CARE ACT SEMINAR

CHARGING

Correct as at March 2015

• To give an overview of the new charging regulations under the Care Act

• For staff/other people in the sector to have a basic level of understanding of the charging regime in North East Lincolnshire

• The importance of Adult social care debt recovery & income maximisation

PURPOSE OF THIS SESSION

• Charging for residential accommodation guide (CRAG) is the current framework for residential charging

• Fairer Contributions is the current framework for domiciliary charging

• Deferred Payments are offered for client who go into care and own a property. This is currently an “interest free loan”

CURRENT CHARGING FRAMEWORK

• The legal basis for charging falls under The Care Act 2014 Care and Support Statutory Guidance

• CRAG & Fairer Contributions cease to exist from 31/03/2015

• All clients must be financially assessed as individuals.

• A light touch financial assessment can be offered where appropriate

KEY CHANGES TO CHARGING FROM APRIL 2015

• Carers Services can now be charged for under the Care Act

• Domiciliary Service users can now be charged from the start of service rather than the date a financial assessment takes place

• Interest can now be charged from day 1 of a Universal Deferred Payment along with an admin fee

• Admin fees can be charged for arranging care and support for a domiciliary care self funder

KEY CHANGES TO CHARGING FROM APRIL 2015

• Service Users must be informed that they have the right to seek Independent Financial Advice and this should be facilitated for them if they are unable to arrange this for themselves.

KEY CHANGES TO CHARGING FROM APRIL 2015

• New charging policy from April 2015 which covers all adult social care charging

• There will be changes for Services Users and how they are financially assessed

• April 2015 policy will only be valid for 1 year due to the 2016 reforms

• Changes have been recommended to the Council in order to have a sustainable charging framework

• Due to the financial climate, Adult Social Care debt recovery must be applied more vigorously

WHAT DOES THIS MEAN IN NEL?

A Universal Deferred Payment (UDP) is where someone opts to accrue the difference between their client contribution and the full cost of care by having a legal charge placed against their property.

From 1st April 2015, a UDP will be offered to:

• anyone whose needs are to be met by the provision of care in a care home. This is determined when someone is assessed as having eligible needs which NELC decides should be met through a care home placement.

• anyone who has less than (or equal to) £23,250 in assets excluding the value of their home (i.e. in savings and other non-housing assets); and

• anyone whose home is not disregarded

*All 3 of the above requirements must be met

A deferred payment will be offered to someone meeting the criteria governing eligibility for deferred payment agreements (DPAs) detailed above who is able to provide adequate security for the debt.

UNIVERSAL DEFERRED PAYMENT AGREEMENTS

North East Lincolnshire Council may refuse a deferred payment agreement despite someone meeting the eligibility criteria, where:

a) NELC is unable to secure a first charge on the person’s property;

b) someone is seeking a top up; and/or

c) a person does not agree to the terms and conditions of the agreement

Deferring further amounts will cease when a person has reached the “equity limit” that they are allowed to defer; or when a person is no longer receiving care and support in a care home. This will also apply when the value of the security has dropped and so the equity limit has been reached earlier than expected. 

UNIVERSAL DEFERRED PAYMENT AGREEMENTS

Under the new charging policy, the Council is committed to recovering monies owed for services received.

The process will become more fluent and debts will be actively monitored and pursued by focus and solicitors where appropriate.

All income collected goes back into the Adult Social Care pot so the more income collected, the more sustainable the system becomes and the more the local community will benefit. Income collection is key due to our ever shrinking budgets. 

ASC DEBT RECOVERY

• A scrutiny Group of Members have reviewed the draft new charging policy and the proposals put forward by Officers.

• The new charging policy and proposals have been out for consultation with service users and the general public. A report of findings is now being prepared for the council members.

• Information is being prepped to better inform people of the charging regime under the Information and Advice Workstream.

• Policies will start to be updated once we have a final decision from the Council’s Cabinet.

• New Deferred Payment Policy and Agreement has been drafted.

PROGRESS SO FAR……..

• Local and national information on Independent Financial Advisors will be provided via Services4Me Website.

• New versions of the ContrOcc system (financial system used for adult social care) are being tested in order to make changes to the financial assessment process and calculate the interest rate for Universal Deferred Payments.

• Briefing sessions for staff to keep them updated on the changes to systems.

PROGRESS SO FAR……..

• We are still awaiting the guidance from the Department Of Health however, we anticipate a large number of changes from April 2016 in relation to the way in which people are assessed as having to contribute towards their care and support needs.

KEY CHANGES TO CHARGING FROM APRIL 2016

FUNDING REFORMS – WHAT WE WERE TOLD IN OCTOBER 2014

The principles of the Dilnot Commission’s recommendations to protect people from potentially huge costs if they develop very complex care needs, such as dementia, have

been accepted and will be implemented from April 2016.

A cap on reasonable care costsPeople of state pension age receiving care which has cumulative value of £60k (equivalent to £72k in 16/17) will be entitled to state support for reasonable care costs to meet their eligible needs.

People of working age who develop eligible care needs before retirement age will benefit from a cap that is lower.

Young people who are assessed before they turn 18 as having on going eligible needs will benefit for a cap set at £0

New financial protection for those with modest wealth

Those with £100,000 or less ( £118 in 16/17 prices) and who own their own home will receive financial support for residential care. Most financial support will go to those with the greatest care needs and the least in savings and home value.This will help them pay towards the cap. The poorest people will continue to have the majority of their care paid for.

New contribution towards general living costs for people in residential carePeople in residential care will make a contribution towards the costs that they would have to meet if they were living in their own home – such as on food, energy bills and accommodation. The government has suggested this will be set at around £12,000 a year from April 2016.

FUNDING REFORMS – WHAT WE THINK NOW WE HAVE THE DRAFT GUIDANCE

A cap on reasonable care costsPeople aged 25+ receiving care which has cumulative value of £72k will be entitled to state support for reasonable care costs to meet their eligible needs.

Young people who are assessed before they turn 25 as having on going eligible needs will benefit for a cap set at £0

Initial increase for working age adults in April 2016 followed by phased increases to reach parity with the minimum income guarantee for people of Pension Credit qualifying age. (Better off by £50 a week)

New financial protection for those with modest wealth

Those with £118,000 or less and who own their own home will receive financial support for residential care. Most financial support will go to those with the greatest care needs and the least in savings and home value.This will help them pay towards the cap. The poorest people will continue to have the majority of their care paid for.

New contribution towards general living costs for people in residential carePeople in residential care will make a contribution towards the costs that they would have to meet if they were living in their own home – such as on food, energy bills and accommodation. The government has suggested this will be set at £230 a week and is a national rate.

• So far the 2016 reforms have not been finalised.

• The Department of Health are currently out to consultation on the new proposals due on 1st April 2016.

• North East Lincolnshire will be responding to the consultation.

• Be aware that the information given today is not set in stone and subject to change.

2016 CHANGES………

• Timescales – Consultation, Cabinet Approval and roll out of new policy.

• In-depth training for the financial assessment team.

• Service Users understanding the changes to the financial assessment process.

• These policy changes are only valid for 1 year.

• Increased workloads due to the 2016 reforms.

CHALLENGES/BARRIERS

• All staff and partners need a greater understanding of what services are charged for and how the process works.

• Inform Service Users of the process and the implications of not paying their contributions.

• If you know someone isn’t paying their contribution, use every opportunity to talk to them about this.

• Encourage Service Users to have an assessment – in most cases this reduces the client contribution payable.

• Signpost people to Information & Advice available (inc. Independent Financial Advice).

• Early intervention is key to reducing the Adult Social Care debt position.

• If someone is struggling with their money let us know and we will try and help.

WHAT DOES THIS MEAN TO ME AND MY ROLE?

What are your thoughts on your role?

• New charging regime to apply from April 2015• One policy to cover all Adult Social Care

charging.• Service users must be informed of their right

to seek Independent Financial Advice.• Information on charging and debt recovery

must be given in order to manage expectations.

• More changes in relation to Adult Social Care Charging to come in April 2016.

TO SUMMARISE

Presented by: Sarah HawkerHead of Business Development & Client

Finance (FOCUS)

For further comments / queries:NELCCG.workforce-FAQ@nhs.net