Domiciliary Care Allowance Review - Welfare.ie

The remainder of the chapter deals with process issues that need to be addressed to improve thescheme administration, to ensure parents/guardians have the appropriate information and toprovide a transparent process that all can have confidence in.5.1. Defining levels of careThe review group held extensive discussions on what constitutes an appropriate “level of care”in order for a child to qualify for DCA. The difficulty is in determining what constitutescare/attention/supervision which is “substantially in excess” of another child. Whilerecognising children with disabilities have additional support needs, the qualifying feature iswhether it exceeds the bar of “substantially in excess”.The main issue is the definition of the terminology used to describe the level of care thatqualifies a child for DCA. The DSP’s information literature states; “DCA is a monthly paymentto the carer of a child with a disability so severe that the child requires care and attentionand/or supervision substantially in excess of another child of the same age. This care andattention must be provided to allow the child to deal with the activities of daily living. The childmust be likely to require this level of care and attention for at least 12 months.”It is accepted that qualification for the allowance is not dependent on the medical diagnosis, butthat qualification derives from the additional care required by the child as a result of themedical condition. This highlights the need to clearly define the level of care that qualifies achild for DCA.Having defined the additional level of care required to qualify for DCA, there is a need todevelop supports to assist parents/guardians in making their claim and also to assist the medicalassessor in determining care need. Addressing these issues is key to assuring parents/guardiansthat the scheme operates fairly and transparently.5.2. TerminologyThe review group explored the use of terminology and the intended meaning of the words usedto describe the level of care that would lead to a child qualifying for the DCA. Submissionsreceived as part of the consultation process highlighted the issue of clarity around theDCA Review Group Report – Final – 21 December 2012 - confidential Page 40