Customer is separated from their partner – temporarily or due to respite care 106-07120040

If a Service Officer

• receives a new claim work item which indicates the customer and their partner are unable to live together due to respite care, go to Step 2
• receives a work item about a request to provide supporting evidence or supporting evidence has been returned, go to Step 9
• receives a work item about reviewing the customer's respite care status, go to Step 11

If the customer contacts and is advising that:

• they or their partner have entered respite care, go to Step 5
• they or their partner have returned home from respite care, see Temporary change of address to an aged care home for respite care
• they or their partner are unable to reside in their own home due to illness, see Assessment of circumstances for a couple separated due to illness
• they or their partner will enter care at a future date, go to Step 8

The following respite care relationship qualifier (RQ) codes are being automatically applied by the system when the customer has advised in their online or Assisted Customer Claim (ACC) they are unable to live with their partner due to respite care:

• REC (In Respite Care)
• REP (Partner in Respite Care)

Check the relationship information in the claim and the Marital Status (MS) screen for any RQ codes. For further information, see Relationship Qualifier codes automatically applied on the Resources page.

Is a REC or REP RQ code present on the customer’s MS screen?

• Yes, go to Step 3
• No, go to Step 5

Check the Document List (DL) screen in Customer First or Notes screen in Process Direct in both the customer’s and their partner’s records to determine if a respite care couple assessment has occurred in the last 13 weeks.

Has a decision been made in the last 13 weeks that the customer and partner are a respite care couple?

• Yes, go to Step 4
• No, go to Step 5

Review the claim details as well as any DOCs or Notes on both the customer’s and partner’s records to determine if there has been a change in their circumstances since the last respite care couple assessment was completed.

Have there been any changes of circumstances in the last 13 weeks that may impact on whether the customer and partner can be considered a respite care couple?

• Yes, a new assessment will be required, go to Step 5
• No, check the date of event, marital status and RQ code recorded on the Marital Status (MS) screen are correct, if not, update the MS screen for both the customer and partner, procedure ends here

Is the change in accommodation permanent?

• Yes, as approved respite care is generally set at a maximum of 63 days per financial year (noting that additional periods of 21 days may be approved where the Aged Care Assessment Team considers extra time is needed), customers who will be permanently living apart cannot be considered a respite care couple. However, they may be a member of an illness-separated couple and entitled to the higher single rate of payment. See Assessment of circumstances for a couple separated due to illness
• No, go to Step 6

A couple is considered to be a respite care couple where:

• one of the members has entered approved respite care, and
• the member who has entered the approved respite care has remained, or is likely to remain, in that care for at least 14 consecutive days

Couples that do not meet the definition of a respite care couple may be in a care situation.

Aspects to consider when assessing if the customer is a member of a respite care couple:

• Approved respite care is care provided in a nursing home or hostel that receives a Commonwealth subsidy
• A statement of admission from a nursing home or hostel can be accepted as verification of the length of admission as long as it states the date of admission and anticipated length of stay
  Note: all nursing homes and hostels that receive a Commonwealth subsidy for the provision of respite care are required to issue each recipient/applicant with a statement on the day of admission setting out details of the anticipated length of admission
• The customer's and partner's record, including scanned documents, should be checked to determine if verification has already been provided
• Aged Care staff can access the Aged Care Staff Portal (ACSP) - Customer Summary to confirm details of respite care including start and end dates
• Non Aged Care staff can contact the Aged Care (RCA) team to confirm details in ACSP if needed. The Resources page has links to Office Locator and contact details
• If verification is not available on the customer's record, contact must be made with the nursing home/hostel to confirm/verify circumstances. The nursing home/ hostel must confirm:
• the date of admission and discharge, and
• that the nursing home/hostel will receive a Commonwealth respite care supplement

Note: information contained in the ACSP is protected under the Aged Care Act 1997, only staff at the APS4 level or above are able to use this information for social security purposes.

Is there sufficient information to assess the respite care?

• Yes, go to Step 12
• No, including where contact with the nursing home has not been successful, go to Step 7

As verification has not been provided and contact with the nursing home/hostel has not been successful, the supporting evidence will need to be requested from the customer. That is, the customer must provide a statement of admission from a nursing home or hostel as evidence, or they cannot be considered a respite couple.

See Requesting information (CLK) for guidance about the most appropriate process to request documentation. For example, it may be appropriate to request information verbally.

Procedure ends here until evidence is returned or the review activity matures.

If the customer advises they or their partner will enter respite care at a future date:

• do not make any changes on the Marital Status (MS) screen
• tell the customer of the general 14 day notification provisions, and
• they will need to contact the agency as soon as the change occurs, and
• provide a statement of admission as evidence
• tell the customer that if the change results in an increase to payment rate, the increase is effective from the date Centrelink is advised of the change. This includes where the customer notifies of the change within 14 days. See Notification Handler (NOHL) for further information
• record the discussion using a Fast Note

Procedure ends here.

When the work item has presented, check the customer's record to confirm whether supporting evidence has been returned.

Has supporting evidence been returned?

• Yes, and
• the customer is to be assessed as a member of a respite care couple, go to Step 12
• the customer is not to be assessed as a member of a respite care couple, go to Step 10
• No, go to Step 10

If there is no supporting evidence to grant the respite care rate, the customer is to continue to be paid at the partnered rate.

The Decision Maker (DM) must explain the decision to the customer. Make genuine attempts to contact the customer by phone. See Advising verbally of an unfavourable decision.

After telling the customer or making a genuine attempt to contact them, if the customer:

• is currently receiving a payment:
• record the decision using a Fast Note
• finalise all associated activities and DOCs on the Activity List (AL) screen
• in Customer First, issue a manual Respite care couple – unfavourable (Q888) letter to advise the customer in writing of the decision
• if the customer’s partner is a current Centrelink customer, also issue a letter to the partner from their own record
• if a correspondence nominee exists, ensure a copy of the letter is issued to the appointed nominee. See Nominees
• has a new claim that can be finalised:
• finalise the claim and document the outcome of the respite couple assessment in the claim finalisation DOC
• there is no requirement to issue a decision letter to the customer when the assessment is part of a new claim. The new claim grant/reject letter forms part of the respite care couple decision
• procedure ends here
• has a new claim that cannot be finalised (further documentation required):
• request the required supporting documentation, see Requesting information (CLK)
• annotate the progress of claim DOC/Note with the outcome of the assessment, procedure ends here

Procedure ends here.

When the review activity for the expected date of return from respite care has matured, check the customer/partner's record to determine the current circumstances.

Go to the Address Details (ADS) screen, if the Temp address is:

• equal to the system date or earlier, the customer/partner has returned home from respite care. For details on updating the Marital Status (MS) screen to end the relationship qualifier code, see Temporary change of address to an aged care home for respite care
• in Customer First, issue a manual Respite care couple – unfavourable (Q888) letter to advise the customer in writing of the decision
  Note: there is no requirement to issue a decision letter to the customer when the assessment is part of a new claim. The new claim grant/reject letter forms part of the respite care couple decision
• if the customer’s partner is a current Centrelink customer, also issue a letter to the partner from their own record
• if a correspondence nominee exists, ensure a copy of the letter is issued to the appointed nominee. See Nominees
• procedure ends here
• a future date, the customer/partner are still in respite care. If verification of the additional time in care:
• has been provided, resubmit the review to fall due on the customer's/partner's revised date of discharge.
  Procedure ends here
• has not been provided, contact the nursing home to confirm the date of discharge and that the aged care home will receive a Commonwealth respite care supplement for the customer. Resubmit the review to fall due on the customer's/partner's revised date of discharge.
  Procedure ends here

If the customer:

• is currently receiving a payment, go to Step 13
• has lodged a new claim for payment:
• if a RQ code has been provisionally applied by the system ensure the date of event, marital status and RQ code are correct, update the Marital Status (MS) screen if details are incorrect, go to Step 14
• if a RQ code has not been provisionally applied by the system, go to Step 13

When it has been established the customer and their partner are a respite care couple, Service Officers must update the MS screen in Customer First (CF) with the appropriate relationship qualifier code. This will make sure the customer's entitlements are treated differently to their recorded relationship status, that is, paid the higher single rate of payment.

Note: if the updates are part of an online claim, the updates need to be made in CF prior to processing the claim in Process Direct (PD). After the updates have been made in CF, the claim information in PD will need to be regenerated prior to selecting Process.

Update the following fields on the MS screen in Customer First:

• Event Date: field, record the date the customer/partner entered respite care
• Marital Status: field will remain as MAR, REG or DEF
• PPE Cust and PPE Ptnr: fields, update as required
• Qualifier Code: field, enter the appropriate relationship qualifier code for the customer's circumstances:
• 'In Respite Care' - where the customer is in respite care
• 'Ptnr in Respite Care' - where the partner is in respite care
• Source: field, enter the source of the information
• DOR: field, enter the date of receipt
• do not complete the activity

Go to Step 14.

Within the same activity as the MS update, go to the Address Details (AD) screen and complete the following fields:

• Address Type: field, select Temporary and continue
• Address Start Date: field, code the date the customer/partner went into respite care
• Address End Date: field, code the date the customer/partner expects to return home
• Address Line 1, 2, & 3: field, code the address details of the nursing home/hostel
• Postcode: field, enter the postcode
• Country: field, code the country
• Make Partner's Address the Same: field code
• 'Y' if both members of the couple have entered respite care, or
• 'N' if only one member of the couple has entered respite care
• Is Rent Assistance being claimed: field, code 'N'
• Is this address in a Remote Area: field, 'Y' or 'N'
• Should this address be used for all mail: field 'Y' or 'N'
• Go to the Assessment Results (AR) screen and finalise the activity

Note: customers who are paying rent for their principal home and were receiving RA before entering respite care can continue to receive RA for the first 52 days they are in respite care. The Accommodation Circumstances (AC) screen will automatically insert a new line based on the single relationship qualifier coded on the MS screen. Accommodation details do not need re-verification in the instance of temporary respite care. See Rent Assistance (RA) for care receivers.

If the customer:

• is currently receiving a payment:
• record details using a Fast Note
• in Customer First, issue a Respite care couple – favourable (Q888) letter to advise the customer in writing of the decision
• if the customer’s partner is a current Centrelink customer, also issue a letter to the partner from their own record
• if a correspondence nominee exists, ensure a copy of the letter is issued to the appointed nominee. See Nominees
• has a new claim that can be finalised:
• the claim information on the Transaction Summary (TS) screen in PD will need to be regenerated before the claim is processed
• select Process, update any required information and finalise the claim
• document the outcome of the respite care couple assessment in the claim finalisation note
• there is no requirement to issue a decision letter to the customer when the assessment is part of a new claim. The new claim grant/reject letter forms part of the respite care couple decision
• has a new claim that cannot be finalised (further documentation required):
• if the claim is being processed in PD, the claim information on the Transaction Summary (TS) screen will need to be regenerated before the claim is processed
• annotate the Progress of Claim Note with the outcome of the respite care couple assessment
• if further documentation is required but has not been requested, see Requesting information (CLK)
• if the claim is being processed in PD, the system will automatically hold the claim for the appropriate amount of time
• if the claim is not being processed in PD, ensure claim is placed on hold for the appropriate amount of time

Go to Step 16.

The couple will no longer be considered a respite care couple once they (customer or partner) are discharged from respite care. To ensure the customer and partner are paid the correct rate the relationship qualifier code should be removed from the Marital Status (MS) screen from the date of discharge. To ensure the MS screen is updated and the relationship qualifier code is removed a manual review is required to be set for the current discharge date.

In Customer First, create a manual review:

• Go to the Review Registration (RVR) screen and complete the following fields:
• Service Reason: customer’s payment type
• Review Reason: MAN (Manual Entitlement Assessment)
• Due Date: date of discharge
• Source: INT
• Date of Receipt: today's date
• Notes: 'Customer/partner entered temporary respite care xx/xx/xxxx. Check discharge from respite care and return to OB 106-07120040 to action.'
• Keywords: ILLSEP
• 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
• If the customer is a carer in receipt of carer payment and/or Carer Allowance, respite absences from care must be recorded on the Absences Details (ABSN) screen. See Temporary Cessation of Care (respite) provisions for Carer Payment (CP) and Carer Allowance (CA)

Procedure ends here.

If a Service Officer receives a work item about reviewing the customer’s temporarily separated status, go to Step 7.

If the customer contacts Services Australia to say they or their partner:

• have temporarily separated, go to Step 2
• have returned home from a temporary separation, go to Step 7
• will temporarily separate at a future date, go to Step 5

Has the customer or their partner moved?

• Yes, and the move is:
• permanent, or the customer is in a ‘trial’ separation, see Change in relationship from partnered to single. Procedure ends here
• temporary, go to Step 3
• No, the customer is not temporarily separated. Consider if a ‘separated under one roof’ assessment is required. See Member of a Couple (MoC) and Separated under one roof (SUOR) assessments. Procedure ends here

For a current customer, check the Payment Summary (PS) screen.

Qualifying add-ons relevant to this process are:

• Rent Assistance (RA)
• Telephone Allowance (TAL)
• Utilities Allowance (UA)

Is the customer or their partner in receipt of or eligible (as part of their claim) for RA, TAL and/or UA?

• Yes, go to Step 4
• No, there is no impact to the customer’s entitlements. Procedure ends here

Is the customer:

• a member of a couple
• living separately and apart from their partner, but not on a permanent or indefinite basis, and
• not part of an illness separated or a respite care couple?

They must be living apart for reasons largely out of their control or where it is reasonable, given their circumstances.

The Resources page has examples of situations where a customer is temporarily separated.

• Yes, go to Step 8
• No, go to Step 6

If the customer tells the agency they or their partner will temporarily separate at a future date:

• do not make any changes on the Marital Status (MS) screen
• tell the customer of the general 14-day notification provisions, and they must contact the agency when the change occurs
• tell the customer that if the change results in an increase to payment rate, the increase is effective from the date they told Centrelink of the change. This includes where the customer notifies of the change within 14 days. See Notification Handler (NOHL) for more details
• record the discussion using a Fast Note

Procedure ends here.

The customer is not eligible to receive RA, TAL and/or UA at a higher rate.

The Decision Maker (DM) must explain the decision to the customer. Make genuine attempts to contact the customer by phone before issuing a written advice of the decision outcome. See Advising verbally of an unfavourable decision.

After telling the customer, or making genuine attempts to contact them, if the customer:

• is currently receiving a payment:
• record the decision using a Fast Note
• finalise all associated activities and DOCs on the Activity List (AL) screen
• in Customer First, issue a manual Temporary separated couple - unfavourable (Q888) letter to advise the customer in writing of the decision
• if the customer’s partner is a current Centrelink customer, also issue a letter to the partner from their own record
• if a correspondence nominee exists, ensure a copy of the letter is issued to the appointed nominee. See Nominees
• procedure ends here
• has a new claim that can be finalised:
• process and finalise the claim
• document the outcome of the temporarily separated assessment in the claim finalisation note
• there is no requirement to issue a decision letter to the customer when the assessment is part of a new claim. The new claim grant/reject letter forms part of the temporarily separated couple decision
• procedure ends here
• has a new claim that cannot be finalised (further documentation required):
• request the required supporting documentation, see Requesting information (CLK)
• annotate the progress of claim note with the outcome of the assessment
• there is no requirement to issue a decision letter to the customer when the assessment is part of a new claim. The new claim grant/reject letter forms part of the temporarily separated couple decision
• procedure ends here

Check the customer’s/partner’s record to determine the current circumstances when:

• a customer tells the agency they are no longer temporarily separated, or
• a review activity for the expected date of return from temporary accommodation has matured

Go to the Address Details (ADS) screen, if the Temp address end date is:

• the same as the system date or earlier, the customer/partner has returned home from temporary accommodation. Update the following fields on the Marital Status (MS) screen in Customer First to end the relationship qualifier code:
• Event Date: field, enter the date the customer ceased being temporarily separated
• Marital Status: field, use the same code as previously stated
• PPE Cust and PPE Ptnr: fields, update as needed
• Qualifier Code: field, leave blank
• Source: field, enter the source of information
• Receipt Date: field, enter the date of receipt
• Select Continue to go to the Customer Details Task (CDTS) screen
• Update any other information by selecting the appropriate screens from the CDTS screen, such as change of address. Make sure the customer's and partner's home address are the same
• Go to the Assessment Results (AR) screen and finalise the activity
• Record a DOC with the actions taken
• In Customer First, issue a manual Temporary separated couple - unfavourable (Q888) letter to advise the customer in writing of the decision.
  Note: there is no requirement to issue a decision letter to the customer when the assessment is part of a new claim. The new claim grant/reject letter forms part of the temporarily separated couple decision
• If the customer’s partner is a current Centrelink customer, also issue a letter to the partner from their own record
• If a correspondence nominee exists, ensure a copy of the letter is issued to the appointed nominee. See Nominees
• Close all relevant open activities/work items on the customer’s record
• Procedure ends here
• a future date, in Customer First, resubmit the review to fall due on the customer's/partner's end date of temporary address:
• Select the review activity from either the Activity List (AL) screen (if due) or the Future Activity List (FAL) screen if due date is in the future
• Update the resubmit date to reflect the end date of the temporary address
• Procedure ends here

After establishing the customer and/or their partner are a temporarily separated couple, update the Marital Status (MS) screen in Customer First (CF) with the appropriate relationship qualifier code. This makes sure customers are paid the correct entitlement for any add-ons.

Rent Assistance can be assessed and paid to each eligible member of a temporarily separated couple. They must have been assessed and coded with the temporary relationship qualifier code on the MS screen.

Note: if the assessment is part of an online claim, the updates to the MS screen must be made in CF prior to processing the claim in Process Direct (PD). After the updates have been made in CF, the claim information in PD will need to be regenerated prior to selecting Process.

Update the following fields on the MS screen in Customer First:

• Event Date: field, record the date the customer/partner temporarily separated
• Marital Status: field will remain as MAR, REG or DEF (as previously coded)
• PPE Cust and PPE Ptnr: fields, update as needed
• Qualifier Code: field, enter the appropriate relationship qualifier code for the customer's circumstances:
• 'Tmp Sep/Left Home' (TEC) - where the customer has left home
• 'Tmp Sep/Ptnr Left Home' (TEP) - where the partner has left home
• ‘Tmp Sep/Both Left Home’ (TEB) – where both the customer and partner have left home
• Source: field, enter the source of the information
• DOR: field, enter the date of receipt
• Do not complete the activity
• Go to Temporary accommodation and Rent Assistance (RA) to record accommodation and rent changes
• Once temporary accommodation details have been coded, go to the Assessments Results (AR) screen and finalise the activity
• Go to Step 9

If the customer:

• is currently receiving a payment:
• Record details on a Fast Note
• In Customer First, issue a manual Temporarily separated couple - favourable (Q888) letter to advise the customer in writing of the decision
• If the customer’s partner is a current Centrelink customer, also issue a letter to the partner from their own record
• If a correspondence nominee exists, ensure a copy of the letter is issued to the appointed nominee. See Nominees
• has a new claim that can be finalised:
• the claim information on the Transaction Summary (TS) screen in PD will need to be regenerated before the claim is processed
• select Process, update any required information and finalise the claim
• document the outcome of the temporarily separated assessment in the claim finalisation note
• there is no requirement to issue a decision letter to the customer when the assessment is part of a new claim. The new claim grant/reject letter forms part of the temporarily separated decision
• has a new claim that cannot be finalised (further documentation required):
• if the claim is being processed in PD, the claim information on the Transaction Summary (TS) screen will need to be regenerated before the claim is processed
• annotate the Progress of Claim note with the outcome of the temporarily separated assessment
• if further documentation is required but has not been requested, see Requesting information (CLK)
• if the claim is being processed in PD, the system will automatically hold the claim for the appropriate amount of time
• if the claim is not being processed in PD, ensure claim is placed on hold for the appropriate amount of time

Go to Step 10.

Once the temporary address has ended and the customer and partner have returned to living at the same address, the relationship qualifier code on the Marital Status (MS) screen must be removed. To ensure the MS screen is updated and the relationship qualifier code is removed, a manual review is required to be set for the end date of the temporary address.

In Customer First, create a manual review:

• Go to the Review Registration (RVR) screen and complete the following fields:
• Service Reason: customer’s payment type
• Review Reason: MAN (Manual Entitlement Assessment)
• Due Date: date of discharge
• Source: INT
• Date of Receipt: today's date
• Notes: 'Customer/partner are temporarily separated. Check customer's/partner's temporary accommodation end date and return to OB 106-07120040 to action.'
• Keywords: ILLSEP
• Workgroup: leave blank
• Position: leave blank
• Transition 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
• If the customer is a carer in receipt of Carer Payment and/or Carer Allowance, check if they are still eligible. See:
• Eligibility for Carer Payment (CP)
• Eligibility for Carer Allowance (CA)
• If care requirements are no longer met, cancel CP/CA. See Cancellation and suspension of Carer Payment (CP) and/or Carer Allowance (CA)

Procedure ends here.