manual. The
Department will review the ongoing operations of the CHSP. The Department may update this
manual in the future.
The manual includes a range of scenarios showing how the CHSP may be delivered and how it
interacts with other programs.
You will find a glossary of terms at the back of this document.
More information
This manual is available on the Department of Health and Aged Care website.
CHSP Service Providers should refer all program inquiries to their Funding Arrangement
Manager.
Clients can access information about the program through the My Aged Care contact centre
(1800 200 422) or website.

1.2 The Commonwealth Home Support Programme

1.2.1 What is the Commonwealth Home Support Programme?
The CHSP provides small amounts of entry-level support to assist older people aged 65 years
and over (50 years and over for Aboriginal and Torres Strait Islander people) to remain living at
home and in their community. The CHSP funds domestic assistance, transport, meals, personal
care, home maintenance, social support, nursing, and allied health. The CHSP also supports
care relationships through planned respite services for older people. These respite services
allow carers to take a break from their usual caring responsibilities.
CHSP services may be short-term, intermittent or ongoing. The program places a strong focus
on activities that support independence and social connectedness and take into account each
person’s individual goals and choices.
For a full list of CHSP services see section 1.2.12.

1.2.2 Entry-level support

The CHSP provides a small amount of services to help frail older people maintain their
independence and continue living safely at home and in their communities.
The CHSP is not designed for older people with more intensive or complex care needs. Clients
who need ongoing high intensity care are outside the scope of this program. People with higher

November 2022 – 1
needs can receive appropriate support through other aged care programs, such as the Home
Care Package (HCP) program or residential aged care. The CHSP does not replace or fund
support systems provided under the health care system.
CHSP services delivered to a client should be lower than the subsidised cost of a Level 1 HCP
(less than $9,000 per annum). CHSP providers may deliver higher intensity services on a short-
term basis where clear improvements in function or capacity can be made, or further decline
avoided. These services should aim to get the client "back on their feet" and able to resume
previous activities without the need for ongoing support.
Client scenario – Entry-level support (social engagement)
Joyce
Joyce’s son comes to visit her and notices that she is not eating well and seems low in spirits.
When they talk about it, Joyce reveals that her closest friend has moved interstate to live with
family. Joyce misses her friend’s company and is feeling lonely. Since she no longer drives, she
has not been able to see her other friends at the local seniors’ centre.
Joyce and her son call My Aged Care and she consents to register as a client and for a client
record to be created. My Aged Care explains the process and arranges a Regional Assessment
Services (RAS) assessment for Joyce.
The RAS assessor talks to Joyce about her needs and goals and establishes a support plan
that includes:
Referral to see a CHSP funded accredited practising dietitian on a short-term basis (to address
nutrition issues)
community transport to the local seniors’ centre where Joyce will see her friends again.
This minimal but practical support enables Joyce to re-connect with her community, improve her
physical and emotional health and continue living in her own home.

1.2.3 History of the Commonwealth Home Support Programme

The Australian Government developed the CHSP as part of a broader suite of changes to the
aged care system aimed at streamlining access to support services.
Since 1 July 2015, the CHSP has delivered a single home support program which consolidated
the following Commonwealth-funded aged care programs:
• The Commonwealth Home and Community Care (HACC) Program
• Planned respite services under the National Respite for Carers Program (NRCP)
• The Day Therapy Centres (DTC) Program
• The Assistance with Care and Housing for the Aged (ACHA) Program.
On 1 July 2016, HACC services for older people aged 65 years and over (or 50 years and over
for Aboriginal and Torres Strait Islander people) in Victoria transitioned to the CHSP.
On 1 July 2018, HACC services for older people aged 65 years and over (or 50 years and over
for Aboriginal and Torres Strait Islander people) in Western Australia transitioned to the CHSP
creating a nationally accessible program.
The design of the CHSP has been informed by a comprehensive consultation process. This has
included advice from the National Aged Care Alliance (NACA), its CHSP Advisory Group and
feedback received from peak groups, organisations and individuals in early 2015. The
Australian Government has continued to refine the CHSP through ongoing consultations with
peak representative bodies, service providers and individuals through targeted consultation and
review processes.
Following the October 2022 Federal Budget for 2022-23, the CHSP has funding allocated for a
further 12 months from 1 July 2023 to 30 June 2024. This aligns with the Australian
Government’s announcement of a return to a start date of 1 July 2024 for a new in-home aged
care program.

December 2022 – 2
1.2.4 Position in the Australian Government’s end-to-end aged care system
My Aged Care is the entry point to the aged care system for older people, their families and
carers and is responsible for conducting assessments for the CHSP. This streamlined entry to
aged care makes it easier for older people to access information, have their needs assessed
and be supported to locate and access aged care services available to them, including entry
level support as delivered under the CHSP. My Aged Care was launched in 2013 and consists
of the My Aged Care website and the contact centre (1800 200 422) and referral to assessment
services. See Chapter 4 for more detail.
The CHSP represents the entry-level tier of the Commonwealth aged care system. In
conjunction with the Home Care Package (HCP) program, residential aged care and other
specialised aged care programs, it forms part of an end-to-end aged care system offering frail
older people a continuum of care options as their care needs change over time.
As people age, they can develop conditions or experience increased frailties which impede their
ability to continue living in their own home. The CHSP plays an important role in supporting frail
older people helping them maintain their independence at own home.
Investment in entry-level support that focuses on keeping people independent and safe in their
own homes can delay the need to move to more intensive forms of care. This benefits frail older
people through increasing their independence and quality of life as well as reducing government
outlays for other forms of care, such as residential aged care. The CHSP ensures that whole-of-
system aged care costs can be kept at a sustainable level as the population ages and the
number of people requiring aged care increases.
The CHSP is complemented by the HCP program which provides the second tier of support in
the aged care system. The HCP program is designed to support older people living in the
community whose care needs exceed the level of support provided through the CHSP. It
provides consumers with higher intensity, ongoing services and case management as well as
an individualised budget developed by the consumer and their provider and sets out how
available package funds will be used to deliver the care and services the consumer needs. Frail
older people who need higher levels of ongoing support are also able to access Australian
Government subsidised residential aged care places.
The Australian Government subsidises information services, assessment services, aged care
services and related support services.
Aged care is provided in home and community settings and in residential aged care settings.
Three levels of subsidised aged care services have been available since 1 July 2015:
• entry level support at home
• more complex support for older people who are able to continue living in their own
homes with assistance
• a range of care options and accommodation for older people who are unable to continue
living in their own home.
Seven aged care programs operate across the three levels of service:
• The CHSP provides entry level support for frail older people who are able to continue
living independently in their own homes with some small amounts of assistance.
• The HCP program provides four levels of consumer directed coordinated packages of
services for more complex support for older people who are able to continue living
independently in their own homes with assistance.
• Residential aged care provides a range of care options and accommodation for older
people who are unable to continue living independently in their own home. Residential
Respite Care also provides short-term planned or emergency residential aged care.
• The Short-Term Restorative Care (STRC) Programme is an early intervention program
that aims to reverse and/or slow ‘functional decline’ in older people and improve
wellbeing through the delivery of a time-limited (up to 56 paid days), goal-oriented, multi-
disciplinary and coordinated range of services designed for, and approved by, the client.

December 2022 – 3
 STRC services may be delivered in a home care setting, a residential care setting, or a
combination of both.
• Transition Care provides short-term, goal oriented and therapy-focused care for older
people after hospital stays either in a home or community setting or in a residential aged
care setting.
• The Multi-Purpose Services (MPS) program is a joint initiative of the Australian
Government and state governments and provides integrated health and aged care
services for small rural and remote communities either in a residential, home or
community setting.
• National Aboriginal and Torres Strait Islander Flexible Aged Care (NATSIFAC) provides
culturally appropriate aged care to older Aboriginal and Torres Strait Islander people
close to home and community and are mainly located in rural and remote areas. Service
providers deliver a range of services to meet the needs of the client, which can include
residential, home care or community services.
Aged care services are underpinned by the Aged Care Quality Standards (Quality Standards),
which sets and monitors care standards and provider responsibilities to ensure older people
receive safe, quality aged care services.
Delivery of aged care services is supported by My Aged Care including independent
assessment services that assess care needs and client care:
• Home Support Assessments for the CHSP are conducted by the My Aged Care
Regional Assessment Services (RAS).
• Comprehensive assessments for home care packages, Transition Care, STRC and
residential aged care are conducted by Aged Care Assessment Teams (ACAT). ACAT
assessors may refer clients to CHSP services where the client is not eligible for more
intensive support or for interim support at entry-level until more intensive services
commence.
Service providers may directly assess potential clients for the NATSIFAC and MPS programs.
The CHSP Client Contribution Framework outlines the principles for service providers to adopt
in setting and implementing their own client contribution policy, with a view to ensuring that
those clients who can afford to contribute to the cost of their care do so, whilst protecting those
most vulnerable. Service providers must be transparent about their fees and advise CHSP
clients of any client contributions payable. More detail on the CHSP Client Contribution
Framework is provided under Chapter 5.
HCP clients require an income assessment by Services Australia and/or the Department of
Veterans’ Affairs.
Residential aged care clients require a combined assets and income assessment by the
Services Australia and/or the Department of Veterans’ Affairs.
Additional support for clients and their carers while care is being received is provided through:
• Carer support, which operates across all three levels of aged care services, Carer
Gateway and through carer specific programs funded through the Department of Social
Services (refer section 1.2.10 Carers).
• Dementia support, which operates across all three levels of aged care services, through
various dementia support services.
• Consumer support and advocacy, which operates across all three levels of aged care
services, through the Community Visitors Scheme, the National Aged Care Advocacy
Program (NACAP), and the Aged Care Quality and Safety Commission.

1.2.5 Objectives
The objectives of the CHSP are to:
1. Provide high-quality support, at a low intensity on a short-term or ongoing basis, or
higher intensity services delivered on a short-term basis, to frail older people to

December 2022 – 4
 maximise their independence at home and in the community, enhancing their wellbeing
and quality of life.
2. Provide entry-level support services for frail older people aged 65 years and older (or 50
years and older for Aboriginal and Torres Strait Islander people) who are assessed by
the RAS as needing assistance, to continue to live independently at home and in their
community.
3. Support frail older clients aged 65 years and over (or 50 years and over for Aboriginal
and Torres Strait Islander people) through the direct service delivery of planned respite
services to CHSP clients, which will allow carers to take a break from their usual caring
duties.
4. Support frail older people or prematurely aged people 50 years and over (or 45 years
and over for Aboriginal and Torres Strait Islander people) on a low income who are
homeless or at risk of homelessness as a result of experiencing housing stress or not
having secure accommodation through access to Assistance with Care and Housing and
other CHSP services targeted at avoiding homelessness or reducing the impact of
homelessness.
5. Support clients to delay, or avoid altogether, the need to move into more complex aged
care by being kept socially active and connected with their community, so that whole-of-
system aged care costs can be kept at a sustainable level as the population ages and
the number of people requiring care increases.
6. Ensure that all clients have equal access to services that are socially and culturally
appropriate and free from discrimination.
7. Ensure compliance with all relevant codes of ethics, industry quality standards and
guidelines, to ensure that clients receive high quality services.
8. Facilitate client choice to enhance the independence and wellbeing of older people
and ensure that services are responsive to the needs of clients.
9. Provide a standardised assessment process which encompasses a holistic view of client
needs.
10. Provide flexible, timely services that are responsive to local needs.

1.2.6 Outcomes
The intended outcomes of the CHSP are to ensure:
• frail older people with functional limitations are supported to live in their own homes.
• frail older people have increased social participation and access to the community,
including through the use of technology.
• frail older people’s psychological, emotional and physical wellbeing and functional status
is maintained and/or improved.
• frail older people are supported to be more independent at home and in the community,
thereby enhancing their quality of life and/or preventing or delaying their admission to
long-term residential care.
• frail older people are supported in a safe, stable and enabling environment.
• carers and care relationships are supported.
• sustainability and service innovation are improved.
• equitable and affordable access to services is provided.

1.2.7 Key features

The CHSP will:
• provide streamlined entry-level support services.
• be supported by My Aged Care in providing access to information and services through:

December 2022 – 5
 o a central client record to allow client information to be appropriately shared with
assessors and service providers
o a consistent, needs-based assessment process
o better access to relevant and accurate information (for clients, carers and family
members, service providers and assessors), and
o appropriate referrals for assessments and services.
• deliver services and support with a strong focus on wellness and reablement and
restorative care on a short-term basis, or of an ongoing nature, or across a small number
of time limited interventions, to maximise a client’s independence.
• provide sector support and development activities.
• promote equity and sustainability through a nationally consistent client contribution
framework.
• streamlined contractual obligations such as consistent record keeping processes and
reporting requirements.

1.2.8 Service delivery principles

CHSP service providers must implement the service delivery principles below when developing,
delivering or evaluating services directed to clients:
• Establish client consent to receive services as a prerequisite for all service delivery.
• Promote each client’s opportunity to maximise their independence, autonomy and
capacity and quality of life through:
o being client-centred and providing opportunities for each client to be actively involved
in addressing their goals
o focusing on retaining or regaining each client’s functional and psychosocial
independence, and
o building on the strengths, capacity and goals of individuals.
• Provide services tailored to the unique circumstances and cultural preference of each
client, their family and carers.
• Ensure choice and flexibility is optimised for each client, their carers and families.
• Invite clients to identify their preferences in service delivery and where possible honour
that request.
• Ensure services are delivered in line with a client’s agreed support plan to ensure their
needs are being met as identified by the RAS.
• Emphasise responsive service provision for an agreed time period and with agreed
review points.
• Support community and social participation opportunities that provide valued roles, a
sense of purpose and personal confidence.
• Develop and promote strong partnerships and collaborative working relationships
between the person, their carers and family, support workers and RAS.
• Develop and promote local collaborative partnerships and alliances to facilitate clients’
access to responsive service provision.
• Have a client contribution policy in place which must be publicly available.
• Establish the client contribution for services delivered with the client prior delivering any
services.
Consumer choice
The CHSP aims to provide choice for consumers through the implementation of a service
delivery model that focuses on a client’s goals and abilities in determining their support service

December 2022 – 6
needs. It aims to empower individuals to take charge of, and participate in, informed decision-
making about the care and services they receive. Through the CHSP, clients will:
• have access to detailed information on aged care options provided through My
AgedCare.
• actively participate in assessment of their needs through a two-way conversation with
My Aged Care assessors.
• identify any special needs, life goals, strengths and service delivery preferences.
• have their carers’ needs recognised and supported by My Aged Care assessors.
• have access to free, independent and confidential advocacy services through the
NACAP.
• have options on how to select their preferred service provider (if they choose to) from
information available through My Aged Care.
• Have access to complaint mechanisms, including the Aged Care Quality and Safety
Commission.
In addition, CHSP service providers must:
• comply with the Charter of Aged Care Rights (the Charter), including providing clients
with a copy of the Charter and assisting clients to understand their rights (refer to section
6.1.2 for further details).
• manage and update their service information via the My Aged Care provider portal to
ensure accurate information is presented publicly through the My Aged Care service
finders and to support appropriate referrals to services by the contact centre and RAS or
ACAT assessors.
• deliver services consistent with the goals and recommendations contained in the client’s
support plan as agreed with the My Aged Care assessor.
• manage client referrals via the My Aged Care provider portal by accepting or rejecting a
client for service within three calendar days and commencing service delivery in line with
the priority timeframes stipulated in the My Aged Care - Provider Portal User Guide
available on the Department’s website.
• update the client record (when a client is accepted for service) through the
My Aged Care provider portal with service delivery information, including
commencement date, frequency and volume of services.
The CHSP does not provide individual budgets like the HCP program and the support services
provided must be targeted towards a client’s needs, not their ‘wants’. However, the high-level
principles of consumer choice underpinning the CHSP include providing choice and flexibility in
service delivery preferences (where possible), consumer rights and participation.

1.2.9 Target groups

Target groups for the CHSP are:
• Frail older people aged 65 years and over (or 50 years and over for Aboriginal and
Torres Strait Islander people) who need assistance with daily living to remain living
independently at home and in the community.
• Frail older clients aged 65 years and over (or 50 years and over for Aboriginal and
Torres Strait Islander people) who need planned respite services, to provide their carers
with a break from their usual caring duties.
• Frail older people or prematurely aged people 50 years and over (or 45 years and over
for Aboriginal and Torres Strait Islander people) on a low income who are at risk of
homelessness as a result of living with hoarding behaviour or living in a squalid
environment.
• CHSP service providers will benefit from a range of activities that are designed to
support, develop and strengthen the service system and the sector.

December 2022 – 7
Clients do not need to be an Australian citizen or permanent resident to access CHSP services.
In exceptional circumstances, CHSP services may be provided to people who do not meet the
target group criteria and who need assistance with daily living to remain living independently at
home and in the community.
These circumstances include where:
• The client is receiving a certain level of care under a program that was consolidated
under the CHSP prior to 1 July 2015 and should therefore expect to retain this service
level until other suitable care options become available.
• Specific arrangements have been agreed to by the respective state or territory
governments and the Commonwealth.
Specific eligibility requirements apply for each sub-program. Chapter 3 of this program manual
provides more detail on sub-programs and eligibility.
The Department recognises that a number of service providers deliver a range of culturally
appropriate support services. While these specialist services are strongly encouraged as
important components of the program, CHSP service providers cannot discriminate against
clients from other cultural or ethnic backgrounds.

1.2.10 Carers
Carers are integral to ensuring the quality of life and independence of many frail older people.
They make a significant contribution to the lives of the older people they care for and an
important economic contribution to the community.
In recognition of the vital role that carers play in supporting frail older people to remain living at
home and in the community, the CHSP supports the care relationship through planned respite
services delivered to frail older people. These services are provided under the Care
Relationships and Carer Support Sub-Program.
Early support for carers is important to prevent strain on the caring relationship. From January
2022, carers will have better access to early intervention support (via Carer Gateway) and
access to additional CHSP respite services (Flexible respite and Centre-based respite). These
additional services will help to reduce carer stress and support the care relationship.
Services offered through Carer Gateway, which is funded through the Department of Social
Services, focus on early-intervention and, preventative and skills building supports. Carer
Gateway aims to improve well-being and long-term outcomes of the care relationship, as well as
crisis support when needed. Specific services include:
• a national phone counselling service to help carers manage daily challenges, reduce
stress and strain, and plan for the future;
• an online peer support forum, connecting carers with other carers for knowledge and
experience sharing, emotional support and mentoring;
• online self-guided coaching resources with simple techniques and strategies for goal-
setting and future planning;
• educational resources to increase skills and knowledge of carers relating to specific
caring situations, to build confidence and improve wellbeing;
• in-person and phone-based counselling and peer support;
• targeted support packages with a focus on employment, education, respite and
transport; and
• access to emergency respite.

1.2.11 Older people with diverse needs

The CHSP recognises that older people display the same diversity of characteristics and life
experiences as the broader population and need to receive services which reflect their diverse
needs. Each person may have specific social, cultural, linguistic, religious, spiritual,
psychological, and medical care needs and may also identify with more than one characteristic.

December 2022 – 8
The CHSP recognises the following special needs groups, which align with those identified
under the Aged Care Act 1997:
• people who identify as Aboriginal and Torres Strait Islander
• people from culturally and linguistically diverse backgrounds
• people who live in rural and remote areas
• people who are financially or socially disadvantaged
• people who are veterans of the Australian Defence Force or an allied defence force
including the spouse, widow or widower of a veteran
• people who are homeless, or at risk of becoming homeless
• people who are lesbian, gay, bisexual, transgender, intersex, queer or asexual
(LGBTIQA+)
• people who are Care Leavers (which includes Forgotten Australians, Former Child
Migrants and Stolen Generations)
• parents separated from children by forced adoption or removal.
The above is not an exhaustive list, and the CHSP acknowledges there are other special needs
groups, such as people with a disability, people with mental health problems and mental illness
and people living with cognitive impairment including dementia. CHSP services may also be
provided to clients in correctional centres and detention facilities where these services are not
already provided by these institutions.
The CHSP will:
• ensure that all clients have equity of access to information and services that are effective
and appropriate to their needs and take into account individual circumstances and are
free from discrimination.
• ensure that services are delivered in a way that is culturally safe, appropriate and
inclusive of all older people with diverse characteristics and life experiences.
• ensure through compliance with the quality framework, that service providers consider
the requirements of people from diverse backgrounds and special needs groups. Note:
New aged care quality standards and changes to the current quality assessment
process are being developed and service providers will be required to the meet the new
Aged Care Quality Standards and participate in the new quality assessment process,
once introduced.
• support access by service providers to translation and interpreting services.
• consider equity of access for all older people in the allocation of new funding.
These principles support the Imperatives and Priorities identified in the Aged Care Diversity
Framework.

December 2022 – 9
Client scenario — accommodating client choice and cultural preference
INKA
Inka is a 76 year old woman who is originally from Finland and lives alone. Though generally
capable, Inka has osteoarthritis and has found that some domestic tasks are becoming more
difficult to undertake due to pain and joint stiffness.
After contacting and registering with My Aged Care, Inka was referred to the RAS for an
assessment, which identified that Inka needed regular help to keep her house clean. A local
CHSP service provider accepted the referral and arranged for a cleaner to go to Inka’s home
once a week. The cleaner usually spent about an hour vacuuming, mopping and cleaning the
bathroom whilst Inka continued to undertake lighter tasks such as dusting and wiping over the
basins.
In summer, Inka asked the cleaner if her hand-woven rag mats could be taken outdoors for
cleaning. This was a Finnish tradition that Inka had done all her life and involved hanging the
mats over the clothesline and whacking them repeatedly with a rug-beater to remove dust and
dirt. The job required shifting furniture, rolling up the long mats and carrying them to the
clothesline in the back garden, which was beyond the cleaner’s ability.
After speaking with her service provider, an arrangement was made for another worker to visit
Inka’s home to clean the mats twice a year, replacing the regular cleaner for just those two
visits.
Interpreting services
Information on how service providers and clients can access interpreting services is available at
Translating and Interpreting Service (TIS National).
Sign language interpreting services
Older Australians who are Deaf, deafblind, or hard of hearing who are seeking to access or are
in receipt of Commonwealth funded aged care services can access free sign language
interpreting and captioning services. Sign language services can be provided face-to-face or by
Video Remote, and live captioning services are available to support clients to engage with:
• Activities of daily living
• My Aged Care
• Regional Assessment Services
• Aged Care Assessment Teams
• In-home aged care service providers
• Residential aged care service providers, and
• Other organisations involved in the provision of Commonwealth funded aged care
services.
Sign language services are available in Auslan, American Sign Language, International Sign
Language, and Signed English for Deaf or people who are hard of hearing, and tactile signing
and hand over hand for deafblind consumers.
The sign-language interpreting and captioning services support older Australians to better
engage and fully participate in their aged care journey. Information on how service providers
can access interpreting services is available at My Aged Care on 1800 200 422 or Deaf
Connect at their Website: //bookings.deafconnect.org.au/ or by calling 1300 773 803 or emailing
[email protected]
People with dementia
The Australian Government considers the provision of appropriate care and support of people
with dementia, their families and carers to be core business for all providers of aged care, given
its prevalence amongst frail older people.
The Australian Government funds a range of advisory services, education and training, support
programs and other services for people with dementia, their families and carers.

December 2022 – 10
CHSP clients may access these supports if appropriate to their needs.

1.2.12 What services are funded under the Commonwealth Home Support Programme?
The following service types, including the activities or sub-types under each, are available under
the CHSP:

Sub-program Service type Service sub-type

Community and Allied Health and Aboriginal and Torres Strait Islander Health Worker
Home Support Therapy Services
Accredited Practising Dietitian or Nutritionist

Diversional Therapy

Exercise Physiology

Hydrotherapy

Occupational Therapy

Ongoing Allied Health and Therapy Services

Other Allied Health and Therapy Services

Physiotherapy

Podiatry

Psychology

Restorative Care Services

Social Work

Speech Pathology

Domestic Assistance General House Cleaning

Linen services

Unaccompanied Shopping (delivered to home)

Goods, Equipment and Car Modifications

Assistive Technology
Communication Aids

Medical Care Aids

Other Goods and Equipment

Personal Monitoring Technology

Reading Aids

Self-care Aids

Support and Mobility aids

Home Maintenance Garden Maintenance

Major Home Maintenance and Repairs

December 2022 – 11
Sub-program Service type Service sub-type

Minor Home Maintenance and Repairs

Home Modifications N/A

Meals At Centre

At Home

Nursing N/A

Other Food Services Food Advice, Lessons, Training, Food Safety

Food Preparation in the Home

Personal Care Assistance with Client Self-administration of Medicine

Assistance with Self Care

Social Support Accompanied Activities, e.g. Shopping

Individual
Telephone/Web Contact

Visiting

Social Support Group N/A

Specialised Support Continence Advisory Services

Services
Client Advocacy

Dementia Advisory Services

Hearing Services

Other Support Services

Vision Services

Transport Direct (driver is volunteer or worker)

Indirect (through vouchers or subsidies)

Assistance with Assistance with Care Hoarding and Squalor

Care and Housing and Housing

Care Flexible Respite Community Access – Individual respite

Relationships and
Carer Support Host Family Day Respite

Host Family Overnight Respite

In-home Day Respite

In-home Overnight Respite

Mobile Respite

Other Planned Respite

December 2022 – 12
 Sub-program Service type Service sub-type

Cottage Respite Overnight Community Respite

Centre-based Respite Centre-based Day Respite

Community Access – Group

Residential Day Respite

Sector Support Sector Support and Sector Support and Development

and Development Development

**The ACH navigation services (assessment/referrals and advocacy) will be available under the new care
finder program from January 2023.
These services are funded under specific sub-programs based on the CHSP target groups
(Section 1.2.9). Details of each sub-program, including eligibility and available service types, are
provided in Chapter 3 of this program manual.

1.2.13 What Commonwealth Home Support Programme funding must not be used for
CHSP grant recipients must not use any of the funds for:
• purchase of land
• purchase of vehicles
• coverage of retrospective costs
• costs incurred in the preparation of a grant application or related documentation
• international travel or expenses related to international travel
• activities that are already funded under other Commonwealth, state, territory or local
government programs
• activities that could bring the Australian Government into disrepute
• client accommodation expenses, as these are provided for within the social security
system (note: Assistance with Care and Housing Sub-Program services deliver
assistance with accessing appropriate support)
• direct treatment for acute illness, including convalescent or post-acute care
• medical aids, appliances and devices which are to be provided as a result of a medical
diagnosis or surgical intervention and which would be covered under a Health Care
system, such as oxygen tanks or continence pads
• household items which are not related to improvement of functional impairment
(i.e. general household or furniture or appliances)
• items which are likely to cause harm to the participant or pose a risk to others
• major construction/capital works (see paragraph below).
For the purpose of the CHSP, capital infrastructure is considered to be real property of a non-
expendable nature, specifically major renovations, buildings and land. CHSP funding must not
be used for the acquisition of capital infrastructure.
The following services are delivered under My Aged Care:
• Assessment – undertaken via initial phone-based screening by the contact centre and
assessments conducted by the RAS (or ACAT).
• Case Management and Coordination – short-term case management services are
available for vulnerable CHSP clients and short term coordination services for CHSP
clients undertaking a reablement program through My Aged Care linking and reablement
services delivered by the RAS.

December 2022 – 13
Client Care Coordination is not funded as a separate service type under the CHSP as this
function is considered to be part of ongoing service delivery.

1.2.14 Where will Commonwealth Home Support Programme services not be provided?
CHSP services will not be provided:
• to permanent residents of residential care facilities (including an MPS), except under
grandfathering arrangements or on a full-cost recovery basis.
• where a resident's accommodation contract provides for similar services to those under
the CHSP.
• where needs can be met by other more appropriate Commonwealth funded programs
such as HCP as outlined in 4.1.1.
A DSOA client cannot access CHSP services that are in-scope or already provided for under
DSOA e.g. a DSOA client accessing nursing and personal care cannot access nursing and
personal care under the CHSP. Accessing services that are in scope under DSOA may impact
a client’s DSOA funding package.
Services can be offered to people in retirement villages and independent living units, where a
resident’s accommodation contract does not include CHSP-like services.
The My Aged Care screening process will help identify what existing services a client is
receiving including accommodation services subsidised by the Australian Government.

December 2022 – 14
Chapter 2 – Supporting independence
2.1 Introduction
CHSP service providers are required to work with frail older people to maximise their
independence and enable them to remain living safely in their own homes and communities.
Providers must structure services with a focus on client strengths and goals to support
independence. This means that service providers should generally not undertake tasks that the
client is capable of doing safely for themselves. The longer a client avoids reliance on ongoing
services, the longer they are likely to maintain their functional independence, giving them more
good days doing the things that matter to them most.
This approach known as wellness and reablement builds on people’s strengths and goals to
promote greater independence and autonomy. Offering care that focuses on individual client
goals and recognises the importance of client participation is fundamental to the CHSP.
The CHSP Reablement Community of Practice is available as a tool for providers to learn,
share and engage with other providers across the CHSP sector. It is an online forum to support
the sharing of ideas, best practice and practical examples to embed wellness and reablement
into everyday service delivery practices. Join the CHSP Reablement Community of Practice at:
more-good-days.

2.2 Why Wellness and Reablement?

Over the past decade, emerging research has demonstrated the benefits of focussing on client
independence. Traditional models of service delivery that focus on what a client can’t do rather
than what they can, tend to lead to an over-reliance on services by clients, which has been
linked with accelerated functional decline.

2.2.1 Understanding the ageing journey

Research suggests that the largest influencer in age-related decline is not genetics, but rather
lifestyle choices. People who continue to do things for themselves tend to remain independent
and live better, longer.
Professor Peter Gore of the Institute of Aging at Newcastle University in the UK has developed
a framework to understand the age-related decline. The framework, called the Life Curve, looks
at the impact of maintaining independence on quality of life and the rate of age-related
functional decline. It illustrates that the sooner someone stops performing certain tasks for
themselves, the faster they tend to lose their functional ability. The aim is to assist people to
perform these daily tasks independently for as long as possible, so they maintain the ability to
maximise independence and autonomy. Retaining physical ability helps people to continue
doing the things they enjoy for longer. The LifeCurveTM App can be downloaded for free from
www.liveup.org.au.
The Life Curve is shown at Figure 1. The vertical axis lists activities of daily living that older
people generally lose over time, in the order in which they tend to be lost, from top to bottom.
The timeframe for this decline is variable and can be influenced by behaviour and interventions.
Difficulty cutting toenails is typically seen as an early indicator that intervention may be needed.
The graph shows two trajectories – a sub-optimal life curve with a fast early decline, and an
optimal life curve in which the early decline is slowed down to give people more good days
before losing the ability to undertake activities like walking, shopping and personal care.

December 2022 – 15
2.3 Benefits of a wellness and reablement approach
Older Australians are not the only ones who benefit from wellness and reablement. Evidence
suggests there are also significant benefits to service provider organisations, families and
carers and the broader community.

2.3.1 Benefits for consumers

Implementing a wellness and reablement approach at the earliest opportunity, focussing on
client goals to maintain or regain functional capacity and social connectedness can have
significant long-term benefits for clients including:
• improved sense of purpose, autonomy and self-worth
• improved physical and emotional health and wellbeing
• reduction in service delivery needs
• increased ability to remain living independently and safely in their own homes for longer
• greater quality of life and retention of pride and dignity
• Improved connection with community
• reduced strain on family and carer relationships

2.3.2 Benefits for service provider organisations

Those organisations who have implemented wellness and reablement have identified significant
benefits for their staff, business model, organisational processes and their clients including:
• greater job satisfaction from actively helping clients achieve their goals and become
more independent
• better utilisation of resources as support workers are able to focus on more complicated
tasks clients can’t perform for them themselves, which means more meaningful and
fulfilling work for staff
• opportunity to broaden the client base by offering more shorter-term support
• improved reputation and repeat business based on providing person-centred care,
focussed on client goals

December 2022 – 16
 • better alignment to aged care reform initiatives, improving preparedness to respond to
changes in aged care policy.

2.3.3. Benefits for families and carers

Wellness and reablement approaches can have significant benefits for family members and
carers, including:
• an opportunity to be involved in supporting their loved one to reach their outcomes
• the benefit of knowing their loved one is retaining or regaining their independence
• reduced strain and pressure due to a decrease in caring requirements

Client scenarios — applying a wellness and reablement approach

HARRY
Harry is a 70 year old man who lives alone. After contacting My Aged Care, a RAS assessment
was undertaken which identified that Harry needed some assistance with clothes-washing and
meals. At first the CHSP service provider visited Harry’s home three times a week to wash and
hang out the clothes for him and cook basic meals for him.
The provider also worked with Harry to identify what he could do for himself and what he
needed assistance with. The support worker encouraged Harry to continue to wash and hang
out smaller items by using a trolley and an easy-to-reach drying rack inside, whilst they
continued to come once a week to help hang out his bigger, heavier items.
Harry also indicated that he was open to doing the cooking, but lacked confidence since his
wife, who had recently passed away, had always done most of the cooking. For a number of
weeks the provider stayed and cooked with Harry to help him to prepare several meals to last
over the week. With his confidence back, Harry has continued to do things for himself and has
remained independent in his own home.

ELSA
Elsa is a 72 year old woman with osteoarthritis who has been receiving domestic assistance
under the CHSP for a number of years. The support worker visited Elsa once a week for two
hours to provide assistance with general housework and laundry. Elsa required no other
assistance.
After applying a wellness and reablement approach to Elsa’s support needs, the service
provider identified that Elsa could still do some basic household chores such as light dusting,
wiping over surfaces, doing her own dishes and using a light weight carpet sweeper.
Over a two month period instead of ‘doing for’ Elsa, the support worker encouraged and
supported Elsa to undertake some of these tasks by herself, whilst the support worker
continued to do more difficult tasks such as vacuuming or cleaning the floors.
Elsa still requires ongoing support however she is now more involved and has increased activity
levels.

2.3.4 Empowering older Australians to remain independent for longer

The LiveUp website enables Australians over 65 years of age to check their health and find
personalised suggestions for products and services that promote healthy ageing. LiveUp can
suggest low-cost assistive products and equipment to help people with everyday living, as well
as personalised exercises and services, to help them or a loved one with age-related wellbeing.
At the LiveUp website anyone can download the free LifeCurveTM App that can track a person’s
health, giving them easy to understand long term advice tailored to their needs. To learn more
about LiveUp, and the products and services that are available, visit www.liveup.org.au or call
1800 951 971.

December 2022 – 17
2.4 Principles of wellness and reablement
Wellness and reablement describe an overall approach to service delivery. The following
principles underpin a wellness and reablement approach.
• Promote Independence – people value their independence, loss of independence can
have a devastating effect, particularly for older people who may find it more difficult to
regain
• Identify clients’ goals – a person’s independence requires more than just services to
help them remain in their home and maintain their current capacity. Service delivery
should focus on supporting the client to actively work towards their goals and improved
independence wherever possible
• Consider physical and psychological needs – independence is not limited to physical
function; it also includes both social and psychological function
• Encourage client participation – being an active participant, rather than a passive
recipient of services, is an important part of being physically and emotionally healthy.
Service delivery should focus on assisting a person to complete tasks, not taking over
tasks that a person can do for themselves
• Regular assessment – client assessment should be ongoing, not one-off. It should
focus on progress towards client goals and consider the support and duration of services
required to meet these goals
• Focus on strengths - the focus should be on what a person can do, rather than what
they can’t. Wherever possible, services should aim to retain, regain, or learn skills rather
than creating dependencies
• Support clients to reach their potential – help clients to maintain and extend their
activities in line with their capabilities
• Individualised support – service delivery should be individualised and suited to the
goals, aspirations and needs of the individual.
Helen
Helen is a 78 year old woman with osteoarthritis. Lately, Helen has been experiencing difficulty
performing household cleaning duties and doing her laundry. At assessment, the RAS assessor
referred Helen for domestic assistance to help her manage around the house.
The CHSP service provider receiving Helen’s referral for domestic assistance, contacts Helen to
understand more about her circumstances and what she needs support with. Applying a
wellness and reablement approach, the service provider speaks with Helen about what’s
happening and what she’s having difficulty with. Throughout this conversation, the service
provider identifies there are still tasks Helen can do but there are certain tasks that impact on
her arthritis. The service provider also identifies that Helen used to enjoy doing the housework
to keep her home nice and clean. Helen also alluded to feeling lonely because she hasn’t had
many visitors lately because she’s worried about her house.
The service provider works with Helen to develop a care plan focused on Helen’s strengths and
the things she wants to regain/maintain. The service provider visits Helen once a week for a few
hours to help her with cleaning and washing. Over a two-month period, the service provider
supports Helen continue to do the things she wanted to, while the provider focuses on the tasks
which provoke Helen’s arthritis such as vacuuming and mopping.
While Helen still requires ongoing support with harder domestic duties, she has improved on her
functional capacity and feels more like herself. By taking a strength-based approach to service
delivery, focusing on ‘doing with’ not ‘doing for’, Helen has been able to maintain some physical
activity and by regaining some independence she is feeling more fulfilled and capable. Helen
has begun engaging with her friends again which has improved her social connectedness.

2.4.1 Time limited support

Wellness and reablement approaches often involve time-limited services. Time-limited care
aims to address a client’s specific barriers to independence and support them getting back to

December 2022 – 18
doing things for themselves. This involves a targeted timeframe, developed with the client, for
achieving their goals.
Understanding what a good day looks like for a client and how it relates to their individual goals
and outcomes is important for determining short-term support needs. This could be maintaining
a level of activity or independence or working towards regaining it. Time-limited reablement
services tend to be delivered within a 12-week period with the aim to wrap up services when the
client has met their goal or specific outcome.
Restorative care services may also be involved where the client has the potential to make a
functional gain. Restorative care involves the delivery of evidence-based interventions led by an
allied health worker or health professional that allows a person to make a functional gain or
improvement after a setback, or in order to avoid a preventable injury. These interventions may
be delivered as one-to-one or group services and may involve a multi-disciplinary approach that
goes beyond CHSP services, for example, involving primary health care providers. These
services are coordinated by providers of allied health and therapy services based on clinical
assessments of the clients.
Other time-limited support could include:
• training in a new skill or actively working to regain or maintain an existing skill
• modification to a person’s home environment
• having access to equipment or assistive technology.

2.5 Wellness and reablement obligations and supports

As part of applying a wellness and reablement approach to service delivery, service providers
are required to:
• ensure services are targeted towards assisting clients to achieve their agreed goals as
outlined in the assessment support plan
• apply a 'doing with' approach across service delivery
• offer time limited interventions where appropriate
• monitor changes in client needs and regularly review support services
• comply with wellness and reablement reporting requirements.
• have an implementation plan outlining their service’s approach to embedding wellness
and reablement in service delivery.
The Living well at home: CHSP Good Practice Guide, provides guidance in how to adopt a
wellness and reablement approach into service delivery. In addition, as part of the outcomes of
the Promoting Independent Living evaluation, the Department of Health and Aged Care has
developed additional tools and information, including an online community of practice, to help
service providers to continue to embed wellness and reablement in their service delivery.

December 2022 – 19
Client scenarios – supporting greater independence 1
ADELINA
Adelina is a 77 year old woman who had a stroke which affected her left side. Her speech was
unaffected but her movement was restricted. She has little function in her left arm, and her left
leg is slightly affected although she is able to walk with a stick.
Adelina felt that she was unable to do very much for herself. She really wanted to be able to
make her own cup of tea, however because of the lack of function in her left arm she felt she
was dependent on carers and unable to make a cup of tea between carer visits unless a friend
or neighbour came by. Adelina had become reconciled that this was how her life would be. She
was dispirited and resistant to her son’s suggestion that she might do a bit more for herself.
However, at the request of her son, Adelina’s support plan was reviewed by the RAS who
recommended a referral to an occupational therapist. An occupational therapist was engaged
under the CHSP who suggested that she could be assisted to learn to use the microwave oven
and a kettle fitted onto a tipper so that she could make her own cup of tea.
For a number of weeks Adelina was supported to build up her confidence in her ability to use
the microwave and the kettle. After a few months Adelina was able to make meals for herself,
her own cup of tea and is living a more independent life. As a result Adelina has said that she is
feeling more hopeful and has started to invite friends over for a meal. Adelina’s son has been
delighted to see his mother’s renewed sense of self and independence.

ROSE
Rose is an 87 year old woman who, as a day centre client, had become very dependent on
support staff. Her confidence had declined to the point where she was not confident in tending
to her own toileting without assistance to and from the toilet at the centre. After discussion
between centre staff and Rose, it was agreed that she was well enough to do more for herself in
the centre and over time was encouraged to do so. Staff were advised to enable her to toilet
independently rather than attempt to assist as previously.
Over time Rose has become more confident and is more independent at the centre. This
confidence has extended to transport arrangements to and from the day centre. Rose does not
like to travel on the centre bus, so has arranged her own transport on the days she attends. She
has commented on how proud she feels of herself and her achievements and is now more
actively involved with the centre, rather than being a passive recipient.

2.5.1 Strategies to assist embedding wellness and reablement

Experience of organisations that have successfully embedded a wellness and reablement
approach into service delivery practice suggests that there are a number of key drivers for
success. These include:
• a whole-of-organisation approach, including commitment from both management and
staff
• reflecting wellness and reablement in organisational policy and procedures, especially in
recruitment, employment, orientation and induction practices
• providing and encouraging staff training and education program
• changing the mindset for management, staff, volunteers, clients and their families and
carers
• establishing a staged approach to implementation and taking time to work with staff at
the beginning of the process to ensure they understand the benefits and reasons for
change.

1Wellness Approach to Community Home Care Information Booklet July 2008 produced by the Western
Australian Department of Health

December 2022 – 20
 • understanding your organisations maturity and readiness in terms of W&R is the first
step to embedding the change
• ensuring communication materials need to reflect the wellness and reablement approach
to assist with setting client and staff expectations.
Client scenarios — short-term wellness and reablement, and restorative interventions
DAVID
David is a 81 year old man who was referred to My Aged Care following a fall he had had two
weeks previously. Although he had sustained no specific injuries, David was pretty shaken up
from the fall and was now lacking in confidence to shower himself independently.
Following his initial screening process through the My Aged Care contact centre, David was
referred to the RAS for an assessment. The assessment identified that David was previously
independent and was motivated to regain his independence. The assessor also identified that
David was still independent in many daily activities but was struggling with his personal care.
Based on the RAS assessment, a support plan was developed with David, which identified his
goal of being able to maintain his personal care independently. The support plan provided
information on David’s strengths and abilities as well as his areas of difficulty and
recommendations to achieve his goals, including a referral to a CHSP service provider for an
occupational therapy assessment and the delivery of time limited personal care services.
The occupational therapist then worked with David and his personal carer to devise a plan to
achieve his goals. Initially personal care services were provided to David three times a week to
assist him with showering. Over a four week period, the CHSP service provider worked with
David to develop specific strategies such as how to step in and out of the shower safely, to help
him to build his capacity and regain confidence in showering. After four weeks of service David
was confident to shower independently again and the services were withdrawn.

BILL
Bill is a 75 year old man who lives at home with his wife Irene. Bill had not previously received
any aged care services since he and Irene had always enjoyed good health. Recently Bill had
an accident which had resulted in him spending time in hospital. Although Bill recovered well
from his accident, it had left him feeling anxious about leaving the house. Also, his hospital stay
and inactivity had reduced his physical fitness, preventing Bill from doing as much around the
house and garden as he had done before.
Bill’s wife Irene contacted My Aged Care and Bill was referred for a RAS assessment. Bill’s
assessor worked with him to identify the things that he liked to do and what he no longer felt
comfortable doing. A support plan was developed with Bill, which included some time limited
interventions with a restorative care focus, including:
• referral to physiotherapy or exercise physiologist (to develop a suitable strength, balance
and endurance program)
• referral to an occupational therapist (to identify energy conservation strategies and/or
suitable equipment to promote functional independence)
• referral for some time-limited home maintenance and domestic assistance.
Following this time-limited support, Bill now feels more confident living at home and has
regained much of his former capacity to undertake the home maintenance and domestic chores
that he used to do. Applying this short-term restorative care intervention approach enabled Bill
to regain his strength and confidence and prevented a possible longer term dependence on
ongoing support services.

2.5.2 Assessment and support planning

Assessment and support planning conducted by the My Aged Care RAS (or ACATs in some
circumstances) must also adopt a wellness and reablement approach to assessment.

December 2022 – 21
The role of the RAS is to work with the client to identify their needs and concerns, as well as
their goals and aspirations. A Home Support Assessment is conducted using the National
Screening and Assessment Form (NSAF) on My Aged Care and includes an assessment of a
client’s:
• current level of support (formal and informal) and engagement
• carer availability and sustainability
• health concerns and priorities
• functional status
• psychosocial and psychological concerns, and
• home and personal safety considerations.
The assessor then works with the client to develop a support plan which focuses the support
needed to assist them to achieve their goals. In developing a support plan with a client the RAS
will:
• focus on what a client can do and discuss what they need to complete more difficult
tasks.
• discuss strategies to manage day-to-day tasks (e.g. transport planning to meet goals
around the use of public transport to maintain usual activities).
• explore the client’s opportunity for supporting independence through wellness and
reablement approaches (e.g. can the client benefit from time-limited support and/or the
use of specific aids and equipment or home modifications such as installing shower rails
to build confidence and independence).
Developing a support plan with the client helps to ensure that it accurately reflects the client’s
needs and goals. This will increase the likelihood that the client will be motivated to work
towards the goals they have identified, including supporting their independence through
wellness and reablement approaches. The client’s support plan is saved to the client record on
My Aged Care and can be viewed by the client’s service provider.
In some circumstances, where the assessment has identified that a short-term intervention is
appropriate, the RAS assessor might take on a coordination role to ensure that all referrals in
the support plan are linked to one or more service providers and that they will all be delivered
within an agreed time frame.
For clients receiving wellness and reablement support, assessors should include review dates
on the client’s support plan to monitor the client’s progress towards their goals and desired
outcomes. The need for ongoing, or an adjustment in services will also be assessed. CHSP
service providers are required to provide time limited services in line with the support plan.

December 2022 – 22
Client scenario – wellness and reablement-focused assessment with support planning
CECELIA
Cecelia is an 81 year old woman who lives alone. Before experiencing a stroke earlier in the
year, Cecelia had been actively involved in her church and local community. However, following
the stroke, Cecelia stopped going out on her own, fearing that her poor balance could result in a
fall. Within her house she had also cut down on the heavier housekeeping tasks like vacuuming,
large cleaning jobs, laundry and gardening.
Cecelia was referred to My Aged Care by her doctor and following the initial registration
process, a RAS assessment was organised. Cecelia’s assessment helped to identify her
strengths and capabilities as well as her needs. The resulting support plan was centred around
Cecelia’s own goals which included getting stronger, resuming her church activities, doing more
about the house and getting back out in the garden. Cecelia’s support plan included:
• referral to an allied health professional to assist with her goal of getting stronger,
• referral to a CHSP domestic assistance service provider to provide assistance with the
more difficult household chores and to help Cecelia to identify which chores she could still
manage to do on her own,
• assistance to identify and make contact with a pastoral care team member to discuss
her continued interest in participating in church activities, and
• referral to a home maintenance service for discussion and planning to convert her
garden to be safer and more accessible, and lower maintenance.
After mastering basic strength and balance exercises through a home exercise program
designed by the allied health professional, Cecelia was eventually able to walk unaided inside
her home. A more confident Cecelia then arranged a ‘buddy’ to drive her to and from church
activities. At the same time, the CHSP domestic assistance service provider worked with
Cecelia to assist her to take on some of the easier housekeeping chores enabling her to remain
more active and independent. Cecelia was also delighted to find that the new raised garden
beds enabled her to access and maintain her garden more safely without affecting her
enjoyment of the garden.

2.5.3 Reporting requirements

CHSP providers are required to submit a wellness and reablement report to the Department
annually outlining their progress in implementing a wellness and reablement approach within
their organisation.
The latest wellness and reablement report, was undertaken in 2022 with the aim of building
understanding and identifying areas that the Department and CHSP providers can focus on to
further imbed wellness and reablement practices.
More information on service provider reporting requirements is provided under Section 6.3.4 of
this manual.

December 2022 – 23
Chapter 3 – Sub-Programs: Eligibility and Services
3.1 Program framework – Commonwealth Home Support Programme
The CHSP program framework includes four distinct sub-programs based on the CHSP’s target
groups as outlined in Section 1.2.9 of this manual:
• Community and Home Support
• Care Relationships and Carer Support
• Assistance with Care and Housing – Hoarding and Squalor, and
• Sector Support and Development.
Each sub-program has its own objective, eligibility criteria and service types.
Under the CHSP Grant Agreement, service providers may receive funding to deliver specific
activities under one or a combination of service types under each sub-program. Details on these
funding arrangements are set out in Chapter 6 of this manual.
The Program Framework of the CHSP, including its sub-programs is provided in the table
below. Details of each sub-program are provided under Section 3.2.
Client scenario – supporting frail older people across sub-programs
MABEL
Mabel is 82 years old and lives alone. Her daughter Claire is her primary carer, and visits most
days to help her mother with a range of activities, including shopping, cooking and cleaning.
Mabel has been diagnosed with macular degeneration and is losing her vision. She no longer
drives and is finding it increasingly difficult to access activities and services in her community
without Claire’s help. However, Claire has a young family of her own and has limited availability.
Mabel wants to remain as independent as possible. She and Claire call My Aged Care together
to see what support is available.
Screening undertaken by the contact centre identifies that Mabel would benefit from a RAS
assessment. Mabel is also provided with information on how to arrange a specialist assessment
and a mobility and orientation instructor to help her manage the functional impacts of her vision
loss.
The RAS assessor discusses Mabel’s care needs with Mabel and Claire and develops a
support plan to assist in meeting her goals, which includes:
• referral to CHSP-funded specialised support services for advice on living independently
with vision loss
• weekly community transport to services and activities in her community, and
• flexible respite services to support Mabel when Claire is unavailable, including a two
week period when Claire will be on holiday later in the year.
The community transport provider sends drivers who have experience with vision-loss clients.
Ultimately, the support provided to Mabel addresses the challenges facing her, helping her to
retain as much independence as possible, while supporting the sustainability of her carer
relationship with her daughter.

December 2022 – 24
Program Framework – Commonwealth Home Support Programme
Sub- Community and Care Relationships Assistance with Sector Support and
Program Home Support and Carer Support Care and Housing Development

Objective To provide entry- To support and To support those To support CHSP

level support maintain care who are at risk of service providers
services to assist relationships between homelessness or through reforms to
frail older people to carers and clients, unable to access the the CHSP, in
live independently at through providing supports they need preparation for a new
home and in the good quality respite as a result of living in-home aged care
community care for frail older with hoarding system, and to
people so that carers behaviour or living in operate effectively in
can take a break a squalid line with the
environment objectives of the
CHSP and within the
context of the
broader aged care
system.
Frail older clients aged
Target Frail older people Frail older people or CHSP service
65 years and over (or
Group aged 65 years and prematurely aged1 providers, excluding
50 years and over for
over (or 50 years who meet each of the provider
Aboriginal and Torres
and over for the following three delivering the SSD
Strait Islander people)
Aboriginal and criteria: service, and aged
will be the recipients
Torres Strait care consumers
of planned respite 1. On a low income 2.
Islander people) seeking assistance
services 2. Living with
who need navigating aged
hoarding behaviour
assistance with daily care.
and/or in a squalid
living to remain
living environment.
living independently
3. At risk of
at home and in the
homelessness
community
and/or unable to
receive the aged
care services they
need.

Service o Allied Health and Centre-based ACH – Hoarding and Sector Support and
types / Therapy Services respite: Squalor Development
activities o Domestic o Centre based day
funded respite
Assistance
o Goods, o Residential day
Equipment and respite
Assistive o Community
Technology access-group
o Home respite
Maintenance Cottage respite:
o Home o Overnight
Modifications community
o Meals
Flexible Respite:
o Nursing
o In-home day
o Other Food respite
Services
o In-home overnight
o Personal Care respite
o Social Support- o Community
Individual access – individual
respite

2 See Section 1.2.9, 3.3.3 and/or Glossary

December 2022 – 25
Sub- Community and Care Relationships Assistance with Sector Support and
Program Home Support and Carer Support Care and Housing Development
o Social Support- o Host family day
Group respite
o Specialised o Host family
Support overnight respite
Services o Mobile respite
o Transport o Other planned
respite.
CHSP providers can refer to the CHSP service catalogue on the Department of Health and
Aged Care website.

3.2 2022-23 CHSP national unit price ranges

The CHSP national unit prices will assist CHSP providers transition to payment in arrears and
prepare for future in-home aged care reforms.
The unit price ranges are broadly in line with historical funding and in many cases consistent
with unit costs of other government funded programs (for standard weekday delivery during
business hours).
These ranges were developed after thorough assessment of unit price information, examining
comparable pricing approaches for other programs, and considering market implications of
funding design.
Assistance with Care and Housing (ACH), GEAT and Home Modifications do not have national
unit price ranges:
• ACH advocacy and assessment services will transition to the care finder program from 1
January 2023. Hoarding and Squalor continues to be funded through the CHSP.
• Home Modifications continues to deliver services based on the cost in dollars and
remains capped at $10,000 (per client per financial year).
• GEAT continues with the output measure of cost in dollars and quantity of items
(purchased or loaned), noting the cap of $1,000 applies per client per year. GEAT
providers need to report the hours of Allied Health and Therapy services associated with
complex GEAT in DEX.
It is important to note these ranges do not include a reasonable client contribution over
and above funding from the Australian Government. CHSP service providers should
implement their own client contribution policy, with a view that clients who can afford to
contribute to the cost of their care should do so.Client contribution arrangements
Charging clients a CHSP fee is determined by CHSP providers as part of their business
operations, and all providers are required to have a Client Contribution arrangement.
There is no formal means testing for CHSP fee charging and CHSP providers need to consider
a range of factors, such as what are the business cost drivers and socio-economic
circumstances of their CHSP clients, when determining their fee schedule. This means that
CHSP fee charging arrangements vary across the country and from client to client. Depending
on where they live, two clients of a similar age with similar support needs may have to pay a
different fee for the exact same service.

For some services in some areas, clients are not currently asked to contribute anything to the
cost of their service, which places increased pressure on the service provider’s ability to
sustainably meet the needs of their local community.
A CHSP reasonable client contribution range for each service type is below. These ranges were
developed along with the unit prices and have been provided as a guide to assist CHSP
providers to implement or review their client contribution policy.

December 2022 – 26
Please note that these reasonable client contribution ranges are provided as a guide and may
not be suitable for all client contribution policies. CHSP providers will still need to follow the
guidance under Chapter 5 – Client contribution framework.
Modified Monash Model (MMM) loadings
If a CHSP service provider delivers the majority of services (51% or more) in a MMM 6 or 7,
they may be able to request a loading of up to 40% be applied to their unit price for a particular
service type. Please note that changes to a service type unit price through an MMM loading will
result in a reduction of outputs for that service type.
2022-23 CHSP national unit prices ranges and client contributions
2022-23 CHSP
CHSP reasonable
CHSP Service Type Output Measure National Unit Price
client contribution
Ranges
Allied Health and Therapy Services Hour $95-$125 $5-15
Centre-based Respite Hour $27-$51 $2-4
Cottage Respite Hour $28-$53 $2-6
Domestic Assistance Hour $48-$61 $6-12
Flexible Respite Hour $51-$67 $4-8
Home Maintenance Hour $53-$75 $8-20
Meals Meal $7.50-$13 $4-12
Nursing Hour $104-$129 $4-10
Other Food Services Hour $25-$41 $6-15
Personal Care Hour $51-$68 $6-12
Social Support Group Hour $17-$27 $2-4
Social Support Individual Hour $39-$60 $4-8
Specialised Support Services Hour $76-$118 $3-12
Transport One-way trip $18-$36 $2-12
Source: ACIL Allen Consulting

3.3 CHSP Sub-Programs – objectives, target populations, eligibility and

services
3.3.1 Community and Home Support Sub-Program
Objective
To provide entry-level support services to frail older people to assist them to live independently
at home and in the community.
Target population
Frail older people aged 65 years and over (or 50 years and over for Aboriginal and Torres Strait
Islander people) who need assistance with daily living to remain living independently at home
and in the community.
Eligibility
Frail older person who:
• is aged 65 years and over (or 50 years and over for Aboriginal and Torres Strait Islander
people), and
• has difficulty performing activities of daily living without help due to functional limitations
(including cognitive), for example communication, social interaction, mobility or self-
care), and
• lives in the community.

December 2022 – 27
Details about the service types provided under this sub-program are provided in the following
tables, including service type definitions, service sub-types, service settings and out-of-scope
activities.

Service type: Allied Health and Therapy Services

Objective Allied Health and Therapy Services - To provide services

that restore, improve or maintain frail older people’s health,
wellbeing and independence including time limited services
to support wellness and reablement goals.

Service type description Allied health and therapy services focus on restoring, improving, or
maintaining older people’s independent functioning and wellbeing.
This is done through a range of clinical interventions, expertise,
care and treatment, education including techniques for self-
management, technologies including telehealth technology, advice
and supervision to improve people’s capacity.
These services assist older people to regain or maintain physical,
functional and cognitive abilities which support them to maintain or
recover a level of independence, allowing them to remain living in
the community. Non-clinical services, including some diversional
and preventative therapies, may be provided to clients under this
service type, however, these must be complementary supports for
the client and not delivered in isolation from the focus of this
service delivery.
Allied Health and Therapy Services funded under the CHSP
include (but are not limited to):
• Aboriginal and Torres Strait Islander Health worker
• diversional therapy
• exercise physiology
• formal counselling from a qualified social worker or
psychologist
• hydrotherapy
• nutritional advice from an Accredited Practising Dietitian or a
qualified nutritionist
• occupational therapy
• other allied health and therapy services
• physiotherapy
• podiatry
• social work
• speech pathology
This list of services is not exclusive and service providers are not
expected to provide all the activities listed.
There are two models of service provision for this service type
available depending on intensity. These are additional service sub-
types to those listed above.
Service providers must indicate which (or both) of the models they
are able to deliver, and which specific allied health or therapy they
will provide under that model.
It is anticipated that service providers will be able to deliver both
models.
1) Ongoing Allied Health and Therapy services
Service providers can deliver one or more of the services in the list
above (exactly which services are delivered by the provider will
need to be identified). These services are of an ongoing or
intermittent nature, are delivered on an individual or group basis
and provided at a low intensity or frequency, with a maintenance or

December 2022 – 28
Objective Allied Health and Therapy Services - To provide services
that restore, improve or maintain frail older people’s health,
wellbeing and independence including time limited services
to support wellness and reablement goals.
preventative focus, for example regular podiatry for a client with
diabetes and group exercise classes.
2) Restorative Care services
Service providers can deliver a time-limited, allied-health led
approach to service delivery that focuses on older clients who can
make a functional gain after a setback. These may be one to one
or group services that are delivered on a short-term basis which
are delivered by, or under the guidance of an allied health
professional.
Their goal will to be to increase the independence of clients. They
will target people who can make a functional gain after a setback,
who are at risk of a preventable injury, or who need other allied
health led services to maintain independence.
In implementing restorative care services, service providers must:
• Conduct an initial assessment of the client to establish a
baseline from which progress or maintenance of function can
be evaluated. This assessment must identify goals and must
include the development of an individual plan for each client.
• Use measurable, objective, quantitative and qualitative
indicators and record results associated with therapeutic goals
or desired outcomes which include the client‘s functional
ability: on entry, at review and at discharge.
• Complete an outcome assessment documenting achievement
or progress made against identified client goals prior to
discharge for each client.

Out-of-scope activities under this Specialist post-acute care and rehabilitation services are out-of-
service type scope and must not be purchased using CHSP funding.

Service delivery setting e.g. Services may be delivered in a client’s home, a clinic, at a day
home/centre/clinic/community centre, a group environment or other community setting.

Legislation Service providers must adhere to any relevant Commonwealth

and/or state/territory legislation or regulations.

Output measure Time (recorded in hours and minutes as appropriate).

Type of care (identify which model/s will be delivered i.e. Ongoing
Allied Health and Therapy Services and/or Restorative Care
Services).

Staff qualifications Allied health providers must meet their respective accreditation and
registration requirements and operate within the scope of practice
of their particular regulated or self-regulated body. For example,
speech pathologists funded under the CHSP must hold the Speech
Pathology Australia Certified Practising Speech Pathologist
credential.
Depending on the respective accreditation and registration
requirements, this may permit activities being undertaken by
assistant allied health professionals or less qualified staff.

Fees Client contribution amount recorded in the Data Exchange (in Fees
field).

December 2022 – 29
Service type: Domestic Assistance

Objective Domestic Assistance - To provide frail older people with

assistance with domestic chores to maintain their capacity to
manage everyday activities in a safe, secure and healthy
home environment including time limited services to support
wellness and reablement goals.

Service type description Domestic Assistance is normally provided in the home and refers
to:
• general house cleaning
• linen services
• unaccompanied shopping (delivered to home)
It can include:
• bill paying (unaccompanied)
• clothes washing and ironing
• collection of firewood (in remote areas)
• dishwashing
• help with meal preparation (where this is not the primary focus
of service delivery)
• house cleaning
• shopping (unaccompanied)
• washing of household linen or provision and laundering of
linen, usually by a separate laundry facility.
Domestic Assistance services may also include demonstrating and
encouraging the use of techniques or specific aids and equipment
to improve the person’s capacity for self-management, build
confidence and support client participation where appropriate.

Out-of-scope activities under this The level and frequency of Domestic Assistance services delivered
service type to a client must directly relate to ensuring client safety in the home.
CHSP service providers do not give financial advice or offer to
assist with managing a person’s finances.
Accompanied shopping, bill paying and attendance at
appointments are not included under Domestic Assistance but are
included under Social Support Individual.
Domestic assistance providers are not expected to move or re-
arrange heavy furniture or items that may put them at risk of injury
or harm.

Service delivery setting e.g. Normally provided in the home, however in special situations
home/centre/clinic/community domestic assistance may be delivered at a centre because it is not
feasible to deliver the service in the client’s home.
For example, a day centre may provide washing facilities so that
domestic assistance can be delivered to an individual client.

Legislation Service providers must comply with relevant Commonwealth and/or

state/territory legislation and regulations, for example relating to
safe food handling and laundering practices.

Output measure Time (recorded in hours and minutes as appropriate).

Staff qualifications Where additional services are performed, such as personal care, in
conjunction with domestic assistance, requirements relating to that
additional service apply.

Fees Client contribution amount recorded in the Data Exchange (in Fees
field).

December 2022 – 30
Service type: Goods, Equipment and Assistive Technology

Objective Goods, Equipment and Assistive Technology - To provide

access to goods, equipment or assistive technology which
enables the client to perform tasks they would otherwise be
unable to do or promote the older person’s safety and
independence including time limited services to support
wellness and reablement goals.

Service type description Goods, equipment and assistive technology are provided to assist
a client to cope with a functional limitation and maintain their
independence. Items include those that provide short-term and
ongoing support and assist with mobility, communication, reading
and personal care. These can be provided through loan or
purchase.
Older people may need a range of items, from smaller inexpensive
‘off the shelf’ items to customised equipment and technology
which requires assessment and prescription by professionals with
specialised skills and knowledge.
Goods, equipment and assistive technologies that can be
purchased under the CHSP fall under the following service sub-
types:
• car modifications
• communication aids
• medical care aids
• other goods and equipment
• personal monitoring**
• reading aids
• self-care aids
• support and mobility aids (including contributing towards the
cost of mobility scooters and vehicle modifications)
and include a wide range of items such as:
• adapted utensils
• assistive technologies such as robotic vacuum cleaners
• dressing aids
• low vision aids such as binoculars, electronic magnifiers and
magnifying/reading software.
• over-toilet frames
• sensor mats
• shower chairs
• walking frames
Generally, clients who are unable to purchase the item/s
independently will be able to access up to $1,000 in total support
per financial year under this service type.
This cap applies in total per client, regardless of how many items
are loaned or purchased, and includes any delivery/installation
costs. It is not a cap applied per item. For example, a client may
purchase or lease a walking frame and shower chair in the same
financial year as long as the total cost for all items is not greater
than the maximum annual cap.
HCP recipients will be able to access up to $2,500 in total support
per financial year for urgent GEAT (See Chapter 4). It is not a cap

December 2022 – 31
Objective Goods, Equipment and Assistive Technology - To provide
access to goods, equipment or assistive technology which
enables the client to perform tasks they would otherwise be
unable to do or promote the older person’s safety and
independence including time limited services to support
wellness and reablement goals.
applied per item. The HCP recipient will be required to pay any
additional cost above this cap using private funds.
Where a provider determines it is necessary, a client may be
referred to an allied health professional e.g., occupational therapist
or physiotherapist for an assessment for items where professional
advice is needed to ensure they are installed and used correctly
e.g., body system monitors and personal alarms.
CHSP GEAT providers may also use grant funds to purchase an
allied health assessment for their clients.
Note: that these funding caps also apply where funds are used to
contribute to the purchase of higher cost items such as mobility
scooters and vehicle modifications
Note: Service providers must record the amount spent in the
‘Notes’ section of the My Aged Care central client record.
Note: while some CHSP service providers deliver occupational
therapy and other allied health professional assessments, GEAT
providers may also purchase assessment services privately from
other organisations that do not receive funding through the CHSP.
Any allied health professional assessments delivered or
purchased must be reported in the Data Exchange.
Out-of-scope activities under this • Items that are not related to the functional impairment (e.g.,
service type general household or furniture or appliances)
• Items that are likely to cause harm to the participant or pose a
risk to others.

Service delivery setting e.g. Varied settings.

home/centre/clinic/community

Use of funds including any target When recording the total cost in dollars for GEAT, CHSP providers
areas should ensure the total cost includes the item cost and any other
charges (if applicable) ie service fee, delivery, and installation.
Service providers can use goods, equipment and assistive
technology funds to provide services that may be necessary to
providing equipment for a client, such as specialised assessment
for goods and equipment, providing training or support using the
item, and maintaining or repairing the item.
These hours must be reported as Allied Health and Therapy
Services hours if they were delivered by an Allied Health
professional.
A client should only be referred for complex goods, equipment and
assistive technology following an assessment by a qualified allied
health professional. Service providers may purchase allied health
professional assessments for clients requiring complex goods and
equipment, for example where home installation is required.
**Personal alarms are becoming increasingly popular to prescribe
to older Australians. Whilst for many clients an alarm is an
appropriate device, this is not always the case.
Personal alarms should only be ordered at the request of the
client.
Research shows that personal alarms are most suitable for
seniors who:

December 2022 – 32
Objective Goods, Equipment and Assistive Technology - To provide
access to goods, equipment or assistive technology which
enables the client to perform tasks they would otherwise be
unable to do or promote the older person’s safety and
independence including time limited services to support
wellness and reablement goals.
• have had a recent fall or are at risk of a fall, or recent illness
• have limited or no family/friends to check in on their
wellbeing
• have a medical condition that increases the risk of requiring
immediate assistance
Research has also highlighted the importance of follow-up with the
client to set up the alarm, provide instruction and encouragement
on use, and to identify any issues that arise following provision.
This will help to reduce abandonment of the alarms.
Clients with cognitive impairment or complex needs should be
referred for an assessment by an allied health professional such
as an occupational therapist for the most appropriate alarm
options according to the clients specific needs and capabilities.

Specific funding advice The CHSP is not designed to replace existing state managed
schemes which provide medical aids and equipment (e.g., Medical
Aids Subsidy Scheme).
CHSP service providers are encouraged to access these state and
territory aids and equipment and personal alarm programs, where
appropriate.
Where a local CHSP GEAT provider is unable to meet a client’s
need, referrals can be made to national GEAT provider
GEAT2GO.
Note: to ensure funding is accessible throughout the year,
GEAT2GO will reduce access to their service when maximum
number of orders is reached each month. GEAT2GO will re-open
at the beginning of each month and prescribers will be able to
submit their ‘draft’ saved orders.
Service providers may seek advice from GEAT2GO, or their state
or territory Independent Living Centre for independent information
on the types of equipment available, and which equipment best
meets the client’s needs.

Legislation Service providers must comply with relevant Commonwealth

and/or state/territory legislation and regulations.

Output measure Quantity – number of items purchased or loaned

Cost in dollars – of the amount service provider spent (noting the
cap of $1,000 applies per client per year). Cost is total amount for
ALL items per client.
Notes: Both fields are mandatory and must be reported.
Hours of Allied Health and Therapy Services delivered must be
recorded separately in the Data Exchange if applicable.

Staff qualifications Training for clients in the use of goods, equipment and assistive
technology should be provided by qualified health professionals
with appropriate knowledge and skills. For example, speech
pathology assessment is required to assess clients for
communication aids and equipment.

Fees Client contribution amount recorded in the Data Exchange (in

Fees field).

December 2022 – 33
Service type: Home Maintenance

Objective Home Maintenance - To provide home maintenance

services that assist clients to maintain their home in a safe
and habitable condition. Maintenance services provided
must be linked to assisting clients to maintain their
independence, safety, accessibility and health and wellbeing
within the home environment. Maintenance services can
also assist in creating a home environment that facilitates a
client’s wellness and reablement goals.

Service type description Home maintenance services provided to clients must focus on
repairs or maintenance of the home and garden to improve safety,
accessibility and independence within the home environment for
the client, by minimising environmental health and safety hazards.
This includes home and yard maintenance and repairs that
mitigate or remove identified risks to a client’s health and safety
and/or services targeted at maintaining a home environment which
supports a client’s wellness and reablement goals.
Services refer to:
• garden maintenance
• major home maintenance and repairs
• minor home maintenance and repairs
A RAS assessment is important for developing initial home and
yard maintenance plans.
Activities funded can include a range of maintenance or repair
tasks such as:
• Accessible, low maintenance garden redesign to support
wellness and reablement goals
• Minor plumbing, electrical & carpentry repairs where client
safety is an issue
• Repair of internal flooring and external access pathways to
address slip and trip hazards
• Secure access issues for clients’ personal safety
• Working-at-height related repairs or cleaning for client health
and safety i.e. gutters, roofs, windows, ceilings, smoke alarms
• Yard maintenance – essential pruning, yard clearance or lawn
mowing where there are issues for client safety and access.*
* The provision and frequency of on-going home maintenance
services (lawn mowing and garden pruning) must directly relate
to assessed client need in terms of maintaining accessibility,
safety, independence or health and wellbeing and be subject to
regular review. Consideration may be given to adjustments in
frequency with respect to seasonal changes (e.g., mowing less
often in winter than summer) as long as the client’s safety and
accessibility is maintained. These are basic services primarily for
function and safety rather than for aesthetic effect.

Out-of-scope activities under this Yard maintenance and gardening services must directly relate to
service type ensuring client safety, rather than maintaining a garden’s visual
appeal or aesthetic value. Extensive gardening services – planting
and maintaining crops, natives and ornamental plants; the
installation, maintenance and removal of garden beds, compost
heaps, watering systems, water features and rock gardens; and
landscaping are outside the scope of this service type.

December 2022 – 34
Objective Home Maintenance - To provide home maintenance
services that assist clients to maintain their home in a safe
and habitable condition. Maintenance services provided
must be linked to assisting clients to maintain their
independence, safety, accessibility and health and wellbeing
within the home environment. Maintenance services can
also assist in creating a home environment that facilitates a
client’s wellness and reablement goals.
General renovations of the home must not be purchased using
CHSP funding.
The program does not provide services that are the responsibility
of other parties e.g. private rental landlords, government housing,
Local Government Authorities or where damage to a property is
covered by insurance.

Service delivery setting e.g. The client’s home and/or yard where the client holds responsibility
home/centre/clinic/community for the maintenance or repair of same.
Note: Services will not be delivered where another entity holds
responsibility for maintenance or repair to the home; similar
Government support is already provided or where it is a state or
territory government responsibility to provide this type of support
e.g. clients living in social housing would receive home
maintenance and repair support through their state or territory
government but may still hold responsibility for the
maintenance of their yard.

Legislation Service providers must comply with relevant Commonwealth

and/or state/territory legislation and local Council Authority
regulations e.g. where the work is undertaken by licensed or
registered tradespeople.

Output measure Time – the total number of hours and minutes (as appropriate).
Cost in dollars - the total amount based on time spent.
Notes: Both fields are mandatory and must be reported.

Staff qualifications Service providers must adhere to any legislative or regulatory

requirements where the work is undertaken by licensed or
registered tradespeople.

Fees Client contribution amount recorded in the Data Exchange (in

Fees field).

December 2022 – 35
Service type: Home Modifications

Objective Home Modifications - To provide home modifications that

increase or maintain levels of independence, safety,
accessibility and wellbeing. Modification services can also
assist in creating a home environment that supports wellness
and reablement and restorative practices.

Service type description Services are provided to assist eligible clients with the organisation
and cost of simple home modifications and where clinically
justified, more complex modifications.
Home modifications provide changes to a client’s home that may
include structural changes to increase or maintain the person’s
functional independence so that they can continue to live and move
safely about the house.
Examples of home modification activities could include:
• access and egress pathways through a property
• appropriate lever tap sets or lever door handles
• grab rails in the shower
• client engagement and support
• installation and fitting of emergency alarms and other safety
aids and assistive technology
• internal and external handrails next
• ramps (permanent and temporary)
• lifts (noting CHSP providers can only contribute up to $10,000
per client per financial year, with the client covering the
remaining costs)
• step modifications
In some clinically justified circumstances home modifications could
also include:
• bathroom redesign (e.g. lowering or removal of shower hobs,
changes to design lay out to improve accessibility)
• kitchen redesign (e.g. lowering kitchen bench tops, changes to
design layout to improve accessibility)
• widening doorways and passages (e.g. to allow wheelchair
access).
Home modifications are provided to improve safety and
accessibility and independence within the home environment for
the client. Simple modifications can be installed by the service
provider, in line with the Building Code of Australia and in
compliance with state and territory building regulations and include:
• hand-held showers, sliding shower rails
• removal of shower screens/doors – installation of weighted
shower curtains
• doorway wedges <35 mm rise
• slip resistant flooring/step treatments including highlighter
strips
• lowering or removal of shower hobs
• lever taps and door handles
• repositioning of clotheslines, letterboxes
• widening of pathways.

December 2022 – 36
Objective Home Modifications - To provide home modifications that
increase or maintain levels of independence, safety,
accessibility and wellbeing. Modification services can also
assist in creating a home environment that supports wellness
and reablement and restorative practices.

More complex home modifications require a specialised functional

assessment of the client to be undertaken by an Occupational
Therapist who will assess the need for home modification, as well
as consider alternative solutions that may be more suitable (for
example assistive technology and equipment). Home Modification
providers may use grant funds to purchase occupational therapy
assessments for their clients to help determine their specific care
needs and requirements. Any occupational therapy assessments
purchased or delivered must be reported on the Data Exchange.
The intent of the CHSP is to primarily fund simple home
modifications for wellness and safety purposes (i.e. modifications
that would incur a cost of less than $1,000 to the Commonwealth).
The Commonwealth contribution to the cost of a complex
modification is capped at $10,000 and applies per client per
financial year. Any cost over the cap must be borne by the client.
Out-of-scope activities under this General renovations of the home and Capital Works are not in the
service type scope of the CHSP.

Service delivery setting e.g. Client’s home.

home/centre/clinic/community
Note: Services will not be delivered where another entity holds
responsibility for structural changes to the home; similar
Government support is already provided through other programs or
where it is a state or territory government responsibility to provide
this type of support (e.g. clients living in social housing would
receive home modification support through their state or territory
government).
It is the responsibility of the client to investigate and gain any
permission necessary before modifications are undertaken, for
example permission to modify a private property the client is
renting, strata scheme permission or local council authority where
applicable.
Support to the client to undertake this process may form part of the
project management activities undertaken by a service provider.

Use of funds including any target Funds must be targeted towards lower cost modifications that meet
areas client needs. Any complex modification that would incur a cost over
the Commonwealth’s capped contribution of $10,000 must be
borne by the client.
Service providers can use their home modification funds flexibly to
obtain appropriate services for clients where clinically justifiable to
increase independence within the home.
Service providers may purchase Occupational Therapy
assessments for clients requiring complex home modifications that
may be prescribed through the Occupational Therapy assessment.

Specific funding advice Funding can be used to cover both the labour costs and the
materials cost or only some part of this, for example the initial work
including measurement of the home, planning processes and for
project management of the modification.

Legislation Service providers must comply with relevant Commonwealth

and/or state/territory legislation and Local Government Authority

December 2022 – 37
 Objective Home Modifications - To provide home modifications that
increase or maintain levels of independence, safety,
accessibility and wellbeing. Modification services can also
assist in creating a home environment that supports wellness
and reablement and restorative practices.
regulations and Building Code of Australia. This includes holding
appropriate licences and insurances, where required.
For example, service providers are required to be aware of their
obligations to comply with state and territory-based laws and
regulations relevant to the safe handling and removal of asbestos
when undertaking home modifications in the homes of clients.

Output measure Cost in dollars.

Types of modification - activity provided, including any
Occupational Therapy assessments funded through this service
type.
Notes: Both fields are mandatory and must be reported.
Service providers must also record the amount spent in the ‘Notes’
section of the My Aged Care central client record.
Hours of Allied Health and Therapy Services delivered as part of
the overall service to the client by an allied health professional
must be reported in the Data Exchange under Home Modifications,
and the activity included in the description of activities provided.

Staff qualifications Providers must comply with Commonwealth and state and territory
legislation regarding who can undertake home modifications.

Fees Client contribution amount recorded in the Data Exchange (in Fees
field).

Service type: Meals

Objective Meals - To provide frail older people with access to meals.

Service type description This service type refers to:

• meals prepared and delivered to the client’s home
• meals prepared in distribution centres (‘meal hubs’) for other
CHSP meals service providers
• meals provided at a centre or other setting.
Providing meals to frail older people at home, a centre or in
another setting may deliver a range of benefits. These include
informal health monitoring of clients and supporting social
participation e.g. time spent with the older person when delivering
the meal and social interactions enjoyed by the older person at a
centre or other setting.
The term ‘Meals’ recognises and includes all varieties of service
models in operation, including the provision of main meals such as
two and three course lunches and dinners and complementary
meal options such as breakfast and snack packs.
The carers of frail older people accessing CHSP meal services
may receive a meal provided at a centre or other setting where
they are accompanying those clients where required.

Out-of-scope activities under this This service type does not include meals prepared in the client's
service type home.
(i.e. must not be purchased using This service does not include meals to carers when meals are
CHSP funding) delivered to the client’s home.

December 2022 – 38
Objective Meals - To provide frail older people with access to meals.

Service delivery setting e.g. Delivered to the client’s home or another CHSP service provider to
home/centre/clinic/community distribute to CHSP clients or provided at a centre or other setting.
Centres may include but are not limited to Senior Citizen Centres
and other community-based venues.

Use of funds including any target For meals delivered to the client at home, funds must assist in
areas paying for the production and distribution of the meal. Funding for
meals at a centre or other setting must assist in paying for the
production of the meal.
Funding may be used to access dietetic advice from an Accredited
Practising Dietitian where required.
Because social security payments provide for the cost of living of
recipients it is expected that the cost of the ingredients of the meal
will be covered by the client (through their personal income,
pension etc.).

Legislation Service providers must comply with relevant Commonwealth

and/or state/territory legislation and regulations, for example
relevant state and territory safe food handling practices.

Output measure Number of meals provided. Meals provided to a carer

accompanying the client at a centre should be counted separately.
If meals are provided as part of the main service being delivered
(e.g. meals provided as part of a Centre Based Respite or Social
Support – Group social excursion) this should not be counted or
reported separately within the Data Exchange. If the service
provider receives separate funding to deliver both Meals and
Social Support – Group and/or Centre Based Respite, any meals
delivered as part of the group or respite activity must be reported
under that service type within the Data Exchange and not
separately as an output under the Meals service type.
Where a provider delivers for example, a two-course meal (e.g. a
main and dessert) this would be considered as one meal. Similarly,
if a provider delivered a larger portion to a client, but it was still
intended to be a part of the same meal, for reporting purposes, this
would also be counted as one meal.
By contrast, if a provider delivered dinners intended for two meals
across the week, this would be considered two meals.
Providers receiving meals via a meals distribution centre (meals
hub) must report within the Data Exchange when the meal is
delivered to the client.
The meals hub provider must not report any meals within the Data
Exchange, unless the meal is provided directly to the client.

Staff qualifications All paid staff and volunteers involved in preparation and handling
of food must adhere to safe food handling practices including
personal hygiene and cleanliness and must be provided with
information regarding safe food handling as it relates to their
activities.

Fees Client contribution amount recorded in the Data Exchange (in Fees
field).

December 2022 – 39
Service type: Nursing

Objective Nursing - To provide short-term or intermittent treatment and

monitoring of medically diagnosed clinical conditions to
support frail older people to remain living at home.

Service type description Nursing care is the clinical care provided by a registered or
enrolled nurse. This care is directed to treatment and monitoring of
medically diagnosed clinical conditions and can include use of
telehealth technologies to support nursing care and recording
client observations. Nursing services can include wound care.
Nursing services also play a role in education of clients in
maintenance of good health practices and the delivery of
treatments and care that improve a client’s capacity to self-
manage.
Nursing care includes and allows the delegation of nursing-related
tasks to other workers, including personal care workers. Where
nursing tasks are delegated to a personal care worker and the
service provider does not have personal care workers on staff, the
provider should contact My Aged Care to facilitate the client’s
access to that support.
CHSP nursing services are not intended to replace or fund support
services more appropriately provided under another system, such
as the health system or palliative care services.

Out-of-scope activities under this Palliative care and nursing services that would otherwise be
service type undertaken by the health system are not funded under the CHSP.
These (complementary) services are considered out-of-scope
because government funding is already provided for them through
other government programs. For example, where only post-acute
care is required, this is considered out-of-scope for the CHSP.
However, a client can receive non-health related CHSP services in
conjunction with post-acute services, for example following a
hospital stay, noting that clients should access appropriate
community nursing services following a hospital stay in the first
instance. After this, support services must be reviewed to
determine whether the client’s current needs are being met.

Service delivery setting e.g. Nursing care can be delivered in the client’s home, a centre, clinic
home/centre/clinic/community or other location. It is expected they will be primarily delivered in
the client’s home.

Legislation Service providers must comply with relevant Commonwealth

and/or state/territory legislation and regulations.

Output measure Time (recorded in hours and minutes as appropriate). Where

nursing is provided, including training of a personal care worker to
undertake delegated tasks, this should be recorded as nursing
hours. Where personal care tasks are provided this should be
recorded as personal care hours.

Staff qualifications Nursing care must be provided by a Registered Nurse or an

Enrolled Nurse. Nursing-related tasks may be overseen by a
Registered Nurse or Enrolled Nurse. Nursing care allows the
delegation of nursing-related tasks to other workers, including
personal care workers.

Fees Client contribution amount recorded in the Data Exchange (in Fees
field).

December 2022 – 40
Service type: Other Food Services

Objective Other Food Services - To educate, train and re-skill frail older
people in preparing and cooking a meal in their own home to
promote their independence supporting their wellness and
reablement goals.

Service type description Other Food Services refers to:

• assistance with preparing and cooking a meal in a client’s
home to promote knowledge, skills, independence, confidence
and safety
• advice on food including food preparation and nutrition,
lessons, training and food storage and safety.

Out-of-scope activities under this This does not cover the delivery of a meal prepared elsewhere or
service type providing shopping services for clients.

Service delivery setting e.g. The client’s home is the primary setting. Some group-based
home/centre/clinic/community education activities, however, may occur at centres such as
education classes about nutrition.

Use of funds including any target Funding must be used for activities that directly involve the client
areas and promote their independence through education and re-skilling
activities.

Legislation Service providers must comply with relevant Commonwealth

and/or state/territory legislation and regulations, for example safe
food handling practices.

Output measure Time (recorded in hours and minutes as appropriate).

Staff qualifications All paid staff and volunteers involved in the preparation and
handling of food must be provided with information regarding safe
food handling as it relates to their activities. Service providers are
required to comply with state and territory-based references and
guidelines relevant to safe food handling practices.
When advice on nutrition is required, it must be provided by an
Accredited Practising Dietitian, a Certificate IV Nutrition and
Dietetics Assistant under the guidance of an Accredited Practising
Dietitian, or a qualified nutritionist.

Fees Client contribution amount recorded in the Data Exchange (in Fees
field).

Service type: Personal Care

Objective Personal Care - To provide frail older people with support in

activities of daily living that help them maintain appropriate
standards of hygiene and grooming including time limited
services to support wellness and reablement goals.

Service type description Personal care provides assistance with activities of daily living
self-care tasks in order to help a client maintain appropriate
standards of hygiene and grooming, including:
• assistance with self-care
• assistance with client self-administration of medicine.
Activities can include support with:
• eating
• bathing

December 2022 – 41
 Objective Personal Care - To provide frail older people with support in
activities of daily living that help them maintain appropriate
standards of hygiene and grooming including time limited
services to support wellness and reablement goals.

• toileting
• dressing
• grooming
• getting in and out of bed
• moving about the house
• assistance with client self-administration of medicine
(including from dose-administration aids and reporting of
failure to take medicines).
Services may also include demonstrating and encouraging the
use of techniques to improve the person’s capacity for self-
management and building confidence in the use of equipment or
aids, such as a bath seat or handheld shower hose to support
wellness and reablement goals.

Service delivery setting e.g. Personal care is normally provided in the home. In special
home/centre/clinic/community situations personal care assistance may be delivered at a centre
or other community setting because it is not feasible to deliver the
service in the client’s home.
This may be because the client is homeless, itinerant or living in a
temporary shelter and the centre is able to provide the shower and
washing facilities required for client care.

Legislation Service providers must comply with relevant Commonwealth

and/or state/territory legislation and regulations.
State and territory legislation governs medication management.
Service providers must consider all relevant legislation and
guidelines in developing policies and procedures around
assistance with client self-administration of medicine (including
from dose-administration aids and reporting of failure to take
medicines) provided under the CHSP.

Output measure Time (recorded in hours and minutes as appropriate).

Staff qualifications For personal care, including assistance with client self-
administration of medicine, a Certificate III in aged/community
care or equivalent is desirable.
This includes any circumstances where nursing-related tasks are
delegated to personal care workers which is permitted under the
CHSP (see the Nursing service type in this program manual for
more information).

Fees Client contribution amount recorded in the Data Exchange (in

Fees field).

Service type: Social Support – Group

Objective Social Support Group - To assist frail older people to

participate in community life and feel socially included
through structured, group-based activities that develop,
maintain or support independent living and social interaction
whilst facilitating their wellness and reablement goals.

Service type description Social support – Group (formerly known as Centre-Based Day
Care) provides an opportunity for clients to attend and participate in

December 2022 – 42
Objective Social Support Group - To assist frail older people to
participate in community life and feel socially included
through structured, group-based activities that develop,
maintain or support independent living and social interaction
whilst facilitating their wellness and reablement goals.
social interactions which are conducted away from the client’s
home and in, or from, a fixed base facility or community based
settings.
These structured activities are provided in a group-based
environment and designed to develop, maintain and support social
interaction and independent living.
Activities may take the form of:
• group-based activities held in or from a facility/centre (e.g.
pre-set or individually tailored activities promoting physical
activity, cognitive stimulation and emotional wellbeing)
• group excursions conducted by centre staff but held away from
the centre
• Online group activities facilitated by the CHSP provider. This
may include computers, laptops or devices owned by or leased
to clients
Services may include light refreshments and associated transport
and personal assistance (e.g. help with toileting) involved in
attendance at the centre.
Social Support Group providers may use grant funding to purchase
IT equipment, including tablets, laptops, and internet subscriptions
to help connect older Australians to their family, carers and social
groups. This support is capped at $500 per client per year (or up to
$1,000 in exceptional circumstances) in accordance with CHSP
arrangements for other aids, equipment and assistive technologies.

Out-of-scope activities under Social gatherings that do not specifically aim to support older
this service type people’s social inclusion and independence.
Personal Alarms and Home Monitoring Equipment.

Service delivery setting e.g. Usually centres or fixed-base facilities but can include community
home/centre/clinic/community settings away from the centre (e.g. group excursions).

Legislation Service providers must comply with relevant Commonwealth and/or

state/territory legislation and regulations.

Output measure Time (recorded in hours and minutes as appropriate).

If a service provider provides transport to/from a centre and
receives funding to deliver both CHSP Transport and Social
Support – Group, they should record the transport to/from the
centre separately to the Social Support – Group activity.
Where transport is provided (separate to any excursion) to a carer
accompanying the frail older client this should also be counted.
CHSP providers that are not funded for Transport may incorporate
the cost of transporting clients to their Social Support – Group unit
price but should not report them as separate Transport outputs in
the Data Exchange. Any transport provided as part of an excursion
or activity within the centre’s program will not be counted as a
separate transport service.
Any meals provided as part of an excursion or activity within the
centre’s program will not be counted as a separate meal service.

December 2022 – 43
 Objective Social Support Group - To assist frail older people to
participate in community life and feel socially included
through structured, group-based activities that develop,
maintain or support independent living and social interaction
whilst facilitating their wellness and reablement goals.

Staff qualifications Appropriately qualified staff must be used to conduct activities of a

specific nature, such as allied health activities or exercise
programs.
Where staff or volunteers are involved in other activities as part of
Social Support – Group, they must have relevant qualifications, for
example any food handling and meal preparation must adhere to
safe food handling practices including personal hygiene and
cleanliness.

Fees Client contribution amount recorded in the Data Exchange (in Fees
field).

Service type: Social Support – Individual

Objective Social Support Individual - To assist frail older people to

participate in community life and feel socially included
through meeting their need for social contact and company
whilst facilitating their wellness and reablement goals.

Service type description Social support – individual is assistance provided by a

companion (paid worker or volunteer) to an individual, either
within the home environment or while accessing community
services, which is primarily directed towards meeting the
person’s need for social contact and/or company in order to
participate in community life.
Services funded include:
• visiting services
• telephone and web-based monitoring services (including
other technologies that help connect older people to their
community e.g. to assist people with sensory impairments or
those living in geographically isolated areas)
• accompanied activities (such as assisting the person
through accompanied shopping, bill-paying, attendance at
appointments and other related activities).
Social support is usually provided one-on-one but may also be
provided to more than one person, for example, where social
support is provided to an aged couple.
Social Support Individual providers may use grant funding to
purchase IT equipment, including tablets, smart devices and
internet subscriptions to help connect older Australians to their
family, carers and social groups. This support is capped at $500
per client per year (or up to $1,000 in exceptional circumstances)
in accordance with CHSP arrangements for other aids,
equipment and assistive technologies.

Out-of-scope activities under this Unaccompanied activities such as bill-paying and shopping,
service type which are considered Domestic Assistance.
Social Support provided to the client in a group-based
environment at, or from a fixed base facility away from their
residence, which is considered Social Support – Group.
Care workers may assist clients to schedule medical
appointments and can wait for the client in the waiting room but
are not required to attend the medical consultation.

December 2022 – 44
 Objective Social Support Individual - To assist frail older people to
participate in community life and feel socially included
through meeting their need for social contact and company
whilst facilitating their wellness and reablement goals.
Personal Alarms and Home Monitoring Equipment.

Service delivery setting e.g. Client’s home or community setting.

home/centre/clinic/community

Use of funds including any target Funding must be targeted at supporting older people to
areas participate in community life.

Legislation Service providers must comply with relevant Commonwealth

and/or state/territory legislation and regulations.

Output measure Time (recorded in hours and minutes as appropriate).

Staff qualifications Where staff or volunteers are involved in other activities as part
of Social Support – Individual, they must have relevant
qualifications, for example any food handling and meal
preparation must adhere to safe food handling practices
including personal hygiene and cleanliness.

Fees Client contribution amount recorded in the Data Exchange (in

Fees field).

Service type: Specialised Support Services

Objective Specialised Support Services - To provide services that

meet the specialised needs of older people living at home.

Service type description This service type refers to specialised or tailored services for older
people who are living at home with a particular condition such as
dementia or vision impairment.
These services help clients, and their carers and families, to
manage these conditions and maximise client independence to
enable them to remain living in their own homes.
They comprise a mix of direct service delivery, tailored support
and expert advice.
They also provide support to other service providers to meet the
specialised needs of those clients through awareness raising,
information sharing and education.
Specific service sub-types delivered include:
• continence advisory services
• dementia advisory services
• vision support services
• hearing support services
• other support services (e.g. occupational therapy driver
assessments)
In 2021-22, the Department reviewed the activities being delivered
under SSS. This review showed a significant number of providers
are delivering a variety of services that are not strictly
individualised specialist services e.g. group social supports and
system navigation. During the 2022-23, there will be a
grandfathering period to enable providers to continue delivering
these out-of-scope activities.
System navigation services, delivered under SSS, will not directly
transition into the Care Finder Program (see chapter 3.3.3).

December 2022 – 45
 Objective Specialised Support Services - To provide services that
meet the specialised needs of older people living at home.
From June 2023, the SSS description and scope will be updated
to remove ambiguity. Further information will be provided in late
2022/early 2023.
Out-of-scope activities under this Specialised support services that would otherwise be undertaken
service type by the health system are not within scope.
Services that are already funded under other Commonwealth,
state, territory or local government programs are not within scope.

Service delivery setting e.g. Varied settings.

home/centre/clinic/community

Use of funds including any target Service providers can use funds to support clients with specific
areas needs such as those with dementia, incontinence, vision
impairment, hearing loss or other specialised needs for diverse
groups in aged care.

Legislation Service providers must comply with relevant Commonwealth

and/or state/territory legislation and regulations.

Output measure Time (recorded in hours and minutes as appropriate).

Outputs recorded should include delivery of all advice and
support, including transport where delivered.
Note: both fields are mandatory and must be reported.

Staff qualifications Appropriately qualified staff must be used to conduct activities.

Allied health providers must meet their respective accreditation
and registration requirements and operate within the scope of
practice of their particular regulated or self-regulated body.
Depending on the respective accreditation and registration
requirements, this may permit activities being undertaken by
assistant allied health professionals or less qualified staff.

Fees Client contribution amount recorded in the Data Exchange (in

Fees field).

Client scenario – SSS provided to diverse groups in aged care

JUDY
Judy is 72 years old and is of a non-English speaking background. She suffers from
incontinence and dementia, and lives with her daughter, Susan, who is her main carer. Susan
provides 24-hour care to Judy covering aspects of daily living which incorporates assistance
with mobilisation and transfers. This extends to bed mobility and assistance with toileting.
There is a high level of stigma attached to accessing aged care services in the CALD
community, as there is an expectation that family members must look after other family
members rather than seeking formal support. These issues are exacerbated by language
barriers, a lack of knowledge of the ageing system and services available, and cultural
differences. The Specialised Support Services (SSS) provider speaks to the client and her carer
every week for over an hour over the phone, slowly explaining services available, the ageing
system and building trust and rapport. Eventually, the client agrees to receive services and the
SSS provider supports her through the MAC registration and assessment process. The SSS
provider assesses the client’s care needs, provides translated materials relating to the Home
Care Packages program and other information regarding the services available to Judy.
During the initial needs’ identification process, it was identified that Judy and her carer, Susan,
would greatly benefit from support services such as dementia advisory, continence advisory,
assistive equipment and case management as a matter of urgency. Due to the information
provided by the SSS provider, Judy and Susan have a better understanding of the support

December 2022 – 46
available to them and the home care service system. They feel open to receive services and
support following engagement from the SSS provider. A high priority Home Care Package was
organised for Judy as well as some short term CHSP support services.
Following the assessment process, the SSS provider remained in contact with Judy, ensuring
the process went as she had hoped and the relevant services were meeting her needs. The
SSS provider acted as an intermediary between Judy and the service providers she was
referred to, to ensure they were working towards Judy’s goals. This included advice to the
service providers as to how to work in a culturally appropriate way with Judy and Susan. With
the support in place, the risk of falls, carer burden and hospitalisations were significantly
reduced.

Service type: Transport

Objective Transport - To provide frail older people with access to

transport services that supports their access to the
community.

Service type description Transport refers to the provision of a structure or network that
delivers accessible transport to eligible clients and includes:
• direct transport services which are those where the trip is
provided by a worker or a volunteer
• indirect transport services including trips provided through
vouchers.
The provision of community transport services under the CHSP
assists frail older people to remain actively connected with their
local community. Transport services aim to assist client to
continue with their usual activities, such as attending community
groups or medical appointments, enabling them to keep active
and socially engaged.
Community transport services delivered under the CHSP are not
intended to replace or fund transport services more appropriately
provided under another system, such as State/Territory
administered patient transport services.
Clients can access more than one transport referral where the
need is not met by one provider e.g. one referral for a transport
provider for week days and one referral for a one-off medical
transport or weekend trip which is not provided by the week day
provider. Clients should contact My Aged Care for assistance with
accessing these referrals.

Service delivery setting e.g. Includes, but is not limited to, transport services provided to or
home/centre/clinic/community from facilities or the client’s home.

Use of funds including any target Funding must be used for non-assisted/assisted transport and
areas planned (group) and on-demand (individual) services.
The carers of frail older people accessing CHSP transport
services may accompany those clients when using those services
where required.
Transport providers may only use CHSP funding to lease, rather
than purchase vehicles.

Legislation Service providers must comply with relevant Commonwealth

and/or state/territory legislation and regulations, for example
holding appropriate licenses, meeting state accreditation
standards and meeting any legislated access requirements.

December 2022 – 47
 Objective Transport - To provide frail older people with access to
transport services that supports their access to the
community.
As per Section 4.2 of this program manual, all CHSP services
must be able to offer accessible service options to people with
physical or sensory disabilities.

Output measure Number of one-way trips.

Service providers are to count clients and carers separately when
reporting outputs within the Data Exchange.
If transport is funded under CHSP and provided as a related, but
still separate service (e.g. transport of clients attending a Day
Therapy Centre) this should be counted as a separate service for
each trip, in addition to the attendance at the Day Therapy Centre,
when recording in the Data Exchange.
Where transport forms part of the main service being delivered
(e.g. a bus trip as part of a Social Support – Group social
excursion) this should not be counted or reported separately
within the Data Exchange.

Staff qualifications Drivers of transport services must hold an appropriate licence.

Service providers must also take reasonable care to ensure the
safety of all concerned where paid staff or volunteers are
providing transport services.
It is the responsibility of the service provider to ensure they are
meeting their Work Health and Safety responsibilities for safe
driving and client transport practices.

Fees Client contribution amount recorded in the Data Exchange (in

Fees field).

3.3.2 Care Relationships and Carer Support Sub-Program

Objective
To support and maintain care relationships between carers and clients, through providing good
quality respite care for frail older people so that carers can take a break.
Target population
Frail older CHSP clients will be the recipients of planned respite services, providing their carers
with a break from their usual caring duties.
Eligibility
CHSP clients who require planned respite services to support and assist with maintaining the
caring relationship.
Funded services
Service providers should give consideration to models of respite care that support CHSP clients
with carers in employment, training or study. This may include for example, the availability of
respite services outside of current standard operating hours, to assist carers to balance work
and caring responsibilities.
Details on the planned respite service types funded under this sub-program are provided in the
tables on the following pages, including a service type definition and service settings.

December 2022 – 48
Client scenario — helping carers continue caring: nurturing the care relationship
KERRY
Kerry is 75 years old. She is the carer for her 83 year old husband, Ronald, who has
incontinence and mobility problems due to muscle weakness. Kerry assists him with his
personal care, drives him to appointments, and takes him on short outings.
In the last six months Kerry has noticed her health beginning to suffer from concern about her
husband and poor sleep. She is also finding it increasingly difficult to balance providing for his
needs and continuing the activities she used to enjoy, such as croquet at the local club with her
friends.
Her sister suggests that Kerry calls My Aged Care to see what support she and Ronald may be
eligible for. Kerry and Ronald both consent for My Aged Care to register them as clients and
create client records. After screening by the contact centre they are both referred for a RAS
assessment.
During the assessment process, both of their care needs and goals are identified: including
what help is needed to support Kerry (as carer) and the care relationship she has with her
husband.
As a result of the assessment, CHSP services are organised to meet their needs. For Ronald,
this includes continence aids and fortnightly physiotherapy to address his muscle weakness.
Two hours per fortnight of ongoing, flexible (in-home) respite care is also arranged.
Over the coming weeks Ronald becomes comfortable with the respite worker and requests that
the same staff member provides the respite services each time. The respite is scheduled at a
time that allows Kerry to return to croquet.
These CHSP services benefit Ronald and give Kerry more balance in her life.
Service type: Centre-based respite

Objective Centre-based respite - To support and maintain care relationships

between carers and clients, through providing good quality respite
care for frail older people so that carers can take a break.

Service type description Respite care is available to CHSP clients. This service benefits the
client’s carer through providing supervision and assistance to the
frail older client. The carer may or may not be present during the
delivery of the service. Centre-based respite care includes:
• centre based day respite – provides structured group
activities to clients to develop, maintain or support independent
living and social interaction conducted in a community setting.
• residential day respite – provides day respite in a residential
facility to the client.
• community access group – provides small group day outings
to give clients a social experience and offer respite to their
carer.
Service providers are required to structure services in such a way
that allows them to be as responsive as possible to requests from
carers for short-term or non-ongoing respite.
Residential day respite is defined as day respite in a residential
facility (where the booking cannot be used for overnight stays)

Out-of-scope activities under this Residential respite that is delivered under the Aged Care Act 1997
service type (see Glossary).

Service delivery setting e.g. Varied group-based settings including a centre and respite
home/centre/clinic/community delivered as an outing etc.

Legislation Service providers must comply with relevant Commonwealth

and/or state/territory legislation and regulations.

December 2022 – 49
 Objective Centre-based respite - To support and maintain care relationships
between carers and clients, through providing good quality respite
care for frail older people so that carers can take a break.

Output measure Time (recorded in hours and minutes as appropriate).

If a service provider provides transport to/from a centre and
receives funding to deliver both CHSP Transport and Centre-
Based Respite, they should record the transport to/from the centre
separately to the respite activity.
CHSP providers that are not funded for Transport may incorporate
the cost of transporting clients into their Centre Based Respite unit
price but should not report them as separate Transport outputs in
the Data Exchange.
Any transport provided as part of an excursion or activity within the
centre’s program will not be counted as a separate transport
service.
Any meals provided as part of centre-based respite within the
centre’s program should not be counted as a separate meal
service.

Staff qualifications Where additional services are performed e.g. personal care, in
conjunction with respite – requirements relating to that additional
service apply.

Fees Client contribution amount recorded in the Data Exchange (in Fees
field).

Service type: Cottage Respite

Objective Cottage respite - To support and maintain care relationships

between carers and clients, through providing good quality respite
care for frail older people so that carers can take a break.

Service type description Respite care benefits the carer through providing supervision and
assistance to the frail older client. The carer may or may not be
present during the delivery of the service.
Cottage respite (overnight community respite) provides overnight
care delivered in a cottage-style respite facility or community
setting other than in the home of the carer, care recipient or host
family.
Service providers are required to structure services in such a way
that allows them to be as responsive as possible to requests from
carers for short-term or non-ongoing respite.

Out-of-scope activities under this Residential respite that is delivered under the Aged Care Act 1997.
service type (see Glossary).

Service delivery setting e.g. Cottage settings.

home/centre/clinic/community

Legislation Service providers must comply with relevant Commonwealth

and/or state/territory legislation and regulations.

Output measure Time (recorded in hours and minutes delivered in a night)

Staff qualifications Overnight respite can have unique risks for service providers and
clients. Service providers need to identify and manage risk through
consistent use of the Home Care Standards or any Standards that
replace them, the CHSP Grant Agreement and relevant state and
territory legislation.

December 2022 – 50
 Objective Cottage respite - To support and maintain care relationships
between carers and clients, through providing good quality respite
care for frail older people so that carers can take a break.
Where additional services are performed e.g. personal care, in
conjunction with respite – requirements relating to that additional
service apply.

Fees Client contribution amount recorded in the Data Exchange (in Fees
field).

Service type: Flexible Respite

Objective Flexible respite - To support and maintain care relationships

between carers and clients, through providing good quality respite
care for frail older people so that carers can take a break.

Service type description Respite care benefits the carer through providing supervision and
assistance to the frail older client. The carer may or may not be
present during the delivery of the service.
Flexible respite care includes:
• In-home day respite – provides a daytime support service for
carers of clients needing assisted support in the carer’s or the
client’s home.
• In-home overnight respite – provides overnight support
service for carers of clients needing assisted support in the
carer’s or client’s home.
• Community access–individual – provides one-on-one
structured activities to give clients a social experience to
develop, maintain or support independent living and social
interaction and offer respite to their carer.
• Host family day respite – day care received by a client in
another person’s home.
• Host family overnight respite – overnight care received by a
client while in the care of a host family.
• Mobile respite – provides respite care from a mobile setting
• Other – innovative types of service delivery to clients.
Service providers are required to structure services in such a way
that allows them to be as responsive as possible to requests from
carers for short-term or non-ongoing respite.

Out-of-scope activities under this Residential respite that is delivered under the Aged Care Act 1997.
service type (see Glossary).
Group based respite.

Service delivery setting e.g. Varied settings including the client’s home, a host family’s home,
home/centre/clinic/community other suitable accommodation in the community and respite
delivered as an outing etc.

Legislation Service providers must comply with relevant Commonwealth

and/or state/territory legislation and regulations.

Output measure Time (recorded in hours and minutes as appropriate).

Staff qualifications Where additional services are performed e.g. personal care, in
conjunction with respite – requirements relating to that additional
service apply.

Fees Client contribution amount recorded in the Data Exchange (in Fees
field).

December 2022 – 51
3.3.3 Assistance with Care and Housing (ACH) – Hoarding and Squalor Sub-Program
Objective
To support those who are at risk of homelessness or unable to receive the aged care supports
they need as a result of living with hoarding behaviour or living in a squalid environment.
Target population and eligibility
Frail older or prematurely aged people who meet each of the following three criteria:
1. On a low income.
2. Living with hoarding behaviour and/or in a squalid living environment.
3. At risk of homelessness and/or unable to receive the aged care services they need.
Prematurely aged people are those aged 50 years and over (or 45 years and over for Aboriginal
and Torres Strait Islander people) whose life course such as active military service,
homelessness or substance abuse, has seen them age prematurely.
Once an individual has been assessed as eligible to access ACH – Hoarding and Squalor
services, they remain eligible for this service type indefinitely and do not require a
re-assessment for ACH – Hoarding and Squalor services, even if they suspend them for several
years. This applies to all ACH – Hoarding and Squalor clients, regardless of age of entry into
the program.
Clients who are eligible to access ACH – Hoarding and Squalor services are also eligible to
access other CHSP services. All clients must be assessed by My Aged Care via the
assessment services to determine eligibility and need to receive additional CHSP services.
Service considerations
To ensure older people are supported to receive the care they need to continue living in the
community, service providers funded to deliver ACH – Hoarding and Squalor must follow the
principles below.
ACH – Hoarding and Squalor services:
• Will undertake outreach services where appropriate to identify potential clients in need of
assistance and keep in contact with those clients.
• Will coordinate and link support for clients in a goal focussed client management
relationship.
• Interact and work with multiple services across a range of sectors.
• Ensure a rapid response to older people who are at risk of homelessness through one-
on-one contact.
• Ensure a flexible and individualised service delivery response within the requirements of
the broader CHSP.
• Must have strong links with the community and all aspects of the aged care sector.
• Will have access to translation and interpreting services under the CHSP to support
clients.
ACH – Hoarding and Squalor Sub-Program service providers
As of 1 January 2023, ACH navigation services (previously known as Assessment - Referrals
and Advocacy – Financial Legal) are delivered and funded through the care finder program.
Additional information is available in the care finder policy guidance for PHNs.
It is recognised that a specialised approach is required for ACH – Hoarding and Squalor clients
due to their particular circumstances. For these clients, care finders may be a point of entry in
addition to My Aged Care.
Care finders can help clients contact My Aged Care and work with the My Aged Care RAS, to
understand what services are available and to find and choose services. It is also appropriate
for the RAS to refer suitable clients identified during the assessment process to care finders for
further support.

December 2022 – 52
Service providers should also update the client’s My Aged Care client record with service
information (including commencement date and frequency/volume of services). Where there are
significant changes in need or additional services needed service providers can request a
support plan review, which may lead to a new assessment for the client.

Client scenario — ACH – Hoarding and Squalor and linking to community support
Francesco
Francesco is a 72-year-old CALD man who lives in a social housing apartment complex in
regional NSW. He speaks limited English and has difficulty with hearing. Francesco does not
have any family or friends involved to support him or assist with communication. His neighbours
have reported the odour coming from his apartment was disturbing residents but were unsure
how to address this.
Francesco was registered and assessed for My Aged Care services during a stay in hospital
where it was determined that he required additional support at home. He was approved for
CHSP ACH – Hoarding and Squalor services. Other services included on his support plan were
social support, domestic assistance, transport, goods, equipment and assistive technology,
Allied health (OT) and HCP Level 1. During the assessment the assessor was given consent by
Francesco to refer him to a local care finder organisation to assist with finding providers and
setting up the services needed.
A care finder called Francesco to explain how she could help him set up all his services. She
started by helping him contact a local ACH – Hoarding and Squalor provider and was with him
when they visited him in his home. A translator was used to assist with communicating with
Francesco to ensure he understood the services being offered and provided informed consent.
Francesco advised that as his mobility had declined, it had become more difficult for him to stay
on top of his cleaning and the apartment become cluttered and squalid. He was experiencing
urinary incontinence but due to the cluttered apartment, he had difficulty making it to the
bathroom resulting in urine spills on the floor which he had difficulty cleaning up. After providing
a clear explanation regarding the services and gaining Francesco’s consent, a deep clean
occurred in his apartment including removing unwanted items (as decided by the client) and the
soiled mattress and lounge. A new bed, mattress and bed linen was sourced through a local
charity and a carpet clean was completed in his bedroom due to urine stains.
At the time of this service, Francesco was not engaged with any other services. He was
assessed and assigned domestic assistance (DA) services under CHSP, but these services
were not comfortable starting until a deep clean had occurred. Staff communicated with the DA
provider and Francesco’s care finder to advise of the deep clean and requesting DA be ready to
commence afterwards to assist with maintaining the apartment. The care finder also worked
with Francesco to set up the other services he had been approved for.
Following the ACH – Hoarding and Squalor service, Francesco reported to be feeling much
happier living in his unit and felt more supported now that he had ongoing services in place.
There was a noticeable improvement in his wellbeing as he was sleeping on a new mattress
and in clean bedding, he had a clear thoroughfare to his bathroom and was living in a hygienic
environment. Francesco is now set up with ongoing support to maintain his living environment
to ensure his health and wellbeing.

Service type: Assistance with Care and Housing

Objective ACH – Hoarding and Squalor - To support those who are at

risk of homelessness or unable to receive the aged care
supports they need as a result of living with hoarding
behaviour or living in a squalid environment.

Service type description Assistance with Care and Housing services link clients to the
most appropriate range of housing and care services in order
to meet their immediate and ongoing needs.

December 2022 – 53
Objective ACH – Hoarding and Squalor - To support those who are at
risk of homelessness or unable to receive the aged care
supports they need as a result of living with hoarding
behaviour or living in a squalid environment.
In practice, it may take numerous interactions with the client for
a provider to gradually develop trust, leading to a supportive
professional relationship.
This requires persistence and a specialised capacity of the
worker to manage challenging behaviour. When linking clients
into services, clients may require a period of continued support
to assist them to remain linked with those services
Hoarding and squalor support may also be required at times
after linkages have been established to conduct early
intervention and prevent estrangement from support services
and a resultant decline in the person’s welfare.
Service providers are required to develop links with other local
care services. Examples of linkages to be made include but are
not limited to:
• CHSP service providers
• the RAS as part of My Aged Care
• Aged Care Assessment Program/Team
• residential aged care where appropriate
• Home Care Packages
• state and territory programs and resources
• veterans’ home care services
• health services
• local government services
• other services appropriate to the needs of the client, such
as community care and other support services.

ACH - Hoarding and Squalor

Hoarding Disorder can be associated with health risks and can
impact on an individual’s friends and family. People
experiencing Hoarding Disorder can be assisted by specialist
intervention.
ACH Hoarding and Squalor services can be offered to clients
experiencing symptoms of Hoarding Disorder or who are living
in severe domestic squalor. The range of ACH - Hoarding and
Squalor services may include:
• developing a client plan
• one-off clean-ups
• review care plans
• linking clients to specialist support services.

Out-of-scope activities Permanent support and/or direct care provision are out-of-
under this service type scope.
Funding to purchase accommodation for clients.

December 2022 – 54
 Objective ACH – Hoarding and Squalor - To support those who are at
risk of homelessness or unable to receive the aged care
supports they need as a result of living with hoarding
behaviour or living in a squalid environment.
Assessment (referrals) and advocacy services (financial, legal).

Service delivery setting Varied – including a client’s home, at a centre or clinic, in the
community.

Use of funds including Service providers are funded to deliver hoarding and squalor
any target areas services. They may provide clients with direct contact details
for linked services, such as a care finder.

Legislation Service providers must comply with relevant Commonwealth

and/or state/territory legislation and regulations.

Output measure Time (recorded in hours and minutes as appropriate).

Staff qualifications Staff must possess an appropriate level of knowledge and

skills in relation to socially isolated and/or disadvantaged
people.

3.3.4 Sector Support and Development Sub-Program

Objective
To support CHSP service providers through reforms to the CHSP, in preparation for a new
in-home aged care system, and to operate effectively in line with the objectives of the CHSP
and within the context of the broader aged care system.
Target population
CHSP service providers, excluding the provider delivering the SSD service, and aged care
consumers seeking assistance navigating aged care.
Service type: Sector Support and Development

Objective Sector Support and Development - To support CHSP

service providers through reforms to the CHSP, in
preparation for a new in-home aged care system, and
to operate effectively in line with the objectives of the
CHSP and within the context of the broader aged care
system.

Service type description From 1 July 2022, SSD activities focus on supporting
CHSP providers prepare for a new in-home aged care
system. As such, SSD providers are required to allocate at
least 75 per cent of their funding to this new focus.

Activities suitable for 75 per cent funding allocation

The below activities can be delivered to continue
supporting providers with current CHSP service delivery or
with a focus on the future reforms to the home care sector
(75% funding allocation):
• Embedding wellness and reablement and restorative
care approaches into service delivery.

December 2022 – 55
Objective Sector Support and Development - To support CHSP
service providers through reforms to the CHSP, in
preparation for a new in-home aged care system, and
to operate effectively in line with the objectives of the
CHSP and within the context of the broader aged care
system.
• Embedding diversity practices and inclusivity within
provider service delivery.
• Developing and disseminating information on the
CHSP and its interaction with the broader aged care
system or aged care reforms.
• Brokering, coordinating and delivering training and
education to service providers, workforce and
consumers.
• Developing and promoting collaborative partnerships
within the CHSP and across the broader aged care
service system.

Activities suitable for the 75 per cent funding

allocation
Types of activities under the 75% requirement may
include:
• Strengthening the capacity of CHSP service providers
through support for business transformation:
o Streamline processes to gather and record
information;
o Financial planning and budgeting (e.g.
operating within nationally consistent unit
prices, fluctuation between seasons etc.);
o Increase reporting and data literacy;
o Forward year workforce and organisation
planning;
o Evaluating organisation workforce culture (e.g.
strategies to attract and retain workforce); and
o Opportunities for partnerships between service
providers.
• Encourage CHSP service providers to engage with the
in-home aged care reform process and participate in
consultations with the Department of Health and Aged
Care.
• Brokering, coordinating and delivering training and
educational materials on the 2022-23 priority areas:
o How to transition records for existing clients
across to a new in-home aged care payment
system (when known*);
o How to apply the payment system to operating
practices;
o Processes to track information and cost of
services provided to individual consumers;
o Supporting CHSP providers to access advice
and best practice on governance structures and
processes (where required);
o Streamlining onboard processes for new aged
care consumers;

December 2022 – 56
Objective Sector Support and Development - To support CHSP
service providers through reforms to the CHSP, in
preparation for a new in-home aged care system, and
to operate effectively in line with the objectives of the
CHSP and within the context of the broader aged care
system.
o How to utilise service delivery information and
data to improve business practices and to
inform forward year financial planning;
o Supporting CHSP providers through the release
of a new Aged Care Act, with conferences,
training sessions and other educational material
(when known*);
o Assisting CHSP providers to understand and
support any new workforce training or
requirements (when known*); and
o Supporting CHSP providers to access advice
and information around changes to aged care
quality and safety requirements (when known*).
• Active participation in an SSD Community of Practice
(CoP):
o Organise event series on aged care reform
matters and initiate and contribute to
discussions on 2022-23 priority areas;
o Work with other SSD providers within the CoP
to establish best practice for CHSP activities, or
broker advice on best practice;
o Promote the adoption of best practice to CHSP
service providers to increase national
consistency of services delivered;
o Assist with maintaining the CoP through
working with moderators and the Department of
Health and Aged Care; and
o Connect and collaborate with other SSD
providers to identify transition support needs
and gaps, and areas where providers can
contribute to business transformation ideas and
discussions.

*As future in-home aged care reforms progress, the CHSP

Manual may be updated with additional SSD activities, or
further details added around existing activities.
During 2022-23, your organisation may have an
opportunity to deliver new activities or redirect existing
activities (where there is limited demand for planned
activities).
Please note it is not anticipated additional funding will be
available, and any additional services, or redirection of
services, must fit within a provider’s current funding
envelope.

Other in-scope activities

Types of activities may also include:
• Strengthening the capacity of CHSP service providers
to deliver quality services that are responsive to client
needs, including clients with diverse needs.

December 2022 – 57
Objective Sector Support and Development - To support CHSP
service providers through reforms to the CHSP, in
preparation for a new in-home aged care system, and
to operate effectively in line with the objectives of the
CHSP and within the context of the broader aged care
system.
• Supporting and maintaining the volunteer workforce
across the sector.
• Mainstream navigation services which support aged
care clients to navigate the aged care system,
particularly clients who are not eligible for care finders
from 1 January 2023.
SSD services should be available to all CHSP service
providers in the SSD service provider’s region, and, if
possible, across Australia (e.g. services and resources
uploaded to a website).
SSD services must not be restricted to CHSP service
providers within an overarching organisation.

Out-of-scope activities under Activities delivered under this service must not include:
this service type
• Activities and services that do not relate to CHSP or
the navigation of aged care.
• activities and services that only build the capacity of
the funded organisation, rather than the capacity of the
sector including:
o the review and development of internal policies
and procedures;
o assessment and compliance with internal or
external policies, procedures, guidelines and laws;
o website maintenance, marketing and promoting
other non-CHSP services delivered by your
organisation;
o support for in-house training and induction;
o supporting the providers own volunteer workforce;
o embedding wellness and reablement in the SSD
service provider’s own organisation
• direct CHSP service delivery and activities more
closely aligned with the objectives of other CHSP
service types like Social Support, Specialised Support
Services, Meals (direct and indirect e.g. distribution
centres) or Transport;
• the provision of advocacy services;
• capital works and building maintenance, repairs and
refurbishments (e.g. renovations, refitting buildings,
installing of gardens, solar panels and blinds etc.);
• developing training or information that duplicates
existing material;
• supporting researchers to recruit older residents to
participate in studies and research projects;
• the facilitation of home share arrangements;
• operating Senior Citizen Centres;
• supporting aged care clients to sign up to the SSD
provider’s other aged care services; and
• services already offered by other Commonwealth and
State/Territory Government agencies.

December 2022 – 58
Objective Sector Support and Development - To support CHSP
service providers through reforms to the CHSP, in
preparation for a new in-home aged care system, and
to operate effectively in line with the objectives of the
CHSP and within the context of the broader aged care
system.

Service delivery setting Activities can be across a range of settings as appropriate.

e.g.
home/centre/clinic/community
Use of funds including any Funding must be used to meet objectives and key
target areas deliverables as outlined in the organisation’s approved
Sector Support and Development Activity Work Plan.

Measure Funds expended and reports provided in accordance with

departmental reporting requirements and the activity
described in the organisation’s approved Sector Support
and Development Activity Work Plan.

December 2022 – 59
Chapter 4 – Access and interactions
4.1 Interaction between the Commonwealth Home Support Programme
and other programs
In general, CHSP services should not be provided to people who are already receiving other
government-subsidised services that are similar to service types funded through the CHSP.
In certain circumstances it is permissible for clients of other programs to access services and
support under the CHSP. However, where this occurs this must not unfairly disadvantage other
members of the CHSP target population.

4.1.1 Interaction with specific programs and services

Health system
CHSP services must not replace, or fund supports provided for under other systems including
the health care system. For example, the CHSP aims to maximise independence and autonomy
for frail older people but is not a substitute for early intervention or rehabilitation, subacute or
transition programs provided under the health system.
Post-acute care is also not funded under the CHSP. Where a client is already eligible for CHSP
funded assistance or was receiving it prior to hospitalisation, additional support services can be
provided following a hospital stay, for a short period of time. After this, support services must be
reviewed.
Home Care Packages (HCP)
The care needs of a person receiving a home care package should be addressed through their
HCP. Any CHSP service types (e.g. meals, transport, nursing) delivered to them would
generally be paid for on a full cost-recovery basis from the HCP client’s individualised budget.
Full cost recovery means that the CHSP provider would charge the HCP client the full cost of
the service provision (e.g. in the case of meals, this would include the ingredients, preparation
and distribution costs).
This is intended to ensure that the CHSP is able to provide entry-level support services to as
broad a population as possible (given that in most cases this will be the only form of support
that people receiving CHSP services access) and recognises that HCP clients already receive
Government subsided home care package services. Clients can purchase additional services
above the value of their package for an agreed fee with their provider.
Where a client needs additional services as a short-term or time limited arrangement, they can
access certain CHSP subsidised services under the six conditions listed below. These are
CHSP subsidised services in addition to the services they are receiving from their HCP. The
additional CHSP services will not be charged to the client’s individualised HCP budget,
however, the client will still be expected to contribute to the cost of these services in line with
the CHSP provider’s client contribution policy. The client contribution must be paid for privately
and not from the client’s package funds.
The six defined circumstances include:
Clients on a Level 1 or 2 package: where a client’s individualised budget has been fully
allocated, HCP clients may access short-term Allied Health and Therapy Services or
Nursing services through the CHSP, where these specific services may assist the client to
get back on their feet after a setback (such as a fall).
Clients on Level 1 to 4 package: where a client’s individualised budget has been fully
allocated and a carer requires it, a HCP client may access additional planned short-term
respite services through the CHSP.
Clients on Level 1 to 4 package: in an emergency situation where they have an urgent and
immediate health or safety need and where a client’s individualised budget has been fully
allocated, some additional CHSP services can be accessed on a short term basis (see
circumstance 6 for goods, equipment and assistive technology). These instances must be
time limited, monitored and reviewed.

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 Clients on an interim Level 1 or 2 package who are waiting for a Level 3 or 4 package:
where the client’s individualised budget has been fully allocated, a client can access
additional home modifications through the CHSP.
Clients on a Level 1 to 4 package who have transitioned from the CHSP may continue to
access their existing CHSP social support group on an ongoing basis to allow the
continuity of social relationships. This only applies to clients attending a pre-existing CHSP
social support group service.
Clients on Level 1 to 4 package or awaiting their package: where there is urgent need, and
the care recipient has insufficient funds in their package budget for goods, equipment and
assistive technology (GEAT), they may access GEAT in the short term. See further details
below.
The short-term or time limited CHSP services are not defined as this will vary on a case by case
basis and will depend on the specific circumstances and needs of each individual client.
However, it is anticipated that up to three months would be considered as short-term services. It
is expected that some additional CHSP services might be delivered for a longer period where
specific circumstances warrant it.
The ACAT is responsible for assessment of a client’s eligibility for services under the Aged Care
Act, including HCP. If an ACAT issues CHSP referrals for a HCP recipient, the ACAT is
responsible for scheduling suitable Support Plan Reviews to review aged care needs.
CHSP service providers also have a responsibility to regularly review a client’s progress against
their individual goals and should refer the client to their most recent assessment service for a
support plan review or re-assessment if their needs change.
Where CHSP services are provided to a HCP client, the CHSP service provider must accurately
report the services delivered in DEX as they would with any other client.
All HCP clients must be assessed through My Aged Care to receive these additional CHSP
services (with the exception of pre-existing CHSP social support group activities). The
assessment should be undertaken by the assessment organisation that undertook the most
recent assessment of the client, which in most instances will be an ACAT. The additional
services must be provided in line with the first four circumstances described above and at an
entry-level of support consistent with services provided under the CHSP.
In addition, CHSP service providers should only supply additional CHSP services to home care
package clients in the first four categories above where they have capacity to do so without
disadvantaging other current or potential CHSP clients - that is, CHSP services should prioritise
people who need CHSP support but do not have access to other support services over people
who are already in receipt of a home care package. Social support group services whose CHSP
clients transition onto a HCP should continue to deliver services under normal CHSP
arrangements to these clients.
Access to urgent GEAT for eligible HCP recipients
HCP care recipients, and approved recipients waiting for a package can access up to $2,500
per year for urgent equipment through the CHSP program.
It is important to note this funding is not available for other CHSP services provided to HCP
recipients. Nor is this funding level available for CHSP clients accessing GEAT. CHSP clients
will continue to access up to $1,000 per year for equipment.
An ACAT assessor will review a care recipient’s situation and determine whether they are
eligible to access urgent GEAT under CHSP.
Urgent circumstances are when the persons immediate health and safety may be at risk if they
do not receive the necessary assistive equipment.
Some examples of urgent circumstances include:

• A care recipient is on the waiting list for a package but requires urgent GEAT.
• An existing care recipient sustains an injury and requires urgent GEAT but has
insufficient funds in their package to cover the purchase.

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 • An existing care recipient uses most of their package each month. They were just
reassessed and require urgent equipment, but with no increase to their package.
• An existing care recipient is receiving a lower-level package while waiting for
assessment or allocation of a higher-level package, but they require urgent GEAT
beyond what their current package allows.
These instances must be monitored and reviewed by the HCP care manager where applicable.

HCP providers should advise recipients what funding is available in their package budget, how
much to allocate for GEAT and discuss options if urgent needs arise.

Depending on how much package funding is available, their options include:

• If a recipient has enough funds in their package to pay for new equipment, they will not
have access to emergency GEAT under CHSP.
• If a recipient has limited unspent funds, they should consider renting or lease to buy
options. All costs related to these arrangements must be agreed in a contract between a
provider and care recipient and included in the home care agreement.
• If a recipient has spent their allocated funds or insufficient funds remain but they require
urgent GEAT, their HCP provider can arrange a referral to the ACAT to have their
circumstances assessed. With this option:
o HCP providers should advise the care recipient that, if the total cost of the item/s
is more than $2,500, the recipient is required to pay the full gap amount using
private funds only.

All requests for urgent GEAT must be sent to the national CHSP provider geat2GO.
Please do not send referrals or requests to another CHSP GEAT provider. Geat2GO is the only
provider authorised to supply equipment under this initiative.

Interim CHSP services for clients on the HCP waitlist

Where a new client has been assessed and approved as eligible for a HCP but is waiting to
receive that package, the Aged Care Assessment Team (ACAT) may approve the client for
services under the CHSP as an interim arrangement. The services will be delivered as entry-
level supports consistent with the CHSP not the level of support of the home care package they
are eligible for. The number of CHSP services provided at an entry level will vary on a case by
case basis and will depend on the specific needs and circumstances of each client. HCP clients
will need to contribute to the cost of the CHSP as per the CHSP client contribution
arrangements and pay for these fees privately (not from their package funds).
Clients with an approval for a HCP, or whom are on the National Priority System, should not be
prioritised above clients without this on the basis of this alone. Priority timeframes are
referenced in the My Aged Care – Provider Portal User Guide document available on the
Department’s website. Service providers are to take this rating into account along with their own
capacity to respond with existing resources within the timeframes before accepting a client.
Residential Care
Residential care recipients (including recipients of residential aged care though a MPS) will not
be able to access CHSP services unless on a full cost recovery basis.
National Disability Insurance Scheme (NDIS) and other disability supports
The NDIS is not intended to replace the health or aged care systems. The National Disability
Insurance Scheme Act 2013 specifies that a person is eligible for the NDIS if they meet its age,
residential and disability requirements. The age eligibility requirements mean that a person
needs to have acquired their disability and made their access request before the age of 65 to be
an NDIS participant.
People who are not able to access the NDIS but have a disability and are aged 65 or over (or
50 years and over for Aboriginal and Torres Strait Islander people) will be able to access the
CHSP if they are eligible, but within its scope as the entry tier of aged care.

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CHSP service providers will be required to make reasonable provisions to accommodate the
specific needs of clients with disabilities to enable them to access services that are within
scope, such as providing services that are responsive to the client’s specific needs.
Disability Support for Older Australians
The Disability Support for Older Australians Program (DSOA) came into effect on 1 July 2021,
replacing the Continuity of Support (CoS) Programme.
The DSOA Program provides support to older people aged 65 and over (and Aboriginal and
Torres Strait Islander people aged 50 years and over) who received specialist disability services
from states and territory governments, but were ineligible for the National Disability Insurance
Scheme at the time of its rollout due to their age. As a result, DSOA is a closed program with no
new client entrants.
The DSOA Program provides a client-centred program, with:
• funding for disability services that is broadly aligned with NDIS prices;
• clients receiving an Individual Support Package overseen by a single DSOA service
coordinator;
• support for DSOA clients with complex needs to continue living at home or in supported
accommodation as their needs change;
• the NDIS Quality and Safeguards Commission regulating DSOA service coordinators
(including subcontracted providers).
DSOA clients are eligible to receive CHSP services that are not provided through DSOA. If a
DSOA client wishes to access CHSP services, they should engage My Aged Care in order to
undertake an assessment to determine whether they are eligible for support. In doing so, DSOA
clients should clearly outline to My Aged Care they are a DSOA client, otherwise they may be
found eligible for services that are provided through DSOA. In the event the DSOA client
accepts supports under CHSP that are delivered through DSOA, it will be taken that the client
has chosen to exit DSOA.
Further information on the DSOA Program is available in the Disability Support for Older
Australians Program Manual.
Care Finder Program
Care finders assist clients by:
• supporting them to interact with My Aged Care so they can be screened for eligibility for
aged care services and referred for assessment
• explain and guide them through the assessment process including, where appropriate,
attending the assessment
• helping them to find the Commonwealth funded aged care supports and services they
need and connect with other relevant supports in the community, including supporting
them to:
o understand the different types of aged care supports and services
o find and make an informed choice about providers or services
o work through income or means testing, if relevant, and costs (with support from
Services Australia as required)
o complete forms
o meet with providers to arrange services (such as by calling providers to check
availability and attending meetings with providers)
o understand the agreement that needs to be signed with the provider
o connect with other relevant supports in the community, noting that, this may
occur before they assist a person to access aged care (as well as any other
time).
Transition Care as a form of Flexible Care
In conjunction with State and Territory Governments, the Australian Government funds the
Transition Care Programme which assists older people to return home after a hospital stay. A
person can only enter transition care directly after being discharged from hospital.

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Transition care provides time-limited (up to 126 paid days), goal-oriented and therapy-focused
packages of services to older people after a hospital stay, allowing them time to complete their
restorative journey and providing them with time to consider their longer-term care options.
Short-Term Restorative Care (STRC) as a form of Flexible Care
STRC is an early intervention program that aims to reverse and/or slow ‘functional decline’ in
older people with the goal of improving individuals’ wellbeing and delaying their need to enter
residential care or receive a home care package. Unlike transition care, short-term restorative
care is available to people without the need for a hospital stay.
STRC provides a time-limited (up to 56 paid days), goal orientated, and coordinated package of
services with a focus on multidisciplinary care. It is designed to be a high intensity period of care
which may be delivered in a home setting, a residential aged care setting, or a combination of
both.
Receiving Flexible Care and CHSP at the same time
People may receive CHSP and flexible care (transition care or STRC) services at the same
time, providing they are assessed as being eligible for each program. There are, however, some
instances where these programs can provide the same or similar services, such as home
modifications or assistance with meals. The department does not support someone receiving
duplicate services through two programs.
When planning care, transition care and STRC providers are expected to liaise with their care
recipient’s existing supports including, where applicable, their CHSP provider.
Palliative care
State and Territory Governments are responsible for the provision and delivery of palliative care
and hospice services as part of state health and community service provision responsibilities.
As such, decisions on the funding and delivery of palliative care and hospice services in each
jurisdiction, are the responsibility of individual State and Territory Governments.
CHSP clients are able to receive palliative care services from their local health system in
addition to their home support services, but this needs to be arranged by the person’s General
Practitioner or treating hospital. As with any palliative care arrangement, the palliative care team
would coordinate the skills and disciplines of many service providers to ensure appropriate care
services. This would include working with the client’s CHSP service provider(s).
Veterans
Veterans can access CHSP services in order to support them to remain independent in their
own home in the same way as the general population. This access is determined by their
eligibility, assessed need, and any service being provided by other government programs.
A person’s eligibility for Department of Veterans’ Affairs-funded services such as the Veterans’
Home Care Program, community nursing, transport or respite does not preclude that person
from accessing services under the CHSP, so long as the client is eligible for services, the
support required from the CHSP is entry-level, and there is no duplication in the specific
services/assistance being provided.
For example, a person may access Veterans’ Home Care for low-level domestic assistance and
personal care, but also be receiving transport and delivered meals through the CHSP.

4.1.2 Transition Arrangements for Existing Clients

When the CHSP was implemented in July 2015, existing clients of the former programs that
were consolidated into the CHSP (including the Commonwealth HACC program; planned
respite services under the NRCP; DTC and ACHA) were transitioned directly into the CHSP to
ensure that continuity of care was provided for these clients.
Existing clients of the Victorian HACC program were transitioned directly into the CHSP on 1
July 2016 and those in the Western Australian HACC program were transitioned directly into the
CHSP on 1 July 2018.
Existing clients are defined as individuals who were accessing services or approved for services
at 1 July 2015 in Queensland, New South Wales, the Australian Capital Territory, Tasmania,

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South Australia and the Northern Territory, at 1 July 2016 in Victoria and 1 July 2018 in Western
Australia; have accessed services at least three times over the previous financial year; or who
received care for a continuous period of six months or more in the previous financial year.
Existing clients that have not accessed a CHSP service in the past twelve months must be
referred to My Aged Care for assessment before any services can be provided.
Existing clients that were transitioned into the CHSP also included some clients who would not
otherwise be eligible for the program (due to their age and/or level of support required). These
clients have been grandfathered into the CHSP and will be supported to transfer to more
appropriate services (such as the NDIS or HCP Program) where appropriate. Service providers
should work with My Aged Care and the client when their needs change to transition them to
more appropriate services, where possible.
Residential Care
Prior to 1 July 2015, services funded under the DTC Program were available to residents with
an Aged Care Funding Instrument (ACFI) ‘low’ score in Australian Government funded
residential care facilities. These DTC clients were grandfathered under the CHSP.
Clients needing services that exceed the level of ‘entry-level support’
Existing clients receiving services prior to 1 July 2015 will continue to receive CHSP support
from the current service providers at the current service level until they are transitioned to other
forms of more appropriate care. Where the client’s service needs have increased or changed,
they must be referred to My Aged Care for an assessment.
Existing clients receiving services over ‘entry-level support’ as they wait for a home care
package
Existing clients receiving services over ‘entry-level’ support prior to 1 July 2015 and waiting for a
home care package can continue to receive CHSP services at the current level until the home
care package becomes available.
Former NRCP or DTC Program clients aged under 65 years
Clients aged under 65 years who were accessing services under the NRCP or DTC Program
prior to 1 July 2015, can continue to receive services under the CHSP until:
• a more appropriate service becomes available, such as the NDIS.
• they no longer require the service.
Carers of clients under the age of 65
Prior to 1 July 2015, there was a small group of carers of clients under the age of 65 receiving
services under the former NRCP. Grandfathering arrangements will apply for existing respite
arrangements to ensure continuity of care for these clients. These clients may retain access to
equivalent services under the CHSP until other suitable services become available.
Registering CHSP clients with My Aged Care
All new and returning clients must enter into the CHSP through My Aged Care. In addition,
where an existing client’s needs change, including where there is a need for a new service type
or a significant increase to their existing service level, the client must be referred to My Aged
Care for an assessment before any additional services are provided.
Where an existing client does not have a My Aged Care record, but the client is receiving CHSP
services and their needs have changed, they will need to contact My Aged Care for a re-
assessment of their needs at which point a My Aged Care record will be created for the client.
The model being proposed for the in-home aged care program is for ongoing services to be
delivered primarily on an activity-based funding basis. From 1 July 2024 all clients will need to
be on My Aged Care with payments made to providers once the services are delivered. To
ensure providers are ready to transition a number of data activities will be undertaken in the
18 months leading to the start date. It is critical that every client who is receiving CHSP services
has an active client record in My Aged Care with all active service delivery linked to
organisations.

December 2022 – 65
The department engaged with the sector to assist in transferring existing clients into My Aged
Care in November 2022 further information about the client transition can be found at our
Reforming in-home aged care webpage or through contacting
[email protected].

4.2 Equity of access

Service providers must ensure that all their clients have equitable access to services. To
achieve equitable access, service providers must consider the following key principles:
• Physical access: all CHSP services must be able to offer accessible service options to
people with physical or sensory disabilities.
• All eligible people assessed as needing a service must have equal access to available
CHSP services whether they are an Aboriginal and/or Torres Strait Islander person; from
a diverse cultural and linguistic background; or on the grounds of location, marital status,
religion and spirituality, gender identity, sexual orientation and intersex status, disability
or whether they have the ability to pay for services.
• The CHSP does not have any exclusion from services based on citizenship, residency
status or eligibility for Medicare support.
• Eligibility does not translate to having an entitlement to services. Services may not be
able to be provided due to other people being assessed as a higher priority or resources
not being immediately available.

4.3 Prioritisation of referral

Priority of the referral will be determined by My Aged Care based on the information the contact
centre has available at the time of screening, including carer availability, cognition and function.
This will be provided with the referral through the My Aged Care provider portal. The priority
timeframes are referenced in the My Aged Care - Provider Portal User Guide available on the
Department’s website.
Service providers are to take this rating into account along with their own capacity to respond
with existing resources within the timeframes before accepting a client.

4.4 Assessment for entry to the Commonwealth Home Support

Programme
4.4.1 Assessment functions undertaken by My Aged Care
Entry and assessment for the CHSP is through My Aged Care. Detailed information for service
providers on interacting with My Aged Care and using the My Aged Care provider portal is
available on the Department of Health and Aged Care website.
My Aged Care incorporates a website and contact centre. The contact centre registers clients
via a phone-based screening process and determines the appropriate assessment pathway for
referral.
Screening and assessment are supported by a standardised national assessment process
(using the NSAF) and a central client record.
The My Aged Care assessment process
The contact centre registers the client (as appropriate), conducts a screening process over the
phone and will then do one of the following:
• refer the client for a home support assessment to be conducted by a RAS, if the client
can be supported by the CHSP.
• refer the client for a comprehensive assessment to be conducted by an Aged Care
Assessment Team (ACAT), if the client’s needs indicate a higher level of care could be
required under the Aged Care Act 1997.

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 • refer the client directly to CHSP service(s), in exceptional circumstances only, as well as
for a home support assessment to be conducted by a RAS or ACAT as circumstances
require.
• provide information about non-Commonwealth funded services.
Where screening over the phone is not appropriate, the contact centre will refer the client for
assessment using the information they were able to collect (and after obtaining the client’s
consent).
Assessments can also be applied for online at myagedcare.gov.au/assessment/apply-online. A
client, family member or friend acting on the client’s behalf, can register and complete a referral
for assessment quickly and easily. Clients can also access the eligibility checker at
myagedcare.gov.au/eligibility-checker.
Assessments can be conducted in the client’s home, over the phone or by video conference.
In person supports are also available at dedicated Services Australia service centres.
Appointments can be made with an Aged Care Specialist Officer (where one is available) at a
Services Australia service centre. Bookings can be made by contacting 1800 227 475
weekdays from 8am to 5pm.More information can be found in the My Aged Care Assessment
Manual.
Core functions delivered by the Regional Assessment Service
Once clients have undertaken a preliminary assessment of their circumstances and eligibility for
aged care services via a phone-based screening with the contact centre, they will then be
further assessed by a RAS to determine their care needs and to provide access to CHSP
services. The RAS is responsible for:
• independent assessment of new clients, with a holistic, goal oriented, wellness and
reablement focus.
• face-to-face assessments as best practice and whenever possible, noting that
assessments can also occur over the phone or by video conference where appropriate.
• involvement by family and their carers, representatives or other advocates as
appropriate.
• valuing and supporting a client’s identify, culture and diversity.
• assessing immediate needs of the client, and not recommending services that are not
supported by the assessment.
• supporting client choice and incorporating goal-based support planning.
• matching and referral of assessed clients to appropriate CHSP services and other
appropriate formal and informal support services to assist the client to live independently
in their own home.
• review or reassessment of existing clients where there is a change in the client’s
circumstances or care needs.
• identifying and supporting clients with special needs and vulnerable clients who require
short-term case management (i.e. linking support) to access a range of aged care and
other services e.g. health, housing, disability, financial and aged care services.
• short-term coordination services to assist a to restore their independence using wellness
and reablement approaches and reduce their need for ongoing CHSP services.
• during an assessment explain to a client that they are expected to contribute toward the
cost of the CHSP services they receive, if they can afford to do so.
• building and maintaining effective and respectful working relationships with all My Aged
Care assessors and service providers.
The RAS are required to have local knowledge of CHSP services.

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Comprehensive assessments for aged care services (such as home care packages) under the
Aged Care Act 1997 continue to be undertaken by ACATs. The RAS can refer clients to ACATs
(when required).
Access to Emergency CHSP services
People seeking access to aged care services for the first time must contact My Aged Care to
have a client record created and arrange for an assessment of their care needs.
Clients seeking new or increased services should not approach CHSP service providers before
registering with My Aged Care directly unless the client requires an urgent and immediate
health or safety intervention.
A client can be referred by My Aged Care directly to a CHSP service provider only if the client
has a need for an immediate health or safety intervention that is not available through other
means. The services where this is likely to happen include nursing, personal care, meals,
grocery shopping and transport.
The circumstances in which there is an urgent need for services to start immediately will vary.
Providers and the contact centre will need to make judgments on a case by case basis. For
example, a client may urgently need immediate services because a carer is no longer available
or there has been a sudden and dramatic loss of a client’s functional ability which, if not
addressed immediately, will place the client at risk.
It is acknowledged that a number of other services including home maintenance, home
modifications, goods, equipment and assistive technology and domestic assistance may be
sought urgently. However, it is less likely that a client’s safety would be at risk if these services
are not provided immediately, in advance of a holistic assessment by the RAS and an
Occupational Therapist (where appropriate).
If the client has a need for an immediate health or safety intervention that is not available
through other means, the services should be:
• For a one-off or short-term intervention (e.g. such as nursing for wound care, transport to
a specialist medical appointment or the delivery of meals, personal care and other
support services due to the absence of a carer) lasting no more than eight weeks.
• For a direct health or safety intervention that needs to occur before an aged care
assessment can take place.
• Monitored by the provider and if the client requires long term or ongoing access to
services, then the CHSP service provider must support the client to register with My
Aged Care (if they have not already done so) and arrange for a RAS or ACAT
assessment.
These circumstances recognise that there are limited situations where delivery of services is
required while maintaining the commitment to a more thorough analysis of the client’s needs by
the RAS or ACAT when possible.
If clients require access to ongoing or long term (greater than eight weeks) services, then the
CHSP service provider must support the client to register with My Aged Care (if they have not
already done so) and arrange for a RAS or ACAT assessment.
GPs and hospitals should use their existing processes and networks to refer patients who need
urgent CHSP services. My Aged Care should not be used for referrals for services that should
be provided to older people through the health system.
If a service provider is approached before the client has contacted My Aged Care, they can
assist clients with the My Aged Care registration process by:
• Calling My Aged Care with the person to help them register and be screened. This is the
quickest method to registering a client.
• Recording client details in an inbound referral form, accessed from My Aged Care that is
sent to the contact centre for actioning.
• Sending a fax with information about the person to My Aged Care for actioning.

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Aged care assessment
Where a face-to-face assessment is required, this will be conducted in the client’s home or
other appropriate location by the RAS (using the NSAF), building on the information collected by
the contact centre during the screening process. Face-to-face assessments are best practice
and conducted whenever possible. Where face-to-face contact between the assessor and a
client is not possible, for example, when assessing a client in a remote area or the client is
inaccessible due to a seasonal weather event or pandemic - a phone, video conference,
telehealth or teleconference assessment may be undertaken.
The assessment may result in referring clients to more specialised assessments undertaken
under the CHSP where required, such as allied health professionals. The central client record
will ensure clients do not need to unnecessarily repeat their story as Commonwealth-funded
service providers will have access to this information.
The assessment will focus on the strengths and immediate needs of the individual client, rather
than be specific to a particular program or care type. RAS assessors are appropriately skilled,
and trained to undertake assessments and identify services appropriate for a diverse range of
clients. The My Aged Care training requirements are set out in the My Aged Care Screening
and Assessment Workforce Training Strategy which defines and sets the minimum training
requirement for the My Aged Care Assessment Workforce.
The national training resources for staff conducting screening and assessment includes
consideration of the needs of people from Culturally and Linguistically Diverse (CALD)
backgrounds, Aboriginal and Torres Strait Islander people, LGBTIQA+ people, and working with
Carers and Care Relationships. The screening and assessment process, facilitated through the
NSAF, ensures diverse needs groups are appropriately considered and provided with culturally
appropriate support.
My Aged Care RAS assessors will approach assessment in a way that maximises client
independence and autonomy, supporting their desire and capacity to make gains in their
physical, social and emotional wellbeing by optimising physical function and active participation
in the community.
Where a client may benefit from a short period of more intensive supports, as part of a wellness
and reablement approach recommended by a My Aged Care RAS assessor, a goal orientated
support service can be delivered under the CHSP for a time-limited period. The nature of these
services should be identified in the support plan agreed with the RAS, including the duration of
the intensive supports.
Review of client needs
Changes in a client’s circumstances or an increase in the client’s service delivery needs will
require a support plan review to be undertaken by the RAS which may result in a new
assessment.
A support plan review refers to a check of the effectiveness and on-going appropriateness of
the services the client is receiving. A review of a client may take place where:

• a client has received restorative care interventions under CHSP and has made a
functional gain or improvement to remain independent.
• short-term or time-limited support/coordination utilising a wellness and reablement
approach has been undertaken by the RAS.
• the My Aged Care assessor sets a review date in the support plan for a short-term
service. For example, where the client is referred for time limited support under the
CHSP whilst a client is waiting for access to a home care package.
• a service provider identifies a change in the client’s needs or circumstances that affects
the existing support plan. Such as informal care arrangements have changed/ceased.
• a client identifies a change in their needs or circumstances or seeks assistance to
access new services or change their service provider.
CHSP service providers have an on-going responsibility to monitor and review the services they
provide to their clients under the client’s care plan to ensure that the client’s needs are being

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met. Where the My Aged Care assessor recommends short term or time limited services,
service providers should incorporate suitable review points in the client’s care plan or
equivalent. Where there is no recommended review date included in the client’s My Aged Care
support plan, service providers must undertake a review of services they are delivering at least
every 12 months. The outcome of this review is to be recorded on the My Aged Care client
record.
Where the client requires a different service or a significant increase in services, or where the
service provider’s review highlights needs or goals not identified on the client’s support plan, the
service provider must request a support plan review refer the client to the RAS (or the latest
assessment organisation) through the provider portal. A client completing a restorative care
program may also be referred to the RAS, for identification of any on-going services needed
following the end of the program.
Service providers should include clear and detailed information on the request for a support
plan review, justify the reason for the review request and, if necessary, outline the urgency for
the review. These actions will assist assessors with managing high volumes of review requests,
reduce the risk of the assessor cancelling the request or the need for the assessor to follow up
individual requests with the provider. Service providers follow the My Aged Care Provider Portal
User Guide for Team Leaders and Staff Members for further guidance on how to request a
support plan review and refer to the When to Request a Support Plan Review from an Assessor
Fact Sheet for more information.
The outcomes of the review may include:
• no change
• an increase or decrease in services or a new service recommendation
• a new assessment to be conducted by the RAS
• a referral to an ACAT for a comprehensive review for services accessed under the Aged
Care Act 1997.
If there is a significant change in the client’s needs and/or circumstances that affect the scope of
the support plan, a new assessment must be undertaken by an assessor. This may be initiated
by an assessor’s support plan review following a request for review by a service provider or by a
client. Clients will be referred to the assessment organisation that last undertook the
assessment.
Implementing a wellness and reablement approach
The RAS assessors meet with consumers to determine eligibility for Commonwealth subsidised
aged care services, and work with the client to identify areas of concern and set goals as part of
developing the client’s support plan. Where appropriate, they can refer clients to available
service providers.
Service providers then interpret the Home Support Assessment and support plan with a
wellness and reablement approach in mind and in consultation with the client by translating
each identified goal into smaller steps to enable clients to progress their goals.
The RAS assessors will be responsible for developing support plans with the client that may
result in referral to services that will support their independence utilising a wellness and
reablement approach. Such a plan might include some of the following:
• need for assistive devices or equipment
• in-home or community linked exercise and daily activity program
• strategies to reduce falls
• improved awareness and understanding of the use of medication
• ways of managing chronic disease, including improved ways of self-management.
Because of the nature of these services, it is possible there will be several items in the support
plan that need to be delivered in a coordinated way over a limited time period. In these

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circumstances, the assessor could refer a client to a lead provider, the organisation or individual
provider who will deliver the key services in the support plan.
More detail on implementing a wellness and reablement approach, to support independence
under the CHSP is provided under Chapter 2 of this manual and resources on the wellness and
reablement webpage.
Avenues for client complaints about assessment
If a client has a complaint about the assessment process or outcome, the client should contact
the RAS in the first instance. The RAS will document the complaint and attempt to resolve the
complaint within their internal complaints system. (RAS providers are required by the
Department to develop and document their own internal complaints system). If a client is not
satisfied that their complaint has been resolved by the RAS, they can escalate the complaint by
contacting My Aged Care. Complaints relating to assessment organisations are escalated to the
Department for investigation. Complaints about service providers are covered under 6.1.7.

4.4.2 Service provider requirements for interacting with My Aged Care

CHSP service providers must:
• provide and update their service data via the My Aged Care online provider portal.
• accept/reject client referrals via the My Aged Care online provider portal in a timely way
specified by the referral priority. Please refer to the department’s website for timelines for
managing referrals.
• accept referrals where they have capacity to provide the services in a timely manner.
• refer or help clients to access My Aged Care where clients have approached them
directly.
• enter and regularly update service information (including commencement date and
frequency/volume of services, waitlist availability) and update client details on the client
record.
• undertake a review of services being delivered, at least every 12 months with the
outcome of the review recorded on the client record.
• maintain up to date service information for the organisation within the provider portal to
support accurate and timely referrals and access for clients.
• deliver services within the scope of the service recommendations specified on the
support plan.
• refer clients back to My Aged Care when their needs have changed through support plan
review request functionality.
• discharge clients whose needs and goals specified on the support plan have been met
and who no longer require care and services.
• Encourage clients whose needs are no longer met by entry level CHSP to have a
reassessment (through a support plan review request) for other aged care programs that
could be more suitable to their changing needs.
• participate in assessment, referral and client record processes as appropriate to support
data integrity within My Aged Care.
CHSP providers can refer to the My Aged Care provider portal resources for service providers
on the Department of Health and Aged Care website.
The use of waitlists
The decision to use and the responsibility for managing waitlists for CHSP services is an
internal business decision for individual service providers. CHSP providers should not accept
clients to waitlists where services are not imminently available as this may prevent other local
CHSP service providers with capacity from meeting client needs.

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4.4.3 Assessment functions undertaken by CHSP service providers
Assessment for eligibility and CHSP services is undertaken by My Aged Care RAS or ACAT
assessors who after completing the assessment, refer the client to services delivered by
approved service providers.
This separation of assessment from service provision allows for the application of a nationally
consistent and standardised approach to assessment delivery. Organisations with service
provision and assessment arms must demonstrate operational separation between these
different services.
However, CHSP service providers are also required to undertake a small number of
assessment functions, where they are intrinsic to the service being delivered.
These include:
• Service level assessment activities relating to the service provider, such as undertaking
Work Health and Safety assessments (for both the care worker and client).
• Specialised assessment based on professional expertise (e.g. Nursing, Allied Health and
Therapy Services; and face-to-face malnutrition risk assessments by Meals providers
where organisations have this knowledge and capacity).
• On-going monitoring of the client, the home environment; and appropriateness of service
arrangements.
• A formal review of services must be undertaken at least once every 12 months (these
may be done over the phone or face to face with the client).
• Support Plan Review request to an assessor through the My Aged Care service provider
portal if the client’s care needs change significantly (e.g. high levels of additional
services are required or new service types are needed). This will likely lead to a new
assessment.
In addition, service providers must follow requirements identified at Section 4.4.2 of this
program manual.
Reporting time spent on assessment and client care coordination:
Where the service level assessment functions involves direct client interaction, the amount of
assistance provided by a CHSP service provider can be recorded in DEX as a session of that
service sub-service type i.e. nursing, occupational therapy, garden maintenance etc.
Time spent arranging services without direct client interaction (except under the Assistance with
Care and Housing sub-programme) should not be reported in DEX.

4.4.4 My Aged Care interactions

Service level assessment
All review and assessment functions undertaken for the CHSP must incorporate the eligibility
and service information and Work Health and Safety requirements outlined in this program
manual.
Privacy and confidentiality
Assessment practices must be in accordance with processes to protect client privacy and
confidentiality.
Sensitive information
With the client’s consent, notify My Aged Care if there is sensitive information concerning the
client that could affect the health and safety of other My Aged Care workforces. This information
is recorded as a sensitive note in the client record that is visible to assessors and contact centre
staff.
Sensitive notes or attachments are not visible through the provider portal. Instead, a message
will display on the client’s record stating “The client has a sensitive note/attachment on the
record”. If you see this message on your client’s record, you should contact the assessor
directly, or call the My Aged Care service provider and assessor helpline on 1800 836 799.

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They will be able to provide you with any relevant information, if it impacts on services you
provide.
Recording deceased clients
When a provider becomes aware a client has passed away, a record must be made in the My
Aged Care provider portal.
Ceasing a client’s service with the reason of ‘Client Deceased’ will change the client’s status to
‘Deceased’ and make the client record READ ONLY. Any unaccepted service referrals will be
recalled and the client’s access to the client portal will be revoked.
Changing the client’s status in this way will also remove the client from the home care package
national priority system (the queue) and withdraw any assigned home care packages. This is
important to prevent distress for grieving family members caused by correspondence received
regarding deceased loved ones.
Instructions on how to discontinue a deceased client’s service in My Aged Care are available in
the Quick Reference Guide - Recording and updating client service delivery information.

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Chapter 5 – Client contribution framework
5.1 Operation of the framework
In October 2015, a principles-based Client Contribution Framework (the Framework) was
introduced for the CHSP. CHSP service providers must adhere to this principles-based
approach to the charging, collecting and reporting of client contributions.
The Framework outlines the principles service providers should adopt in setting and
implementing their own client contribution policy with a view to ensuring that those who can
afford to contribute to the cost of their care do so, whilst protecting those most vulnerable. It is
designed to support the financial sustainability of the CHSP whilst creating fairness and
consistency in the way both new and existing clients contribute to the cost of their care.

5.2 Exclusions from the framework

Some CHSP activities and services are specifically excluded from this Framework:
• Assistance with Care and Housing Sub-Program
• Sector support and development activities

5.3 Framework objectives

For all other services provided under the CHSP, it is expected that contributions towards the
cost of care will move towards a nationally consistent approach over time.
Other than for those services outlined under section 5.2, all CHSP service providers are
required to have a documented and publicly available client contribution policy in place that
aligns to this Framework and balances the following objectives:
• To move towards national fairness and consistency in client contributions
Service providers should move towards collecting contributions if they are not already doing so.
Service providers will need to disclose their contribution policy across their range of services
and agree contribution amounts with clients in advance of care being provided. The creation
and application of a client contribution framework for the provision of CHSP services provides
an opportunity to address a number of inconsistencies and financial anomalies inherent in the
existing fees and charges for services provided to assist frail older people to remain in their own
homes.
• Improve the sustainability of the CHSP
Those service providers who have not previously required clients to make a contribution for
the services they receive must have in place a contribution policy with a view to supporting
ongoing service delivery and utilising the additional revenue to expand their services.
• Provide appropriate safeguards for financially disadvantaged clients
Client contributions policy should ensure that those least able to contribute towards the cost of
their care are protected.

5.4 Client contribution principles

Contribution policies for the provision of CHSP services should incorporate the principles below.
Further explanation and case studies are provided in the separate National Guide to the Client
Contribution Framework.
1. Consistency: All clients who can afford to contribute to the cost of their care should do
so. Client contributions should not exceed the actual cost of service provision.
2. Transparency: Client contribution policies should include information in an accessible
format and be publicly available, given to, and explained to, all new and existing clients.
3. Hardship: Individual policies should include arrangements for those who are unable to
pay the requested contribution.

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 4. Reporting: Grant agreement obligations include a requirement for service providers to
report the dollar amount collected from client contributions.
5. Fairness: The Client Contribution Framework should take into account the client’s
capacity to pay and should not exceed the actual cost to deliver the services. In
administering this, service providers need to take into account partnered clients, clients
in receipt of compensation payments and bundling of services.
6. Sustainability: Revenue from client contributions should be used to support ongoing
service delivery and expand the services providers are currently funded to deliver.

5.5 Guide to the framework

The National Guide to the CHSP Client Contribution Framework (the Guide) was also
introduced in October 2015. The Guide complements the Framework and has been developed
for service providers to assist with the establishment of flexible options for client contribution
arrangements and updated in June 2022.

5.6 CHSP reasonable client contributions

A CHSP reasonable client contribution range for each service type is available under 3.2 –
CHSP national unit price ranges. These ranges were developed along with the unit prices and
have been provided as a guide to assist CHSP providers to implement or review their client
contribution policy.
Please note that these reasonable client contribution ranges are provided as a guide and may
not be suitable for all client contribution policies. CHSP providers will still need to follow the
guidance in this chapter.

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Part B – Administration of the Commonwealth Home
Support Programme
Chapter 6 - Service provider and Departmental responsibilities
6.1 Service provider responsibilities
In entering into a Grant Agreement with the Department, the service provider must comply with
all requirements outlined in the suite of documents that comprise the Agreement, including:
• the CHSP Extension Grant Opportunity Guidelines
• the Commonwealth Standard Grant Agreement (including the Commonwealth Standard
Grant Conditions and any Supplementary Terms from the Clause Bank)
• the Grant Details (including any other document referenced or incorporated in the Grant
Details including the Activity Work Plan)
• this CHSP Program Manual
• the Aged Care Quality Standards
• other documents incorporated by reference into the above documents.

Service providers are responsible for ensuring:

• the requirements of the CHSP Grant Agreement are met
• service provision is effective, efficient and appropriately targeted
• services delivered to clients are in line with individual goals, recommendations and
assessment outcomes as identified in their individual My Aged Care support plan.
• wellness and reablement, and restorative approaches to service delivery support older
people improve their function, independence and quality of life
• highest standards of duty of care are applied
• services are operated in line with, and comply with, the requirements as set out within all
state and territory and Commonwealth legislation and regulations
• that staff and volunteers in direct care roles with responsibility for the safe delivery of
services to clients or groups of clients, receive current and accredited first aid
certification
• that up-to-date infectious disease controls and policies are in place and enforced.
• older people with diverse needs have equal and equitable access to available services
and are delivered in line with the Aged Care Diversity Framework
• they work collaboratively with stakeholders to deliver services
• they contribute to the overall development and improvement of service delivery such as
sharing best practice
• they manage and keep up-to-date their service information via the My Aged Care web-
based provider portal.

CHSP providers can refer to the CHSP My Aged Care Provider Journey infographic on the
Department of Health and Aged Care website for further information.

This chapter outlines service provider and Departmental responsibilities relating to the
administration of the CHSP, including:
• Quality arrangements (Section 6.1.1).
• Funding arrangements (Section 6.2).

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 • Reporting requirements (Section 6.3).

6.1.1 Quality arrangements for service delivery

All CHSP service providers must operate in line with the Aged Care Quality Standards (the
Standards) and have appropriate procedures in place to meet these. The Quality Standards
relate to quality of care and quality of life for the provision of aged care in the community. A link
to the Standards is provided in Appendix A of this program manual. The Standards require
service providers to demonstrate effective management processes based on a continuous
improvement approach to service management, planning and delivery.
This includes policies for managing staff and volunteers, regulatory compliance with funded
program guidelines, relevant legislation including work health and safety legislation and
professional standards and having complaint mechanisms in place. Some of the Home Care
Standards relate to service access and assessment and referral practices.
The Standards apply to all aged care services including residential care, home care, flexible
care and services under the CHSP.
There are eight Standards including:
• Standard 1 Consumer dignity and choice
• Standard 2 Ongoing assessment and planning with consumers
• Standard 3 Personal care and clinical care
• Standard 4 Services and supports for daily living
• Standard 5 Organisation’s service environment
• Standard 6 Feedback and complaints
• Standard 7 Human resources
• Standard 8 Organisational governance
Each of the eight Standards includes:
• a statement of outcome for the consumer
• a statement of expectation for the organisation
organisational requirements to demonstrate that the standard has been met.
The Standards have been structured so that aged care providers will only have to meet those
Standards that are relevant to the type of care and services they provide and the environment in
which services are delivered. For more information, providers should visit the Aged Care Quality
and Safety Commission website.
My Aged Care undertakes the registration, screening and assessment of clients requiring aged
care services. Although the responsibility of assessments for services under the CHSP resides
with My Aged Care and RAS, service providers are expected to continue to monitor and review
the client’s circumstances to ensure the service delivery is appropriate for the client in meeting
their care needs. Service providers must comply with all requirements relating to access and
assessment as outlined in Chapter 4 of this program manual.
Service providers must report through the Data Exchange that they have a client contribution
policy in place that is consistent with the Client Contribution Framework as detailed in Chapter 5
of this program manual.
Quality reviews
The Aged Care Quality and Safety Commission undertakes all quality reviews of aged care
services provided in the community, including the CHSP service providers. In accordance with
the CHSP Grant Agreement, service providers are obliged to provide the Aged Care Quality and
Safety Commission with access to a service delivery site or service outlet, for the purpose of
undertaking a quality reporting site visit.
The Aged Care Quality Standards support service providers to maintain the high quality of
service delivery expected by all providers of aged care. Only the CHSP sub-programs which

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deliver direct care to clients will be subject to Quality Reviews by the Aged Care Quality and
Safety Commission.
Further information about the Quality Review process is available at the Aged Care Quality and
Safety Commission website. Service providers must address any non-compliance and return to
compliance as quickly as possible.
Note: the Sub-Programs Assistance with Care and Housing and the Sector Support and
Development are not subject to Quality Reviews.

6.1.2 Client rights and responsibilities

Service providers must comply with the Charter of Aged Care Rights within the User Rights
Amendment (Charter of Aged Care Rights) Principles 2019 under the Aged Care Act 1997.
Respect for, and promotion of, the rights of clients is integral to the consumer choice philosophy
that underpins the CHSP, which also includes a strong emphasis on wellness and reablement.
New CHSP clients
CHSP service providers must meet all of the requirements of the Charter for all new clients
before they enter the CHSP service. For all new clients, CHSP service providers have a
responsibility to:
• give the client a copy of the Charter signed by a staff member of the provider;
• assist the client to understand information about consumer rights and responsibilities in
relation to the aged care service and consumer rights under the Charter;
• ensure the client, or their authorised person, are given a reasonable opportunity to sign
a copy of the Charter;
• keep a record of the Charter given to the client, including:
o the signature of provider’s staff member; and
o the date on which the provider gave the client a copy of the Charter; and
o the date on which the provider gave the client (or their authorised person) the
opportunity to sign the Charter; and
o the full name and signature of the client (or authorised person) if they choose to
sign).
The purpose of seeking the client’s signature is to allow them to acknowledge they have
received the Charter and have been assisted to understand it and their rights.
Clients are not required to sign the Charter and can commence, and/or continue to receive care
and services, even if they choose not to sign the Charter.
Where a client, or authorised person, has not signed a copy of the Charter, providers will need
to:
• set out the date on which the client, or authorised person, was given a copy of the
Charter
• include the full name of the client or authorised person.
Additional information about the Charter is available on the Aged Care Quality and Safety
Commission website.
Scheduling appointments
In accordance with the Aged Care Quality Standards, clients have the right to be consulted and
respected, receive services that are appropriate, planned, delivered and evaluated regularly and
have access to complaints and advocacy information and services.

Where possible, service providers should seek to maintain regular and consistent appointment
schedules. Service providers should give their clients as much notice as possible if they have to
reschedule, cancel or are running late for an appointment. Where a client is unhappy with their

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care plan arrangements and, they need to contact their service provider in the first instance to
make alternative arrangements.

Where a client cancels their appointment within 24 hours of the visit start time, providers do not
need to record the service as it was not delivered. Providers should have a clear cancellation
policy as part of their client contribution policy and clients should be made aware of this as part
of their care plan discussions.

6.1.3 Police checks

Service providers have a responsibility to ensure staff members working with vulnerable people,
volunteers and executive decision makers undergo police (or relevant) checks.
Service providers have a responsibility to ensure that all staff, volunteers and executive decision
makers working in CHSP services are suitable for the roles they are performing. Service
providers must ensure that staff involved in service delivery, including sub-contractor staff
meets the Commonwealth Home Support Programme Police Certificate requirements at
Appendix D of this program manual.
The CHSP Police Certificate Guidelines have been developed to assist service providers with
the management of police check requirements under the CHSP (Appendix D).
Where urgent and immediate staff or volunteer recruitment is necessary, CHSP providers may
allow essential workers who have applied for, but not yet received, a police check to make a
statutory declaration before commencing duties. In these instances, the employee or volunteer
must sign a statutory declaration stating that they have never, in Australia or another country,
been convicted of a serious or violent crime. A statutory declaration template and more
information about statutory declarations are available at the Attorney-General’s Department’s
website.
The payment of the cost of obtaining a police certificate is a matter for negotiation between the
service provider and the individual. Individuals may be able to claim the cost of the police
certificate as a work-related expense for tax purposes. Further advice on this issue is available
on the Australian Taxation Office website.
Volunteers may be eligible to obtain a police certificate at a reduced cost whether the certificate
is requested by an individual or by a service provider on behalf of a volunteer. This must be
confirmed with the agency issuing the police certificate.
Note: The NDIS worker screening arrangements are acceptable for employees who also deliver
services under the CHSP.

6.1.4 Staffing and training

Service providers are required to meet staffing and training requirements under the Standards.
Examples of desirable staff qualifications under the CHSP are outlined in the ‘Staff
Qualifications’ sections in Chapter 3 of this program manual.
First Aid Training
To help support vulnerable, older Australians, all CHSP service providers are responsible for
ensuring staff and volunteers in direct care roles receive accredited first aid training and
certification as soon as practicable.
The department regards the cost of first aid training as a reasonable and necessary expense of
safe and effective aged care service delivery. As such, CHSP providers should factor the cost of
first aid training into their existing grant funding in the same way as rent, utilities, personal
protective equipment and staff wages. CHSP providers can use their existing CHSP grant
funding, including unspent funds, to cover the cost of staff and volunteers attending first aid
training and refresher courses, where applicable.
It is the responsibility of CHSP providers to factor the level and appropriateness of first aid
training needs into their business risk management plan. In considering the level of training
offered to staff and volunteers, CHSP service providers should consider the specific needs of

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their clients and any additional risk factors they may present (e.g. dementia; falls risk; other
disabilities, health problems or co-morbidities).
Where appropriate, CHSP providers may consider the option of online first aid courses to
enable staff or volunteers to complete the training where it is difficult to attend a face-to-face
course.
It is the responsibility of individual service providers to factor into their business risk
management strategies how many and which staff/volunteers need to hold and maintain First
Aid Training qualifications to ensure the safe delivery of services to their clients.

6.1.5 Work Health and Safety

Legislation relating to Occupational Health and Safety (OH&S) is being replaced by legislation
referring to Work Health and Safety (WHS) following the passage of the Work Health and Safety
Act 2011 Commonwealth.
The Australian Government, Northern Territory, Queensland, New South Wales, Tasmania,
South Australia and the Australian Capital Territory have implemented the new legislation.
Victoria and Western Australia have not yet introduced the WHS legislation. It is intended that
the term OH&S will be incrementally replaced with WHS in all Australian Government, state and
territory documents.
Providing a safe and healthy workplace
CHSP service providers must provide a safe and healthy workplace for their employees and
volunteers in accordance with relevant Commonwealth, and state or territory governments WHS
or OH&S legislation, as well as relevant codes and standards.
In many cases, the workplace will be the client’s home. Service providers are responsible for
addressing the safety of employees and volunteers delivering services to a client or carer in
their home.
Service providers are required to be aware of their obligations to comply with state and territory-
based laws and regulations relevant to the safe handling and removal of asbestos when
undertaking home modifications to the homes of clients. For detailed information on laws
applying to the workplace, service providers must contact the relevant work health and safety
regulator in their state or territory.
Service providers must also consider and assess WHS, or OH&S, Australian Building
Standards and other local requirements, as these relate to their own offices and facilities,
vehicles, and other physical resources used by their staff and volunteers.

6.1.6 Client not responding to a scheduled visit or service

Service providers should refer to the Guide for Community Care service providers on how to
respond when a client does not respond to a scheduled visit (the Guide) published in
September 2009 as a set of nationally consistent protocols to deal with non-response from a
client who was scheduled to receive a service.
Service providers may use the Guide when developing their own policies and procedures on the
issue of clients not responding to scheduled visits.

6.1.7 Complaints mechanism

Dealing with complaints about services
CHSP clients and their carers must be actively encouraged to provide feedback about the
services they receive. A client has the right to call an advocate of their choice to present any
complaints and to assist them through the complaints management process.
Clients (or their representative) can raise a complaint in the following ways:
• Directly with the service provider through their publicly available complaints system.
• With the Aged Care Quality and Safety Commission on an open, confidential or
anonymous basis by phoning 1800 951 822 [free call] or by visiting the website
www.agedcarequality.gov.au.

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The Aged Care Quality and Safety Commission provides a free service for anyone to raise
concerns about the quality of care or services delivered by Australian Government funded aged
care services. The Aged Care Quality and Safety Commission is independent of the
Department of Health and Aged Care.
The Aged Care Quality and Safety Commission takes all complaints seriously and will work with
the client (and/or their representative) and the service provider to resolve the concerns.
The Aged Care Quality and Safety Commission’s process for handling complaints is outlined on
their website at www.agedcarequality.gov.au.
This includes the capacity for the Aged Care Quality and Safety Commission to issue a direction
to a CHSP service provider where they fail to meet their responsibilities under the CHSP Grant
Agreement. In these circumstances, the direction will be issued through a Notice under the
CHSP Grant Agreement. The provider is obliged to comply with any direction issued.
Service providers are also responsible for the services provided by subcontractors, including
resolving any complaints made about that organisation. Should a complaint regarding a
subcontractor be made, the service provider retains responsibility for liaison with the Aged Care
Quality and Safety Commission and ensuring the subcontractor complies with all reasonable
requests, directions and monitoring requirements requested.
In recognition that many service providers also deliver multiple services through other
Australian Government and/or state and territory government programs, the Aged Care Quality
and Safety Commission will, from time to time, share information with other relevant parties to
ensure clients continue to receive appropriate services.
CHSP clients can also contact the Older Persons Advocacy Network (OPAN) if they would like
assistance in directly engaging with Commonwealth-funded aged care services. OPAN supports
consumers to access and interact with Commonwealth funded aged care services and can be
contacted on (free call) 1800 700 600 or at www.opan.org.au.
If a CHSP client witnesses, suspects or experiences elder abuse, they can contact the National
Elder Abuse phone line for free and confidential information, support, and referrals. Elder abuse
may involve physical harm, misuse of money, sexual abuse, emotional abuse or neglect. CHSP
clients can call 1800 ELDERHelp (1800 353 374) or visit the COMPASS website at
www.compass.info for information, a support directory and resources about elder abuse.

6.1.8 Service continuity

Service providers must develop Activity Continuity Plans that address any risks associated with
being unable to continue to deliver services and have systems, internal policies and processes
in place to appropriately manage, monitor and report incidents. The Activity Continuity Plan
should include:
• Management of serious incidents such as natural disasters and emergency events (e.g.
how to provide service delivery in the event of an emergency such as flood, fire or during
a heatwave).Transitioning-out of service provision (e.g. transferring services to another
service provider or where the CHSP Grant Agreement has expired or is terminated).
Compliance with the Standards
In line with the Aged Care Quality Standards, service providers are required to have systems
and processes in place to identify, manage and respond to risks in relation to service continuity,
serious incidents and other events.
Transition out
The 'transition-out' component of Activity Continuity Plans ensures clients’ service standards
and delivery are not compromised. The transition out plan details how service providers plan will
ensure continuity of service delivery to CHSP clients in the event of termination or expiry of a
grant agreement, including if an organisation requests to withdraw from providing CHSP
services.

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Transition out plans should include the following:
• service details, including specific services being delivered to client groups i.e. cultural or
centre based activities specifically designed to meet the needs of clients;
• client details, including information about high risk or high need, CALD, Indigenous or
other clients to ensure a smooth and efficient transition of services;
• specific service delivery requirements due to cultural, area specific (rural/remote) or
other reasons that impact on current service delivery and transitioning services;
• client details such as the status of clients’ care plans and reviews and information about
client waitlists (if any);
• details of any communications with staff about services being proposed for withdrawal;
• My Aged Care and DEX data registration details, including whether information and care
plans are up to date;
• information about inactive clients;
• any subcontracting arrangements; and
• detail any current issues that may impact the client transition.
Organisational information
• timeframe with activities to undertake for transition
• staffing arrangements
• assets
• information and records (including authority of release from the clients)
• communication strategy
• telephones.
Service providers must notify their Funding Arrangement Manager and the Department of
Health and Aged Care in writing of their proposal to transfer all or part of their services as soon
as possible with a ‘draft’ Transition Out Plan being provided at this time. The proposed
withdrawal date must be a minimum of four months from the date of the first ‘draft’ transition out
plan being provided to the organisation’s Funding Arrangement Manager and the Department
via email. service providers must negotiate with the Department on a suitable transition date
with the replacement organisation. Providers can seek a copy of the transition Out template
from their Funding Agreement Manager.
The transition out plan is intended to assist CHSP service providers to develop their strategic
planning for a smooth transition of services to an alternative CHSP service provider. It is
imperative that the standard and delivery of services do not suffer, and continuity of care is
supported through the transition. The department uses the Transition out plan as a tool in
selecting incoming providers based on information including client numbers, models of care,
access to facilities and regional coverage.
The service provider must assist the Department and new service provider/s in the transition of
goods and/or services to achieve an effective transition. This includes client care continuum
with the provision of the goods and/or services from your organisation to the new provider.
CHSP ad hoc grant opportunity
The Department recognises the operating environment and demand for services may change
during the term of the current CHSP grant agreement. To support CHSP service providers to
respond flexibly to local changes, CHSP providers may be able to access additional funding
through ad hoc grant opportunities. CHSP providers can access information about how and
when to apply and any application forms on Grant Connect.

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6.1.9 Acknowledging the funding
Service providers must acknowledge Commonwealth financial and other support in all
applicable Grant Agreement Material that they publish. The following wording must be used:
“Funded by the Australian Government Department of Health and Aged Care”. Or
“Supported by the Australian Government Department of Health and Aged Care”.
CHSP providers should not use the Commonwealth Coat of Arms in their internal advertising
and promotion of CHSP services.
Disclaimer
Publications and published advertising and promotional materials that acknowledge the CHSP
funding must also include the following disclaimer:
“Although funding for this [insert service/activity] has been provided by the
Australian Government, the material contained herein does not necessarily represent the views
or policies of the Australian Government.”
Other options for acknowledging the funding
If for any reason service providers wish to acknowledge the funding in a different manner to the
options set out in this program manual, they must obtain the Department’s prior written consent.
Questions on acknowledging funding
Service providers who are unsure whether they need to acknowledge the CHSP funding or
have any queries relating to acknowledgement of funding should contact their Funding
Arrangement Manager.
Monitoring of the use of acknowledgements
Service providers are responsible for ensuring they and their subcontractors comply with the
requirements for acknowledging the funding which are set out in this section.
The Department will notify service providers in writing if it considers that a service provider or
their subcontractor has failed to comply with the CHSP Grant Agreement. In certain
circumstances, the Department may, by notice in writing, revoke its permission for any person to
use this wording (for example, if the service provider or subcontractor has not complied with all
the requirements of this program manual).
Service providers should inform the Department if they become aware of any unauthorised use
of the due recognition branding by any person.

6.1.10 Subcontracting
Service providers may select and use subcontractors in accordance with Condition 6
[Subcontracting] of Schedule 1 of the CHSP Grant Agreement.

6.1.11 Responsibilities during a national or state emergency

The Department of Health and Aged Care reserves the right to enact temporary changes to
program guidelines in the event of a national or state emergency. This may include relaxing
flexibility provisions, waiving or extending reporting deadlines and performance milestones or
modifying service type descriptions in accordance with the nature, severity, duration and
geographic scale of the emergency.
Any changes to the program will be communicated to the sector via the Department’s regular
newsletters and announcements. All service providers should sign up to access these
resources on the Department’s website: https://www.health.gov.au/using-our-
websites/subscriptions/subscribe-to-aged-care-sector-announcements-and-newsletters.

For more information, please contact your Funding Arrangement Manager.

6.1.12 COVID-19 Vaccination Reporting

All CHSP providers are required to report on their staff COVID-19 vaccinations in the My Aged
Care provider portal. The information reported on the in-home community care workforce

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COVID-19 vaccination status is used to determine worker vaccination status ensuring an
accurate picture of the level of vaccination coverage across the in-home aged care workforce.
For information, refer to the Health website under Mandatory COVID-19 vaccination reporting.

6.1.13 Spending the grant

Service providers must spend the funds in accordance with their CHSP Grant Agreement.
Service providers are responsible for sustainably managing their service delivery and number of
clients. Service providers are contracted to deliver a specific number of outputs and any
decision to exceed these agreed outputs is taken at your own risk and cost.
For information on availability of CHSP funding, please refer to the CHSP Guidelines, and the
CHSP website.
Payment in arrears
All CHSP providers, excluding providers who only deliver SSD, will receive a standard monthly
payment in arrears. This standard monthly payment is the total value of the grant agreement
divided by twelve. SSD providers’ funding will remain upfront quarterly payments.
Payments will be released automatically in line with the CHSP grant agreement. Due to
processing, it may take three to four business days before CHSP providers receive their
monthly payment. Payments may be delayed if a provider is not up to date with their monthly
Data Exchange reporting obligations.

6.1.14 Assets
Service providers must refer to Supplementary Term 5 [Equipment and assets] of the CHSP
Grant Agreement and comply with the requirements for acquiring and managing Assets with the
funds.

6.1.15 Code of Conduct Aged Care

The Code of Conduct for Aged Care will protect care recipients by ensuring a suitable standard
of conduct from their aged care providers, workers and governing persons (for example, board
members and CEOs).
The Aged Care Quality and Safety Commission will monitor and enforce compliance with the
Code, as well as training and development of educational materials.
From 1 December 2022, new powers will allow the Aged Care Quality and Safety
Commissioner to take enforcement action for breaches of the Code. Enforcement actions can
include banning or restricting individuals from working in aged care.
Banning Orders under the Code of Conduct
Before employing or otherwise engaging or extending or renewing the contract or agreement of
a person (whether as a staff member, volunteer or executive decision-maker), CHSP service
providers have a responsibility to take reasonable steps to ensure they do not commence the
employment or engagement of an individual to whom a banning order under the Aged Care
Quality and Safety Commission Act 2018 applies inconsistently with the requirements of that
banning order.
For more information, go to the department’s website or the Aged Care Quality and Safety
Commission website and search for Code of Conduct for Aged care.

6.2 Serious Incident Response Scheme (SIRS) responsibilities

From 1 December 2022, the Serious Incident Response Scheme (SIRS) requirements apply to
providers of aged care in home or community settings. This includes providers of home care or
flexible care provided in home or community settings under the CHSP.
The SIRS aims to reduce abuse and neglect in aged care. Under the SIRS, service providers
have responsibilities to manage incidents and take reasonable steps to prevent incidents,

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including implementing and maintaining an incident management system. Service providers are
also required to report certain incidents to the Aged Care Quality and Safety Commissioner
(Commissioner).
CHSP service providers will also have to provide certain protections to persons who make
disclosures about reportable incidents.
Incident management system
The SIRS requires service providers to have in place and maintain an effective incident
management system – a set of protocols, processes, and standard operating procedures that
staff are trained in and are expected to use when reporting and responding to incidents.
The incident management system is used to deal with a broad range of incidents that occur, or
are alleged or suspected to have occurred, in connection with the delivery of aged care, that
either have caused, or could reasonably have been expected to have caused, harm to a client
or another person. For example, this would include a client assaulting a staff member of the
service provider, or a staff member of the service provider using unreasonable use of force
against a client. Service providers must establish and document a set of incident management
procedures to be followed to support the identification, management and resolution of incidents
that can occur during the course of delivering care and services to clients. The procedures must
address the following:
• how incidents are identified, recorded, and reported, and to whom incidents must be
reported to.
• how the service provider will provide support and assistance to those affected by an
incident to ensure their health, safety, and wellbeing (e.g., providing information about
access to advocates).
• how those affected by an incident (or their representatives) will be involved in managing
and resolving the incident.
• when and how the service provider will require an investigation into an incident to work
out the cause, any harm, and any operational issues that may have contributed to the
incident occurring.
• when remedial action is required and what that action would be.
• who is responsible (e.g. a staff member) for notifying the Commissioner about reportable
incidents (explained under the ‘Reportable Incidents’ heading below).
This set of procedures will assist service providers and their staff to have a standardised
approach to identify, respond to, resolve, and learn from incidents.
The documented procedures must be made available in an accessible form to clients, their
families, representatives, advocates and other significant persons, and each staff member of
the service provider. The service provider should be able to assist these persons to understand
how the procedures operate and ensure that all of their staff comply with the incident
management system.
The service provider must also provide training for each staff member on using and complying
with the incident management system including staff roles and responsibilities.
As part of the incident management system, the service provider must have a recording tool
that is used to capture information about incidents. Some incident management systems use
computer-based electronic tools, while others are paper-based. When recording incidents, the
incident management system must include the following details, as a minimum, about each
incident:
• a description of the incident including the harm that was caused, or could reasonably
have been expected to have caused, to each person affected by the incident, and if
known, the consequences of that harm,

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 • if known, the time, date, and place it happened, or was alleged or suspected to have
happened,
• the time and date the incident was identified,
• the name and contact details of the person/s directly involved in the incident,
• the name and contact details of any witnesses to the incident,
• details of the assessment of the support and assistance required, and the actions taken
to ensure the health, safety, and wellbeing of those affected by the incident,
• details of the assessment of whether the incident could have been prevented and how
well the incident was managed and resolved,
• details of what action could be taken to improve management and resolution of future
similar incidents and what actions have been taken in response to the assessment,
• details of the assessment of whether remedial action needs to be taken, and if so the
details of the action taken,
• whether there were reasonable grounds to report the incident to police, and if so the
details of when and how the incident was reported,
• details of the assessment of how to appropriately involve those affected by the incident
in the management and resolution, the actions taken to involve those persons and any
other consultations undertaken with the people affected by the incident,
• whether persons affected by the incident have been provided with any reports or
findings about the incident,
• if an investigation was undertaken into the incident, and if so, the details and outcomes,
• the name and contact details of the person making the record of the incident, and
• whether the incident is a reportable incident (explained under the ‘Reportable Incidents’
heading below).
These records must be kept for seven years after the incident was identified. The Aged Care
Quality and Safety Commission (the Commission) may request to see these records as part of
its compliance and monitoring functions.
Service providers must be able to use the information collected through their incident
management system to be able to identify similar incidents, and to assist with meeting other
incident management responsibilities (explained under the ‘Managing and responding to
incidents’ heading below).
While all incident management systems should have the above components in common, the
detailed design of each provider’s incident management system is likely to be different. This is
because an incident management system should be tailored to the service size, location, the
types of services provided, and the clients receiving the services.
For more information and examples on incident management systems, please review guidance
on the Commission’s website.
Managing and responding to incidents
Under the SIRS service providers need to manage incidents and take reasonable steps to
prevent incidents with a focus on the health, safety, and wellbeing of clients.
Consistent with the incident management system arrangements, these responsibilities relate to
a broad range of incidents that occur, or are alleged or suspected to occur, in connection with
the delivery of aged care, that either have caused, or could reasonably have been expected to
have caused, harm to a client or another person.
As part of these responsibilities, service providers must respond to incidents by assessing and
providing support and assistance to persons affected by incidents to ensure their health, safety,
and wellbeing. Service providers should use an open disclosure process and make sure to
involve persons affected by incidents in the management and resolution process.

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CHSP service providers must also assess the incident (taking into account the views of those
affected), including whether:
• it could have been prevented,
• if any remedial action needs to be undertaken to prevent similar incidents and minimise
harm,
• it was managed and resolved well,
• any actions could be taken to improve management of similar incidents in future, and
• other persons or bodies should be notified of the incident.
CHSP service providers must take reasonable steps to implement any remedial actions that
may need to be taken to prevent similar incidents identified through this process. The service
provider should also implement any actions identified through this process to improve
management of similar incidents in future and must notify other persons or bodies that have
been identified through this process.
CHSP service providers must also report incidents to police if there are reasonable grounds to
do so (e.g. the service provider suspects that the incident may be criminal in nature, such as
sexual assault). The provider must notify a police officer of the incident within 24 hours of
becoming aware of the incident. If the provider later becomes aware of reasonable grounds to
report the incident to police (e.g. the incident happened some time ago, although the provider
has just become aware of additional detail) then the provider must report the incident to police
within 24 hours of becoming aware of those grounds.
CHSP service providers must also collect data relating to incidents (e.g. through their recording
tool that forms part of their incident management system) to assist with continuous improvement
of their management and prevention of incidents. This data should assist the service provider to
identify trends or systemic issues with the quality of care they provide and enable the provider
to give feedback and provide training to staff members about the management and prevention
of incidents. The provider must regularly review and analyse this data to assess the
effectiveness of their management and prevention of incidents and if any actions could be taken
to improve their effectiveness. This assessment should be used to take any actions that may
improve their management and prevention of incidents.
For more information refer to the SIRS guidance for providers on the Commission’s website.
Reportable incidents
Under the SIRS, CHSP service providers are required to report certain types of incidents to the
Commissioner. This includes incidents that occur, or are alleged or suspected to have occurred,
and will include incidents involving a client with cognitive or mental impairment (such as
dementia). The types of reportable incidents are those listed below:
• where unreasonable use of force has been used against the client (e.g. kicking, hitting,
pushing, shoving, or rough handling),
• where unlawful sexual contact, or inappropriate sexual conduct has been inflicted on the
client (e.g. sexual assault, indecent assault, sexually explicit comments, or overt sexual
behaviour),
• psychological or emotional abuse of the client (e.g. name calling, bullying, intimidation,
or threats to withhold care or services),
• the unexpected death of a client (e.g. untreated wounds leading to a client’s untimely
death),
• where a staff member has stolen from, or financially coerced, a client (e.g. a staff
member stealing the client’s valuables, or a staff member coercing a client to change
their will in favour of the staff member gaining a benefit from their will),

December 2022 – 87
 • neglect of a client (e.g. withholding personal care, untreated sores and wounds, lack of
adequate medical care),
• where a client goes missing in the course of a service provider providing care and there
are reasonable grounds to report their absence to the police.
• use of a restrictive practice in relation to a client that does not meet all of the following
requirements:
o before the restrictive practice is used, the client’s care plan must detail the
circumstances in which the restrictive practice may be used and the behaviours it is
seeking to address,
o the care plan must outline how the restrictive practice is to be used, including its
duration, frequency and intended outcome,
o the restrictive practice must be used in the circumstances and manner set out in the
care plan and in accordance with any other provisions of the plan that relate to the
use of the restrictive practice, and
o the service provider must ensure details about the actual use of the restrictive
practice are documented and is consistent with the care plan as soon as practicable
after its use.
However, with respect to incidents involving neglect of a client, it is not a reportable incident if
the incident results from a choice made by the client about the care or services offered by the
service provider (e.g. if a client with diabetes refuses to eat a diabetic diet and as a result
develops a wound with poor healing prognosis), or if it results from a choice made by the client
as to how the care or services are to be provided (e.g. if a provider delivering in-home cleaning
services is directed by the client not to move item/s within the home and the client later trips
over these item/s). Details of this refusal or choice by the client, as well as details of any
discussions or actual or attempted interventions by the service provider, must be recorded in
the client’s care plan.
Further, if a reportable incident relates to a particular client who has been diagnosed with
dementia and experiences delusions, and continues to report a particular event which has been
investigated and is found to be based on a delusion, the service provider may contact the
Commission regarding this. The Commission will consider the circumstances of the case and
may decide that further repeat allegations of the same reportable incident do not need to be
notified.
For more detail on what constitutes a reportable incident and examples, please review guidance
on the Commission’s website.
All ‘Priority 1’ reportable incidents occurring in home or community settings must be reported to
the Commissioner, and the police where there are reasonable grounds to do so (e.g. where the
service provider suspects the incident is of a criminal nature), within 24 hours of the service
provider becoming aware of the incident. Priority 1 reportable incidents are:
• where the incident has caused, or could reasonably have been expected to have
caused, a client physical or psychological injury, illness or discomfort that requires
medical or psychological treatment to resolve, or
• any incident where there are reasonable grounds to report that incident to police.
Certain types of reportable incidents must always be reported as a Priority 1 reportable incident:
• the unexpected death of a client,
• the unexplained absence of a client,
• unlawful sexual contact, or inappropriate sexual conduct with a client.
All ‘Priority 2’ reportable incidents occurring in home or community settings must be reported to
the Commissioner within 30 days of the service provider becoming aware of the incident.

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Priority 2 reportable incidents include all other reportable incidents that do not meet the criteria
for a Priority 1 reportable incident. CHSP service providers must ensure that if their staff
become aware of a reportable incident, they must notify one of the service provider’s executive
decision makers, a supervisor or manager or the person who is responsible for notifying the
Commissioner of reportable incidents as soon as possible.
CHSP service providers must notify the Commissioner of reportable incidents using the form
available through the My Aged Care provider portal (or any other form approved by the
Commissioner). The Department of Health and Aged Care provides information and support to
access and log into the provider portal. Fact sheets are also available with further information
about My Aged Care. Alternatively, service providers can call the My Aged Care Contact Centre
on 1800 200 422 between 8.00am to 8.00pm [AEST/AEDT] Monday to Friday and 10.00am to
2.00pm on Saturday (a free call from fixed lines; calls from mobiles may be charged).
When notifying the Commissioner of reportable incidents, the form must include the following
details about each reportable incident:
• the name and details of the service provider,
• a description of the reportable incident, including the kind of reportable incident (e.g.
unreasonable use of force or neglect) and the harm that was caused, or that could
reasonably have been expected to have been caused, to each person affected, and if
known, the consequences of that harm,
• if it is a Priority 1 reportable incident, the immediate actions taken in response to the
reportable incident, including actions taken to ensure the health, safety and wellbeing of
the clients affected by the incident, and whether the incident has been reported to police
or any other body,
• if it is a Priority 2 reportable incident, the actions taken in response to the reportable
incident including actions taken to ensure the health, safety and wellbeing of the clients
affected by the incident, and whether the incident has been reported to police or any
other body,
• any further actions proposed to be taken in response to the incident,
• the name, position, and contact details of the person completing the form,
• if known, the time, date, and place where the incident occurred, or is alleged or
suspected to have occurred,
• the names of the persons directly involved in the incident, and
• if known, the level of cognition of the clients directly involved in the incident.
If it is a Priority 1 reportable incident, the service provider does not need to include all of the
above information if it is not available to them within 24 hours of becoming aware of the
incident. Although if not provided within 24 hours, that information must be provided to the
Commissioner within 5 days of becoming aware of the incident (or another period specified by
the Commissioner).
If a CHSP service provider later becomes aware of significant new information about a
reportable incident that has already been reported to the Commissioner, they must provide this
information to the Commissioner in writing as soon as possible.
Under the Aged Care Quality and Safety Commission Rules 2018 (see Part 6A – Division 2),
once the Commissioner has been notified of a reportable incident by a CHSP service provider,
the Commissioner may require that further information be provided, or other actions be taken by
the CHSP service provider in relation to the reportable incident. This may include undertaking
remedial action, conducting an investigation of the reportable incident, or providing a report to
the Commissioner containing any specified information about the reportable incident. CHSP
service providers must comply with these requirements or requests in the manner and
timeframes required by the Commissioner. The Commissioner may also take other actions in

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relation to reportable incidents that the Commissioner considers reasonable in the
circumstances, including referring the matter to the police or any person or body with
responsibilities in relation to the incident.
If CHSP service providers have any questions or issues they can contact the Commission at
[email protected] or 1800 081 549 between 9.00am to 5.00pm [AEST/AEDT]
Monday to Friday and 8.00am to 6.00pm Saturday to Sunday (a free call from fixed lines; calls
from mobiles may be charged).
Reportable incidents involving other service providers
Where a reportable incident occurs, or is alleged or suspected to have occurred, and it is known
or suspected that another service provider committed or caused the incident, the CHSP service
provider that becomes aware of the incident (Provider A) should notify the provider that
allegedly committed or caused the incident (Provider B).
If a CHSP service provider has concerns about another provider’s behaviour, conduct or
management of incidents other than reportable incidents, they are encouraged to contact the
Commission via email [email protected] or through the online form on the
Commission’s website. Alternatively, service providers can call the Commission on
1800 951 822 between 9.00am to 5.00pm [AEST/AEDT] Monday to Friday, or you can leave a
voice message (a free call from fixed lines; calls from mobiles may be charged). Please note
that complaints can be made to the Commission anonymously or confidentially.
Protecting disclosers of information about reportable incidents
Under the SIRS, the CHSP service provider must have procedures in place to protect disclosers
from being victimised. Disclosers are specified persons or bodies who disclose information
about reportable incidents.
The following table summarises the disclosers that the CHSP service provider must ensure they
have procedures in place to protect, and who the disclosers need to have disclosed the
information about a reportable incident to in order to be protected:

Disclosers Persons or bodies disclosers must

disclose to in order to be protected

A person or body who is, or was, any of the The disclosure is made to one of the
following: following:
• a service provider under the CHSP • the Commission or Commissioner
program • the service provider
• one of the service provider’s key • one of the service provider’s key
personnel or executive decision personnel or executive decision
makers makers
• a staff member of the service provider • a staff member of the service provider
• a client of the service provider • another person authorised by the
• a family member of a client of the service provider to receive reports of
service provider reportable incidents, or
• a carer of a client of the service • a police officer
provider
• a representative of a client of the
service provider
• an advocate of a client of the service
provider
• another person who is significant to a
client of the service provider, or

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 Disclosers Persons or bodies disclosers must
disclose to in order to be protected
• a volunteer who provides care or
services for the service provider

The CHSP service provider’s procedures must protect the discloser where:
• they have disclosed information about an incident to the persons or bodies listed in the
table above,
• the discloser discloses their name before disclosing information about the incident (it is not
an anonymous disclosure),
• the discloser has reasonable grounds to suspect that the information indicates that a
reportable incident has occurred, and
• the discloser discloses information about the incident in good faith.
As part of the above procedures, the CHSP service provider must not engage in conduct which
causes detriment, or threatens to cause detriment, to another person because that person or
another person is a discloser.
The CHSP service provider must also ensure, as much as reasonably possible, that its staff
members, and other parties with whom it contracts services, comply with the above
requirements to protect disclosers. Specifically, they must protect the discloser from:
• conduct by a person (Person A) that is intended to cause detriment to another
person (Person B) because Person B or a third person (Person C) is a discloser, and
• threats by Person A, to cause any detriment to Person B or Person C that is intended to
cause fear or is reckless as to causing fear that the threat will be carried out, because
Person B or Person C has or may make such a disclosure.
The CHSP service provider must also authorise specified persons to receive reports of
reportable incidents (authorised report recipient), and the discloser’s identity.
Where a person reports a reportable incident to the CHSP service provider, or one of the
service provider’s executive decision makers or authorised report recipient, the CHSP service
provider must take reasonable measures (including ensuring that the executive decision makers
and authorised report recipient are aware) to protect the discloser’s identity, and ensure that the
discloser’s identity is only disclosed to:
• the Commissioner (and the Commission); or
• a person, authority or court as required by a law of the Commonwealth or a state or
territory; to one of the service provider’s executive decision makers, or to a police officer
and is not disclosed to any other person.
The CHSP service provider must not enforce a contractual or other remedy or exercise any
other right against a discloser with whom they have an agreement because that person has
made a disclosure (e.g., the provider cannot terminate the person’s employment, or any other
person’s employment, based on the disclosure).

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6.3 Service provider reporting
6.3.1 Overview
Reporting elements and timing of reports
Under the CHSP, service providers will be required to submit a range of reports relating to the
Activity described under Item B [Grant Activity] of the CHSP Grant Agreement.
This includes:
• Financial reporting – to facilitate acquittal of funds expended, providing assurance and
evidence that public funds have been spent, as specified in the CHSP Grant Agreement.
• Performance reporting – on service delivery activities and outcomes.
• Wellness and reablement reporting – to provide service level information on wellness
and reablement approaches being implemented by the service provider.
Service providers are required to submit the reports as outlined under Item E [Reporting] in the
timeframes provided at Item E [Reporting] of the CHSP Grant Agreement – see table below.

Monthly performance reporting via Data Exchange

From 1 July 2022 all CHSP providers, excluding providers who only deliver SSD, are required to
submit monthly performance reports through Data Exchange.
Monthly performance reports will be due on the 14th day of each month (or next business day),
commencing from 14 August 2022. The submission of a monthly performance Data Exchange
report will be mandatory and may be linked to the release of a provider’s next monthly payment.
A provider can choose to submit a report more frequently, such as each fortnight, however at a
minimum a report must be submitted monthly within the timeframes provided below.
CHSP providers only delivering SSD will remain on a six-monthly Data Exchange reporting
schedule.

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Key Reports – CHSP

Report Reporting Period Due date to the Description

Department
14 August
Performance Report (for Monthly Client and service delivery
14 September
service delivery) via the information reported via the
14 October
Department of Social DSS Data Exchange in
14 November
Services (DSS) Data accordance with the Data
14 December
Exchange Exchange Protocols.
14 January
Note: this report is not 14 February Refer to CHSP Grant
applicable for Sector 14 March Agreement Item E [Reporting]
Support and 14 April
Development Activities 14 May
14 June
14 July
Note: The DSS Data
Exchange dates are
defined in the Data
Exchange Protocols.
Service providers can
enter data at any time
during the reporting
period.

Performance Report for 1 July to 31 January Refer to CHSP Grant

Sector Support and 31 December Agreement Item E [Reporting]
31 July
Development Activities
1 January to 30 June
only

Embedding wellness and As specified in the 31 October Refer to CHSP Grant

reablement report Agreement Agreement Item E [Reporting]

Financial Declaration 1 July to 30 June 30 July A Financial Acquittal Report in

accordance with the CHSP
Grant Agreement.
Refer to CHSP Grant
Agreement Item E [Reporting]

Note: Service providers not meeting the reporting requirements identified in the above table will
be subject to non-compliance actions in accordance with their obligations under the Grant
Agreement. Monthly performance reports will be due after the end of the month on the dates
specified in the table above. The submission of a monthly DEX report will be mandatory and
may be linked to the release of a provider’s next monthly payment.

6.3.2 Accounting for the grant

As specified under Condition 10 [Spending the Grant] of Schedule 1 of the CHSP Grant
Agreement service providers must spend the Grant:
• Only on carrying out the Activity.
• In accordance with the CHSP Grant Agreement.
All financial information provided by service providers should relate to the relevant financial year
that is being acquitted.
The financial reporting process
The Department requires service providers to provide assurance and evidence that grant funds
have been spent for their intended purpose. This is in the form of financial reporting which is
used to determine:

December 2022 – 93
 • that funding provided by the Department has been spent by the service provider in
accordance with the CHSP Grant Agreement.
• expenditure only related to CHSP service delivery in accordance with the Activity Work
Plan and CHSP Grant Agreement (expenses related to other funded programs or
expenses related to fees collected, donations or other contributions must not be included
in the service provider’s financial reports).
For multi-year grant agreements the Department acquits funding annually. Annual acquittals
allow the Department to assess whether the service provider is on target with their expenditure
and performance.
Service providers should refer to their CHSP Grant Agreement regarding their reporting periods.
Identified underspend through the acquittal process
Service providers must ensure that their reported outputs recorded in DEX aligns with the
amount of unspent funding they are acquitting within a financial year. Unspent funds identified
through the acquittal process for a financial year and within the term of the funding agreement
must be returned to the Department. Only in exceptional circumstances, the Department may
consider the carry-over of unspent funds where there is evidence of reasonable costs being
incurred by the service provider. Proposals to carry over funds will need to be submitted in
writing to the Department.
Service providers will not be allowed to retain unspent funds once the CHSP Grant Agreement
has terminated. At the end of the CHSP Grant Agreement, service providers must repay any
unspent funds identified through the acquittal process. The Department will issue the service
provider with a debt collect form to return any unspent funds.
Types of financial reports
Service providers must provide financial declarations in the form provided by the Department
and at the times set out in Item E [Reporting] of the CHSP Grant Agreement, or otherwise
notified in writing.
Service providers should only acquit the funds that the Department has provided the
organisation through the CHSP Grant Agreement within a particular financial year. Service
providers must not include their own funds in the Financial Declaration.
Client contributions
Client contributions are defined in Chapter 5 of this program manual. The Data Exchange
requires CHSP service providers to record all client contributions collected over the financial
year. Note: the client contribution is a mandatory field in the Data Exchange. For details on the
Data Exchange refer to 6.3.4 Activity Reporting.

6.3.3 Managing performance

The CHSP Grant Agreement requires service providers to deliver the service outputs specified
in the Agreement. However, if a client’s needs are changing significantly or an additional, new
service type is needed, the service provider must refer the client to My Aged Care for review.
This helps ensure client needs are assessed appropriately and any new services are recorded
on the client record. This process is outlined in Section 4.4.1 of this program manual.
Flexibility Provision
The flexibility provision under the CHSP is designed to provide a flexible approach to ensuring
compliance with contractual performance reporting requirements under the CHSP Grant
Agreement whilst enabling CHSP service providers to meet changes in the demand for
services. Where there is demonstrated client need (based on My Aged Care referral requests),
service providers have full flexibility to re-allocate up to 100 per cent of their grant funds
between funded service types and ACPRs listed in their CHSP Activity Work Plan to better meet
local demand pressures. The flexibility provision applies across all CHSP service types and
Sub-Programs.
In choosing to use flexibility provisions, CHSP service providers must not:
• Re-allocate funding to a service type or ACPR they are not funded for,

December 2022 – 94
 • Leave a service gap in an area they are currently operating in – i.e., resources may only
be re-allocated out of a region where there is a clear drop in demand or need for the
service, and/or
• Suspend services or move all resources and funding for a service type out of an ACPR
unless prior approval is granted by the Department of Health first, and then only for a
specified time limited basis.
It is also expected that CHSP service providers will work with the Department of Health and
Aged Care, the Community Grants Hub, My Aged Care and assessment services to routinely
monitor demand levels for each service type in each ACPR they are funded to operate in and
be prepared to re-allocate their funding and resources back to their normal service delivery and
geographic footprint if there is a significant reduction in demand for those services and clients
can continue to access appropriate services. Delivery of these outputs is recorded in the Data
Exchange only and should not require any change to the service provider’s CHSP Grant
Agreement.
Flexibility under Assistance with Care and Housing
Due to the vulnerable and disadvantaged nature of most clients in need of support under the
Assistance with Care and Housing Sub-Program, the Department of Health and Aged Care has
implemented additional criteria around the flexibility provisions in relation to this service type.
CHSP service providers have full flexibility to re-allocate funds from other service types and
from other Aged Care Planning Regions into Assistance with Care and Housing, but cannot re-
allocate base funding from Assistance with Care and Housing to other service types or outside
of an Aged Care Planning Region without prior written approval from the Department of Health.
Flexibility under Sector Support and Development
From 1 July 2022, the objective of SSD has changed to support CHSP service providers
through reforms to the CHSP, in preparation for a new in-home care system, and to operate
effectively in line with the objectives of the CHSP and within the context of the broader aged
care system.
Given the importance of this work, the Department of Health and Aged Care has implemented
additional criteria around the flexibility provisions in relation to this service type.
CHSP service providers have full flexibility to re-allocate funds from other service types and
from other Aged Care Planning Regions into Sector Support and Development, but cannot re-
allocate base funding from Sector Support and Development to other service types or outside of
an Aged Care Planning Region without prior written approval from the Department of Health
and Aged Care.
How Flexibility Provisions Work
For example, where a service provider receives a large volume of referrals from My Aged Care
for clients requiring Social Support, but less than the level of referrals expected for Personal
Care in the same Aged Care Planning Region, then the provider may use the flexibility provision
(providing it is funded to deliver both of these activities under its CHSP Grant Agreement). The
provider can use up to 100 per cent of the funding it receives for Personal Care to deliver Social
Support to meet the demand for Social Support services where these services are funded in the
same Aged Care Planning Region.
The service provider must record their actual service delivery in the Data Exchange in order to
provide the Department with visibility that they are utilising the flexibility provision (please refer
to 6.3.4 Activity Reporting).
Where service providers have special conditions identified in their Grant Agreement, service
providers are required to deliver the services as stipulated in the special conditions prior to
applying the flexibility provision. Special conditions take precedence over the flexibility
provision.

December 2022 – 95
Case studies – In scope
Example 1 – (within a CHSP sub-program)
A service provider is funded to deliver Domestic Assistance and Personal Care in the same
Aged Care Planning Region. The service provider receives more referrals from My Aged Care
to deliver Domestic Assistance than Personal Care in this region.
In this instance the service provider may use up to 100 per cent of the funding allocated to
Personal Care for Domestic Assistance, provided they are still meeting the service demand for
Personal Care in the region.
Example 2 (value for money)
A service provider is funded to deliver Nursing and Personal Care. In the reporting period the
organisation is receiving more referrals from My Aged Care for Nursing rather than Personal
Care. The provider utilises the flexibility provision and 100 per cent of Personal Care funding is
used to meet the increased service demand in Nursing. In using the flexibility provision, the
provider must also demonstrate they have achieved value for money by reporting the service
delivery outputs in the Data Exchange and including the use of the flexibility provision in their
financial report.
The Department will consider the indicative unit cost of Personal Care delivered by the provider
in that region (i.e., 100 hours for $1,000 is $10 per hour) and of Nursing (100 hours for $2,000 is
$20 per hour). The provider has $200 available from Personal Care to use for Nursing, equating
to an extra 10 hours of Nursing. The provider enters their service delivery outputs into the Data
Exchange, 80 hours of Personal Care and 110 hours of Nursing, demonstrating value for money
has been achieved.

December 2022 – 96
Case Studies – Out of scope:
Example 1 (new services not funded for)
A provider wants to use the flexibility provision to establish new transport services that they are
not currently funded for under their Grant Agreement. The flexibility provision cannot be used in
this instance.
Establishing new services in a region would need to be considered by the Department in
accordance with the CHSP Guidelines and CHSP planning framework.
Example 2 (across Aged Care Planning Regions)
A provider is funded to deliver Meals in one Aged Care Planning Region and wants to establish
new meals services in another Aged Care Planning Region. The provider cannot use the
flexibility provision to deliver the meals services in this instance.

6.3.4 Activity reporting

CHSP service providers must provide activity and performance data in line with their CHSP
Grant Agreement and Activity Work Plan details.
The DSS Data Exchange is an approach to program reporting that has been designed to reduce
red tape for organisations by streamlining the data and providing simple and easy ways to
submit data.
Data requirements are divided into two parts: a small set of priority requirements that all service
providers must report, and a voluntary extended data set that service providers can choose to
share with the Department in return for relevant and meaningful reports, known as the
partnership approach. This will help build the evidence base regarding the effectiveness of
Department of Health and Aged Care programs and service delivery approaches. Participation
in the partnership approach is voluntary and there will be no negative consequences if a service
provider chooses not to provide their extended data set.
There are a number of options available for service providers to report through the Data
Exchange. If organisations do not currently use a client management system the Data
Exchange has a web-based portal that they can access as free client management system to
support service delivery. If however, service providers already have their own client
management system then they can choose to submit data to the Department of Social Services
(DSS) through a system-to-system transfer or bulk upload.
The Data Exchange Technical Specifications are available on the DSS grants website to
support organisations that may want to use system-to-system transfers or bulk uploads. The
Technical Specifications outline the initial coding changes required to meet the Department’s
data formats.
There is a range of other training and support material on the website to help organisations use
the Data Exchange. The Data Exchange Protocols have been designed as a practical support
manual to guide managers and frontline staff. The CHSP section of the Appendix B to the Data
Exchange Protocols outlines CHSP-specific reporting guidance and examples of reporting. A
set of task cards are also available as well as video training modules that provide a visual
demonstration of the web-based portal.
Organisations have access to the CHSP Organisation Overview Report, a new and interactive
tool (Qlik) to view and analyse their organisation’s data that has been entered into the Data
Exchange. Access to the report is available via the Data Exchange portal and further
information is available on the Data Exchange website.
A dedicated Data Exchange Helpdesk for service providers is available for access and technical
questions on reporting. Organisations can email [email protected] or
phone 1800 020 283 for any questions.
For Developer and IT support for Data Exchange application development please email
[email protected].
For general CHSP grant and program enquiries on reporting, please contact your Funding
Arrangement Manager.

December 2022 – 97
Reporting through the Data Exchange – Performance Management and Flexibility
Provisions.
Service providers are required to report service delivery at the client and service type level.
Service delivery information reported in the Data Exchange including outputs, service types and
the location of service delivery (based on the outlet location) will be used to inform the
performance management of service providers against the key performance indicators in their
CHSP Grant Agreements. The Data Exchange is also designed to manage data from providers
using the Flexibility Provision. Performance management is undertaken by Funding
Arrangement Managers to ensure that the program objectives are being met and to ensure
accountability of relevant program funds.
As demand for services changes, information reported in the Data Exchange will also be used
as a source of evidence to inform the CHSP planning framework.
Emergency COVID-19 funding – reporting
Service providers who received emergency support through an ad hoc proposal or additional
meals funding as part of the CHSP COVID-19 Emergency support round were issued with a
separate grant agreement and a performance report template. These providers must report any
additional outputs and increases in capacity delivered against their emergency funding in this
performance report and should also report through DEX. The performance report contains a
narrative section to enable service providers the opportunity to explain how these funds are
being used and to account for the grant. Service providers who received additional meals
funding will also be required to complete regular survey monkeys in addition to their
performance report.
Sector Support and Development – reporting
Service providers with grant funding for Sector Support and Development must provide regular
progress reports against the activities specified within the Activity Work Plan and in accordance
with the CHSP Grant Agreement.
The Department of Health and Aged Care will provide a reporting template for this purpose.
Service providers must provide the report in the format required by the Department using the
template supplied.
Embedding a wellness and reablement approach – reporting
Service providers must provide regular reports to the Department regarding their organisation’s
progress towards adopting a wellness and reablement approach to service delivery in
accordance with the CHSP Grant Agreement. The Department has provided a reporting
template for this purpose. Service providers must provide the report in the format required by
the Department using the template supplied and in the timeframes outlined under Section 6.3.1.
These reports will be used to provide the Department with service level information on the
service provider’s progress towards embedding a wellness and reablement approach in their
service delivery practices. The reports will also be used to assist the Department identify
national resource gaps or strategies that could be implemented to drive continuous
improvements in the delivery of wellness and reablement approaches across the sector.

6.3.5 Aged Care Workforce Census

If a service provider receives an aged care workforce census form sent by, or on behalf of, the
Department then the service provider must complete the form and return it to the Department,
or another address as directed, by the date specified in the form.
If a service provider for a community aged care service was not responsible for the operations
of a service during all or some of a period covered by an aged care workforce census, then the
service provider is taken to have complied with the census.
If a service provider’s funding is less than $35,000 per annum and it receives an aged care
workforce census form, the form is to be completed and returned on a voluntary basis and is not
a mandatory condition of funding.

December 2022 – 98
6.4 IT and system requirements
Service providers must have systems in place to allow them to meet their service delivery, data
collection and reporting obligations outlined in their CHSP Grant Agreement.

6.4.1 System requirements

My Aged Care
CHSP service providers will need a computer with an internet connection and a standard
internet browser that supports authenticated access via an approved authentication service -
myGovID and the Relationship Authorisation Manager (RAM) or VANguard Federated
Authentication Services to access the My Aged Care provider portal and the Data Exchange
reporting system to meet their activity and reporting requirements.
The My Aged Care provider portal is the key tool for CHSP service providers to interact with
My Aged Care regarding the services they deliver, managing referrals and updating client
information.
Information about the My Aged Care provider portal (including, factsheets, videos and
frequently asked questions) is available on the Department of Health and Aged Care website.
For technical support, contact the My Aged Care service provider and assessor helpline on
1800 836 799.
Data Exchange reporting system
Information about the Data Exchange reporting system requirements is located on the
Department of Social Services website. For IT systems access and technical enquiries, contact
the Developer Support Helpdesk via email at [email protected]

6.5 Government responsibilities

6.5.1 Planning framework
The CHSP planning framework is based on Aged Care Planning Regions. The CHSP planning
framework takes into account existing services available in a given region, projected growth in
the target population and other factors influencing service delivery supply and demand.
Planning processes for the CHSP will also consider parallel planning cycles and processes in
other related sectors, including aged care more broadly and the disability care sector.
This will ensure that the needs of various clients are considered and the funding is allocated so
that growth in home support services complement and enhance services already being
delivered.

6.5.2 Government reporting

As with all Government funding arrangements, the Australian Government has a responsibility
to report on the planning, implementation and evaluation of the CHSP.
CHSP service providers are required to submit specific reports. The information provided
through these is utilised by the Australian Government to report on the continued development,
implementation and on-going evaluation of the program.

December 2022 – 99
Appendix A – Useful resources
Publications
Productivity Commission – Caring for Older Australians Inquiry
http://www.pc.gov.au/inquiries/completed/aged-care/report

Australian Government Websites

Australian Taxation Office https://www.ato.gov.au/
Australian Privacy Principles https://www.oaic.gov.au/privacy/australian-privacy-principles

Advocacy
National Aged Care Advocacy Program (NACAP)
The Older Persons Advocacy Network (OPAN) provides NACAP services across Australia.
https://opan.org.au/education/education-for-professionals/
1800 700 600

Aged Care Quality Standards

Aged Care Quality and Safety Commission
https://www.agedcarequality.gov.au/providers/standards

Carers
Carer Gateway
www.carergateway.gov.au
1800 422 737

Interpreting support for service providers

National Translating and Interpreting Service
https://www.tisnational.gov.au/

National Auslan Interpreter Booking & Payment Service

http://www.nabs.org.au/

Dementia Support
Dementia Australia
https://www.dementia.org.au
National Dementia Helpline: 1800 100 500

Dementia Training Australia

https://www.dementiatrainingaustralia.com.au

Dementia Support Australia - DBMAS and SBRT programs

https://www.dementia.com.au
1800 699 799

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Continence Support
Department of Health and Aged Care Bladder and Bowel Health Information
https://www.health.gov.au/health-topics/bladder-and-bowel

Continence Foundation of Australia

https://www.continence.org.au

National Elder Abuse Support

https://www.compass.info/
1800 ELDERHelp (1800 353 374)

Meals on Wheels National Meal Guidelines

https://mealsonwheels.org.au/learn-more/national-meals-guidelines/

The National Public Toilet Map

https://toiletmap.gov.au/

Freecall 1800 330 066

Resources relating to My Aged Care

My Aged Care website http://www.myagedcare.gov.au/
My Aged Care includes the My Aged Care contact centre (1800 200 422) and the website.
Together, they provide consumers with information on aged care, whether for the client, their
family or carer.
The contact centre can be phoned on 1800 200 422 between 8.00am and 8.00pm on weekdays
and between 10.00am and 2.00pm on Saturdays, local time. The contact centre is closed on
Sundays and national public holidays.
My Aged Care provider portal https://myagedcare-serviceproviderportal.health.gov.au/
The My Aged Care provider portal will be the key tool for managing referrals and updating client
information.
Further information to support the use of the provider portal (including fact sheets, videos, and
quick reference guides) is available on the Department of Health and Aged Care website
https://www.health.gov.au/initiatives-and-programs/my-aged-care/my-aged-care-resources.

The My Aged Care service provider and assessor helpline is available on 1800 836 799 to
assist service providers with technical support.

National Guide to the CHSP Client Contribution Framework

https://www.health.gov.au/resources/publications/national-guide-to-the-chsp-client-contribution-
framework

Resources relating to the DSS Data Exchange and CHSP

Performance Reporting
Data Exchange https://dex.dss.gov.au/training
CHSP Reporting Requirements
https://www.health.gov.au/initiatives-and-programs/commonwealth-home-support-programme-
chsp/managing-the-commonwealth-home-support-programme-chsp

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Resources relating to support for people with disability
Guide Dogs Australia
http://www.guidedogsaustralia.com/

National Insurance Disability Scheme

http://www.ndis.gov.au

National Disability Services

http://www.nds.org.au/

Optometry Australia - Good Vision for Life

https://goodvisionforlife.com.au/

Perkins School for the Blind eLearning

http://www.perkinselearning.org/scout

Royal Society for the Blind

http://www.rsb.org.au/

Vision Australia
www.visionaustralia.org

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Appendix B – Policy and Guidelines resources
Aged Care Planning Region Maps
https://www.gen-agedcaredata.gov.au/Resources/Access-data/2018/May/Aged-Care-Planning-
Region-Maps

Aged Care Quality and Safety Commission

https://www.agedcarequality.gov.au/

Carer Recognition Act 2010

https://www.legislation.gov.au/Details/C2010A00123

Charter of Aged Care Rights

https://www.agedcarequality.gov.au/consumers/consumer-rights

Australian Criminal Intelligence Commission (formerly CrimTrac)

https://www.acic.gov.au/

Aged Care Diversity Framework

https://www.health.gov.au/resources/publications/aged-care-diversity-framework

DSS Data Exchange Protocols

https://dex.dss.gov.au/data-exchange-protocols/

Assessment Quality Reviews

https://www.agedcarequality.gov.au/providers/assessment-processes/quality-review

Using My Aged Care

https://www.health.gov.au/initiatives-and-programs/my-aged-care/using-my-aged-care

On the record – Guidelines for the prevention of discrimination in employment on the basis of
criminal record
https://humanrights.gov.au/human_rights/criminalrecord/on_the_record/index.html

Care Finder policy guidance for PHNs

https://www.health.gov.au/resources/publications/care-finder-policy-guidance-for-phns

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Appendix C – State Funding Arrangement Managers for
the Commonwealth Home Support Programme Contacts
Northern Territory
[email protected]

NSW and ACT

[email protected]

Queensland
[email protected]

South Australia
[email protected]

Tasmania
[email protected]

Victoria
[email protected]

Western Australia
[email protected]

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Appendix D – Commonwealth Home Support Programme
Police Certificate Guidelines

Commonwealth Home Support Programme - Police Certificate Guidelines - July 2015

1 Introduction
The CHSP Grant Agreement sets out the conditions under which service providers are funded
by the Commonwealth Government for Activities delivered under the CHSP.
The Police Certificate Guidelines form part of the CHSP Program Manual. The Guidelines have
been developed to assist service providers with the management of police check requirements
under the CHSP.
Police checks are intended to complement robust recruitment practices and are part of a service
provider’s responsibility to ensure all staff, volunteers and executive decision makers are
suitable to provide services to clients of the CHSP.

2 Your obligations
Service providers must ensure that all staff, volunteers and executive decision makers working
in CHSP services are suitable for the roles they are performing. They must undertake thorough
background checks to select staff in accordance with the requirements under the CHSP Grant
Agreement and the Standards.
As part of this, Service providers must ensure national criminal history record checks, not more
than three years old, are held by:
• staff who are reasonably likely to interact with clients
• volunteers who have unsupervised interaction with clients
• executive decision makers.
Service providers must ensure they have policies and procedures in place to assess police
certificates. A service provider’s decision to employ or retain the services of a person with any
relevant recorded convictions will need to be rigorous, defensible and transparent.
For information about assessing police certificates for staff, volunteers and executive decision
makers see: 5 Assessing a Police Certificate in these Guidelines.

3 Police certificates
3.1 Police certificates and police checks
A police certificate is a report of a person’s criminal history; a police check is the process of
checking a person’s criminal history. The two terms are often used interchangeably in aged
care.

3.2 Police certificate requirements

A police certificate that satisfies requirements under the CHSP Grant Agreement and CHSP
Program Manual is a nation-wide assessment of a person’s criminal history (also called a
“National Criminal History Record Check” or a “National Police Certificate”) prepared by the
Australian Federal Police, a state or territory police service, or an Australian Criminal
Intelligence Commission (ACIC) accredited agency.
In place of a national criminal history record check, service providers may accept staff members
and volunteers who hold a card issued by a state or territory authority following a vetting
process that enables the card holder to work with vulnerable people. Executive decision makers

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are required to have a national criminal history record check and have additional requirements
to meet, see: 5.5 Assessing information obtained from a police certificate for executive decision
makers.
For more information about assessing police certificates, including the different types, please
see: Section 5 Assessing a Police Certificate.

3.3 Australian Criminal Intelligence Commission checks

National Police History Checks prepared by ACIC accredited agencies are considered by the
Department as being prepared on behalf of the police services and therefore meet the
Department’s requirements. More information about ACIC is available at: ACIC.

3.4 Statutory declarations

Statutory declarations are generally only required in addition to police checks in the following
instances:
• For essential new staff, volunteers and executive decision makers who have applied for,
but not yet received, a police certificate
• For any staff or volunteers who have been a citizen or permanent resident of a country
other than Australia after the age of 16
• Executive decision makers who have held or hold citizenship, or hold or have held
permanent residency of a country other than Australia after the age of 16.
In these two instances, a staff member, volunteer or executive decision maker can sign a
statutory declaration stating either that they have never, in Australia or another country, been
convicted of an offence or, if they have been convicted of an offence, setting out the details of
that offence. Note that a person is entitled to sign a statutory declaration stating that they have
not been convicted of an offence if they have been convicted of an offence but the conviction is
a ‘spent’ conviction (see 5.8 Spent convictions).
Statutory declarations relating to police certificate requirements must be made on the form
prescribed under the Commonwealth Statutory Declarations Act 1959 (the Declarations Act).
Anyone who makes a false statement in a statutory declaration is guilty of an offence under the
Declarations Act.
A link to the statutory declaration template is provided at Appendix 3b of these Police Certificate
Guidelines. More information about statutory declarations is available at: Statutory Declarations.

4 Staff, volunteers and executive decision makers

4.1 Staff, volunteers and executive decision makers
Police certificates, not more than three years old, must be held by:
• staff who are reasonably likely to interact with clients
• volunteers who have unsupervised interaction with clients
• executive decision makers.

4.2 Definition of a staff member

A staff member is defined, for the purposes of the Guidelines, as a person who:
• has turned 16 years of age
• is employed, hired, retained or contracted by the service provider (whether directly or
through an employment or recruitment agency) to provide care or other services under
the control of the service provider
• interacts, or is reasonably likely to interact, with clients.
Examples of individuals who are staff members include:

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 • employees and subcontractors of the service provider who provide services to clients
(this includes all staff employed, hired, retained or contracted to provide services under
the control of the service provider whether in a community setting or in the client’s own
home)
• employees and subcontractors who contact the client by phone.

4.3 Definition of non-staff members

Individuals, who are not considered to be staff members, for the purposes of the Guidelines,
include:
• employees who, for example, prepare the payroll, but do not interact with clients
• independent contractors.
Generally, an independent contractor is a person:
• who is paid for results achieved
• provides all or most of the necessary materials and equipment to complete the work
• is free to delegate work to others
• has freedom in the way that they work
• does not provide services exclusively to the service provider
• is free to accept or refuse work
• is in a position to make a profit or loss.
For the purposes of these Guidelines, a subcontractor who has an ongoing contractual
relationship with the service provider is not taken to be an independent contractor but is
regarded as a staff member. A person who is contracted to perform a specific task on an ad-hoc
basis may fall within the definition of an independent contractor.
Having an Australian Business Number does not automatically make a person an independent
contractor.

4.4 Definition of a volunteer

• A volunteer is defined, for the purposes of these Guidelines, as a person who:
• is not a staff member
• offers his or her services to the service provider
• provides care or other services on the invitation of the service provider and not solely on
the express or implied invitation of a client
• has, or is reasonably likely to have, unsupervised interaction with clients.
A student undertaking a clinical placement in the community who is over 18 years and has, or is
reasonably likely to have, unsupervised interaction with clients would be a volunteer.
Examples of persons who are not volunteers under this definition include:
• persons volunteering who are under the age of 16 (except where they are a full-time
student, then under the age of 18)
• persons who are expressly or impliedly invited into the client’s home by a client
(for example, family and friends of the client)
• persons who only have supervised interaction with clients.

4.5 Definition of unsupervised interaction

Unsupervised interaction is defined as interaction with a client where a volunteer is
unaccompanied by another volunteer or staff member.

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In regard to volunteers, if volunteers are visiting a client in pairs it is not a requirement for either
of those volunteers to have a police certificate.

4.6 Definition of an executive decision maker

An executive decision maker is:
• a member of the group of persons who is responsible for the executive decisions of the
entity at that time
• any other person who has responsibility for (or significant influence over) planning,
directing or controlling the activities of the entity at that time
• any person who is responsible for the day-to-day operations of the service, whether or
not the person is employed by the entity.
In determining who are executive decision makers, service providers need to consider the
functional role individuals perform rather than their job title.

4.7 New staff

While service providers must aim to ensure all new staff members, volunteers and executive
decision makers have obtained a police certificate before they start work, there are exceptional
circumstances where new staff, volunteers and executive decision makers can commence work
prior to receipt of a police certificate.
A person can start work prior to obtaining a police certificate if:
• the care or other service to be provided by the person is essential
• an application for a police certificate has been made before the date on which the
person first becomes a staff member or volunteer
• until the police certificate is obtained, the person will be subject to appropriate
supervision during periods when the person interacts with clients
• the person makes a statutory declaration stating either that they have never, in Australia
or another country, been convicted of an offence or, if they have been convicted of an
offence, setting out the details of that offence.
In such cases, the service provider must have policies and procedures in place to demonstrate:
• that an application for a police certificate has been made
• the care and other service to be provided is essential
• the way in which the person would be appropriately accompanied
• how a person will be appropriately accompanied in a range of working conditions, e.g.,
during holiday periods when staff numbers may be limited.

4.8 Staff, volunteers and executive decision makers who have resided
overseas
Staff members or volunteers who have been citizens or permanent residents of a country other
than Australia since turning 16 years of age and executive decision makers who have held or
hold citizenship, or hold or have held permanent residency of a country other than Australia
after the age of 16, must make a statutory declaration before starting work with any CHSP
service provider stating either that they have never, in a country other than Australia, been
convicted of an offence or, if they have been convicted of an offence, setting out the details of
that offence.
This statutory declaration is in addition to a current national police certificate, as this reports
only those convictions recorded in Australian jurisdictions.

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5 Assessing a police certificate
5.1 Police certificate format
Police certificates may have different formats, including printed certificates or electronic reports.
Every police certificate or report must record:
• the person’s full name and date of birth
• the date of issue
• a reference number or similar.
A service provider must be satisfied that a certificate is genuine and has been prepared by a
police service or ACIC accredited agency. An original police certificate or a certified copy must
be provided rather than an uncertified photocopy.
It is up to the service provider to be satisfied that a certificate meets the requirements, and
enables them to assess a person’s criminal history. Any police certificate decision must be
documented by the service provider. For more information on record keeping, and the sighting
and storing of police certificates, see: 6 Police Check Administration.

5.2 Purpose of a police certificate

A police certificate that best satisfies requirements under the CHSP police check regime is one
obtained for the purposes of aged care. However, a national criminal history record check
undertaken for another purpose will generally also satisfy the requirements for the CHSP. It is
best practice to specify the purpose of the police check to the police service or ACIC agency
issuing the certificate.

5.3 Police certificate disclosure

A police certificate discloses whether a person:
• has been convicted of an offence
• has been charged with and found guilty of an offence but discharged without conviction
• is the subject of any criminal charge still pending before a Court.
The information on the certificate is drawn from all Australian jurisdictions and is subject to
relevant state and territory spent conviction schemes. For more information about spent
convictions, see: 5.8 Spent convictions.

5.4 Assessing information obtained from a police certificate for staff and
volunteers
CHSP service providers may use discretion when assessing a person’s criminal history to
determine whether recorded offences are relevant to the job. The principle that service
providers must apply is to determine the risk of harm to clients.
Service providers must ensure they have policies and procedures in place to assess police
certificates. A service provider’s decision to employ or retain the services of a person with any
relevant recorded convictions will need to be rigorous, defensible and transparent.
For more information see: 5.7 Refusing or terminating employment on the basis of a criminal
record.

A risk assessment approach

The following considerations are intended as a guide to assist service providers to assess a
person’s police certificate for their suitability to be either a staff member or volunteer for a CHSP
service provider:
• Access: the degree of access to clients, their belongings, and their personal information.
Considerations include whether the individual will work alone or as part of a team, the

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 level and quality of direct supervision, the location of the work, i.e., community or home-
based settings
• Relevance: the type of conviction and sentence imposed for the offence in relation to the
duties a person is, or may be undertaking. A service provider must only have regard to
any criminal record information indicating that the person is unable to perform the
inherent requirements of the particular job
• Proportionality: whether excluding a person from employment is proportional to the type
of conviction
• Timing: when the conviction occurred
• Age: the ages of the person and of any victim at the time the person committed the
offence. The service provider may place less weight on offences committed when the
person is younger, and particularly under the age of 18 years. The service provider may
place more weight on offences involving vulnerable persons
• Decriminalised offence: whether or not the conduct that constituted the offence or to
which the charge relates has been decriminalised since the person committed the
offence
• Employment history: whether an individual has been employed since the conviction and
the outcome of referee checks with any such employers
• Individual’s information: the findings of any assessment reports following attendance at
treatment or intervention programs, or other references; and the individual’s attitude to
the offending behaviour
• Pattern: whether the conviction represents an isolated incident or a pattern of criminality
• Likelihood: the probability of an incident occurring if the person continues with, or is
employed for, particular duties
• Consequences: the impact of a prospective incident if the person continues, or
commences, particular duties
• Treatment strategies: procedures that will assist in reducing the likelihood of an incident
occurring including, for example, modification of duties.

5.5 Assessing information obtained from a police certificate for

executive decision makers
CHSP service providers may use limited discretion when assessing a person's criminal history
to determine whether any recorded offences are relevant to performing the functions and duties
of an executive decision maker.
A CHSP service provider must not allow a person whose police certificate records a precluding
offence to perform the functions and duties of an executive decision maker.
The offences that preclude a person under the CHSP police check regime from performing the
functions and duties of an executive decision maker are:
• a conviction for murder or sexual assault
• a conviction and sentence to imprisonment for any other form of assault
• a conviction for an indictable offence within the past 10 years.
Whether or not an offence is an indictable offence will depend on legislation within the
jurisdiction. Service providers might need to seek legal advice if there is any doubt. If a
conviction for what would otherwise be a precluding offence is considered 'spent' under the law
of the relevant jurisdiction (see: 5.8 Spent convictions), the conviction does not preclude the
person from performing the functions and duties of an executive decision maker.
While a service provider may not use discretion to allow a person whose police certificate
records a conviction for a precluding offence to perform the functions and duties of an executive
decision maker, service providers may use discretion in determining whether any other

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recorded convictions are relevant to performing those functions and duties. The risk
assessment approach set out in 5.4 may be used as a guide to assist service providers to
assess the relevance of any non-precluding offences to performing the functions and duties of
an executive decision maker.
A service provider’s decision to allow a person with any recorded convictions to perform the
functions and duties of an executive decision maker must be rigorous, defensible and
transparent. The overriding principle that service providers must bear in mind is to minimise the
risk of harm to clients.

5.6 Committing an offence during the police certificate period

Service providers must take reasonable measures to require each of their staff members,
volunteers and executive decision makers to notify them if they are convicted of an offence in
the period between obtaining and renewing their police check. If an executive decision maker
has been convicted of a precluding offence they must not be allowed to continue as an
executive decision maker.

5.7 Refusing or terminating employment on the basis of a criminal

record
If a service provider refuses or terminates employment on the basis of a person’s conviction for
an offence, the conviction must be considered relevant to the inherent requirements of the
position. If in any doubt, service providers must seek legal advice regarding the refusal or
termination of a person’s employment on the basis of their criminal record.
Under the Fair Work Act 2009 there are provisions relating to unfair dismissal and unlawful
termination by employers. More information about the Fair Work Act 2009 is available at:
Fair Work Commission. In addition, under the Human Rights and Equal Opportunity Act 1986,
the Australian Human Rights Commission has the power to inquire into discrimination in
employment on the ground of criminal record.
If a person feels they have been discriminated against based on their criminal record in an
employment decision of a service provider, they may make a complaint to the Australian Human
Rights Commission. Further information on discrimination on the basis of criminal record is
available at: Australian Human Rights Commission.

5.8 Spent convictions

Convictions that are considered ‘spent’ under state, territory and Commonwealth legislation will
not be disclosed on a police certificate unless the purpose for the application (for example,
working with children) is exempt from the relevant spent conviction scheme. If a conviction has
been ‘spent’ the person is not required to disclose the conviction. The aim of the scheme is to
prevent discrimination on the basis of old minor convictions, once a waiting period
(usually 10 years) has passed and provided the individual has not re-offended during this
period.
Spent conviction legislation varies from jurisdiction to jurisdiction. In some circumstances or
jurisdictions certain offences cannot be spent.
Further Information on spent convictions can be found at: Spent Convictions Scheme

6 Police Check Administration

6.1 Record keeping responsibilities
Service providers must keep records that can demonstrate that:
• there is a police certificate, which is not more than three years old, for each staff
member, volunteer and executive decision maker
• an application has been made for a police certificate where a new staff member,
volunteer or executive decision maker does not have a police certificate

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 • a statutory declaration has been provided by any staff member, volunteer or executive
decision maker who has not yet obtained a police certificate or was a citizen or
permanent resident of a country other than Australia.
How a service provider demonstrates their compliance with record keeping requirements is a
decision for their organisation to make based on their circumstances. The Aged Care Quality
and Safety Commission may review this record keeping as part of Expected Outcome 1.2
Regulatory Compliance under the Home Care Common Standards.

6.2 Sighting and storing police certificates

The collection, use, storage and disclosure of personal information about staff members and
volunteers must be in accordance with the Privacy Act 1988 (Commonwealth). State and
territory privacy laws can also impact on the handling of personal information such as a police
certificate. Further information about privacy is available at: Office of the Australian Information
Commissioner.
When individuals undertake to obtain their own police certificate, or employment agencies hold
police certificates, service providers must sight an original or a certified copy of the police
certificate and the information and reference number must be recorded on file.
If it is impossible to assess a person’s police certificate for any reason, the individual may be
required to obtain a new police certificate in order for the service provider to meet their
responsibilities under the CHSP police check regime.

6.3 Cost of police certificates

Service providers have a responsibility to ensure all staff members, volunteers and executive
decision makers undergo police checks. However, the payment of the cost of obtaining a police
certificate is a matter for negotiation between the service provider and the individual.
Individuals may be able to claim the cost of the police certificate as a work-related expense for
tax purposes. Further advice on this issue is available from the Australian Taxation Office
through their website at: Australian Taxation Office.
Volunteers may be eligible to obtain a police certificate at a reduced cost whether the certificate
is requested by an individual or by a service provider on behalf of a volunteer. This must be
confirmed with the agency issuing the police certificate.

6.4 Obtaining certificates on behalf of staff, volunteers or executive

decision makers
A person may provide a police certificate to the service provider or give consent for the service
provider to obtain a police certificate on their behalf.
Service providers can obtain consent forms from the relevant police services or accredited
agencies. In some jurisdictions, parental consent may be required to request a police certificate
for an individual under the age of 18 years.

6.5 Police certificate expiry

Police certificates for all staff, volunteers and executive decision makers must remain current
and need to be renewed every three years before they expire. If a police certificate expires
while a staff member is on leave, the new certificate must be obtained before the staff member
can resume working at the service. Service providers must note that the application or renewal
process can take longer than eight weeks.
It is the responsibility of the service provider to ensure that staff have a new police certificate
prior to the expiry date.

6.6 Documenting decisions

Any decision taken by a service provider must be documented in a way that can demonstrate to
an auditor the date the decision was made, the reasons for the decision, and the people

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involved in the decision i.e., the service provider, the individual, a legal representative,
board members etc.

6.7 Monitoring compliance with police check requirements

Service providers must have policies and procedures in place to demonstrate suitable
management and monitoring of the police certificate requirements for all staff members,
volunteers and executive decision makers. This includes, for example:
• three-year police check renewal procedures
• appropriate storage, security and access requirements for information recorded on a
police certificate
• evidence of a service provider’s decisions in respect of all individuals, or where staff are
contracted through another agency, evidence of contractual arrangements with the
agency that demonstrates the police certificate requirements.

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Appendix D Attachment 3a – Police Service contact details
for Police Checks
Police Service Contact Details

Australian Federal Phone: (02) 6140 6502

Police (for ACT
National Police Checks
and Nationally)
(https://www.afp.gov.au/what-we-do/services/criminal-records/national-police-
checks)
New South Wales Phone: (02) 8835 7888
Police Service
NSW Police Force
(https://www.police.nsw.gov.au/online_services/criminal_history_check)

Victoria Police Phone: 1300 881 596

Victoria Police
(https://www.police.vic.gov.au/national-police-records-checks)

Queensland Police Phone: (07) 3364 6262

Service
Queensland Police
(https://www.police.qld.gov.au/documents-for-purchase/national-police-certificates)

Western Australia Western Australia Police

Police Service (https://www.police.wa.gov.au/Police%20Direct/National%20Police%20Certificates)

South Australia Phone: (08) 7322 3347

Police
South Australia Police
(www.police.sa.gov.au/services-and-events/apply-for-a-police-record-check)

Tasmania Police Phone (03) 6173 2928

Tasmania Police
(https://www.police.tas.gov.au/services-online/police-history-record-checks/)

Northern Territory Phone: 1800 723 368

Police
Northern Territory Police
(https://forms.pfes.nt.gov.au/safent/Apply.aspx?App=CHC)

Appendix D Attachment 3b – Statutory declaration form

Commonwealth of Australia
The statutory declaration form can be found on the Attorney General’s website
(https://www.ag.gov.au/legal-system/statutory-declarations).

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Glossary
Term Definition
Advocacy The process of speaking out on behalf of an individual or group to
protect and promote their rights and interests.
Aged Care Assessment The assessment teams that determine the care needs and eligibility for
Team (ACAT) aged care services (such as home care packages or residential care)
under the Aged Care Act 1997 (referred to as Aged Care Assessment
Services in Victoria).
Aged Care Funding The ACFI is a tool to assess the level of care needed for residents of
Instrument (ACFI) residential aged care services. The classification primarily determines
the level of care funding payable for that resident. This tool consists of
questions and collects information about mental and behavioural
disorders, medical conditions, and other care needs. The information is
used to categorise residents as having nil, low, medium or high needs in
each of the three care domains.
Aged Care Quality and The Aged Care Quality and Safety Commission provides a free service
Safety Commission for anyone to raise their concerns about the quality of care or services
being delivered to people receiving aged care services subsidised by
the Australian Government, including residential care, home care
packages and CHSP services.
The Aged Care Quality and Safety Commission also administers the
Australian Government's Quality Review Program including conducting
quality reviews of home care services.
Aged Care Quality Refers to the Aged Care Quality Standards set out in the Quality of
Standards Care Principles 2014.
Assistance with Care and The former ACHA Program supported older people who were older or
Housing for the Aged prematurely aged people on a low income who were homeless (at the
(ACHA) time) or may have been at risk of becoming homeless as a result of
experiencing housing stress, or not having secure accommodation.

Care finder program Primary Health Networks (PHNs) will establish and maintain a network
of care finders to provide specialist and intensive assistance to help
people within the care finder target population to understand and
access aged care and connect with other relevant supports in the
community.

Care Leaver A person who was in institutional care or other form of out-of-home
care, including foster care, as a child or youth (or both) at some time
during the 20th century. Care Leavers include Forgotten Australians,
former child migrants and people from the Stolen Generation.

Carer A person such as a family member, friend or neighbour, who provides

regular care and assistance to another person without payment for their
caring role. The definition of carer excludes formal care services such
as care or assistance provided by paid workers or volunteers arranged
by formal services.

Carer Gateway Carer Gateway provides carer specific supports and services nationally.
Carer Gateway supports and services can be accessed by calling 1800
422 737, Monday to Friday, between 8am and 5pm or by visiting
www.carergateway.gov.au

Charter Means the Charter of Aged Care Rights or any Charter that replaces it.
Charter of Aged Care Rights The Charter of Aged Care Rights outlines the rights and responsibilities
(the Charter) of care recipients when receiving home care and services.

Client A person who is receiving care and services under the CHSP funded by
the Australian Government.

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Term Definition
Client’s home The client’s home is considered to be where the client is currently living.
This may be the home of both the client and their carer, in cases where
the client and carer share a residence. See 1.2.13 of this program
manual for settings where CHSP services will not be delivered.

Co-habiting clients Co-habiting Clients means spouses, children and other dependants who
share the housing situation of the Principal Client and whose
relationship with the Principal Client requires continuation of co-
habitation.
Culturally and Linguistically Clients may be defined as Culturally and Linguistically Diverse where
Diverse (CALD) they have particular cultural or linguistic affiliations due to their:
• place of birth or ethnic origin
• main language other than English spoken at home
• proficiency in spoken English.
Day Therapy Centres (DTC) The former DTC Program provided a range of therapies and services
Program including allied health support.

Department The Australian Government Department of Health and Aged Care.

Department of Social The DSS Data Exchange commenced from 1 July 2014 and is the
Services (DSS) Data Department of Social Services’ IT system that is used for program
Exchange performance reporting, including for the CHSP. Information on the DSS
Data Exchange is available at https://dex.dss.gov.au/

Diversity Framework The Aged Care Diversity Framework released in December 2017
supports and extends upon the actions and initiatives already
undertaken by the Australian Government and the aged care sector to
build an inclusive, respectful, and person centred aged care system.
The Diversity Framework builds on the 2013-2017 National Culturally
and Linguistically Diverse and the National Lesbian, Gay, Bisexual,
Transgender and Intersex aged care strategies.
Financially or Socially Individuals who, for whatever reason, are without on-going financial
Disadvantaged support as a result of incurred debt, unemployment, age or a disability.
These individuals may also be socially vulnerable as a result of
perception or inaccessibility or have a tendency for self-isolation.

Frail For the purposes of the CHSP, frail refers to older people who have
difficulty performing activities of daily living without help due to
functional limitations (for example communications, social interaction,
mobility or self-care).

Full cost recovery Where access to a service is at full cost recovery, this means that the
CHSP provider would charge the full cost of service provision.

Grant Agreement Grant agreements are performance based, legally enforceable

agreements between two or more parties that set out the terms and
conditions governing a business relationship.
The CHSP grant agreement includes the Terms and Conditions of
funding and the Grant Schedule.
Home and Community Care The former Commonwealth HACC Program and the (joint
Program (HACC) Commonwealth-State) HACC Program in Victoria and Western
Australia provided basic maintenance, support and care services to
assist eligible clients to remain living at home and in their communities.
From 1 July 2015 the Commonwealth HACC program was consolidated
into the CHSP. HACC services for older people in Victoria and Western
Australia were transitioned into the national CHSP on 1 July 2016
(Victoria) and 1 July 2018 (Western Australia).

Home Care Packages A home care package is an Australian Government-funded co-ordinated

package of services tailored to meet the person's specific care needs,

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Term Definition
with eligibility determined by an ACAT. There are four levels of
packages.

Homeless Homeless means people who are:

• without any acceptable roof over their head e.g., living on the
streets, under bridges, in deserted buildings etc. (absolute
homelessness or sleeping rough)
• moving between various forms of temporary or medium term
shelter such as hostels, refuges, boarding houses or friends
• constrained to living permanently in single rooms in private
boarding houses
• housed without conditions of home e.g., security, safety, or
adequate standards (includes squatting).
Housing Stress The Australian Institute of Health and Welfare defines housing stress as
households which spend more than 30 per cent of their household
income on housing costs. Low-income households in housing stress are
of particular concern since the burden of high housing costs reduces
their ability to meet their other living expenses.

LGBTIQA+ People who are lesbian, gay, bisexual, transgender, intersex, queer or
asexual.

Low Income Low Income is equivalent to:

• iincomes in the bottom two-fifths of the population
• the maximum gross income or less necessary to qualify for or
retain a Low Income Health Care Card, as issued by Centrelink
• whichever amount is greater.
My Aged Care My Aged Care was introduced on 1 July 2013 and assists older people,
their families and carers to access aged care information and services
via the My Aged Care website and My Aged Care contact centre
(1800 200 422).
National Aged Care National Aged Care Advocacy Program services have been provided by
Advocacy Program Older Persons Advocacy Network (OPAN) since 1 July 2017. OPAN
(NACAP) – provided by organisations offer free aged care advocacy services that are
Older Persons Advocacy independent and confidential, with services focused on supporting older
Network (OPAN) people and their representatives to raise and address issues relating to
accessing and interacting with Commonwealth funded aged care
services.
National Aged Care Alliance The National Aged Care Alliance (NACA) is a representative body of
(NACA) peak national organisations in aged care, including consumer groups,
service providers, unions and health professionals, working together to
determine a more positive future for aged care in Australia.
National Continence The National Continence Program (NCP) aims to improve awareness,
Program (NCP) prevention and management of incontinence so that more Australians
and their carers can live and participate in the community with
confidence and dignity.
National Disability Insurance The National Disability Insurance Scheme provides community linking
Scheme (NDIS) and individualised support for people with permanent and significant
disability, their families and carers.
National Respite for Carers The National Respite for Carers Program (NRCP) was a former
Program (NRCP) Commonwealth funded respite program that was consolidated into the
CHSP from 1 July 2015. The NRCP contributed to the support and
maintenance of caring relationships between carers and care recipients
by facilitating access to information, respite care and other support

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Term Definition
appropriate to the carer’s individual needs and circumstances, and
those of the care recipient.

National Screening and To ensure a nationally consistent and holistic screening and
Assessment Form (NSAF) assessment process, the NSAF will be used by My Aged Care staff, the
RAS and existing ACATs.
Not having secure Not having secure accommodation refers to accommodation where the
accommodation person's tenure is precarious or there is a likelihood that they will have
to move on because of an escalation in rental cost, exploitation or
unsuitability of the accommodation for their needs. This may include
boarding and lodging arrangements, public housing and staying with
friends or relatives. It may also include accommodation owned by the
client for which they are in immediate circumstances of losing
ownership and accommodation rights.

Older people For the purposes of the CHSP, older people are people aged 65 years
and over and Aboriginal and Torres Strait Islander people aged 50
years and over.

Out-of-scope Services and items that must not be purchased or delivered using
CHSP funding.

Planned Respite Planned respite includes a range of respite services delivered on a

short-term or time-limited bases and planned in advance. Planned
respite can be provided in a client’s home or temporarily in another
setting such as a day centre or in the community.

Planning Framework Approach used to plan for funding and ongoing program management
of aged care service delivery at a regional level. The CHSP uses Aged
Care Planning Regions.

Prematurely aged people People aged 50 years and over (or 45 years and over for Aboriginal and
Torres Strait Islander people) whose life course such as active military
service, homelessness or substance abuse, has seen them age
prematurely.
Primary Health Networks Australia’s 31 PHNs are independent organisations working to
(PHNs) streamline health services – particularly for those at risk of poor health
outcomes – and to better coordinate care so people receive the right
care, in the right place, at the right time.

Principal Clients Principal Client means the sole client or the older client in a household.

Quality Review The process of reviewing the quality of services delivered against the
Quality Standards. The process includes an onsite quality audit, a
quality audit report and a performance report.
Information is available on the Aged Care Quality and Safety
Commission website for home services providers on the quality review
process.

Reassessment A reassessment takes place where an existing client has received an

assessment and support plan and there is a significant change in a
client’s needs or circumstances which affect the objectives or scope of
the existing support plan or care needs or following a short-term
episode of restorative care or reablement service delivery. Providers
can request a reassessment through the support plan review process.
Assessors are best placed to make the decision as to whether a client
requires a reassessment following the review. This decision is
supported by the information provided by the client, the contact centre,
service providers and health professionals.
Regional Assessment The RAS is responsible for assessing the home support needs of older
Services (RAS) people. The service provides timely support for locating and accessing
suitable services based on the preferences of older people. Assessors

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Term Definition
are appropriately skilled to undertake assessments and identify services
appropriate to a diverse range of clients.

Residential day respite Residential day respite provided under the CHSP is defined as day
respite provided in a residential facility – it does not include consecutive
days or nights and is not consider to be the same as Residential
Respite which is delivered under the Aged Care Act 1997

Residential respite Residential respite that is delivered under the Aged Care Act 1997 is
defined as residential care or flexible care (as the case requires)
provided as an alternative care arrangement with the primary purpose
of giving a carer or care recipient a short-term break from their usual
care arrangement.

Restorative Care For a smaller sub-set of older people, restorative care may be
appropriate, where assessment indicates that the client has potential to
make a functional gain.
Restorative care involves evidence based interventions that allow a
person to make a functional gain or improvement in health after a
setback, or in order to avoid a preventable injury. Interventions are
provided or are led by allied health workers based on clinical
assessment of the individual. These interventions may be one to one or
group services that are delivered on a short-term basis which are
delivered by, or under guidance of an allied health professional.
Sector Support and Activities which support CHSP service providers prepare for in-home
Development aged care reforms, and to operate effectively in line with the objectives
of the CHSP and within the context of the broader aged care system.

Serious Incident Serious incidents are defined as those which may have an adverse
impact on the health, safety or wellbeing of a client, or seriously affect
public confidence in the CHSP.

Short-Term Restorative The Short-Term Restorative Care (STRC) Programme is an early

Care (STRC) intervention program that aims to reverse and/or slow ‘functional
decline’ in older people and improve wellbeing through the delivery of a
time-limited (up to 56 paid days), goal-oriented, multi-disciplinary and
coordinated range of services designed for, and approved by, the client.
STRC services may be delivered in a home care setting, a residential
care setting, or a combination of both.

Service provider Service provider refers to service providers or organisations funded to

provide services under the CHSP.
Single Aged Care Quality The Single Aged Care Quality Framework comprises a single set of
Framework quality standards, new quality assessment arrangements across aged
care and enhanced quality information to enable consumers to make
choices about the care and services they need.

Standards Means the Aged Care Quality Standards or any standards that replace
them.

Support Plan Review A review of services may be undertaken by the service provider to
check the effectiveness and on-going appropriateness of the services a
client is receiving.
A support plan review of client needs is undertaken by My Aged Care
RAS or ACAT where:
• The assessor sets a review date in the support plan for a short-
term service.
• A service provider identifies a change in the client’s needs or
circumstances that affects the existing support plan.

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Term Definition
• A client identifies a change in their needs or circumstances, or
seeks assistance to access new services or change their service
provider.
Transition Care Transition Care provides short-term, goal oriented and therapy-focused
care for older people after hospital stays either in a home or community
setting or in a residential aged care setting.
Veterans’ Home Care The Veterans’ Home Care program provides low level home care
(VHC) services to eligible veterans and war widows and widowers.

Volunteers A volunteer is defined, for the purposes of this program manual, as a

person who:
• is not a staff member
• offers his or her services to the service provider
• provides care or other services on the invitation of the service
provider and not solely on the express or implied invitation of a
client
• has, or is reasonably likely to have, unsupervised interaction with
clients.
Wellness and Reablement Refer to Chapter 2 – Supporting Independence

Work Health and Safety Workplace Health and Safety (WHS) often referred to as Occupational
Health and Safety, involves the assessment and mitigation of risks that
may impact the health, safety or welfare of those in your workplace.
This may include the health and safety of your clients, employees,
visitors, contractors, volunteers and suppliers. As a service provider
there are legal requirements that you must comply with to ensure your
workplace meets WHS obligations.

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