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Submission 2003

Submission to the Department of the Environment, Heritage and Local Government:
Review of the Disabled Persons Grant

August 2003

Final Draft

Introduction

The Disabled Persons Grant (DPG) is designed to assist people who need to have their homes adapted as a result of physical disability, a mental disability or a severe mental illness for which they are receiving treatment. The grant is jointly funded by the Department of the Environment, Heritage and Local Government and local authorities. The DPG represents just one element of overall state housing policy as it pertains to people with disabilities and this submission confines itself to an analysis of the grant as it is experienced by people with disabilities and, to a lesser extent, those who administer the grant. The data upon which this submission is based came from a variety of sources including Citizen Information Centres, Disability organisations, local authorities, the Department of the Environment, Heritage and Local Government and other sources, which are referenced in the footnotes.

The review arose out of a Dail debate back in April 2003 when Minister Ahern announced that his Department would undertake a review of the DPG to establish the views of local authorities and a range of other stakeholders about how the scheme should be managed going forward.

This submission is important because it has given Comhairle and the National Disability Authority (NDA) an opportunity to comment jointly, for the first time, on the problems identified with the DPG as an element of housing policy that directly affects people with disabilities.

Comhairle and the NDA were established in June 2000, as independent statutory bodies to enable Government deliver on its strategy to mainstream services for people with disabilities and to promote and help to secure the rights of people with disabilities.

Comhairle achieves this by supporting the provision of information, advice and advocacy services for people with disabilities and by supporting the network of 85 Citizen Information Centres (CICs) around the country, developing and maintaining the Citizens Information and OASIS Databases and through the provision of a wide range of training and support programmes. One of Comhairle's statutory functions is to promote and develop the provision of information on the effectiveness of current social policy and services and to highlight issues, which are of concern to CIC clients. In delivering on this function Comhairle relies heavily on feedback from CICs and on networking with other NGOs to build up a pool of knowledge covering inequities, gaps and anomalies in both entitlements and service delivery.

The NDA achieves this by influencing public policy and legislation and working to ensure that services to people with disabilities are of the highest standard and quality. Specifically, the NDA develops, coordinates and advises on policy, monitors and advises on the implementation of standards for programmes and services, prepares codes of practice and undertakes and commissions research.

Both the National Disability Authority and Comhairle support the rights of people with disabilities to live independently where possible, to live in dignity, and to lead an active and fulfilled life.

Background

The Commission on the Status of People with Disabilities in 1996 stated that: "housing provides much more than shelter in modern society: it is the base from which people participate in society and can reflect as well as dictate their level of participation".¹

It found that people with disabilities have less freedom of choice than others in relation to housing, are often heavily dependent on family members, and are sometimes left in situations of acute isolation. This has led to the exclusion of people with disabilities from their local communities and to their inappropriate placement in expensive institutions.²

The Commission found links between disability and low incomes and that the added cost of suitable housing put people with disabilities at a disadvantage in terms of housing.³

In order for people with disabilities to achieve equal status they must have the means to exercise their right to equality in housing, to personal autonomy, to a similar range of choices as everyone else and to participate in the life of the local and national community. This requires the removal of existing barriers, positive provisions and redistribution of resources in housing.⁴

The Commission on the Status of People with Disabilities made the following recommendations:

The DPG be modified to cover up to 95% of approved costs
The grant be extended to the occupants of new houses and to those renting in the voluntary/non-profit sector who have security of tenure. There should be greater uniformity in the implementation of the grant by local authorities. Information about the grant and its appeals procedures needs to be made available more widely.⁵

National Anti Poverty Strategy

The Government has committed itself, through the National Anti Poverty Strategy (NAPS) to substantially eliminate poverty in Ireland. The NAPS definition of poverty used is that: "People are living in poverty if their income and resources (material, cultural and social) are so inadequate as to preclude them from having a standard of living which is regarded as acceptable by Irish society in general".⁶

Lack of access to toileting and washing facilities is a basic poverty issue. Adaptations and alterations to housing for people with disabilities are not lifestyle choices but a basic necessity if people with disabilities are to remain within their own communities, live independently and have a secure base from which to participate in society.

The overall housing and accommodation objective is "to enable households experiencing poverty and disadvantage to have available to them housing or accommodation which is affordable, accessible, of good quality, suitable to their needs, culturally acceptable, located in a sustainable community and, as far as possible, in a secure tenure of their choice".⁷

The overall NAPS commitment for people with disabilities is to "support people with a disability, and their families, to lead full and independent lives".⁸

An increase in funding for, and the effective, equitable administration of the DPG is necessary if these commitments are to be met.

Sustaining Progress

The Social Partnership Agreement for 2003 - 2005 sets out a commitment to review the effectiveness of programmes designed to assist low-income groups, including those with disabilities.⁹

The Government has as an objective to "build a fair and inclusive society and to ensure that people have the resources and opportunities to live life with dignity".¹⁰

The current financial and administrative constraints upon the DPG mean that many people with disabilities who require adaptations to their homes are being prevented from living full and independent lives.

Housing Related Grants

Under the Housing (Disabled and Essential Repairs Grant) Regulation 2001 the Disabled Person's Grant is administered via local authorities and available for the adaptation of houses for people with disabilities. The grant may be given where an extra room or other structural changes are, in the opinion of the Authority, necessary for the accommodation of a person or a member of the household who is either:

"physically handicapped and the works are necessary for his or her proper accommodation, or
suffering from severe mental handicap or severe mental illness, for which he or she is undergoing treatment, and the works are necessary for his or her proper treatment and accommodation".¹¹

The Local Authority will decide if the proposed work is necessary. The amount of the grant is the full cost of the work in the case of a rented local authority house or flat or 90% of the cost (up to a maximum of €20,320) for private houses. Where the house is less than one year old or where a new house is being built specifically to meet the needs of a person with a disability a grant of up to €12,700 is available. The Local Authority recoups 60% of such grants from central government (DEHLG).

The Home Improvement Scheme for Older People is operated by Health Boards and directed by the Task Force on Special Housing Aid for the Elderly to improve the living conditions of older people living alone or in unfit or unsanitary conditions. The type of work carried out includes essential repairs, provision of heating/water/sanitary facilities and security devices. It does not normally cover major structural works.

The Essential Repairs Grant is administered by Local Authorities, and is intended to be used to improve dwellings which are not fit for habitation, thereby preventing the move of the occupant, often elderly, to local authority housing. Two thirds of the amount of the Essential Repairs grant is paid to a maximum of €9,530.

Current Situation

Little progress has been made since the 1996 Commission on the Status of People with Disabilities report, with evidence of erosion of provisions for many. The maximum allowable grant was raised to cover only 90% of costs (up to a maximum of €20,320) and people living in the private rented sector are still not entitled to receive the grant. Minister Noel Dempsey amended Part M of the Buildings Regulations in June 2000 requiring all new houses commencing on or after 1st January 2001 to be ‘visitable' by people with disabilities. The main features of the visitable housing requirements are the provision of:

level or gently sloping approaches to buildings
level access at entry door
sufficiently wide doors and corridors to accommodate a wheelchair
ground floor toilet facilities for wheelchair users and other people with disabilities.¹²

Already some disability groups have noted a tendency for developers to circumvent these regulations and a lack of appropriate resources to ensure their enforcement. Despite these difficulties occupants of houses less than one year old can receive a maximum grant of only €12,700 to cover the cost of necessary adaptations. An appeals process exists but varies between local authorities.

As reported in the Dail, demand for the grant is increasing, while construction inflation is high. The overall budget for the DPG has been cut by an estimated €0.25 million in 2003, which equates to an 8% cut.¹³

Local Authorities must fund one third of the total cost of the scheme from their own resources but with overall funding constraints, are unable to meet their commitments under the scheme. Grant application deferrals to following year budgets have resulted in building delays, increased costs and disruption to the lives of people with disabilities. Many people with acquired disabilities find themselves in sub-standard accommodation, unsuited to their needs.

Reviews of the administration of the scheme have resulted in the introduction of measures that include establishing priority systems, introducing means testing, and reducing the amount of the grant available to applicants.¹⁴
In effect, the grant has been eroded in value and this is of considerable concern to efforts to ensure people with disabilities have the right to live independent lives with an acceptable standard of accommodation. Little progress has been made since the 1996 Commission on the Status of People with Disabilities report, with evidence of erosion of provisions for many, as this submission indicates.

Eligibility

In terms of eligibility it is housing status - i.e. owner occupier, local authority tenant or private rented sector tenan t- as opposed to the degree or nature of a disability which may ultimately determine qualification for the grant thereby resulting in uneven coverage across the various local authority areas.

Of the 10,996 applications made in 2002 6,231 were approved and a total of 5,932 payments were made.¹⁵
The table below records the most recent figures available on the grant, which reflect an increase in total expenditure of 302% between 1998 and 2002. However, the average amount of grant payable has risen by only 3.7% in the period from 2001 to 2002 at a time when inflation in consumer prices averaged around 4.7%.

Disabled Persons Grants paid by Local Authorities

Year	Total Expenditure(€m)	Total Grant payments	Average Grant(€)
1998	13.072	2,455	5,325
1999	15.869	2,875	5,520
2000	27.693	3,646	7,595
2001	41.736	4,883	8,547
2002	52.599	5,932	8,867

Source: Housing Statistics Bulletin 2002

From 2000 to 2002 the number of applications for adaptations received by local authorities increased on average by 36%, or 18% per year. In some local authority areas, such as Laois the demand for funding under the DPG grew by over 200%. The disparity between the level of demand and the number of grant payments being made suggests that there is much unmet need. Also, the disparity between the number approved and the grant payments actually made by local authorities suggest that eligibility for the grant does not guarantee that the person will be able to have the work carried out. For example, in 2002 Cork County Council received 946 grant applications, approved 712, but paid out only 577. Because the housing statistics compiled by the Department of the Environment, Heritage and Local Government do not tell us about an applicant's disability, employment status, age profile or the extent to which approved grants cover the full amount of the cost of adaptations, it is difficult to say whether the DPG is being effectively targeted at those in greatest need. A number of disability organisations report that the ceiling of €20,320 on the grant payment results in many people with a disability having to make up a considerable shortfall in the actual costs of their housing adaptation.

Risk of Poverty

Figures from the Combat Poverty Agency show that households headed by a disabled / ill person ran the greatest risk of experiencing poverty in 2000. Households headed by a disabled / ill person had the highest risk of poverty at the 60 % of average income poverty line rising from 30 % in 1994 to 54 % in 2000.¹⁶

Risk of Poverty by Household Type at 60 % of Average Income

Head of Household	Risk of Poverty at 60 % poverty line
Disabled / ill	54.4
Self Employed	20.8
Farmer	24.3
Unemployed	50.7
Employee	7.4
Retired	33.8
Home worker	47.6

People with disabilities are often unable to meet the shortfall in the actual cost of housing adaptations for a number of reasons:

The rate of unemployment amongst disabled people is just under 60%¹⁷
Over 130,000 people with disabilities are dependant upon some form of social welfare payment.¹⁸
In the case of a recently acquired disability applicants are likely to be uncertain about their future income and work opportunities.

General Administration

There is no national policy for the administration of the grant scheme.

Applicants currently have no right to the grant. This lack of a statutory right has resulted in less than satisfactory living situations for people who may already have a high level of needs and be vulnerable to poverty and ill health. It can also lead to people being unable to move out of hospital or institutional care.

The grant applicant is expected to make contact directly with contractors, and oversee their work. Some people with disabilities may require advocates to assist with the actual application process, and may have support needs around negotiating with contractors.¹⁹
These needs are not provided for in the current system.

There is evidence that people go on to make applications across the various housing alterations and improvements schemes if they have been unsuccessful under a specific scheme.²⁰
This indicates the level of need for assistance in order to make homes habitable.

Uniformity / Geographical Variations

Given that this is a national scheme there are considerable inconsistencies in the way in which the scheme is administered by local authorities. The system for assisting disabled people to adapt their homes is complex and the standard of service people receive may depend on where they live. Financing problems mean that some local authorities are unable to meet their statutory grant obligations. The following data taken from a report of the National Rehabilitation Hospital and the Spinal Injury Action Association - DPG Special Interest Group contrasts the experience of a person living in Wexford and in Roscommon and clearly illustrates the varying impact of the grant on the lives of two patients with similar needs who applied for the DPG.

Grant approval wait time for DPG applicants

County Council	Date of application	Date approval received	Waiting time	Response / Comment	Discharged before work completed
Roscommon	March 2000	November 2001	20 months	Discharged home with no shower facilities	Yes Discharged home
Wexford	December 2000	January 2001	1 month	Service was excellent and helpful	YesDischarged home

Source: National Rehabilitation Hospital and the Spinal Injury Action Association

The flexibility of the system at local level should allow local authorities to respond more quickly to urgent cases. In reality, however, this does not appear to happen. Instead it leads to variations in standards between local authorities and dilutes accountability between local authorities, health boards, and the Department of the Environment, Heritage and Local Government.

There are no standard guidelines on what is deemed a "necessary" alteration or adaptation. This has resulted in a lack of uniform application of the scheme with variations between local authority areas. Each local authority has its own set of procedures concerning the grant application and some local authorities produce more detailed guidelines than others. The quality of information held by local authorities on the housing needs of people with disabilities is generally poor and disabled people tend not to be involved in planning processes for housing in any systematic way.

A number of local authorities have introduced a priority ranking system (e.g. Galway, Westmeath County Council, Longford County Council). The impact of this is that some applicants may be unsuccessful in their application to one local authority area, where they might have succeeded in another. This variation in the application of the scheme creates geographical disadvantage for some applicants.

There is no consistent definition of disability used. Nor is there a list of conditions that are excluded from eligibility for the grant. Local authorities have developed their own systems for defining what is or is not eligible. For example, Kilkenny County Council lists severe mental illness as Medium Priority and age-related disease as Low Priority. Kildare County Council, which also operates three priority levels does not refer to any conditions in its ranking. Overall, the ranking systems tend to be simplistic. The NDA would recommend that any introduction of a ranking scheme should be consistent across authorities and use the World Health Organisation's ICF generated definitions that give a social context to the individual's condition.

Some local authorities have introduced an application fee (e.g. Kilkenny €10.00) despite the fact that many people with disabilities are welfare dependent and are living in poverty.²¹
Just over 40% of people with disabilities between the ages of 15 and 65 are in employment.²²
With the already additional general living costs faced by people with a disability the application fee is yet another tax on the disabled.

The Irish Wheelchair Association survey established that a number of Health Boards are no longer assisting local authorities with processing applications (e.g. Midland, North Eastern.) This lack of professional support will serve to lengthen delays for applicants in these areas.²³

The timing of the payment of the grant varies between local authority areas. Some authorities require an applicant to complete work before approval whilst others prohibit works to start before approval has been granted.

Appeals System

There is no consistent formal appeals system for applicants who are refused a grant. While most local authorities do operate their own appeals system, applicants are not always adequately informed about how it works. Very often the same personnel who refused the grant in the first instance will also process the appeals.

The absence of a well-publicised and transparent appeals system may encourage people to expedite their application through a local politician or council member thereby perpetuating the market for political brokerage or ‘clientelism' in Irish politics. In a system where bureaucratic procedures are slow and inefficient, it is difficult for people with disabilities to obtain information about their entitlements, redress in the event of incorrect or unfair decisions, or proof that their case is being fairly decided. For all these reasons, voters depend on the assistance of politicians and the local authority bureaucracy enables politicians to carry out this brokerage role by responding more quickly to their interventions.

Assessments

Delays in assessments by Occupational Therapists have resulted in applicants being advised to pay for private OT assessment. Despite gaining private assessments some applicants are then unsuccessful due to lack of local authority funding.²⁴

The administration of this grant should not rely on privately funded assessments. This creates further disadvantage to those who are unable to afford private fees, and adds to the overall costs of adaptation to the home.

In some areas the local GP carries out inspections, which fast-tracks the grant approval process, although because assessment is not a GP's specialism, this could result in additional adaptations being required in the future.²⁵

There are examples of good practice. South Dublin Council are supplying their own OT to ensure planned adaptation work meets the present and likely future requirements of the person with a disability. If an OT were readily available in other areas this would reduce the assessment stage of waiting times.²⁶

A recent report prepared by the Occupational Therapists Special Interest Group on Housing in Ireland and presented to the Inter-Departmental Group on the Needs of Older People in July 2003 expresses the concerns of Occupational Therapists about the current system for allocating housing grant schemes and the varied implementation of these schemes throughout the country. The report emphasises the cost effectiveness of the Disabled Persons Grant when it states that:

"the average amount of the Disabled Persons Grant (for persons over age 65) was €12,951 in 2002 while the cost of long term care is in the region of €36,000 - €42,000 per annum"…the DPG and other housing grant schemes should be recognised as essential elements in Primary Care. Appropriate housing adaptations are preventative measures that can minimise risk and maximise health and safety in the home environment".²⁷

Assessment is the foundation on which the entire edifice of adaptation expenditure rests. Assessments based on user preferences should improve the cost effectiveness of the scheme by achieving better value for money without increasing expenditure.

Waiting time

There is significant variation between Local Authority areas. Some Local Authorities are still processing 2002 applications (e.g. Fingal) and have yet to begin processing 2003 applications. Applicants in North Galway can wait for three years for grant clearance, whilst applicants in Limerick face a one-year delay.²⁸

Research by the National Rehabilitation Hospital found that there was an average waiting time for approval of just over 7 months, with the longest wait some 20 months.

The requirement by many Local Authorities to have an Occupational Therapist assessment results in delays, due to the national shortage of Occupational Therapists. For example, Dun Laoghaire applicants were experiencing a 10 month wait for OT assessment.²⁹

There are numerous incidences where applicants have been approved for the grant, secured contractor quotes and returned to the Authority to be told the funding had run out and grant payments were being suspended.³⁰

Reports from Waterford indicate that in some areas there is an added difficulty in getting contractors to carry out the work.³¹
These delays result in increased costs, such as increased VAT as well as inflation adjusted pricing of materials and labour. These rising costs are not factored into approved costs by the Local Authorities.

Time delays in processing grant applications may exceed the time left for a terminally ill person. People in such circumstances require a rapid response that is flexible to their particular needs. In at least one local authority area there is anecdotal evidence to suggest that people with progressive illnesses are being considered ineligible for the grant. Also, people with progressive illnesses are likely to develop different needs as their condition worsens and may find it difficult to obtain grant approval for further adaptation work.

A delay of up to 20 months for permission to commence work is a very long time for any person who is unable to use bathroom facilities with dignity.

Notification of authorisation to proceed following the death of a loved one can be a very distressing experience for the bereaved.

Delays in securing adaptations to houses means people with acquired disabilities cannot be discharged from hospital, or are transferred into interim accommodation at a substantial cost to the State.³²

Level of funding for DPG

Given rising building costs the grant ceiling of €20,320 is no longer adequate for major structural alterations and therefore people experience a considerable shortfall in funding.

Many people with disabilities are without personal financial resources, are dependent on social welfare and live with the everyday additional costs of disability. The National Rehabilitation Hospital research found that lack of ability to make up the additional 10% has acted as a deterrent for some in applying for the grant.³³
These people are forced to live in substandard accommodation that is not suitable to their needs.

Regional variations are evident in the application of levels of grant funding. For example, Galway County Council has introduced ceilings on the different types of alterations catered for and Clare County Council applicants are expected to borrow and repay loans when an approved grant comes through.²⁸
For people on low incomes accessing loans is problematic and the requirement to pay interest on loans becomes an added burden.

Funding of approved works has been reduced to a maximum of 75% in Sligo, as demand has outstripped the funding available. Kilkenny County Council will pay only up to a maximum of €15,000 per applicant.³⁴

Some authorities have introduced means testing. For example, Kildare insists that the maximum gross household income permissible must be under €40,000.³⁵

Where accident compensation is claimed the grant will only be paid after an undertaking by a solicitor to refund the amount in full. Other restrictions include a possible reduction in the grant payable if other properties are owned. Applicants who are non-owners are required to live on in the adapted house for a minimum of 5 years or repay the grant.³⁶

Applicants who live in council owned properties also report lengthy delays in work being carried out, reportedly due to the unavailability of contractors.³⁷

Some local authorities have stated that there is insufficient money in the estimates to meet the number of applications received for the grant.³⁸

Suspension of DPG Scheme

The NDA and Comhairle are concerned at the suspension of the scheme by a number of Local Authorities. For example, Dun Laoghaire Rathdown County Council advertised in April that they were not accepting any new applications³⁸ and reversed this in July, although only for application assessment purposes while Meath County Council, Thurles and Kilkenny have suspended the scheme.³⁹

Impacts

Delays in, and failure to complete, housing adaptations will result in people remaining in hospital for longer, being transferred to nursing homes in the interim, and transferring to social housing lists, all at a significant cost to the State. The cost of residential care is approximately €2,500 per person per month.⁴¹

People with disabilities who cannot make the necessary adaptations to their homes are forced to rely heavily on family, or are institutionalised, and so denied the right to live independent, fulfilling lives within their communities.

Case Studies

This submission found that the Disabled Persons Grant experiences considerable difficulties relating to funding, eligibility and general administration. The case studies arising from social policy reports completed by Citizen Information Centres supported by Comhairle clearly illustrate the problems with the grant and underpin the recommendations outlined in this submission. The case studies are as follows:

Case Study 1

A Citizens Information Centre (CIC) information provider endeavored to locate a copy of the official guidelines for the DPG. These efforts were a direct result of queries from a number of CIC clients who had sought information on the subject from the local County Council. The information provider found that the County Council could not offer anything in writing that would act as a guide for potential applicants. The County Council stated that they adhered to the guidelines set out by the Department of the Environment, Heritage and Local Government.

Having obtained this information the CIC worker contacted the Department but found that no one there could provide a written copy of the guidelines for the grant either. As one call turned into several the CIC worker expressed exasperation at being unable to access what should be routine information. The CIC worker calculated that he spent a total of 2.5 hours holding on the phone awaiting a response to his query.

Having failed to make any progress with the query the CIC worker suggested to a Department official that the information requested might be obtained through the Freedom of Information (FOI) Act 1997, at which point he was transferred to a supervising official. The supervisor stated that grant guidelines constituted ‘confidential information between the Department and the Local Authority'.

Following on this conversation the CIC worker contacted the Deputy FOI Officer in the Department of the Environment, Heritage and Local Government who eventually agreed that the grant guidelines should be available on request to a member of the public. The grant guidelines were later forwarded to the CIC.

Case Study 2

A CIC client had been approved for receipt of the DPG and was awaiting assessment by an Occupational Therapist. However, due to the acute shortage of available Occupational Therapists to assess the level of adaptation required, the client's case had been on hold for a number of months. The client also experienced delays in acquiring quotes from registered building contractors. However, having overcome these difficulties the client returned to the County Council to inquire about the processing of the grant. To her distress the client was informed that grant funds were depleted and that the County Council was no longer in a position to approve her application.

The CIC worker attempted to find alternative funding for the client through the Special Housing Aid for the Elderly Scheme, which offers a Home Improvements Scheme to eligible applicants. The Health Board Coordinator of the Housing Aid Scheme reported a dramatic increase in cases where insufficient funds available for the DPG meant that some people were resorting to the Housing Aid for the Elderly Scheme in the hope of securing funding.

Case Study 3

A CIC client had applied for the DPG and was requested by the County Council to provide a plan outlining the repairs/ alterations he needed done to his home. The cost to the client of producing this plan was €300. Having completed an application form and provided all the relevant details the client was refused the grant on the grounds that he was not a blood relative of the owner of the house in question.

The client had been living with the family occupying the house for some 30 years and did not have access to alternative accommodation. Had the County Council requested all the relevant data regarding ownership of the house at the start of the application process, the applicant would not have incurred fees of €300 for the plan.

Case Study 4

A pensioner client of the CIC (over 80 years old) with severe arthritis applied for a DPG. She had to be assisted in completing the application form, which she found extremely complex and daunting. Part of the form needed to be signed by the client's GP. Despite being a medical card holder the GP charged the client a fee of €12.70 to sign the application form.

Case Study 5

A CIC has reported numerous complaints from clients in recent months regarding suspension of the DPG, which, it states, is causing severe hardship for people who are disabled. The Local Authority has stated that there are no funds available to finance the scheme and they cannot say at what stage in the DPG scheme will be reinstated. This has left applicants approved for the grant owing substantial amounts of money to contractors for work, which they would not have undertaken without being awarded the DPG. The CIC reports that some applicants have been left with works partially completed and others are unable to get vital adaptations due to the suspension of payments.

Case Study 6

A young couple, both wheelchair users, are finding it impossible to secure accessible accommodation in the private rented sector. They cannot find accommodation that is accessible and neither can they avail of the DPG to modify private rented accommodation. Given the difficulties people with disabilities have accessing suitable accommodation in the private rented sector the CIC worker calls for a greater number of Local Authority residential units to be purpose-built for people with disabilities.

Case Study 7

A 72 year old client presented at a CIC with a query in relation to her central heating system which had been installed in 1992. The company that services her heating system stated that it needed to be replaced. The client received a quote of €3,200 to have the system replaced and contacted the grants section of Dublin City Council to enquire if she would be covered by the Essential Repairs Grant Scheme. The client was informed that the Essential Repairs Grant no longer covered central heating. She was advised to make an application for the DPG or alternately the Special Housing Aid for the Elderly Scheme administered by the Health Board. According to the CIC both of these schemes are also experiencing funding difficulties and lengthy delays and moreover the DPG does not cover central heating either. The DPG should be extended to cover the installation of central heating systems, as this is a vital utility for older people and for people with specific disabilities.

Case Study 8

At the end of May 2003 a County Council informed a CIC worker that 50 per cent of the annual budget for the DPG had been spent by the end of March 2003 and no new assessments had been carried out since February of this year. According to the Council the budget utilised so far this year comprised mainly the grants approved in 2002 and now requiring payment following completion of the work. The Council could not confirm the amount of the 2002 allocation for the DPG. The Council confirmed its intention to introduce a priority rating system and means testing for future applications received.

Case Study 9

A Disability Action Group report the case of a 22 year old single man with muscular dystrophy who lives at home with his father. The man needed to have a bedroom, shower and toilet facilities installed downstairs. He applied for the Disabled Persons Grant and received a grant payment of €20,320. However, the extension to the house cost €48,250 plus an additional cost of €600 for building plans leaving an overall deficit of €28,530. The man's father had to borrow this amount to pay the builder. He also had to cover the cost of decorating and furnishing the new extension.

Case Study 10

The majority of people with Motor Neurone Disease - 67% remain and die at home with care and support from their families. At present the Irish Motor Neurone Disease Association is in contact with more than 200 families who are caring for someone with MND. For these families the need to access the Disabled Person's Grant is usually an urgent one. Currently there is evidence to suggest that people with MND are being considered ineligible for the grant due to the progressive nature of their condition. The Irish Motor Neurone Disease Association is very concerned about this development as the DPG is often crucial to enabling people with MND to remain at home especially in the later stages of their illness.

Conclusion

According to research carried out in the UK by Frances Heywood, Research Fellow at the University of Bristol (2001)⁴² home adaptations improve the health and safety of people with disabilities and have in many instances transformed their lives. Their positive effects, which include reducing the need for hospital and residential care, prove that they are a highly effective use of public money and are therefore deserving of increased investment. The rising demand for housing adaptations in recent years is one measure of the success of care in the community. People who formerly might have remained in residential care have been able to choose to live in their own homes. Adequate financial provision should be made available for the DPG to ensure that requests for adaptations can be processed. Both Comhairle and the NDA adopt the position that people will benefit most from a service that is tailored to their needs. Significant gaps in housing provision remain a problem for people with disabilities who experience difficulties in finding adapted or accessible accommodation. In order to support people with disabilities in achieving a base from which to participate in society and to meet the NAPS commitments to the provision of accessible, good quality, suitable housing it is clear that adjustments to the funding and administration of the Disabled Persons Grant must be urgently implemented. Comhairle and the NDA feel that both short term and longer-term solutions should be examined and make the following recommendations:

Recommendations for the Short-term:

Carry out the recommendations of the Commission on the Status of People with Disabilities relating to proportion of grant and eligibility of tenure.
Change the name of the scheme to reflect its purpose and the changing views regarding people with disabilities in society - "Housing Grant for People with Disabilities."
Increase the funding available for distribution through the scheme, to ensure people on waiting lists have their claims met more quickly.
Introduce a formal, national policy for the administration of the grants, including a requirement that grants are applied consistently across Local Authorities, so as to remove any geographical disadvantage.
Ensure that any policy guidelines are made readily available in accessible formats.
The maximum time allowed for decision making by the local authority should be regulated, as are decisions on planning applications.
Ensure that grounds for appeal are made clear to applicants, across Local Authorities. There should be an option of appeal to a body external to the local authority administering the grant.
Take into account the progressive nature of specific disabilities and introduce a level of flexibility in the system of grant payments to cater for this. Currently it is possible for a recipient of a grant payment to reapply for a further grant after a 10 year period has elapsed. For people with progressive conditions this period should be reduced.
Clarify when it is appropriate to have an OT assessment and when other professionals' assessments would be sufficient in determining the adaptation work necessary. There are substantial differences in approaches to the assessment of housing needs both within and between professions. This can impact negatively on the extent to which the needs of the user are taken into account and their choices respected.
The Department of the Environment, Heritage and Local Government should take responsibility for monitoring the administration and overall standard of the works grant aided through the DPG scheme.
As part of the commitment to making public services accessible training should be provided to local authority staff who administer the scheme, to ensure understanding of the housing and environmental issues facing people with disabilities.
Provide payment for works in several instalments and at commencement of work to ease financial pressures on applicants / potential applicants.

Recommendations for the Longer-term:

A policy on housing for people with disabilities should be formulated and publicised in accessible format by the Department of the Environment, Heritage and Local Government.
The application process should be streamlined in order to speed it up by ensuring greater co-ordination between health boards and local authorities.
The development of an Independent Living Fund, which amalgamates existing house improvement grants, should be explored.
Medical conditions should be graded consistently, preferably using ICF generated definitions that give a social context to the individual's condition and ensure those in greatest need are given priority

Footnotes

1. Report of the Commission on the Status of People with Disabilities, A Strategy for Equality, Ch. 12, Housing and Accommodation 12.1
2. Report of the Commission on the Status of People with Disabilities, A Strategy for Equality, Ch. 12, Housing and Accommodation 12.2
3. Report of the Commission on the Status of People with Disabilities, A Strategy for Equality, Ch. 12, Housing and Accommodation 12.3
4. Report of the Commission on the Status of People with Disabilities, A Strategy for Equality, Ch. 12, Housing and Accommodation 12.3
5. Report of the Commission on the Status of People with Disabilities, A Strategy for Equality, Ch. 12, Housing and Accommodation, Sections 12.19, 12.20
6. Building an Inclusive Society, Review of the National Anti-Poverty Strategy under the Programme for Prosperity and Fairness, 2002, Point 5, page 6
. Building an Inclusive Society, Review of the National Anti-Poverty Strategy under the Programme for Prosperity and Fairness, 2002, Point 16, page 13
8. Building an Inclusive Society, Review of the National Anti-Poverty Strategy under the Programme for Prosperity and Fairness, 2002, Point 21, page 17
9. Sustaining Progress, Social Partnership Agreement 2003 - 2005, Section 2.3.2
10. Sustaining Progress, Social Partnership Agreement 2003 - 2005, Section 1.6
11. Housing (Disabled and Essential Repairs Grant) Regulation 2001
12. Building Regulations (Amendment) Regulation, 2000, S.I.179 of 2000
13. Dail Debate 3rd March 2003
14. Survey of Local Authorities conducted by the Irish Wheelchair Association, April 2003
15. Government of Ireland (2002) Housing Statistics Bulletin. Dublin: DEHLG.
16. Combat Poverty Agency (2000) Poverty Briefing Number 13. Dublin: CPA
17. Quarterly National Household Survey, Nov 2002, Central Statistics Office
18. Department of Social, Children and Family Affairs, 2001
19. Disabled Person's Grant Survey, The National Rehabilitation Hospital and the Spinal Injury Action Association DPG Special Interest Group, Feb 2003
20. Social Policy Alert, Comhairle, May 2003
21. Living in Ireland Survey, ESRC, 2000
22. Quarterly National Household Survey, Nov 2002, Central Statistics Office
23. Survey of Local Authorities conducted by the Irish Wheelchair Association, April 2003
24. Disabled Person's Grant Survey, The National Rehabilitation Hospital and the Spinal Injury Action Association DPG Special Interest Group, Feb 2003
25. Survey of Local Authorities conducted by the Irish Wheelchair Association, April 2003
26. Disabled Person's Grant Survey, The National Rehabilitation Hospital and the Spinal Injury Action Association DPR Special Interest Group, Feb 2003
27. Occupational Therapists Special Interest Group on Housing in Ireland, July 2003
28. & 29. Survey of Local Authorities conducted by the Irish Wheelchair Association, April 2003
30. Social Policy Alert, Comhairle, May 2003
31. Social Policy Alert, Comhairle, May 2003
32. & 33. Disabled Person's Grant Survey, The National Rehabilitation Hospital and the Spinal Injury Action Association DPR Special Interest Group, Feb 2003
34. & 35. Survey of Local Authorities conducted by the Irish Wheelchair Association, April 2003
36. & 39. Survey of Local Authorities conducted by the Irish Wheelchair Association, April 2003
37. & 38. Disabled Person's Grant Survey, The National Rehabilitation Hospital and the Spinal Injury Action Association DPG Special Interest Group, Feb 2003
38. Irish Times, April 11th 2003
41. Dail Debate 3rd March 2003
42. Heywood, F. (2001) Money Well Spent: The effectiveness and value of housing adaptations. Abingdon: The Policy Press.