PAPER H
Committee : SOCIAL SERVICES, HOUSING AND BENEFITS
SELECT COMMITTEE
Date : 14 JANUARY 2003
Title : FAIRER CHARGING POLICY FOR NON
RESIDENTIAL SOCIAL CARE SERVICES – CONSULTATION PROPOSALS
REPORT OF THE ACTING STRATEGIC DIRECTOR OF SOCIAL SERVICES AND HOUSING
1.
SUMMARY/PURPOSE
This report is prepared in response to the Fairer Charging Policies for
Home Care and other non-residential Social Services’ Guidance issued by the
Department of Health. Elected members will recall the paper presented to this
committee on 6 November 2002 in which it was noted that various charging
options would be placed before them in order to establish a new charging policy
effective from April 2003.
This paper outlines the Council’s draft proposals, and sets out the
consultative framework that has to be applied before the Policy is approved. It
also makes the following recommendations:
1.
To approve the draft policy, subject to
consultation
2.
To approve the consultative questionnaire
2.
BACKGROUND
2.1 The Directorate is currently
completing its review of all users’ charges in line with the statutory guidance
referred to in the previous report presented to this committee. The data
gathered from this is being used to assist the consultation process that is
necessary in order to formulate a new policy from April 2003.
2.2 The
Department of Health’s “Fairer Charging” guidance for non-residential services
has to be fully effective from 1 April 2003. In summary, the guidance requires
local authorities to:
·
Charge people according to their ability to
pay
·
Not charge people whose income is below
“basic” Income Support + 25%
·
Offset appropriate disability-related costs
from any disability benefits included in the assessment
·
Not charge against earnings or low income
benefits linked to earnings such as Working Families Tax Credit
·
Give full welfare rights advice to the user
and / or carer
·
Introduce an integrated assessment for
services – one charge for a package of services
·
Set charges which are a proportion of the
real cost of service provision
·
Introduce the scheme after consultation with
stakeholders
2.3 Fairer Charging brings no
additional central government resources. The Fairer Charging guidance suggests
that any loss of income or increased administrative cost should be met by increasing
users income through benefits advice and support when making a claim. This
would have the effect of increasing users’ charges.
The Council’s draft response to the government’s
requirements is set out in Appendix A.
The guidance is both
detailed and far-reaching in its effect on users charges. To assist elected
members in considering its implications the main areas for consideration in
this report have been numbered in conjunction with the Council’s draft
proposals and set out as follows:
Services Currently
Charged For
Who Can Be Charged?
How Much Can Be
Charged?
Consultation Proposals
Details of the effect of these, and other
changes required by the guidance, are set out in the Commentary Paper (Appendix B).
2.4 Services Currently
Charged For
Elected members are
asked to note that the current charging policy incorporates:
Home Care
Day Care
Day Care – Meals
Meals on Wheels
Community Alarm
(Wightcare)
In addition, from April
2003, a charge will be made for Housing Related Support Services, a report on
which was presented to Executive Committee on 3 December 2002.
Please note that the
numbers in brackets refer to Appendix A
Consideration has been
given to each of the above charges and the principal change set out in the draft
proposals is that the flat rate 2-tiered charge for day care be abolished and
partly offset by increasing the charge for meals taken in day care
establishments (3,4,5). This is considered necessary because the current
systems the Council has for assessing and collecting charges does not allow for
a “packaged” charge that can vary dependent upon the level of service given.
2.5 Who Can Be Charged?
The guidance sets out a number of requirements that must be taken into
account when undertaking an assessment of a users ability to pay charges. These
new assessment rules have been applied in the review of users’ charges that has
recently taken place and is effective from 1 October 2002. 288 out of
approximately 1200 home care and day care users have been assessed as being
exempt from charging under the new guidelines.
Elected members are asked to note the requirement that is placed on
local authorities to provide a full benefits advice service will have the
effect of bringing some of these users back into charging at a later date (12).
Some users will be exempt from charging because of the nature of the
services they are receiving and these have been acknowledged in the draft
policy (2). Furthermore, Fairer Charging guidance is aimed at adult
services users but must obviously be applied to children’s services as a
minimum. Many children’s services users who receive a home care support service
have previously had their charges waived and it is proposed to take the
opportunity of these new arrangements to formally apply a waiver to all
children’s services charges for home care. This will have a minimal effect on
income. Consequently, there is no specific reference to children’s services in
the draft policy proposals.
2.6
How Much Can Be Charged?
Discretion is still available to the Council
to set a level of charge for its services but considerations have to be given
to the level of service, cost of providing the service and the maximum charge
that can be levied. These have all been acknowledged in the draft proposals (1,4,17,7).
Once the policy is approved, the levels of
charges will have to be calculated in line with the cost of providing the
service. This may lead to difficulties if updated provider costs are not known
at the time of setting a charge each April (17).
A specific issue for elected members to
consider is the level of capital, above which it may require users to pay the
full cost (13). The current capital limit for home care will have to be
increased in line with Charging Regulations (CRAG) but there is no current
capital limit for day care and, if the Council wishes to apply a similar level
there will be some users (approx 30) who will have their current charge of
£6.30 per session (potentially a nil charge from April 2003) increased to an
amount in the region of £30. There will inevitably be risk effects to this that
may need individual assessment and it is considered more appropriate to
introduce a day care charge of £7 to users who have capital above the threshold
limit.
2.7 Consultation Proposals
A draft questionnaire to be sent to users is attached as Appendix C. Consultation with users
and stakeholders is a specific requirement of the guidance and the statutory
consultative issues are:
Discretion to charge or not
Should charges reflect both ability to pay and the level of service
Setting a maximum charge
Allowing expenses for disability to all users
Taking account of savings
It is intended to consult:
Service Users, Voluntary Groups, Primary Care Trust, Care Providers,
Carers Groups etc, etc.
3. FINANCIAL IMPLICATIONS
The Council has recognized the financial impact that Fairer Charging
will have and has set aside £200,000 in 02/03 to cover any shortfall in income
following the review of users charges that was effective from 1 October 2002,
plus £250,000 in 03/04.
The exact financial implication is difficult to forecast as it depends
upon a number of factors. In addition to considering the policy set out in
Appendix A, the Council has yet to set it charge levels for 03/04. However, to
assist elected members, the broader financial implications of the introduction
of Fairer Charging as set out in the policy (Appendix A) are listed at the end
of the commentary (Appendix B). This shows that the Council will receive
approximately £283k less than it would otherwise have received.
4. LEGAL IMPLICATIONS
Councils are expected to implement this guidance under section 7 of the
Local Authority Social Services Act 1970 (Section 1) by the dates given above.
Members are asked to recommend
to the Executive : a)
The approval of the draft proposals,
including : i) Abolishing day care charges ii)Waive all charges
for children’s services iii)Charge £7 to day
care service users with capital above limit
iv)Abolishing charges
for intermediate care (up to 6 weeks) b) The Approval of the consultative
questionnaire |
6.
BACKGROUND PAPERS
Dept of Health’s Local Authority Circular
LAC (2001) 32 dated 23 November 2001
Dept of Health’s Fairer Charging Policies for Home Care and other
non-residential Social Services – Practice Guidance (August 2002)
Contact
Point : Dawn Cousins, 520600
Ext 2236
J DOYLE
Acting Strategic Director of Social Services and
Housing