4Eligibility criteria

4 Eligibility criteria

(1) The eligibility criteria for a person to participate in this Scheme are that the person: (a) suffers from permanent and severe incontinence: (i) caused by an eligible neurological condition; or (ii) Caused by an eligible other condition; and the person has or is eligible to have a pensioner concession card issued under Division 1 of Part 2A.1 of the Social Security Act 1991 or is the dependant of a holder of a pensioner concession card, as defined in section 6A of the Social Security Act 1991; or (iii) caused by an eligible other condition and the person has a Department of Veterans’ Affairs Pensioner Concession Card or entitlement, whether as a primary cardholder or a dependant of a cardholder; and (b) is an Australian citizen or permanent resident within the meaning of those terms in the Australian Citizenship Act 2007; and (c) is not ineligible because of subsection (2).

Note: Item 3 of the Amendment Act provides that a person who was receiving assistance under the Continence Aids Assistance Scheme immediately before 1 July 2010 is taken to participate in this Scheme from 1 July 2010 subject to complying with that section and, after 30 June 2011, meeting the eligibility criteria in this section.

(2) A person in any of the following categories is not eligible to participate in this Scheme: (a) (for the avoidance of doubt) people who suffer from transient, rather than permanent and severe, incontinence; (b) children under 5 years of age; (c) care recipients, under the Aged Care Act 1997: (i) whose classification level includes any of the following: (A) high ADL domain category; (B) high CHC domain category; (C) high behaviour category; (D) a medium domain category in at least 2 domains; (ii) who are receiving a home care package and the care recipient’s care plan includes continence aids;

Note: The following expressions are defined in the Classification Principles 2014

ADL domain
CHC domain
behaviour domain
domain
domain category

(ca) NDIS participants where an NDIS plan is in effect for the NDIS participant and the NDIS plan contains a statement specifying that reasonable and necessary supports (that include continence aids) will be funded under the National Disability Insurance Scheme;
(d) people eligible to receive assistance for continence aids under the Rehabilitation Appliances Program (or replacement program if the name of that program is changed) through the Department of Veterans’ Affairs;
(e) Australian citizens or permanent residents who have resided outside Australia for a continuous period of three years (including any periods of leave from the country in which that person resides);
(f) a person serving a prison sentence.

(3) For a person who: (a) is eligible to participate in this Scheme under subparagraph 4(1)(a)(iii); and (b) meets the other eligibility criteria for participation in this Scheme; and (c) applied to participate in this Scheme between 1 July 2010 and the commencement of the Continence Aids Payment Scheme Variation 2011 (No.2); the CAPS payment is the amount calculated in accordance with section 9 with effect from the date of application. (4) Subsection (3) applies, even if the person’s application was rejected, provided that the person would have been eligible to participate in this Scheme if subparagraph 4(1)(a)(iii) had been in effect at that time. (5) For the purposes of this section: