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Title: DEP PR-5 Client Contribution Procedure Type Department Author Procedure Health Christine McCallum Approved by Service Position Robyn Westerman Aged and Disability Program Director Disability Equipment Program Procedure Client Contribution Target Audience Areas applicable: Approved Prescribers and Aged and Disability Program Staff Aim To outline the client contribution process for the provision of Disability Equipment Program aids and equipment. Personnel able to perform procedures Approved Prescribers DEP Work Unit staff DEP Cost Centre Managers Procedure This procedure is to be actioned in accordance with the DEP PO-5 Client Contribution Policy and other relevant components of the DEP Policy and Procedure Manual. 1. Discussion a. Approved Prescribers discuss the Client Contribution Policy with clients at the time of application. Clients acknowledge that they may be required to contribute when signing the DEP A1 Application Form. b. If the cost of the item/s prescribed is known and exceeds the applicable Maximum Subsidy amount outlined in the DEP Approved Equipment List, the Approved Prescriber discusses the required contribution amount with the client and includes these details on the DEP Prescription Form. i. Approved Prescribers may step through and complete the DEP A5 Client Contribution Agreement with the client at the time of application if details are known. ii. Approved Prescribers discuss and assist the client to coordinate Centrelink Centrepay or other payment options to facilitate payment if required. c. It is recognised that some clients may elect to contribute to the purchase of an item that would generally be funded by DEP or may request Optional Accessories and/or Modifications for client preference. In these instances, the Client Contribution Agreement is completed for formalise contribution arrangements. 2. Agreement a. The DEP Clinical Leader or DEP Cost Centre Manager confirms that a client contribution is required at the time of approval and if applicable, the Maximum Subsidy applied and client contribution amount. The DEP Prescription Form outlines the details of the client contribution arrangements as discussed between the Approved Prescriber and the client. b. Upon receipt of an approved prescription, the DEP Work Unit reconfirms the amount of contribution outlined on the DEP P-B Prescription Form Part B. DEP PR-5 Client Contribution Procedure Page 1 of 5 Created: March 2013 | Review: March 2014 Department of Health is a Smoke Free Workplace Title: DEP PR-5 Client Contribution Procedure Type Department Author Procedure Health Christine McCallum Approved by Service Position Robyn Westerman Aged and Disability Program Director i. When multiple items are prescribed, a client contribution is only required if the total cost of the item/s exceeds the total applicable Maximum Subsidy amounts as outlined in the DEP Approved Equipment List. ii. Re-issue and standard stock items do not require a client contribution. iii. Where a client contribution is confirmed to be different to that estimated by the Approved Prescriber, the DEP Work Unit note this change on the DEP P-B Prescription Form Part B. DEP Cost Centre Manager re-approval is required if DEP are required to contribute in excess of the applicable Maximum Subsidy. iv. For PERS: A client contribution letter is not required. DEP will fund installation only. All ongoing monitoring and rental costs are between supplier and client. The LTR-PERS1 DEP Request for Installation of PERS letter template is used and sent to supplier. The LTR-PERS2 Ongoing Cost of Monitored PERS or the LTR-PERS3 Ongoing Cost of Non Monitored PERS letter template is used and sent to client to advice of client responsibility for any ongoing costs c. The DEP Work Unit inputs client information and contribution amounts into the Client Contribution Agreement. i. Co-payment arrangements between a third party and a client are acceptable however the Client Contribution Agreement will be with the client. DEP does not enter into Client Contribution Agreements with a third party. Refer to Step 6. d. The DEP Work Unit prepares a quote outcome letter advising the supplier of client contribution arrangements using the LTR-Q1A Quote Successful Contribution Required Letter template. i. Where the Approved Prescriber has already had the Client Contribution Agreement signed by the client, the LTR-Q1B Quote Successful Contribution Required with Agreement Letter template is used and a copy of the Client Contribution Agreement/letter sent to the third party contributor are provided to the supplier. e. The DEP Work Unit prepares an outcome letter for the client using the LTR-P2 Prescription Approved Pending Contribution Letter template. Two copies of the Client Contribution Agreement and a copy of the letter sent to the supplier are attached to the outcome letter. i. Where the Approved Prescriber has already had the Client Contribution Agreement signed by the client, the LTR-P3 Prescription Approved Contribution Payable Letter template is used and a copy of the agreement provided to the client. f. A copy of ALL correspondence and the Client Contribution Agreement are sent to the Approved Prescriber for action with the DEP ACT-1 Approved Prescriber Action Advice coversheet. i. Outcome letters and Client Contribution Agreements are addressed to the client and sent to the Approved Prescriber who determines the most appropriate way to relay the outcome and discuss required contributions with their client. Where the client’s capacity to accept responsibility for a contribution is not in doubt, Client Contribution Agreements may be sent directly to the client to provide the maximum time for payment arrangements. 3. Unsigned/Unreturned Agreements a. In the event that a client does not sign and return the Client Contribution Agreement within the two week period specified, the DEP Work Unit notifies the Approved Prescriber using the Approved Prescriber Action Advice coversheet. DEP PR-5 Client Contribution Procedure Page 2 of 5 Created: March 2013 | Review: March 2014 Department of Health is a Smoke Free Workplace Title: DEP PR-5 Client Contribution Procedure Type Department Author Procedure Health Christine McCallum Approved by Service Position Robyn Westerman Aged and Disability Program Director b. The Approved Prescriber contacts the client to reiterate the Client Contribution Policy and DEP terms and conditions previously acknowledged at the time of application. i. All DEP processes are conducted with client or guardian consent. Refer to the Aged and Disability Program (A&DP) Informed Client Consent Policy. ii. Approved Prescriber must feel confident that the client has capacity to make an informed decision where there is no legal guardian. This includes acceptance of equipment responsibility and acknowledgement of DEP terms and conditions. iii. Where there is concern about the client’s capacity to make an informed decision, the Approved Prescriber must ensure that they seek appropriate confirmation of capacity (eg. from a Doctor or Psychologist) or initiate Adult Guardianship processes to determine if a guardian is required in accordance with the Adult Guardianship Act. c. The Approved Prescriber supports the client with any further follow up required. i. The client may state they are unable to make the agreed contribution. The Approved Provider discusses alternate funding sources and explores the option of Special Consideration see DEP PO-2 Financial Eligibility Policy (if applicable). ii. The client may require assistance to understand or sign the agreement. All application, assessment and prescription processes are conducted with client or guardian consent. With consent, information may also be obtained from other professionals and agencies (eg doctors, allied health professionals, and psychologists). Refer to the Aged and Disability Program (A&DP) Informed Client Consent Policy. The Approved Prescriber confirms guardianship arrangements for the client. The Approved Prescriber discusses the agreement details and explains the contribution required from the client with the client and/or guardian. Approved Prescribers must feel confident that the client has capacity to make an informed decision where there is no legal guardian. This includes acceptance of equipment responsibility and acknowledgement of the DEP terms and conditions. Where there is concern about the client’s capacity to make an informed decision, the Approved Prescriber must ensure that they seek appropriate confirmation of capacity (eg. from a Doctor or Psychologist) or initiate Adult Guardianship processes to determine if a guardian is required in accordance with the Adult Guardianship Act. iii. The client may refuse to sign the agreement or make contribution towards the necessary item/s in accordance with the PO-5 Client Contribution Policy. The Approved Prescriber confirms guardianship arrangements for the client. If no legal guardianship arrangement is in place and the Approved Prescriber is confident of the client’s capacity, the client is afforded dignity of risk. In this situation, the Approved Prescriber has a duty of care to follow up and seek the client’s written consent to confirm that the available equipment options and risks have been fully explained and understood. Refer to A&DP Informed Client Consent Policy. d. The DEP Work Unit will follow up with the Approved Prescriber two weekly until the agreement is received or the Approved Prescriber advises the DEP Work Unit that the prescription is to be cancelled. The Community Care Information System (CCIS) Diary function can be used to schedule a reminder for this purpose. DEP PR-5 Client Contribution Procedure Page 3 of 5 Created: March 2013 | Review: March 2014 Department of Health is a Smoke Free Workplace Title: DEP PR-5 Client Contribution Procedure Type Department Author Procedure Health Christine McCallum Approved by Service Position Robyn Westerman Aged and Disability Program Director 4. Processing and Payment a. Upon receipt of the signed agreement, the DEP Work Unit record and order required items using the DEP PR-6 Ordering and Payment Procedure. 5. Unpaid Client Contributions a. Where a client contribution is unpaid or only partially paid, the DEP Work Unit will request Approved Prescriber follow up as appropriate using the Approved Prescriber Action Advice. b. In exceptional circumstances, DEP may contribute further funds towards an item however this is considered on a case by case basis and is at the discretion of the DEP Cost Centre Manager. c. In the event that an unpaid invoice addressed to the client is received by DEP, the DEP Work Unit request Approved Prescriber for follow up as appropriate using the Approved Prescriber Action Advice. i. The Approved Prescriber follows up all possible avenues for payment including escalation to the DEP Cost Centre Manager. In the event the invoice remains unpaid, the DEP Cost Centre Manager contacts Legal Services to further escalate the matter and seek legal advice. 6. Third Party Contributions a. Approved Prescribers must investigate the availability of support from alternate funding sources prior to submitting a prescription for their client. b. When a third party contribution has been confirmed, the Approved Prescriber details arrangements in on the prescription and attaches relevant documentation to the prescription. c. If approved, the DEP Work Unit use the LTR-P3A Third Party Contribution Payable Letter template to confirm and request the third party contribution. i. For contributions in excess of 50 percent of the purchase price, ownership of the item is considered and if required, transferred in accordance with the DEP PO-6 Ownership and Portability Policy and DEP PR-8 Stock and Re-issue Procedure. ii. Co-payment arrangements between a third party and a client are acceptable however the Client Contribution Agreement will be with the client. DEP does not enter into Client Contribution Agreements with a third party. Additional Information DEP Policy and Procedure Manual Associated Documents DEP A1 Application Form DEP A5 Client Contribution Agreement DEP Approved Equipment List DEP Prescription Forms (1-12) DEP P-B Prescription Form Part B DEP PO-2 Financial Eligibility Policy DEP PO-5 Client Contribution Policy DEP PO-6 Ownership and Portability Policy LTR-PERS1 DEP Request for Installation of PERS DEP PR-5 Client Contribution Procedure Page 4 of 5 Created: March 2013 | Review: March 2014 Department of Health is a Smoke Free Workplace Title: DEP PR-5 Client Contribution Procedure Type Department Author Procedure Health Christine McCallum Approved by Service Position Robyn Westerman Aged and Disability Program Director LTR-PERS2 Ongoing Cost of Monitored PERS LTR-PERS3 Ongoing Cost of Non Monitored PERS LTR-Q1A Quote Successful Contribution Required Letter LTR-Q1B Quote Successful Contribution Required with Agreement Letter LTR-P2 Prescription Approved Pending Contribution Letter LTR-P3 Prescription Approved Contribution Payable Letter LTR-P3A Third Party Contribution Payable Letter DEP PR-6 Ordering and Payment Procedure DEP PR-8 Stock and Re-issue Procedure DEP ACT-1 Approved Prescriber Action Advice DEP GL DEP Glossary A&DP Informed Client Consent Policy Key Legislation, Acts & Standards NT Disability Services Act NT Disability Service Standards Adult Guardianship Act References Author / Contributors Name Christine McCallum Susan Esmonde Valli Camara DEP Steering Committee DEP Operational Committee Position Senior Policy Officer TIMES/SEAT Review Project Officer Senior Policy Officer Governing Body DEP Work Unit Managers and Administration Officers Service/Program Aged and Disability Program Aged and Disability Program Aged and Disability Program Aged and Disability Program Aged and Disability Program Alternative Search Words Disclaimer for reformatting – format has been changed to accommodate technical requirements. Content has not been altered. DEP PR-5 Client Contribution Procedure Page 5 of 5 Created: March 2013 | Review: March 2014 Department of Health is a Smoke Free Workplace