18.104.22.168 Qualification during Temporary Absence from the Private Home - Hospitalisation (CA)
Care receiver in hospital
- the carer is providing additional care and attention (i.e. where the carer makes regular visits and assists with feeding, exercising, etc),
- the care is on a regular and ongoing basis,
- the care receiver (except where terminally ill) is likely to return home.
Where the care receiver is a disabled adult, the care receiver may be in hospital for a maximum of 63 consecutive days or non-consecutive days that amount to 63 days in the calendar year.
Note: Where the care receiver is a child, the care receiver may be in hospital for an unlimited number of days providing the carer continues to provide additional care and attention while the child is in hospital.
New claims while the care receiver is hospitalised
In the case of adults or children (including babies who have not been home since birth and care receivers who are terminally ill) who are hospitalised, the carer may qualify if the claim is made while the care receiver is in hospital, providing they meet the qualification requirements. This includes a reasonable expectation that the care receiver will reside in their private home upon leaving hospital and the requisite score under the ADAT (for an adult) or DCLA (for a child) is achieved or the child's disability is a recognised disability, and other criteria as found in the SSAct are met. Backdating provisions may also apply.
When the care receiver is aged 16 years or over & is hospitalised for more than 63 days in a calendar year
If the care receiver is aged 16 years or over (adult) and remains in hospital for longer than 63 days in one calendar year, a carer may use the balance of their 63 day temporary cessation of care entitlement to remain eligible for CA. If both hospitilisation and temporary cessation of care provisions have been used in full within a calendar year AND the care receiver remains in hospital or is readmitted to hospital within that period, CA should be cancelled. The carer will need to reclaim CA when the care receiver returns home. Further temporary cessation of care or hospitalisation entitlement will not be available until the next calendar year, unless the Secretary's delegate deems there is a special reason, under SSAct section 198AC (3) - see 22.214.171.124.
Example: Mr Lime is caring for his wife who enters hospital for a lengthy period on 1 August. As he is participating in his wife's care while she is in hospital, Mr Lime continues to receive CA for 63 days until 2 October. Mr Lime has not used any temporary cessation of care entitlement during the calendar year so payment may be continued for another 63 days, until 4 December. If there are no special circumstances which would warrant extension of the 63 days, payment will be cancelled from 5 December. Mr Lime may reclaim CA once his wife returns home but will not receive any further temporary cessation of care or hospital entitlements until the next calendar year.
Where there is more than one adult care receiver
A person is allowed 63 days hospitalisation for each adult care receiver for whom the person is qualified for CA in their own right. Where 2 carers each receive a percentage of CA in a shared care situation, the carer receiver may be hospitalised for 63 days and both carers will remain qualified provided they provide care to the care receiver while they are in hospital.
Carer in hospital
A carer who is admitted to hospital can utilise the temporary cessation of care provisions.
Act reference: SSAct section 954B Qualification for CA-receiving CP for caring for child or children, section 955 Qualification for CA-hospitalisation, section 957(1) Continuation of allowance where temporary cessation of care, section 957(2) Continuation of payment after hospitalisation-s955 ceases to apply, section 957(3) Limit on subsections (1) and (2)
Policy reference: SS Guide 126.96.36.199 Qualification for CA (child) - Automatic Qualification for CA (child) through Qualification for CP (child), 188.8.131.52 Qualification for CA during Temporary Cessation of Care