1 a consultation on the 2016 reforms under the care act
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1
A consultation on the 2016 reforms under the Care Act
2
Overview
Discussion
Introduction
Cap on care costs
Appeals
Questions
3
Introduction
4
Dilnot Commission
Report___________
July 2011
• Caring for our Future White Paper• Draft Care and Support Bill• Progress report on funding______________
July 2012
Consultation on reforming what and how people pay for their care & support________________
July 2013
Care Act receives
Royal Assent __________
May 2014
Announcement on funding
reform______________
Feb 2013
Implementation_____________
April 2015 – April 2016
The reform timelineThis consultation is the latest step in delivering the Government’s Vision for Adult Social Care document and White Paper.
Draft Regs & Guidance for
2015 published
__________Oct 2014
Draft Regs & Guidance for
2016 published
__________Oct 2015
Consultation on draft regulations
and guidance______________
Feb – March 2015
Election______________
7 May 2015
Care Act comes into force
______________April 2015
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The Care Act• Realises the vision set out the Care and Support White Paper
published in 2012• It sets a new framework for the future that will enable the
system to respond to the challenges of an ageing population• To do that, the system must enable people to stay well and
independent by:– Promoting people’s wellbeing– Enable people to prevent and postpone the need for care and
support– Put people in control of their lives so they can pursue opportunities to realise their potential
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TimelineWhen? What?23 October 2014 Final regulations & guidance that will come into force on
1 April 2015 published4 February 2015 Consultation on draft regulations and guidance for the
cap on care and policy proposals for an appeals systemFebruary 2015 Launch consultation events
March 2015 ADASS/DH financial modelling exercise for 16/17 costs
30 March 2015 Consultation closes
April 2015 2015 package of regulations and guidance come into force
7 May 2015 General Election
October 2015 Final regulations and guidance that will come into force on 1 April 2016 published
April 2016 Cap on care costs and appeals comes into force
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This consultation• Covers the cap on care costs and appeals• For the cap on care costs it:
– Sets out draft regulations and guidance– Responds to the last consultation– Sets out work since
• For appeals it:– Sets out policy proposals
• The consultation will run until 30 March 2015
We want to hear what you think• We welcome views on the draft regulations & guidance. Do they
provide a robust framework? What have we missed?• What do you think of the policy proposals?• It is available at www.careact2016.dh.gov.uk
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The Cap on Care Costs
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Why is reform needed?• Care and support has never been free, but most people do not realise.• Current system is no longer fit for purpose:
– It is outdated in how we define rich and poor – It was created in 1948 when average life expectancy was 68 - it is now 80
and rising.
• Those unlucky enough to have high care needs for a long period risk losing nearly everything they have to meet that cost.
20103 million
20304.5 million
20508 million
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Funding Reform – what is it?
• And for the first time creates protection from the risk of catastrophic lifetime care costs for those unlucky enough to face them.
• Limits the amount people have to pay towards their eligible care and support needs and extends the point at which help is available.
• This creates a new partnership between the individual and the state that is fair for all.
£0k
£50k
£100k
£150k
£200k
£250k
£300k
0% 20% 40% 60% 80% 100%
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The aim is to protect people against catastrophic costs
0%
20%
40%
60%
80%
100%
Assets on going into care
Indi
cativ
e as
set d
eple
tion
Current72K Cap with increased ucl72K Cap
• Current system can force people with average and lower wealth to spend >80% of their assets on care & support
• The cap provides protection from costs rising above £72,000• But it is combining the cap with the extension to the means test
that delivers protection from significant asset depletion
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• Everyone with eligible needs will be able to progress towards the cap.• The cap will be set at £72,000.• The rate at which they progress will be based on what the cost is, or in
the case of self-funders would be, to the local authority.• This cost will be set out in a personal budget or an independent
personal budget. • Progress towards the cap will be recorded in a care account.• The local authority will maintain the care account and provide people
with annual statements so they are informed of their progress.• Consulting on 3 different options for working age adults.
Cap on care costs:How will it work?
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Cap on care costs:What counts towards the cap? • Only the cost of care to meet a person’s eligible needs.
• This is based on what the cost is, or in the case of self-funders would be, to the LA of meeting those needs.
• Where a person is in a care home the LA will deduct £230 per week for daily living costs to work out how much counts towards the cap.
• This will not affect how much the provider receives
• Other costs do not count:o Top-up feeso NHS-funded care
• Only costs from April 2016 onwards count
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• When a person reaches the cap the local authority will take over paying for the care component of a person’s care package.
• The person will remain responsible for paying their daily living costs and any top-up they have chosen to pay.
Cap on care costs:What happens when a person reaches the cap?
Before reaching the cap self–funder contributes:
Care CostsDaily living costs
“Top Up”
Counts Doesn’t count
After reaching the cap :
Care CostsDaily living costs
“Top Up”
LA contributes: Person contributes:
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Increased financial support• We are increasing the capital limits
used to determine what people can afford to pay.
• This will mean more people get financial help as they progress towards the cap.
• We are also making a change to ensure no-one is worse off as a result of the interaction with benefits.
.
Is the person receiving care
in a care home?
Do they own a property?
Is the property
disregarded
Apply £27,000
upper capital limit
Apply £118,000
upper capital limit
Apply £118,000
upper capital limit
Apply £27,000
upper capital limit
Yes
Yes
Yes
No
No
No
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Policy proposals for appeals
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The Appeals Proposals• Means of redress – The Appeal system is a means to review council decisions
relating to care and support.
• Work with the existing complaints system – The intention is that the appeals system will only cover key care and support decisions. The complaints system will deal with all other areas.
• Independence – The Appeals system will introduce an independent review of the local authority’s decision.
• Openness and assurance – The Appeals system is intended to provide both the person and local authority with a clear line of sight on the rationale and recommendation of the Independent Reviewer (IR).
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Why Appeals?• We are putting forward proposals for an appeals system that we think
can provide an efficient, cost effective, open means of redress.
• Currently there is a lack of formal means to appeal care and support decisions.
• Hull City Council noted that “there appears to be a lack of potential
dispute resolution within the prescribed legislation” and suggested that this can lead to “costly challenges”. - Law Commission consultation on Care and Support, paragraph 14.21, March 2011.
• Bring in line with DWP Benefits, Education & NHS – all have appeals systems – adult social care doesn’t currently have an appeal system.
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Appeals Potential Benefits
• People avoid the stress and cost of going to court while councils could reduce the administrative and cost pressures of legal challenges, freeing up resource.
• The proposed Appeals system has early resolution built in as a primary focus of the policy. The emphasis is to talk through issues between a person and the local authority.
• People are helped to understand why decisions have been made in a particular way and have their concerns addressed quickly. This helps protect a vulnerable cohort where disagreements arise.
• The Appeals system introduces an independent review of the local authority’s decision. This means people can be confident that they have received a fair and equitable review of their appeal. Councils receive a cost effective, independent means of ensuring they are getting their care and support decisions correct.
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Proposed Appeals System- 3 stage process
Appeals Consultation
EARLY RESOLUTION
- An Independent Reviewer (IR) is appointed to make a recommendation to the LA
The Local Authority makes a final decision with reference to IR’s recommendation
- LA and the person work together to try and resolve differences, early, wherever possible
NON CONFRONTATIONAL
GOOD COMMUNICATION
INDEPENDENT REVIEW STAGE FINAL DECISION
MEET TO RESOLVE ISSUES
LA & PERSON WORK
TOGETHER
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Rest of the day
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Agenda• Questions!• Workshops:
1. Overview of the cap & extension to the means test2. Independent Personal Budgets & metering3. Appeals4. Working Age Adults
• Break• Workshops – same again• Plenary• Planning & preparing for implementation• Close
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Please respond to the consultation• Comment online: www.careact2016.dh.gov.uk
• Email us at: careactconsultation@dh.gsi.gov.uk
• Share your thoughts: #careact2014
• Write to: Care and Support Funding Reform & Appeals Consultation
Department of HealthRoom 313B, Richmond House, 79 WhitehallLondon, SW1A 2NS
Please make sure all responses are received by 30 March 2015
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Questions
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