Red tape puts care dependency grant out of reach of most in need

The care dependency grant, R2,180/month for guardians of children with disabilities who are in need of full-time care, is not reaching enough children, and it is not enough to cover care needs.

Zara Trafford, senior researcher at Stellenbosch University’s Institute for Life Course Health Research, said the uptake of the care dependency grant is very low. About 165,000 people in SA receive the grant.

It is difficult to estimate how many children in SA would qualify for the grant because there is no accurate incidence rate of childhood disability. The most recent Stats SA disability report, from 2014, estimates 718,409 people under the age of 19 live with disabilities. But there are caveats: children under the age of five with psychosocial or neurological disabilities were not counted, and there are indications that some parents may have misreported certain categories.

Trafford said few people were aware of the grant and that there was confusion around the criteria for eligibility. The Social Assistance Act, which governs the care dependency grant and other social grants, originally said the grant was for children with “severe” disabilities. The word “severe” was later dropped from the act, but it remains on many government websites that describe the grant.

“Severe disability” was not a reliable concept, said Trafford. Any child who needed full-time care should be eligible, she said.

As part of the application process, potential beneficiaries are expected to undergo disability assessments conducted by a doctor. Trafford said there were not many doctors registered with SA Social Security Agency (Sassa) to conduct the assessments, which led to application backlogs. A 2023 research paper by Trafford and Professor Leslie Swartz found that doctors conducting disability assessments were often overloaded and “have been inserted into a large system that is focused on grants administration”, without specific interest or training in social security or social assistance.

Sabrina Chalmers, operations manager at Gabriella Centre, a day-care facility for children with disabilities, said the means test required as part of the eligibility criteria alienated some potential beneficiaries.

“Many families may assume they are ineligible without fully understanding the specific income thresholds, or they may find the process of proving their financial status too cumbersome. This can discourage them from even attempting to apply,” said Chalmers.

The application process was complicated and should be streamlined, she said. Many applicants do not have the necessary resources or support systems to go through the application process.

To apply, people are required to visit many different places in person: home affairs for identity documents, public hospitals for medical assessments, banks to open accounts and Sassa offices to apply. “This can be overwhelming for families already stretched thin by the demands of caring for a child with disabilities,” said Chalmers.

She said the grant fell short of “covering the full spectrum of care needs for children with disabilities”.

Chalmers said the costs of transport, specialised care, medical treatments and assistive devices could “far exceed the monthly grant amount”.

Care was so expensive that people even over the income threshold of R223,200/year for a single person or a combined household income of R446,400, could still need support, said Chalmers, adding that it should be adjusted.

The grant was rarely enough to employ professional carers, Trafford said. Instead, the grant often replaced the income of mothers who were unable to work because they needed to care for their children full time. Most early childhood centres and schools do not cater for children with disabilities and parents prefer to stay at home with their children.

She recommended that recipients of the care dependency grant also be eligible to receive the grant in aid, which was aimed at adults on the old age and disability grants who required full-time care, or the child support grant. Both these grants are valued at R530/month and the child support grant reaches 13.2-million children.

Current regulations prohibit recipients of the child support grant from also accessing the care dependency grant. Development Pathways has found that many children with disabilities are accessing the child support grant and not the care dependency grant.

Sassa and the department of social development did not respond to GroundUp’s questions sent a week ago.

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