220.127.116.11 Assessment of CP Claim - Other Factors
Carer must personally provide constant care (1.1.C.310)
With the exceptions noted below, the carer must personally provide constant care in the home of the care receiver. This means that CP CANNOT be paid to a claimant who is indirectly providing a care receiver with care.
Example: Someone employing a nurse or meeting the cost of nursing could not receive CP.
Exceptions: A carer does not need to provide constant care in the home of the care receiver if they are:
- participating in the care of a care receiver in hospital (18.104.22.168), OR
- accessing temporary cessation of care provisions (22.214.171.124), OR
- caring for 2 or more care receivers aged under 16 on an exchanged care (126.96.36.199) basis, OR
- travelling overseas with the care receiver (188.8.131.52).
Explanation: For exchanged care the carer will have at least one child in their care at all times, but it will not be the same child all the time. The carer will provide personal constant care to the child/ren in a private home of the child/ren. Each child will have more than one home, that is, they will live in the homes of each of their parents as they are exchanged in accordance with the parenting plan or order.
Carers of a HIGHER or LOWER ADAT SCORE ADULT (1.1.H.63) (1.1.L.130) and carers of a child aged under 16 years with severe disability (1.1.S.133), severe medical condition (1.1.S.130), disability, medical condition or who has a terminal condition (1.1.T.86) must provide details of the care they provide. Delegates must be satisfied about the extent of the care the carer is providing to the care receiver. This is particularly important during periods where the care receiver is away from home, or the carer is absent from the care situation, in circumstances not covered by the temporary cessation of care provisions.
Carers of a PROFOUNDLY DISABLED CHILD (1.1.C.146) or 2 OR MORE CHILDREN WITH DISABILITY (1.1.T.190) (i.e. those who qualified and remain qualified under the pre 1 July 2009 qualification provisions) are NOT required to provide details of the level of care they provide. In these situations it would generally be accepted that constant care is being provided. However, if doubt exists about whether the claimant is personally providing constant care, further investigation may be appropriate.
Example: A social worker home visit.
The medical report for a PROFOUNDLY DISABLED CHILD (1.1.C.146) seeks a diagnosis and specific indications based on the legislative definition of a profoundly disabled child. This removes any discretion from the assessment of the care required. However, the delegate must be satisfied that the carer is providing constant care.
Explanation: A child that meets the definition of a profoundly disabled child requires a very high level of care.
Policy reference: SS Guide 184.108.40.206 Qualification for CP
Age of carer
There are no legislative age limits applicable to CP, but claims from carers (1.1.C.40) under 18 years of age, or 80 years of age or older require a referral to a social worker. This is necessary to ensure that the carer can and does, provide the care receiver (1.1.C.20) with the constant care required. A social worker should assess and document the care situation.
Explanation: There are 2 main reasons for this:
- to ensure that the carer has the physical and emotional capacity to provide the level of care needed, and
- a very young or elderly carer may have difficulty accessing support services and resources. A social worker can provide information and assistance in this regard.
For carers under school leaving age the social worker should also check that the appropriate education authority has given permission for the young person to leave school.
Note: Students in all states are required to remain in some form of education, training or employment until they turn 17. The requirement for participating in training and/or employment differs in some states.
Note: Where there are concerns about the capacity of the carer to provide the appropriate care, regardless of their age, advice from a social worker should be sought. This is NOT the same as a referral to a carer specialised assessment team (CSAT) (1.1.C.55).
Social worker assistance in determining claim (not including referrals to a CSAT)
Social workers can provide information to verify:
- the care receiver's personal care or supervision needs in the home,
- the level of care or supervision actually being provided by the carer,
- whether any other person assists with the care of the care receiver, and if so whether the CP claimant/recipient is personally providing constant care, and
- whether the carer has the physical and/or emotional capacity to deal with the care receiver's care needs, if the carer is under 18 years of age, or 80 years of age or older.
Information provided by a social worker should contribute to a decision about qualification for CP, but the delegate, NOT the social worker, makes the decision about qualification. CP should not be rejected or cancelled without contacting the carer/THP to discuss conflicting information.
If a carer claims CP and they are being remunerated for the care they provide to a care receiver, e.g. a paid nurse, this does not necessarily preclude them from qualification. Any income earned by the carer would be assessable under the pension income and assets test, and may mean that CP is not payable. The carer must continue to meet all CP qualification criteria including 'constant care'. Where payment is received for caring as opposed to reimbursement of costs, this is considered a 'commercial arrangement' regardless of the fact that the caring may occur in a person's own home. Where a partner or another person is paid to provide the care this is also considered a commercial arrangement.
Example: Matthew provides care for his 40 year old cousin Tom who has autism. Tom lives with Matthew 11 days per fortnight and his elderly parents the other 3 days per fortnight. Tom receives $800 per week from the Western Australian Disability Services Commission, which is paid through Perth Home Care Services, to pay Matthew in recognition for the care he provides.
The $800 per week income Matthew receives from Tom is not exempt income from the pension income test.
Note: Ministers may approve personal care support schemes under SSAct section 35A. Payment from 'approved schemes' are paid towards the cost of personal care support services and do not provide income support for the person who is receiving care. Payments made from an approved scheme are exempt from the income test under SSAct section 8(8)(zi), but ONLY in the hands of the person who is receiving care. Payments that do not belong to the person receiving care are not exempt under section 35A. Payments are not exempt in the hands of the carer (220.127.116.11).
Act reference: SSAct section 35A Personal Care Support, section 8(8)(zi) a payment towards the cost of personal care…
Policy reference: SS Guide 1.1.C.206 Commercial care arrangements (CA, CP)
Carer lives in separate accommodation
It is not necessary for the carer and the care receiver to be living in the same home. However, if the carer does not share the same accommodation as the care receiver, the constant care criteria must be closely considered. The following factors in particular should be taken into account:
- the nature of the care receiver's disability or medical condition,
- the type of care or supervision needed,
- the method of communication between the 2 homes, and
- the speed with which the carer can respond to an emergency.
Situations where the carer and care receiver reside separately may involve:
- a disabled adult living in their own accommodation, OR
- exchanged care (1.1.E.162), OR
- a care receiver with severe disability or severe medical condition who has more than one carer.
These situations will require thorough assessment to ensure that the carer/s qualify for CP.