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:
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.
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 a Care Management Charge and Package Management Charge to your Home Care Package.
Care Management Charge covers the cost of care management which includes but not limited to reviewing the care plan, coordinating and scheduling care and services, ensuring care and services are aligned with other supports.
Package Management Charge covers the cost of ongoing organisational activities associated with quality smooth delivery and financial management of your Home Care Package.
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 consumers 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 relevant funding body.
Home Care Packages (HCP)
- AccessCare does not implement the Commonwealth Basic Daily fee for consumers on a HCP.
- Centrelink assesses all consumers on a HCP and depending on their circumstances 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.
- 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.
- HACC/ CHSP are based on a person’s income and factors that affect the person’s ability to pay the fee.
- Commonwealth Home Support Program (CHSP) and Home and Community Care Program for Younger Persons (HACC PYP)
- Consumers receiving CHSP and HACC PYP will be assessed to determine what level of fee they are required to pay based on the CHSP and HACC fees schedule.
- HACC/ CHSP fees are based on a person’s income and factors that affect the person’s ability to pay the fee.
- Fees are set at low, medium or high which is determined by the consumers 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 consumer 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.
- 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.
- Linkages package fees are a contribution nominally set at 17% of the pension however can be negotiated based on ability to pay. Linkages fees encompass service provision and care management.
- AccessCare can use discretion to charge or suspend the fee for Linkages consumers if they are on leave depending on services and care 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.
HCP Charges and Contribution Principles
- AccessCare charge the Home Care Package the costs of care management and package management. These two charges are set out in the consumers Budget in the Agreement Details.
- 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.
- During periods of leave the HCP client contribution will be suspended, unless otherwise instructed by the consumer/ representative.
- AccessCare will continue to charge the Care Management and Package Management charge to the HCP during periods of leave, to cover ongoing coordination and financial management
- HCP client contribution reviews are 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 following a review.
- In instances where we are holding unspent funds, AccessCare will distribute these amounts to the Commonwealth and the consumer 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