FAIRER CONTRIBUTIONS AND CHARGING POLICY (including Disability Related Expenditure)

Transcription

1 Appendix 2 BOROUGH OF POOLE ADULT SOCIAL SERVICES DRAFT 23/12/14 FAIRER CONTRIBUTIONS AND CHARGING POLICY (including Disability Related Expenditure) Applicable to: First implemented (date): Procedure Owner: Last Review (date): Reviewed by: Next review (date): Added to intranet (Loop) by: Distribution: Version number: Reference code: 1

2 1. MANAGEMENT SUMMARY This document describes the Borough of Poole policy on service user contributions and charging for non-residential care services. The policy is based upon 2009 Department of Health Fairer Contributions Guidance. The term contribution refers to a sum paid by a service user towards the cost of their care following a financial assessment. A charge is a sum paid for care services (or services related to providing care) which is not dependent on a financial assessment. 1.3 The principle of a single means tested contribution to the overall cost of care for an individual ensures a fair and equitable process for all clients. The policy ensures that people with a similar service may be asked to contribute different amounts if they have the financial means to do so. 1.4 In addition to a single means tested contribution for care costs, Borough of Poole may charge for non-care services, such as meals at day centres based on a fixed fee which will not be higher that recovering the full cost of the service but which may be subsidised where to do so would protect vulnerable residents. 1.5 Adjustments to charges or contributions made by service users to reflect cost inflation will be based on officer decisions. 2. INTRODUCTION 2.1 Legal Context of Fairer Contributions Adult Social Services Departments of Local Authorities have been until 1 st April 2015 entitled, under Section 17 of the Health and Social Services and Social Security Adjudication Act (1983), to seek a contribution towards the cost of non-residential services provided to adults. Under Section 17 (3) of this Act, users of these services can request a review of their assessed contribution at any stage In November 2001, the Department of Health issued statutory guidance to Local Government Authorities on charges for non-residential Social Services entitled Fairer Charging Policy for Home Care and other non-residential Social Services Guidance for Councils with Social Services Responsibilities. This guidance required that all Adult Social Services Departments implemented a Fairer Charging Policy In July 2009, The Department of Health issued a best practice Fairer Contributions Guidance for use when calculating an individual s contribution to their personal budget. This supplements the national Fairer Charging 2

3 Guidance and was updated in The 2014 Care Act replaces existing social care legislation that relates to charging and fairer contributions, but retains the same powers under Part 1, sections of the Act and paragraph 8.2 of the accompanying Guidance. 3. TYPES OF SERVICE 3.1 Services that fall within the Fairer Contributions Policy are: Any service or personal budget allocation that is eligible under the Care Act Services that will not be subject to the Fairer Contributions and Charging Policy: After care services under Section 117 Mental Health Act 1982 Intermediate Care Services Preventative services Treatment services Provision of information, advice and guidance Services provided to carers under Section 2 Carers and Disabled Children Act CONTRIBUTIONS 4.1 Every client will be requested to undertake a financial assessment to determine the sum of money they can contribute towards their personal budget (care costs). The financial assessment will be reviewed periodically for all clients. If a financial assessment is declined, the client will contribute the full cost of services. Clients will be given information on all benefits that they should be accessing in order to maximise their ability to contribute to their care costs, thereby reducing the burden of funding which could otherwise transfer to the Council. As part of the financial assessment, the formula for calculating basic living allowance is the equivalent of Income Support or Pension Credit plus 25%. 4.2 Borough of Poole with fund the difference between what a client is assessed as being able to contribute to their care costs and the full care costs, where such a difference exists. 4.3 Contributions will not exceed either the cost of providing the service or (if in receipt of one), a person s individual budget. 4.4 Contributions will not be required for the cost of the assessment or administration processes for the services provided, these will be funded by 3

4 the Council How contributions are calculated Borough of Poole currently follows National Association of Financial Assessment Officers (NAFAO) guidance when assessing contributions as well as Disability Related Expenditure (DRE). 4.6 Home care rates will be set by the Head of Commissioning and Improvement People Services and will reflect the cost of providing care to service users. 4.7 Disregards in Income Assessments Basic Income Support/Pension Credit plus 25% is disregarded as part of the financial assessment. Basic Income Support/Pension Credit includes Personal Allowance, age and disability premiums but not Severe Disability Premium, Attendance Allowance or Disability Living Allowance. DLA Mobility and War Pensioners mobility supplement are also disregarded from income assessments, as is the difference between the low and high rate of Attendance Allowance and Disability Living Allowance (unless the client has night care commissioned by Borough of Poole). Within disability benefits policy, night care is classed as care during the period when the client is in bed and the household is shut down for the night. War Widows supplementary Pension, 10* of War Pensions and War Widows Pension, Pension Savings Credit, all earnings and Child Tax credit are all also disregarded In relation to assets (and for ), currently capital below 14,250* is fully disregarded. There is a tariff Income of 1 per week for every 250 (or part of 250) for assets above 14,250* and up to 23,250* (if the upper capital limit is applied). In relation to expenses, mortgage payments or rent are fully disregarded, less any Housing Benefit paid, as is Council Tax, less any Council Tax benefit paid. *These sums may be revised by officer decision based on changes to national legislation, regulations, guidance or because of inflationary factors or changes to benefits policy or levels of payment There is no cap on the amount of contribution a service user can make towards the costs of their care. 5. PERSONAL BUDGETS 5.1 The means tested contribution for home care services is inclusive of all direct care costs and overheads which are needed to commission and manage the provision of care. These charges must be presented transparently at the earliest opportunity so clients can make informed decisions, exercising their choice and control. 5.2 A Personal Budget can be taken as a Direct Payment where the client 4

5 chooses to arrange their own services or a commissioned service where the Council is asked to provide/arrange services, or a mixture of both. 5.3 Direct Payment If a client chooses to take their personal budget as a direct payment they will be expected to pay their assessed contribution into a bank account set up specifically for this purpose. This contribution will then be topped up by the Council to the agreed individual personal budget. Clients will be expected to pay in their contribution each month, regardless of whether they undertake the full range of services in their Support Plan on any given month. 5.4 Commissioned Services If a client chooses to take all or part of their personal budget as a commissioned service, the agreed contribution will be payable whether or not they use that service unless the contribution is waivered or written-off by Borough of Poole. 5.5 Debt recovery may be pursued for all outstanding verified contributions. 6. SUSPENSION OF SERVICE 6.1 A client will not be charged for planned breaks in care services where 72 hours notice or more has been given. 6.2 A client will not be charged for unavoidable, unplanned hospital admissions. 7. WAIVERS FOR CARE COSTS 7.1 Waivers or written-off outstanding debt in respect of client contributions are at the discretion of the Service Unit Head. 8. DISABILITY RELATED EXPENDITURE (DRE) 8.1 The amount a person is expected to contribute towards their care costs will take account of a person s additional living costs in relation to their disability. The Council individually assesses the level of DRE as part of the financial assessment. 8.2 DRE is awarded to support service users to maintain an independent lifestyle (as far as possible) despite their disability. It is the responsibility of the Financial Assessor to ensure that all service users maximise their benefits (particularly where a service user is not in receipt of disability benefit income) and to ensure they are fully aware of the needs of the service user as described in their assessment/support plan. 8.3 Clients not receiving disability benefits will be guided to where they can get help with applying. DRE will only be allowed to ensure that clients are able to maintain a basic healthy, hygienic and safe standard of living. 5

6 8.4 DRE will only be made where costs are met entirely by the client, exceed normal cost of living expenses and are specifically resulting from the client s disability. 8.5 Everyday living expenses will not be considered when awarding DRE. Additional costs for day care activities that are not already covered as part of a support plan and assessed under Fairer Charging Guidelines will not be allowed. The following items are considered to be everyday living expenses or a lifestyle choice (this list is not exhaustive) Food & Beverages Clothing/Shoes Accommodation Costs e.g. Rent/Mortgage/Repairs & Maintenance Accommodation Related Costs e.g. house/contents insurance Fuel e.g. gas/electricity/oil/coal Water Furniture & Flooring (including carpets), and Household Appliances Household textiles, cutlery, crockery and cooking utensils Personal transportation costs e.g. fuel/tax/insurance/servicing Entertainment & Media (TV including digital TV reception/telephone (including. mobile phones)/internet & Broadband), Computing and Gaming Hardware and Software Domestic Pet expenses Short Breaks and Holidays 8.6 Housing Costs Housing costs are not considered care related DRE. Councils, however, are legally obliged to cover these costs (see section 23 of Fairer Charging Policies for Home Care and other non-residential Social Services) and, therefore, some housing costs are covered by DRE payments - for example where a service user s Housing Benefit has been restricted and the service user is not eligible for a Discretionary Housing Payment. 9. DISCRETIONARY DRE 9.1 In exceptional circumstances, the responsible Service Unit Head may allow specific items of client expenditure to be treated as DRE which would otherwise be excluded from the DRE calculation. DRE exceptions would be made to avoid exceptional hardship or to prevent (or minimise the risk of) harm to the client or their carer. 6

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