Recommendations 16 - 20
That the Minister for Families, Housing, Community Services and Indigenous Affairs and the Minister for Health and Ageing and the Attorney-General fund a national information campaign to raise awareness about the need for, and benefits of, enduring powers of attorney and advanced care directives in the general community and among health and community care professionals.
As stated in the response to Recommendation 15, the Commonwealth Government will continue to support the development of a nationally consistent approach to enduring powers of attorney and advanced care directives through the Standing Committee of Attorneys-General and the Australian Health Ministers’ Advisory Council, respectively. The need for a national information campaign may be considered following harmonisation of approaches between jurisdictions.
The Commonwealth Government provides funding for a number of initiatives which raise awareness and support the development of enduring powers of attorney and advanced care directives.
The Commonwealth Government, through the Department of Families, Housing, Community Services and Indigenous Affairs funds the Family Relationship Services Program. This includes a Family Relationship Services for Carers initiative where organisations are funded to deliver information, support and family counselling and mediation services to families who are considering future care arrangements for a family member with disability.
The Commonwealth Government, through the Department of Health and Ageing, is also funding Austin Health’s Respecting Patient Choices program to develop advance care planning in acute care settings and to pilot this particular model in a number of residential aged care facilities. Austin Health is funded $2.9 million over three years (2007-2010) to operate the Respecting Patient Choices program. The Respecting Patient Choices website (www.respectingpatientchoices.org.au) offers a range of free downloadable guides and leaflets suitable for individuals living at home and their families as well as acute care patients, aged care residents and care workers.
The Commonwealth Government also produces and distributes a number of resources which are aimed at: raising awareness of the need for and benefits of enduring powers of attorney and advanced care directives; and providing information on how to make such arrangements. These resources include:
- Planning for the Future: people with disability, produced by the Department of Families, Housing, Community Services and Indigenous Affairs
- Dementia - The Caring Experience and the Dementia Resource Guide, produced by the Department of Health and Ageing
- Living with Dementia and Planning Ahead: a guide to putting your affairs in order, produced by the Department of Veteran’s Affairs
- Carer Information Pack, available from Commonwealth Carer Resource Centres.
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That the Minister of Families, Housing, Community Services and Indigenous Affairs examine how carer payments may be restructured to better reflect differences in the levels of care provided.
The recent changes to Carer Payment (child), as noted by the Committee, included the introduction of a new instrument for assessing qualification for the payment. The new instrument, the Disability Care Load Assessment (child), assesses the level of care required by a child or children because of their disability or medical condition, and the level of care provided to the child or children by their carer, rather than basing eligibility on a narrow list of medical conditions.
However, this new assessment only considers the total care load of the carer for the purpose of determining qualification for payment; the assessment of care load does not determine the amount of income support payable.
The Committee suggests that the Commonwealth Government examine how carer payments could be restructured to better reflect differences in the levels of care provided so that ‘the more time the carer needs to spend to support the care receiver, the greater should be the carer’s compensation’ (p.45).
Australia has historically focused on providing comprehensive, conditional, basic income support to those who are most at risk of falling below an acceptable standard of living at a point in time.
Structuring financial support for carers in a wage or compensation based way, so that payments relate to the activity of providing care itself, rather than to the financial circumstance of the individual carer or their household, would require a fundamental shift in the principles that underpin the income support system for carers.
The system of income support for carers has already been comprehensively examined as part of the Pension Review. The report of the Pension Review found that Carer Payment performs a number of roles in the income protection and social protection systems, the most important of which is providing adequate income support to those with little or no private means. The Pension Review also concluded that the pension should be paid at the same rate for those who are retired, or not currently expected to work because of their significant disability or caring responsibilities.
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That the Australian Government significantly increase the base rate of carer payments.
The Commonwealth Government has implemented this recommendation through the 2009–10 Budget Secure and Sustainable Pension Reform package.
This package provided an increase in pension rates from 20 September 2009. The increase in the rate of pensions, which includes Carer Payment, was $32.50 per week for full rate singles and $10.15 per week for couples combined.
In addition to the rise in the rate of Carer Payment, the Commonwealth Government introduced a new, permanent Carer Supplement of $600 per year for Carer Payment recipients, and an additional $600 per year for Carer Allowance recipients for each eligible person in their care. The first Carer Supplement payments were made in late June 2009, and from 2010 will be made from 1 July every year. This supplement replaces previous Budget one-off carer bonuses and is intended to ensure ongoing and certain government financial assistance for carers.
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That the Minister for Families, Housing, Community Services and Indigenous Affairs examine and implement the most appropriate option(s) to reduce the disincentive for carers to earn supplementary income.
AGREE TO FURTHER CONSIDER
The Commonwealth Government notes that the Australia’s Future Tax System review is looking at working age income support payments, including Carer Payment, and work incentives.
Accordingly, further consideration on this issue may be undertaken, pending the outcome of the review into Australia’s Future Tax System.
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That the Minister for Families, Housing, Community Services and Indigenous Affairs direct the Department of Families, Housing, Community Services and Indigenous Affairs to review its assessment for Carer Payment/Allowance (adult) with a view to:
- extending the range of health and allied health professionals who are authorised to verify the applicant’s claim;
- enabling acceptance of recent supporting documents that may already be held by the carer to verify the claim where these documents provide a sufficient level of detail regarding the care needs of the care receiver;
- developing a new assessment process that acknowledges the level of support provided by carers of people with intellectual disability, mental illness or with challenging behaviours. The assessment should also have regard to the episodic nature of some conditions; and
- reviewing the purpose and frequency of review processes, particularly in circumstances where it is evident the needs of the care receiver will not decrease over time.
AGREE TO CONSIDER FURTHER
The Government notes the significant financial implications of the recommendation in the context of the current fiscal environment.
The Government will give further consideration to undertaking a review of the Carer Payment (adult) and Carer Allowance (adult) assessment processes. Any such review would seek to simplify and improve processes within existing eligibility criteria.
The Commonwealth Government will also give further consideration to reviewing the purpose and frequency of the review processes for Carer Payment (adult) and Carer Allowance (adult).
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