AccessCare is committed to ensuring that individual contribution towards the costs of services is determined on the basis of equity, ability to pay and a consistently implemented process. The process considers each client’s individual circumstances.
Purpose and Intent
To ensure a client’s financial contribution is in accordance with funding body requirements. This policy establishes guidelines which cover each funding source:
- Home and Community Care Program for Younger People (HACC PYP)
- Commonwealth Home Support Program (CHSP)
- Commonwealth Home Care Packages (HCP)
- Council funded services
- Private Clients
Fees are the payment made by Consumers in accordance with government guidelines in an effort to contribute towards the cost of their care. Fees apply to HACC PYP, CHSP, and Linkages.
Basic Daily Fee is the Fee that the Commonwealth sets as the maximum daily fee that HCP providers can charge the consumer.
Client Contributions are the voluntary contributions made to package funds to increase the value of the package funds for the purchase of services in addition to the government subsidy. Contributions mainly apply to HCP consumers but may be referred to in other funding sources such as CHSP.
Income Tested Fees (ITF) are set by the Commonwealth Government for Home Care Packages. The nominated amount is deducted from the funding that AccessCare receives from the Commonwealth Government for that HCP. The government’s expectation is that AccessCare will collect this fee from the Consumer. If a consumer fails to declare their income level to Centrelink the highest ITF amount will be charged.
AccessCare Charges as an approved provider AccessCare is able to charge the Home Care Package costs involved to deliver case management and to administer the Home Care Package.
Exit Amount is at termination of the HCP agreement, this charge will be deducted from the HCP available balance. The amount is subject to any applicable rules in the Aged Care Act and only applies to HCP.
Private Advice Fee is the fee set by AccessCare to provide case management services to an individual not receiving a Home Care Package or Linkages.
- Consumers have the right to an independent advocate to assist in fee/contribution negotiations. Information regarding Advocacy is provided within the Client Agreement given to all new clients.
- People can be assisted if necessary to access an advocate or other nominated person to manage negotiations on their behalf.
- Consumers have the right of appeal against decisions.
- All clients have the right to have their fees and/or contributions reviewed, at any time while they are receiving services.
- AccessCare’s mechanism for review of client fees/ contributions is dealt with in line with the expectations of the funding body supporting the services involved.
- Accesscare has chosen not to implement the Commonwealth Basic Daily fee for consumers on a HCP.
- Centrelink will assess consumers on a HCP and consumers may be asked to pay an Income Tested Fee (ITF). The consumers’ income is reviewed by Centrelink each March and September and the ITF adjusted accordingly.
- Aged Care Advisers can assist consumers on a HCP to apply for Financial Hardship Assistance if consumers believe they will face financial hardship in paying their assessed ITF.
- HACC/ CHSP are based on a person’s income and factors that affect the person’s ability to pay the fee.
- If a consumer fails to declare their income level, CHSP and HACC PYP client fees may be nominated to the highest rate.
- Fees are increased periodically in line with increases to pension rates and cost of service provision for HACC/CHSP
- Consumers receiving CHSP and HACC- PYP will be assessed to determine what level of fee they are required to pay based on the HACC fees schedule. Fees are set at low, medium or high which is determined by the consumer’s financial circumstances. A consumer will not be denied a service if they are unable to contribute towards the cost of their support services. However, services may be denied if a consumers incurs a debt and refuses to negotiate a reasonable contribution to their services. HACC PYP and CHSP fees are directly related to the service provided.
- Linkages package fees encompass service provision and case management.
- AccessCare can use discretion to charge or suspend the fee for Linkages consumers if they are on leave depending on services and case management being provided during the period of leave.
- AccessCare has the right to negotiate with the Linkages consumer/ representative to pay a contribution towards extra services or to withdraw services when the cost of providing services exceeds the ability of the program to pay.
- When consumers are on leave from the HCP, whether hospital, respite, transition care or social the ITF amount will be reduced by the terms set out by the Commonwealth.
HCP Charge and Contribution Principles
- If services are required at levels above the value of the HCP subsidy, the consumer will be asked to pay a Contribution to make up this difference, unless another source of funding can be applied.
- Consumers receiving meals as part of their HCP will be asked to make a 30% contribution towards the food component
- AccessCare has the right to withdraw services if providing services is deemed unsafe regardless of whether the consumer is paying a contribution.
- If a consumer doesn’t require the full extent of the administrative and Case Management services AccessCare provide, the AccessCare Charge may be modified accordingly. This is at the discretion of AccessCare.
- During periods of leave the HCP client contribution will be suspended, unless otherwise instructed by the consumer/ representative.
- AccessCare will continue to charge the AccessCare Charge to the HCP during periods of leave given the ongoing coordination and administration that occurs during this time
- HCP client contribution reviews must be conducted at least annually or more often if required and\or requested by either the consumer or AccessCare. Amounts can be waived, reduced or increased as a result of a review.
- When the HCP ceases any unspent home care funds will be returned minus the Exit Amount. The unspent home care amount is distributed proportionately to the Commonwealth and the Client in accordance with the User Rights Principles 2014.
Fee and Contribution Collection
Consumers are given choice regarding payment options. Details are provided within all AccessCare’s Information booklets and Consumer Agreements