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Long Term Care Fund (R.72/2022): Executive Response

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STATES OF JERSEY

LONG TERM CARE FUND (R.72/2021):

EXECUTIVE RESPONSE

Presented to the States on 10th May 2021 by the Public Accounts Committee

STATES GREFFE

2022  R.72 Res.

FOREWORD

In accordance with paragraphs 64-66 of the Code of Practice for engagement between Scrutiny Panels and the Public Accounts Committee' and the Executive', (as derived from the Proceedings Code of Practice) the Public Accounts Committee presents the Executive Response to the Comptroller and Auditor General's Report entitled Long Term Care Fund (R.72/2021) presented to the States on 6th May 2022).

As a result of the minimal time remaining before the suspension of the Public Accounts Committee's activities  before  the  2022  General  Election,  the  Public  Accounts  Committee  would  therefore recommend  that  its  successor  should  consider  publishing  comments  on  the  Executive  Response following the appointment of new members on 19th July 2022.

Connétable K. Shenton-Stone Vice-Chair, Public Accounts Committee

R.72/2022 Res.

Chief Executive and Treasurer's Response to C&AG Review: Long Term Care Fund – Executive Response to PAC by 12 noon on 3 May 2022, please.

Summary of response

The Chief Executive and Treasurer welcome the Comptroller and Auditor General's acknowledgement that the Long-Term Care Fund and the Long-Term Care Scheme have met their intended policy objectives for over seven years of operation.

The Chief Executive and Treasurer agree that the Long-Term Care Fund would benefit from the review, simplification, and streamlining of the systems and processes that underpin it as well as the guidance and tools provided to support its claimants. To this end, all recommendations excluding Recommendation 20 have been accepted.

The Comptroller and Auditor General's report makes many helpful recommendations, and it should be noted that four of the accepted recommendations have been closed immediately on the basis that they have already been fully implemented or that their principles have already been incorporated within the relevant processes. Two recommendations have been partly accepted. The implementation of the remaining fourteen will have a positive impact in terms of service user experience, care outcomes, and the cost of care.

Action Plan

 

Recommendations

Action

Target date

Responsible Officer

R1 Review the cross departmental governance arrangements to include:

establishment of a LTCF Board; and

reinvigorating the Long-Term Care Senior Liaison Group with a more structured agenda and minutes.

Accept

A Long-Term Care Fund Board will be established and will review what cross departmental governance arrangements are required, including the arrangements for the LTC Senior Liaison Group.  

Q4 2022

Director  General CLS

R2 Publish key performance measures related to the LTCF, including the LTCS, either as part of the States of Jersey Annual Report and Accounts or as part of the CLS departmental reporting process.

Accept

The Long-Term Care Board will consider the publication of key performance measures related to the LTCF using existing reporting structures, including open data.

Q4 2022

Director  General CLS

 

R3 Ensure that the actuarial review based on 31 December 2021 data is commissioned as soon as possible for reporting in 2022 and to inform the Government Plans from 2023

Accept

The Minister for Social Security has already instructed officers to undertake this review. a key element of the review is a population model. a new population model will be developed using the information from the 2021 census. some preparatory work can be undertaken in advance of the newmodel being available, the final report of the actuarial review will be produced as soon as possible after the population model has been completed

Q1  2023  – although  will depend  on  the production  of  the population model

Policy Principal, Long  Term  Care SPPP

R4 Review the LTCF investment strategy in light of experience since the last formal actuarial review, to assess whether the current strategy is the most appropriate.

Accept in principle and close

The overall investment strategy is reviewed annually, with reviews of the strategy for specific funds happening at least tri-annually, with additional reviews occurring were evidence exists to suggest this is required.

The LTCF strategy was formally reviewed by TAP in 2021, and will next be reviewed in 2024, or sooner is sufficient evidence exists to suggest that this is needed. This  would  include  an  updated  actuarial  review,  or significant changes to cash flows against expectations.

 

Director   Treasury and  Investment Management

R5 Carry out detailed analysis of the LTCF contributions collected by Revenue Jersey and use this to inform or validate future revenue forecasts for the Government Plan.

Partly Accept

At its simplest, LTC is charged upon the total income subject to tax for an individual. Noting that the income is that of an individual rather than a taxpayer, and the amount chargeable to LTC is subject to a cap, broadly the amount of LTC a taxpayer is charged is in a ratio to what they are charged to tax.

As  income  tax  revenue  is  influenced  by  a  range  of economic  factors,  the  forecast  is  prepared  by  the Economics  Unit  in  conjunction  with  the  Income

Q4 2022

Head  of  Financial Planning  (Secretary of IFG)

 

 

Forecasting  Group.  It  would  therefore  appear appropriate to bring LTC forecasting formally within the terms of reference for IFG, using a similar methodolgy.

 

 

R6 Re-evaluate the basis for the grant contribution from the States to the LTCF.

Accept  -  to  be  decided  by  the  next  Council  of Ministers

The  re-evaluation  of  the  grant  contribution  from  the States to the LTCF would need to be undertaken in line with a wider review of the long-term sustainability of the Social Security Fund and Long-Term Care Fund, which would consider the balance of funding sources, including from government, employees and employers.

This is a substantial piece of work, and should be carried out as part of wider strategic finance decision making in future Government plans, if prioritised by future Council of Ministers.

Q4 2023

Group  Director  – Strategic Finance

R7 Carry out a full review of the management charge to the LTCF and ensure that the charge is an accurate representation of the costs of managing the fund.

Accept

A full review of the management charge to the LTCF will be completed.

Q4 2023

Director  General CLS

R8 Complete the proposed review of the asset disregard level included in the LTCS during 2022, to

consider whether a revised level is more appropriate to meet the objectives of the scheme; and

provide a basis for future reviews.

Accept

The level of the asset disregard is set by the Social Security Minister by ministerial order. Any change to the level  would  need  to  be  approved  by  the  incoming Minister.

The  report  to  the  Minister  dated  25  October  2021 acknowledges the increase in property prices since the inception of the scheme and recommends a review of the asset disregard level in 2022.

Q4 2022

Policy  Principal, Long  Term  Care, SPPP

 

 

The  recommendation  to  undertake  a  review  will  be explained to the incoming Minister and officer resources will be made available to undertake this review.

 

 

R9 Undertake a formal analysis of care costs to inform the 2022 review of the following variables within the LTCS:

standard care cost at each level

standard co-payment

standard personal allowance; and

standard care cost cap – single and couple.

Partially accept

Standard care costs, the copayment, personal allowance and care costs cap are all set by the Social Security Minister using ministerial orders.

Successive ministers have regularly increased each of these statutory amounts.

The Co payment and personal allowance are specifically designed to cover costs that do not relate to care needs and would not be appropriately included in a review of care costs.

it is agreed that care costs are subject to different cost pressures compared to general inflation.

The care costs cap is a measure of the contribution required of an individual with sufficient means to meet some of their own care costs. Accumulation to the cap is made at the standard care cost for that individual, regardless of the actual cost of the person's care. To date ministers  have  always  chosen  to  increase  the  cap proportionately to the increase in the care costs. The effect of this constant relationship is that the time a claimant spends supporting their own care costs before they reached the care cost cap has not changed since the  scheme  began.   Increasing  or  decreasing  this amount of time would have cost implications to the Fund overall and would require careful consideration.

 receiving care well responsible for

Q4 2022

Policy  Principal, Long  Term  Care, SPPP

 

 

The recommendation to undertake a formal analysis of care costs in order to set the next set of standard rates will be explained to the incoming Minister and officer resources  will  be  made  available  to  undertake  this review.

 

 

R10 Review and update the LTCS guidance following feedback from the community as part of the planned engagement initiatives.

Accept

As part of CLS Customer Engagement initiative CLS plan to engage with a variety of stakeholders this year and will update the LTC guidance accordingly in response to this feedback.

Q4 2022

Customer Operations  Director, CLS

R11 Complete the planned systems updates to provide a direct data link for the LTCS between HCS and CLS systems.

Accept

We  will  review  planned  systems  update to  establish whether the replacement of legacy system (Transform) supersedes this activity.  

Q4 2023

Customer Operations  Director, CLS

R12 Update the standard hourly rate figures for domiciliary care in the Resource Allocation System and ensure that these are reviewed and revised annually.

Accept and close Completed Feb 2022.

Q2 2022

Customer Operations  Director, CLS

R13 Publish the re-determination and appeals process for both care needs and financial assessments on the website and in future guidance.

Accept

All letters have redetermination rights in communication. However, the redetermination process will be added in the public domain within the www.gov.je website.

Q2 2022

Customer Operations  Director, CLS

R14 Undertake a review of all performance measures for the LTCS to:

• establish a more comprehensive suite of performance measures to reflect the customer journey, including metrics to monitor the balance between residential and domiciliary care provision

Accept

Refreshed KPIs for the Adult Social Care Team have been  developed  in  partnership  with  Informatic colleagues.

These KPIs are aligned with the updated forms now within Care Partner (Strength and Needs Assessment (SANA),  and  the  Face  Support  Plan  &  Budget

Q4 2022

General  Manager, Adult Social Care

 

ensure data and other information for all performance measures are reported and monitored on a regular basis; and

ensure underlying reasons for performance variances are investigated and improvement plans are agreed to address risks and issues arising.

Summary). From an assurance perspective these KPIs are  reported  via  the  monthly  HCS  Care  Group Performance Reviews, which in turn feeds through to the HCS Assurance Committees. Operationally the care group's  Governance  Framework  ensures  regular monitoring of performance variances alongside progress updates of associated actions and implementation plans.

 

 

R15 Review and update existing framework agreements with all care providers. Ensure that the update includes a clear articulation of the data and quality standards required from care providers.

Accept

CLS  are  currently  updating  the  Approved  Provider Framework agreement.

Q4 2022

Customer Operations  Director, CLS

R16 Prepare a detailed plan to implement a range of initiatives to reduce demand on the LTCF in future This plan could form part of the Jersey Care Model implementation and should include shifting the emphasis of care provision to prevention and domiciliary care.

Accept principle and close

This work is already included in the JCM programme.

 

 

R17 Review the potential to streamline the claims process, for example, through:

providing an online self-assessment tool

providing a standard template for claimants to notify a change of circumstances; and

simplifying the property loan process and guidance.

Accept

CLS will work with HCS to conduct a review of the claims process  to  identify  opportunities  to  streamline. Consideration will be given to the costs vs benefit of any potential  implementation  to  ensure  that  the  effort  is proportionate to the potential benefits.  

Q4 2022

Customer Operations  Director, CLS

R18 Introduce a performance measure to monitor the timeliness of annual reviews of individual claims.

Accept

Q4 2022

Principal  Social Worker, HCS

 

 

Timely delivery of reviews is measured as a KPI, and this has shown that some reviews have fallen behind the aspired timescale fallen as demand grows.  

A project group was formed in early 2021 to analyse using LEAN methodology the approach currently taken towards reviews.  

In the short term this has established the headcount required to keep pace with reviewing demand. Short term  measures  were  also  implemented  to  maximise efficiency.  

In the longer term virtual review "clinics", shared reviews and prioritisation of annual reviews for those who are unbefriended or provided individual support.  

It should be noted that the demand to complete reviews will grow at a unique pace in Jersey, as the Long-Term Care Scheme means there are no self-funders on the island in the way that Local Authorities in other areas of the  UK  would  experience.  Consequently,  whilst  the above is necessary, there will inevitably be a need for further human resource to keep pace with demand.

 

 

R19 Resolve the issues in the interface between the CRM system and NESSIE as soon as possible to avoid requirement for duplicate data entry. In doing so, review the allocations of payments to LTC Benefit and LTC Support in both systems to eliminate adjusting entries.

Accept in Principle and close

The new CLS benefit system project (Transform) will replace Nessie and will address this point. Whilst we accept the principle of the recommendation, we do not feel it is advisable to spend money on integration for a legacy system that is due to be replaced in the near future.

 

Customer Operations  Director, CLS

Recommendations not accepted  

Recommendation  Reason for rejection

R20  Review the potential to move to a single, consistent approach to  LTC benefit is paid in advance and therefore there is an making payments due from the LTCS.  inherent, but low risk that circumstances will change after

payment has been made. Nearly all payments are paid to care

 

 

 

homes and therefore recovery of overpayment is straightforward. CLS currently offers flexibility of our payment process for claimants and providers, based on their needs. This type of arrangement suits all parties.