Carer or care receiver is absent from care for Carer Payment (CP) and/or Carer Allowance (CA) 009-25112618

Carers receiving CP or CA can take breaks from providing care in some circumstances. These circumstances fall under two categories:

• Respite (Temporary Cessation of Care (TCC)) provisions
• Hospitalisation provisions

Respite provisions allow carers to continue to receive CP and/or CA when they take a break from caring, for up to 63 days in each calendar year. These days may be used for any purpose including:

• formal respite care, such as community in-home or residential respite, or
• informal respite provided by a friend or family member

Although both CP and CA allow up to 63 days respite in a calendar year, if a carer gets both payments for the same care receiver, the respite days are counted together, not separately. This means the carer gets a total of 63 days of respite in the calendar year, not 126 days.

Respite does not have to be 'approved respite care' as defined by the Department of Health and Aged Care and Ageing.

A carer may temporarily cease providing care in the home to a care receiver who has been hospitalised. Hospitalisation provisions only apply when the care receiver is in hospital and still receiving some care from the carer. It is a separate allocation from respite provisions.

An adult care receiver can be in hospital for up to 63 days per calendar year. If they are hospitalised for more than 63 days, any available respite days can be used.

Note: if respite days have been exhausted, the carer cannot use any available hospitalisation days remaining for that calendar year as respite.

For a child care receiver, there is no limit for hospitalisation, but they must be recorded.

Hospitalisation provisions can be accessed if either of the following occurs:

• the carer is participating in the care of the care receiver while in a hospital:
• upon release, the care receiver is expected to return to the care of the carer at the appropriate residence for their payment. For more information see Eligibility for Carer Payment (CP) and/or Carer Allowance (CA), and
• it is reasonable to assume that, had the care receiver not been hospitalised, the carer would still qualify for payment
• the carer is actively participating in the care of a care receiver who is terminally ill
• if the care receiver is in palliative care, hospitalisation provisions do not apply when palliative care is in the home of the care receiver

Note: if the care receiver is hospitalised 'indefinitely', the hospitalisation provisions may still be used if the care receiver is expected to return to the care of the carer when discharged from hospital. (An 'indefinite' stay in hospital may also qualify the carer and care receiver for payment under the separated due to ill health rules if they are also partners).

These two 63 day periods are mutually exclusive in the sense that any time a carer ceases to provide care, the absence against both the respite and hospitalisation cannot be counted.

If a care receiver is in respite or hospital at the time a carer lodges a CP/CA claim, see Complications to grants of Carer Payment (CP) and/or Carer Allowance (CA).

Absence must be temporary

The absence must be temporary. When a carer accesses respite provisions, it is assumed that an organisation or other person is providing care. However, this is not a legislative requirement.

Note:

• if the absence is permanent, see Care receiver permanently enters or temporarily/permanently leaves an institution
• refer cases where it is difficult to determine if the absence is temporary to the Level 2 Policy Helpdesk. For example, cases involving family and domestic violence. See Tier 2 technical support - Service Support Officer (SSO)

Regular absence and one-off absence

A regular absence is where a carer advises that a care receiver will be absent from the home for the same number of days every week for a certain period.

A one-off absence is where the care receiver is entering respite care for one period.

The system deems regular absences to be at the end of the fortnight in which the absences occur. For example, if there were 4 regular absences per fortnight, the system deems them to have occurred on the 11th, 12th, 13th, and 14th days of the absence fortnight and not the days when the absence actually occurred.

Calculation of absences/definition of a 'day'

For respite and hospitalisation purposes, a 'day' must be a whole 24 hour period from 12:00 am to 12:00 am (midnight to midnight). Part days do not count in the calculation of absences for Carer Payment (CP) or Carer Allowance (CA).

This does not change the rules around coding respite in conjunction with the 100 hour work limit. The 100 hour provision cannot be extended by using a carer’s TCC (respite) entitlement. For more information, see Carer Payment (CP) carer undertakes paid employment, self-employment, voluntary work, education or training activities.

Absences less than one day/24 hours

Short term care provided by someone else, such as a neighbour, another family member, or a day care centre, during the day or evening are not respite and do not automatically make a person ineligible for Carer Payment (CP) or Carer Allowance (CA), even if it happens regularly. If the main carer continues to give a high level of care when they are available and only arranges alternative care to manage their own personal needs, they are still considered to have primary responsibility for the person needing care.

Services Australia has the discretion to extend the period of respite in special circumstances. What constitutes a special reason cannot be defined, and decision-makers must therefore exercise discretion. Such reasons would be outside the carer's control and would be consistent with their role as a carer. It should be clear in these situations that a return to caring at home at the required level can be expected after a definite period and that the carer will resume providing the care. There would be no special reason associated with the imprisonment of a care receiver.

A special reason is determined by an APS5/6 level officer. The APS5 does not have to occupy a specialised position to have the delegation for this decision.

There is no discretion to extend the number of days for an appropriate special reason with hospitalisation.

The EXSP allows for the suspension of CP, except XWP for up to 26 weeks (6 months) where all of the following criteria have been met. The carer:

• would have been cancelled because of exceeding respite days
• resides in Australia, and
• remains eligible for all other reasons

If the carer does not meet this criteria, or does not want a suspension, their CP must be cancelled.

A care receiver who has been assessed as 'care awaiting placement' may be in either a hospital or an Aged Care or Multipurpose Service Facility whilst waiting for a permanent placement. In these situations, the following usually occurs:

• the care receiver is admitted to hospital
• an Aged Care Assessment Team (ACAT) assessment has been done
• the care receiver is assessed as care awaiting placement and either remains in the hospital or is transferred to an Aged Care or Multipurpose Service Facility on a temporary basis
• the care receiver is transferred to an Aged Care or Multipurpose Service Facility on a permanent basis

If the care receiver is assessed as care awaiting placement and is in a hospital, then the carer should be contacted to clarify whether the care receiver is likely to return home. If the care receiver is likely to return home, the hospitalisation and/or temporary cessation of care provisions would apply.

Care awaiting placement in an Aged Care or Multipurpose Service Facility would usually be considered as a permanent admission to an institution.

When determining the date of admission, consider the advice from the carer and any other relevant factors before making a decision. See Care receiver permanently enters or temporarily/permanently leaves an institution.

Rehabilitation facility vs hospital facility

The term hospital is not defined in either the Social Security Act or the Social Security Guide. A hospital is an institution providing medical and surgical treatment and nursing care for sick or injured people. If the rehabilitation facility is attached to a hospital, it would meet the definition of a hospital, and the hospitalisation provisions may apply.

If the care receiver is not likely to return home or has been admitted to an Aged Care or Multipurpose Service Facility, and there are no extenuating circumstances, they are considered to have permanently entered an institution. See Care receiver permanently enters or temporarily/permanently leaves an institution.

Some hospitals, particularly in rural areas, may also contain government funded aged care beds, or a multipurpose service wing. If the care receiver has been admitted to a hospital with multiple facilities such as these, ascertain whether the care receiver is in:

• a hospital ward
• a government-funded aged care bed, or in the
• multipurpose service wing

The above guidelines should then be applied.

The rules for respite and portability may differ between CP and CA depending on the situation.

A customer receiving CP or CA must advise of travel in some situations. See Carer Allowance (CA) and Carer Payment (CP) interaction of portability and temporary cessation of care (respite) rules.

The respite and portability rules must be considered together in each case.

If the carer goes overseas temporarily:

• without the care receiver, and the care receiver stays in Australia, this is usually deemed a 'respite period'. The travel is also subject to the maximum portability period of 6 weeks
• with the care receiver, only portability provisions apply. However, any subsequent respite while overseas, must also be coded as an absence as the carer's payment(s) may be affected before the portability period expires

If the care receiver goes overseas temporarily:

• without the carer, this is usually deemed a 'respite period'. Portability provisions apply for the care receiver if they are in receipt of a payment. The relevant portability provisions will be those specifically relating to the type of payment the care receiver is paid
• with the carer, portability provisions apply for the care receiver if they are in receipt of a payment. However, any respite while overseas, must also be coded as an absence from care as the carer's payment will stop if respite is exhausted before their 6 week portability period ends

Times where overseas travel might not require respite coding

Respite may not apply for an overseas absence if a customer is paid:

• CP under:
• exchanged care provisions, or
• multiple carers qualify for the same care receiver, or
• CA under Shared Care provisions

Note: portability rules still apply.

See:

• Carer Payment (CP) (child) exchanged care
• Carer Payment (CP) for 2 or more carers in respect of the same care receiver, or
• Shared care for Carer Allowance (CA)

Standard CP and CA (adult) hospitalisation and temporary cessation of care rules apply to the adult care receiver, and therefore, to the carer who is in receipt of CP (child) under multiple care provisions, if the disabled adult enters hospital or respite care. If the child is away hospitalisation wouldn’t apply, but respite would.

If there is more than one carer, and one carer receives CP and the other CA, the absence must be recorded against both carers when the care receiver is absent from both carers.

Carer Payment carers can participate in paid work, including self-employment, for 100 hours in a 4 week period. This does not include travel time to and from work.

See Carer Payment (CP) and Carer Allowance (CA) carer undertakes paid employment, self-employment, voluntary work, education or training activities.

A care receiver's participation in paid employment or self-employment does not impact on the carer's qualification for CP, if constant care is still being provided.

If there is an absence for a significant part of each day, and it has been determined that ‘constant care’ is not being provided every day, the carer's qualification for CP should be checked. For further information see Carer Payment (CP) and/or Carer Allowance (CA) care receiver commences or returns to work.

Where a carer in receipt of Carer Payment (CP) provides care for a lower ADAT score adult care receiver, and that care receiver provides care for a child, an absence of either the adult or the child is counted as an absence for the carer.

The carer has only one allocation of respite care days, and an absence by either the adult care receiver, or the child, is counted as an absence for the carer. When it is the child who is absent, details must be recorded on both the care receiver's record (for CA purposes) and the record of the CP carer. See Eligibility for Carer Payment (CP) under the Lower Adult Disability Assessment (ADAT) Tool for more information.

Where 2 or more disabled children collectively qualify a carer for a single rate of CP, only one allocation of 63 days is given to the carer. For details, see:

• Carer Payment (CP) (child) when caring for 2 to 4 children each with a disability or medical condition (combined care), or
• Assessing a claim for Carer Allowance (CA) using the combined assessment scores of two children

If they are paid under the short term care or episodic care provisions, their respite limit will be a pro-rata amount, based on the period for which CP (child) is being granted.

If separated or divorced parents are paid CP (child) under the exchanged care provisions, either parent will only use their respite days if they temporarily cease to provide care when the child is meant to be in their care (provided they are not making use of the hospitalisation provision or 100 hour work limit).

If CP is granted under exchanged care provisions for child care receivers, CA is usually under shared care provisions.

Respite and hospitalisation rules do not apply to CP (XWP) - Carer Payment (CP) that is paid under grandfathering provisions for ceased Wife Pension carers. However, respite and hospitalisation rules still apply to CA for that customer as normal. See Transfer from Wife Pension (WP) to Carer Payment (CP).

There is no qualification for CP where care is shared, however respite may be used to stay on payment in shared care situations. If a carer shares care of the care receiver, respite days are to be used when the care receiver is with the non-CP carer. See Assessing Carer Payment (CP) when the care is shared.

For CA, where 2 carers each receive a percentage of CA in a shared care situation, each carer is entitled to access the 63 days allocation of respite for the care receiver. An absence only occurs when neither carer provides any care in the midnight to midnight 24 hour period. For example, when there is no arrangement to swap or change caring days and the care receiver is in the home of a third carer. In these cases, respite should be recorded against the carer who would normally provide care. Recording or updating an absence on one carer will automatically record or update the record of the other carer, provided the other carer currently receives a part rate of CA for the same care receiver.

Note: if the shared care provisions do not apply and the arrangement is temporary, then the respite provisions may apply whilst the child is in the care of the other carer. If the shared care provisions do not apply and the arrangement is not temporary, then the carer may lose entitlement to CA if daily care is not being provided.

In the case of a child care receiver or co-resident adult care receiver, temporary cessation of care has not occurred if daily care and attention continues to be provided by a current partner or another person who lives with the carer.

In the case of a non-co-resident carer, temporary cessation of care has not occurred if the daily care and attention continues to be provided by another person who does not live with the care receiver.

See Shared care for Carer Allowance (CA) for more information.

A carer receiving CA for a child care receiver may access respite provisions when the child is absent due to Education, Training and Treatment (other than a hospital). ETT does not apply to CP or adult care receivers.

CA (child) carers whose children are absent from home for education, training or treatment (ETT) and who have utilised their 63 respite days per calendar year do not lose qualification for CA payment, but are only payable for the period that the child is in their care.

To be considered absent from the carer, the child care receiver must be away for a full 24 hour period. For example, attending boarding school and staying overnight, for a full 24 hour period, is an absence for ETT, whereas attending school during normal hours and returning home that afternoon is not considered an absence for ETT.

If the child is in the parent's care for some part of each fortnight, eligibility for payment is maintained on a pro rata basis after the 63 days respite quota has been used. For example, if on the advice of the carer, the child is at school Monday to Friday but returns home on weekends. Service Officers should code Tuesday to Thursday as the regular 24 hour (midnight to midnight) absence days out of care.

For absences due to ETT, once the 63 days of respite have been utilised, an automatic advice regarding 'entering a nil rate period' will be issued to payment level Carer Allowance (CA) carers who are not on a pro rata rate of CA. CA paid under CA auto provisions and CA Health Care Card (HCC) only carers will not receive this letter.

CA HCC only customers do not need to report temporary absences, as respite and hospitalisation provisions do not apply. The provisions that allow carers to remain qualified for Carer Allowance if they temporarily cease to provide care for up to 63 days in calendar year require the carer to be receiving payment of Carer Allowance. Absences that impact on the ability to provide 14 hours of care will require an assessment of if CA HCC only needs to be cancelled.

If the care receiver is imprisoned or in psychiatric confinement because they have been charged with committing an offence, this could be considered a temporary absence and the carer's qualification for payment may continue. CP and/or CA will then auto cancel when the 63 day respite limit is reached.

If the care receiver is detained in an acute care ward in a psychiatric hospital because they have been deemed as a danger to themselves and/or others, and have not been charged with committing an offence, this could be considered a temporary absence and the carer's qualification for payment may continue. The 63 day hospitalisation provisions could be used and any allowable respite days remaining for that calendar year may then be used to allow the carer to remain qualified for payment.

The hospitalisation provisions cannot be applied if the carer is hospitalised.

If the carer is hospitalised and is expected to return to the caring duties once released, respite may be used, as the carer is temporarily not providing care to the care receiver. However, if the total number of respite days exceeds 63 days, and CP/CA cannot be extended for a special reason, CP is to be suspended or cancelled, CA is to be cancelled.

If the carer is hospitalised and is not expected to return to their caring duties once released, CP/CA is to be suspended/cancelled from the first day they did not provide care. In most cases it will be the day after they entered the institution or hospital. (An ‘indefinite’ stay in hospital may also qualify the carer and care receiver for payment under the separated due to ill health rules if they are partners).

Note: a social worker referral may be necessary to make sure the care receiver is continuing to receive adequate care and attention daily from someone else while their carer is in hospital. The social worker can also provide information to help Service Officers to determine whether the carer has the physical and/or emotional capacity to deal with the care receiver’s care needs when they are discharged from hospital.

Payment of CP and/or CA will not continue if the absence is due to the carer being in prison, or in psychiatric confinement because they have been charged with an offence. In this case, respite days cannot be used, and the payment is suspended when the absence is for 13 weeks or less and cancelled when the absence is for more than 13 weeks. If a carer is in periodic detention or weekend detention for a whole 24 hour period from midnight to midnight, they lose qualification for CP and/or CA as the respite provisions cannot be used for this type of absence and therefore, daily care is not being provided.

This is not respite and the Cancellation and Suspension workflow must be used to:

• suspend if absence is less than 13 weeks, or
• cancel if absence is longer than 13 weeks

If the carer is detained in an acute care ward in a psychiatric hospital because they have been deemed as a danger to themselves and/or others, and have not been charged with committing an offence, and is expected to return to the caring duties once released, respite may be utilised, as the carer is temporarily not providing care to the care receiver. However, if the balance of respite days exceeds 63 days, and CP/CA cannot be extended for a special reason, CP is to be suspended or cancelled, CA is to be cancelled.

Re-claims after cancelling due to 63 days

If a carer’s CP or CA has been cancelled due to hospitalisation and/or respite absences, and they reclaim (all within the same year), once the care receiver returns home, there are no hospitalisation days or respite days available until the next calendar year.

Granted part way through a calendar year

Carers who are granted CP or CA part way through a calendar year are entitled to the full 63 days respite for each care receiver for that year. When calculating the number of respite days a carer has used, only absences that have occurred since the date of grant are considered. Note: if CP and/or CA has been cancelled because the carer has used more than 63 days respite, they may reapply for CP and/or CA when they resume caring.

The carer would only be entitled to further respite days for the remainder of that calendar year if the delegate exercised discretion that 'special reasons' for the absence apply. If the carer does not provide care again in the same calendar year, their payment could be suspended or cancelled again but the carer is entitled to reapply each time they resume caring.

Absences that cross over years

When an absence starts in one calendar year and ends in the next (for example, from December to January), the 63 days allowed resets on 1 January. Only the days in the relevant calendar year count toward the limit, so only days in January will count towards the new 63 days.

Change of care receiver

In cases where a carer has a change of care receiver(s) during the calendar year, they are entitled to the full 63 days of respite. Old balances of respite days for the previous care receiver should not be transferred to the new CP/CA care receiver.

Respite care couple

Where the carer and care receiver are partnered, they may be considered members of a respite care couple if:

• one of the members has entered approved respite care, see Legislation on the References page, and
• the member who has entered the approved respite care has remained, or is likely to remain, in that care for at least 14 consecutive days

A respite care couple are entitled to be paid at the single rate of CP until the period of respite ends. See Customer is separated from their partner - temporarily or due to respite care.

Linking carer and care receiver

Where the carer and care receiver are not linked and the absence is for Carer Payment, the absence cannot be coded.