Additional Child Care Subsidy (ACCS) (child wellbeing) review and appeals 007-19021400

Child care services seeking a review of decision of an ACCS (child wellbeing) application may complete a Review of a decision form and upload with supporting evidence for a new application request.

Where a child care service has lodged a Review of a decision form, the request at first instance should be treated as a request for reassessment of the original decision.

The Review of a decision form should be completed by the service with the following details:

• Service ID: The identification number for the child care service
• Enrolment ID: The identification number pertaining to the enrolment for the child
• Document ID: The identification number of the original application the service is requesting a review
• Start Date: The start date of the rejected application the service is requesting a review
• Date of the decision (if known): The date the service received notification of the original decision outcome
• Why do you believe the decision is incorrect? Field allowing the service to explain why the original decision should be reviewed
• Do you have new evidence to support the determination? Yes/No option with a prompt to upload evidence
• Requested by: Contact details of the requesting child care staff member

Note: where the provider or customer has lodged an appeal via the Internal Review/Explanation Script and the appeal has been allocated, see Table 5.

Paste the Child Customer Reference Number (CRN) details in the Filter Child CRN field and select Search icon.

Review the Child Wellbeing certificate and determination history for the child to identify any non-payment periods or rejected applications.

Note: if the childcare provider is seeking a review, though the full period has already been approved for ACCS (child wellbeing), see Table 3.

If the request for review is related to:

• certificate/determination with exceptional circumstances backdating, go to Step 3
• determinations, go to Step 4

From 16 October 2023, Services Australia are responsible for assessing all ACCS (child wellbeing) applications where the child care service has indicated that exceptional circumstances exist and has requested the start date be backdated up to 13 weeks. The Department of Education are responsible for assessing all exceptional circumstance applications lodged prior to 16 October 2023.

See Processing Additional Child Care Subsidy (ACCS) (child wellbeing) applications for criteria which meet the exceptional circumstances definition. Any circumstances outside of this criteria do not meet the definition for the purposes of backdating ACCS (child wellbeing) applications.

When assessing or reviewing:

• exceptional circumstance certificate applications:
• Assess if the evidence provided supports that the prescribed exceptional circumstances apply
• Services Australia are not required to assess if the evidence supports that the child meets the definition of ‘at risk’. This is the responsibility of the child care service issuing the certificate
• If the evidence does not demonstrate that exceptional circumstances exist to support the backdated start date, grant the certificate in line with standard 28 day backdating provisions
• exceptional circumstance determinations
• assess if the evidence provided supports if the child meets the ‘at risk’ criteria and if prescribed exceptional circumstances apply
• If the child meets the ‘at risk’ criteria, however the evidence does not demonstrate that exceptional circumstances exist to support the backdated start date, grant the determination in line with standard 28 day backdating provisions

If the review relates to:

• one of the above circumstances, Go to step 4
• the start date see Table 2

Check the notes relating to the previous application under review. Notes can be searched using the child CRN or Document ID numbers

• select the Notes icon
• filter the Text field by clicking on Text which will drop down a filter box
• in the Filter box enter the Document ID or child CRN (try searching the CRN with and without gaps for example, XXXXXXXXXA or XXX XXX XXXA) then press [Enter]
• locate the note relevant to the previous application

Where the review relates to:

• the start date of the approved application, see Table 2
• a rejected application, go to Step 5

Determine whether the supporting evidence now meets evidence requirements. See Processing Additional Child Care Subsidy (ACCS) (child wellbeing) determinations for more information regarding evidence requirements.

If the application was rejected due to minimum basic evidence requirements and new evidence is uploaded, and the evidence now cumulatively meets requirements, staff can retrospectively review the application.

Example

An application for the period 10/09/2018 - 09/12/2018 was rejected as the court order was dated more than 6 months in the past.

Provider lodged a new determination for dates 08/10/2018 - 06/01/2019 (due to system backdating limitations) and uploaded an ACCS Request for review form, asking for the assessment from 10/09/2018 to be reviewed. The provider also uploaded a letter dated 10/11/2018 from state based child protection stating that the court order remains in force and the child continues to be in foster care.

Cumulatively, the evidence now meets minimum basic requirements; therefore, the original assessment and any additional evidence can be reviewed favourably and retrospectively applied.

Does the evidence provided now meet the ACCS (child wellbeing) evidence requirements?

• Yes, go to Step 6
• No, the reassessment is to be rejected as the evidence does not meet minimum requirements. See Step 3 in Table 3

Under Family Assistance Law, the time limit for seeking a review of an original decision relating to Child Care Subsidy or Additional Child Care Subsidy is 13 weeks after the person is notified of the decision. This is unless special circumstances prevented the person from applying for a review.

The time taken to deliver the notice must be taken into account when deciding if a person has requested a review within 13 weeks of being given the notice. See Customer initiated review of decision.

Determine if the review was requested within 13 weeks of being notified of the original decision (e.g. check dates on the rejection letters issued, or notes on the record).

Was the review made within 13 weeks of being notified of the original decision?

• Yes, go to Step 7
• No, the reassessment is to be rejected. See Step 3 in Table 3

This step applies to determination applications only. Services Australia are not required to assess if the child meets the assessment of at risk for certificate applications. For more information, see Processing Additional Child Care Subsidy ACCS (child wellbeing) applications.

Does the evidence support the assessment of the child being at risk?

• Yes, see Step 1 in Table 3
• No, the reassessment is to be rejected as the evidence does not support the child being assessed as at risk. See Step 3 in Table 3

The provider has indicated in the ACCS (child wellbeing) Request for review form that they are requesting reassessment to the start date of an approved certificate or determination.

If the provider is requesting the start date to apply from:

• a later date than what was originally assessed, go to Step 2
• an earlier date than what was originally assessed, go to Step 3

Where a service requests the start date of an approved application to be applied from a later date than what was originally assessed, if favourable Edit the approved start date in accordance with Processing Additional Child Care Subsidy (ACCS) (child wellbeing) applications.

In the event that a service lodged a new determination application with the review request or if unfavourable:

• the new determination is to be rejected with the reason 'Evidence does not demonstrate child at risk'
• create notes on the service record

When assessing an ACCS (child wellbeing) application the Service Officer may deem it appropriate to change the start date of the assessment. These reasons may include:

• Determinations – the evidence does not support that the child meets the definition of ‘at risk’ from the requested start date, but does demonstrate from a later date
• Determinations/certificates – the evidence does not demonstrate that exceptional circumstances exist to backdate the commencement date of the certificate/determination more than 28 days and up to 13 weeks

To check if the start date of the application was changed:

• go to the Child Wellbeing (CWB) screen, select the original certificate or determination twisty
• Applications lodged on or after 16 October 2023 will display a new requested certificate/determination start date field. This shows the date that the service requested as part of their child wellbeing application.
• The Certificate/Determination Start Date shows the date that the Service Officer assessed as the relevant start date

Process the new application

Where a Request for review is unfavourable as a reassessment, the adverse decision is to be taken as a request for formal appeal. See Table 4.

Select the provisional transaction and edit the date and week fields to match the previously rejected determination.

• Select Edit on the Certificate/Determination activity. The Change Certificate/Determination screen displays
• Edit the Start Date to match the exact same start date of the previously rejected application
• Edit the Risk Weeks to match the exact same number of weeks as the previously rejected application
• Backdate: Where the start date of the application is more than 28 days before the application is processed, select Yes from the dropdown menu. Enter 'Review outcome outside 28 days' in the Reason field.
• Go to the Status field and select Approved from the drop down list
• Select Save to finalise the assessment
• Enter date and source information. Select Submit to finalise the activity

For more information, see Processing Additional Child Care Subsidy (ACCS) (child wellbeing) applications.

Go to Step 2.

Record details of the reassessment by selecting the Notes icon:

• select Add case note
• copy and paste the following into the Text field:
• REASSESSMENT OF ORIGINAL DETERMINATION/CERTIFICATE - APPROVED
  Document ID:
  Transaction ID:
  Original Document ID:
  Child CRN and Name:
  Assessment Type: Initial Determination/Subsequent Determination
  Outcome of reassessment: Granted
  Reassessment Reason: [Reason why the reassessment is favourable]
  Grant weeks: [including reason for reducing requested weeks if appropriate]
  Evidence to support Grant meets requirements: Yes/No. If No, include details why evidence is not sufficient
  Other information relevant to assessment: Assessment made in accordance with FA Act S85CF (Variation and revocation of determinations)
• select Save to finalise the Case Note

Procedure ends here.

Select the provisional transaction and edit the date and week fields to match the original application. The reassessment should completely duplicate the previously rejected application.

• Select Edit on the Certificate/Determination activity. The Change Certificate/Determination screen displays
• Edit the Start Date to match the exact same start date of the previously rejected application
• Edit the Risk Weeks to match the exact same number of weeks as the previously rejected application
• Backdate: Where the start date of the application is more than 28 days before the application is processed, select Yes from the dropdown menu. Enter 'Review outcome outside 28 days' in the Reason field
• Go to the Status field and select Rejected from the drop down list
• Select the appropriate rejection reason from the list
• ACCS Cap reached (Services Australia have been instructed not to reject determinations for this reason until further notice)
• evidence does not demonstrate child at risk
• evidence does not meet minimum requirements
• no certificate lodged (Services Australia have been instructed not to reject determinations for this reason until further notice)
• no evidence provided for determination
• evidence more than 6 months old
• Select Save to finalise the assessment
• Enter date and source information. Select Submit to finalise the activity

Go to Step 4.

Record details of the reassessment by selecting the Notes icon:

• Select Add case note
• Copy and paste the following into the Text field:
• REASSESSMENT OF ORIGINAL CERTIFICATE/DETERMINATION - REMAINS REJECTED
  Document ID:
  Original Document ID:
  Child CRN and Name:
  Assessment Type: Initial Determination/Subsequent Determination/Certificate
  Outcome of reassessment: Rejected
  Reassessment Reason: [Reason why the reassessment is unfavourable]
  Grant weeks: [including reason for reducing requested requests if appropriate]
  Evidence to support Grant meets requirements: Yes/No. If No, include details why evidence is not sufficient
  Other information relevant to assessment: Assessment made in accordance with FA Act S85CE (Determination for ACCS (child wellbeing)
• Select Save to finalise the Case Note

Where a Request for review is unfavourable as a reassessment, the adverse decision is to be taken as a request for formal appeal. See Table 4.

ACCS (child wellbeing) Review of decision forms are to be treated firstly as a request for reassessment of entitlement.

If a reassessment of ACCS (child wellbeing) has been conducted and the outcome is still unfavourable, the provider is taken to have engaged their appeal rights. Therefore, the request for formal review is to be recorded via the Internal Review/Explanation script in Customer Record. There is no requirement to record an explanation of decision before referring for a formal review.

The following details from the Organisation Customer Reference Number (CRN) should be noted prior to commencing the script:

• Service ID
• Document ID(s) of determinations/certificates relating to the review
• Date of decision

Navigate to the Enrolments icon and use the Child Name, Child CRN and Enrolment ID filter in the Enrolments List to locate the relevant child.

Is the enrolment Type recorded as a Complying Written Agreement (CWA) for the relevant child?

• Yes, the enrolment Type is CWA. Go to Step 4
• No, the enrolment Type is ACCS or recorded as a type other than CWA. Go to Step 3

Provider reviews for ACCS enrolment types will need to be referred to the Level 2 Helpdesk.

Include the following information in the Enquiry Description field:

• ACCS (child wellbeing) appeal – ACCS enrolment type
• Service CRN
• Document ID
• Child CRN
• Any relevant information including reason for rejection

Highlight the enrolment line to populate Enrolment Notices and locate the enrolment relating to the original decision.

Copy the Individual CRN and enter the primary carer record in Customer Record.

Is there an existing formal review relating to the ACCS (child wellbeing) assessment?

• Yes, the existing appeal will be allocated to relevant staff for review. Procedure ends here
• No, go to Step 5

Provider initiated formal reviews will need to be recorded on the primary carer's record:

• Select the Script Selector in Customer Record
• Select Internal Review/Explanation Script and follow the script prompts
• On the Select Path screen, ensure the radio button for 'I am registering for a new application for formal review' is selected
• Where the question 'Why is the customer applying for a formal review of the decision?' presents, record the following reason:
• Provider is seeking review of Document ID/s XXXXXXXXXX (insert Document ID). Please refer to Note on Provider ID 19000XXXXX (insert Provider ID)
• Finalise the script

Any sensitive information pertaining to the assessment is to be recorded on the provider record. Navigate to the Service ID and record the following in Notes:

• REVIEW OF DECISION - REQUEST PENDING
  Parent CRN: XXXXXXXXXA
  Appeal number: APL SXXXX
  Document ID/s:
  Provider is seeking a review of decision relating to CWB certificate/determination. The application was rejected as (select most appropriate):
• Evidence does not demonstrate child at risk (determinations only)
• Evidence does not meet minimum requirements
• No certificate lodged (Services Australia have been instructed not to reject determinations for this reason until further notice)
• No evidence provided for determination
• Evidence more than 6 months old
• No exceptional circumstance to backdate
• Additional information:
• Name and contact details for personnel requesting review:
• Reason for review: (include full reason why the provider is requesting a review. Note: if the provider has lodged an enquiry via the ACCS Review Mailbox, include any additional reasons not listed on the Review of Decision form)

As ACCS (child wellbeing) decisions affect both the child care service and the customer, both parties have a right of review and can appeal a decision regarding an ACCS (child wellbeing) determination. A customer may:

• request an explanation of decision by an ACCS SME, or
• apply for a formal review of decision

Has the customer lodged an application for a formal review?

• Yes, an Authorised Review Officer (ARO) will review the decision and try to contact the customer. For more details, see Reviews by an Authorised Review Officer ARO. Procedure ends here
• No, a request for explanation has been lodged see SME explanations, ARO referrals and implementing ARO decisions

Note: any other action, including withdrawal of an explanation or application for a formal review, explanation of decision, allocation of ARO further action required work item, see SME explanations, ARO referrals and implementing ARO decisions.

Services Australia are responsible for the assessment of all exceptional circumstance certificate/determination applications lodged on or after 16 October 2023.

This includes if the application lodged on or after 16 October 2023 is a request for reconsideration of a previously rejected exceptional circumstance application, made by the Department of Education.

• Check the notes relating to the previous determination under review.
• If the Original determination was assessed by the Department of Education, do not transfer the work item to the Department of Education.
• Check the case notes to determine the background and reason for the decision
• Assess the review/application in accordance with Processing Additional Child Care Subsidy (ACCS) (child wellbeing) applications

Services Australia are responsible for assessing all applications lodged on or after 16 October 2023.

Procedure ends here.