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3.6.4.150 Continuation, Variation or Termination of CP

Summary

The following is a list of the circumstances in which payment of CP may be changed or stopped:

  • if the carer (1.1.C.40) ceases:
    • providing constant care for more than 25 hours per week, to undertake training, education, employment or voluntary work, and have depleted their working credit and temporary cessation of care days, OR
    • to have a qualifying child (1.1.Q.17) in their care in an exchanged care situation, OR
    • to participate in the care of a care receiver who is in hospital, OR
    • to be qualified while overseas, OR
    • if receiving CP and fails to meet the 20 hours per week minimum level of personal care when applying for CA under section 954A - this indicates they are not providing constant care for CP purposes.
  • if the care receiver (1.1.C.20):
    • or any other person to whom the care receiver income test applies underestimated their income for the care receiver income test and the actual income is above the income ceiling, OR
    • is temporarily admitted to an institution for a period longer than allowed under the temporary cessation of care provisions, OR
    • is permanently admitted to an institution which provides personal care, OR
    • is a higher ADAT score adult (1.1.H.63) and their social security or DVA payment is stopped, OR
    • was a child with a profound disability who no longer meets the definition of a 'profoundly disabled child', OR
    • is a child and no longer requires a level of care that attains a qualifying rating of intense under the DCLA, OR
    • recovers, OR
    • dies.

 

Assessment against the ADAT (1.1.A.78) is current for 2 years

There is no need to reassess the care receiver if they have a current ADAT and a previous carer recommences care, OR a new carer applies for CP for them.

 

Policy reference: SS Guide 3.6.9 Adult Disability Assessment Tool (ADAT)

 

CP (child) (1.1.C.361)

If a carer reapplies for CP (child) for the same child or children with severe disability, severe medical condition, disability or medical condition, a new ACL questionnaire and professional questionnaire are NOT required UNLESS the delegate has reason to believe that they do not reflect the functional ability, behaviour and special care needs of the child or children at the time of the reclaim.

 

If a NEW carer applies for CP (child) for a child or children with severe disability, severe medical condition, disability or medical condition, a new ACL questionnaire for each child or children for whom they are applying for CP (child) is required. A new professional questionnaire is not required unless the delegate has reason to believe that the existing professional questionnaire is no longer an accurate reflection of the functional ability, behaviour and special care needs of the child or children.

 

Carer whose CP (child) was cancelled on or after 1 July 2008 & before 1 July 2010

Carers who qualify for CP (child) under the pre 1 July 2009 qualification provisions AND were/are in receipt of CP (child) on or after 1 July 2008 (even if only for one day), and have their CP (child) cancelled for any reason prior to 1 July 2010, and then reapply for CP (child) before 1 July 2010, can be reassessed for CP (child) under either the pre 1 July 2009 qualification provisions or the qualification provisions current at the time of reapplication.

 

In these circumstances, the child or children maintain their qualification status (i.e. as a profoundly disabled child OR 2 or more disabled children) and will not need to be reassessed. However, if the delegate believes that the person is not qualified for CP (child), for any reason, then the child or children will need to be reassessed.

 

If the delegate determines that the carer's eligibility needs to be reassessed, the carer can have their eligibility reassessed under either the pre 1 July 2009 qualification provisions, or the new (1 July 2009) qualification provisions.

Note: The carer must be claiming for the same child or children.

 

If, on or after 1 July 2009, a carer chooses to claim under the new (1 July 2009) qualification provisions, the child or children must be reassessed under the DCLA claim process.

 

Act reference: SSAct Schedule 1A clause 141 Saving-profoundly disabled child and disabled children

Policy reference: SS Guide 1.1.G.55 Grandfathering arrangements (CP (child)), 1.1.T.190 Two or more children (CP (child)), 3.6.4.15 CP (child) - Conditions Related to Qualifying as a Child with a Profound Disability

 

Carer ceases to provide constant care for more than 25 hours per week

If the carer no longer satisfies the constant care criteria due to exceeding the 25 hour per week provision due to participation in education, training or employment (they do not have access to working credit) and they have no temporary cessation of care days remaining, then CP is cancelled.

 

In these circumstances, payment is cancelled under SSAct sections 197B to K or subsection 198(2), NOT subsection 198(AC). Payment may be regranted when the carer resumes providing constant care.

 

Policy reference: SS Guide 3.6.4.70 Changes to Carer Situation - Effect on CP Qualification, 3.1.11 Working Credit

 

Carer ceases to have a qualifying child in their care in an exchanged care situation

For exchanged care (1.1.E.162), a carer must at all times have a qualifying child (1.1.Q.17) in their care. If a carer is exchanging the care of 2 or more care receivers with one or more other carers, and do not exchange the care receivers in the correct combination, i.e. the combination for which they qualify for CP (child), they are no longer caring for a qualifying child and therefore are no longer qualified for CP. Payment may be regranted when the carer resumes caring for a qualifying child, i.e. they have the correct combination of care receivers in their care.

 

Carer ceases to participate in the care of a care receiver who is in hospital

A carer qualifies for CP for a care receiver (1.1.C.20) who is in hospital provided the carer continues to participate in the care of a care receiver who is in hospital.

 

To satisfy this requirement the carer must provide additional care and attention, (i.e. where the carer makes regular visits and assists with feeding, exercising, etc AND the care is on a regular and ongoing basis).

 

If the carer cannot participate in the care of the care receiver in hospital they may use the balance of their 63 days temporary cessation of care entitlement for respite to remain eligible for CP. This temporary cessation of care allowance may be extended in special circumstances - see 3.6.4.40 for further information.

Note: A care receiver who is an adult may be hospitalised for 63 non-consecutive or consecutive days in the calendar year. If the number of days is exhausted, and there are no special circumstances which warrant extension of the 63 day limit provision, the carer may use the balance of their 63 day temporary cessation of care allowance for respite to remain eligible for CP.

 

A care receiver who is a child may be in hospital for an unlimited number of days.

 

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, (i.e. 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 in hospital will be reviewed every 12 weeks of continuous hospitalisation. A more comprehensive review will be undertaken after 24 months of continuous hospitalisation.

 

Policy reference: SS Guide 3.6.4.50 Qualification for CP during Temporary Absence from the Private Home - Hospitalisation

 

Carer temporarily goes overseas with care receiver

CP is portable for temporary overseas absences of up to 6 weeks. If the overseas absence becomes permanent the carer loses eligibility for CP and their payments should be cancelled. Payment may be regranted when the carer and care receiver return to Australia and the care situation continues.

 

Policy reference: SS Guide 7.1.2.20 Portability Table

 

Carer temporarily goes overseas without the care receiver

CP continues to be payable if the carer is using temporary cessation of care provisions. If the absence exceeds the temporary cessation of care provisions the carer loses eligibility for CP. Payment may be regranted if the carer resumes providing care in Australia.

 

Policy reference: SS Guide 3.6.4.40 Qualification for CP during Temporary Cessation of Care

 

Care receiver underestimated income for the care receiver income test

CP must be cancelled or suspended if evidence is received that the income of the care receiver, and/or any other person included in the care receiver income test, was underestimated and the actual taxable income is more than the care receiver income test income ceiling. The date of effect of the suspension or cancellation is the day on which the determination to accept the estimate was made. An overpayment will result for the period when the estimated income was used, however the overpayment may not be recoverable, unless it was reasonable for the CP recipient to know of the situation that led to the debt arising.

 

Policy reference: SS Guide Part 4 Income & Assets, 6.3 Assessing Overpayments

 

Carer requires care or the care receiver provides care to a third party

If a carer makes a CP claim for caring for a person who is receiving CP themselves, or if a care receiver who qualifies a carer for CP makes a claim for CP for another care receiver, a social worker should assess the situation to ensure both carers personally provide constant care (1.1.C.310).

Example 1: Jill receives CP for caring for her adult daughter, Angela. Jill is involved in an accident that results in brain injury and problems with mobility. Jill's partner, James, resigns from his job to care for Jill. James applies for CP for the care he provides to Jill and meets all the qualifying criteria. James is granted CP. However, a social worker determines that while Jill continues to provide some care to Angela, she does not personally provide constant care and Jill's CP is cancelled.

 

Example 2: Debbie qualifies for CP for the care she provides to her sister-in-law, Edna, who has paraplegia. Edna is employed full-time. Edna's older sister develops Alzheimer's disease and must have constant supervision (e.g. to prevent injury and ensure medication is taken etc) and prompting to undertake personal care activities (e.g. showering, grooming, etc) rather than needing much physical help. Edna decides to quit her job to care for her sister. She applies for CP, even though she herself needs a carer to help her to do most physical tasks. A social worker determines that Edna provides constant care and CP is granted.

 

Care receiver is temporarily admitted to an institution for longer than the temporary cessation of care provisions allow

If the care receiver is temporarily admitted to an institution the carer may use the temporary cessation of care provisions. If the care receiver remains in the institution longer than the temporary cessation of care provisions allow, their carer loses qualification for CP (provided there are no special circumstances under which the delegate might extend the temporary cessation of care) and should have their payment cancelled. Payment can only be resumed if the care receiver returns to the carer's care and the carer reapplies for CP.

 

Policy reference: SS Guide 3.6.4.40 Qualification for CP during Temporary Cessation of Care

 

Care receiver's temporary admittance becomes permanent

Often a care receiver is admitted temporarily, with the admission subsequently becoming permanent. In such cases, the temporary cessation of care provisions may apply up to the date of permanent admission (as long as it does not exceed the number of days available). The 14 week continuation of CP for the adjustment period would then start on the date of permanent admission.

 

If the temporary admission in an institution exceeds the number of days allowable under temporary cessation of care provisions in that calendar year before the date of permanent institutionalisation, the carer ceases to qualify for CP when the 63 days are exhausted. In this case CP would be cancelled and the 14 week continuation would NOT occur because the carer did not qualify for CP at the time the care receiver was permanently institutionalised. However, there is the Secretary's discretion to extend the 63 days if special reasons exist.

Example: A carer had only 7 days of their temporary cessation of care allocation remaining when the care receiver was temporarily admitted to an institution. The carer is continuing to assist with the care needs. On day 10 the temporary status is made permanent. In this case consideration should be given to extending CP eligibility using Secretary's discretion. This would then enable the carer to access the 14 week adjustment period.

 

Care receiver is permanently admitted to an institution

For the purposes of CP, permanent admission to an institution means that in light of available evidence, the admission is likely to continue for the foreseeable future. A care receiver admitted to hospital or palliative care and expected to return home at some future time, would not meet this definition.

Example: An institution which provides care could be a nursing home or hostel providing a level of care that would normally meet CP criteria. A self-care unit or hostel providing only meals, would not meet the definition.

 

If a care receiver is admitted PERMANENTLY to an institution, which provides care, the carer remains qualified for CP for 14 weeks starting from the day the carer did not provide care. In most cases, it will be the day after the person enters the institution (to allow the carer to adjust to their changed circumstances).

Explanation: The extension of CP is made in recognition of the impact on the carer of no longer being in the caring role. The carer will need to make adjustments to their life and may need to seek employment or another form of income support.

 

Note: If the former care receiver dies during the 14 week adjustment period and the former carer and care receiver were not members of the same couple, CP will continue to be paid for the remainder of the 14 weeks. The former carer will not be entitled to a further 14 week bereavement period or a lump sum bereavement payment.

 

If the former care receiver and the former carer were members of the same couple and the care receiver dies within the 14 week adjustment period of permanently entering an institution, the carer is eligible for a new 14 week bereavement period if all aspects of section 237 are met. The carer may also be eligible for a lump sum bereavement payment.

 

Act reference: SSAct section 198AAA Continuation of qualification when person receiving care admitted to institution, section 235 Continuation of carer payment for bereavement period where person cared for dies, section 237 Qualification for payments under this Subdivision

Policy reference: SS Guide 3.1.5 Bereavement Payment Provisions, 3.6.4.10 Qualification for CP, 3.6.4.40 Qualification for CP during Temporary Cessation of Care

 

Care receiver's social security or DVA income support payment stopped

If a higher ADAT score adult receives a social security or DVA income support payment, and that payment stops, the carer is no longer qualified to receive CP. However, the care receiver may still qualify their carer for CP under the care receiver income and assets tests.

Example: On the basis of his severe medical condition, Maurice qualifies his daughter, Alison for CP. Although his medical condition is unchanged, Maurice wins a sum of money in a lottery, which puts his assets over the assets limit and he is no longer able to receive a pension. However, Maurice may still qualify Alison for CP under the care receiver income and assets tests.

 

Note: The Secretary has the discretion, under specific conditions, to decide that the care receiver assets test does not disqualify the carer from CP.

 

Act reference: SSAct section 198(5) Income and assets tests etc, section 198N Exemption from care receiver assets test, refer to (2), (3) and (4)

Policy reference: SS Guide 4.2.5 CP Income & Assets Tests

 

Death of care receiver

If a care receiver dies, the carer(s) may qualify for bereavement assistance in the form of a 14 week extension of CP. In some cases, the carer may also qualify for a lump sum bereavement payment. This provision may apply even if the care receiver dies before the carer's first payday.

 

For a person who qualifies for CP on the basis of caring for 2 or more children (1.1.M.155), or a lower ADAT score adult (1.1.L.130) and the adult's dependent child, the death of a child will necessitate a review of their qualification for CP before CP bereavement assistance is processed. This is because the carer may have an on-going qualification in respect of the remaining care receiver(s). If NOT, the carer would continue to receive CP for 14 weeks and then have the payment cancelled.

 

Policy reference: SS Guide 3.1.5 Bereavement Payment Provisions, 3.6.4.10 Qualification for CP, 3.1.5.130 Bereavement Payment Provisions for CP

 

Transfer between CP & other payments/benefits

If a person ceases to qualify for CP or becomes eligible for another income support payment, they may be able to transfer to that payment. As there are differences in the way bereavement, portability and RA are treated between payments, as well as differences in their administration, a person may need guidance about the relative advantages of one over another. No transfers should occur without the knowledge and consent of the person.

Example: If a person receiving CP reaches age pension age, the person/recipient's payment should NOT be automatically transferred to Age.

 

Comparable foreign payment (1.1.C.230)

CP may be terminated if a person or their partner fails to take action to obtain a CFP.

 

Policy reference: SS Guide Part 7 Portability & CFP

 

Cancellation of PCC or HCC if CP is cancelled

A carer in receipt of a PCC or HCC because they are receiving CP, will lose their card if their CP is cancelled.

 

Policy reference: SS Guide 3.9.1 HCC - Qualification Provisions, 3.9.2.10 Qualification for PCC

_______________________________________________________

Last reviewed: 11 February 2013


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Last Edited: 07/06/2013 3:56:42 PM


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