Working to achieve fairness for carers - Clare Duffy Policy and Public Affairs Manager

Working to achieve fairness for carers

Clare Duffy                         National Freephone Careline
Policy and Public Affairs Manager          1800 240724

1. About Family Carers Ireland

We are the national charity dedicated to supporting Ireland’s 355,000+ family cares,
      who are the hidden, unpaid army propping up our healthcare system.

 Our primary focus is on supporting the carer as an individual in their own right, as
      well as a key contributor to the sustainability of our healthcare system.

     We do this through the provision of much needed supports and services.

                     National Freephone Careline
                            1800 240724

                                                                                  3

   We listen
                We provide advice and support
                We support you with applications and appeals
                We lobbying and work with Government to better support carers.
                We are a voice to carers through our advocacy service
                We offer dedicated carer training
                We run condition specific workshops
                We provide counselling services
                We deliver Home Supports on behalf of the HSE
                We provide home respite services
How can we   
             
                 We host over 60 Carer Support Groups
                 We offer membership discounts
 help you?   
             
                 We administer the Senior Alert Scheme
                 We host an annual Carer Respite Weekend
                Have Irelands onlyYoung Carer Project
                Celebrate caring every Carers Week (June)
                FREEPHONE Careline 1800 24 07 24

Family Carers Ireland Centre Locations

1. Cavan (Kilnaleck)
2. Clare (Ennis)
3. Cork (City)
4. Dublin South (Heuston South Quarter)
5. Dublin North (Mulhuddart)
6. Galway (Loughrea)
7. Galway (Tuam)
8. Kilkenny (City)
9. Laois/Offaly (Tullamore)
10. Limerick (City)
11. Longford/Westmeath/Meath (Mullingar)
12. Mayo (Castlebar)
13. Monaghan (Castleblayney)
14. Roscommon (Roscommon town)
15. Sligo/Leitrim (Sligo town)
16. Tipperary (Clonmel)
17. Waterford (City)
18. Wexford (Wexford town)
19. Outreach Centre - Carlow
20. Outreach Centre - Kildare/West Wicklow
21. Outreach Centre – Wicklow

A Decade Lost: The situation of carers has gotten worse
Between 2009 and 2019 carers report poorer health, less support and are more
worried about the future.

48% of carers have been diagnosed with mental ill-health.
67% of carers suffer with physical ill-health.
68% of carers felt their health had suffered as a result of caring.
76% of carers have no access to home support
83% of carers’ loved one have no access to appropriate respite.
82% of carers provide more than 50 hours care each week

In the last decade there has been a:
70% increase in number of carers diagnosed with depression
24% increase in carers reporting poor health
65% increase in carers who have no access to respite

2. Financial Support for
         Carers

1. Carers Allowance –
Max €219 per week (€257over 66yrs)
• Means-tested payment for carers caring for someone in need of full-time care.
• Carers caring for two or more people may receive additional 50% of personal rate
• Don't get a Carers Allowance because you care– you get it because you care FULLTIME!

Six Tests to establish eligibility:
1.   Means Test
2.   Habitual Residency Condition
3.   Provision of Fulltime Care
4.   15 Hour Rule
5.   Location
6.   Medical Assessment

Means Test
• €665 disregarded couple /€332.50 single person
• PRSI, superannuation, trade union subscriptions and €15 travel disregarded.

Example: Family of six – four children aged between 4 and 11 years. One of the children has a profound
disability and is a wheelchair user. Dad gave up work in 2014 to provide fulltime care. His wife earns a
gross salary of €56,000. They have no savings.

Weekly income (Gross):               €1,166
Less PRSI:                           €46.50
Less Pension:                        €35
Less Travel:                         ¬€15
Assessable income:                                      €1,069.50
Less income disregard:                                  €665
                                                        €404.50 / 2 (moiety) = €202.25 assessable means
Carer’s Allowance entitlement of €24 per week.

Capital Formula –
Assessing savings/2nd Property/Assets

       Capital/savings                     Assess                 Weekly Means

€0 - €20,000                 Disregarded                               €0

€20,000 - €30,000            Assess €1 in every 1000                   €10

€30,000 - €40,000            Assess €2 in every 1000                   €20

€40,000 +                    Assess €4 in every 1000

For example a single person with €100,000 in savings or a second property worth €100,000
would be considered to have an assessable income of €270 per week.

Carers Allowance: Additional Benefits
When a Carer is approved for Carers Allowance they are automatically entitled to:

• Annual Carer Support Grant* €1700
• Free Travel Pass
• Household Benefits Package*
• GP Visit Card

* Formerly called the Respite Care Grant
** Since Budget 2012 new applicants must live with the caree to receive HBP.

2. Half Rate Carers Allowance –
Max €109.50 pw (€128.50 over 66yrs)
• Means tested payment for people in receipt of certain other social welfare
  payments but who are also providing fulltime care.

• Allows them to keep their main social welfare payment and also get Half Rate
  Carer’s Allowance.

• One of the few times a person can receive two social welfare payments.

• Remember: Half Rate does NOT mean ‘half care’. Carers must provide
  FULLTIME care and satisfy all 6 eligibility tests for Carers Allowance.

Carer providing Care for one adult
Total Household Income €422 pw

                                Carers Allowance               Disability Allowance
                                   €219 p.w.                        €203 p.w.

                                  Carer Support    Household
  GP Visit Card   Free Travel         Grant         Benefits
                                    €1700p.a.       Package

Carer providing Care for one adult
Total Household Income €447.20 pw

                          Half Rate Carers Allowance               Disability Allowance
                                 €109.50 p.w.                           €203 p.w.

                                                                      Qualified Adult
                                 Carer Support         Household         €134.70
  GP Visit Card   Free Travel        Grant              Benefits
                                   €1700p.a.            Package

3. Carers Leave and Carers Benefit
Carers Leave: Carer's Leave Act 2001 allows employees to leave their employment temporarily to provide
full-time care for someone in need of full-time care. Entitled to take Carer’s Leave of at least 13 weeks up to
max 104 weeks. Carers Leave Act 2001 stipulates that your job is protected. You must have worked for your
employer for a continuous period of 12 months.
Carers Benefit: Non means tested payment for people who need to give up work for up to 2 years to provide
care to someone in need of full-time care. Can get Carer's Benefit for a total of 2 years for each person being
cared for.

Qualifying Conditions for Carers Benefit
• In employment at least 8 wks in the previous 26 wks. Have worked for min 16hrs pw or 32hrs per fortnight.
• Not be engaged in employment or training for more than 15 hours pw. Max you can earn is €332.50 pw.
• PRSI contribution conditions - at least 156 contributions paid at any time between entry into insurance and
  the claim for Carer's Benefit and:
  - 39 contributions paid in the Relevant Tax Year (i.e. 2 years prior) or
  - 39 contributions paid in the 12-month period before the start of Carer's Benefit or
  - 26 contributions paid in the Relevant Tax Year and 26 contributions paid in the previous Tax Year.

4. Carer Support Grant
Non means tested annual payment of €1700.

• Annual payment of €1700 for carers who look after people in need of full-time care.
• Carers can use the grant however they wish.
• The payment is made regardless of the carer's means but is subject to certain conditions:
• One full grant paid for each person receiving care.
• Automatically paid to recipients of Carer's Allowance, Carer's Benefit or Domiciliary Care
  Allowance.

If you don’t receive any of these payments you can still apply as long as:
       You have been providing care for at least six months
       and on first Thursday in June.
       you aren’t working/studying more than 15 hours per week.

4. Carer Tax Credits/Relief
1. Incapacitated Child Tax Credit - €3,300
• You can claim an Incapacitated Child Tax Credit if you are the parent or guardian of a child who is
   permanently incapacitated, either physically or mentally.

2. Home Carer Tax Credit - €1,500
• Tax credit given to married couples or civil partners (jointly assessed for tax) where one spouse or
   civil partner works in the home caring for a dependent person.
• Full tax credit if carer earns less that €7,200. Reduced tax credit if carer earns between €7,200 -
   €10,200.
• Must live with cared for person or next door.

3. Dependent Relative Tax Credit - €70
• Can claim if you maintain a relative at your expense. Previously linked to medical expenses.

4. Tax Relief on Cost of Employing a Home Carer
• Relief on cost of employing home carer paid at your highest tax rate. Max deduction of €75,000.

2. Policy and Legislation
     Development

Assisted Decision-making (Capacity) Act 2015
• Signed into law on the 30th December 2015. Not yet fully commenced. Essential for UNCRPD.
• The Act is about supporting decision-making and maximising a person’s capacity to make decisions.
3 Parts to the Capacity Act
1.    Supported Decision Making
       - Assistant Decision Maker (registered with the Director of the Decision Support Service)
       - Co Decision Maker ((registered with the Director of the Decision Support Service)
       - Decision Maker Representative (appointed by Circuit Court)
2. Wards of Court
     • Will abolish the Ward of Court system
     • All existing Wards to be reviewed within specified time frame.
3. Advance Healthcare Directives (Living Wills)
     • Provides legislative basis for Advance Healthcare Directives, i.e. an advance expression made by a
       person with capacity which contains their will and preferences concerning medical treatment
       decisions which may arise if the person were to subsequently lack capacity or be unable to express
       their preference. Can be stand-alone or can appoint a Designated Healthcare Representative.

Statutory Homecare Scheme
• Anomaly between the right to nursing home care under the provisions for Fair
  Deal vs discretionary nature of home care.
• Underfunding of homecare is leaving thousands of people stuck in hospitals or
  forced into nursing homes and putting enormous pressure on carers to care
  alone and unsupported.
• In 2017 Government committed to the introduction of a Statutory Homecare
  Scheme by 2021 to address this anomaly.
• Scheme will mean that people assessed as needing homecare will have a right
  to receive it however they will likely to make a co-payment.
• Pending introduction of the Scheme in 2021 interim measures are urgently
  needed to address the homecare crisis.
   Calling for an increase of €110 million in the home supports budget in Budget 2020
                in an effort to begin to meet actual demand for the scheme.

Carer Needs Assessment (CNA)
• Since 2012 the HSE has been working with Family Carers Ireland, InterRAI and
  other stakeholders to develop Irelands first Carer Needs Assessment.
• Designed to identify the needs of family carers, give information and advice,
  explore difficulties they may experience and make contingency plans if they are
  ill or are unable to continue to provide care.
• CNA will be pilot tested in CHO 2 (Galway Roscommon Mayo) in January 2020.
• Part of the Single Assessment Tool process.
• Means that healthcare professionals should begin to consider the needs of
  family carers as well as the person in need of care.
  “Develop and roll out a single assessment tool for older people and ensure that the views of
    carers as well as the people they care for are taken into consideration” National Carers
                                      Strategy action 2.1.3.