Integrated care - Managing issues after care determination 277-03060080

If a customer contacts Services Australia on the same day that the care determination is made and the new information will change the outcome, it may be possible to reconsider the decision.

The data transfer can occur for care determinations where the pended care record is changed from Pended to Accepted, even when eligibility has not yet been run.

Delete the accepted care record/s and cancel letters in Cuba and Customer First immediately. This prevents data transfer or customer letters issuing until the reconsideration is finalised. A decision becomes final when communicated in writing to the relevant parties.

In Cuba:

• delete the accepted care record and all letters generated by the care change
• run eligibility (make sure the assessment returns to what it was before the care was accepted)
• pend the care

In Customer First:

• delete the accepted care record and all letters generated by the care change
• reverse any debt or arrears that have been created due to the accepted care that is now being reconsidered

Ask the customer to provide further supporting evidence to the agency as soon as possible. Set a reasonable due date in line with the customer’s circumstances.

Tell the customer they can use self service to provide information/evidence and manage other business with the agency. Help the customer to transition to self service unless the customer is not eligible or it is deemed inappropriate.

If a customer (or party affected by the care decision) contacts Services Australia after the care decision has been made and:

• asks if their child support and family assistance assessments have been updated with the care decision, go to Step 2
• does not agree with the care determination or wants a review of a decision, go to Table 2

Note: if a customer lodged a Family Tax Benefit (instalment and/or lump sum) claim, finalise the claim. See Processing standalone and combined claims for family assistance and/or Paid Parental Leave Scheme Payments.

For mutual customers, data exchange will occur overnight to transfer the information to the customer’s relevant assessments. Check the case/record the day after the care determination has been processed to make sure the change in care data has been exchanged and shows correctly on the customers’ relevant assessments.

Check customer records to make sure the care update details and data has transferred correctly:

• check all past and current care determinations have been finalised and prior care periods aligned after 1 July 2010 (after 3 March 2011 for WA Ex-nuptial cases)
• review the customers' relevant child support and family assistance assessments, and
• identify if updates have caused intended impacts

For care determinations finalised in:

• Cuba, check the Centrelink record of each party and make sure the:
• care details have populated correctly, and
• event date is the same
• Customer First, open the Care and External Information Care windows in Cuba for each customer and check:
• reference numbers
• child’s name and date of birth
• child’s gender
• date of notification
• date of event
• type of care
• percentage of care for the mutual customer
• additional carers indicator (if applicable)
• disputed care indicator (if applicable)
• objection/review indicator (if applicable)
• relationship of the customer

Make sure the care information displays correctly in the case liability rates.

If the data exchange has:

• transferred correctly, go to Step 5
• resulted in:
• Centrelink care intrays in Cuba, go to Step 3
• Alignment of Care Manual Follow Up (MFU) activities in Customer First, go to Step 4

In the event Centrelink care-related information for a mutual customer does not transfer or apply automatically to the relevant Cuba record/s, a care intray generates indicating further action is required.

If a care intray generates, action the care intray. Each data transfer will raise only one intray, make sure all relevant party records are checked. Otherwise go to Step 5.

For Customer First, an MFU activity may generate on the relevant party or child records indicating that child related information from Cuba could not be automatically applied and further action is required. Action relevant MFU activities on the customer’s record.

Note: always add Disagree or Disputed keywords to any work item, Fast Note or workflow before actioning.

Go to Step 5.

Review the effects the change in care has had on all relevant party assessments and entitlements.

For Child Support, check for:

• a payee overpayment
• a retrospective liability increase for the payer
• changes to prescribed non-agency payment (NAP)
• the customers’ child support case reversing

For Centrelink, check for:

• overpayment
• rate reduction/s of FTB and/or other Centrelink payment/s
• cancellation of FTB and/or other Centrelink payment/s
• arrears payment/s

If a customer has at least regular care of the child, are not Family Tax Benefit current (FTB/CUR), and they have not lodged a claim issue a Q369 letter - Invite to claim for Family Assistance and Parental Leave Pay

Refer outstanding collection or common activities to the owning business area after finalisation of the care determination.

One genuine attempt to contact must be made with customer/s after making a care determination where

• customer/s request post decision contact, or
• there were unexpected outcomes when processing the care change

An “unexpected outcome” could be, but is not limited to:

• system issues preventing care from being reflected correctly in Cuba and/or Customer First
• Changes to Child Support assessment or Centrelink payments that differ to what has been discussed with the customer/s

IMPORTANT: If there are concerns about the customer’s safety or they are experiencing vulnerability, staff should use their discretion and make phone contact to offer appropriate referrals and support. See Identifying customer vulnerability and risk issues.

If a customer (or party to the care decision) contacts the agency in response to the care determination letter about:

• being dissatisfied with the care determination and believes the agency has made a mistake or applied the law incorrectly, go to Step 2
• a review of a care determination or objection they have lodged, go to Step 3

Ask the customer why they are dissatisfied with the care determination. Identify the reasons and try to resolve the issue by explaining how the decision was made.

Note: if one party involved in the care decision is a mutual customer, a review of the decision can be requested through Child Support Objections or Centrelink review and appeal process. If the party requesting the review is a non-Centrelink customer, and the care decision has no effect under the Family Assistance law (neither party is claiming family assistance or allowances), Child Support must review the decision. See Internal review process for care decisions for procedures to follow.

Depending on the customer’s specific issues, see Customer Referral Guidelines (CRG) - Child Support for:

• a referral to an external service provider
• a transfer to a specialised Child Support Operations business area
• a transfer to Centrelink for out of scope activities
• escalation through the Complaints process
• lodgement of an objection of a Child Support care decision, or application for a forma, review of a Centrelink care decision

If the customer wants to pursue an objection or apply for a formal review of the care decision, they can do so verbally with either:

• Centrelink, see Request for an explanation or application for a formal review, or
• Child Support, transfer to the Objections team

If there has been another care change since the date of event of the care determination that was made, treat this as a new change in care notification. See Integrated care - Notification and recording of change in care.

If the customer states the care percentage recorded on their assessment is different to the care determination letter, this may indicate a keying error has occurred:

• for Child Support seek technical support to consider correcting the error to amend the care percentage, see Technical support in Child Support
• for Centrelink, if the care percentage on the FTB Shared Care (FSC) screen is different to that stated on the decision letter, check the decision document:
• if the customer has received a FTB rate letter that states a different care percentage to that which is on the FSC screen, check the Assessment Explanation (AX) screen, the actual percentage of care may be different to the percentage of FTB paid. For example, an actual care percentage of 35% equals to 25% FTB entitlement. See Assessment of shared care arrangements for Family Tax Benefit (FTB)
• if there appears to be an error in the keying, correct the error

Document the discussion:

• for Cuba, record in the Care window notepad
• for Customer First, use the appropriate File Note

If a customer contacts the agency about a review, check that the Appeal indicator has a status of ‘Y’ and that a review is in progress:

• for Cuba, view this in the External Information Care window
• for Customer First, view this on the Child's Objection Appeal Details (!COAD) screen. When the application is recorded, a document will be updated to reflect the reason for the review with reference to the original decision

Open the Objections window in Cuba to check if there is a Child Support objection in progress. If there is no objection in progress, the review is being managed by Centrelink.

Note: if the Appeal Related indicator has a status of 'Y' and the customer states that they have not lodged a review, the other party may have initiated this. Check their record for progress of the review, and provide information to the customer as relevant. Create a work item for the appropriate Centrelink team to discuss the review in progress.

For reviews lodged with:

• Child Support, transfer the customer to the appropriate team to discuss the review in progress
• Centrelink, advise the customer an Authorised Review Officer will be in contact to discuss the review in progress

Centrelink will make a formal decision for all parties affected by a care decision. Review all relevant customer records and assist them to manage their options.

Document the discussion:

• for Cuba, record in the Care window notepad
• for Customer First, use appropriate File Note