BGF Client Service Changes

Talkabout received a number of enquiries and passionate letters about the BGF client service changes. We sat down to talk to BGF CEO Bev Lange to put forward some of your concerns. Here, she discusses the refocussing of financial assistance, explains the limitations of BGF’s funding sources (and explains those ‘other expenses’) and talks about how they will help clients make the transition.

Talkabout: The announcement of the latest round of client service changes has many people talking and there is a lot of speculation. So, let’s start at the beginning. Can you give us a brief overview of the current round of changes: What are they and why are they being made now?

Bev: When BGF first introduced financial assistance, it was very short term, making sure people who were very unwell could maintain power for heating and refrigeration, keep a telephone to minimise social isolation and other medical assistance.

People living with HIV now have a longer life expectancy, their needs have changed and our assistance has to change as well. Planning for the future, supporting greater self reliance, maintaining health and developing new skills are a greater priority for many of our clients.

The current changes will direct BGF’s financial assistance away from the daily costs of energy and telephone towards assistance with antiretroviral therapy and non-PBS prescriptions, alternative therapies, dental health and medical gap costs.

We are also building on the successful Phoenix Workshops, providing employment and training programs such as the BGF Intern Program, in addition to the vocational guidance we currently provide. BGF is also exploring pilot programs which will create a more direct pathway to employment for those who are interested.

Our assistance will be based on the needs of the individual and this will ensure those needing greater or different assistance will continue to be supported.

Talkabout: Some people are upset at the prospect of losing a trusted source of financial assistance for utilities, particularly long-term clients who may have been receiving this support for some time. How can BGF stop offering this financial assistance?

Bev: BGF is not stepping away from financial assistance but it is changing the focus. As some clients have told us, there is a need for people to be supported individually, but many people are able to support themselves with minimal help from us. We want to be here for PLHIV for many years, and these changes are based in better assessing and supporting individual needs, helping people plan for the future and ensuring our assistance is available for everyone in need.

Talkabout: So, as you said earlier, BGF will continue to provide direct financial assistance for medical expenses. This is surely a good thing. I think this is something makes BGF unique – the payment of money to meet living expenses. Although, you note that BGF will continue to provide a similar level of direct financial assistance, there is some concern about how clients will meet their utilities costs. Are there other means of support for those clients concerned about expenses no longer covered by BGF?

Bev: BGF is unique. To my knowledge, no other service provides direct financial assistance to people with HIV. It is important to note that in addition to the Disability Support Pension the following supplements are available:

• Mobility Allowance – The Basic Rate is $80.50 per fortnight, payable to those travelling to undertake paid or voluntary work or vocational training for 32 hours every four weeks. The Higher Rate is $112.70 per fortnight, payable to those working 15 hours a week, or looking for work that will be 15 hours per week.
• Pension Supplement – $56.10 per fortnight. From 20 September 2009, the following payments will be rolled into the new Pension Supplement which will be automatically paid to pensioners and other eligible income support payment recipients with their regular fortnightly payment:
  - Pharmaceutical Allowance (PA)
  - Utilities Allowance (UA)
  - GST Supplement
  - Telephone Allowance (TAL)

• Education Supplement – $62.40 per fortnight. This payment (or Abstudy PES for indigenous students) helps with the costs of full or part-time study.
• Energy Rebate – $33 per quarter. A NSW Government Energy Rebate is available through each energy provider. This may have lapsed and a new application may be required – caseworkers can assist clients. If the rebate is current, it will be noted on your quarterly bills.
• EAPA Vouchers – $30 per month. Energy Accounts Payment Assistance (EAPA) vouchers are provided to community services agencies, including BGF, to assist people experiencing difficulties paying their energy bills. It should be noted that EAPA vouchers are for emergency and occasional use only and not as a regular income replacement.

Talkabout: How will BGF help people plan for and manage the transition of financial assistance towards medical and dental expenses?

Bev: Briefings are being held across NSW to provide the opportunity for as many clients as possible to ask questions of BGF staff. Caseworkers are contacting clients to take them through the changes and review the potential impact for each individual.

These changes won’t commence until 1 July for existing clients, giving sufficient time to understand the changes and for caseworkers and clients to develop new plans.

Individual needs will continue to be met by BGF and I encourage all clients to talk with their caseworkers about any financial matter as we can provide substantial information.

Talkabout: Positive Life has asked BGF to let clients know about the ability to appeal individual decisions and has also asked that BGF keep track of the impact of these changes on clients. How will you do this?

Bev: People are encouraged to speak with their caseworker or escalate to the Client Services Director, myself or the Board if they would like to appeal a decision about financial assistance.

BGF has established a Client Services Advisory Committee which comprises ACON, Positive Life, Positive Central, HIV Community Team, Social Workers in AIDS (SWAIDS) and NAPWA. The Committee has been consulted on a range of matters including the changes to financial assistance. The Committee will continue to meet quarterly to discuss the development of other programs, changes in HIV that need to be addressed, provide feedback about existing programs and particularly feedback about the changes to financial assistance.

BGF, in consultation with the Committee, is developing an evaluation program to ensure people are not negatively impacted by these changes and this will be reviewed at the quarterly meetings after 1 July.

Separately, all service providers are encouraged to provide feedback regarding any issues a client might have with BGF, which will be monitored.

Services and support

Talkabout: In addition to the direct financial support, BGF provides a range of services focussed on practical and financial needs for people with HIV. Can you tell me a little about the staff and the work they do?

Bev: BGF has one full-time and one-part time financial counsellor to assist people manage debt arrears; negotiate with creditors on clients’ behalf, which often results in improved or reduced repayment plans; and provide advice on complex financial matters.

There are eight full- and part-time community support workers who support people remain in their own homes. Community support workers also staff Bobby Goldsmith House, undertake in-home care, and support and work with people who have issues with alcohol and other drugs.

Case workers provide case coordination, develop plans and budgets with clients, process requests for financial assistance, liaise with creditors where circumstances are complicated, undertake outreach across NSW and process No Interest Loans Scheme (NILS®). I should note that in the last financial year, we distributed almost $100,000 in NILS® loans [that’s in addition to direct financial support reported elsewhere].

Caseworkers also develop workshop programs, intake new clients and liaise with other service providers.

Talkabout: I imagine there are a lot of administrative time and cost involved simply in paying client bills. Can you explain a little bit about the human cost of providing financial assistance?

Bev: BGF pays an average of 800 bills per month and this clearly takes substantial resources including staff time to the extent that there often is insufficient time to speak in detail with their clients. We’re eager to maximise the time caseworkers spend with their clients so that we can better understand their needs and provide better and more appropriate support. Caseworkers have greater skills than paying bills and they are a wonderful resource for people living with HIV in NSW. There was a 20% increase in new clients during the 2008/09 financial year. We now have 1,450 clients to support in NSW.

Financial matters

Talkabout: I’d now like to address some of the financial aspects of BGF if I can. Am I right in assuming that the government funding can’t be used for direct financial assistance, only the money you raise can be used for financial support? Can you explain the difference in your funding sources and what this means about how you can use them?

Bev: Each year, we receive a non-government organisation (NGO) grant from the South Eastern Sydney and Illawarra Area Health Service (SESIAHS). This funding is for client services staffing only. This staffing supports the administration of various BGF programs including provision of financial assistance, financial counselling, vocational guidance, case coordination and supported accommodation.

While our government grants cover most client supporting positions, there is still a shortfall that we need to cover with fundraised monies. This means we actually have limited funds that we can use for direct financial assistance. We rely solely on our fundraising income to provide financial assistance.

While our fundraising income has been steady over the last two years, there has been a significant increase in new clients. In this financial year, we will distribute close to $400,000 in direct financial assistance.

Talkabout: What impact has the drop in income from fundraising and bequests had on financial support and other services over the last few years?

Bev: In the last financial year, the BGF Board made the strategic decision not to reduce services despite the decline in investments due to the global financial crisis and related downturn in community donations. This is why we have a current deficit of $783,401. In order to continue to meet the diverse needs of our client base, we had to reallocate client services priorities.

Through our case management model, we have implemented some new procedures to make our services more accessible to people living with HIV. As a result, we’ve seen a significant increase in new clients since mid-2007 and we believe this trend will continue for the foreseeable future.

Talkabout: A number of our readers expressed concern about the reporting of “other expenses” of $1,334,966 in the Income Statement in the Financial Report. What does this figure represent?

Bev: Other expenses in the Income Statement in the 2008/09 Annual Report contains items such as Accountancy Fees, Audit Fees, Bank Charges, Client Amenities, Computer and office infrastructure, Fundraising costs including events and appeals, Insurance, Legal Costs, Light & Power, Motor Vehicle Expenses, Printing & Stationery, Postage, Rent & Outgoings, Repairs & Maintenance, Telephone and Mobile Telephone, Vital Call Pagers and Volunteer Costs.

Talkabout: Finally, any comments you would like to make about the overall financial health of the organisation? How is BGF placed to move forward?

Bev: BGF is in a sound financial position with money on investment that will fund new programs, maintain existing programs and the future of the organisation. The Finance Committee and BGF Board oversee the governance of BGF and for many years the auditor has provided an unqualified annual financial report.

BGF is investigating other opportunities to diversify our revenue as there is so much competition for the fundraising dollar.

If you would like to share your thoughts on this article, email editor@positivelife.org.au [5]

Making the transition

• You should work with your caseworker to identify your needs and priorities for support. Together, you will create an annual Individual Service Plan that will be reviewed each year.
• If you receive financial assistance, you will now need to provide a Proof of Income (generally a Centrelink Income Statement) once a year if you are on a Disability Support Pension or Aged Pension and every six months if you are on Newstart Allowance or a low income.
• If you receive financial assistance, you will have greater attention to ensure you understand and manage your spending and cashflow challenges. Your caseworker will help you complete a spending plan/budget.
• You will receive assistance to organise deductions through Centrepay for your energy bills and, in some cases, direct debits for rates, rent, telephone, etc.
• You will receive information about other BGF services and/or you may be referred to external programs that may be able to help you.

Three levels of financial support

1. Ongoing financial assistance
This will be available for all eligible clients and relates to health and well-being including:

• Costs of HIV anti-retroviral medications
• Costs of HIV related non-PBS medications (with doctor’s confirmation)
• Costs of HIV related vitamins and supplements (with health professional confirmation)
• Costs of alternative therapies (with health professional recommendation)
• Costs of medical gap fee for HIV-related procedures (with doctor’s confirmation)
• Costs of annual dental check where no other assistance available.

2. Short-term, targeted financial assistance
This will be available on assessment by your caseworker for:

• Emergency support – one-off assistance for food or shelter
• Short-term (3–6 months) assistance to enable a client to be housed, stabilise finances etc – generally get back on their feet
• Fees and /or materials for approved courses (returning to workforce or capacity building)
• Costs of returning to employment – clothing, materials, etc.

Note: This assistance is short-term only and will be reviewed every three months.

3. Specific, targeted financial assistance
This assistance is available if assessed by your caseworker as having high support or complex needs. Assistance will depend on your specific needs and depending on your priorities may include:

• Help with medical equipment
• Help with childcare
• Help with utilities
• Help with purchasing glasses or hearing aides.

Note: This assistance will be determined only after assessment and discussion with your caseworker and will be reviewed at least once a year.