Disability Care Load Assessment (Child) Determination 2009

EXPLANATORY STATEMENT

Disability Care Load Assessment (Child) Determination 2009

Summary

The Disability Care Load Assessment (Child) Determination 2009 (the Determination) is made by the Secretary of the Department of Families, Housing, Community Services and Indigenous Affairs (the Secretary) under section 38E of the Social Security Act 1991 (the Act).

The Determination will enable the Secretary to assess the functional ability, behaviour and special care needs of a child through the assessment of care load (which is completed by the claimant) and a professional questionnaire (completed by a treating health professional). Completion of the two parts of the Determination is part of the qualification criteria for carer payment (under section 197B, 197C or 197D of the Act).

Background

In the 2008-09 Budget, the Government announced measures to expand qualification for carer payment paid in respect of a child. As part of this measure, the Government announced that it would implement a new assessment process to determine qualification for carer payment paid in respect of a child, based on the amount of care required by a child with disability or two or more children with disability, rather than the rigid medical criteria used to assess qualification for the payment.  

The Social Security Legislation Amendment (Improved Support for Carers) Act 2009 (the Improved Support for Carers Act) changed the qualification criteria and assessment process for carer payment for care provided to children with disability or a medical condition to provide a fairer and more equitable process based on the level of care required.

Relevantly, the Improved Support for Carers Act inserts sections 38E, 197B, 197C and 197D into the Social Security Act 1991. Section 38E provides that the Disability Care Load Assessment (Child) Determination may provide a method for giving a qualifying rating to a person who is a carer, that takes into account the care provided by the carer to the child and the assessment completed by a treating health professional.  As a part of the process in providing the qualifying rating, the Secretary may devise a test for assessing the functional ability, behaviour and special care needs of a person aged under 16 and a method for rating the care needs of the child.  Section 38E provides that the test is to include an assessment that must be completed by a treating health professional.  

If the carer who is caring for a child is also providing care for one or more other people, whether it is other children or a disabled adult, the Determination may provide a method for giving a qualifying rating to the carer that takes into account the care provided for the child by the carer and the assessment completed by the treating health professional and the care provided by the carer for each other person.

The Determination is broken into two parts and contains two schedules.  Schedule 1 contains the assessment of care load questionnaire (ACL) and the professional questionnaire.  Schedule 2 contains the rating methods for the ACL questionnaire and the professional questionnaire. 

The assessment of care load, found in Part 1 of Schedule 1 to the Determination and completed by a claimant, and the professional questionnaire, found in Part 2 of Schedule 1 to the Determination and completed by a treating health professional, comprise the new test that will be used for a carer of one child or multiple children and is a step in the process of determining whether one or more carers are qualified for each child.  The new test will also be used for carers of one or two children who are also providing care for a disabled adult or, alternatively, in cases where there is care provided to more than one child with a disability at the same time.

Sections 197B, 197C and 197D of the Act provide, as part of the qualification criteria, that a person be given a qualifying rating of intense under the Determination.  If a person does not achieve a qualifying rating of intense in relation to care that they provide for one or more care receivers then they are unable to qualify for carer payment under section 197B, 197C or 197D.

Explanation of the provisions

Section 1 states the name of the Determination.

Section 2 states that the Determination commences on 1 July 2009. This corresponds with the commencement date of the amendments to the Act under which the Determination is made. The amendments are made by the Social Security Legislation Amendment (Improved Support for Carers) Act 2009.

Section 3 contains interpretation provisions.

Section 4 states that the Secretary may delegate any or all of his powers under this Determination.  The delegation of the Secretary's powers under this Determination is within the Secretary's discretion.  In order to facilitate the day to day administration of the social security law the Secretary’s powers under this Determination will be required to be delegated to officers of the Department of Families, Housing, Community Services and Indigenous Affairs and Centrelink employees.  The delegation power is cast in broad terms to reflect that the powers contained in this Determination may be exercised by a wide range of officers and employees.  Careful consideration is given to the delegation of such powers to ensure that they are exercised by persons at appropriate levels and performing relevant tasks.

Section 5 states that Part 2 of the Determination sets out the Disability Care Load (Assessment) Child.

Section 6 provides that there are two questionnaires. Subsection 6(1) states that Part 1 of Schedule 1 sets out the ACL questionnaire about the functional ability, behaviour and special care needs of a child.  Subsection 6(2) provides the ACL questionnaire may only be completed by a person seeking to claim a carer payment for the care of a child. 

Subsection 6(3) provides that the professional questionnaire is set out in Part 2 of Schedule 2 and subsection 6(4) provides that only a treating health professional may complete the professional questionnaire.

Section 7 sets out the rating method for the Disability Care Load Assessment (Child).  A claimant achieves a qualifying rating of intense if the sum of the scores in each domain on the completed ACL questionnaire is a qualifying ACL score and the score on the completed professional questionnaire is a qualifying professional questionnaire score.  A claimant cannot achieve a qualifying rating of intense without the requisite scores on both the ACL and the professional questionnaires.

Section 8 sets out further detail in relation to the ACL questionnaire. 

Subsections 8(1) – (4) set out the scoring method for the ACL questionnaire.  The questions in the ACL questionnaire are grouped into four domains (subsection 8(1)) and the total score for each domain must not be less than 0 (subsection 8(4)). 

Subsection 8(2) provides that if the claimant marks more than one answer to any question then only the answer that gives the highest score should be taken.  The scoring for questions within each domain, and the method used to determine the total score for each ACL questionnaire is set out in Part 1 of Schedule 2 (subsection 8(3)).

Subsection 8(5) provides that the Secretary must be satisfied that a completed ACL questionnaire is an accurate reflection of the functional ability, behaviour and special care needs of the child to whom it relates.  If the Secretary is not satisfied that the completed ACL questionnaire is an accurate reflection of the child’s functional ability, behaviour and special care needs, subsections 8(6) – (8) provide the Secretary with the power to add additional points to the scores of the claimant for the Behavioural and Functional Abilities domains.  Additional points may only be added to Domains A, B and C.  The value of any additional points added to any of the domains may not exceed the highest score from one extra question in that domain.  The Secretary cannot add additional points to the Special Care Needs domain.

Section 9 sets out further detail in relation to the professional questionnaire. 

Subsection 9(1) provides that the scoring method for the professional questionnaire is set out in Part 2 of Schedule 2.  Unlike the ACL questionnaire, the score for the total professional questionnaire score may be less than 0 (subsection 9(3)).  If the Secretary is not satisfied that a completed professional questionnaire is an accurate reflection of the functional ability, behaviour and special care needs of the child to whom it relates, then subsection 9(5) provides the Secretary with the power to request a replacement questionnaire be completed by an alternate treating health professional.

Section 10 sets out the qualifying scores that a person who is caring for a child with severe disability or severe medical condition has to obtain to achieve a qualifying rating of intense.  Section 10 applies to a person whether they are the only person providing care for the child or whether they are one of a number of carers. 

Subsection 10(1) provides that a professional questionnaire must be completed for the child and the claimant must complete an ACL questionnaire for the child.  A claimant receives a qualifying rating of intense under subsection 10(2) if the total score on the person’s ACL questionnaire is 85 or more and the score on the professional questionnaire is greater than 0. 

If more than one person has claimed carer payment for the care of the same child, only one professional questionnaire needs to be filled out in respect of the child and that professional questionnaire can be used to contribute to each person’s qualifying rating.  However, each person must complete a separate ACL for the child.

Section 11 sets out the qualifying scores that a person, who is caring for two, three or four children each with disability or medical condition, has to obtain to achieve a qualifying rating of intense.  If a claimant is caring for two or more children, each of whom has a disability or medical condition, the claimant must complete an ACL for each child and a professional questionnaire must be completed for each child.  In order for the claimant to achieve a qualifying rating of intense the total score from the contributing ACLs must be 85 or higher and each child must receive a professional questionnaire score of greater than zero.  An ACL score in respect of care that the claimant gives to a child must be 20 or more for the ACL to be able to contribute to the qualifying rating.  If a claimant does not achieve an ACL score of 20 or more in respect of care that they provide to a child then that ACL cannot contribute to the claimant’s qualifying rating.  A maximum of four ACLs and four professional questionnaires can contribute to a person’s qualifying rating.  The ACLs and professional questionnaires must be completed in respect of the same children.

Examples

Nigel provides care for his five children, Nigella, Thomasina, Horatia, Thomas and Horatio, each of whom has a disability or medical condition.  Nigel completes an ACL in respect of the care that he provides to each of the five children.  A professional questionnaire is also completed for each child.  The children receive the following scores:

Nigella’s, Thomasina’s, Horatia’s and Thomas’ ACL score are all above 20 and, therefore, their scores can be used to contribute to Nigel’s qualifying rating.  Their combined score is 86 and they each have a professional questionnaire score of greater than 0.  Therefore, Nigel achieves a qualifying rating of intense for the care that he provides to Nigella, Thomasina, Horatia and Thomas.  As Horatio’s ACL score is below 20 and his professional questionnaire score is below 0, he is not able to contribute to Nigel’s qualifying rating.

Section 12 sets out the qualifying scores that a person who is caring for a lower ADAT score adult and one or two children with disability or medical condition is to achieve to have a qualifying rating of intense.  To achieve a qualifying rating of intense in this situation the claimant must achieve a total ACL score of 85 or more and the score on the contributing professional questionnaire for each child must be greater than 0.  The lower ADAT score adult is taken to contribute 40 to the total combined score for the contributing ACLs.  A maximum of two ACLs and two professional questionnaires can contribute to a person’s qualifying rating.  The ACL is a contributing ACL only if the total ACL score for that ACL is 20 or more.

Examples

Melonee provides care to her husband, Dorrien, and daughter, Doronee.  Dorrien has been assessed and rated under the Adult Disability Assessment Tool and given a score of 25, with a professional questionnaire score of 10.  Melonee has completed an ACL for Doronee and has achieved a rating of 47.  Doronee’s professional questionnaires score is 3.  Melonee’s combined ACL score is 87 and as Doronee’s professional questionnaire score is greater than 0, Melonee achieves a qualifying rating of intense.

Consultation

Assessment of care load

The Department of Families, Housing, Community Services and Indigenous Affairs (FaHCSIA) engaged the Centre for Health Service Development (CHSD) at the University of Wollongong to develop the Assessment of Care Load questionnaire.  CHSD has expertise in assessment tool development for both carers and people with disability. 

Consultations conducted by CHSD and FaHCSIA included:

•                  an expert reference group comprised of targeted paediatric health and medical professionals, a member of Carers NSW and a private consultant with knowledge of both the Adult Disability Assessment Tool (contained in the Adult Disability Assessment Determination 1999) and the Child Disability Assessment Tool (contained in the Child Disability Assessment Determination 2001).  The consultant also conducted the focus group organised by FaHCSIA as part of the Carer Payment (child) Review.  The expert reference group met formally on two occasions and provided assistance with both the development and scoring methodology of the questionnaire;
•                  approximately 10 carers who participated in user testing of the draft ACL questionnaire, prior to the pilot;
•                  a random sample of carers of children under 16 years with disability or medical conditions who participated in a pilot of the ACL questionnaire and provided feedback on the assessment from a carer perspective.  Questionnaires were mailed out to 7,500 carers of children with disability or medical conditions who were invited to participate.  Over 1200 carers responded to the pilot and CHSD analysed these results; and
•                  Centrelink.

Professional questionnaire

The professional questionnaire contained in this Determination is almost identical to the professional questionnaire that is included in the Child Disability Assessment Determination 2001.  The professional questionnaire was developed following extensive consultation with peak disability groups and specialists in childhood disability.  Based on this consultation, FaHCSIA considered that further consultation was not required in relation to the professional questionnaire.

Regulatory Impact Analysis

This Determination does not require a Regulatory Impact Statement (RIS) nor a Business Cost Calculator Figure.  This Determination is not regulatory in nature, will not impact on business activity and will have no, or minimal, compliance costs or competition impact.