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Assistance for Carers Legislation
Amendment Bill 1999
Date Introduced: 17 February 1999
House: House of Representatives
Portfolio: Family and Community Services
Commencement: The provisions which extend
the carer payment and introduce the carers allowance commence on 1
To give effect to
measures aimed at improving assistance to carers by extending
eligibility for carer payment and introducing a simpler system of
income supplements for carers - the carer allowance.
The Development of Carer
Payments for carers in Australia are of two
sorts: means tested income support and non-means tested assistance
with the extra costs of providing care. Carer payment provides the
former and Domiciliary Nursing Care Benefit and Child Disability
Allowance provide the latter. The development of each payment is
briefly set out below.
Social security income support for people caring
for adults with disabilities originated with the creation of the
Spouse Carer's Pension in December 1983. It was payable to the
husband of a severely handicapped age or invalid pensioner or
rehabilitation allowee who required constant care and attention
either permanently or for an extended period. The care had to be
provided by the husband in person and in the matrimonial home. The
husband could only receive CP if he was ineligible for age, invalid
or service pension. The rates and conditions were the same as for
Wife Pension (WfP).
From November 1985 this payment was renamed
Carer's Pension (CP) and made available to anyone caring for a
severely handicapped relative who was an age or invalid pensioner.
The care had to be provided by the carer in person and the carer
had to live in the home of the handicapped relative.
From February 1988 CP could be paid to a carer
who was not a relative of the person being cared for. The
requirement that constant care and attention was necessary was
removed. It was replaced by a stricter provision that personal care
in connection with bodily functions (including eating, toileting
and medication) had to be given or that constant supervision to
prevent injury to the person or others was required.
From January 1991 CP was made available to
people caring for a severely handicapped person in receipt of any
income support payment. Carers who lived in neighbouring dwellings
to those in which the person they cared for lived were also made
eligible for CP.
From July 1993 carers were allowed to cease care
for a total of 42 days in a calender year (up from 28) and still be
eligible for CP. They were also allowed to travel overseas during
the periods when they were not giving caring. Carers were allowed
to participate in employment, education or training for up to ten
hours per week. Carers were allowed to accompany the person being
cared for overseas for up to three months without losing
From March 1996 CP was paid for 14 weeks after
the permanent institutionalisation of the person who had been
receiving care. CP was payable where the person receiving care was
not receiving a social security payment. The carer was no longer
required to live in the same house or in an adjacent house to the
person being cared for.
From July 1996 carer pensioners were eligible
for advance payments of pension of between $250 and $500 to assist
with living or capital expenses.
From July 1997 CP was renamed Carer Payment. The
number of hours that a carer could spend in employment, voluntary
work, education, or training was extended from 10 to 20 hours per
week. The number of days that a carer may temporarily cease caring
in a calendar year was increased from 42 to 52.
From July 1998 eligibility for CP was extended
to carers of profoundly disabled children under 16 years of age.
Carers were to be able to cease caring for up to 63 days in a
calendar year and still qualify for CP.
In July 1998 there were 33,983 people receiving
CP with total outlays of $270 million in 1997-98.
Domiciliary Nursing Care Benefit
From March 1973 Domiciliary Nursing Care Benefit
(DNCB) was introduced at the rate of $14 per week. It was paid to
carers of people aged 65 years or more who had a continuing need
for nursing care. A doctor's certificate was used to establish
entitlement and a registered nurse had to certify that they visited
at least twice weekly. The rationale for the payment was to provide
assistance with the costs of home care for people who would
otherwise be admitted to a nursing home.
From November 1979, the age limit was reduced
from 65 years to 16 years. The rate of payment was increased in
1980 to $42 per fortnight (pf) and in 1993 to $52 pf. From then on
it was indexed to the CPI. In July 1998 an above indexation rise of
$16.60 brought the rate up to $75.10 pf.
From July 1998, the rate of DNCB was aligned
with that for Child Disability Allowance (CDA) and the number of
days per year that carers could temporarily cease to give care was
standardised for all carer payments at 63 days per year.
In 1997-98 program expenditure was $72 million.
45,675 carers were assisted to care for 46,124 people.
Child Disability Allowance
From December 1973, a Handicapped Child's
Allowance (HCA) of $10 per week was introduced for parents or
guardians caring for severely handicapped children under the age of
16 years who were at home and in need of constant care and
attention on a permanent or long-term basis. The allowance was not
taxable, nor was it subject to an income test.
From November 1977, eligibility for HCA was
extended to persons caring for children who were substantially,
rather than severely, handicapped. The rate of HCA for
substantially handicapped children was not fixed and was to be set
at the discretion of the Director-General of the DSS, but was not
to exceed the rate of HCA payable in respect of a severely
handicapped child. This allowance was subject to an income test,
but was not taxable.
From November 1987, CDA replaced HCA. The old
distinction between handicapped and severely handicapped was
removed and the new allowance was payable at the rate of $122 per
The rate of CDA has been indexed to the CPI
since January 1990. From January 1999 the rate is $75.60 pf.
From July 1998 a new assessment method was
introduced for determining eligibility for CDA. Under the previous
assessment system for CDA, a child had to have a disability and as
a result of that disability require substantially more care and
attention on a daily basis than a child of the same age without a
disability. Some disabilities were considered sufficient in
themselves to automatically fulfil the care requirement. They were
called manifest disabilities and eligibility was automatic.
The new assessment tool consists of
questionnaires for parents and treating doctors. It tries to assess
functional ability in a range of areas: special care needs,
behavioural issues and emotional state issues. The new system also
classifies certain conditions as recognised disabilities or chronic
conditions, which give automatic eligibility.
From July 1998 the rate of DNCB was aligned with
that for CDA and the number of days per year that carers could
temporarily cease to give care was standardised for all carer
payments at 63 days per year.
In June 1998 carers of 101,377 children and
students were receiving CDA.
Accelerated Pace of Recent
During the 1990s awareness of the role and
contribution of carers has increased steadily. Parties of all
persuasions have looked favourably upon efforts to increase
financial assistance to carers. The most recent reforms prior to
the measures, which are the subject of this Bill, were announced in
the 1997-98 Budget and called the 'Carer Package'. It included all
those measures mentioned above which commenced in July 1998. The
present set of measures is part of a broader package announced in
'Staying at Home Package'
The 'staying at home package' aimed to ensure
.. staying at home and receiving community care
is a real option for those older Australians who choose to do
The bulk of the package involved improved
services to older people living at home and their carers including
community care packages, respite care, continence management and
assessment. Reform of social security payments for carers made up
the remainder of the package.
Carer Allowance (CA)
A new Carer Allowance was announced as part of
the package. It will be created by the amalgamation of the existing
CDA and the DNCB (presently administered by the Department of
Health and Family Services). This merger will create a payment for
carers of people of all ages. When compared to the DNCB eligibility
will be easier. This is the result of the use of a new adult
assessment tool which will allow an additional 14 000 people caring
for adults to receive the new payment at a cost of $92 million over
four years. Eligibility for CA for carers of children will remain
much the same as it was under CDA. The major reform of CDA, a new
assessment tool, was introduced in July 1998. It attracted
considerable debate because it tightened eligibility. An evaluation
of the CDA assessment tool is currently under way and can be
expected to make some modifications to the tool in response to
submissions from groups representing people with disabilities.
The creation of CA simplifies carer payments and
brings them all into the one Department.
The allowance will be, like its predecessors,
income and assets test free and set at a modest rate of payment
($75.10 pf in 1998) considering the level of care provision
expected of recipients. Both DNCB and CDA have been largely token
payments giving some recognition of the extensive care efforts of
the carers who receive them. The creation of CA does not address
concerns about the adequacy of these payments.
The New Adult Assessment Tool
The new Adult Disability Assessment Tool (ADAT)
will be used when assessing eligibility for both CA and CP. It will
assess the functional ability of the care recipient on a more
consistent basis than the previous DNCB arrangements. It replaces a
rather restrictive and unsatisfactory requirement that the person
being cared for must be in continuing need of nursing home care.
This had the effect of discriminating between people with similar
care needs. The ADAT is intended to fix this problem by extending
eligibility to more people with cognitive impairments such as
dementia, intellectual disability or psychiatric illness. It is to
be expected that the detail of the ADAT will attract debate
centring on its treatment of specific conditions. The ADAT will be
set out in a disallowable instrument, which should be available for
scrutiny by the Parliament soon after the Bill is passed.
Carer Payment Eligibility Extensions
The Bill contains a number of eligibility
extensions to Carer Payment:
- Where a carer cares for the child of a person with a disability
as well as that person, CP will be easier to access. The level of
disability required in these cases will be set at a lower level
than where no children are involved. This will be the case where
any child less than 6 years is involved or the child has a
disability, which allows Carer Allowance to be paid.
- Carers who care for a person who is hospitalised will continue
to receive CP or CA for up to 63 days of the hospitalisation period
in a calender year. This provision is in addition to the existing
63-day cessation of care provision.
- Qualification for bereavement payments for carers will be
extended so that it is payable if the deceased partner was a long
term recipient of a social security benefit (eg. Newstart). At
present it is restricted to partners who were pensioners.
These measures continue the incremental
expansion of the coverage of CP that has been under way since its
Position of the Carers Association
The Carers Association of Australia has been
extensively consulted by the Government in the development of this
package of measures. They are generally pleased with the direction
of reform in this area and supportive of the measures in this Bill.
The financial assistance available to carers will still be
considerably less than the Association feels is desirable, but the
amounts paid, the eligibility criteria and administration will all
The Association supports the introduction of the
ADAT, but expects the Government to conduct a post implementation
evaluation and address any issues that arise.
Schedule 1 contains the provisions of the Bill
that extend the carer payment by amending the Social Security
Act 1991. It is also includes technical amendments to
the Income Tax Assessment Act 1997 which are consequential
to changes in the carer payment.
The former test which related to 'severely
handicapped persons' is repealed by Item 3.
Item 4 repeals the definition
of care receiver.
Item 5 introduces
proposed section 38C which will empower the
Secretary of the Department of Social Security to make a
determination formulating an 'adult disability assessment tool'.
This tool will be used to assess the disability, emotional state,
behaviour and special care needs of a person aged 16 or over and
will assign to a person a score indicating the level of disability
that they experience. The tool is a disallowable instrument for the
purposes of the Acts Interpretation Act 1901.
The qualifications for carer payment are
contained in Item 7. Proposed section
198(2)(d) extends the qualification for carer payment to
persons who are caring for an adult with a child and that adult's
child is aged between 6 and 16.
Proposed section 198AA extends
the eligibility criteria for the carer payment to persons who
participate in the care of a child or adult with disabilities or a
dependent child of a disabled adult who is in hospital. The payment
is limited to a period of 63 days per calendar year.
Item 94 amends section 237 and
will allow carer payments to be made for a bereavement period if
the care receiver was a long-term social security recipient. The
current provision provides for bereavement payments if their
partner was in receipt of a pension or income support
Schedule 2 introduces the carer
allowance and repeals the child disability allowance and
domiciliary nursing care benefit. Proposed new section
953 sets out the qualifications for the carer allowance
where a person cares for a disabled child or 2 disabled children.
These reflect the child disability allowance criteria.
A person must be an Australian resident
providing daily care in their own home to a disabled dependent
child under the age of 16. In the case where one child is cared
for, that child must have been assessed and rated under the child
disability assessment tool (CDAT) and given a positive score of not
less than 1. Where two children are being cared for, their
individual score must be a positive score less than 1 but their
aggregate greater than 1.
Proposed new section 954 sets
out the qualification criteria where a person cares for a disabled
adult. An Australian resident is qualified for a carer allowance
for a disabled adult if:
- the care receiver is an Australian resident and
- the care receiver is a family member of the carer (or approved
by the Secretary of Department of Social Security) and
- the care receiver has been assessed and rated, and been given a
score of not less than 30, under the Adult Disability Assessment
- the care is provided on a daily basis by the person, or the
person and another person, in a private home that is the residence
of the receiver and the carer.
Proposed section 955 provides
that carers participating in the care of a disabled person may be
paid the carers allowance while that person is in hospital for a
period up to 63 days.
New sections 961 and 962 allow
for the backdating of carer allowance payments for up to 12 months
if the claim relates to one or two disabled children and up to six
months if the claim relates to a disabled adult.
The Bill provides for situations where a person
receives care from more than one carer. Proposed section
964 provides that where 2 people (who are not a couple)
are both qualified to receive a carer allowance, only one should
receive it unless the Secretary makes a declaration under
proposed section 981 that the allowance is to be
shared. When 2 people providing care are a couple, the carer
allowance may only be paid to one of them. This will generally be
the person deemed by the Secretary to be the primary carer
(proposed section 965).
The Bill is likely to find broad support as a
beneficial measure for carers. Concerns have been expressed that
the Adult Disability Assessment Tool has only been released in
draft form making it difficult to assess the full impact of the
changes. Further consideration of the tool is likely when it is
considered by the Senate as a disallowable instrument.
Department of Health and Family Services,
Staying at Home - A New $280m Package for Older
Australians, Information Sheet No.1 (available at Internet
The Association's position on the income needs
of carers is fully explored in Caring Enough To Be Poor: A
Survey of Carer's Income and Income Needs, Canberra: Carers
Association of Australia, 1997.
Dale Daniels and Mark Tapley
30 March 1999
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