A PERSONAL BUDGETS OPTIONS & PROCESS INFORMATION FOR PROVIDERS

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1 A PERSONAL BUDGETS OPTIONS & PROCESS INFORMATION FOR PROVIDERS People who are eligible for social care services will be allocated a Personal Budget the amount of money available to spend on meeting their support needs. When a person s Support Plan has been agreed, they can get their Personal Budget in several different ways: 1. A Cash Payment paid straight into the person s bank account (this needs to be a separate account just for this money). 2. A Third Party Cash Payment paid to someone else who will manage the money for the person. There are several ways of doing this: (a) Payment to a Supporter (relative or friend) (b) Payment to a Provider Managed Account (c) Payment to a separate Independent Payments Service The third party is accountable to the Customer, who is accountable to the County Council. 3. A Managed Budget the Council will hold onto the budget and buy the person s care and support. 4. A Combination of a Managed Budget and a Cash Payment, or a Managed Budget and a Third Party Cash Payment. In all of these options the Customer (person with support needs) will always know exactly how much money is in their Personal Budget and what it is being spent on. The Customer may have to make a contribution towards the costs of their support the amount they have to contribute is determined through a Fairer Charging Assessment. Each option for Personal Budget management has different implications and requirements. Whatever the way the Personal Budget is taken, the money has been allocated following an assessment of need and agreed support plan. If the Customer s needs increase, you or the Customer need to contact Adult Social Care before any additional services are provided please note that unless the service has been agreed, there is no guarantee of payment. If the Customer s needs decrease, and there is a build-up of surplus funding, you, or the Customer, or their Supporter should contact Adult Social Care and inform them of the situation. As a service provider you have responsibilities and legal obligations to protect data. Find out more about data protection from the Information Commissioner's Office (ICO) - go to TIP: Good practice would be to agree with your client what information may be shared, with whom, and in what circumstances An outcome of an assessment of need may identify the need for a contingency fund. Providers need to be aware that if the Customer has to make a contribution (following a Fairer Charging Assessment), they must also contribute to the contingency fund.

2 How does each option work? 1. CASH PAYMENT The customer chooses to have their Personal Budget paid into their separate Personal Budget bank account, and to arrange and pay for their support services. If the Customer has to make a contribution from their own money, they need to pay the contribution into their Personal Budget bank account so that there is enough to pay for all their support. The Customer must manage their own support and take responsibility for the money and be accountable for how it is spent. The Customer must make sure they pay any contributions from their own money. If the Customer goes into hospital: For hospital stays, the Cash Payment continues for a 4-week period and within that time commissioners review any further extension beyond that period. Whilst a payment continues to be made, a contribution charge will continue to be made. (NB the Customer can request cessation period of cash payment at any time for full week periods, and for those full week periods no payment will be made to the provider or Customer and no contribution charge expected from the Customer.) (i) PROCESS STEP BY STEP: LCC agrees the budget and pays the agreed amount into the person s Personal Budget bank account every 4 weeks. The person pays their own contribution into their Personal Budget bank account. (iii) The person pays each provider from their Personal Budget bank account and keeps records of what has been bought and what has been paid out. (iv) At the Customer s next review, LCC will need to see the records and will review what has been bought and what has been paid out. If the user wants to pay by Direct Debit (DD) you will need to request a weekly DD payment from user. This will address the issue of banks only facilitating monthly DD (not 4 weekly) 2. THIRD PARTY CASH PAYMENT If the Customer does not wish to take on responsibility for managing their own Personal Budget, or cannot do this for themselves, a Third Party can manage it for them. The Third Party could be a supporter (a

3 friend or relative), a provider delivering services to the Customer (Provider Managed Account provider) or an Independent Payments Service. If the Customer has to make a contribution from their own money, they (or their Supporter) need to pay the contribution to the Third Party so that there is enough to pay for all their support. If the Customer goes into hospital: For hospital stays, the Cash Payment to the Third Party continues for a 4-week period and within that time commissioners review any further extension beyond that period. Each case must be considered individually to determine what action should be taken. Whilst the Cash Payment continues to be made, the Customer remains responsible for paying their Fairer Charging assessed contribution. (NB the Customer can request cessation period of cash payment at any time for full week periods, and for those full week periods no payment will be made to the provider or Customer and no contribution charge expected from the Customer.) Only if If the Provider has the agreement of the Customer to share information with the Council, should they inform the Council of the hospital admission. The Customer s Support Plan may indicate what action they wish to be taken in the event of being admitted to hospital. OPTIONS FOR THE MANAGEMENT OF THIRD PARTY CASH PAYMENTS: (a) Supporter (relative or friend) The Supporter must take responsibility for the money and be accountable to the Customer for how it is spent. (i) (iii) (iv) (v) (vi) Process Step by Step LCC agrees the budget, including any assessed charge that the Customer must pay (determined through a Fairer Charging assessment). The Customer identifies who will manage the budget. The Customer completes a Cash Payment Agreement form and a Bank Details form (with details of the Supporter s account into which the money is to be paid) and returns these to the County Council. LCC pays the agreed amount into the Supporter s bank account every 4 weeks. The Customer pays their assessed charge to the Supporter The Supporter pays each provider and keeps records of what has been bought and what has been paid out. Copies of the Forms are attached as Appendix 1 and 2

4 (vii) At the Customer s next review, LCC will need to see the Representative s records and will review what has been bought and what has been paid out. (b) Provider Managed Account (PMA) The Customer chooses to take a Cash Payment for their Personal Budget but they or their Supporter do not want to manage the money themselves. They choose a Provider to manage their Personal Budget account (the PMA provider). On request from the Customer, the Personal Budget is paid to the Customer s chosen Provider (with that Provider s agreement). The Provider sets up a contract with the Customer to manage their Personal Budget through a Provider Managed Account (a PMA Provider). A template for a contract between the Provider and the Customer is attached as Appendix 3 If the Customer wants to buy any other services out of their personal budget, they need to tell their PMA Provider. The Provider then arranges to pay the service provider(s) on behalf of the Customer. (i) (iii) Process Step by Step LCC agrees the budget, including any contribution required from the Customer (determined through a Fairer Charging assessment). The Customer identifies who they want to manage their Personal Budget and agrees this with the Provider. Community Care Finance send a welcome letter to the Customer detailing the total personal budget, what the Council pay and how much the Customer s contribution is. The letter also outlines what the Customer needs to do and what Community Care Finance will do in relation to payments. The Customer and the PMA Provider sign a contract between the two of them. This should include: - Details of how much LCC will pay - Details of any assessed charge the Customer must pay (following a Fairer Charging Assessment) - Details of the services to be paid - Details of any management charges for the PMA provision - Agreement by the Customer to share relevant information with the Provider TIP: Before providing a service, ask the referrer if a Fairer Charging Assessment has been done, and if so, how much is the Customer s contribution. Each Customer will receive a Welcome Letter from the Council detailing how much they have to contribute. An example of the Welcome Letter is available at Appendix 4 TIP: Include the setting up of a Standing Order for the Customer s contribution as a requirement in the contract ( for contract template see Appendix 3). TIP: Where the PMA provider is the sole provider, any charges may be included in the hourly service rate. (iv) The Customer completes a Cash Payment Agreement form, and a Bank Details form (with details of the PMA Provider s account into which the money is to be paid) and returns these to the County Copies of the Forms are attached as Appendix 1 and 2

5 (v) (vi) (vii) Council. Every 4 weeks, LCC Finance Section send out a letter to the customer informing the Customer of how much will be paid to their PMA provider for each 4-week period, and how much the Customer has to contribute themselves (referred to as Deductions). This letter is sent out 3 days before the start of each 4 week period. LCC pays the agreed amount into the PMA Provider s bank account every 4 weeks. This will be done via a BACS transfer, and a BACS Remittance Advice will be sent to the Provider by the Treasurers Department. To ascertain which Customer the payment relates to, look at Your Reference Number : the last 6 digits are the end date of the relevant 4-week period. The first 5 or 6 digits are the Customer s SSIS (LCC Social Services) reference number. Interim Payment Advice until September 2012 Community Care Finance section will send you a letter with a Four Weekly Payments Sheet, which will list all your PMA clients and the amount paid for each of them. To support this, you will also receive a spreadsheet which provides a breakdown of all individual payments for that 4 week payment period. The Four Weekly Payments Sheet will include the necessary data for you to identify for whom each payment has been allocated, and what any Fairer Charging contribution is in each case. The Customer pays their assessed charge to the PMA Provider. TIP: Ask the Customer for sight of these letters - see Appendix 5 for example. TIP: The BACS reference number will change each time but the SSIS part of it remains constant. By using that SSIS number as your customer reference number, you can easily and quickly identify who the payment is for. See Appendix 6 for example. The process for Treasurer s Section to make payment and send out the BACS advice takes a minimum of 14 days and may take 1 month TIP: For an example of the Four Weekly Payments Sheet, see Appendix 7 (viii) The PMA Provider pays themselves and any other provider and keeps records of what has been bought and what has been paid out. (ix) (x) (c) The PMA Provider sends regular statements of income and expenditure to the Customer. LCC reviews records of income and expenditure at the Customer s next review. Independent Payments Service The Customer chooses to take a Cash Payment for their Personal Budget but they or their representative do not want to manage the money themselves, nor do they wish for one provider to be responsible for paying other providers. On request from the Customer, the Personal Budget is paid to the Customer s chosen Independent Payments Service (with their agreement). The Independent Payments Service contracts with the Customer to manage their Personal Budget, and pay the support providers on behalf of the Customer. What this means for the Customer

6 (i) Process Step by Step LCC agrees the budget, including any assessed charge required from the Customer (determined through a Fairer Charging assessment). The Customer identifies the Independent Payments Service they wish to use for the management of their Personal Budget and agrees this with the Provider. (iii) (iv) (v) (vi) (vii) The Customer and the Independent Payments Service sign a contract between the two of them. This should include: - Details of how much LCC will pay - Details of any assessed charge the Customer must pay (following a Fairer Charging Assessment) - Details of the services to be paid - Details of the Independent Payments Service s charges - Agreement by the Customer to share relevant information with the Provider The Customer completes a Cash Payment Agreement form, and a Bank Details form (with details of the Independent Payments Service s account into which the money is to be paid) and returns these to the County Council. LCC Finance Section notifies the Customer of how much will be paid to the Independent Payments Service for each 4-week period, 3 days before the start of that period, and how much the Customer has to contribute themselves. LCC pays the agreed amount into the Independent Payment Service s bank account every 4 weeks. This will be done via a BACS transfer, and a BACS Remittance Advice will be sent to the Independent Payments Service. To ascertain which Customer the payment relates to, look at Your Reference Number : the last 6 digits are the end date of the relevant 4-week period. The first 5 or 6 digits are the Customer s SSIS (LCC Social Services) reference number. LCC sends a BACS Remittance Advice to the Customer when the payment is made into the Independent Payments Service s Account. The Customer pays their assessed charge to the Independent Payments Service Copies of the Forms are attached as Appendix 1 and 2 (viii) The Independent Payments Service pays each provider and keeps records of what has been bought and what has been paid out. (ix) (x) The Independent Payments Service sends regular statements of income and expenditure to the Customer. LCC reviews records of income and expenditure at the Customer s next review.

7 3. MANAGED BUDGET The Customer does not wish to organise their own care and support, and asks the Council to hold onto their Personal Budget and buy the services on their behalf. The Customer s care and support will be organised by the Council using only providers who are on the appropriate framework. This restricts choice and control for the customer, and may limit their opportunities.