Money management - Juggling different funding streams
Managing different funding streams is complex and time consuming for people who uses services
The development of personal health budgets means more people are likely to have direct payments which cover both health and social care needs.
Helping people to manage direct payments (DPs) which include multiple funding streams will become increasingly important and councils are in a great position to lead activity around this. Learning the lessons from areas which have trailblazing integrated budgets can help others to understand what works well in supporting people in this way.
What are the outcomes we want to achieve?
- Person is clear how their budget has been calculated
- The individual understands each element of the personal budget and what it will cover
- People understand the financial contribution they are expected to make and the process for making a contribution
- The allocation reflects a cost-effective and reasonable amount to meet the identified outcomes
- The budget is sufficient to meet the outcomes identified
- Any restrictions and reporting requirements are clearly communicated and understood for each funding stream comprised within the final budget
- From a legal point of view the social care duty is to be provide sufficient funds to meet needs.
- Sufficient funds have to be provided for a direct payment holder even if the sum that has to be provided is more than the amount the Council would spend for the same service or product and same outcomes. This is the case as long as the direct payment has been lawfully decided upon by the Council in the first place
- The final allocation is not a surprise to the people concerned and reflects a shared understanding of what is reasonable in individual circumstances including in circumstances when it might be regarded as best value to fund a subjective reasonable preference and not merely an objectively reasonable one.
What tools and resources do we need to do a good job? What are the steps we have to go through?
- A simple co-ordinated calculation process which can be easily communicated by staff to people and families -compliant with the guidance to fund for sufficiency (refer to Outcomes section)
- A generic process for everyone
- A reference tool indicating the cost of the objectively reasonable services which the Council would arrange to meet eligible unmet needs
- A transparent decision-making process to finalise the allocation
- Timely financial assessment(s) for each of the funding streams involved
- Personal top-up options where appropriate
- Wherever possible a full year's budget allocated
Information and Policy
- Information describing a dispute resolution process where budgets are not agreed involving staff competent to spot where any of the earlier stages may have been flawed and provide reasons for the authority's stance
- Information and advice on the options for managing personal budget including direct payments
- A generalised policy in relation to funding independent support
- A statement of when a council might be likely to find it necessary to allow the direct payment holder to pay direct payment funds to normally 'prohibited persons' for admin
- Clear information, including forms and templates to enable people to meet the requirements for recording and reporting how they use the money for all funding streams
- Clear information outlining any legitimate restrictions on how money may be used for each funding stream
What are the products we will have at the end of this process?
- An agreed delivery mechanism or mechanisms for the budget (this may include a mix of options such as part direct payment and part commissioned package or commissioned and sub contracted package -Individual Support Fund (ISF) -, or part direct payment and part ISF.
- A combined pooled budget where additional funding streams are involved with clear information regarding the requirements for each funding stream and the review process to be used
- Agreed start date for services
- A reasonable measure of flexibility to cover fluctuating needs where relevant over an appropriate period as per the guidance
When does this process start and end and within what timescales should this process be completed?
- Final budget approval should follow swiftly after the care planning stage, where informal social capital offsets eligible need
- Wherever possible timescales for any additional funding stream should be coordinated to enable a single allocation to be allocated with a single start date
- Should meet with standards agreed locally for decision-making from the point of approving the plan
Who needs to be involved and what is their role? Who is taking the lead?
- Financial assessment team
- Direct payment support team/brokers
- Care coordinator
- Relevant professionals with specialist knowledge linked to additional funding streams
Managing funding complexities is onerous, particularly for people with disabilities who may simultaneously be employing personal assistants.The Care Act facility for allowing relatives and others to be paid to manage and administer budgets should go some way to solving this problem if councils accept that this is necessary to meet needs and payment for this is included in the personal budget. However, problems are encountered whenthe funding from other organisations is not aligned. The result is an additional parallel processes (ie multiple bank accounts, repeating information and process).
There are a number of parts of the Care Act and its Guidance that supports the principle of cooperation. Intrinsic to this is the ability for a person to have registered, in their personal budget, that they have multiple funding streams. The PB therefore can explicitly acknowledge that people have various forms of state support, and the DP regulations also state that Councils should take reasonable steps to align DP processes if the person has a PHB DP.
- Case study: Kent Council and Clinical Commissioning Group -Juggling different funding streams (pdf - 462Kb) (opens new window)