I propose to take Questions Nos. 293 to 295, inclusive, 297 and 298 together.
Domiciliary care allowance (DCA) can be paid in respect of children under 16 years of age who have a disability so severe that it requires the child needing care and attention and/or supervision substantially in excess of another child of the same age. This care and attention must be given by another person, effectively full-time, so that the child can deal with the activities of daily living. The child must be likely to require this level of care and attention for at least 12 months.
Eligibility for the DCA is not based primarily on the medical or psychological condition, but on the resulting lack of function of body or mind necessitating the degree of extra care and attention required. Each application is assessed on an individual basis, taking account of the evidence submitted. In addition, the person claiming the allowance for the child must be providing for the care of the child and must be considered habitually resident in the State.
DCA cases are routinely reviewed to ensure that the conditions for receipt of the payment continue to be met. Cases are reviewed based on either:
1) A scheduled review based on the recommendation of one of the Department's medical assessor when the claim is initially processed; or
2) On the basis of information received about a change of circumstances which potentially affects the continued entitlement of a case already in payment.
Scheduled reviews, on the recommendation of the medical assessor, are based on the prognosis of the child's disability and how their condition may improve over time. There were 128 customers notified regarding a scheduled review of their claims in November 2011.
Customers who are reviewed are asked to provide relevant up-to-date medical evidence and details of the extra care needs of their child. This information is assessed by a medical advisor and a decision is made based on their medical opinion.
In January 2012, following a review of their claims, 57 customers were notified that they no longer qualified for the payment. Where payment is stopped as a result of a review, the customer is invited to submit any further information they may wish to have considered and that information will be further examined and/or they may appeal the decision to the Social Welfare Appeals office.
A savings figure of €326,239 relating to these 57 DCA claims and associated respite care grants has been recorded. This figure will increase when the savings figure relating to any associated carers allowance is finalised.
Prior to the transfer of the DCA scheme from the HSE in 2009, an expert medical group examined the scheme and made recommendations on how it should operate within the Department of Social protection. These recommendations included the need for a review process and the minimum term to be applied to such reviews. The expert medical group comprised senior medical personnel from both the HSE and the Department. A consultant child psychiatrist and an international expert on disability assessment were also members of the group and its final report was reviewed by two independent medical experts.
Careful consideration was given to the DCA application process prior to the transfer of the scheme to the Department and it is considered that, overall, it is operating as envisaged. The operation of the scheme is monitored on an on-going basis and any improvements to the delivery of service that are identified are implemented.