Bills Digest No. 148  1998-99 Assistance for Carers Legislation Amendment Bill 1999


Numerical Index | Alphabetical Index

WARNING:
This Digest was prepared for debate. It reflects the legislation as introduced and does not canvass subsequent amendments. This Digest does not have any official legal status. Other sources should be consulted to determine the subsequent official status of the Bill.

CONTENTS

Passage History
Purpose
Background
Main Provisions
Concluding Comments
Endnotes
Contact Officer and Copyright Details

Passage History

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 July 1999.

Purpose

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.

Background

The Development of Carer Payments

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.

Carer Payment

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 entitlement.

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 month.

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 Reform

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 April 1998.

'Staying at Home Package'

The 'staying at home package' aimed to ensure that:

.. staying at home and receiving community care is a real option for those older Australians who choose to do so.(1)

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 inception.

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 be improved.(2)

The Association supports the introduction of the ADAT, but expects the Government to conduct a post implementation evaluation and address any issues that arise.

Main Provisions

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 supplement.

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 Tool and
  • 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).

Concluding Comments

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.

Endnotes

Department of Health and Family Services, Staying at Home - A New $280m Package for Older Australians, Information Sheet No.1 (available at Internet address http://www.health.gov.au/acc/sreform/curfacts/csoa/01csinfo.htm).

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.

Contact Officer and Copyright Details

Dale Daniels and Mark Tapley
30 March 1999
Bills Digest Service
Information and Research Services

This paper has been prepared for general distribution to Senators and Members of the Australian Parliament. While great care is taken to ensure that the paper is accurate and balanced, the paper is written using information publicly available at the time of production. The views expressed are those of the author and should not be attributed to the Information and Research Services (IRS). Advice on legislation or legal policy issues contained in this paper is provided for use in parliamentary debate and for related parliamentary purposes. This paper is not professional legal opinion. Readers are reminded that the paper is not an official parliamentary or Australian government document.

IRS staff are available to discuss the paper's contents with Senators and Members
and their staff but not with members of the public.

ISSN 1328-8091
© Commonwealth of Australia 1999

Except to the extent of the uses permitted under the Copyright Act 1968, no part of this publication may be reproduced or transmitted in any form or by any means, including information storage and retrieval systems, without the prior written consent of the Parliamentary Library, other than by Members of the Australian Parliament in the course of their official duties.

Published by the Department of the Parliamentary Library, 1999.

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