Finian McGrath (Dublin North Central, Independent)
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Question 240: To ask the Minister for Social Protection if she will support a matter (details supplied) regarding domiciliary care allowance [22949/12]

Joan Burton (Dublin West, Labour)
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The person concerned is in receipt of the domiciliary care allowance and has raised a number of general questions in relation to the role and operation of the scheme. The following general information in relation to the scheme addresses the issues raised.

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. No specific condition or disability rules a child in - or out - of qualifying for the allowance. There are no undue delays in the processing of DCA claims at present. The Department aims to process DCA claims in 7 weeks, while currently it can take up to 8 weeks to process a claim due to the volume of work in the medical assessment area.

An Expert Medical Group was established in advance of the transfer to this Department in 2009, and recommended that the most appropriate way for the Department to conduct assessments for medical eligibility was by way of desk assessment of the evidence submitted by the claimant, as provided by themselves and the medical staff who regularly see the child. It was considered that is was not necessary for the child to be physically examined by the Department's Medical Assessors as the diagnosis of the child's condition by their GP is accepted. What is being assessed is the level of additional care and attention that the child requires as a result of that condition/disability and if this is substantially in excess of that required by a child of the same age without the condition.

A review policy in an integral part of all social welfare schemes and is necessary to ensure that payments continue to be made only to those customers who meet the qualifying conditions. DCA cases are routinely reviewed to ensure that all the conditions for receipt of the payment continue to be met. Cases are reviewed based on either a scheduled review on the recommendation of the medical assessor when the claim is initially processed or on 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 care needs may change over time. In circumstances where a child has a lifelong disability that is unlikely to improve by any significant degree, a "do not review again" status may be used by the Medical Assessor.

Customers who are reviewed are asked to provide relevant up-to-date medical evidence and details of the additional care needs of their child and are now afforded 60 days in which to return this information to the Department. This information is assessed by a medical advisor and a decision is made based on their medical opinion. 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 is further examined and/or they may appeal the decision directly to the Social Welfare Appeals office.

The effective and efficient operation of the scheme is monitored regularly and any improvements to the delivery of service that are identified are implemented.