Child Disability Payment decision making guide
Continual supervision
Supervision means the precautionary or anticipatory presence of another person to monitor an individual’s physical, mental or emotional health. It includes monitoring for obstacles or dangerous places or situations (CDP regs, reg. 11(7)).
Supervision is a more passive concept than attention. All of the following criteria must be met in order to meet the eligibility criteria:
- the individual’s disability can cause a substantial danger to the individual or to someone else
- the danger must not be too remote a possibility
- there is a need for supervision to ensure that the individual avoids the substantial danger
- the supervision needed must be continual.
The supervision an individual requires must be continual. This means the supervision needs to be required repeatedly, but is not necessarily constant and uninterrupted. The supervision must involve the presence of another person, but this presence can be precautionary or anticipatory. The level of supervision may be what is reasonable in the circumstances and can be more passive depending on the nature of the danger. “Continual supervision” only applies to the daytime needs test (CDP regs, reg. 11(1)(c)(ii).
Case managers should consider:
- whether the individual’s health condition is predictable
- if there are any practical steps an individual can take to guard against danger
- the individual’s age and nature of their health condition
- the individual’s ability to understand the risk of danger.
Katie is 12 years old and has epilepsy which was relatively well controlled with her medication. Katie’s seizures have changed since the onset of puberty and she now has seizures about once or twice a day. One of her recent seizures occurred while bathing and her mum had to intervene to stop Katie inhaling water or hurting herself on the bath. Her mum now stays in the bathroom whilst Katie has a bath. Katie’s mother reports this change in circumstances and also tells the case manager in a follow up phone-call that she is required to sleep in Katie’s room at night in order to care for Katie if she has a seizure while sleeping. This is because Katie could injure herself during the seizure. She has struck her head on furniture previously when seizing. Katie’s mum also has to monitor the length of the seizure accurately asif it goes on too long, she needs to phone an ambulance. For up to an hour after a seizure Katie can be disorientated, distressed and confused. Her mum helps settle her and ensure she remains in her bed. Although the case manager has useful information about Katie’s needs at night in terms of attention required, the case manager has to look exclusively at Katie’s daytime needs to establish whether she meets the test for needing ‘continual supervision throughout the day to avoid substantial danger to herself or others’. The case manager determines that Katie needs continual supervision whilst bathing, which happens during the household’s daytime (before Katie’s parents would ordinarily go to bed). This supervision avoids substantial danger to Katie should she bathe alone. The case manager reviews the information provided and awards the highest rate care component as Katie requires continual supervision during the day, and prolonged or repeated attention from another person at night in connection to Katie’s bodily function of sleeping. These needs would be considered to be in excess of the needs of another child the same age.