The need for the amendment to the Social Assistance Bill was realised when the 2003/4 uptake of disability grants spiked to more than three times the projected figure for that period. An investigation was done to establish the cause of this sudden increase. The core findings were that there was no common definition for what constituted a disability, and there was no uniform assessment method or tool to determine whether a person had a disability. This situation resulted in errors of both inclusion and exclusion.
The amendment was made to have a common definition of disability to be applied uniformly by the Department of Social Development and Department of Health for purposes of Disability Grants and free health care. The amendment also provided the South African Social Services Agency (SASSA) with a uniform tool & mechanism when considering decisions made for DG applications.
In May 2005, Cabinet approved a common definition of disability for eligibility for Disability Grants and Free Health care for people with disabilities. It read:
A person was 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 made him/her unfit to obtain by virtue of any service, employment or profession, the means needed to enable him/her to provide for his /her own maintenance
(b) Income below a prescribed means level; and
(c) Attained the prescribed age.
A Harmonised Assessment Tool (HAT) was developed & piloted in 2006 jointly by DOH and DSD and was approved by Cabinet in August 2007.It contained a breakdown of activities which the DoH used to determine the extent of the disability a person suffered from.
There was concern amongst Members about how current recipients of disability grants would react when they discovered that they were disqualified from receiving a disability grant in terms of the new definition of what constituted a disability. There was a concern that it could lead to more litigation against SASSA and the DSD.
Members asked questions about other ways in which people with chronic illnesses would be assisted. Members asked questions about the monitoring of this method of assistance, because it lent itself easily to abuse. Long delays years, between an application for a disability grant and a final outcome where also questioned. Further questions were asked about staff vacancies in SASSA and when it would be filled, the internal review process in SASSA.
Ms Bathabile Dlamini, Deputy Minister of Social Development attended the meeting. Ms Dimakatso Moutlaotse, Resident Director: Disability & Old Age Grants in the Social Assistance Chief Directorate, Comprehensive Social Security, Department of Social Development (DSD), delivered the first part of the presentation on the Social assistance Amendment Bill – B5 – 2010. Mr Puseletso Loselo, Chief Director: Legal, DSD, delivered the second part of the presentation, dealing with the Draft amendment to section 18 of the Act.
Department of Social Development (DSD) Presentation: Social Assistance Amendment Bill
Mr Vusi Madonsela, Director General, DSD said that the Social Assistance Amendment Bill was an attempt to deal with the definition of disability, which was a very complex matter. The Executive had decided to review the existing legislation after noticing an exponential rise in the applications for disability grants. Upon closer scrutiny it was discovered that the current definition of disability as defined by the law, included many people it should exclude, and vice versa. The Social Assistance Amendment Bill aimed to clearly define what exactly constituted a disability and who should and should not benefit from a disability grant. One of the criteria used, in terms of the new Bill to determine whether a person had a disability was the person was able to enter the labour market.
The rationale for the Bill was that it would facilitate correct selection and targeting for eligibility for disability grants and free health care. The HAT would facilitate uniform assessment. It would significantly reduce disability grant fraud.
Section 18(1) as it stood only permitted applicants or persons acting on their behalf to appeal against decisions of the Agency relating to any matter regulated by the Act. The section did not permit beneficiaries whose grants had been terminated or suspended to appeal against any decision of the Agency relating to any matter regulated by the Act. A beneficiary, thus had no choice, but to approach the court for review.
The amendment to this section would allow a beneficiary to appeal against a decision of SASSA. The Amendment also allowed for SASSA to reconsider a decision by means of the process of an internal review. The amendment also allowed an applicant or beneficiary to lodge an appeal with the Independent Tribunal after the 90 day period had lapsed since the grant had been terminated, which was not the case before. Thus it provided more time for applicants or beneficiaries to appeal.
Ms Moutlaotse proceeded with the presentation. (See attached document)
Mr Loselo delivered the presentation on the Draft Amendment to section 18. (See attached document)
Ms M Mafolo (ANC) asked whether the number of people receiving disability grants would decrease or increase when those who did not qualify any longer was removed from the database of disability grant beneficiaries and the ones who were excluded before were added.
Ms Mafolo asked what the value of the food voucher that were considered to be given to people suffering from chronic illnesses, would be. Would it be equal in value to a disability grant? What would be the interval in between the issuing of the food vouchers?
Mr R Bhoola (MF) said that the food vouchers mentioned should be clearly defined and controlled. During recent elections, there were rumours that food vouchers were distributed by certain parties to gain votes. This was of grave concern. He asked what the chances were that these vouchers could be used to manipulate votes in future elections.
Ms N Gcume (COPE) asked how these food vouchers would be monitored at the points of distribution, because she was aware of cases, where she came from, where the food supplements that people received from the state ended up being sold in shops for profit. Without proper monitoring and evaluation even officials become tempted to help themselves to the aid meant for the needy.
Ms H Lamoela (DA) cited personal experience of a person who did not receive her pension for three years during which time she only received two food parcels. She asked how the monitoring and evaluation of the issuing of food parcels would be done and whether the food parcels would be equal in value to a grant.
Mr Thabo Rakoloti, Chief Director, DSD said that the DSD distinguished between a disability and a chronic disease. The DSD looked at different options in dealing with the chronically ill, for example income support or a different grant for the chronically ill. Food vouchers were another option. The Department of Health would provide nutritional support for people with chronic diseases. When chronic disease was discussed within the Social Protection Cluster it was decided that it needed an integrated approach as all chronic diseases did not need the same interventions. It was then decided that the Departments of Health and Agriculture had to come up with options to present to Cabinet as to how they wanted to respond to the needs of the chronically ill.
The vouchers that were mentioned earlier by Mr Bhoola and others were the vouchers that formed part of the Social Relief of Distress Programme of the DSD. This has nothing to do with the vouchers suggested as an intervention to assist the chronically ill.
Mr Coceko Pakade, Acting CEO of SASSA, followed up on what Mr Rakoloti said about SRD, by saying that SASSA had presented to the PC at previous occasions and admitted that it had challenges. The challenges were picked up by the Auditor General as well. SASSSA had developed a detailed action plan to deal with the possible abuse of the Social Relief of Distress (SRD). The action plan basically dealt with screening processes. In this SASSA worked closely with Social Development, because SASSA wanted Social Workers to verify the plight of the people who were supposed to benefit from the help. Another part was the monitoring function. There was a process of reconciliation after the distribution of SRD to verify that the assistance went to the right people.
Ms Lamoela said that she believed that something had to be done to get people off social grants. She dealt with many cases where people were waiting to be approved for grants for up to three years. She then asked whether it was because of incompetence of staff within SASSA or a lack of social workers.
Mr Bhoola reiterated the need to move away from a welfare state to a nation of self reliant citizens. He however questioned the need for the long delays in the processing of social grant applications. Some people waited longer than three years. He asked what the Department planned to do about the lack of social workers as it impacted severely on service delivery. In his understanding some people did not have the knowledge to have their documents certified by the South African Police Service, which also caused delays.
Mr Pakade said that some of the delays reported were caused by the previous model where SASSA depended on doctors from the Department of Health to asses candidates for disability grants. Under the new model, SASSA had its own contracted doctors in all regions, which should speed up the rate of assessment. From the first of April the doctors would be paid a standardized rate. The situation needed to be monitored, but early indications was that that it was working well.
Ms Lamoela asked how the lack of social workers, doctors and nurses would impact on the implementation of the Bill.
Ms Lamoela mentioned that during the South African Social Services Agency (SASSA) hearing before the Standing Committee on Public Accounts (SCOPA), it emerged that there were many vacant positions in SASSA. She asked how SASSA would cope with an even bigger workload as a result of the Bill, in the light of the budgetary constraints it was already labouring under.
Mr Pakade said that SASSA was in the process of finalizing discussions with Treasury and it was agreed that there were essential posts that had to be filled within the new financial year.
Ms P Tswete (ANC) what the strategy was to inform people that were currently receiving disability grants, but would not qualify under the amended law, that they would no longer receive it.
Mr Loselo said that the current law made provision for a review of any grant at any given time. The person had to be informed in writing that SASSA was considering reviewing his/her grant. The person had to give reasons why the grant should not be cancelled. Failing that, the grant would be terminated.
Mr Bhoola raised the issue of the child support grant. There was a stipulation that the child who received the grant, should be in school. He said that there were concerns about recipients of child support grants going on to tertiary education.
Mr Loselo said that there was an obligation on the primary care giver of a child who received a grant to make sure that the child attended school. This was actively encouraged by the DSD, but the grant would not be taken away if the child did not attend school. The department would investigate why the child did not attend school and take remedial action to get the child into school.
Mr Bhoola asked whether the internal review process would synchronize with an assessment by a board of medical practitioners. He also wanted to know who would have the final say; the SASSA board or the Independent Tribunal and how the final outcome after 90 days related to these two appeals.
Ms Gcume asked the Department to assist the meeting in understanding what a chronic condition was and to give examples of these. She said that some chronic diseases like hypertension and diabetes lead to strokes.
Ms Moutlaotse defined chronic illness. She said that a chronic illness was an incurable prolonged medical condition that a person suffered from, but the person did not have activity limitations. The person would have activity limitations only when he did not stick to the management regime for that condition and became incapacitated as a result. Epilepsy, bipolar disorder, hypertension, tuberculosis and diabetes were examples of chronic diseases. It was possible that some of these conditions could escalate for example a person suffering from diabetes or hypertension could suffer a stroke and would then become disabled, in which case the person would then qualify for a disability grant.
Mr Madonsela said that there was a list of chronic illnesses that was published by the Department of Health, which could be made available to the PC.
Ms Gcume asked whether the temporary disability grant would continue after the passing of the Bill.
Mr Loselo said that as long as the recipient complied with the new definition of a disabled person, it would be given.
Ms S Kopane (DA) said that the DA supported the Social Assistance Amendment Bill, because the amendments would make it harder for people to obtain disability grants fraudulently. She however raised a concern about the media used to advertise the public hearings on the Bill. She was under the impression that only the Mail & Guardian was used to advertise the hearings. She felt that it was the wrong publication, because the people who had an interest in social grants did not read it. She asked whether the community press and community radio stations were not more appropriate for reaching the target audience in this case.
The Chairperson said that the advertisement for people to make presentations on the Social assistance Amendment Bill appeared in the City Press, the Sunday Times, the Rapport and the Mail & Guardian. The advertisements ran for fourteen days. The 16th of April, 2010 was given as the closing date for submissions. She promised to give a layout of the programme later in the meeting.
Ms Kopane said that there were more than four thousand cases pending against SASSA. The passing of this Bill would result in people suffering from chronic diseases, who were currently receiving the disability grants, to be excluded. There was a distinct possibility that some of these people may litigate against SASSA and the DSD as well. There was also a backlog of more than seven thousand applications for disability grants awaiting outcomes. She asked whether there was a way to fast-track these applications, as many of these would also end up litigating against SASSA, because they waited too long. She asked whether the DSD had a strategy to reduce or prevent more litigation against it.
Ms H Makhuba (IFP) expressed her approval of the Social Assistance Amendment Bill. She said that she knew about people who have appealed and never received any response. The internal review process would assist them in getting an outcome. She wanted to know how long an appellant would have to wait for a response from the Department.
Mr Pakade said that reviews would be done internally. There was mention made of an internal board. The idea was not to replicate the Independent Tribunal that was dealing with appeals. The contracted doctors would be used to reassess people before they lodge a formal appeal with the Minister. This process would apply to other grants as well. The issue for SASSA was more the delegation in terms of the Improved Grants Administration Process (IGAP). Currently, the approvals were done at level seven. The people assessed would be referred to higher levels in the chain, so that those people could review the decisions of officials in local and district offices. Hopefully any oversight would be picked up before a formal appeal process was followed.
Mr Loselo said that the full detail of how the internal review would be carried out would be contained in the Regulations. As soon as the DSD had the draft of regulations it would be presented to the PC for perusal and to make recommendation on how it could be improved.
Mr Loselo said that it was supposed to be 90 days. This was in line with Promotion of Administrative Justice Act (PAJA). But there was a backlog. Until such time that the backlog had been dealt with, it would be longer than 90 days.
Mr Madonsela suggested that the Departments of Health and Agriculture should be invited to co-present with the DSD to the PC on Social Development so that the process could be more informed. The probable implications of the Amendment would be discussed and these Departments would be able to spell out their responses to it. In that way, the PC would have a more balanced view of what the consequences would be, and how it would be dealt with.
Adoption of Committee Programme for Second-Term
The Chairperson gave a brief outline of the Committee’s programme for the second-term highlighting the process that would be followed leading up to the adoption of the Social Assistance Amendment Bill.
The Committee adopted the programme without amendments.
Adoption of Outstanding Minutes
The Chairperson tabled the draft minutes of the PC meeting that took place on 24 February 2010.The necessary corrections were done and the minutes were adopted.
The meeting was adjourned.
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