Your Essex is changing let s talk. about it. Have your say. Deferred Payment Agreement consultation. January Gemma Warsap.

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1 Your Essex is changing let s talk about it Have your say Deferred Payment Agreement consultation January 2015 Gemma Warsap January

2 Contents Introduction... 2 Executive summary... 3 Who gave their views?... 4 Detailed findings... 6 Introduction The Care Act 2014 is the biggest reform of adult social care since The new law sets out a clearer national approach to financial assessment and charging that Essex County Council will follow. Growing demand for social care services, together with limited funding means Essex County Council has a duty to make sure it gets best value from all resources. This will help protect the council s financial sustainability and services for the future for all its citizens, especially the most vulnerable. In November/December/January 2014 we carried out a survey asking for the views of Essex residents about how a universal deferred payments scheme could work in Essex. Firstly, to charge interest on deferred payment agreements (DPAs) during the lifetime of the agreement. This is a change to our current charging policy, as allowed by the Care Act. Secondly, the council can arrange care and support services for people who are not eligible for financial assistance with their care and support costs. For this service we wish to charge an administrative fee. This is a new charge allowable under the Care Act. We will use the information gathered from this survey to help inform our decision. Deferred Payment agreement When someone moves into permanent residential or nursing care their main home may be taken into account when assessing their contributions towards care costs. Some people find that they may have to sell their property to pay for residential or nursing care costs. However in some cases, people who own their own home may be able to make an arrangement with the council so they do not have to sell their property immediately to pay for the costs of residential care. This is called a deferred payment agreement. This arrangement means the council will pay an individual s residential care fees upfront. The council will recover the money it has paid for the persons care, plus interest, a/ when they choose to sell their property at a later date, or b/ from their estate. 2

3 Administrative charges The Care Act lets Essex County Council ask people who can afford to do so, to cover the cost of arranging support for them. We call this an administration charge. The amount an individual would pay would be limited to the actual administrative cost incurred by the council and Essex County Council will only charge what it costs to make the necessary arrangements. Executive summary With only 57 responses in total it is difficult to draw robust conclusions from the data, but there are some messages that have emerged. Half of respondents agreed with the proposal to charge interest on deferred payment agreements, with 12% not sure and 38% disagreeing. Four of the people who made comments about the deferred payment agreement agreed that it was reasonable for Essex County Council to charge interest but suggested that interest rates should remain as low as possible, that interest rates should reflect market rates and that Essex County Council must ensure that this proposal is in line with best practice nationally and that more information needs to be provided regarding interest rates so that individuals can compare this to other equity services. Two respondents questioned the ethics of the proposal and stated that they did not believe that Essex County Council should make any additional profit from the scheme, while one person had concerns that interest payments could overtake the market price of the home they own. In regards to the proposal to recover administrative charges when setting up care arrangements, the just over half of respondents agreed with the proposal, 11% were unsure and 32% disagreed. Five people out of the 11 who provided comments gave positive comments regarding Essex County Council s proposal to recover the administration costs involved in setting up care and arranging services for people who pay for their own care. However it was highlighted that in terms of specialist provision (e.g. for those who do not have the physical or mental capacity to arrange care for themselves), that perhaps a different approach may be needed. Three people criticized the proposal stating that it would create a two tiered system, discriminate against those with more complex needs and create a brokerage system. One respondent argued that if people have paid council tax their whole life this should cover any costs of administrative tasks regarding setting up care arrangements later in life. 3

4 Who gave their views? A total of 57 people responded to the survey. Of the total, 62% of respondents were female, 28% male and 10% preferred not to say. Although this sample is not robust enough to show statistically significant differences, it is possible to use the data qualitatively and give an indication of people s views regarding a universal deferred payment scheme in Essex. 87% of respondents were White British, while 3% were Asian/Asian British other and 10% preferred not to say. Out of the 57 respondents 63% were Christian, 3% Muslim, 17% preferred not to say, while the rest stated that they do not have a religion/faith. Over half of respondents said that they do not have a disability while nearly a fifth of all respondents said that they have a long term health condition. Most respondents were aged between Total Percent % % % % % % % % % Total Respondents 32 The breakdown of respondents by the home district is shown below Total Percent Basildon 2 7% Braintree 4 13% Brentwood 0 0% Castle Point 0 0% Chelmsford 4 13% Colchester 4 13% Epping Forest 0 0% Harlow 3 10% Maldon 0 0% Rochford, including Rayleigh 4 13% Tendring 4 13% Uttlesford 1 3% Other, please state 4 13% Total Respondents 30 4

5 Detailed findings Respondents were asked whether they agreed or disagreed with two proposals. Proposal 1: Essex County Council should charge interest on deferred payment agreements, which allow people to avoid having to sell their home in their lifetime, to ensure we can recover our costs and get best value for money. Out of the 34 respondents 50 % either agreed or strongly agreed with the proposal regarding deferred payment agreements, 12 % were unsure and 38% either disagreed or strongly disagreed with the proposal. Deferred Payment agreement Total Percent Strongly agree 5 15% Agree 12 35% Neither agree nor disagree 4 12% Disagree 9 26% Strongly disagree 4 12% Total Respondents 34 Proposal 2: Essex County Council should recover the administration costs involved in setting up care and arranging services for people who pay for their own care, to ensure we get best value from our limited resources. Over half (57%) of respondents to the survey either agreed or strongly agreed with the proposal, 11% were unsure and 32% either disagreed or strongly disagreed with the proposal. Administrative charges Total Percent Strongly agree 4 11% Agree 16 46% Neither agree nor disagree 4 11% Disagree 9 26% Strongly disagree 2 6% Total Respondents 35 For both of the proposals respondents were also asked if they had any other comments and overall 24 comments were made. Deferred Payment agreement In total 13 respondents to the survey gave comments about the proposal for Essex County Council to charge interest on deferred payment agreements. Out of those, six respondents gave positive comments, most stating that they thought it was reasonable for Essex County Council to charge Comment [vb1]: Rather than leaving this in as a table format I d suggest that you convert the table to text using the options under layout. This will then read more neatly. 5

6 interest rates and that this was in line with most other bank and equity loan services. However it was stressed by several respondents that the interest rates should be kept as low as possible and be in line with best practice nationally. A significant amount of council funding will be tied up in Deferred Payments for a prolonged period of time, during which the property value is likely to appreciate and there may be rental income, so it is fair to charge a reasonable interest. I think it would be reasonable to pay for a deferred payment given the cost to the tax payer and Local authority budget restraints. Otherwise this will create an additional burden tot restricted funds available to commission services for all. Interest charges should be kept as low as possible in line with best practice nationally. Interest should be at a low rate. Should also encourage good value equity release schemes. Banks charge interest, payday loans charge interest, in fact just about everybody does, so I suppose it's only fair that ECC plays the game and charges a bit of interest too. In the area of deferred payments, care providers must be given the full facts about the financial status of the service user and have the ability to charge full fees. A further two respondents agreed with the proposals but asked for further information regarding interest rates, specifically to enable customers to compare the Council with other equity services. Interest rates are not specified but should reflect market rates. I think you would have to give details of how much interest was to be charged so people could assess the cost to them against other alternatives such as equity release. Two respondents stressed that Essex County Council should not make any additional money or profit from the deferred payment agreements. Essex County Council will receive any costs they have paid out - it would be unethical to generate income in this situation. As long as Essex recovers the full cost of care, then they shouldn't make additional money from it.. ECC funders don't pay additional and would lead to two tiers. Finally there were three respondents who disagreed with the proposal and emphasized the ethical and political nature of the subject, with one respondent having concerns that interest payments may overtake the market price of the individual s home. It is a politically volatile subject and is certainly incredibly emotive. From a personal perspective, as my father in law is in this position, the proposal that he would have interest accrued on the charges placed against his shared property due to care home costs has been 6

7 incredibly distressing to him and has a substantially detrimental impact on his mental wellbeing. I appreciate that there is a need for best value and costs recouped but this should not be by penalizing an infirm individual for living longer and therefore accruing interest charges for it. You are punishing someone for surviving. Charging Interest on Payments made to Providers would not be ethical as this promotes a two tiered charging system. SU are not requesting a loan but setting aside the cost against property (asset) that will reimburse ECC. Concerned that the interest payments will overtake the market price of the home that hey own, will there be a cap on this interest. Administrative charges In total 11 respondents to the survey gave comments regarding the proposal for Essex County Council to recover the administration costs involved in setting up care and arranging services for people who pay for their own care. Out of those 11 respondents five gave positive comments, most commenting that they thought for an administrative task it was reasonable for Essex County Council to charge, as a service is being provided. However it was highlighted that in terms of specialist provision perhaps a different approach may be needed. This is for an administrative task and therefore a reasonable charge as a service is being provided. It is SU's who are choosing the option to have this service rather than an independent arrangement. Agree however, in terms of specialist provision of information e.g. to Deaf people Essex County Council should work closely with specialist providers e.g. The Royal Association for Deaf People. At a reasonable charge as it sustains our service provision as well as providing a service. For those able to make their arrangements but choose to use the local authority, an admin fee is reasonable. For those who lack the physical/mental capacity to do, perhaps a different approach should be considered. Only where based on ability to pay. Out of the 11 respondents who commented four disagreed with the proposal. One respondent argued that this proposal would create a two tiered system and discriminate against those with more complex needs, while another stated that it would create a brokerage team. Another respondent disagreed with the proposal stating that if people have paid council tax their whole life this should cover any costs of administrative tasks regarding setting up care arrangements later in life. Finally one respondent believed that the wording of the question suggested that the proposal was already a foregone conclusion. 7

8 This would provide a 2 tier system for people. If someone had complex needs we could end up charging them more than someone with less complex needs. If someone contributed towards the cost of their care at any level they would get 'free' admin but someone who paid the full cost would be charged more. This is not an equal playing field. Surely this is just creating a brokerage team? I suspect there would be an argument put forward by many people in this situation that they have paid their council tax for years and that should cover any administration costs of the council setting up care for privately funding people. On an ethical and moral level it would seem to penalize people who may have saved diligently in their working lives. The wording of your question suggests that this is a foregone conclusion (e.g. to ensure we get best value from our limited resources.) Finally two of the respondents disagreed with the proposal but suggested that alternatively Essex County Council should refer or sign post people to other advocacy and brokerage organisations. ECC should merely signpost people to care providers rather than act as a broker in a monopsony position. More than this will have the potential to destabilize the market. I am sure it is possible to refer people to for instance ILA Essex to assist as an advocacy service and or a brokerage service to assist people to source and set up their care. It may be that the safeguards to using this kind of service (independently of local authorities) could attract an administration cost to support the on-going provision of the service. ILA Essex already do this in essence for people with personal budgets. 8

9 This publication is issued by Essex County Council, Community Involvement & Engagement Team You can contact us in the following ways: By Visit our website: By post: Essex County Council, Community Involvement and Engagement Team, Room E1, County Hall, Essex CM1 1LX The information contained in this document can be translated, and/or made available in alternative formats, on request. Published January

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