Aged care financial hardship assistance - assessment 065-05030010

Choose an assessment:

• For reviews of previous completed hardship assessments or change in circumstances, see Aged care financial hardship assistance - review/cease/revoke
• If a pre entry hardship assessment was completed and care recipient has now entered care, see Table 2 > Step 4
• For a new hardship assessment, go to Step 2

Confirm if there is a current period of hardship recorded for the care recipient:

• Home care
• In ACMPS check Hardship & Income Suspension tab
• In ACSP check Hardship summary
• Respite and residential care
• In ACSP check Hardship summary

To confirm current home care details, go to care recipient record in ACMPS and review:

• current ACAT: Assessment & Events tab > Assessment Details
• current MTA: Means Testing Data tab > Means Tested Assessments

To confirm current residential/respite care details, see care recipient record in Aged Care Staff Portal (ACSP) and review:

• Care recipient > Event Summary
• Means Testing > Resident Contribution type
• Fees and charges > Fees and charges details

Note: if the care recipient is a Department of Veterans' Affairs (DVA) responsibility, refer the details to DVA for updates. See the Resources page for contact details.

Complete any income and/or asset updates based on information provided in the hardship form:

• Complete updates to income and assets from relevant dates - refer to Aged care reviews - reassessments and updates
• Check if a Complex Assessment Officer (CAO) referral is required:
• If a CAO assessment has been completed within the last 12 months, a new referral may not be needed
• Review the CAO Assessment Doc to make sure the latest information is applied to the previous CAO Assessment
• Complete a Complex Assessment Officer (CAO) referral (if needed)
• If immediate processing of CAO referral is needed, see Immediate new claim and non-new claim priority processing for escalation process
• Hardship is calculated based on adjusted ongoing fees
• Complete an Ad-hoc review if required, see Aged care reviews - ad hoc reviews

A care recipient is ineligible for a hardship assessment when they meet one of the criteria below:

• Own assets valued at more than the current hardship threshold (excluding any assets that cannot be sold or borrowed against)
• Gifted more than $10,000 in the previous 12 months and/or $30,000 in the previous 5 years
• Started a home care package before 1 July 2014 (and has not opted into the post 1 July 2014 scheme)
• Have not provided income and/or assets in a means assessment. See Aged Care means assessment for details on when a verbal assessment can be completed
• Is currently receiving residential care under a pre 1 July 2014 assessment scheme and they occupy an extra services place:
• In the Aged Care Staff Portal (ACSP), go to Care recipient > Event summary to see when extra service is coded

Does the care recipient meet any of the above criteria?

• Yes, care recipient is ineligible for hardship, complete a hardship entitlement calculation so HREJ Hardship reject letter will be sent. See Table 2 > Step 10
• No, go to Step 3

Confirm if more details are needed before completing the hardship assessment:

• Home care only - Aged Care Assessment Teams (ACAT) approval
• Update to income and assets

Check the hardship form is complete and all supporting documents lodged:

• See Resources for information on evidence needed for essential expenses and assets that cannot be sold or borrowed against
• Evidence is not required if there is monthly expense threshold and the amount claimed is below this amount

In Customer First Document Tools, check for any previous RFIs scanned and uploaded as a PDF. Consider using the Staff Feedback Tool if a previous RFI sent did not request all information needed

Is more information and/or supporting documents needed to assess the hardship claim?

• Yes, and information and/or supporting documents were:
• not requested before, go to Step 4
• already requested, go to Step 5
• No, and all information and/or supporting documents given and questions on the hardship form are completed, see Table 2

Phone the care recipient, nominee, executor, or Power of Attorney to clarify the outstanding documents required. Proof of identity (POI) requirements are the same for inbound and outbound phone calls, see Calling a customer or returning a customer's call.

Send a Request for Information (RFI) letter through Create hardship letter in the care recipients ACSP record.

• In Hardship tab select Hardship summary
• Select on Create hardship letter
• Letter type – select HRFF - Hardship request further information
• Record date hardship claim form received
• Select Care type
• Select Entry type
• Printer ID – select the printer applicable for your work area
• Select and select Add for each item individually
• Select Submit to create letter
• ACSP will generate letters for the care recipient and nominee if applicable
• Collect letter/s from the printer and confirm all required information is in the letter
• include all appropriate forms and put in the mail
• Note: the letters will display in ACSP Letter Summary for the care recipient with a status of Sent (ACSP will not send the letter)

Any documents requested for a deceased care recipient will have the letter created for the confirmed executor or guardian of the estate including any:

• information needed to complete a means assessment
• supporting documentation needed to calculate hardship

In Customer First:

• record all documents requested including attempted outbound call details in a Fast Note
• Aged Care > Hardship > AC HOM/RSP Fin Hardship Prog of claim Residential care
• Aged Care > Hardship > AC RES Fin Hardship Progress of claim
• Leave Fast Note open
• hold the open hardship Fast Note for 28 days and allow extra time for mail delivery
• copy the DOC from Customer First

In the ACSP:

• create a care recipient note, see Aged Care Staff Portal (ACSP) - Care Recipient in Context (CRiC) for details
• procedure ends here

Consider the information requested. If evidence has not been provided:

• of an expense:
• see the Resources page for a List of allowable essential expenses
• use monthly amount for expense if threshold applies, or
• remove the expense from the calculation
• add notes in calculator to explain decision
• to verify an asset is unrealisable, the asset is included in assessment, therefore the hardship application may be rejected

A hardship application may be withdrawn when:

• an RFI has been issued, and
• there is not enough information to complete a calculation of potential hardship entitlement

Confirm that 28 days (plus an allowance for mail delivery) has passed since the hardship request for information (RFI) was sent.

Service Officers should assess the application if it can be completed using the information provided without the RFI response.

Does the hardship assessment application meet the criteria to be withdrawn?

• Yes, withdraw the hardship assessment, go to Step 6
• No:
• Proceed with hardship calculation, see Table 2
• Due to assets the care recipient is ineligible for hardship, see Table 3 > Step 4

Hardship assessment may be withdrawn when the care recipient/authorised representative:

• has not given the information or supporting documents requested in the hardship RFI letter
• requests the withdrawal of their claim verbally or in writing at any time before the claim is determined

Service Officers can use the original application if the care recipient later provides the requested information within 13 weeks.

To complete the withdrawal:

• Make 2 genuine attempts to phone the care recipient or nominee/authorised representative to advise the outcome
• Document contact attempts, see Advising verbally of an unfavourable decision
• Annotate and complete the Hardship Prog of claim Fast Note clearly stating what details are needed to reassess the claim
• Create a new Fast Note - select Auto Text, use Aged Care > Hardship > Care type > WTHDRN
• In the Aged Care Staff Portal (ACSP) go to Care recipient > Care recipient notes and Fast Note text
• Use date of receipt (DOR) as the date of withdrawal
• Copy the DOC from Customer First

In the ACSP:

• Create care recipient note in ACSP. see Aged Care Staff Portal (ACSP) – Care Recipient in Context (CRiC) for details

The Hardship assessment calculator in ACSP will:

• Make the determination
• Grant – pre and post entry
• Reject – pre and post entry
• Complete a review, reassessment, cessation or revocation
• Create the appropriate letter
• Code the grant amounts for a post-entry care assessment,
• Change the coded amount for a reassessment, and
• Code a cessation or revoke

The legacy Hardship subsidy calculator (link in Resources) will need to be used for the following scenarios:

• Reassessment, cessation or revocation of hardships granted and coded prior to 8 February 2025
• Care recipient is deceased
• Care recipient had a period of respite, and has now entered permanent residential care, or home care, and fees have set based on MTA coded for that entry, but there is no valid MTA for the earlier respite period
• Pre 1 July 2014 care recipients
• Go to Table 3

For all other scenarios, go to Step 2

Does the care recipient have a current period of hardship recorded?

• Yes, the current period of hardship needs to be end dated to enable the new hardship calculation to proceed
• go to Step 3
• No, has already ceased, or has never been granted hardship, go to Step 4

The care recipient has a current period of hardship recorded that needs to be end dated to enable the new hardship calculation to proceed.

If hardship grant was coded manually and/or prior to 8 February 2025

• Home care
• ACMPS, in care recipients record, navigate to Hardship & Income Suspension
• Select the period you need to update and select Edit list
• Update the end date to the date of lodgement of the new hardship claim minus 1 day. Select Save
• Permanent residential care or residential respite care
• In ACSP, in care recipients record, navigate to Hardship summary
• In the Current and future hardship section select the status hyperlink of the hardship record
• Select Update, and change the end date to the date of lodgement of the new hardship claim minus 1 day, then select Submit
• Go to Step 4

If coding was after 8 February 2025 and was automatic

• A cessation will need to be completed, with the cessation letter suppressed or cancelled. See the Cease or revoke hardship assistance table in Aged care financial hardship assistance – review/cease/revoke
• When ceased, go to Step 4

For hardship assessments lodged before the care recipient enters care:

• the hardship start date is the date of lodgement
• use the current rates of income support payment (ISP), for example, the partnered rate if partner is not in care
• the ISP rate is reassessed when the care recipient starts care
• the hardship assessment is valid for 120 days from the date the claim is completed

Permanent residential care - calculating residential accommodation costs as an essential expense (pre-entry assessments)

• If the care recipient is low means, assess the accommodation contribution up to the maximum accommodation supplement amount, see the Resources page for a link to the Schedule of Fees and Charges for residential care
• If the care recipient is not low means, and the Refundable Accommodation Deposit (RAD) is not known:
• use the maximum accommodation supplement amount as the default for accommodation costs
• Go to Step 6
• If now advising has entered care after being granted hardship pre-entry, go to Step 5

The below relates to home, permanent residential or residential respite care.

If the care recipient has entered care within 120 days of the pre-entry assessment, complete a new calculator assessment using the pre-entry expenses as at the date of entry into care (as per Step 10).

If the care recipient has entered care outside of the 120 days of the pre-entry assessment, a new claim needs to be completed with expenses provided as of date of entry into care:

• Confirm date of entry into care
• Confirm fees have been set for entry
• Review previous hardship assessment calculations:
• changes to income (for example, care recipient now illness separated)
• expenses that may no longer apply (such as rent assistance)
• additional expenses that may now apply
• add calculated Means Tested Care Fee (MTCF)/Income Tested Care Fee (ITCF)
• permanent residential care – confirm accommodation costs from residential/accommodation agreement provided and add to Fortnightly Expenses

Go to Step 10 to complete a new hardship calculation using date of entry into care as the start date.

The hardship start date is the date the care recipient first experienced hardship. This may be the date the care recipient:

• started receiving care
• lodged the claim, or
• showed they meet the criteria for hardship assistance (even if the start date written is later)

Determine the start date based on information provided, all calculations and information will apply from this start date.

Ongoing hardship claims

• If a care recipient lodges a new hardship claim for the same type of care before the end of a current hardship period
• start date is the date of lodgement of assessment
• If a care recipient lodges a new hardship claim for the same type of care after the end of a current hardship period. Start date will be either:
• previous hardship end date +1, or
• date they met criteria for hardship assistance
• If a care recipient lodges a new hardship claim for a different type of care before the end of a current hardship period, a new application is required. Start date will be:
• the date criteria is met, or
• date of entry to care type

Grant duration (end date)

Hardship assistance is granted for:

• 3 years, to be used when:
• a care recipient is in permanent residential care and their circumstances are not likely to change
• post 1 July 2014 scheme care recipients who have an asset that is unreasonable to sell due to joint ownership or a near relative living in the home
• pre 1 July 2014 scheme residential care recipients who no longer have funds to pay for an accommodation charge or bond
• 12 months, to be used when:
• hardship is granted for home or residential respite care
• a temporary situation is causing hardship, such as being unable to sell a property
• less than 12 months to be used when:
• legal investigation/action to recoup misappropriated funds
• structural damage repair due to natural disasters

Note: correct duration of grant period should be used to ensure hardship determinations are applied correctly and do not disadvantage care recipients.

When granting a hardship claim, the end date is determined by the grant duration minus 1. See the Frequently Asked Questions table on the Resources page for more examples.

Take note of the end date and review requirements, see Table 4 > Step 9 for more information on Reviews.

New Pre-entry assessments

When a care recipient has not yet entered care, the end date is 120 days from the date the assessment is completed and is also the date the hardship pre-approval is valid until. Hardship is only coded when the care recipient starts care within this period. Procedure ends here.

Residential respite care

When a care recipient:

• is currently in residential respite care, the end date will be:
• 12 months from date of assessment if no end date recorded, or
• end date of residential respite care period if coded in ACSP
• has left residential respite care – end date is one day prior to departure date

The hardship assessment remains valid for original period (for example, 12 months). If a care recipient starts residential respite care again in the 12 months validity period, it can be coded without a new claim being lodged. If the residential respite care is with a different provider, a new letter to the service will be required.

When completing hardship calculations, use the full fees for a care recipient, not the current hardship reduced fee. For ongoing claims, check if there were any issues with previous claim.

At the hardship start date, the care recipient must have total assets below the relevant asset threshold.

The Resources page contains information on the types of assets that cannot be sold or borrowed against, and the current and historical thresholds for financial hardship - assets.

Using the relevant thresholds, determine the:

• total assessable assets
• value of any assets that cannot be sold or borrowed against (unrealisable asset)
• care recipient's net assets:
• total assessable assets - value of any assets that cannot be sold or borrowed against = net assets

Note: if assets are above the threshold and later reduce, the hardship assistance start date changes.

Is the care recipient eligible for hardship assistance based on the total net assets?

• Yes, go to Step 9
• No, see Table 3 > Step 4

Include any income (see below) into the fortnightly income calculation as at the start date of the hardship claim.

At the hardship start date, the care recipient must have total income below the relevant income threshold after essential expenses have been deducted.

The Resources page contains information on the current and historical thresholds for financial hardship - income.

Using the relevant thresholds, determine the:

• annual income amounts, show on the RCA Income Assessment Summary (RIAS) screen
• Energy Supplement (displayed as CES)
• Rent Assistance (RA), check Payment Summary (PS) to confirm if CES and RA are paid with an ISP
• Defence Force Income Support Allowance (DFISA) for periods of entitlement up to, and including, 31 December 2021, check DFISA Summary (DFS)

Note: National Disability Insurance Scheme (NDIS) is not included as income. See, Allowable and non-allowable essential expenses information on the Resources page.

Has the care recipient departed from care without a valid MTA (including deceased) or is a Pre 1 July 2014 residential care recipient?

• Yes, see Table 3
• No, go to Step 10

Care subsidy reduction (CSR) to zero

If a care recipient's CSR is set to zero, they do not have to pay any ITCF/MTCF for that period. They still must pay any Basic Daily Fee (BDF) and Accommodation costs (for residential care).

Service Officers must consider any previous application of CSR to zero before finalising the hardship assessment.

See Aged Care fees and charges - care subsidy reduction to zero for help.

If the hardship assessment start date is during the period of CSR to zero and, the end date is after the end of the CSR to zero period:

• Two hardship calculations will need to be completed
• The first one will be from the start date during the period of CSR to zero, to the date the CSR to zero has ended less one day
• The second assessment will start from the date CSR to zero ended and MTCF commenced
• Two HGRE Hardship grant letters will be created and sent

When calculating amounts, round up figures to 2 decimal places:

• In ACSP, see Fees and charges > Fees and charges details to confirm historical and current fees and charges
• Home care:
• Basic Daily Fee (BDF) will auto populate as a fortnightly expense amount when the Care type and the Homecare package level is selected, and will display in the Expenses field
• Manually add income tested care fee (ITCF) in Care recipient expenses as a fortnightly amount under Expenses type Care Accommodation Fortnightly Expenses for pre-entry hardship claims (homecare only)
• Residential care and respite care:
• BDF will auto populate as a fortnightly expense amount when the Care type is selected and will display in the Expenses field
• Manually add Means Tested Care Fee (MTCF), ITCF and/or accommodation costs including RAD/DAP in Care recipient expenses as a fortnightly amount under Expenses type Care accommodation
• For continuation of hardship calculations - the amount coded should equal the fee a care recipient is liable to pay, prior to any hardship being granted

Income:

• Take note of the Total Income amount recorded in the current MTA
• ACMPS – open the most recent Assessment ID in the Means Tested Assessments tab and select Total Amount Details
• ACSP – navigate to Means testing current summary and take note of the Total Income amount
• PD – take note of the Clean energy supplement and Rent assistance (if applicable)

To complete the hardship entitlement calculation:

In the care recipient record in ACSP, under the Hardship tab select Hardship assessment summary:

• Select Register hardship assessment tab
• Circumstances page
• Answer all fields marked with an asterisk
• Is the care recipient's total assets under the current asset threshold? – Yes or No
• Has care recipient gifted more than $10,000 in the previous 12 months and/or $30,000 in the previous 5 years? – Yes or No
• Number of dependants
• Start date
• End date
• Care type – Home care, Permanent residential care, or Respite residential care
• Pre-entry letter – Only tick this box if is a pre- entry assessment
• If care type is Home care select the care level from the drop down box
• Select Next
• If answer is No to assets threshold question, or Yes to the gifting question select Next until arrive at the Hardship details page

Note: an error will display if there is no valid means assessment

• Care recipient income page
• Select applicable income types from the Income type drop down box and record the fortnightly income amount, add notes, then select Add for each item
• If an income item has been coded in error select Remove beside the item
• Select Next
• Care recipient expenses page
• Record all applicable expense types by selecting from the drop down box options – the BDF will already be displaying
• See the Resources page for a list of allowable essential expenses
• If an allowable expense has been claimed but no evidence provided, the expense can be accepted up to the relevant monthly threshold limit (if applicable) for the expense
• After recording an item select Add
• If an expense has been Added in error, to remove from the calculator select Remove beside the item
• When all expenses have been added select Next
• Pharmaceuticals page
• Select the month from the drop down box
• Record the amount and a note, then select Add
• When up to 3 consecutive months have been added select Next
• Hardship details page
• Confirm the assessment outcome is as expected and the fee reduction is displaying in the correct hierarchy
• The RAD/DAP amount will prepopulate with the maximum hardship supplement
• For post-entry Residential care not low means select the Edit button and record the actual DAP amount the care recipient is liable to pay in the Ceiling fee column
• If there is an unallocated reduction amount that can be applied to the new DAP amount record the new amounts in the Adjusted reduction amount column
• then select Next
• Letter details page
• Confirm letter type matches assessment outcome and the start date is correct
• If outcome is reject, a reject reason will need to be added from the drop down box that will appear
• More than one reason can be selected and added
• then select Next
• Hardship summary details page
• Confirm all fields are correct
• Add Notes, then select Submit

• Post-entry reject
• Navigate to care recipients Letter summary
• Confirm HREJ – Hardship reject letter has created
• Preview the letter to confirm content is correct
• Pre-entry grant
• Navigate to care recipients Letter summary
• Confirm HPRE – Hardship pre-entry letter has created
• Preview the letter to confirm content is correct
• Post-entry grant
• Navigate to care recipients Letter summary
• Confirm HGRA – Hardship grant letter has created
• Preview the letter to confirm content is correct
• Navigate to Hardship summary page and confirm the hardship reduction for each fee type is correct
• Navigate to Fees and charges details and confirm the hardship reduction for each fee type is correct

If the content of the letter is incorrect as does not match the hardship assessment:

• Cancel the Queued letter
• Review the completed assessment by selecting the status link in Hardship assessment summary
• If there is an error in the hardship assessment it will need to be deleted and completed again
• If the assessment is correct escalate to ICT, complete and issue a manual letter

Granted financial hardship assessment:

• Complete the Customer First Progress of Claim DOC and any work items associated with the hardship claim
• Add Aged Care Financial Hardship Granted Fast Note. Include:
• hardship assistance start and end dates
• calculations
• assessment outcome
• use DOR as the date of grant
• Go to the Care recipient notes in ACSP care recipient record and add the same details

Is the hardship assistance grant for 3 years?

• Yes, see Table 5 > Step10 to set a 12 month review
• No, procedure ends here

Rejected financial hardship assessment:

• Complete the Customer First Progress of Claim DOC and any work items associated with the hardship claim
• Add Aged Care Financial Hardship Reject Fast Note. Include:
• calculations and outcome of assessment, or
• reason for hardship being rejected prior to calculation
• use DOR as the date of reject
• Go to the care recipient notes in ACSP care recipient record and add the same details
• Procedure sends here

The legacy Hardship subsidy calculator (link in Resources) will need to be used for the following scenarios:

• reassessment, cessation or revocation of hardships granted and coded prior to 8 February 2025
• care recipient is deceased
• care recipient had period of respite, and has now entered permanent residential care, or home care, and fees have set based on MTA coded for that entry, but there is no MTA for the earlier respite period
• pre 1 July 2014 care recipients

For the above care recipients, other than Pre 1 July 2014

• manually calculate the fortnightly income and expenses
• calculate the income as at the Hardship start date
• see Resources for a link to the Aged Care Fee Calculator

To complete the Hardship entitlement calculation:

• open the Hardship Subsidy Calculator tab
• in the Fortnightly Income section, add the care recipient's claimed assessable income types
• in the Fortnightly Expenses (Other) section, add the care recipient's claimed essential expenses:
• use the drop down boxes to select the types of expenses
• record details of 'Other' expenses in the Comments field
• the Fortnightly Hardship Amount section:
• displays the updated information
• includes the Hardship assistance amount
• select, Create Output PDF option to create a PDF document
• save PDF to the ‘Customer Information’ folder located on your team’s shared drive’. Do not save customer information to desktops or personal H drives
• upload PDF to the care recipient's Customer First record

For Pre 1 July 2014:

For calculations for dates earlier than 1 July 2014, use 1/07/2014 as the assessment date. Manually calculate and input the Basic Daily Fee information in the 'Fortnightly Hardship Amount' section. Accommodation costs are assessed separately for hardship reduction.

If assessing financial hardship for accommodation charge use the unrealisable assets amount in the pre 1 July 2014 accommodation calculator.

Note: to calculate the unrealisable assets amount, calculate assets at entry and minus assets at assessment date.

After determining the hardship grant for accommodation charge, calculate the BDF and Income Tested Fee (ITF) reduction based on assessment of current income and expenses (do not include accommodation charge in this calculation).

To complete the Hardship entitlement calculation:

• open the Hardship Subsidy Calculator tab
• Fortnightly Income: key the care recipient's claimed assessable income types
• Fortnightly Expenses (Other): key the care recipient's claimed essential expenses:
• use the dropdown menus to select the types of expenses
• record details of 'Other' expenses in the Comments field
• Fortnightly Hardship Amount:
• displays the updated information
• includes the Hardship assistance amount
• select, Create Output PDF option to create a PDF document
• save PDF to the Customer Information folder located on the team's shared drive. Do not save customer information to desktops or personal H drives
• upload PDF to the care recipient's Customer First record

Is the care recipient eligible for Hardship assistance?

• Yes, go to Step 2
• No, go to Step 4

Grant duration (end date)

Hardship assistance is granted for:

• 3 years, to be used when:
• a care recipient is in permanent residential care and their circumstances are not likely to change
• post 1 July 2014 scheme care recipients who have an asset that is unreasonable to sell due to joint ownership or a near relative living in the home
• pre 1 July 2014 scheme residential care recipients who no longer have funds to pay for an accommodation charge or bond
• 12 months, to be used when:
• Hardship is granted for home or residential respite care
• A temporary situation is causing hardship, such as being unable to sell a property
• Less than 12 months to be used when:
• Legal investigation/action to recoup misappropriated funds
• Structural damage repair due to natural disasters

Note: correct duration of grant period should be used to ensure hardship determinations are applied correctly and do not disadvantage care recipients.

When granting a hardship claim, the end date is determined by the grant duration minus 1. See the Frequently Asked Questions table on the Resources page for more examples.

Take note of the end date and review requirements, see Table 4 > Step 9 for more information on Reviews.

New pre-entry assessments

When a care recipient has not yet entered care, the end date is 120 days from the date the assessment is completed and is also the date the hardship pre-approval is valid until. Hardship is only coded when the care recipient starts care within this period. Procedure ends here.

Residential respite care

When a care recipient:

• is currently in residential respite care, the end date will be:
• 12 months from date of assessment if no end date recorded, or
• end date of residential respite care period if coded in ACSP
• has left residential respite care – end date is one day prior to departure date

The hardship assessment remains valid for original period (for example, 12 months). If a care recipient starts residential respite care again in the 12 months validity period, it can be coded without a new claim being lodged. If the residential respite care is with a different provider, a new letter to the service will be required.

For grants, go to Step 3.

For rejections, go to Step 4.

Finalise the hardship assessment:

• if is a reassessment of a current hardship grant, see Aged care financial hardship assistance – review/cease/revoke
• Home care, see Table 4 > Step 1
• Permanent residential or respite care, see Table 5 > Step 1

Make 2 genuine attempts to telephone the care recipient/nominee/authorised representative to advise the outcome:

• Document all attempts. See Advising verbally of an unfavourable decision (CLK)

Create a HREJ- Hardship reject letter using ACSP.

• In the care recipients ACSP record navigate to Hardship summary
• Select Create hardship letter
• Select Letter type HREJ- Hardship reject
• In the Start date field record date hardship claim lodged
• Select Care type
• Using drop down box select Rejection reason and select Add
• More than one reason can be selected and Added
• Select Submit
• Then select Yes
• Go to Letter summary to review the queued letter

Scan and upload the Hardship calculations, if completed, to Customer First as a PDF.

These will appear in the Document Tools tab. See Attaching electronic documents to a Centrelink customer's record using Document Tools in Customer First.

Complete the Customer First Progress of Claim DOC:

• Add a Fast Note. Select Auto Text, use Aged Care > Hardship > Aged Care Fin Hardship > Home/Res/RSP > Care REJECT using DOR as date of rejection. Include:
• calculation information and outcome of the assessment, or
• reason for hardship being rejected prior to calculation
• If home care, In ACMPS, open Notes tab and copy Reject Fast Note information
• If residential care or respite care add care recipient note in ACSP

Apply hardship assistance to aged care fees in the same order as below:

• Basic Daily Fee (BDF)
• Income Tested Care Fee (ITCF)

If only one fee is selected on the hardship claim:

• contact the care recipient or authorised third party by phone and discuss:
• the hardship grant, and
• the fees hardship is applied to
• if the contact is unsuccessful:
• only grant hardship to the selected fee
• create a Fast Note. Document if the contact was successful/unsuccessful

Apply fee reduction to reduce BDF. When the total hardship reduction is more than the BDF:

• BDF reduces to $0
• Apply the remainder to the income tested subsidy reduction (ITCF)
• Hardship reduction minus BDF = amount of reduction for ITCF

A care recipient must enter care before recording the hardship assessment in ACMPS.

Check the Assessments & Events tab Entry Details.

Has the care recipient started receiving home care?

• Yes, go to Step 2
• No, go to Step 3

Before adding or updating the hardship assessment details, check ACMPS under the Hardship & Income Suspension tab for an existing hardship assessment recorded.

If there are existing BDF and/or ITCF hardship details recorded:

• select Edit List in the relevant hardship record (Maintain Hardship BDF or Maintain Hardship ITF):
• If both fee types are recorded, end date each fee type separately
• select Correction and End date the record one day before the start date of the new assessment
• add notes in the Hardship Comments field
• select Save

To code hardship assistance for home care in ACMPS:

• go to the Hardship & Income Suspension tab
• select Edit List in the Maintain Hardship BDF and/or Maintain Hardship ITF field
• select Insert to create a new record line
• Hardship Type field: select from the dropdown menu the applicable fee reduction option:
• BDF as a partial supplement or BDF to $0
• ITF as a partial reduction or ITF to $0
• Hardship Amount field: if the hardship type is:
• BDF/ITF as a partial supplement/reduction, key the hardship assistance amount
• BDF to $0, do not key an amount. The system sets the BDF to $0 automatically
• if the hardship assistance grant reduces the ITCF to less than $1, ACMPS automatically sets the ITCF to $0
• add notes in the Hardship Comments field:
• The assessment creation date and time displays under Hardship Assessment
• key the Start Date field with the hardship assistance start date
• key the End Date field with the hardship assistance end date
• select Save to apply the hardship assistance

The hardship assistance displays in a separate line in the provider's payment statement:

• BDF hardship assistance displays as BDF Hardship
• ITCF hardship assistance displays as CSR Hardship

Create a manual letter using the Hardship Grant templates and upload to Aged Care Staff Portal (ACSP). See Aged care letters - creating manual letters on how to complete letter templates. To upload documents:

• Upload hardship manual letters to ACSP as a PDF using the following field details:
• Letter code*: Home Care Legacy
• Letter Description: update this field with code and letter type (that is, AC-HARDSHIP GRANT - CR)
• Upload Hardship Calculations (if completed) to Document Tools in Customer First as a PDF. See Attaching electronic documents to a Centrelink customer's record using Document Tools in Customer First

The letters advise:

• the fee amounts payable, for example, the maximum BDF payable is $10.75, and the care recipient needs to pay $1.75
• fees are subject to indexation

To record the decision:

• Complete the Customer First Progress of Claim DOC
• Add Aged Care Financial Hardship Granted Fast Note. Include:
• hardship assistance start and end dates
• calculations
• assessment outcome
• use DOR as the date of grant
• Select Notes in ACMPS, and add the same details
• Create a care recipient note in ACSP and add the same details

Is the hardship assistance grant for 3 years?

• Yes, see Table 4, Step 9 to set a 12 month review
• No, procedure ends here

Apply hardship assistance to aged care fees in the same order as below:

• Basic Daily Fee (BDF)
• Means Tested Care Fee (MTCF)
• Accommodation contribution (MTC)/daily accommodation payment (DAP)

End date any existing hardship supplements recorded, one day before the start date of the new hardship assessment.

Check ACSP for an existing hardship assessment:

• Locate care recipient record in ACSP
• Current and historical hardship located on Hardship > Hardship summary

To check for historical hardship, go to Customer First and check the Document List (DL) screen for previous hardship grants.

Hardship is only coded for periods that a care recipient is in care:

• Check the Care recipient summary to confirm start and end dates for all care types
• If coding hardship for a previous period/s in care, the end date will be coded as the day before departure

Does ACSP show that the care recipient has started respite or permanent residential care?

• Yes:
• Care recipient is currently in care
• Care recipient is claiming hardship for a previous period of care
• go to Step 2
• No:
• Pre-entry hardship has been granted
• Hardship cannot be coded until care starts
• go to Step 8

For BDF hardship, the care recipient contribution is the only field coded. This amount remains constant for the period of hardship. Consumer Price Index (CPI) changes that affect the BDF and the fee reduction amount will be applied automatically.

In ACSP:

• Locate care recipient record
• Go to Hardship > Hardship summary
• If there is a current BDF hardship coded that needs to be end dated:
• From the Summary screen, select Status field: Created/Updated
• View hardship screen will show details of current hardship
• To change, select Update
• On Update hardship screen, change the end date to the day prior to the new start date
• Select Update
• Select Go to hardship summary
• Select Register hardship and complete required fields:
• Hardship type: Basic Daily Fee
• Start date: hardship start date - must be on or after start date of care type
• End date: hardship end date
• Maximum hardship reduction: select yes if customer’s contribution is $0. Otherwise, no
• Care recipient contribution: if not maximum, code the amount of BDF that a care recipient is liable to pay
• Fee reduction amount: will be populated once coding completed and appear in a table on Hardship summary screen, including CPI changes
• Reason: select most appropriate from dropdown menu
• Additional notes: mandatory field for relevant details on the grant
• Select Submit
• Receipt will confirm successful coding, and table will show fee reduction amounts for each CPI date
• Error will show if hardship was not registered

To view a completed hardship assessment in ACSP including fee table and notes, go to Hardship summary and select hyperlink in Status column for current hardship.

Is this care recipient eligible for a further reduction of fees due to hardship?

• Yes, to code hardship for:
• ITF, MTCF or AC, go to Step 3
• Post 1 July 2014 RAD/DAP, go to Step 4
• Pre 1 July 2014 accommodation costs, go to Step 5
• No, care recipient is not eligible for further hardship reduction, go to Step 8

Make sure any income and asset updates have been made and an ad-hoc review completed to update fees, where required. See Aged care reviews - ad hoc reviews.

For ITF, MTCF and MTC fees:

• the care recipient contribution is coded from the start date and will not be updated after this. This amount will be used to populate fees on a hardship letter when they are issued in ACSP
• the fee reduction amount as at the start date is coded. This amount remains constant for the period of hardship unless hardship is reviewed
• if there are changes to circumstances that affect the fees a care recipient is liable to pay, the care recipient contribution will be adjusted
• current fees will show on Fees and charges > Fees and charges details

In ACSP:

• Go to Hardship > Hardship summary
• If there is a current ITF/MTCF or AC hardship coded that needs to be end dated
• From the Summary screen, select Status field: Created/Updated
• View hardship screen will show details of current hardship
• To change, select Update
• On Update hardship screen, change the end date to the day prior to the new start date
• Select Update
• Select Go to hardship summary
• Select Register hardship and complete required fields:
• Hardship type: select relevant fee type
• Start date: hardship start date
• End date: hardship end date
• Maximum hardship reduction: is always No
• Care recipient contribution: code this amount as at start date
• Fee reduction amount: code the fee reduction that applies for this fee type, this amount remains constant for period of hardship
• Reason: select most appropriate from dropdown menu
• Additional notes: mandatory field for relevant details on the grant
• Select Submit
• Receipt will confirm successful coding
• Error will show if hardship was not registered
• Repeat for any ITF, MTCF or AC hardship reduction

Is this care recipient eligible for a further reduction of fees due to hardship?

• Yes, to code hardship for:
• Post 1 July 2014 RAD/DAP, go to Step 4
• Pre 1 July 2014 accommodation costs, go to Step 7
• No, care recipient is not eligible for further hardship reduction, go to Step 8

For RAD/DAP hardship:

• The care recipient contribution coded will remain constant for the period of hardship
• The service is paid a hardship accommodation supplement from 1 August 2022
• This supplement is the maximum accommodation supplement payable for the service less any care recipient contribution
• Any RAD/DAP hardship granted for a period prior to 1 August 2022 is paid as a manual adjustment by Health Service Delivery Division (HSDD)

In ACSP, go to Hardship > Hardship summary and review current hardship coding.

Is the start date for this grant of RAD/DAP hardship, or date of effect for correction or change to RAD/DAP hardship prior to the 1 August 2022?

• Yes, go to Step 5
• No, go to Step 6

Any RAD/DAP hardship granted for a period prior to 1 August 2022 is paid as a manual adjustment by Health Service Delivery Division (HSDD).

Any subsequent review or correction to RAD/DAP hardship for period prior to 1 August 2022 will need to be completed as a manual adjustment.

For any period from 1 August 2022, hardship supplements will adjust automatically.

Example: Care recipient granted RAD/DAP hardship from 1 March 2022

• RAD/DAP hardship is coded in ACSP from 1 March 2022
• Supplement is paid manually to the service for period 1 March 2022 to 31 July 2022
• Supplements will be paid automatically from 1 August 2022
• A review of hardship changes the RAD/DAP hardship reduction amount
• Details from 1 March 2022 to 31 July 2022 need to be referred to HSDD for a manual adjustment to be paid
• ACSP updated coding will then adjust any RAD/DAP hardship from 1 August 2022 onwards

Send an LPS escalation

• Aged Care > Enquiry 1 Providers > Enquiry 2 Adjustments Resi Care > Enquiry 3 Hardship
• Provider team does manual adjustment
• Note escalation on care recipient's record in the relevant system (ACSP/ACMPS)

Go to Step 6.

Coding hardship reduction for a DAP in ACSP.

If there is a current RAD/DAP hardship coded that needs to be end dated:

• From the Summary screen, select Status field: Created/Updated
• View hardship screen will show details of current hardship
• To change, select Update
• On Update hardship screen, change the end date to the day prior to the new start date
• Select Update
• Select Go to hardship summary
• Select Register hardship and complete required fields:
• Hardship type: RAD/DAP Accommodation Payment - Post July 2014
• Start date: hardship start date
• End date: hardship end date
• Maximum hardship reduction: Select yes or no
• Care recipient contribution: if not maximum, code the amount of RAD DAP that a care recipient is liable to pay
• Fee reduction amount: code the fee reduction amount
• Reason: select most appropriate from dropdown menu
• Additional notes: mandatory field for relevant information on grant - include the text 'Hardship granted for RAD DAP. Full RAD DAP payment is $NN.NN per day'
• Select Submit
• Receipt will confirm successful coding
• Error will show if hardship was not registered

Go to Step 8.

In ACSP:

• Go to Hardship > Hardship summary
• If there is a current hardship coded that needs to be end dated:
• From the Summary screen, select Status field: Created/Updated
• View hardship screen will show details of current hardship
• To change, select Update
• On Update hardship screen, change the end date to the day prior to the new start date
• Select Update
• Select Go to hardship summary
• Select Register hardship and complete required fields:
• Hardship type: relevant accommodation cost for Pre July 2014 or Pre March 2008
• Start date: hardship start date
• End date: hardship end date
• Care recipient contribution: if not maximum, code the daily amount of accommodation cost that care recipient is liable to pay
• Fee reduction amount: will show once coding completed
• Reason: select most appropriate from dropdown menu
• Additional notes: mandatory field for relevant information on the grant
• Select Submit
• Receipt will confirm successful coding
• Error will show if hardship was not registered

Create a manual letter using the Hardship Grant templates and upload to Aged Care Staff Portal (ACSP) See Aged care letters - creating manual letters on how to complete letter templates.

To upload documents:

• Upload hardship manual letters to ACSP as a PDF, using the following field details:
• Letter code*: Resi Care Legacy
• Letter Description: update this field with code and letter type (that is, AC-HARDSHIP GRANT - CR)
• Upload Hardship Calculations (if completed) to Document Tools in Customer First as a PDF. See Attaching electronic documents to a Centrelink customer's record using Document Tools in Customer First

The letters advise:

• the care recipient contribution for all fee types
• the start and end dates that hardship is applied
• for pre-entry hardship assessments - care recipient/nominee must contact Services Australia when they do start care

Record decision in Customer First:

• Add the Fast Note - select Auto Text, use Aged Care > Hardship > AC Fin Hardship (relevant Grant doc) Aged Care Financial Hardship Granted and include:
• hardship assistance start and end dates
• calculations
• assessment outcome
• use DOR as date of grant
• Complete the Customer First Progress of Claim DOC

In ACSP - Care recipient > Care recipient notes:

• Select Add note
• Select Subject: Other
• In Note field, add a summary of the decision outcome including:
• all fees that have reduced
• amounts
• period of reduction (start and end dates)
• a note that manual letters have been sent
• Service Officer's username and logon
• Select Submit

Is the hardship grant for 3 years?

• Yes, go to Step 10
• No, procedure ends here

Annual reviews establish continuing eligibility for hardship assistance grants for 3 years. A review may also be set to confirm that details have not changed when deemed necessary.

When setting the review, include information on the action needed. For example, if a review is needed for an asset that is unable to be sold or borrowed against, include the property address to check if asset has been sold.

• Hardship assistance granted for 3 years should have an annual review to confirm continuing eligibility
• The review is set for 12 months from the assessment completion date
• For example, a review may be needed when an asset is assessed as unable to be sold or borrowed against because:
• the joint title holder is unwilling to sell a property
• a family member is living in the home

A care recipient can ask for a review of the hardship assistance before the hardship end date, for example if essential expenses have increased.

See, Aged care financial hardship assistance – review/cease/revoke for more information.

Set a 12-month review

In Customer First, create a manual review on the Review Registration (RVR) screen and complete the fields as follows:

• Service Reason: RCA
• Review Reason: HDP (Hardship Assessment Review)
• Due Date: 12 months from assessment date
• Source: INT
• Date of Receipt: today's date
• Notes: 'Check current financial circumstances of the care recipient to determine if they still meet eligibility for hardship assistance'
• Keyword: HRTG
• Workgroup: leave blank
• Position: leave blank
• Transfer to Region: leave blank

The review will mature on the Due Date coded in the RVR activity. Workload Management will allocate the review for manual action.

See, Aged care financial hardship assistance - review/cease/revoke.