Service Agreement – Support at Home Program

We offer Services under the Support at Home program to older people who have a Classification we can support.  We aim to provide eligible participants with Services that meet their assessed care needs to help them stay safely in their Home, underpinned by a person-centred, wellness and reablement approach. 

We will:

• Work with you to create your service agreement (being this document).

• Consult with you and people you nominate to develop a Care Plan and Budget for the types of Services you want to receive.

• Have ongoing discussions with you to ensure the Services meet your needs.

• Respect your rights.

This document is made up of several parts.  Together they form a legally binding agreement.

A supporter registered with the System Governor is a formally recognized person who helps an older individual understand, make, and communicate decisions about their aged care, without overriding their autonomy.

If your Support Plan is amended to allow you to access Services funded under these Support at Home Classifications and we agree to provide these Services, we may ask you to enter into a new agreement or provide those Services under this Agreement.

This Agreement will apply, as if you had signed it, if you accept Services in accordance with this Agreement

Agreement by notifying us that you want to withdraw.  If you choose to withdraw within that time, this Agreement has no effect and we will refund any amounts you have paid us in advance.

You can also terminate this Agreement at any time in accordance with clause E8.

You are entitled to make informed decisions.  You acknowledge that:

• You have had a reasonable opportunity to have this Agreement explained to you.

• You have been able to ask questions about this Agreement and the Support at Home program.

• You have been able to request information from us as is reasonably necessary to assist you to choose services that best meet your goals, needs and preferences, within the limits of the resources available.

• You have been able to obtain independent advice (including legal and financial advice).

• You are satisfied with all elements of the manner in which Services will be provided.

You acknowledge that:

• You have been involved in the development and negotiation of this Agreement.

• We have given you the opportunity to have someone present during the development and negotiation of this Agreement, such as a Supporter, family member, carer or advocate.

A1: Independence, autonomy, empowerment and freedom of choice

1. An individual has a right to:

   1. exercise choice and make decisions that affect the individual’s life, including in relation to the following:

      1. the funded aged care services the individual has been approved to access;

      2. how, when and by whom those services are delivered to the individual; and

      3. the individual’s financial affairs and personal possessions;

   2. be supported (if necessary) to make those decisions and have those decisions respected; and

   3. take personal risks, including in pursuit of the individual’s quality of life, social participation and intimate and sexual relationships.

A2: Equitable access

1. An individual has a right to equitable access to:

   1. have the individual’s need for funded aged care services assessed, or reassessed, in a manner which is:

      1. culturally safe, culturally appropriate, trauma‑aware and healing‑informed; and

      2. accessible and suitable for individual’s living with dementia or other cognitive impairment; and

   2. palliative care and end‑of‑life care when required.

A3: Quality and safe funded aged care services

1. An individual has a right to:

   1. be treated with dignity and respect;

   2. safe, fair, equitable and non‑discriminatory treatment;

   3. have the individual’s identity, culture, spirituality and diversity valued and supported; and

   4. funded aged care services being delivered to the individual:

      1. in a way that is culturally safe, culturally appropriate, trauma‑aware and healing‑informed;

      2. in an accessible manner; and

      3. by aged care workers of registered providers who have appropriate qualifications, skills and experience.

2. An individual has a right to:

   1. be free from all forms of violence, degrading or inhumane treatment, exploitation, neglect, coercion, abuse or sexual misconduct; and

   2. have quality and safe funded aged care services delivered consistently with the requirements imposed on registered providers under this Act.

A4: Respect for privacy & information

1. An individual has a right to have the individual’s:

   1. personal privacy respected; and

   2. personal information protected.

2. An individual has a right to seek, and be provided with, records and information about the individual’s rights under this section and the funded aged care services the individual accesses, including the costs of those services

A5: Person‑centred communication and ability to raise issues without reprisal

1. An individual has a right to:

   1. be informed, in a way the individual understands, about the funded aged care services the individual accesses; and

   2. express opinions about the funded aged care services the individual accesses and be heard.

2. An individual has a right to communicate in the individual’s preferred language or method of communication, with access to interpreters and communication aids as required.

3. An individual has a right to:

   1. open communication and support from registered providers when issues arise in the delivery of funded aged care services;

   2. make complaints using an accessible mechanism, without fear of reprisal, about the delivery of funded aged care services to the individual; and

   3. have the individual’s complaints dealt with fairly and promptly.

A6: Advocates, significant persons and social connections

1. An individual has a right to be supported by an advocate or other person of the individual’s choice, including when exercising or seeking to understand the individual’s rights in this section, voicing the individual’s opinions, making decisions that affect the individual’s life and making complaints or giving feedback.

2. An individual has a right to have the role of persons who are significant to the individual, including carers, visitors and volunteers, be acknowledged and respected.

3. An individual has a right to opportunities, and assistance, to stay connected (if the individual so chooses) with:

   1. significant persons in the individual’s life and pets, including through safe visitation by family members, friends, volunteers or other visitors where the Participant lives and visits to family members or friends;

   2. the individual’s community, including by participating in public life and leisure, cultural, spiritual and lifestyle activities; and

   3. if the individual is an Aboriginal or Torres Strait Islander person—community, Country and Island Home.

4. An individual has a right to access, at any time the individual chooses, a person designated by the individual, or a person designated by an appropriate authority.

B1: Your Support Plan and Classification

1. Self-Management Roles and Responsibilities are determined having regard to our obligations under the Aged Care Act and your preferences. 

2. The initial roles and responsibilities are set out in this Part B, which we will review with you if your choices or needs or circumstances change or if we have concerns about your level of self-management

B2: Reviewing allocated responsibilities

1. The particulars set out above reflects the level of involvement you wish to have in self-managing your Support at Home Services. We must still provide Care Management as required under the Aged Care Act or agreed with you and you can choose to have us fully manage your Support at Home Services at any time.  

2. You must tell us as soon as possible if you no longer wish to self-manage your Support at Home Services or if you are no longer able or willing to perform any of the tasks assigned to you above.  We will work with you to implement the change as soon as practicable.

3. We will let you know if we have any concerns about you completing your responsibilities in the Self-Management Roles and Responsibilities. On doing so, we may require:

   1. the Self-Management Roles and Responsibilities to be reviewed; and

   2. your Support at Home Services to be fully managed by us (if you still want our support).

4. On electing to self-manage your Support at Home Services you accept responsibility for scheduling and overseeing Services, as set out in the Self-Management Roles and Responsibilities. 

5. You also acknowledge that our ability to meet our obligations under the Self-Management Roles and Responsibilities may be impacted by your actions, in which case our obligations will be qualified accordingly.

B3: Changing to a fully managed arrangement

1. If:

   1. you determine that you no longer want to self-manage your Support at Home Services or discharge any of the Self-Management Roles and Responsibilities allocated to you;

   2. we determine that your care needs would be better met by your Support at Home Services being fully managed; or

   3. we cease to offer or support self-management (unless this isn’t permitted under the Aged Care Act),

   4. you can continue to receive support from us under a fully managed arrangement (if offered by us that that time) or elect to transfer your Support at Home Services to another home care provider.

2. If we offer to continue supporting you under a fully managed arrangement, we will outline the basis upon which we propose to continuing support you, for you to consider and approve.

3. If your Support at Home Services become fully managed by us, your Services will be delivered in accordance with the terms outlined to and accepted by you, in which case, this Agreement will be taken to be varied accordingly (unless a new agreement is entered into).

C1: Your Support Plan & Classification

1. The Government will:

   1. assess what Services you require and design a Support Plan based on that assessment to achieve your goals; and

   2. assign you a Support at Home Classification, which determines how much funding you can access under Support at Home.

2. We can only claim from Government funding for Services that align with your Support Plan.

3. You or we can ask the Government to review your Support Plan and Classification when:

   1. your needs, goals or circumstances change;

   2. you need additional services beyond what your Support Plan allows; or

   3. a time-limited Service has ended.

4. If your needs or circumstances change you may be assigned a different Classification that allows you to access additional Services on an ongoing or short-term basis.

5. You:

   1. authorise and consent to us applying to the Government to review your Support Plan and/or re-assess your Classification;

   2. must provide us with any information we reasonably require about your Support Plan and/or Classification; and

   3. must promptly tell us if:

      1. you or anyone else requests a revocation, variation or re-assessment of your Classification; and

      2. you have provided us with incomplete or inaccurate information about your Support Plan and/or Classification.

6. If you aren’t eligible to access funded Services under Support at Home and we agree to keep providing Services under this Agreement you will be required to self-fund the Prices

C2: Your Care Plan & Budget

1. Based on your Support Plan, your Care Partner will partner with you to create and help you understand a Care Plan and Budget setting out the Services you will receive.  We will regularly review these with you (including at least once every 12 months after the Start Day) and revise them, including if:

   1. there is a change in the available funding, including because your Classification changes;

   2. the cost of delivering Services changes; or

   3. the Service Contribution you must make changes.

2. You can also request a review of your Care Plan and Budget, with a view to ensuring that you can set individual goals and receive Services most appropriate to your assessed care needs and resources.

3. A copy of your initial Care Plan and Budget will be given to you as soon as practicable.  If your Care Plan and Budget changes, including at your request, we will give you an updated copy as soon as reasonably practicable and within any time period specified in the Aged Care Act.

4. The Services you can incorporate in your Care Plan depend on:

   1. your Support Plan and your Quarterly Government Funds; and

   2. the Services you want to self-fund by paying Self-funded Service Fees.

5. If your Classification changes and it is agreed that we are to continue supporting you under this Agreement, we will work with you to develop a new Care Plan and Budget.

6. Depending on your Support Plan, the Services we can charge to your Quarterly Government Funds are listed in the Service List.

7. We can refuse to provide a Service if:

   1. we assess that the Service is unsafe or outside the scope of our practice;

   2. that Service is unavailable or if we are unable to secure a suitable Associated Provider; or

   3. the cost of that Service exceeds or is likely to exceed the funds available in your Budget.

8. You will be responsible for the cost of a service if you arrange a service without consulting us and without it being incorporated into and covered by your Care Plan and Budget.  We are not obliged to reimburse you for any services you arrange which are not incorporated in your Care Plan and Budget

C3: Your Care Partner

1. Your Care Partner will work with you to arrange and review the Services you receive.  This includes:

   1. regularly reviewing and checking whether we are meeting your needs and goals (including any changes to them);

   2. if your Support Plan or your care needs or circumstances change, reassessing the most appropriate Services for you and working with you to design new Care Plan;

   3. helping you identify changes you want to make to your Care Plan;

   4. being available if you have any questions or concerns about the Services you receive or how we manage those Services for you; and

   5. liaising with relevant personnel and health practitioners.       

2. Each time we assess your needs and capabilities and/or assess the suitability of Services you are receiving, you must co-operate, provide us with accurate and complete information and consult with your health practitioners (as necessary

C4: Service Delivery

1. Where agreed, you are responsible for choosing suitable service providers to provide the Services as independent contractors, other than to the extent we have agreed to provide Services or the Self-Management Roles and Responsibilities state otherwise.

2. This includes:

   1. ensuring service providers have the necessary qualifications and experience to meet your care needs and preferences, in accordance with your Care Plan;

   2. assessing the costs or fees service providers charge; and

   3. ensuring service providers satisfy the standards under the Aged Care Act.

3. We may require you to stop using a service provider if we have concerns about their ability to provide you with Services as required by this Agreement or the Aged Care Act and/or the Services they provide.

4. We may provide you with a list of preferred service providers, being service providers we consider suitable to provide Services.  If you choose to use a preferred service provider, you must still satisfy your Self-Management Roles and Responsibilities.

5. We discourage you from engaging family members or friends as service providers due to many factors, including the need to consider insurance, legal responsibilities, qualifications, training and safeguards against elder abuse. A participant’s family member may be engaged to deliver funded aged care services — but only under limited and specific conditions.

   1. when there are no other options available.

      1. Before doing so, the provider must consider whether:

         1. The participant is at risk of harm or neglect without the delivery of services;

         2. The participant lives in a rural or remote area (as defined by the Modified Monash Model);

         3. The participant is Aboriginal or Torres Strait Islander, or from a culturally and linguistically diverse (CALD) background;

         4. The family member is appropriately qualified to deliver the specified service(s); and

         5. The family member meets all other worker obligations under the Aged Care Act (e.g., worker screening, training, compliance).

6. You must:

   1. ascertain the basis upon which service providers you want to engage will provide Services to you, including what scheduling commitments they will make, what standards they will adhere to and what insurance they will maintain (which must meet any requirements we have); and

   2. oversee and monitor the service providers you choose to engage, including scheduling and co-ordinating Services, and meet your other Service delivery and reporting obligations under the Roles and Responsibilities.

7. If you engage service providers through a Service Platform, you authorise and must allow us to monitor your use of the Service Platform, including the choices you make and your communications with potential, current and past service providers.

8. You are responsible for meeting the cost of the Services, including the amounts charged by the service providers you select.  Accordingly, you should only schedule Services if you can pay for them out of your Quarterly Government Funds as per your Budget, or if not, if you are prepared to pay for them privately.

9. If you engage service providers, you are responsible for reviewing, negotiating and agreeing to their charges.  On doing so, it is important that you consider and clarify how such charges are reviewed or increased by the service provider.

10. If we agree to provide Services:

    1. we will develop a Service schedule with you, setting out the proposed or preferred days and times Services are to be provided.  We may need to reschedule Services, for example because people are unable to attend to assist you.  If this happens, we will work with you to reschedule Services to an acceptable day and time;

    2. you must be at your Home at the agreed times to receive those Services, unless we agree to provide Services while you are absent.  If we are unable to provide Services because you are absent, we may still charge you and/or claim available funding for the attendance;

    3. you can change or cancel a Service by providing us with at least 1 full business days’ notice so we can plan accordingly. If you do not provide us with 1 full business days’ we may still charge for the Service (including any applicable Service Contributions), unless:

    4. you had reasonable grounds for the late cancellation or no-show (for example, you were in hospital, or experienced a health incident); and

    5. you provide us with written evidence to substantiate this;

    6. you must allow attending personnel to complete and perform their duties in the time allocated to you; and

    7. you must tell us about anything that relates to or may affect us providing those Services to you.  For example, if you believe a Service may pose a danger to you, you must immediately tell the attending personnel about your concerns.

C5: Involvement in decision making

1. You are entitled and encouraged to:

   1. be involved in decisions concerning the Services you receive; and

   2. let us know if you would like us to make changes to the way Services are delivered to you, including how, when and by who Services are provided.

2. We will:

   1. let you know if we are able to provide Services at a different time and/or in a different manner based on the nature of the Services, your needs and/or available personnel and work with you to identify how we may be able to change the way in which Services are delivered; and

   2. do this by involving you in the regular reviews we undertake and responding to any requests you make

C6: Who will provide Services & Care Management

1. Services and Care Management will be provided to you:

   1. fully or partly by us; and/or

   2. by an Associated Provider we consider suitable based on your choices and assessed care needs.

2. If you don’t believe those providing the Services are suitable, we will work with you to identify what changes can be made.

3. If we engage an Associated Provider to provide Services to you we are still responsible for ensuring Services are provided to you in accordance with our responsibilities under this Agreement.

4. We will ensure our personnel are appropriately qualified and skilled to provide safe, respectful and quality Services.

5. We have a list of preferred Associated Providers.  If you wish to receive Services from another supplier, we will try to arrange this and let you know the costs if we are able to do so.

6. We can refuse to use particular personnel or a particular service provider or supplier to provide you with Services if:

   1. they do not meet our supplier requirements which includes entering into a satisfactory agreement with us; or

   2. if we determine at any time that the goods or Services they provide do not meet the standards required under this Agreement or the Aged Care Act.

7. Even if we agree to you self-managing Services or arranging Services we will still provide some Care Management as required by the Aged Care Act.

8. If self-management creates an inconsistency with our obligations, our obligations are to be read and applied in a manner required to give effect to the agreed self-management arrangement.

9. Although we will endeavour to ensure Services are provided by your preferred personnel, Services may be supplied by various Associated Providers and personnel from time to time.

C7: Equipment

1. Subject to your Support Plan, you may be able to use your Quarterly Government Funds to purchase, hire, maintain and/or repair aids and equipment, provided you have sufficient funds and it is otherwise permitted by the Aged Care Act.  You may be required to pay Service Contributions for these Services.  Otherwise, you can choose to self-fund the purchase or use of equipment.

2. If the Care Plan we design with you requires supporting equipment, we will seek to procure that equipment to assist you.  We may ask you to undergo assessments by others, such as occupational therapists, who may rely upon information you provide.  We will not verify the assessments they make or the information you provide.

3. If you enter into an agreement directly with a third party supplier for the purchase or hire of aids or equipment, you must comply with their terms and conditions.

4. Assessments you receive may require equipment to be of a specific type or specification, based on your identified needs.  Equipment that looks similar may not reflect the assessments you have obtained or meet the requirements for payment from your Quarterly Government Funds.  When selecting equipment, you are responsible for ensuring it meets your initial and ongoing requirements.  This may mean that you need to have the suitability of equipment reassessed.

5. There are risks with using equipment.  This means it is important you seek advice and guidance on the use of equipment.  This may include trialling and reviewing equipment with your occupational therapist to ensure equipment is suitable, can be correctly used and does not present a significant risk to you.  If you want us to assist you with using equipment we will let you know if any additional Fees apply and seek your consent to those Fees.

6. You must maintain any equipment you purchase.  You may be able to use your Quarterly Government Funds to help fund this.  You must also enforce any rights you have against the supplier or manufacturer should the equipment be faulty or defective.

7. If equipment is damaged (other than by attending personnel), you are responsible for the repair costs and/or replacement of the equipment (as determined by us).  You may be able to use your Quarterly Government Funds to pay these costs.

8. If we decide that you no longer need any equipment that we have supplied for hire or loan, you must promptly make the equipment available for collection or return.

9. Once this Agreement ends, you must promptly make any equipment we have provided available for collection or return (unless you have paid for the equipment).  If you fail to do so, you must pay us the costs of replacing the equipment.

C8: Medical Emergencies

1. We are not a medical service provider.  If our personnel are present in the event of a medical emergency, ambulance support will be sought.  You will be responsible for the costs of the ambulance and any medical treatment you are provided with.

2. If you need urgent care, please contact your general practitioner or dial 000.

C9: Reimbursements, Participant Payments, & Third-Party Worker Arranagements

1. You may only pay service providers directly and seek reimbursement from us if the requirements set out in clause D9 are met.

2. We will ordinarily make payments directly to approved suppliers, workers, or service providers for services and supports delivered under your approved Care Plan. Reimbursements to you are not the standard method of payment and may only occur in limited and exceptional circumstances, subject to the conditions set out in this clause.

3. General Reimbursement Principle
   Reimbursement of costs by the Approved Provider (or via the Participant’s budget) shall only occur in accordance with the rules of the Support at Home Program and the requirements set out in the Program Manual (version 4) effective from 1 November 2025. The Participant acknowledges and agrees that reimbursement is not automatic; it depends on compliance with the conditions below.

4. Conditions for Reimbursement
   The Participant understands that a reimbursement claim may be approved only when all of the following conditions are met:

   1. The item or service is included in the Support at Home Service List.

   2. The Participant has been approved to receive that service under their Support Plan.

   3. The Approved Provider is registered to deliver that type of service (even though a third-party worker may not be registered).

   4. The Participant has sufficient available funding in their individualised Support at Home budget and the service or item is included in that budget and Support Plan.

   5. The reimbursement arrangement was agreed in writing in advance between the Participant and the Approved Provider, including how any Participant contribution will be handled.

   6. The amount paid:

      1. is within the Client’s available SaH budget and consistent with applicable price caps and program limits; and

      2. the Provider determines that the reimbursement complies with the Support at Home Program Manual, the Claims and Payments Business Rules, and any relevant law, direction, or guideline issued by the Department or the Aged Care Quality and Safety Commission

   7. A valid invoice and proof of payment (receipt or bank statement) are presented that clearly show the service provider or worker’s identity (and ABN if applicable), service description, date, unit/quantity, rate, and total cost.

   8. The claim for reimbursement is lodged within the timeframe stipulated by the Program (in most cases within 60 days after the end of the quarter in which the service was delivered).

5. Third-Party Worker / Independent Provider Arrangements

6. For self-managing Participants engaging independent service or support providers (third-party workers):

   1. The Approved Provider must have formally engaged or authorised that worker to deliver the service and met the mandatory worker-screening, police check and other compliance requirements before the service is delivered.

   2. The service must still meet eligibility (on the Service List), be included in the Participant’s budget and plan, and meet the documentation requirements set out above.

   3. Reimbursement will be refused if these compliance steps are not completed prior to delivery of the service.

7. Participant Contributions and Up-front Payments

   1. The Participant understands their income-tested contribution (if any) must be collected in accordance with the Program rules and documented in the agreement

   2. If the Participant pays a service provider up-front (private funds) and seeks reimbursement from their budget, the arrangement must be agreed in writing beforehand; the Participant is responsible for providing the invoice and proof of payment; and reimbursement will only be made if all conditions in (2), (3) and (4) have been satisfied

   3. The Participant contribution portion is not reimbursable from government subsidy funds.

8. Calculation of Reimbursement

   1. Reimbursement will be based on the GST- exclusive amount of the invoice.

   2. Sensible Care is not permitted to reimburse the GST component of any purchase.

   3. Your Service Contribution (co-contribution) will be deducted from the GST-exclusive amount before reimbursement is made.

   4. Example: If the invoice total is $110 (including $10 GST) and your contribution is 20 %, reimbursement = $100 × 80 % = $80

9. Non-Reimbursable Items
   The Participant acknowledges that reimbursement will not be made for:

   1. Services or items not included in the Service List;

   2. Services not approved under the Participant’s Support Plan or budget;

   3. Services delivered by an unengaged/un-screened worker;

   4. Invoices or payments not meeting the documentation requirements or presented outside the claim timeframe;

   5. Amounts that exceed market-reasonable rates or were agreed without prior written approval.

10. Audit, Recovery and Record Keeping

    1. The Participant and the Associated Provider agree to retain all documentation (invoices, receipts, worker screening evidence, proof of payment, service logs) for at least seven (7) years (or the period required by law) and make them available for audit by the Approved Provider or the Department.

    2. If a reimbursement has been made in error or later found to be ineligible, the Approved Provider may recover that amount from the Participant’s budget or via other lawful means.

11. Submitting Claims

    1. To be eligible for reimbursement, you must submit:

    2. an itemised tax invoice in your name showing the supplier’s ABN and GST status; and

    3. proof of payment (receipt, EFT confirmation, or bank statement).

12. Processing Timeframes

    1. Reimbursements will be processed within 21 days of receiving all required documentation.

    2. Claims lodged more than 30 days after purchase may not be reimbursed unless prior approval has been obtained.

13. Audit and Compliance

    1. Sensible Care may decline or recover any reimbursement that:

    2. falls outside your approved Support at Home service categories;

    3. is inconsistent with Commonwealth claiming rules; or

    4. lacks adequate supporting evidence.

14. Participant Acknowledgement
    

    By signing this Agreement, the Participant affirms that they have read and understood the reimbursement terms above, agree to abide by them, and accept responsibility for ensuring services they pay for (and seek to be reimbursed for) are eligible, documented and within budget

D1: Your Budget

    1. We will help you to develop a Budget that reflects your Support Plan and the choices you have made in your Care Plan.  It will reflect the following:

    2. We will work with you to allocate expenditure from your Budget towards Services.  You cannot allocate your Budget toward items not provided for in the Care Plan.

    3. We will give you a copy of your Budget as soon as practicable once we have the necessary information to complete it.  If your Budget changes, we will give you an updated version.

    4. Your Budget will outline the total amount of the Quarterly Government Funds available to you in the quarter, as well as the planned expenditure including the Prices that we will charge for the Services that we have agreed to provide.

    5. The amounts we charge cannot exceed any caps or limitations under the Aged Care Act.

    6. If the Services you request exceed or are likely to exceed your available Quarterly Government Funds:

            6.1 provided we discharge our obligations under the Aged Care Act, we are not obliged to provide or facilitate those Services;

            6.2 you can elect to receive and pay for those Services independently of us or by paying us privately for those Services (at the Prices specified in our Current Price List or as otherwise agreed); and

            6.3 we will work with you to identify Service changes to bring costs in line with your Quarterly Government Funds.  This may include identifying alternatives and re-assessing your priorities.

    7. If you don’t have enough money available in your Quarterly Government Funds to pay for the Services you want you can:

            7.1 suspend some or all of the Services based on the limits of your available resources;

            7.2 review and readjust your Budget to bring planned Prices in line with your Quarterly Government Funds; and

            7.3 allocate, charge and/or apply any Unspent HCP Funds towards overspends prior to new Prices being paid or incurred (if permitted under the Aged Care Act).

D2: What happens to unspent Quarterly Government Funds

1. We will work with you to ensure that you benefit from the full use of your Quarterly Government Funds, by fully utilising the Quarterly Government Funds that are available to you.

2. If you:

   1. have an ongoing Classification for Support at Home; and

   2. still have funds available in your Quarterly Government Funds at the end of a quarter,

3. the Government will rollover the greater of $1,000 and 10% of what is left in your Quarterly Government Funds (or any other amount prescribed under the Aged Care Act) to the next quarter.

4. The Government will retain any remaining Quarterly Government Funds.
   

D3: Means tested Service Contributions

    1. Services are funded through Government contributions and depending on your means, individual Service Contributions.  This means that depending on your assets and pension status you may have to pay more or less toward the Services you receive, which may impact on the amount of funding provided by Government.

    2. If you were assessed as eligible for, or receiving a Home Care Package prior to 12 September 2024, your Service Contributions will be determined according to the Support at Home Transition Contribution Rates. 

    3. Otherwise, the Service Contributions you pay will be determined in accordance with the Service Contribution Rates under the Aged Care Act which, as at the date of preparing this Agreement, are as follows:

    4. If you have applied for a Fee Reduction Supplement under sub-section 197-20(1) of the Aged Care Act:

        a) you must provide us with any information we reasonably require regarding the application, including that the application has been made and its status; and

        b) we will not charge you the Service Contributions while the Government is considering the application. 

    5. If the System Governor decides that the Fee Reduction Supplement doesn’t apply, you must pay the Service Contributions for the relevant period:

        a) by the sooner of:

                i) the end of the then current Payment Cycle; and

                ii) within 7 days of the System Governor’s determination; and

        b)before you seek to reapply for a Fee Reduction Supplement (if that is permitted under the Aged Care Act).

D4: Changes to your Service Contribution Rate

1. Your Service Contribution Rates will be reviewed and adjusted in accordance with the Aged Care Act.  This includes adjustments to reflect changes to your financial situation and/or the aged pension.  It is important that you keep your asset and income details up to date with Services Australia.

2. You can apply to the Government to have your Service Contribution Rates reviewed at any time, for example, if your financial circumstances change.  This includes if you experience financial hardship and need hardship assistance to pay your Service Contributions.

3. You must immediately tell us if the Government tells you that your Service Contribution Rates are to change.

4. We may require you to start paying higher Service Contributions if you have paid or we have previously accepted less than the maximum amount we can require you to pay under the Aged Care Act. 

5. You must pay your Service Contributions even if you disagree with your Services Australia assessment.  We will refund you for any overpaid Service Contributions if Services Australia decides your Service Contribution Rate was incorrect and you have paid too much.

6. You are personally liable for your Service Contributions (even if you or we end or suspend this Agreement).

7. This Agreement will continue to apply if your Service Contribution changes.  Any change will take effect on the sooner of the date notified by the Government, the date specified in the Aged Care Act and the date your next payment is due.

8. You acknowledge that we have consulted with you about possible changes to your Service Contributions, and you must pay any other applicable fees or contributions referred to in Division 3 of Part 3 of Chapter 4 of the Aged Care Act.
   

D5: Prices

1. Our Standard Prices and a List of all your known service provider’s prices at the time of signing this agreement are included in Part L of this agreement. Your Budget will set out the costs of the Services you are planning to receive.  If there is any inconsistency between this Agreement and the effective prices of your service providers regarding the Prices, the effective prices of your service providers prevail unless otherwise stated.

2. We will advise you in writing of the Prices applicable to any Services that are not listed in our Current Price List or Services provided by Associated Providers or others as part of the Budget planning process or at the time the Services are arranged.

3. We will review our prices under our Current Price List at least once a year, in a manner set out in clauseD6 or in any other manner agreed with you.  We will outline or explain any changes proposed as a result of the review and/or notify you of the date a Price increases under clauseD6.

4. Any agreed Alternative Prices apply instead of the Standard Prices for the corresponding Services

D6: Price increases

1. Our Prices will be subject to regular increases to account for indexation and the cost of delivering services.  Details of how we will increase our Prices are set out in the Agreement Details and/or our Current Price List.  Any delay in adjusting the Prices does not prevent us from applying a charge from the relevant date.

2. If an adjustment will result in the amounts we charge exceeding any caps or limitations under the Aged Care Act, an adjustment will be made up to the maximum amount permitted.

3. You acknowledge that we have consulted with you about how we will increase our Prices.  Any other changes, including the introduction of new charges, can only occur with your consent, following consultation.

4. If:

   1. you ask for a Service we don’t usually provide;

   2. you want to make a change to your regular Services; or

   3. we have to cancel a Service and you want the Service provided by a third party service provider instead,

5. we will let you know the cost of the Service if you decide to proceed.  Costs you have agreed to will be set out in your monthly statement.

6. If:

   1. you engage a third party service provider to provide you with Services; or

   2. we agree that Services are to be provided by a service provider you request,

7. then:

   1. the amounts they charge may change, without them consulting with us or you.  You have the right to negotiate those charges and you should verify the amount they will charge before receiving Services; and

   2. a surcharge may apply in accordance with clause D7.

8. If our Current Price List sets out how Prices are increased or adjusted, we can only change that method with your consent, following consultation.

9. To the extent of any inconsistency between the adjustment methods set out in this clause and the Current Price List, the Current Price List prevails.

D7: Third-party Workers, Suppliers and Invoice Processing Methodology

1. You may nominate your own worker, contractor or service provider (“Third-party Worker”) to deliver Support at Home services. Sensible Care must review and approve each Third-party Worker before services start to ensure the arrangement aligns with your assessed needs, budget and the Support at Home Service List.

2. Sensible Care will verify that every Third-party Worker has a current police or NDIS Worker Screening clearance, relevant qualifications and registrations, and suitable insurance cover. You agree to assist by providing contact details or documents needed for these checks. Services will not be funded until screening is complete.

3. Approved Third-party Worker services may be paid directly by Sensible Care or reimbursed (please see clause C15 below for rules around reimbursements) to you once a valid tax invoice is received. Invoices must show the worker’s legal name, ABN (if applicable), GST status, service details and dates. Sensible Care may decline or recover payments where documentation is incomplete or non-compliant.

4. A 10 % provider overhead is applied to all Third-party Worker services to cover the additional administrative, compliance and risk-management work required. This overhead is charged to your Support at Home funding, not to you personally, and is calculated on the GST-exclusive invoice amount in accordance with Aged Care Rules 2025 §273-15 and Support at Home Manual Ch 11.5.

5. Sensible Care remains responsible for verifying compliance and overall service safety. Each Third-party Worker is responsible for the quality and conduct of their own work

6. You agree to indemnify Sensible Care for any costs, claims or liabilities that result from your engagement of non-compliant Third-party Workers.
   

D8: Self-funded Services

1. If:

   1. you do not have sufficient Government funds to pay for the Services you wish to receive; or

   2. your Support Plan does not give you sufficient funding for the Services you wish to receive,

2. you can pay for Self-funded Services by paying the applicable Fees for the Service at the rates set out in our Current Price List or as otherwise agree.  If you stop paying these, we will speak to you about how this will affect your Services.

3. You can choose to stop receiving Self-funded Services at any time.  You need to give us at least 2 business days so that we can cancel the Services without incurring any costs
   

D9: Management of your Quarterly Government Funds

1. We will manage your Quarterly Government Funds to the extent set out in the Self-Management Roles and Responsibilities or required under the Aged Care Act.

2. We will claim for Care Management and other funded Services we provide from your Quarterly Government Funds.  We may also charge your available Quarterly Government Funds to pay Cancellation Fees and any other permitted amounts payable by you under this Agreement.

3. If under the Self-Management Roles and Responsibilities you are authorised to pay service providers directly we will let you know:

   1. what limits apply to the amounts you can authorise or pay;

   2. what procedures you need to follow to authorise or make payments;

   3. what you need to do to be reimbursed by us from your Quarterly Government Funds; and

   4. how regularly we will make reimbursements (which you will need to take into account when agreeing to how soon you will pay an Associated Provider after Services have been provided).

4. If under the Self-Management Roles and Responsibilities you are responsible for verifying the amounts invoiced by service providers, you must only submit or authorise invoices you have verified or approved.

5. We may reject a reimbursement request or refuse to pay an Associated Provider if:

   1. the Associated Provider does not meet the requirements of this Agreement;

   2. you have not followed the procedures for engaging or paying an Associated Provider;

   3. the Services provided were not allocated in and funded under your Budget or are not permitted under this Agreement;

   4. we require additional information or documentation to assess or verify a reimbursement or payment; or

   5. there is insufficient funds available in your Quarterly Government Funds. 

6. You are responsible for any late fees charged by Associated Providers if a reimbursement or payment cannot be made by the Associated Provider’s due date for payment by reason of your acts or omissions.

7. References in this Agreement to us claiming from your Quarterly Government Funds include (and to the extent permitted by the Aged Care Act you authorise us to do the following):

   1. applying to the Government for available funding and supplements for you based on the Services and Care Management you receive; and

   2. allocating, claiming, paying or applying or deducting from available funding and supplements, amounts payable to us or third parties concerned with the provision of the Services or Care Management

D10: Government Subsidy, Participant Contribution, & Back-dating Arrangements

1. Government Subsidy and Participant Contributions

   1. The Participant acknowledges that Sensible Care, as the Approved Provider, will claim the Australian Government subsidy for eligible services delivered under this Agreement in accordance with the Support at Home Rules 2025 and the Support at Home Program Manual (v4 or later).

   2. The Participant agrees to pay any Participant Contribution (income-tested or otherwise) applicable to their services as determined under the Support at Home Program.
      c. Sensible Care may invoice or claim for the combined amount (Government subsidy + Participant Contribution) in accordance with the Program claiming rules and the Participant’s approved budget.

2. Back-dated Claims and Payment Authorisation

   1. Where a service has been delivered but the related claim or invoice is lodged after the date of service, the Participant authorises Sensible Care to submit a back-dated claim for the Government subsidy and the associated Participant Contribution, provided the claim is made within the period permitted by the Department of Health and Aged Care and complies with Support at Home claiming rules.

   2. The Participant authorises Sensible Care to apply their Support at Home budget funds to any eligible service delivered under this Agreement even if the claim or invoice is processed at a later date, within the allowable back-dating timeframe.

   3. If the Department rejects or disallows a subsidy claim because it falls outside the allowable claiming timeframe or otherwise fails to meet program rules, the Participant acknowledges that the Participant Contribution remains payable and may not be reimbursed.

3. Participant Contribution Payment Process

   1. The Participant agrees that their contribution portion shall be invoiced either separately or together with the subsidy claim, as determined by Sensible Care.

   2. Participant Contributions are due within [14 days] of the invoice date

D11: Unspent HCP Funds

1. If you previously held a home care package under the HCP Program you may have Unspent HCP Funds.

2. We can choose how to manage any portion of the Unspent HCP Funds we hold, including returning the HCP Unspent Funds to you.  The Government’s portion of the Unspent HCP Funds can be used to pay for Services when permitted under the Aged Care Act

D12: Monthly statement

1. In addition to your Budget, we will provide you with a monthly statement as required by the Aged Care Act setting out information about your Quarterly Budget and how it has been used including:

   1. the amounts of subsidy available for you during the quarter and the relevant month;

   2. any rollover credits received for you in respect that that quarter;

   3. a list of the Services you received during the month;

   4. how much was claimed from your Quarterly Government Funds during that month for Services;

   5. the Service Contribution you paid towards the Services; and

   6. any other information the Aged Care Act requires us to include.

2. A monthly statement will be provided for each month, including partial periods, months when no Services are delivered and the month after Services cease, by no later than the last day of the following calendar month. You must promptly provide us with any information we require about the Services you have received so that we can prepare an accurate monthly statement.

3. We will inform you of and help you understand the monthly statements we provide.

4. We may estimate Prices for Services delivered by Associated Providers or other third party suppliers in the monthly statement if we have not received their invoices.  Any adjustments will be made in the monthly statement you receive after we actually receive the supplier invoice. 
   

D13: Postage Costs

1. We may provide you with and ask for information and issue notices to you under this Agreement by email.  It is important that you check your emails and let us know if your email address changes.

2. If you require information, including monthly statements:

   1. to be posted; and/or

   2. provided to multiple recipients

3. and we agree to do that, you must pay any applicable and agreed Fee (unless we cannot charge it under the Aged Care Act).
   

D14: How to pay your Service Contributions, Self-funded Service Fees and any other Fees

1. We will invoice you for amounts payable to us under this Agreement.  Each invoice must be clear and in a format that is understandable.

2. You must pay your Service Contributions, Self-funded Service Fees and any other agreed Fees by direct debit (unless we expressly agree to any other payment method), from your nominated bank account, in accordance with the payment cycle set out in the Agreement Details or as notified to you.

3. You (or anyone else who has agreed to make payments on your behalf) must provide us with a Direct Debit Authority in the form provided to you, unless we agree to another payment method. You must also update these authorities where required (for example, because your Service Contributions change).

4. We will process direct debit payments in accordance with the Payment Cycle or, if a payment date falls due on a weekend or a public holiday, the next business day.  Payments will be deducted from your authorised account on those days.

5. You must not cancel or suspend the direct debit authority until all outstanding Service Contributions and Fees are paid in full and unless alternative payment arrangements (that we have agreed to) have been made.

6. If in any payment period you believe you will have insufficient funds in your nominated bank account when a payment is due, you must tell us immediately to avoid bank charges and make alternative payment arrangements.  We will pass on any bank fees incurred under this clause to you.

7. Once this Agreement has ended, your direct debit authority must not be cancelled until all outstanding Service Contributions and Fees have been paid.

D15: Interest on late payments and costs if you default

1.  If you don’t pay your Service Contributions and Fees on time, we may, at our discretion, charge you interest on the unpaid amount at a rate equivalent to the MPIR at the time payment was due.  Interest will be charged for the period over which payment was late, compounding monthly. 

2. If you breach this Agreement, you must also pay or reimburse us all costs, charges, losses, expenses and damages we reasonably incur as a result of the breach if we ask you to
   

D16: GST

1. All or most Services we provide will be GST-free because they are funded by Government.  If you pay for Services that aren’t funded by the Government they may still be GST-free under GST laws, including if the Services:

   1. are part of your Care Plan and Budget; or

   2. are of a type the GST laws state are GST-free.

2. GST may apply where you pay for Services outside of your Support at Home Services, depending on the type of Services.  You must pay any applicable GST or similar tax that is payable on or in connection with the Services at the time a taxable supply arises.  You authorise us to charge any GST to your Quarterly Government Funds (or a component of them) where permitted by law, including the Aged Care Act.

3. To account for GST under GST laws you or we may need to be considered to act as an agent.  We will let you know if that is permitted and necessary, and if so, the basis upon which:

   1. we arrange or pay for your Services as your agent; or

   2. you arrange or pay for Services we reimburse you for as our agent

D17: Financial Hardship and Debt Management

1. Fee Reduction Supplement

   1. If you are unable to pay your Service Contributions, you may apply to Services Australia for a Fee Reduction Supplement (financial-hardship assistance). Sensible Care will provide information and reasonable assistance with this process.

2. Proof of Application

   1. Where you advise that a hardship application has been made, you must provide evidence of that application (for example, an acknowledgement or reference number from Services Australia) within 10 business days.

3. Pending Applications

   1. While verified hardship applications are being assessed, Sensible Care will pause collection of contributions as required by the Aged Care Rules 2025. If the application is not verified within 10 business days, or is later declined, normal contribution collection will resume.

4. Service Limitation

   1. If hardship remains unconfirmed or unverified, Sensible Care may temporarily suspend or reduce non-critical Everyday Living or Independence services to prevent the accumulation of unpaid contributions. Clinical services will continue to ensure safety and continuity of care.

5. Debt Recovery

   1. Any unpaid contributions that remain after a hardship application is declined are recoverable as a civil debt under this Agreement. Sensible Care may commence recovery action once internal reminders and hardship verification steps have been completed.

6. Referral for Independent Support

   1. Participants may seek free, independent advice or advocacy from the Older Persons Advocacy Network (OPAN) on 1800 700 600 or from a qualified financial counsellor.

7. Policy Reference

   1. This clause operates together with the Financial Hardship and Client Contributions Policy, which forms part of this Agreement and is available on request or at Sensible Care’s website
      

D18: Care Management Increments

        a) Care Management time is recorded and billed in 15-minute increments, as permitted under Chapters 7.3 and 8.10 of the Support at Home Program Manual (v4.0).

        b) Charges are based on the total time spent providing direct and indirect Care Management activities, including coordination, documentation, communication, and planning.

E1: Legal rights and obligations

1. You have rights and responsibilities at law, including under the Statement of Rights and the Australian Consumer Law. 

2. On delivering Services we must take all reasonable and proportionate steps to act compatibly with your rights under the Statement of Rights, taking into account:

   1. competing or conflicting rights; and

   2. the rights and freedoms of others.

3. We have obligations at law, including under the Aged Care Act, the Aged Care Code of Conduct and the Australian Consumer Law as well as statutory duties in the Aged Care Act which are monitored by Government

E2: Your right to information about your Support at Home Services

1. You are entitled to make informed decisions.  You can ask us for more information to assist you to understand the decisions you can make in relation to the Services you receive, including making decisions about Services that best meet your goals and assessed care needs within the limits of your Quarterly Government Funds and other resources.

2. You can access records and information we hold about you or concerning this Agreement in accordance with the Aged Care Act.  You can also authorise others permitted by the Aged Care Act to access those records and information and we will facilitate that in accordance with the Aged Care Act.

3. On request, we will provide you with a copy of your current Care Plan and Budget.

4. Within seven days of receiving a request, we will also give you:

   1. a clear and simple presentation of our financial position; and

   2. if we are required to prepare audited accounts under the Corporations Act 2001 (Cth), a copy of the most recent version of our audited accounts or, if we are part of a broader organisation, a copy of the audited accounts of our aged care component.

5. We will also provide you with other financial information relevant to your Services, if you request it.

E3: Appointing an advocate, Supporter or other representative

1. You are entitled to be supported by an advocate or other person, including a Supporter.

2. You can also appoint a representative to act on your behalf, such as an attorney, guardian or financial manager.

3. A Supporter may with your consent do things such as:

   1. receive information about you; and

   2. communicate your decisions and preferences,

   3. so long as they are registered with the System Governor and authorised to do so under the Aged Care Act.  A Supporter cannot make decisions on your behalf.

4. You must:

   1. tell us if your advocates, Supporters and/or authorised representatives change; and

   2. provide us with any information we reasonably require to verify who your advocates, Supporters and authorised representatives are and what they are authorised to do (or they must do so on your behalf).

5. If we have concerns about whether an advocate, Supporter or representative is fulfilling their duties we may:

   1. raise our concerns with the Government;

   2. seek the appointment of a formal or different decision maker; and/or

   3. make changes to the way we interact with them, including how we handle or communicate information. 

E4: Reviewing this Agreement

1. We will review this Agreement:

   1. at least once every 12 months after the Start Day; and

   2. at your request,

   3. to consider whether any changes should be made to this Agreement.

2. You have an opportunity to participate in these reviews.

3. Any changes to this Agreement following a review must be made in accordance with clause E2.
   

E5: Preventing damage to your Home

1. We will take reasonable steps to prevent our personnel from damaging your Home (including things in your Home) in the course of providing the Services (beyond fair wear and tear).

2. You accept that some damage may occur because of the existing state and condition of your Home (including pre-existing damage that may be exacerbated by the Services), any specific consumables you use or we provide and you accept and/or directions you give for the manner in which Services are undertaken or provided.

3. You must promptly let us know if you believe we have damaged your Home or things in your Home and allow us to verify the extent or nature of that damage

E6: Providing a safe environment

1. You must assist us to ensure that our personnel can work in a safe environment.  For example, you must:

   1. make sure your Home is safe to enter and free of hazards;

   2. make sure there is unobstructed access and adequate space for our personnel to work in;

   3. not ask our personnel to do hazardous manual tasks;

   4. make sure things in your Home, including equipment, is safe, fully functioning and well maintained and use the equipment we provide to assist our personnel, such as lifting equipment;

   5. treat our personnel with dignity and respect;

   6. not abuse, bully or harass our personnel or discriminate against them; and

   7. co-operate with our personnel.

2. You must assist us to ensure that we can provide a safe working environment by way of taking steps to ensure that your relatives, friends and visitors are aware of and comply with our expectations of you.

E7: Infection control

1. To assist us to manage infection risks you must provide us with any information we reasonably require about your immunisation history.

2. You must immediately tell us if:

   1. you have any cold or flu-like symptoms, or any other infection that may put others at risk;

   2. you have been in contact with others who have an infection that may put you or others at risk; and

   3. you have been advised to take particular precautions in relation to your health or the health of others, including any requirement for you to limit or manage your contact with others in a particular way.

3. You must also follow any reasonable procedures we outline in connection with infection control.

E8: Suspending your Support at Home Services

1. You may suspend your Services on a temporary basis.  For example, if you go on holiday or go into hospital, respite care or transitional care.

2. Some Services may also be suspended if you receive Short-term Supports.

3. We must continue to provide Care Management during your leave.  We will continue to claim from the Government for the Care Management we deliver to you.

4. You must give us at least 2 business days’ notice when you want to suspend your Services except in an emergency, in which case you must tell us as soon as reasonably practicable.  If you do not tell us when you are going on leave, we may continue to charge for Services and Care Management we deliver during that period.

5. Your Government funding for Support at Home will cease when a total of four consecutive quarters (one year) and 60 days have passed since the end of the quarter from when the last Service was delivered.

6. We will notify you if we have not delivered a Service (other than Care Management) for more than a year.

E9: When we can suspend your Services

1. We may suspend your Services (in full or in part) if:

   1. we have any concerns about you self-managing your Support at Home Services and:

      1. we have outlined those concerns to you; and

      2. you and we cannot agree on a way to address those concerns or the same issues or concerns keep arising;

   2. you do not meet your responsibilities under this Agreement including, but not limited to, your obligations under the Self-Management Roles and Responsibilities and your obligation to pay your Service Contribution;

   3. your conduct towards our personnel and/or access to your Home poses an unacceptable risk to the health, safety and/or the wellbeing of personnel or others; or

   4. for any other reason we are entitled or obliged to suspend Services under the Aged Care Act or we need to do so to respond to an event beyond our control and during that time we discharge our obligations under the Aged Care Act.

2. If we suspend your Services:

   1. we will only recommence providing Services if we are satisfied the events giving rise to the suspension have been addressed; and

   2. you must continue making payments to us, as if Services had been suspended by you.

3. If you or we are not satisfied with the basis upon which Services are to recommence after a period of suspension, you or we may terminate this Agreement in accordance with clause E18.

E10: Complaints and feedback and whistleblower protections

1. You are entitled to make a complaint and provide feedback about any aspect of the Services or Care Management you receive, without fear of reprisal.  You are also entitled to enforce your rights, including under the Australian Consumer Law.

2. You should promptly contact our designated complaints officer or any other member of staff if:

   1. you have a concern or complaint concerning:

      1. us;

      2. the Services or Care Management we provide; or

      3. our handling of personal information; or

   2. you want to provide feedback.

3. You can make a whistleblower report or disclosure to us, a police officer, an independent aged care advocate, the Department (or an official of the Department) or the Complaints Commissioner.

4. A copy of our current Complaints, Feedback and/or Whistleblower Policy(ies) are set out in Part K.  We will let you know if these policies change (if they do, we must provide you with at least 14 days’ notice of the change).

5. If you choose to make a complaint or provide feedback:

   1. you can withdraw that complaint or feedback in accordance with the Complaints, Feedback and/or Whistleblower Policy(ies); and

   2. relevant information may be shared with the System Governor.

6. You may refer your complaint to the Complaints Commissioner or any State or Territory advocacy service, consumer protection agency or any other relevant government body at any time.  The Complaints Commissioner can be contacted on 1800 951 822.  The contact details of the consumer protection agency in your State/Territory can be found on the Australian Competition & Consumer Commission website (www.accc.gov.au).

7. You may make a complaint about our handling of your Personal Information to the Office of the Australian Information Commissioner.

8. If you have a complaint:

   1. we can still claim for Care Management and other Services we provide from your Quarterly Government Funds; and

   2. you must continue to pay any applicable Service Contribution and Self-funded Service Fees.

9. You must tell us if you are having any issues with Associated Providers or attending personnel.

E11: Consumer Advisory Body

    1. Under the Aged Care Act, participants have an opportunity to join a Consumer Advisory Body.

    2. We will provide you with information about how you can join a Consumer Advisory Body.  Please contact us if you have any questions about this or would like more information about how to join.

E12: Prescriptions for Support at Home Services

1. Some Services we provide may require a prescription by a suitably qualified health/allied health professional including:

   1. allied health professionals such as, occupational therapists, speech pathologists, physiotherapists and podiatrists;

   2. registered health professionals including registered nurses and general practitioners;

   3. Aboriginal and community health workers; and/or

   4. rehabilitation specialists.

2. If required, you must work with us to obtain a prescription by an allied health professional who we consider is suitably qualified to provide the necessary prescription.

E13: Evidence required by Government for us to claim funding

1. We may need to provide certain documentation to the Government to make a claim for Services we provide you.  This may include invoices, prescriptions, quotes, contracts and photographs of any modifications to your Home.

2. You must provide us with any information we require to submit a claim for the Services we have provided and/or assist us to obtain the information we require.

3. You authorise to collect information for this purpose from any third party involved in the prescription or provision of Services to you under this Agreement.

E14: Privacy and protection of personal information

1. Under the Aged Care Act we must:

   1. ensure the protection of your personal information;

   2. only use your personal information for a purpose:

      1. connected to the delivery of Services; or

      2. for which the personal information was given to us;

   3. unless you consent we must not disclose your personal information to others, other than for a purpose:

      1. connected to the delivery of Services;

      2. for which the personal information was given to us; or

      3. of complying with an obligation under the Aged Care Act; and

   4. ensure your personal information is protected by security safeguards that are reasonable in the circumstances to take against the loss or misuse of information.

2. We recognise your right to personal privacy and guarantee that we will take all reasonable steps to protect the confidentiality of your Personal Information as far as legally permissible in accordance with Privacy Laws.

3. Our personnel also have rights in relation to their privacy.  On request, you must:

   1. provide us with any information we reasonably require about devices in your Home that film or record personnel and/or their interactions with you; and

   2. comply with any reasonable policies we provide to you about how the presence of those devices and/or the filming or recording of personnel should be brought to their attention, which may include without limitation, installing signage in your Home.

4. Further information about the way we manage personal information is set out in our privacy policy.  We may also provide you with other policies about how we handle Personal Information which should be read along with this Agreement.

5. You must contact us if you would like to see any of your Personal Information or if you have questions or complaints about the handling of your Personal Information.

E15: Uses of personal information you consent to

1. You consent to us using your Personal Information for the purposes of:

   1. providing or procuring Services and Care Management;

   2. providing or procuring care and services at your Home as an incident of this Agreement or the other Services you receive, including any Short-term Supports;

   3. claiming and administering funding and supplements;

   4. enabling internal administration, quality improvement processes, industry benchmarking and analysis, training, assessments, reviews and investigations into and notification and management of complaints, claims, serious incidents and reportable events; and

   5. any other use permitted by law.

2. We may need to disclose Personal Information to third parties who are concerned with or may be concerned with providing or procuring Services, including contractors.  We may also disclose information to other third parties, including health professionals, advisors, insurers and regulatory authorities.  You consent to us doing this.  When we disclose Personal Information to third parties, we will seek to ensure it is handled appropriately.

3. We may need to request or access personal information about you from third parties to allow services to be provided to you, including your family, carers, representatives, Supporters, general practitioner, medical specialists, allied health providers and others involved in your care.  You authorise us to request and access such information.

4. If you fail to provide us with the Personal Information we ask for, this may affect the fees and charges you are required to pay under this Agreement and the Services we provide.

5. You agree that we may consult with your representative and emergency contact person(s) (as advised to us) and that these individuals may speak on your behalf.  On request, you must provide us with evidence of the authority your representative has to deal with or manage your affairs (or they must do so on your behalf).

E16: Indemnity and limitation of liability

1. To the extent permitted by law, we are not liable for and you must indemnify, keep indemnified and hold us harmless from and against any liability, claims, damages or expenses of any kind arising directly or indirectly in connection with:

   1. Services being provided to you by a third party at your request or direction;

   2. any services provided to you after you enter into an agreement with another Support at Home Provider;

   3. the suspension of your Services or the termination of your Support at Home Services at your request or instigation;

   4. informal services provided to you by your family, neighbours or friends; and/or

   5. your failure to comply with this Agreement.

2. Except to the extent you are entitled to the benefit of one or more of the Consumer Guarantees, we do not provide any guarantees or warranties regarding the suitability, fitness or timing of the Services and Care Management provided under or in connection with this Agreement.  To the extent permitted by law, our liability for a breach of a Consumer Guarantee and any other claim you may have under or in connection with this Agreement concerning inadequate or unsuitable Services and Care Management is limited to (at our option):

   1. supplying the Service(s) and Care Management the subject of the claim again; or

   2. paying the cost of having the Service or Service(s) or Care Management the subject of the claim supplied again.

E17: Assignment

1. So long as we meet our obligations under the Aged Care Act, we may assign or novate all or part of our interest, rights and obligations under this Agreement to a third party.  This means that if for example we transfer our government funded aged care operations to someone else, this Agreement will continue between you and the new provider unless you choose to have your Support at Home Services provided by someone else.

2. We will write to you if an assignment or novation is to occur.  If we do, references in this Agreement to ‘us’ or ‘we’ will be taken to be references to the notified new provider, with the change to take effect from the date specified in the notice.

3. You may not assign or novate all or any part of your interest, rights or obligations under this Agreement.

E18: Ending this Agreement

1. You can end this Agreement and stop us being your Support at Home Provider by giving us at least 7days’ written notice.

2. We can end this Agreement and stop your Support at Home Provider by giving you at least 14 days’ written notice if any of the following occur:

   1. you cannot be cared for in the community with the resources available to us;

   2. you notify us in writing that you wish to move to a location where we do not provide home care;

   3. you notify us in writing that you no longer wish to receive home care;

   4. your needs or condition changes to the extent that you no longer need home care or your needs as assessed by an Aged Care Assessment Team can be more appropriately met by other types of services or care;

   5. you have not paid your Service Contribution or Fees for a reason within your control and:

      1. you have not negotiated an alternative payment arrangement with us; and

      2. you don’t have an application for a Fee Reduction Supplement in place;

   6. you have intentionally caused serious injury to a staff member; or

   7. you have intentionally infringed the right of one or more of our staff members or other attending personnel who provide the Services to work in a safe environment.

E19: What happens when this Agreement ends

1. When this Agreement ends:

   1. you must return to us or allow us to collect any of our property or documents provided to you, including any equipment we have lent you;

   2. we must provide you with a final monthly statement in accordance with the Aged Care Act;

   3. we will retain and manage your health records and other Personal Information in accordance with our legal obligations;

   4. we must reconcile any HCP Funds we hold for you for the period prior to 1 September 2021 in accordance with the Aged Care Act.  This means we will retain any unspent HCP Funds for the period prior to 1 July 2015 and as otherwise permitted by the Aged Care Act following which, if there is a positive amount:

      1. we will transfer any remaining unspent HCP Funds we hold, including any income tested fees (less any amounts you owe us) to the Government or your account managed by the Government; and

      2. if we hold any other amounts you have paid in advance that are not to be transferred to the Government, we will refund those amounts (less any amounts you owe us) to you or your estate or transfer them your new provider under clause D20; and

   5. we will provide you and/or Government with any other notices, statements or information required under the Aged Care Act.

2. The termination of this Agreement does not relieve you of your obligation to pay any amounts which are unpaid or which are payable as an incident of this Agreement ending including:

   1. to the extent permitted by the Aged Care Act, because your Quarterly Government Funds have a negative balance; or

   2. because you have unpaid Service Contributions and/or Self-funded Service Fees (whether because you have paid us late or because your Service Contribution Rates have changed).

3. If an amount you must pay can’t be calculated at the time that payment would otherwise be due, we may claim, charge, retain or deduct such amount as we reasonably estimate will become due, until the actual amount has been determined.  Once the actual amount has been determined, we will make any necessary adjustment or notify you of any additional amount you must pay.

4. The provisions of this Agreement dealing with payments, charging your Quarterly Government Funds, indemnities, limitation of liability, privacy and consequences of termination survive the end of this Agreement and may be enforced after this Agreement has ended.

E20: Transferring to a new registered provider

1. This clause applies if:

   1. you are a pre-1 November 2025 care recipient and we hold HCP Funds for you; and

   2. you notify us within 56 days of us ceasing to be your Support at Home Provider that you are transferring your Support at Home services to another registered Support at Home Provider.

2. After reconciling your HCP Funds in accordance with clause D19(1)(d), we will transfer the balance of any HCP Funds we hold to the new Support at Home Provider and/or the Government (as applicable) within 70 days of us ceasing to provide you with Services or any other period prescribed by the Aged Care Act.

3. You authorise us to provide information to the new Support at Home Provider for this purpose.

E21: Variation of this Agreement

1. This Agreement can be varied by mutual consent, following adequate consultation between us and you.  We do not need your consent if the variation is necessary to implement the GST Act and we have given you reasonable notice in writing about the Variation.  However, we cannot vary this Agreement in a way that conflicts with applicable Laws, including the GST Act and the Aged Care Act.

2. If the Services are varied in accordance with this Agreement, this Agreement will continue to apply.  If we stop providing Services, and you want us to start providing Services again, Services will be provided pursuant to this Agreement, unless a variation or new terms are expressly agreed at the time.

3. When Prices change in accordance with clause C6, this Agreement will be applied with the updated rates.

4. If the Aged Care Act is changed in a way that affects this Agreement, for example, there is a change to our obligations as an aged care provider, this Agreement will be read subject to those changes.  We will tell you if a change of law impacts you and speak to you about how this may affect you.

F1: Definitions

Meanings apply to capitalised terms used in this Agreement as specified in this clause and any other expression used that is defined in the GST Act or the Aged Care Act and used in the manner contemplated in the GST Act or the Aged Care Act has that defined meaning, unless the context otherwise requires:

1. Access Approval means an access approval for Support at Home under the Aged Care Act, including the Date of this Agreement the Access Approval set out in Part H.

2. Aged Care Act means the Aged Care Act 2024 (Cth), the Aged Care Rules 2025 (Cth) and, to the extent relevant, the Aged Care Act 1997 (Cth), the Aged Care (Transitional Provisions) Act 1997 (Cth) and their associated regulations, rules and principles.

3. Aged Care Code of Conduct means the Aged Care Code of Conduct under the Aged Care Act establishing how we and our personnel must treat you as a consumer, a copy of which is set out in Part G.

4. Aged Care Quality Standards means the aged care quality standards set out in the Aged Care Act.

5. Agreement means this agreement for the provision of Services and includes the cover page(s), the Agreement Details, the Parts and any associated documents issued under this agreement. It also includes any Variation(s) that are made to this Agreement.

6. Agreement Details means the details at the start of this Agreement.

7. Alternative Price Acknowledgement means any agreement or acknowledgement between us and you concerning the Alternative Charges to apply in connection with this Agreement.

8. Alternative Prices means the Prices negotiated and agreed instead of our Standard Prices for the applicable Services and Care Management as set out in an Alternative Price Acknowledgement, your Budget or any other notification or acknowledgement regarding the fees and charges payable for Services, subject to any Variation.

9. Associated Provider means .an associated provider for the purposes of the Aged Care Act, being a contractor or supplier we engage.

10. AT-HM means assistive technology and home modifications.

11. AT-HM Scheme means the AT-HM scheme under the Aged Care Act.

12. AT-HM Services means assistive technology and/or home modifications services under the AT-HM Scheme.

13. AT Services means equipment and products specified in the Aged Care Act for the AT-HM Scheme.

14. Australian Consumer Law means the law set out in in Schedule 2 of the Competition and Consumer Act 2010 (Cth).

15. Available Quarterly Government Funds means at the relevant time the balance of Quarterly Government Funds available, minus the Care Management Allocation, and including any amounts carried over from a prior quarter in accordance with the Aged Care Act.

16. Budget means an individualised budget developed in partnership with you which sets out government subsidies available to you, the Prices we will charge for the Services we expect to provide and any Self-funded Service Fees you have agreed to pay.

17. Care Management means the management of Services to ensure your care and support needs are met on an ongoing basis, as prescribed in the Aged Care Act.

18. Care Management Allocation means the portion of your Quarterly Government Funds that the Government sets aside for the Care Management we provide.

19. Care ManagementFee means the amount the Government will pay us for providing Care Management from your Care Management Allocation, including if applicable, a Care Management Supplement.

20. Care Management Supplement means an extra supplement that you may be eligible for under the Aged Care Act in relation to Care Management and that is paid to us for providing you with the additional Care Management services you may need.

21. Care Partner means the person(s) nominated to oversee your Services as specified in the Agreement Details or as otherwise advised to you.

22. Care Plan means your care plan setting out the Services you will receive that we develop in consultation with you as set out in as updated from time to time.

23. Classification means a classification that can be assigned to participants that are approved to receive Support at Home under the Aged Care Act, which determines the level of available funding, including ongoing classifications and short-term classifications.

24. Clinical Supports means those Services which are prescribed as falling in the clinical supports means testing category in the Service List.

25. Common Price List means the price list we are required to publish on our website showing the prices we have most frequently charged for services in the Service List over a prior period. This is different to our Current Price List.

26. Complaints, Feedback and/or Whistleblower Policy(ies) means the policy or policies set out in Part M and/or any additional or replacement policy or policies notified by us in relation to the management or regulation of complaints, feedback and/or whistleblower protections in connection with the provision of Services.

27. Complaints Commissioner means the Aged Care Complaints Commissioner established under the Aged Care Act (or any successor).

28. Consumer Advisory Body means a consumer advisory body established by us in relation to the Services you receive and the area in which they are provided, for the purposes of the Aged Care Act.

29. Consumer Guarantees means the guarantees set out in Division 1 of Part 3.2 of the Australian Consumer Law.

30. Current Price List means our list of Prices, being as at the Date of this Agreement as set out in Part L and if applicable the Agreement Details.

31. Date of this Agreement means the date set out in the Agreement Details or if no date is specified, the date on which we and you have executed this Agreement, or if you do not execute this Agreement, the date on which this Agreement is deemed to apply.

32. Default Contribution Rate means the default contribution rate set out in the Aged Care Act if any, or if there isn’t a default contribution rate, the maximum Service Contribution permitted under the Aged Care Act.

33. Department means the Commonwealth Department of Health, Disability and Ageing or any successor or substitute Commonwealth government department or instrumentality under the Aged Care Act.

34. End-of-Life Care means Services we may agree to provide under the short-term End-of-Life Pathway.

35. End-of-Life Care Partner means your Care Partner or any other person we allocate to you to coordinate your End-of-Life Care Services if we agree to provide you with End-of-Life Care.

36. End-of-Life Care Plan means a specific care plan that will be developed for you under the End-of-Life Pathway if we agree to provide those Services.

37. End-of-Life Pathway means additional funding the Government may provide to you to support you during your end-of-life if you are eligible.

38. End Date means:

    1. the date on which this Agreement is ended; or

    2. in the case of any agreed Short-term Supports, the end of the applicable funding period.

39. Estimated Completion Date means the date that we estimate your restorative care episode will be completed as set out in Part J or as otherwise set out in writing.

40. Extra Condition means any extra condition(s) specified in the Agreement Details.

41. Fees means the costs, fees, charges and other amounts:

    1. payable by you to us under this Agreement, including the Self-funded Service Fees; or

    2. which we can claim from or charge to the Government in connection with the provision of Services.

42. Goal Plan means a plan we will develop for you if we agree to provide you with Services under the short-term Restorative Care Pathway as set out in Part J.

43. Government includes government departments and agencies who oversee or administer matters relevant to the provision of Services, including the Commissioner, Services Australia, Department of Veterans’ Affairs, Department of Health, Disability and Ageing and the System Governor (as the context permits).

44. GST means the goods and services tax levied under the GST Act or any other goods and services tax, value added tax, consumption tax or tax of similar effect levied from time to time.

45. GST Act means the A New Tax System (Goods and Services Tax) Act 1999 (Cth).

46. Hardship Supplement means a supplement we may receive from the Government if you have been approved for hardship under the Aged Care Act.

47. HCP Funds means any funds we may hold for you for the period prior to 1 September 2021 under the HCP Program.

48. HCP Program means the home care packages program under the Aged Care Act 1997 (Cth).

49. HM Services means the services in the service type home adjustments as set out in the Aged Care Act for the AT-HM Scheme.

50. Home means the place specified in the Agreement Details where we will provide you with Services (unless otherwise agreed).

51. Independence Supports means those Services which are prescribed as falling in the independence means testing category in the Service List.

52. Laws means all relevant State, Territory and Commonwealth laws and regulations and where the context requires, includes all Government policies applicable to the delivery of the Services.

53. MPIR means the maximum permitted interest rate under the Aged Care Act at the applicable time.

54. Part means a section of this Agreement with the heading ‘Part’.

55. Participant means:

    1. you, being the individual specified in the Agreement Details who is to receive Services under this Agreement; and

    2. includes where the context permits, your authorised representative(s).

56. Payment Cycle means the manner or intervals when fees and charges are payable to us, as set out in the Agreement Details or agreed or, if no cycle is specified, monthly, or in the case of an amount which is not payable at regular intervals, including a change to your Service Contribution and Fees, on demand and on this Agreement ending, means the date this Agreement ends.

57. Payment Method means the method by which payments are to be made by you under this Agreement, as set out in the Agreement Details or agreed, without deduction or set-off unless a deduction or set-off is authorised under the Aged Care Act.

58. Personal Information means information about you and includes personal, sensitive or health information of or about you within the meaning of the Privacy Laws.

59. Prices means the Fees and charges for the Services which are charged by us, our Associated Providers or any other suppliers, including the Care Management Fee.  This includes the Fees and charges in our Current Price List, any other agreed Fees and any other charges set out in your Budget or any other notification or acknowledgement regarding the Fees and charges payable for Services.  These amounts may be increased from time to time in accordance with this Agreement.  Any Prices quantified in the Agreement Details may be estimates for Budget purposes with the amount payable to be determined in accordance with this Agreement.

60. Privacy Laws means, to the extent applicable, the Privacy Act 1988 (Cth) and equivalent State/Territory Laws concerning the handling of personal, health or sensitive information and their respective Australian Privacy Principles, Information Privacy Principles and Health Privacy Principles.

61. Quarterly Government Funds means the total amount of Government funds allocated and available for Services under your Support Plan each quarter, including any carry over that is permitted under the Aged Care Act. 

62. Registered Provider means the registered provider specified in the Agreement Details or any notified any assignee and ‘we’, ‘us’ and ‘our’ have a corresponding meaning.

63. Restorative Care Pathway means the restorative care pathway under the Aged Care Act.

64. Self-funded Services mean Services that you want to receive and which we agreed to provide in addition to the Services funded by or provided for in your Quarterly Government Funds and Support Plan.

65. Self-funded Service Fee means each Price you choose to and must pay, at agreed intervals, to receive Self-funded Services.

66. Self-Management Roles and Responsibilities means the roles and responsibilities you and we have in connection with your Support at Home Services.  The initial roles and responsibilities are set out in Part B but these will change to reflect agreed changes to the manner in which your Support at Home Services are managed and Part B will be taken to include any additional or replacement statement of roles and responsibilities we provide to you to reflect a change under this Agreement.

67. Service Contribution means the contribution you are required to pay towards a Service funded by Government based on your means, which is the maximum contribution you can or must make under the Aged Care Act, calculated in accordance the Aged Care Act.

68. Service Contribution Rate means the rate that is used and applied by Services Australia to determine the Service Contribution you must make.

69. Services means those products and services we or an Associated Provide to you under this Agreement, including Care Management.

70. Service List means the then Current service list for Support at Home under the Aged Care Act, which as at the date of preparing this Agreement is the service list set out in Part N.

71. Service Period means:

    1. the duration of the period commencing on the Start Day and ending on the End Date; and

    2. in the case of Short-term Supports provided in the course of that period, means the period over which the Short-Term Supports are to be provided.

72. Short-term Supports means Classification for one of the three short term supports or pathways under Support at Home, being for Restorative Care, End-of-Life Care or AT-HM.

73. Standard Prices means the standard Prices for Services and Care Management and other amounts set out in our Current Price List, subject to any Variation.

74. Start Day means:

    1. the date we will start providing Services to you under this Agreement, as specified in the Agreement Details, or any other date we start providing Services to you under this Agreement, which is also the date this Agreement commences; and

    2. in the case of Short-term Supports provided after that day, the agreed start day for those Short-term Supports.

75. Statement of Rights means the Statement of Rights under the Aged Care Act, which as at the date of preparing this Agreement is in the form set out in Part A.

76. Support at Home means the Support at Home program funded under the Aged Care Act.

77. Support at Home Provider means the registered provider who is responsible for the provision of care management and services to you under Support at Home.

78. Support at Home Services means Services under the Support at Home program including Short-term Supports.

79. Support at Home Transition Contribution Rates are the Contributions that you may be required to pay if you are a Pre-12 September 2024 Care Recipient as set out in the Aged Care Act.

80. Support Plan means the Support at Home support plan prepared by the Government for you from time to time.

81. Supporter means a person or people who are authorised to act as your supporter under the Aged Care Act.

82. System Governor means the Secretary of the Department.

83. Unspent HCP Funds means any unspent funds you had under the HCP Program prior to the commencement of the Support at Home program which are to be retained and used under the Aged Care Act for the Support at Home program.

84. Variation means any change made pursuant to or in accordance with the Agreement and any other variation agreed by us and you or which you are taken to have agreed to.

85. Wrap-around and Coordination Services means wrap-around and/or coordination services we may agree to provide to you, if we agree to provide you with AT-HM Services

F2: General Provisions

1. This Agreement is subject to any Extra Conditions in the Agreement Details.  If there is an inconsistency between an Extra Condition and another provision of this Agreement, the Extra Condition prevails.

2. This Agreement is to be read in conjunction with and subject to any part of the Aged Care Act which regulates our dealings.

3. If there is an inconsistency between the Self-Management Roles and Responsibilities and our obligations under the Aged Care Act, our obligation under the Aged Care Act overrides the Self-Management Roles and Responsibilities and will be discharged by us.

4. If any one or more of the provisions of this Agreement are found to be illegal, void or voidable by any judicial or other competent authority, those provisions must be severed from the Agreement and the remaining provisions of this Agreement will remain in effect.

5. If any one or more of the provisions of this Agreement would result in you being treated less favourably in relation to any matter than you would otherwise be treated, under any law of the Commonwealth, in relation to that matter, such provisions are to be read subject to that law.

6. Any delay or failure by you or us to exercise a right or enforce an obligation doesn’t prevent you or us from relying on this Agreement.

7. Reference to a statute, code or other law includes regulations, principles, standards and other instruments made under it and includes consolidations, amendments, re-enactments or replacements of any of them and all statutory instruments issued under any of them.

8. Any guide or explanatory materials provided to you in conjunction with this Agreement don’t form part of this Agreement.

9. We may estimate or calculate monthly amounts on the basis of a set number of days in a month (for example, 31 or 30 days).  This may mean that the amount payable for a month varies having regard to the actual number of days in the month.

10. This Agreement may be executed in any number of counterparts and all the counterparts together constitute one and the same instrument.  This Agreement may be executed by hand and delivered by email to the other party in a ‘pdf’ data file.  Execution and delivery in that format will be valid and binding as if the ‘pdf’ copy is an original.

11. We may elect to and/or require you to execute and exchange this Agreement electronically in which case:

    1. you must comply with the processes and instructions we provide;

    2. a printed or an electronic form of this Agreement with a party’s electronic signature(s) appearing will constitute an executed counterpart; and

    3. the date, time and location of the electronic execution will be established by us or the utilised electronic execution system.

12. Any person who executes this Agreement on behalf of the Participant warrants that they are authorised to bind the Participant to this Agreement, and all Parts of this Agreement apply to the Participant, irrespective of any limitations in the authority of the representative or any disclosure made to us about the authority of the representative.

13. This Agreement is governed by and interpreted in accordance with the Laws of the State/Territory in which we provide you with Services.  A reference to a business day means a business day in that State or Territory, being a day other than a public holiday or weekend.

14. Any notice received by us after 4:00 pm on a business day or on a public holiday or weekend is taken to be given and received on the next business day (unless the Aged Care Act sets out when such notice is received).

15. Subject to our obligations under the Aged Care Act, if the Support at Home program is replaced, we will let you know if we will keep providing services under this Agreement.  If a new agreement is required, we will consult with you about how we can continue providing services

1. The following applies to us, as the Registered Provider, our responsible persons and aged care workers.

2. When providing care, supports and services to people, I must:

   1. act with respect for people’s rights to freedom of expression, self-determination and decision-making in accordance with applicable laws and conventions; and

   2. act in a way that treats people with dignity and respect, and values their diversity; and

   3. act with respect for the privacy of people; and

   4. provide care, supports and services in a safe and competent manner, with care and skill; and

   5. act with integrity, honesty and transparency; and

   6. promptly take steps to raise and act on concerns about matters that may impact the quality and safety of care, supports and services; and

   7. provide care, supports and services free from:

      1. all forms of violence, discrimination, exploitation, neglect and abuse; and

      2. sexual misconduct; and

   8. take all reasonable steps to prevent and respond to:

      1. all forms of violence, discrimination, exploitation, neglect and abuse; and

      2. sexual misconduct

If you have been approved AT-HM Funding and we agree to provide you with AT Services and/or HM Services under this Agreement, the following part of this Agreement applies.  We can fill in the details in this Part when we prepare this Agreement (if we have the relevant details) or complete, confirm or tell you the details set out below, once we have the necessary information.

I1: Responsibility for equipment and modifications

1. If you receive additional supplements to purchase equipment or carry out modifications to your Home, you are responsible for any associated and ongoing maintenance and dealing with any supplier if the equipment or modifications are defective.   You may have rights against a supplier under the Australian Consumer Laws.

2. Depending upon the nature or scope of Home Modifications, you and we may need to enter into an agreement with a supplier or contractor to record certain rights and responsibilities in relation to building works.

I2: Additional Wrap-around and Coordination Services

1. The Aged Care Act may limit the amount we can charge for Coordination Services and Administration Services.  As at the date of preparing this Agreement, the amount we can charge for:

   1. Administration Services for AT Services, is limited to $500 or 10% of the Costs of your AT Services (whichever is less); and

   2. Coordination Services for HM Services, is limited to $1,500 or 15% of the Costs of your HM Services (whichever is less).

I3: Contributions

1. You agree to pay the applicable Service Contributions that apply to the Services you receive under the AT-HM Scheme. Unless otherwise agreed, Service Contributions will be payable as per the Payment Cycle and by direct debit unless otherwise agreed.

I4: End Date and time-limit

1. We will cease delivering AT-HM Services to you on the date set out in the Key Details of this Part or any other agreed date or date on which this Agreement ends.

2. You acknowledge that funding under the AT-HM Scheme is time limited and must be spent, not just committed, within a 12 month period unless the Government approves an extension.

3. You must cooperate with us to ensure we can provide the AT-HM Services in the necessary timeframe.

4. If we anticipate that we will not be able to provide the AT-HM Services within the relevant time period, you agree to submit an application for an extension if we ask you to.

5. If you do not assist us to complete the AT-HM Services in this timeframe and you do not obtain an extension, you will be personally liable for any costs we incur in seeking to procure the AT-HM Services on your behalf.

If you are approved for Restorative Care Funding under the Restorative Care Pathway and we agree to provide you with Restorative Care Services, the following part of this Agreement applies.  We can fill in the details in this Part H when we prepare this Agreement (if we have the relevant details) or complete, confirm or tell you the details set out below, once we have the information we need.

J1: Care Management under Restorative Care

1. Notwithstanding other terms in this Agreement, there is no specific limit or amount deducted from the budget for Care Management under the Restorative Care Pathway.  

J2: Goal Plan

1. Your Restorative Care Partner will work with you to develop an individualised Goal Plan and Budget which must be finalised before the Restorative Care Start Date.

2. Your Goal Plan:

   1. replaces the care plan required for ongoing Support at Home Services or any prior goal plans from previous Restorative Care episodes;

   2. must be finalised before the Start Day; and

   3. will be reviewed in accordance with the Aged Care Act.

3. We will review your Support Plan and any other existing care plans (for ongoing Support at Home Services) or previous goal plans (from previous restorative care episodes), if available.

4. Your Goal Plan must include:

   1. the Start Day and Estimated Completion Date of the episode;

   2. your needs, specific goals, preferences and existing supports which have all been drawn from your Support Plan developed during the aged care assessment;

   3. any other services or supports you are receiving to help support meeting the goal;

   4. any risks identified through assessments of the you or your Home;

   5. the specified services to be delivered including the frequency and expected dates of delivery;

   6. the budget for the episode; and

   7. the process for monitoring and evaluating the episode including any assessment tools and measures to be used by the multidisciplinary team and the dates of evaluation.

If you are approved for funding under the End-of-Life Pathway and we agree to provide you with End-of-Life Care, the following part of this Agreement applies.  We can fill in the details in this Part when we prepare this Agreement (if we have the relevant details) or complete, confirm or tell you the details set out below, once we have the information we need.

K1: Period

1. Your End-of-Life Funding will be available for a period of 16 weeks from the Start Day outlined above.

2. If you require services after this time, you can:

   1. access Unspent HCP Funds, if available; and/or

   2. work with us to request an urgent Support Plan review to move to an ongoing Support at Home Classification.

K2: Care Plan

1. Your End-of-Life Care Partner will work with you to design an End-of-Life Care Plan.

K3: Contributions

1. You agree to pay the applicable Contributions that apply to the Services you receive under the End-of-Life Pathway. Payments must be made in accordance with the Payment Cycle.

1. Pricing Principles

   1. As a self-managing Support at Home participant, you may engage your own independent third-party support and service providers (“Associated Providers”) and negotiate prices for their services.

   2. Prices must be reasonable, transparent, and consistent with market rates for comparable services in your local area.

   3. All prices must:

      1. align with your approved Support Plan and budget;

      2. comply with the Support at Home Rules 2025 and the Support at Home Service List; and

      3. represent value for money in accordance with the Aged Care Act 2024.

2. Known Prices of Current Providers
   All known prices of the selected independent third-party providers engaged by the Participant at the date of signing this Agreement are listed in Schedule A – Current Independent Provider Price List.
   These prices were agreed directly between the Participant and each provider, and are subject to review by the Approved Provider to ensure compliance with Support at Home Program rules and reasonableness requirements.

3. Future Providers and Addenda
   The Participant may, from time to time, engage new independent third-party providers or negotiate new pricing arrangements.
   Any such new engagements must be recorded on a “New Independent Service Provider Advice Form”, which will include:

   1. the associated provider’s name and ABN,

   2. Associated provider’s contact information,

   3. the nature of services provided,

   4. the agreed rate(s), and

   5. the effective date of engagement.
      
      The completed Advice Form will be taken to form an addendum to this Agreement and will have the same legal force and effect as if incorporated herein.
      Each Advice Form will be signed by the Participant (or their representative) and acknowledged by the Approved Provider before any payments are made from Support at Home funds.
      
      

4. Approval and Claiming

   1. All prices and providers, including those added via Advice Forms, are subject to verification by the Approved Provider prior to payment.

   2. Services are only payable where they are:

      1. within the approved Support at Home budget;

      2. consistent with the Participant’s Support Plan; and

      3. supported by valid invoices and service evidence.

5. Adjustments and Reviews
   

   Prices may be periodically reviewed to ensure they remain reasonable and compliant with government guidelines. Any adjustments will be confirmed in writing and reflected in the Participant’s updated Support Plan and Budget

The following Whistleblower Protection Policy forms part of the Service Agreement. Sensible Care maintains the Whistleblower Protection Policy that applies to all participants, workers, contractors and associated providers.

This policy explains how anyone can raise a serious concern or disclosure about misconduct or breaches of the Aged Care Act 2024 and outlines the protections available under the Aged Care Rules 2025 and the Corporations Act 2001.

The current Whistleblower Protection Policy (attached as Schedule K1) forms part of this Agreement.
Participants and their representatives can request a copy at any time or access it on our website or by contacting Sensible Care directly.

Whistleblower Protection Policy

Purpose:

Sensible Care is committed to upholding the highest standard of integrity, consistent with our purpose and values.

This Policy outlines how Sensible Care supports and protects whistleblowers in accordance with the Corporations Act 2001 (Cth)andtheAged Care Act 2024.

Definitions:

Whistleblower- Any person who discloses or reports actual or suspected misconduct, wrongdoing or breaches of the Aged Care Act.

Disclosable matters- Any concern or reasonable suspicion that someone has breached, is breaching, or about to breach a provision of the Aged Care Act. Such concerns or suspicions need to be in relation to “misconduct” or an “improper state of affairs”.

Disclosures qualifying for protection- A disclosure of information by an individual qualifies for protection if:

• the disclosure is made to one of the following:

• an Appointed Commissioner or a member of the staff of the Commission

• the System Governor, or an official of the Department

• a registered provider of funded aged care services

• a responsible person of the registered provider

• an aged care worker of a registered provider

• police officer

• an independent aged care advocate

• the disclosure is made either verbally or in writing and is submitted anonymously or not

• the individual has reasonable grounds to suspect that the information concerns conduct that may breach a provision of the Aged Care Act.

Misconduct- Illegal, unacceptable or undesirable conduct or behaviour (actual or attempted) that is: dishonest, unethical, fraudulent, corrupt, non-compliant or may give rise to questionable accounting or auditing practices, may cause financial loss, or acts inconsistent with the organisation’s purpose, values and code of conduct.

Workers- refers to all staff, employees, associated providers (i.e. agency staff, contractors, etc), students and volunteers of the organisation.

Standard 2 expectation statement for older people:

The organisation is well run. I can contribute to improvements to care and services. My provider and aged care workers listen and respond to my feedback and concerns. I receive funded aged care services from aged care workers who are knowledgeable, competent, capable and caring.

Outcome 2.6a Complaints and feedback management for aged care workers
The provider must encourage and support aged care workers to make complaints and give feedback about the provider’s delivery of funded aged care services without reprisal.

The provider must acknowledge and transparently manage all complaints and feedback and use complaints and feedback to contribute to the continuous improvement of funded aged care services.

Whistleblower Protection Commitment:

This Whistleblower Protection Policy forms part of your rights under this Service Agreement and aligns with the Aged Care Act 2024 s.23 and Aged Care Rules 2025 Part 10 Division 2. It ensures you, your representatives, and our workers can raise concerns safely and without reprisal.

Sensible Care is committed to supporting whistleblowers to report any misconduct or wrongdoingand protecting them from any adverse consequences following disclosure by:

• ensuring workers, older people and all stakeholders feel safe and supported to raise concerns by actively promoting a “speak up” culture, emphasising protections and Sensible Care’s commitment to addressing concerns without reprisal

• promoting at least monthly that whistleblower disclosers are welcomed and encouraged using various communication channels such as newsletters, posters, internal statements and other appropriate communication platforms

• maintaining a structured and transparent system that enables individuals to make disclosures safely and appropriately by:

• clearly defined policies and procedures

• providing multiple secure and accessible reporting channels that enable individuals to make disclosures including:

• internally and externally

• face to face

• over the phone

• in writing (e.g. feedback boxes, emails etc.)

• assessing disclosures to ensure it qualifies for whistleblower protections

• providing up to date information about how disclosures can be made, what disclosures qualify for protection and eligible recipients' disclosures can be made to

• informing the individual against whom a matter has been raised as soon as practicable, to ensure they are given a fair opportunity to respond

• reporting to external bodies as required (i.e. Aged Care Quality Safety Commission)

• ensuring all disclosures will be investigated in a fair, objective, confidential and transparent manner in line with the principles of natural justice including:

• acknowledging and responding to disclosures in a timely manner

• adopting a positive, blame-free approach that focuses on the process and avoids any negative repercussions for the individual providing disclosure

• ensuring investigations are conducted by appropriate and impartial person (e.g. a relevant manager or delegated investigator)

• evaluating each disclosure thoroughly, with outcomes documented and communicated to relevant parties where appropriate and permissible

• collecting evidence to substantiate or refute claims

• taking appropriate corrective action as warranted by the investigation

• investigating all disclosures, including those made anonymously noting that where a disclosure was made anonymously, that there may be limitations to being able to respond to the discloser

• providing regular feedback to those involved in the disclosure, including throughout and after the investigation

• preparing a comprehensive report outlining the findings, evidence and outcomes of the investigation

• supporting potential whistleblowers to access appropriate information through the Human Resources or Legal department or seeking independent legal advice

• taking all reasonable steps to support whistleblowers and any other person or entity that is associated with them following disclosure, during and after the investigation by:

• facilitating access to counselling services or other appropriate supports

• offering temporary or permanent relocation or reassignment of duties, where necessary, to protect the well-being and safety of the individual (if agreed to and as long as this does not include victimisation)

• ensuring no disciplinary action is taken against a whistleblower when the disclosure was made with a genuine or reasonable belief regarding the misconduct, even when that allegation is incorrect

• facilitating access to legal remedy or compensation where they have experienced detriment as a result of disclosure

• allowing whistleblowers to make a disclosure to a regulator or legal practitioner. Whistleblowers may also make an emergency or public interest disclosure to a journalist or parliamentarian

• protecting their identity or identifying information, to the fullest extent possible (with some exceptions such as where it is necessary to share information with the Aged Care Quality and Safety Commission or a lawyer to prevent a serious threat to a person or people)

• not tolerating any threats, acts or omissions designed to cause detriment to a whistleblower (or another person) in relation to a disclosure. This includes dismissal or termination, demotion, reputational damage or injury or damage to person or property

• ensuring fair treatment of any individuals mentioned in the disclosure informed by the principles of natural justice.

• ensuring the whistleblower policy is easily accessible to all workers, made available to older people, their supporters and other stakeholders on request in a format that the individual can understand.

• providing education and training to workers on:

• the whistleblower policy and process

• how to report misconduct and any personal work-related grievances

• how to handle personal information and data (within their scope)

• how to recognise and respond to disclosers that qualify for protection

• when and how to escalate disclosures

• their roles and responsibilities in the system

• supporting individuals with specific needs and diverse backgrounds to make disclosures

• providing training regularly, at least annually and when:

• the person becomes an aged care worker or responsible person for our organisation

• there is a change to the person’s role that affects the person’s roles and responsibilities in the system

• there is a change to how the system works that affects the person’s roles and responsibilities in the system

• ensuring all instances of known or suspected misconduct or wrongdoing are reported to a Senior Manager and to the Board for oversight and monitoring.

• keeping confidential and secure records that protect the anonymity or confidentiality of all people involved in the disclosure by:

• storing all paper and electronic documents and other materials of disclosures safely and securely

• limiting access to information related to disclosers to those directly involved in managing and investigating disclosures

• keeping all documentation and records for 7 years

• reviewing our organisation’s system at least annually and implementing improvements as required.

• All whistleblower disclosures, investigations and outcomes will be recorded and retained for a minimum of seven (7) years in accordance with Aged Care Rules §154-205.

Roles and Responsibilities:

Whistleblower disclosures are managed within Sensible Care’s Complaints and Feedback Management System, ensuring consistent logging, investigation, and reporting.

Governing Body

The Sensible Care’s Governing Body has ultimate responsibility for the organisation’s accountability and management of disclosures under its risk management and compliance responsibilities including ensuring matters contained in this policy are endorsed and clearly communicated. The Sensible Care Governing Body ensures systems and processes for effectively managing disclosures are maintained and effective in driving continuous quality improvement. The Sensible Care Governing Body is responsible for building an open and transparent culture where older people, their supporters, workers and visitors are encouraged, supported and feel safe to make disclosures.

Management

Sensible Care Management is responsible ensuring all workers and stakeholders are aware of this policy and understand how to reports concerns. Sensible Care Management are responsible for fostering a culture where disclosures are encouraged, reported and investigated. This includes ensuring workers have the required skills to recognise and response to disclosers that qualify for protection and when and how to escalate disclosures. They are also responsible for monitoring compliance of this policy and related processes and identifying opportunities for improvement such as by reviewing and auditing records, training records and older people’s documentation.

Sensible Care Management is responsible for reporting disclosures to the Executive Team/Senior Management and Sensible Care Governing Body and where required, to external agencies.

All Workers, including associated providers, volunteers and students

All Workers, including associated providers (i.e. contractors and agency staff), volunteers and studentsare required to comply with this Policy and act within their delegated level of authority.

Suggested Evidence:

• Records of communications to workers and others about whistleblowing

• Incident register

• Feedback register

• Records of investigations conducted in relation to whistleblower disclosures

• Worker training records and schedules

References: