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1.
Discretion to charge
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- Budgeted
income from charging for non residential services amounts to £1,457,454
in 02/03.
- A
sum of £200k has been allowed in this year’s budget to offset the
reduced income that will result from the re-assessment of users income
that was required by the new guidance from 1/10/02. This budgeted loss
of income has been increased to £450k for the full year effect in 03/04.
- It
is anticipated that the loss of income will be reduced over a period of
time by specialist staff working with users to increase their income by
maximising benefit payments.
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2.
Services that may not be charged for
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- Guidance
is clear that local authorities cannot charge for these services
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3.
Charges have to reflect a “package” of services and cannot
be levied independently
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- Previously,
the Council levied its charges independently. This practice has had to
be reviewed.
- Other
than for “flat rate” charges that are allowed ie meals at home and in
day care establishments, all other charges have to be considered on a
weekly basis by calculating the amount of service received alongside the
users ability to pay. This is administratively complex to apply. For
example, detailed consideration will have to be given as how to make a
charge to a user who receives a personal home care service alongside a
support service provided under the new Supporting People Grant that
becomes effective with the withdrawal of Transitional Housing Benefit
from April 2003.
- Current
charging systems are having to be reviewed to ensure that users are
being charged in line with this requirement
- In
particular, the current charging systems do not allow a “packaged”
charge that includes both homecare and day care. Consequently, it is
considered necessary to abolish the flat rate charges for day care.
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4.
Charges should reflect level of service provided
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- The
Council currently relates its home care charges to the level of service
provided and the draft proposal is for this to continue.
- The
current charge for day care services is set at a 2 tiered level - £3.60
per session for users on prescribed benefits and £6.30 for others. The
charge is also only levied to older people and people with physical
disabilities.
- Many
users will be exempt from charging following the assessment of their
ability to pay and the cost of assessment and the establishment of an
administrative system to make charges to the remaining users would mean
additional staff and central support costs in excess of the income to be
generated.
- Consideration
should be given to charging a meal cost to all users to minimise the
loss of income (see note 3).
- Consideration
should also be given to making a full cost charge to day care users who
have savings in excess of the upper limit to bring this service in line
with home care (note 13). It is anticipated that this will affect
approximately 30 users who would be required to pay up to £30 per
session instead of the current charge of £6.30. The risk effect of this
would require an individual assessment on the impact of charging. It is considered more appropriate to
introduce a charge of £7 per session to these users.
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5.
Flat rate charges eg meals at home or in day care
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- The
charge for these services can be made without the need for assessment.
- The
introduction of a charge for meals (including refreshments) in a day
care establishment was introduced in October 2002 in order to minimise
the loss of income following the re-assessment of users’ ability to pay
in line with the new guidance.
- Currently,
this charge is applied to all users except learning disabilities.
- The
increase of meal charges in line with the proposal would generate an
extra £31k.
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6.
Users must be able to retain an amount equivalent to
Income Support + 25% before charges can be considered
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- This
major change to charging policy was introduced in line with the new
guidance from October 2002 following a complete review of all users
charges.
- To
ensure that users are charged correctly, it is anticipated that a full
review of their ability to pay will have to be undertaken each April
alongside the already established review of users in residential care.
This will mean that approximately 2000 users will have to be financially
re-assessed and will create significant resource issues for financial staff
(note 14).
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7.
Maximum charge for non residential care
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- The
Council is determined to meet the requirement of PAF Indicators C28 :
C32 and help people remain in their own home for as long as possible.
- Setting
a maximum charge for a full cost payer at 75% of the cost of basic
residential care reflects this commitment.
- At
current charge levels this will mean a charge can be made for up to 20
hours of home care.
- It
would also mean that the majority of home care users that are assessed
to pay will only be charged a maximum amount that varies between 4%
(band B users) and 30% (band H users) of the full cost of residential
care.
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8.
War Disability Pensions and War Widows Supplementary
Pensions
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- The
disregards applicable to these benefits will be fully applied.
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9.
Disability Related Benefits
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- The
Council currently includes these benefits as income (see also note 11).
- Fairer
Charging guidance gives Councils the option of not including these
benefits as income but this would adversely affect the amount of income
that is collected.
- The
exact amount of income that would be lost cannot be calculated as income
is also dependent upon the levels of service provided but, approximately
500 people were assessed as receiving these benefits during the October
02 review.
- If
the Council decided not to include these benefits as income it would not
be required to undertake a separate assessment of disability related
expenditure, although guidance suggests that it is still good practice
to undertake this work as part of the review of users benefits (note
12).
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10.
Disability Related Expenditure
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- The
Council was required to assess this expenditure for all users who
received more than 10 hours of home care service each week from October
02.
- This
requirement is extended to all users who have their disability related
benefits taken in to account in their assessed ability to pay from April
02.
- Substantial
work was undertaken to meet this requirement during the October 02
review and experience has now been gained to enable such expenditure to
be assessed fairly and consistently.
- Details
from the recent review indicate that there were approximately 170 users
who were not in receipt of disability related benefits.
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11.
Higher rates of Attendance Allowance and Disability Living
Allowance
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- Attendance
Allowance and Disability Living Allowance is paid at a higher rate, if a
person has day and night needs, or a lower rate if a person has
day or night needs.
- It
has been found to be unfair for a Council to treat as income available
for day care sums of Attendance Allowance and Disability Living
Allowance paid in respect of night time care.
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12.
Benefits Advice
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- This
is a significant new requirement set out in guidance. 2 extra Visiting
Finance Officers have been appointed to support the team carrying out this
work and closer working links will be set up with the Dept for Work and
Pensions.
- Evidence
gathered from the October 02 review clearly indicates that there are
approx 40% of service users who are not claiming their full entitlement
of income related benefits.
- These
people will be approached with a view to the Council assisting with any
such claims if the user so wishes.
- A
successful claim will result in a re-assessment of charge that will have
a positive affect on the Council’s income.
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13.
Savings and Capital
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- Guidance
allows Councils to charge the full cost of services to users who have
capital above the limit set out in the Dept of Health Charging for
Residential Accommodation Guide (CRAG).
- The
current capital limit for home care is £12000 (£19000 for couples), but
there is no capital limit for day care services.
- The
capital limit must be increased to at least £19000 from April 03 and be
reviewed each year in line with CRAG.
- Users
who have capital in excess of £11750 will be required to contribute a
small amount from their savings towards the cost of their service.
- Guidance
requires the issue of charging full cost to people with savings to be
the subject of consultation.
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14.
Charges to be reviewed at regular intervals
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- Previously,
a 10% random review took place each year for home care service users but
this is not acceptable under the new guidance.
- There
will be significant pressures on finance based staff to undertake full
reviews of users charges each year (April) and the need to consider
temporary resources to carry out this work will have to be evaluated.
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15.
Treatment of jointly held (couples) income and savings
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- Currently,
all users who are part of a couple are assessed on the basis of the
couples’ income.
- The
guidance envisages that Councils will have regard to an individual
user’s income, and recommends a “better off” assessment is calculated in
the service user’s favour.
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16.
Disregard of earnings
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- The
Council complied with this guidance when undertaking the October 02
review.
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17.
Charges based on actual cost of service and hours of
service
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- The
maximum charge for home care is currently calculated against an average
cost for providing the service and then reduced in line with a banding
system that reflects the chargeable income of the user. This means that
charges are levied as a contribution towards the cost.
- Current
systems do not allow a charge to be levied against the exact cost of the
service and so an averaged contribution towards the maximum charge will
have to be made.
- Guidance
does not allow any charge to be greater than the cost of providing that
service and so the averaged maximum charge must be lower than the cost
of any provider rates.
- This
will create difficulties at the time of setting a charge each April as new year provider rates
are often not known until after 1 April each year.
- The
Council does charge on an hourly basis.
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18.
Charges must be applicable to user or carer
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- The
Council has always undertaken to charge in line with this requirement.
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19.
Services provided by Direct Payments
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- The
Council has always undertaken to charge in line with this requirement.
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20.
Charges for Intermediate Care
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- Intermediate
care services can be provided from both residential and non-residential
care settings.
- Currently,
the 2 rehabilitation units at Gouldings and Adelaide are in operation
and users pay the minimum charge for residential care (£58.70 per week).
- There
is currently no provision for short term rehabilitation within home care
but this is planned to be introduced in 03/04.
- Consequently,
the loss of income at this stage is related to residential care services
only and amounts to approximately £30,000.
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21.
Information to users
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- The
Council will have to review all its leaflets about charging and make
sure these are explained to users
- Charges
cannot be levied until the user has been informed of the charge in
writing.
- The
immediate targets set for the Visiting Finance Team, Financial
Assessment Team and other Operational Support staff will be based on
undertaking their work as quickly as possible in order to minimise any
loss of income resulting from this new guidance directive.
- The
aim is to undertake the assessment in the user’s home and confirm this
immediately in writing.
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22.
Refusal to pay charge
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- It
is accepted that services cannot be withdrawn if a user refuses to pay.
- A
debt recovery system with recourse to the Civil Courts is available.
- Careful
consideration will be given to requesting users to pay the full cost if
they refuse to provide information for a charge assessment.
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23.
Review of assessed charge and complaints
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- A
formal review procedure is being drafted in line with the guidance. This
review will consider whether the charging policy has been applied
properly and whether there are any particular circumstances that may
require special discretion.
- All
users receive a copy of the Social Services Complaints Leaflet at the
time of their care assessment.
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24.
Information on levels of arrears and costs of collection
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- The
guidance is prescriptive in the information it requires local authorities
to gather in order to monitor the effectiveness of Fairer Charging.
- The
Council will have to set up systems to meet this requirement.
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