The unspent funds of a care recipient refer to the total amount remaining in their package as of the date when you, as your provider, ceased providing care. It is crucial to calculate the unspent funds when a care recipient exits your Home Care Package service.
To determine the unspent funds, you need to calculate the amount for the period between either:
- 1 July 2015 or the date they commenced receiving home care from you (whichever is later)
- the cessation date. It is important to note that you will not receive a Home Care Package subsidy for the cessation date.
Ensuring accurate calculations of unspent funds is essential for both the care recipient and the provider to maintain transparency and accountability in the Home Care Package service.
Calculate unspent funds
Before starting the calculation process, it is vital to ensure that you have fulfilled the following tasks:
- finalized all outstanding claims with Services Australia
- received all Home Care Package fees
- Identified all expenses, including any outstanding invoices for services rendered.
It is important to note that the following should not be included in the calculation:
- fees that have been paid in advance, as these must be refunded separately to the care recipient
- a Home Care Package subsidy for the cessation date, as this subsidy will not be accessible for that specific date.
To determine a care recipient’s unspent funds for the required period, follow these steps:
- calculate the total amount of Home Care Package subsidy, fees, and transfer portions that have been paid.
- calculate the total amount that has been spent or will be spent on providing services
- subtract the amount calculated in Step 2 from the amount calculated in Step 1. If the result is negative, consider it to be zero.
Submit a written notification
Within 56 days after the cessation date, you must provide the care recipient (or their authorized representative) with written notice of any unspent funds. This notice must contain the following information:
- The cessation date
- The total amount of unspent funds
- Any outstanding fees that have been deducted
- The method and timeframe for disbursing the unspent funds
It is essential that you identify the following amounts, regardless of whether they are zero:
- care recipient portion: the unspent funds from fees paid in advance (after deducting any outstanding fees)
- Government portion: the unspent funds from the Home Care Package subsidy that was provided
- transfer portion (if switching providers): the unspent funds that will be transferred to the new provider, which may include a care recipient portion and/or a government portion.
If a care recipient has unpaid fees, it is your responsibility to handle this in accordance with the terms outlined in their Home Care Agreement. It is important to note that subsidies cannot be used to cover these outstanding fees.
Release the unspent funds
When a care recipient moves to a new provider
When a care recipient switches providers, any remaining funds will be transferred to the new provider. It is the responsibility of the care recipient to inform their new provider within 56 days of the cessation date. Within 70 days of the cessation date, the existing provider must transfer the funds to the new provider and provide them with a copy of the written notice at the time of payment.
The new provider is required to clearly indicate the transfer portion in the care recipient’s monthly statement.
If the care recipient fails to provide you with the new provider’s details within 70 days, you must consider any unspent funds as if they have exited the program.
When a care recipient discharges from the program or passes away
Within 70 days after the cessation date, you are required to inform Services Australia about the government portion through the Aged Care Provider Portal. The process will vary depending on the circumstances:
- If the care recipient joined the program on or after September 1, 2021, or before that date but you had previously chosen to return unspent government funds, Services Australia will reconcile the outstanding amount through the claim period and return it to the government.
- If the care recipient joined the program before September 1, 2021, and you did not choose to return the government portion, you are responsible for holding all unspent funds and must create a ‘Commonwealth unspent amount on departure’ event. Services Australia will then return the funds to the government.
- If you do not hold any government unspent funds, you must report a $0 amount to Services Australia. Do not adjust the unspent funds amount in the departure month if the invoice amount exceeds the maximum contribution amount for that month.
Services Australia will recover the government portion by deducting amounts from future subsidy payments for the care recipient or issuing a debt notice. Additionally, you must pay the care recipient portion (such as the income-tested care fee) to the care recipient or their authorized representative within 70 days after the cessation day if the care recipient is leaving the program, or within 14 days after providing the probate will or letters of administration if the care recipient has passed away.
Document information
To ensure compliance with regulations, it is imperative to maintain a detailed record of the following:
- the written notice regarding unspent funds
- the disbursement of unspent funds to alternative providers or care recipients (or their estate).
Keeping accurate documentation of these transactions is essential for transparency and accountability. Failure to do so may result in potential legal ramifications.