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0018 2023/24
21/07/2023
Integrated Health and Social Care
All wards
Implementation of pilot to move from net to gross payments to care homes
To introduce a pilot to move from net to gross payments to care homes within the borough
To seek approval to implement a pilot to move from net payments to gross payments to care homes within the borough
In St Helens, payments for care to care homes are currently made net of the service user’s assessed financial contribution with the home then collecting the contribution directly from the individual. Under section 8 of the Care Act 2014 (Care and Support statutory guidance), the local authority is responsible for the gross cost of care. Currently, the local authority discharges this duty by taking on payment for unpaid client contributions when approached by homes. However, this approach is becoming more of an outlier with recent benchmarking analysis over the North West showing that 20 out of 23 authorities now pay care homes gross. Furthermore, the continuing impact of the pandemic on the sector along with the subsequent cost of living crisis has increased instability in the care market. The key reasons for moving to gross payments are as follows: • Full compliance with the Care Act 2014; • Stability of cash flow for care homes; • Greater control over unpaid client contributions.
The move to gross payments will achieve the following: • Full compliance with the Care Act 2014; • Stability of cash flow for care homes; • Greater control over unpaid client contributions.
The implementation of the pilot and complete roll out will call on a resource commitment across various teams in the Council including: • Payments and Charges • System development • Income • Accounts Payable Moving from net to gross payments to care homes means that the Council will be responsible for collecting the assessed contribution from service users, whereas previously this had been undertaken by the homes. This will result in around 650 more invoices being raised every four week period and the resulting debt having to be managed. The Council’s level of outstanding debt and potential bad debt could increase as a result of becoming responsible for the recovery of service users’ assessed contributions.
The Payments and Charges team will raise the invoices and although there will be a higher volume of transactions, the process will be virtually the same as currently. The Income team will be responsible for implementing debt recovery processes. As residential debt is quite stable in that contributions are not subject to as much discretion as non-residential debt which is managed within the Payments and Charges Team, it is considered that this task will not place an onerous burden on the Income Section. Following discussion and regular meetings across the working group incorporating representatives from the teams listed, it is considered that the pilot and roll out can be achieved within existing resources. The Council’s level of outstanding debt and potential bad debt could increase as a result of becoming responsible for the recovery of service users’ assessed contributions. The level of increase is unknown at this stage but will be regularly monitored to understand and manage any adverse impact on debt levels. Also, recovery of contributions will be made via direct debit wherever possible.
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Please contact Joanne Webb on 01744 676344
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