C1 Package Funds
- The key financial elements of your Home Care Package are shown below.
|What government pays|
|Home Care Package Funding (Government|
|We receive monthly subsidies from the|
Government. The amount we receive depends on your Home Care Package level.
|What you pay|
|Contribution||This is an amount you may be required to|
pay to us to contribute towards your Home Care Package. The amount of your Contribution
is determined by a government assessment and may comprise:
|Top-up Contributions||If you want to access more Services, you|
can elect to pay a Top-up Contribution to increase the amount of money in
your Home Care Package.
|What we charge|
|Care Management Fee||This is a fee we deduct from your Home Care Package to cover the costs of providing you with Care Management. It may be a fixed amount each month or may vary depending on the amount of Care Management we provide. The amount of Care Management provided will be limited to any maximum hours set out in the Pricing Schedule of you Budget.|
|Package Management Fee||This is a fee we deduct from your Home Care Package to cover the ongoing administration and organisational activities associated with your Home Care Package. The amount of Package Management provided will be limited to any maximum hours set out in the Pricing Schedule of you Budget.|
|Service Charges||These are the charges that we will deduct for the Services you receive, whether provided by us, our suppliers, or third parties selected by you.|
|Other Costs||Where applicable and agreed, we may deduct other agreed charges from your Package including but not limited to those in the Standard Pricing Schedule.|
C2 Your Budget
(1) As part of developing your Care Plan, we will work with you to develop a Budget for your Home Care Package.
(2) Your Budget will outline your Home Care Package income (including your Contribution and any government funding) as well as the planned expenditure/deductions from your Package Funds (including your Care Management Fee, Package Management Fee, Service Charges and, if applicable, Contingency Amount).
(3) You may allocate expenditure from your Budget towards any of the Services that you receive. If you do not have enough money in your Package Funds to pay for the Services you wish to receive, you must make Top-up Contributions to your Package Funds to make up the shortfall. If you stop paying these, your Services will be altered accordingly.
(4) You can stop making elective Top-up Contributions at any time if you no longer want to receive
additional Services provided you give us reasonable notice so that we can cease the Services or cancel the Services without incurring any costs. Your Budget and Services will be adjusted accordingly.
(5) If the Services you request exceed or are likely to exceed your Package Funds:
(a) we are not obliged to provide or facilitate those Services;
(b) you can elect to receive and pay for those Services independently of us outside of your Home Care Package or by paying us privately for those Services (at the rates specified in the Pricing Schedule or as otherwise agreed);
(c) we will work with you to identify Service Changes to bring costs in line with your Package Funds; and
(d) if your Package Funds go into a negative balance, we may:
(i) suspend some or all of the Services based on the limits of your available resources; and
(ii) allocate Package Funds towards overspends prior to new costs being incurred.
(6) We will give you a copy of your Budget before, or within 14 days after, you commence receiving services from us. If your Budget changes, we will give you an updated version.
C3 Your Contribution
(1) You must pay your Contribution and any Top-up Contributions you have agreed to pay.
(2) If you started receiving home care before 1 July 2014, your Contributions will be calculated in accordance with the Aged Care Act rules for pre 1-July 2014 consumers.
(3) Your initial Contribution is set out in the Agreement Details. It is calculated based on the information available to us at the date of preparing this Agreement. Your Contribution will not exceed the maximum amount notified to us by the Department or, if no amount is notified, the maximum amount prescribed by the Aged Care Act.
(4) You must immediately tell us if you are notified by the Department that you should pay a higher or lower Income Tested Care Fee from the amount set out in the Agreement Details.
(5) You authorise us to contact the Department to verify your Contribution.
(6) If we receive insufficient information concerning your income and expenses or you do not complete an income assessment we may charge you the maximum Contribution permitted.
C4 Changes to Your Contribution
(1) Your Contribution will be adjusted if, for any reason, we determine that your Contribution should be lower or higher than:
(a) the amount set out in the Agreement Details; and/or
(b) the amount the Department has determined for you.
(2) This Agreement will continue to apply if your Contribution is adjusted. Any adjustment will take effect on the date your next payment is due or within any shorter period prescribed by the Aged Care Act.
(3) If the Department decides you must pay a higher Income Tested Care Fee than previously agreed or previously assessed for you, you must pay the balance owing regardless of the reasons why this has changed. You are personally liable for this amount (even if you terminate or suspend this Agreement).
(4) Your Contribution will also be adjusted twice yearly (in March and September) in accordance with the Aged Care Act. It may also be adjusted to reflect changes to your financial situation. You can apply to your Care Manager to have your Contribution reviewed at any time. We encourage you to apply to have your Contribution reviewed if your financial circumstances change.
C5 Service Charges
(1) Details of the amounts you must pay for Services (Service Charges) under your Home Care Package will be set out in your Budget. Our Standard Charges are set out in the Pricing Schedule. Unless otherwise stated, if there is any inconsistency between this Agreement and the Pricing Schedule regarding the Service Charges, the Pricing Schedule prevails.
(2) We will advise you of the Service Charges applicable to any Services that are not listed in our Pricing Schedule or Services provided by our preferred suppliers or others as part of the Budget planning process or as part of us agreeing to provide Services in addition to those funded under you Home Care Package.
(3) We will review our Standard Charges under our Pricing Schedule at least once a year, in a manner set out in clause C6 or in any other manner agreed with you.
(4) Any agreed Alternate Charges apply instead of the Standard Charges for the corresponding Services.
C6 Adjustments to Service Charges, Care Management Fee and Package Management
(1) If the Care Management Fee, Package Management Fee and/or any of Services Charges are expressed as a dollar amount (rather than a percentage) we may adjust these or a component of them:
(a) annually with effect from 1 July, to reflect the percentage change in CPI for the prior period 1 July to 30 June (if a positive amount) or in any other manner agreed, including as set out in the Pricing Schedule;
(b) by any amount we reasonably determine to recover or offset any additional costs and/or any expenses we incur in connection with the delivery of Services or management/administration of your Home Care Package (e.g., if our suppliers increase their prices); and
(c) to recover or offset any additional tax, duty, levy or impost directly or indirectly payable or incurred by us in connection with this Agreement or the delivery of Services. An adjustment under this clause will not exceed the amount of the additional tax or duty.
(2) Any changes to the charges under clause C6(1)(b) and (c) will take effect on the date the change is agreed to take effect (if a change can only occur under the Aged Care Act by agreement) or, in any other case, 28 days after we give you written notice of the new charges.
(3) If the Care Management Fee, the Package Management Fee and/or any of the Service Charges are expressed as a percentage of the Package Funds, then unless otherwise agreed, these percentages are fixed even if the Package Funds change.
(4) To the extent of any inconsistency between the adjustment methods set out in this clause and the Pricing Schedule, the Pricing Schedule prevails.
C7 Management of Your Package Funds
(1) We will manage your Package Funds to pay the expenses and deductions in your Budget, including allowed Service Charges, Care Management Fees and Package Management Fees. We may also apply your Package Funds to pay Cancellation Fees and any other amounts payable by you under this Agreement.
(2) You authorise us to apply to the government for available subsidies for your Home Care Package based on your level of care.
C8 Monthly Statement
(1) In addition to your Budget, we will provide you with a monthly statement of how much you actually spent on Services under your Home Care Package and the funds remaining in your Home Care Package.
(2) We will estimate outstanding supplier invoice amounts in the monthly statement. Any adjustments will be made in the monthly statement you receive after we actually receive the supplier invoice.
C9 Payment by Direct Debit
(1) You must pay your Contribution and any Top-up Contributions and other costs and charges payable to us under this Agreement (plus applicable taxes) by direct debit in accordance with the Payment Cycle. You must provide us with a direct debit authority unless another payment method is agreed.
(2) Deductions will be made in accordance with the Payment Cycle or, if a payment date falls due on a weekend or a public holiday, the next business day.
(3) You must not cancel or suspend the direct debit authority unless alternative payment arrangements (acceptable to us) have been made.
(4) If within any month you believe you may have insufficient funds in your nominated account, you must notify us immediately to avoid bank charges and make alternative payment arrangements. We will pass on any bank fees to you.
(5) Once this Agreement has ended, your direct debit authority must not be cancelled until all outstanding costs and charges have been paid.
C10 Interest on Late Payments and Costs on Default
(1) Late payments will attract interest at a rate equivalent to the MPIR at the time payment was due, compounding monthly (unless we expressly waive this requirement in writing).
(2) If you breach this Agreement, you must pay or reimburse us on demand all costs, charges, losses, expenses and damages we reasonably incur as a result of the breach.
(1) If for GST purposes we are or can be considered to arrange or pay for your Services as your agent, we will make purchases as your agent unless we notify you and/or a supplier otherwise.
(2) Any GST or similar tax payable on or in connection with the Services is payable by you, in addition to the base amount, at the time a taxable supply arises. You authorise us to deduct any GST from your Package Funds (or a component of them) where permitted by law, including the Aged Care Act.