Table of Content
Local authorities will provide regular care account statements, and engage early with the person once they are close to approaching the cap to discuss how their needs will be met. Further detail on care account statements will be set out in our consultation. This document sets out further detail on the workings of the new charging reform framework and confirms key outstanding policy details, including the standard level at which ‘daily living costs’, will initially be set. One benefit from the upcoming reforms is that both the upper and lower capital limits will be increased. The upper capital limit will be increased from £23,250 to £100,000, and the lower capital limit will be increased from £14,250 to £20,000.
The introduction of the new care cost cap means there are now financial benefits to receiving care in your own home, in addition to the personal benefits that come from remaining in a familiar environment. “Under this Conservative Government we are seeing multiple crises tear through our health and social care services, whilst the cost of living disaster continues to spiral and economic turmoil grips the country. Primary legislation sets out that the level of the cap should increase in line with average earnings, and that the level of the cap should be set in regulations each year. The level of upper and lower capital limits and the level of DLCs are for ministers to determine each year, through the setting of regulations. Everyone will have a care account which will be maintained by the local authority and will keep track of their progress towards the cap.
Waiver Renewal Application
Our software can reduce admin time as much as 80% and helps make budgeting easier to steamline your payments and billings. Some people will be eligible to fully funded social care before their cap is reached. Others may experience being below the upper limit and only their contributions will count towards the cap. Those with assets valued at less than £20,000 won’t be expected to contribute towards their social care costs. Unlike those in care homes, all your care costs will count towards the cap. Furthermore, once the cap is reached, all care costs will be covered by the government.
People will remain responsible for their DLCs throughout their care journey, including after they reach the cap. The term ‘personal care costs’ refers only to the components of any care package considered to be related to personal care, not hotel and accommodation costs (see the ‘Daily living costs’ section below). Care and support costs that count towards the cap are the costs of any provision that helps meet eligible needs as defined under the Care Act 2014. It is this agreed provision, which forms the basis of the costs that count towards the cap – less DLCs for those receiving care in a care home. The statutory guidance to be consulted on in the new year will set out further detail to support local authorities in this ask.
Ask the Community
While MPs at Westminster were focused on the scandal over MPs’ second jobs, the government published new details of how the social care cap will operate. People with assets of less than £100,000 will receive means-tested support to help them pay for their care, under the new system. The Institute and Faculty of Actuaries recommends an all-inclusive cap of £100,000. This would cover all care costs and give more clarity to people who pay for their own care. This means the maximum amount anyone will have to pay for personal care to meet their eligible care and support needs from October 2023 onwards will be £86,000.
If you are funding yourself, you will be able to ask your council to negotiate the care home fee for you. But many care homes say the local authority rate doesn't cover their costs. A cap on care costs was originally legislated for by MPs in the 2014 Care Act under David Cameron’s coalition government but never implemented. That legislation will now have to be amended to make it operate in the way the government is suggesting. This could give Conservative MPs concerned about the impact on lower-income households the opportunity to express their concerns and possibly rebel against the government.
Not all care costs will count towards the cap
The Division of Medical Assistance held five listening sessions across North Carolina to allow interested stakeholders to participate in a collaborative dialogue focused on key areas of the waiver renewal. These sessions were held in the months of March and April in the cities of Raleigh, Kannapolis, Lenoir, Hendersonville and Greenville , and included 125 stakeholders. If you are a CAP/DA case management entity or a qualified home- and community-based provider, a referral can be completed in the e-CAP system.
But the problem is not many people live that long once they move into a care home. The plan for England sounds simple - from 2023 no-one will pay more than £86,000 for the care they need for daily tasks such as washing, dressing and eating. So, on the surface it would appear that everyone except those with the minimum means will have to pay £86,000 before becoming eligible for funding. It ends some of the uncertainty as to the maximum anyone may have to pay for their care. Councils only have to offer these if an individual has less than £23,250 in assets other than their property, although they are free to be more generous if they wish.
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The government intends to test the implementation of these charging reforms with a small group of volunteer local authorities that will implement the reforms in advance of the national roll-out. Taking this approach will ensure smoother delivery of the reforms for most people across the country. We will publish the basis of which we will select these areas in due course. CAP/DA can provide in-home and community based care for adult Medicaid recipients. The goal is to offer a quality cost effective alternative to intermediate and skilled care in nursing homes.
In addition to the waiver renewal application, the Clinical Coverage Policy, 3K-2, Community Alternatives program for Disabled Adults (CAP/DA), will be revised to support the clinical operation of CAP/DA. The original incorrectly suggested the social care cap would cover the whole of the UK. But Department of Health and Social Care guidance has revealed that only the amount these households contribute themselves – not the total cost of their care – will count towards the £86,000 cap. In other words, many will still end up paying a total of £86,000, the same contribution those with much larger assets will have to make.
These top-up payments, on top of the cost specified in someone’s personal budget or independent personal budget, will not count towards the cap and will still be payable by the person once the cap has been reached. It is important that the new reforms are clear and reduce complexity. Therefore, government will introduce an amendment to the Care Act 2014 to the way that people within the means test progress towards the cap. The much more generous means test is the main means of helping people with lower levels of assets.
Being prepared for future demands when the social care cap will be implemented is crucial. It will determine that everyone needing care will get the provisions they require and will be appropriately means tested without any discrimination. Local authorities’ adult social care departments are already challenged by market shaping and the care cap changes will complicate matters further. Training provided an in-depth overview of the newly implemented workflow and business steps to render CAP/DA services as outlined in the renewed CAP/DA HCBS waiver application and the amended CAP/DA Clinical Coverage Policy, 3K-2. On average, care homes cost over a whopping £33,000 per year in the UK (over £42,000 including nursing care), although this can depend on where you live.
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