Q&As regarding announcement of national approach to carer support services

Q&As regarding announcement of national approach to carer support services

Posted March 5, 2018

  1. 1.       What is the Carer Allowance?

A fortnightly payment available for someone who gives daily care to someone who has a disability, serious illness, or is frail aged.  In order to qualify the person being cared for must

  • Score high enough on the Adult Disability Assessment tool which measures the impact of a physical, intellectual and/or psychiatric disability (including disabilities arising from chronic illness).
  • Be likely to have the illness or disability for at least 12 months, unless it is terminal
  • Get care from the carer in their home, in the carer’s home or in hospital.

Currently the Carer Allowance is not income tested. 

The indexed Allowance is currently $127.10 per fortnight (or $63.55 per week) plus a health care card if caring for a child.  You can get more than one Allowance if you care for more than one person who meets the disability level requirements.

 

  1. 2.       What is the Carer Supplement?

The Carer Supplement is an additional payment of $600 per year which is paid to those receiving the Carer Payment and/or the Carer Allowance.  As with the Carer Allowance, a person can receive more than one supplement, depending on the number of people they care for who meet the disability requirements.

 

  1. 3.       Is this the only financial support carers receive from government?

No.  The Carer Payment is also available to provide basic income support for carers who provide a substantial amount of care and are unable to engage in employment (or only very limited employment) as a result.  However this payment is income tested.  It’s a welfare payment like the Aged Pension or the Disability Support Pension.

 

  1. 4.       What do carers spend the Carer Allowance and Carer Supplement on?

Both the Carer Allowance and the Carer Supplement can make a major contribution to assisting with the extra costs of caring.  It is up to the carer how they spend this funding.  In a survey of carers conducted by Carers Australia in 2014, carers reported spending the Carer Allowance on many extra, constant and continuing expenses.  These extra needs included:

  • transport costs to and from appointments (including keeping a car on the road or parking)
  • medications and other pharmacy products not covered by either the MBS or PBS
  • private health insurance
  • constant repairs to, or replacement of, clothing and household items destroyed by people with behavioural or sensory problems
  • high electricity costs associated with operating specialist equipment
  • expensive special dietary requirements.

This list is not exhaustive.  The extra costs of caring will depend on family circumstances and the needs of those being cared for.

The Carer Supplement is designed to assist with larger expenses.  Examples might include:

  • the cost of unsubsidised or inadequately subsidised  medical equipment and assistive technology
  • paying for dental care
  •  replacing essential household equipment such as washing machines and dryers (very important when you are caring for someone who is incontinent).

Again, this list is indicative only.

 

  1. 5.       What is changing?

A cut off point of a household income of a quarter of a million dollars per year will be introduced.  In other words, the Carer Allowance and any attached Carer Supplements will not be available to carers in households exceeding this income threshold.  This measure will come into effect in September 2018.

 

  1. 6.       Why means test the Carer Allowance?

 

  • Other than the Blind Pension, the Carer Allowance is the only Centrelink payment which is not means tested.
  • There is a need to invest funding into improved carer support services.  A significant proportion of DSS carer support services funding devoted to meeting the needs of carers is being gradually transferred to fund the NDIS which supports the person with disability.  However, there is a growing demand for these carer services, especially with the ageing of the population and growth in carers’ awareness of their status and the services which are available to them.  The government has been developing an improved carer support services model over the past few years, but it requires a higher level of funding than is currently available and the government has decided that this additional funding can only be financed by savings from the sector.

 

  1. 7.       How much of the savings will be used to support improved services?

 

100% of the savings will be devoted to carer services, amounting to $85.6 million over the Forward Estimates (4 years).  The new funding of is in addition to the existing funding provided by the Department of Social Services for carer supports and services.

 

  1. 8.       How many carers will be affected by the decision to means test the Allowance?

About 1% of CA recipients.

 

  1. 9.       Setting the income threshold at $250,000 household income per annum seems exceptionally generous compared to other government income support payments.  Why should it be so high?

We recognise that the threshold is very generous compared to other income support payments and we respect that the government has set the limit at a level which is likely to minimise the impact on carers who make substantial financial sacrifices in their caring role – especially if they are caring for more than one person.

 

  1. 10.   Is access to carer services income tested?

There is no requirement to income test carer services offered under Department of Social Services carer programs and, to the best of our knowledge, there is no intention to do so.   Carers in households with incomes over $250,000 per year will be able to benefit from improvements to carer services to improve their own wellbeing and to assist them in their caring role.

 

  1. 11.   How do you anticipate carers will respond to the means testing of the Carer Allowance?

It’s only natural when people have become accustomed to receiving a benefit to feel aggrieved when it is taken away.

Some carers regard the Carer Allowance and the accompanying supplement as a sort of reward or payment for caring.  However these payments are in recognition that providing substantial care to someone with a disability, a chronic illness, a mental illness, who is terminally ill or is frail aged can add substantially to the usual costs of maintaining a household, especially for those in the lower income brackets. 

 

  1. 12.   What sort of changes are being proposed to carer support services?

Historically carer services across Australia have been somewhat fragmented.  There are a multiplicity of programs, each with their own eligibility requirements and reporting arrangements and each requiring separate grant applications, which place heavy administrative burdens on both government and service providers. The historical accumulation of sub-programs to meet particular needs for sub-groups of carers which assumed high priority at certain times has also created gaps for carers who do not fall into the particular demographic to which these programs are targeted.

Organisations striving to provide a suite of service supports to carers regardless of the carer’s own age and the age and condition of those they care for have struggled to coordinate funds from as many streams as possible.  The new model is being designed to provide an integrated approach to service provision for carers, whoever they may be caring for.

In addition, direct funding for support services to assist carers with their own needs has been declining over a number of years with the introduction of the NDIS and national aged care reform which have seen the transfer of some funds and programs from carer support to the support of those they care for.  This is despite the fact that the demand for carer services is likely to grow significantly as carers become more aware of their need and right to access support through initiatives such as the Carer Gateway and through the advocacy, communication and promotional activities of organisations such as our own.

The Integrated Carer Support model is designed to promote equitable access to carer supports across Australia and to offer the full range of carer supports in a one stop shop through the creation of regional hubs.  It will also incorporate some supports which are not currently available.  It will bring the delivery of some services more up-to-date through digital delivery, where that makes sense, without abandoning phone or face-to-face contact and direct  provision of services where that is the carer’s preference and where it is the better mode of delivery.

 

  1. 13.   What sort of carer support services will be delivered under the Integrated Carer Support program?

The ICSS will deliver many of the services currently available to carers:

  • information and referral to a variety of carer-specific and other community services
  • counselling
  •  emergency respite
  •  education and training, and
  • peer support. 

However the model aims for less fragmentation in funding and better national coverage.  There will also be a national carer needs assessment and the provision of planning and coaching assistance. Some targeted financial support is envisaged. 

 

  1. 14.   Don’t improvements to the support services to those they care for – such as through the NDIS and aged care reform – mean that carers don’t need so much support themselves?

For many carers who care for someone who is eligible for high levels of support through the NDIS or aged care, a great deal of the strain associated with caring will be alleviated.   But surveys conducted by Carers Australia associations and other organisations indicate that, especially with respect to the NDIS, many carers are providing as much care as they ever did and, if they are managing packages, even more time devoted to the caring role than before. 

And it is important to remember that not all the strains associated with caring can be addressed by better equipment, a few hours of replacement care a week or even better opportunities for the person they care for to participate in community life. 

There can be many emotional strains in a care relationship.  Carers often suffer guilt because they cannot address all the deficits in the life of those they care for, because they worry that they are not doing a perfect job as carers, because they sometimes feel resentful of the loss of their own life chances. They also tend to be socially isolated or lonely.  They are frequently financially insecure.  Wider family relationships can become very tense around the caring role. In addition, carers are often the ones who often have to negotiate the supports for and assert the rights of those they care for.  They may need legal advice.  They may need education in the care they provide.  They may need a rest.

It is also important to recognise the large number of carers who care for people who are not covered by the NDIS or may not have access to high level Home Care Packages in aged care.  With respect to NDIS eligibility, the condition of person they care for must be permanent.  With respect to aged care packages, the number is capped and there are waiting list.  The wait can be very long.

So, welcome as they are, better disability support and aged care support are not a panacea to address carers many needs.

 

  1. 15.   Does Carers Australia have any concerns about the new services model?

 

We have been involved in the design of the model over a period of time and endorse the approach.  However there are some aspects of the model which still need to be fully articulated.

 

Where we do have concerns is with respect to its implementation.

 

We have made it very clear to government that we do not want implementation to be rushed.  We don’t want a repeat of the NDIS situation where changes were introduced too fast and have resulted in some serious administrative and service failings.

 

Importantly, we want proper transition arrangements from the current service landscape so that existing services don’t suddenly disappear through the lack of reasonable transitional funding certainty, leaving significant gaps in support for carers while the new model gets up to speed.

 

This means that existing contracts for the delivery of services through government grants must be extended, until such time as the new model is fully operational.

 

  1. 16.   Will Carers Australia and its associations benefit from the transfer of funding from the Carer Allowance and Carer Supplement to service provision?

Carers Australia state and territory associations will be in the mix of organisations which will apply for grant funding under the new program.

 

 

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