126.96.36.199 Qualification for CP during temporary absence from the private home - hospitalisation
Care receiver in hospital
- the carer is providing additional care and attention (that is, where the carer makes regular visits and assists with feeding, exercising, etc), AND
- the care is on a regular and ongoing basis, AND
- the care receiver (except where terminally ill) is likely to return home, AND
- 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, unless they have a terminal illness and are not expected to live more than 3 months.
Where the care receiver in hospital is aged under 16 years
Where the care receiver is aged under 16 years and the carer has qualified for CP while the care receiver is hospitalised the carer is entitled to CP for the duration of the child's hospitalisation provided they continue to meet all the qualification requirements.
If the child remains in hospital for a period of 12 consecutive weeks, the carer will be reviewed and be required to provide written confirmation to the Secretary that the child is still in hospital and that they are still participating in the care of the child while they are in hospital (that is, the carer continues to provide additional care and attention while the child is in hospital). The carer's continued participation in the care of the child will be reviewed every 12 weeks of continuous hospitalisation. A more comprehensive review will be undertaken after 24 months of continuous hospitalisation.
Where the care receiver in hospital turns 16 years
A carer in receipt of CP (child) before the child turns 16 years can remain qualified under CP (child), which includes unlimited hospitalisation provisions, until the later of the following:
- the child turns 16 years and 3 months of age, OR
- where all CP (child) to CP (adult) transfer documentation is submitted on or before the day the child turns 16 years, until the CP (adult) assessment is completed.
Where the care receiver in hospital is a CP (child) with a terminal condition
Where the carer is qualified for CP for a child who has a terminal condition, provided the carer continues to meet all other qualification requirements, the carer is qualified for CP until the child turns 18 years of age. The carer must then apply for and be assessed under CP (adult) rules. If all CP (child) to CP (adult) transfer documentation is submitted on or before the day the child turns 18 years, they remain qualified until the CP (adult) assessment is completed.
Act reference: SSAct section 197K Remaining qualified after child turns 16, section 197E Qualification – child who has a terminal condition
Policy reference: SS Guide 188.8.131.52 CP (child) to CP (adult) transfer process
Where 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 CP. If both hospitalisation 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, CP should be cancelled. The carer will need to reclaim CP 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 184.108.40.206.
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 CP 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 CP, once his wife returns home but will not receive any further temporary cessation of care or hospital entitlements until the next calendar year.
When there is more than one care receiver
Where the carer qualifies for CP on the basis of their combined care of 2 or more children aged under 16 years, each CHILD may be in hospital simultaneously or separately for an unlimited number of days.
Where the carer qualifies for CP on the basis of their multiple care of a disabled adult aged 16 years or over, and one or more children aged under 16 with disability or medical condition, or a disabled adult and their dependent child, each CHILD may be hospitalised for an unlimited number of days. The 63 day limit will still apply to the ADULT care receiver, that is, the ADULT care receiver may be in hospital for a maximum of 63 days (either continuous or broken) in one calendar year and still qualify their carer for CP.
Providing care to all care receivers when a care receiver is hospitalised
Where the carer qualifies for CP on the basis of 2 or more care receivers and one care receiver is hospitalised, the carer must continue to provide constant care to all other care receivers that qualify the carer for CP, in order to remain qualified for CP.
If the carer is unable to provide constant care to the care receiver/s that are not in hospital due to their participation in the care of the hospitalised care receiver/s, the carer may use the temporary cessation of care provisions up to their 63 day limit. Similarly if the carer is unable to participate in the care of the hospitalised care receiver/s due to the constant care required by care receiver/s that are not in hospital, the carer may use the temporary cessation of care provisions up to their 63 day limit.
Act reference: SSAct section 198AC Effect of cessation of care etc. on CP
Policy reference: SS Guide 220.127.116.11 Qualification for CP during temporary cessation of care
Short term & episodic care
Where a carer qualifies for CP on a short term (1.1.S.172) or episodic care (1.1.E.132) basis for a child care receiver who is hospitalised, providing the carer meets all other qualification requirements, the carer will continue to qualify for CP during the hospitalisation of the child for the period of short term or episodic care.
Example: Mary qualifies for CP for care provided to Sarah on the basis of short term care for a period of 4 months (1 March - 30 June). Sarah is in hospital during this period from 1 March to 15 June. Mary will qualify for CP for all the days that Sarah is in hospital provided she continues to satisfy all the requirements of CP. If Sarah was in hospital beyond the end date of the period of care for which Mary qualifies for CP, Mary would no longer qualify for CP unless an extension of the period of CP is sought and granted.
Act reference: SSAct section 197G Qualification-short term or episodic care of children, section 197H Qualification-extension of short term or episodic care
Carer in hospital
A carer who is admitted to hospital can utilise the temporary cessation of care provisions.
Act reference: SSAct section 198AA Qualification for CP-hospitalisation, section 198AC(1) Continuation of payment where temporary cessation of care, section 198AC(2) Continuation of payment after hospitalisation-section 198AA ceases to apply