PORTABILITY OF THE CONSUMER’S PACKAGE AND WHAT IT MEANS FOR THE PROVIDER
Funding for home care will continue to be paid directly to the provider post 27 February 2017, so no change there, however what does change is if the consumer:
- Transfers to a new provider – balance of unspent funds to be transferred to the new provider.
- Leaves home care – balance of unspent funds to be refunded to the consumer and the government based on their contributions.
- Passes away – balance of unspent funds to be refunded to the consumer’s estate and the government based on their contributions.
Currently, the provider is allowed to keep the unspent funds when the consumer leaves their package however this will no longer be the case and should be taken into account when completing next year’s budget.
EXIT FEES
The provider will be able to charge an exit fee, deducted from the unspent home care funds when the consumer leaves that provider, however the maximum fee:
- Must be clearly identified in the Home Care Agreement.
- Must be provided to the Department for publication on My Aged Care.
- Cannot be more than: – The exit fee in the Home Care Agreement. – The published exit fee (as provided to the Department), and – The unspent home care amount (consumer can’t go into debt).
Currently, there is no exit fee charged so this will need to be inserted into your Home Care Agreement and lodged with My Aged Care (supposedly towards the end of this year).
TRANSITIONAL PROVISIONS
An exit fee may be included in the Home Care Agreement entered into/varied & provided to the Department for publication, before 27 Feb 2017, however it can’t be charged until that date.
UNSPENT HOME CARE AMOUNT
The outgoing provider:
- Has to calculate what is owed to the Commonwealth (home care subsidies & supplements) and what is owed to the consumer (basic daily fee & income tested fee).
- Has up to 56 days to calculate the unspent funds and issue a written notice to the consumer.
- Has to include in the “Notice of unspent funds” the cessation date of the package, the unspent package amount taking into account all committed income & expenditure, Commonwealth portion of unspent funds, consumer portion of unspent funds, exit fee if deducted and information on payment arrangements.
- Has another 14 days to: – Transfer the balance of the funds to the new provider if the consumer is transferring. – Transfer the balance of the consumer funds to the consumer if they are leaving home care. – Inform the Commonwealth of portion owing to them. – Transfer the consumer portion to their estate if they passed away, however this does require receipt of probate/letter of administration.
- Must keep a copy of the notice letter issued to the consumer and a record relating to the actual payment.
The new provider must include the transferred amount on the consumer’s statement.
The legislation does not specify how these funds are to be transferred.
Before finalising the unspent funds, the outgoing provider should ensure that all expected government funding has been received, all outstanding consumer fees have been paid and all supplier charges included.
This information has been sourced from the Department of Health, Increasing Choice in Home Care – February 2017.
Contact Debra Ward at Care Collaborator via the web www.carecollaborator.com.au, email debra@carecollaborator.com.au or mobile 0438 020 728 for assistance with Consumer Directed Care or if interested in a demonstration of the software solution developed to:
- Ensure consumer satisfaction by providing full transparency and “buy in” through collaboration and efficiency of the process.
- Increase the case manager’s job satisfaction by simplifying the budget calculation and reducing the number of trips required to complete the process.
- Provide the Home Care Manager with information on each case manager’s case load and the number of outstanding agreements.
- Provide data integration into other systems reducing the risk of errors.
