Portfolio Committee on Social Development Social Assistance Amendment Bill –B5-2010, 13 April

Presentation Outline What triggered the need for the amendment? Why the amendment? Revised definition HAT Rationale for the Bill Implications Amendment to Section 18 2

What triggered the need for a definition of disability? In 2003/4 the uptake of disability grants spiked to over 3 times the projected figure There was litigation indicating misunderstanding of the term disability CASE was appointed to determine the causes of the significant increase in the uptake of disability & care dependency grants The following findings were made: (a) Lack of uniformity in assessment methods, resulting in errors of inclusion and exclusion 3

What triggered the need for the amendment (cont) (b) Provinces defined and assessed disability differently, thereby providing access to the disability grant even for people with chronic illnesses (Since the 1992 Social Assistance Act was applicable, & in some instances currently) (c) The lack of a common definition of disability and the absence of a uniform assessment (d)Heightened public awareness of the constitutional right of access to social grants 4

Why the amendment? To have a common definition of disability to be applied uniformly by DSD and DoH for purposes of Disability Grants (& free health care) To ensure a seamless assessment & uniform implementation of the common definition by DSD and DoH To ensure a uniform treatment of applicants for Disability Grants To provide SASSA with a uniform tool & mechanism when considering decisions made for DG applications 5

Revised definition In May 2005, Cabinet approved a common definition of disability for eligibility for Disability Grants Free Health Care & for people with disabilities. It reads: A person is eligible for a disability grant if he / she has (a)a moderate to severe limitation in ability to function or ability to perform daily life activities as a result of a physical, sensory, communication, intellectual or mental impairment which makes him/her unfit to obtain by virtue of any service, employment or profession, the means needed to enable him or her to provide for his or her own maintenance; (b)income below a prescribed means level; and (c)attained the prescribed age. 6

Revised definition (cont) The published definition reads that: ‘disability’, in respect of an applicant, means a moderate to severe limitation to his or her ability to [function] or perform daily life activities as a result of a physical, sensory, communication, intellectual or mental disability rendering him or her unable to— (a) obtain the means needed to enable him or her to provide for his or her own maintenance; or (b) be gainfully employed; 7

HAT A Harmonised Assessment Tool (HAT) was developed & piloted in 2006 jointly by DOH and DSD The HAT was approved by Cabinet in August 2007, with the decision that DoH is responsible to determine disability, & measures categories of activity limitations in terms of: 1. Self care, which includes fine motor skills required for handle buttons, zips, knife, cup, etc. Self care includes eating, washing the body, grooming, dressing (upper and lower body). 2. Elimination, which includes toileting. 8

HAT (cont) 3. Mobility, differentiated in separate body parts, including changes in body position, transfers, walking on different surfaces and climbing stairs, as well as travelling. 4. Vision 5. Hearing 6. Communication divided in understanding, and producing language 7. Cognition – problem solving, memory. 8. Global assessment of function (GAF) meant to assess spatial awareness and psychological / mental health. 9

HAT (cont) NOTE: 1 – 6 are assessed with or without personal assistance or assistive devices. The implementation of the HAT will correct a major error of inclusion – mainly people with chronic conditions who are currently receiving disability grants The strategic focus of amending the definition of disability in the Social Assistance Act 13 of 2004 is to facilitate the implementation of HAT The implementation of HAT will enhance the effectiveness and efficiency of the provision of the disability grants 10

Rationale for the Bill To seek Parliament’s approval the new definition of disability in the Social Assistance Amendment Bill 2009 The definition will facilitate the implementation of HAT, which is to be operationalised through Regulations of the Social Assistance Act The HAT will ensure uniform assessment and determination of eligibility for the disability grant It will also accomplish correct targeting for purposes of the disability grant It is also envisaged that the HAT will significantly reduce the risk of disability grant fraud. 11

Implications Communication Implications Public awareness raising on the implementation of HAT for DGs. A communication strategy will be developed together with the DoH, DSD, National Treasury, GCIS, the South African Disability Alliance & the Ministry for Women, Youth, Children and People with Disabilities Implications for Vulnerable Groups - Women with disabilities will be adequately catered for with the implementation of the tool - People with disabilities will be accurately assessed for eligibility for disability grants (& free health care), reducing the risks of exclusion errors 12

Implications (cont) - Children with disabilities are considered separately Constitutional implications - People with chronic conditions, once the tool is implemented, will no longer qualify for disability grants as is currently the case. The exclusion is not intentional, but meant to address effective identification of disability - Many are awarded temporary disability grants - Many rejections lead to appeals 13

Cluster Decision on Chronic Conditions DSD presented policy options to Cluster - A means tested social assistance income support for chronic illnesses. - Food / vouchers be provided by the Department of Health at the point of medicine collection. The decision made was that: - a grant is not an appropriate option, - the matter be referred to Integrated Food Security task team for further attention. - the issue here is food security to comply with medication since there is high unemployment & poverty in the country 14

Draft amendment to section 18 A.The right to appeal  Currently section 18(1) only permits applicants or persons acting on their behalf to appeal against any decision of the Agency relating to any matter regulated by the Act  The section does not permit beneficiaries (people who are in receipt of a grant) whose grants have been terminated or suspended to appeal against any decision of the Agency relating to any matter regulated by the Act. 15

Draft amendment to section 18 Cont…  As a result beneficiary are left with no recourse other than approaching the courts for review. PROPOSED AMENDMENT TO SECTION 18  That section 18 be amended to insert “beneficiary” so as to accord the beneficiary the right to appeal against the decision of the Agency. 16

Draft amendment to section 18 Cont… B. Reconsideration of decision by the Agency  Section 18 does not make provision for the Agency to review its decision before the applicant or beneficiary can appeal against any of its decisions relating to any matter regulated by the Act  As a result the Independent Tribunal is clogged with unnecessary cases 17

Draft amendment to section 18 Cont…  The increase in the number of appeals leads to unnecessary costs both in respect of litigation and the consideration of appeals. PROPOSED AMENDMENT  That section 18 be amended to provide for a beneficiary or applicant to first request the Agency to reconsider its decision before the beneficiary or applicant can appeal that decision to the Independent Tribunal 18

Draft amendment to section 18 Cont… Proposed amendment  That section 18 be amended so as to read thus: “…after consideration of the matter, confirm, vary or set aside that decision [or make any other decision which is just] (words in bold to be deleted).  This deletion is intended to clarify the powers of the Independent Tribunal in relation what decision it can make 19

Draft amendment to section 18 Cont…  Currently the Independent Tribunal has adopted a broad interpretation of the words: “…or make any other decision which is just”  The effect thereof is that in some instances the Independent Tribunal has made decision which are not in line with the intention of the legislature 20

Draft amendment to section 18 Cont … C. Condonation of late application  Section 18(4) has been drafted to allow for the Independent Tribunal to consider late application by the applicant or beneficiary  It will provide for applications later than 90 to be considered as the Minister shall prescribe 21

Thank You 22