7.2.7 Child care

Short term support

There are two options for providing time-limited and short term child care support for clients who are struggling to cope with unexpected circumstances that are impacting on their ability to manage their child care responsibilities. These are:

• through the household services provisions where time limited child care support is . “required for the proper running and maintenance of the person's household”; and
• through the psychosocial rehabilitation provisions where a lack of child care support is creating barriers to the person being able to access treatment or programs that will help them to manage the impact of their accepted conditions - refer to section 6.5.2 of the Rehabilitation Policy Library.

Child care as a household service

DVA can only pay for child care through the household services provisions in the following specific circumstances:

• where the child/children were born prior to the service related injury or disease;
• where the client had responsibility for caring for the child/children during working hours prior to their service related injury or disease;
• where there are no other members of the client’s household who could reasonably be expected to care for the child/children without this creating substantial disruption to their work or other daily activities; and
• where the client is now having to pay for child care (eg. family day care, child care centre, nanny etc) because the client is unable to care for their child/children because of their service related injury or disease.

This in-line with the criteria outlined in section 7.2 Criteria for assessing what is reasonable.

However, in some situations, short-term support may be provided to address crisis or unexpected situations, regardless of whether a client had responsibility for caring for the child/children prior to their accepted service injury or disease. This approach recognises the impact that a service injury or disease can have on the client's family.

Delegates are expected to utilise a whole-of-person approach which acknowledges that mental health and physical health conditions can have a similar impact on a person's ability to manage household activities. For example, if a client's accepted depressive disorder symptoms have flared, this can make managing caring for children and undertaking other household activities as challenging as an accepted back condition which is causing chronic pain.

Some examples are included below to help guide decision making about whether child care support can be provided through the household services provisions:

• A client secures employment and needs to start immediately but they have no family or friends that could provide child care support. A short period of child care assistance, such as the services of an in-home nanny or attendance at an occasional care facility, can be considered while the person investigates and secures an ongoing child care place. It is important that the client understands that ongoing assistance cannot be provided and the support is only to address a short-term immediate need. In this example, the support could be provided regardless of whether the client was responsible for caring for the child/children prior to their service injury or disease.
• A client has been working part-time as part of a work trial and their employer asks them to work an additional day for a short-term period while someone else is on leave. The client has been unable to secure child care for their child from their normal child care facility for this additional day and there are no family members who could reasonably be expected to provide assistance. Therefore, a short period of child care assistance such as the services of an in-home nanny can be considered for the specific period the client is working the extra day. If child care assistance is required outside the initial short-term period, the client will be responsible for meeting these costs.
• A client is unable to work, or care for their children on their own, due to their accepted injuries. Their partner also does not work and  they are at home caring for children. The client's partner is taken to hospital for emergency medical treatment and the client is unable to care for the children alone. A short period of child care assistance can be considered for the period the partner is in hospital receiving emergency medical treatment.
• A client who has not yet been referred for a rehabilitation assessment needs to have  surgery for an accepted knee injury and as a result they will be unable to walk for a month following surgery. Their partner works full time and they have one child who is usually cared for by the client. The client’s surgery has been  scheduled quickly, and while they have family who can care for the child one day a week, they have been unable to find appropriate child care assistance for the remaining four days a week. As the client is not on a rehabilitation program, a short period of child care assistance can be considered under the household services provisions, to assist the family while the client is recovering and unable to walk. This approach acknowledges that removing the need for the client to care for a young child, will greatly aid their ability to recover from surgery. It should be noted that usually this scenario would be more appropriately covered under a psychosocial rehabilitation program however, because the client is not currently undertaking a rehabilitation program, the household services provisions must be utilised instead.  

In the scenario where a person is unable to access treatment or self-management programs due to a lack of child care, generally support should be considered under the psychosocial rehabilitation provisions – refer to section 6.5.2 of the Rehabilitation Policy Library.

However, if the person has no undergone a rehabilitation assessment, then the request should be considered under the household services provisions. This will enable the person’s request to be considered as quickly as possible without the need for a rehabilitation assessment and helps to ensure that the principle of early-intervention is utilised. In these cases, it would be appropriate for a referral to be made for a whole-of-person rehabilitation assessment, to investigate what other needs the person may have, and help to maintain momentum following their treatment or self-management course.

Ongoing child care assistance

Making decisions about how to manage ongoing child care responsibilities is something that all parents need to do. Finding the most appropriate child care options for a family can be challenging, particularly where one family member is experiencing ill-health. Compensation payments, such as incapacity payments, are an important part of the assistance that DVA provides, to assist families to meet their costs of daily living, which may include the costs of child care.

DVA will not pay household services for ongoing child care costs, where a client remains at home with a child/children, while their partner returns to work. This is because child care costs are considered to be part of the usual costs that a family need to manage when one partner returns to employment. The only exception to this would be where short term/crisis care was needed because usual child care arrangements were disrupted due to unexpected circumstances. Some examples to guide decision making are included later in this reference.

Planning for change

Planning for change is an important part of learning to self-manage the impact of a service injury or disease. It is therefore important that the rehabilitation provider discusses potential child care issues with the client at the beginning of the rehabilitation program, and at any other appropriate times during the program. This is particularly important at times of transition, where for example, maternity leave entitlements are coming to an end, and a decision needs to be made about how ongoing child care will be managed, or where the client begins to actively seek employment. Planning ahead will help the client and their partner to put strategies in place to ensure that the client is able to effectively manage their health and wellbeing into the future, or if they are job seeking, so that they can take up employment opportunities that may arise.

Child care costs are generally regarded as part of the costs associated with undertaking training or employment. Therefore, where a person is undertaking a work trial, studying as part of their rehabilitation program, or has successfully gained employment, they would usually be expected to cover their own child care costs. The exceptions to this would occur where unexpected situations arise, as highlighted in the examples above.

Working with children checks

A Working with Children check is a requirement for people who work or volunteer in child-related work. It involves a national criminal history check and a review of findings of workplace misconduct.

It is mandatory that in all cases where DVA funds child care, that the person providing the care has passed a Working with Children or equivalent check in their relevant state or territory. The responsibility for ensuring that carers have passed with check lies with the DVA client. This is because while DVA is responsible for considering whether child care is reasonably required and approving the level of service, it is the DVA client who is responsible for choosing and "contracting" the service provider and ensuring that they meet all of the necessary requirements to be able to fulfil their contract. More information about this can be found in section 7.3.1 of this library.

In many cases, particularly where a child will be cared for in a child care centre, clients can be confident that the carer's employer will have ensured that the necessary requirements have been met. However, where child care is being provided by a nanny or a family day carer, either in the client's or the provider's home, it is important that clients ensure that they sight the provider's current and valid Working with Children or equivalent state or territory card before any care is provided.

Clients may find the links available on the Australian Criminal Intelligence Commission - Working with Children Checks website, useful for more information about these checks.

Communicating decisions

It is the role of the DVA delegate and not the rehabilitation provider, or the health professional who undertook the home/activities of daily living assessment, to inform the client of the issues that were considered, and the outcome of their request for household services assistance. It is always expected that a client-centric, empathic approach is used when communicating with clients, particularly where a request for assistance is being denied, and that guidelines available on the intranet for communicating adverse decisions are followed.

Payment of child care costs

The administration of Child Care Benefits through the Department of Human Services requires that all child care costs approved by DVA are to be paid on invoice from the service provider, that is directed to DVA, indicating DVA is the party liable for the costs. Clients do not have the option to pay these costs, and then be reimbursed for them.