Payments towards non residential social care services

Transcription

1 Payments towards non residential social care services Information about the Adults & Health Charging Policy and how it affects you. 1st April 2017 to 31st March 2018

2 Chargeable services This booklet explains the way we charge for non residential services and aims to answer any questions you may have. A care manager has looked at how Adults & Health can help and support you. As a result you may get at least one of the following services provided or arranged by Adults & Health: Home Care Day Services Transport to Services Supported Living Telecare Pendant Alarm Telecare Shared Lives Sitting Services Mental Health Day Services Mental Health Housing Support Services A Direct Payment for you to arrange your own services Adults & Health asks people to contribute, where they can afford to, towards the cost of their services. This is to help to provide and develop services to a high standard. If you receive a Direct Payment any contribution you are assessed to make will be deducted from the amount we pay you. Please note: if you have a Telecare Pendant Alarm only, you will not be financially assessed unless you receive them alongside other services (see page 3). 1

3 Standard Rates for Financially Assessed Services Type of Service Home Care and Supported Living Housing Support Services Day Centres Older People Physical Disabilities Learning Disabilities Transport Transport to Service Shared Lives Sitting Services Outreach - daytime support Outreach - waking night-time support Day Support Service Mental Health Services Day Services - group session Day Services - one-to-one support Telecare pendant alarm Charge per hour per hour per day per day per day 5.80 per day 8.40 per hour per hour 8.40 per hour 9.90 a session per hour From 01/04/2017 From 01/07/2017 Telephone monitoring of pendant alarm 2.70 per week 2.80 per week Mobile response service for pendant alarm (only available for customers with no next of kin living in or near Leeds) Telecare pendant alarm with additional Telecare sensors 0.50 per week 0.50 per week Telephone monitoring of Telecare equipment 3.20 per week 3.30 per week Mobile response service for Telecare equipment (only available for customers with no next of kin living in or near Leeds) 3.20 per week 3.30 per week Telecare pendant alarm with additional Telecare sensors and GPS systems Telephone monitoring of Telecare and GPS equipment Mobile response service for Telecare and GPS equipment (only available for customers with no next of kin living in or near Leeds) 9.60 per week 9.90 per week 3.20 per week 3.30 per week No matter how many services you receive you will not have to pay more than per week 2

4 Charging for services In order to work out your actual contribution you will need to be financially assessed. The assessment looks at the money you have coming in and makes allowances for some of your expenses. Pages 11 and 12 show examples of how your contribution will be worked out. If you receive Direct Payments your contribution will be deducted directly from the amount you receive. Other than charges for meals, there is no contribution required from people: Whose services have been arranged and are provided under Section 117 of the Mental Health Act Who have Creuzfeldt Jacobs Disease (CJD). Who qualify for Continuing Health Care Funding from the NHS. Please be aware that if your circumstances change your eligibility for Continuing Health Care Funding can be cancelled. Who are receiving Reablement support. Standard charges for non-financially assessed services Respite Care Per week State Pension Age (SPA) and over Aged 25 to SPA (disability/enhanced disability premium) Aged 25 to SPA (no disability premium) Aged under 25 (disability/enhanced disability premium) Aged under 25 (no disability premium) Meal Charges Per meal Main meal 5.05 Second meal (for tea-time) Telecare Pendant Alarm Telephone monitoring of Telecare Pendant Alarm only* Mobile response service for Telecare pendant alarm (only available for customers with no next of kin living in or near Leeds * From 01/04/2017 From 01/07/ per week 2.80 per week 0.50 per week 0.50 per week *If you receive Telecare Pendant Alarm services alongside other services, the whole package of care will be financially assessed 3

5 What will happen now? When Adults & Health has agreed that you are going to receive some services they will ask the Financial Assessments & Benefits Team to visit you to carry out a financial assessment to see what your contribution will be, if any. What do I need to do? A visiting officer will come to see you at home to do the financial assessment, and they will need to see proof of all your income, savings and investments. (see pages 5, 6, & 7) You should also tell the visitor about anything you pay for which you think may be a disability-related expense. (see page 10). In order for the visitor to consider these expenses they will need to see the last four weeks worth of any bills or receipts that detail these additional costs. Please spend some time thinking about what your disability-related expenses are and get your receipts together before the visit takes place. Can I have someone with me for the financial assessment? If there is anyone, like a relative or friend who usually supports or helps you to deal with your financial affairs, you can ask them to attend the appointment with you, or the Financial Assessments & Benefits Team can make alternative arrangements to see them with your permission. Please note that the Financial Assessments & Benefits Team will make every effort to meet with you at your convenience and will take into account when arranging the meeting any disabilities that you may have. However, if we arrange to come out to see you and you are not available on three separate occasions without good reason, or if you unreasonably do not provide us with all of the information that we require to complete the financial assessment, you will be charged the standard rate for services (this amount will not be more than the actual cost for delivery of the service). See page 2. What if I am entitled to any extra benefits? The visiting officer will also do a full welfare benefits check for you and / or your partner to make sure that you are receiving all the benefits you are entitled to, and if there are any other services you may be able to get. If the visiting officer believes that you may be entitled to extra benefits they can help you to complete the applications forms if you want them to. Any extra benefits you receive may affect your contribution towards your services but the visiting officer will explain this to you. They will tell you how much your contribution will be if extra benefits are awarded. 4

6 How is your contribution worked out? Income and capital At the visit, the Financial Assessments & Benefits Team will look at all the money you are receiving and any savings or investments you have. If you have savings or investments worth 23,250 or over (the value of your home is ignored) or if you choose not to disclose your financial information, you will be charged at the standard rate for services as detailed on page 2. Do you take into account all my income? The Government tells us that we have to ignore some of your income to allow for general costs of living such as food, clothing, water charges, utility bills, telephone bills etc. The amount we ignore depends on your personal circumstances and these are shown on pages 8 and 9. If your income (including tariff income - see page 7) is less than this ignored amount you will not pay for your services. What documents will the visiting officer need to see? To do this the visiting officer will need to see: Recent benefit award letters from the Department for Work and Pensions or up-to-date bank statements showing details of these payments Letters from works pensions or annuity providers or bank statements showing these payments The Financial Assessments & Benefits Team will look at all your income, including any disability benefits you get to help you pay for the extra help or care you may need. Savings and investments over 14,250 will also be looked at to work out your contribution. Recent bank or building society statements or pass books Details of any shares, national savings products or other property held (excluding the home that you live in). Any other income and investments. 5

7 How is your contribution worked out? Income The visiting officer will look at your income to see what needs to be included and what can be ignored. Examples of Income included: State Retirement Pension Occupational Pension/Private Pension Guarantee Credit (Pension Credit) Income Support Employment and Support Allowance (ESA) Severe Disablement Allowance Armed Forces Independence Payment Disability Living Allowance (DLA) Care Component Attendance Allowance (AA) Constant Attendant Allowance Personal Independence Payment (PIP) Daily Living Component Industrial Injuries Disablement Benefit Universal Credit Examples of Income ignored: War Disability Pension War Widows Pension Earnings Working Tax Credit Savings Credit (Pension Credit) Disability Living Allowance Mobility Component Personal Independence Payment Mobility Component War Widows Supplementary Pension Guaranteed Income Payments from the Armed Forces Compensation Scheme Armed Forces Independence Payment Mobility Student Finance If you qualify for extra benefits but choose not to claim them we still have to include the money you would get in the financial assessment. Please note that any personal debt cannot be taken account of in your financial assessment. We can refer you to an organisation that can help you to manage your debt 6

8 How is your contribution worked out? Capital Savings and investments If you have savings and investments of 14,250 or less they will be ignored completely. If you have savings of above 14,250 to 23,250, the visiting officer will need to work out a weekly amount on top of your other income to include in your assessment. For every 250 you have between 14,250 and 23,250, 1 will be considered as extra weekly income (known as tariff income). If you have savings and investments over 23,250 you will have to pay the standard contribution towards services (see page 2). Money you pay out Apart from personal debt, the Financial Assessments & Benefits Team will also be able to take into account some of the money you pay out, which may reduce the amount you have to contribute towards your services such as: Weekly rent or mortgage (less any Housing Benefit or any other eligible housing support) Buildings insurance (where mortgage payable on property) Council tax (less any council tax support) Disability related expenses (see page 10) Proof of these will be required so please have them available when the Financial Assessments & Benefits Team visit you. Housing Cost Allowance If you live with other adults who are legally liable to pay housing costs (excluding your partner), a fixed allowance of will be taken into account which may reduce the amount you have to contribute towards your services. Assessed weekly contribution Your assessed weekly contribution is the difference between the amount of money you are receiving and the amount of money we can disregard. Please note you can never pay more than your assessed weekly contribution for all the services you receive. If the weekly cost of your service is less than your assessed weekly contribution you will pay the lower amount No matter how many services you receive you will not have to pay more than per week. Pages 11 and 12 of this booklet give examples of how contributions are worked out. 7

9 How is your contribution worked out? Ignored amounts The tables below show you how much income (including tariff income) a person is allowed before paying anything for their services. A person with income below these levels will not be charged for their services, except for meals and respite care which are charged at standard rates (see page 2). If you are responsible for children who live in the same house as you, an extra per child will be added to the amounts below. Single People aged 18 to 24 Weekly Basic rate With a disability premium or DLA (middle or low rate care) or PIP (standard daily living component) With DLA (high rate care) or PIP (enhanced daily living component) With a carer s premium With a disability premium or DLA (middle or low rate care) or PIP (standard daily living component) and a carer s premium With DLA (high rate care) or PIP (enhanced daily living component) and a carer s premium Single Person aged 25 to State Pension Age (SPA) Weekly Basic rate With a disability premium or DLA (middle or low rate care) or PIP (standard daily living component) With DLA (high rate care) or PIP (enhanced daily living component) With a carer s premium With a disability premium or DLA (middle or low rate care) or PIP (standard daily living component) and a carer s premium With DLA (high rate care) or PIP (enhanced daily living component) and a carer s premium Single aged State Pension Age (SPA) Weekly Basic rate With a carer s premium

10 How is your contribution worked out? Ignored amounts - continued If you are responsible for children who live in the same house as you, an extra per child will be added to the amounts below If you are part of a couple aged 18 to State Pension Age (SPA) Weekly Basic rate With a disability premium or DLA (middle or low rate care) or PIP (standard daily living component) With DLA (high rate care) or PIP (enhanced daily living component) Where one person gets a carer s premium With a disability premium or DLA (middle or low rate care) or PIP (standard daily living component) where one person gets a carer s premium With a disability premium or DLA (middle or low rate care) or PIP (standard daily living component) where both people get a carer s premium With DLA (high rate care) or PIP (enhanced daily living component) and a carer s premium With DLA (high rate care) or PIP (enhanced daily living component) where both people a carer s premium Couples who have reached State Pension Age (SPA) Weekly Basic rate Where one person gets a carer s premium Where both people get a carer s premium

11 How is your contribution worked out? Disability related expenses We will take into account any reasonable disability related expenses (DREs) unless these are already funded in your Care & Support Plan or by other government agencies. You might have DREs because you have to pay for items or services that you only have because of your disability or frailty. For example, if you pay for a gardener because you are no longer able to maintain your own garden. Anything you pay for by choice is not a disability related expense. Below is a list of some examples that can be considered as DREs if they are reasonable and your disability or frailty makes them a necessity. Household expenses such as: Cleaner Excess household energy costs Wear and tear due to equipment use Gardener Excess laundry costs Travel/transport* such as: Specialist holidays/trips Public transport To and from respite care Shopping Taxis for essential journeys* *Only transport costs which exceed any mobility awards will be considered Personal care and other expenses such as: Bed linen Clothing/specialist footwear Hair washing (not cutting / styling) Dog walking expenses Chiropodist Equipment/adaptations such as: Adaptations Bath/shower Powered bed Hoist Stair lift Walking aid/wheelchair Specialist equipment Please note these are just some examples of DREs. There is no complete list and each person s DREs are considered on an individual basis. You should tell the visiting officer about anything you pay for which you think might be a DRE so they can consider them You will need to provide proof of your expenses. In most cases, the last 4 weeks worth of any bills or receipts that detail these additional costs will need to be provided. Receipts must show the name and address of the person or company providing the services or equipment to you. 10

12 How is your contribution worked out? Examples: single and state pension age Here are some examples of an assessment of contribution: Example A Money coming in per week State Pension Pension Credit Total income Income is less than the ignored amount of so the service is free. Example B Money coming in per week State Pension Private Pension Attendance Allowance Pension Credit Total income Money going out and ignored amount Income ignored Excess fuel allowance 4.00 Stair lift maintenance 2.85 Cleaner Total disregards Total income of less total disregards of = Assessed weekly contribution is per week.* Example C Money coming in per week State Pension Private Pension Attendance Allowance Savings 20,000 (tariff income) Total income Money going out is the same as example B = Total income of less total disregards of = Assessed weekly contribution is per week.* 11

13 How is your contribution worked out? Examples: single and working age Here are some examples of an assessment of contribution: Example A: Money coming in per week Income Support DLA low rate care Total income Income is less than the ignored amount of so the service is free. Example B: Money coming in per week ESA Support group PIP high rate daily living Total income Money going out & ignored amount Income Ignored Housing cost allowance Excess fuel allowance 6.34 Wheelchair maintenance 3.00 Total disregards Total income of less total disregards of = Assessed weekly contribution is per week.* Example C: Money coming in per week ESA Support Group Occupational Pension DLA high rate care Total Money going out is the same as example B = Total income of less total disregards of = Assessed weekly contribution is per week.* *Please note: your assessed weekly contribution is the maximum amount you will be asked to pay, but if your services cost less than this you will pay the lower amount 12

14 How and when do I pay for my services? After your financial assessment, if you have a contribution to make, you will usually be sent an invoice. You will contribute the standard payments for your services as listed on page 2 of this booklet, or your maximum assessed contribution, whichever is the lower. Please bear in mind that your first bill may take some time to be issued because we have to wait for the people who provide your services to tell us exactly how much care you have received so that we can send you a bill for the correct amount. The charge will apply from the date you start to receive services You should therefore put the money aside to pay for these bills. After your first bill, you should then receive regular bills every four weeks. Bills for very small weekly contributions may be sent at longer intervals. A choice of payment methods will be explained on the back of the invoice. complete a full financial assessment with you due to you unreasonably not being available on those occasions or unreasonably not providing all of the information required, and you are due to be sent a bill, the services will be charged at the standard rate (see page 2). When a full financial assessment has been completed, any refund will be applied in the next bill you receive. It is important that you make every effort to meet with the visiting officer from the Financial Assessments & Benefits Team to complete the financial assessment, to ensure you are not charged more than you can afford to pay. Please telephone (0113) if you wish to arrange an appointment. If you need any further information the contact details for the Financial Assessments & Benefits Team are on the next page. The Billing Team telephone number is (0113) If you have a query about your bill, please ring this number. Please remember that the Financial Assessments & Benefits Team will make every effort to meet with you at your convenience on three separate occasions. If it has not been possible to 13

15 How to Appeal If you have been assessed to contribute towards your services and you do not agree with it, you can ask for it to be looked at again. You can do this by telling us why you think the decision is wrong. If you think there is any additional information that should be considered please let us know On receipt of your appeal a manager will reconsider your assessment taking account of any additional information you have provided. Once a review has taken place you will be notified of the outcome by post, phone or Contact details Adults & Health Financial Assessments & Benefits Team 4th Floor West Civic Hall Portland Crescent Leeds LS1 1UR Telephone: (0113) lbs.visitors@leeds.gov.uk If you are still not happy with the contribution after the review then you can appeal against the decision by writing to: Senior Finance Manager Adults & Health 4th Floor West Civic Hall Portland Crescent Leeds LS1 1UR If you have a complaint about any other aspect of the assessment process (for example the time taken to carry out an assessment; or the attitude and conduct of the assessor) then you may complain to: Adults & Health Complaints Manager 2nd floor Enterprise House St Paul s Street Leeds LS1 2LE Telephone: (0113) complaints.socs@leeds.gov.uk 14

16 Copyright Leeds City Council 2017 If you would like this information in a different format, language or larger print including Easy Read, please contact us on (0113) If you do not speak English and need help in understanding this document, we may be able to provide a translation or an interpreter. Please contact Adult Social Care customer services. Telephone: Textphone: BG