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Dáil Éireann díospóireacht -
Wednesday, 9 Oct 2002

Vol. 554 No. 5

Written Answers. - Health Board Allowances.

Dan Neville

Ceist:

1172 Mr. Neville asked the Minister for Health and Children when he made a decision to end back payment of domiciliary care allowance to the time of diagnosis; his views on the fact that many carers are not aware of their eligibility to claim and as such many carers will lose out on financial assistance dating back months; if he will reconsider his decision; and if he will make a statement on the matter. [16925/02]

Domiciliary care allowance, DCA, was introduced in 1973 by way of circular 24/73 and is payable under section 61 of the Health Act, 1970. Following a request by my Department, a national health board working group was established towards the end of 1999. One of the main objectives of this group was to examine all the various disability related allowances, which come under the remit of my Department, including DCA.

During the course of discussions of the national health board working group, the health boards had informed my Department that, up to July 2002, DCA had operated on the basis that it was paid to applicants from the date of diagnosis or when care and attention in excess of that normally required by a child of the same age commenced. This was despite the fact that circulars governing the scheme stated that the allowance could be paid in respect of eligible children from the date of application. The group made recommendations to my Department in May of this year, with a view to standardising the procedure for the allowances across all the health boards.
My Department issued the group's recommendations by way of circulars, as departmental policy with effect from 1 July 2002. The DCA circular reads as follows:
DCA may be paid in respect of eligible children from birth to the age of 16, who have a severe disability requiring continual or continuous care and attention which is substantially in excess of that normally required by a child of the same age. The condition must be likely to last for at least one year. Where medical confirmation is supplied which pre-dates the actual date of application and the health board's senior area medical officer is satisfied that the child required continual or continuous care and attention, substantially in excess of that normally required by a child of the same age, then payment may be made from the date that the senior area medical officer is satisfied that such additional care and attention was required.
This circular gave effect to what the health boards had informed my Department was already the practice on the ground and was issued on the basis of written assurances received from the working group that the cost of implementing the revised circulars on a variety of allowances, including domiciliary care allowance, would be budget neutral. However, subsequent to the circulars of 1 July being issued, the Southern Health Board advised my Department that any back dating of domiciliary care allowance as indicated in the circular of 1 July would have an estimated cost implication of €2 million for that board. In view of this, my Department, while committing to examine the issue further, rescinded the circular of 1 July replacing it on 26 July with the following wording: "Where a child qualifies for DCA, payment should be made from date of application."
Following representations made to me, I instructed my Department to revert to the position of 1 July 2002, whereby the payment of DCA may be backdated to a date when the senior area medical officer is satisfied that the child required continual or continuous care and attention, substantially in excess of that normally required by a child of the same age. My Department is now undertaking an examination of the cost implications of this issue, especially in light of the assurances received in May 2002 that backdating would be budget neutral.
Previous to 1 July 2002, it had been health board policy supported by my Department that payments of DCA could be backdated prior to date of application, if it was clear that the applicant was not aware of his/her entitlement. In these cases payment of the allowance was backdated to the date where the child would have become eligible.
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