Makhanda (Grahamstown) residents and businesses have opened their hearts to donate food and other necessities to the McKaiser Old Age Home. The home, a residential facility for frail and elderly persons, currently provides 24 hour care to 22 residents from some of the poorest areas of Makhanda. McKaiser depends on a monthly subsidy from the Department of Social Development (DSD), but did not receive this subsidy for four months earlier this year. The organisation has warned the DSD of another Life Esidimeni and filed a complaint with the Human Rights Commission (SAHRC).
Beginning of November, calls were made on social media to assist McKaiser with food and other necessities as a result of delayed subsidy payments. The call for help claimed that staff had not been paid, and that the home could no longer afford private security services.
Jonathan Walton, Chairperson of McKaiser’s Governance Committee, told Grocott’s Mail that they didn’t receive their subsidy for four months. McKaiser is a registered non-profit organisation, and depends on this subsidy to function.
At the start of the current financial year, McKaiser waited patiently for their first month’s subsidy. The waiting continued until the end of July. Four months without their subsidy left McKaiser in dire straits, but this isn’t the first time these subsidies have been delayed.
“We told [staff]it’s an annual occurrence,” he said. “It’s nothing new. It’s been six years now that it’s been delayed by the department.” Walton confirmed that currently staff had been paid.
“[The DSD says] in the service level agreement, that [funding]commences on 1 April 2019, but they [hadn’t] paid us for April, May, June and July. So the money comes [at the]end of July; but there was no money at McKaiser to buy food, diapers, to pay the staff and the creditors for four months.
“When that money arrived into the account, that money was already committed to pay the accounts that were in arrears, the wages… that money was gone in a flash.”
National Departmental spokesperson, Abram Phahlamohlaka, said the department was aware of the delays, “which are due mainly to the introduction of new features on the IT system”.
“These new features were added to minimise payment risks and subsequently increase accounting and reporting efficiency,” he said.
McKaiser is still gratefully accepting donations of food and other items from the local community, and have had their monthly security services bill waived by Hi-Tec Security.
Stretching the Rand
“We are required in terms of the Older Persons Act, to look after those residents, that’s what the law says,” said Walton. “If you look at the funding they give us, we have 22 residents, and the subsidy is R2 000 per person per month.”
Walton said that this year’s subsidy was an increase from R1 700 in previous years.
“In other provinces, the subsidy is much higher,” he said.
Grocott’s Mail requested a provincial breakdown of subsidies for older persons in residential care facilities, but did not receive a response by the time of publication.
From this R2 000, according to DSD’s specifications, McKaiser must provide well-balanced nutritious meals for R900 per person, per month. According the StatsSA, the cost of food in South Africa increased by 3.9 percent in September.
“Then they say we must provide nursing care, personal hygiene, first aid, adult diapers and detergent for R100!” Walton emphasised.
The average price of one adult diaper ranges from R10-R15 depending on the brand, with a pack of about 10 going for R150. A staff member at McKaiser told Grocott’s Mail that one pack lasts one resident a maximum of two to three days.
“Then they have recreation: we must spend R200 on what they call active ageing and clothing. Lastly, from the same R2000 we must spend R800 on administration, which is stationery, subsistence and travelling and training our volunteer caregivers,” said Walton.
The subsidy does not fund infrastructure or maintenance to the facility, assets, medical services, salaries, or safety and security.
“They don’t even fund the salary for a professional nurse,” he said.
“It is not possible, given the funding they give, to comply with what the law prescribes. So what is needed is a complete review of the funding policy.”
A tough price to pay
“An older person is no longer a priority for the government, once you’re 60, 65, you’re no longer on the agenda of government. That’s the attitude they have,” said Walton.
“All matters related to older persons are guided by the provisions of the Older Persons Act. The Department of Social Development is the custodian of the Act,” said Phahlamohlaka. Information concerning further government action and engagement to improve the welfare of older persons was not provided.
“I warned this department,” said Walton. “I reminded them about the Life Esidimeni situation. I said to them, ‘If you mess around with NPOs, especially with older persons organisations, we’re heading that way because you are not considerate about the plight of the elderly.”
How it works
Each October, the DSD puts out a call for funding proposals from NPOs providing various activities and specialised services. Interested NPOs are required to submit a ‘business plan’ with information requested by the department by the first of November. This outlines how much funding the NPO is requesting based on their needs and the services they provide.
Should the NPO be successful in this process, the department issues an allocation letter and requests the NPO to sign what’s called a ‘service level agreement’ (SLA). The SLA binds the NPO to terms and conditions regarding the subsidy they ought to receive on a monthly or quarterly basis. The SLA and allocation letter do not specify as to when the subsidy will be paid to the NPO, it simply states “monthly” or “quarterly”. However, the SLA states that NPOs must submit claim forms and other documents (depending on what they do) before the subsidy is paid either monthly or quarterly.
NPOs are also provided with “Service Specifications”, which the SLA serves in relation to. These “Service Specifications” outline exactly how much money is allocated to each kind of NPO; how it should be spent, and what it should succeed in doing. Should NPOs fail to adhere to these “Service Specifications”, they can lose their subsidy.
For McKaiser; their subsidy falls into the category of “services to older persons” as a “residential care facility”, meaning that part of their “service specifications” is to provide 24/7 care to frail and elderly persons.
On top of providing 24/7 care, McKaiser must also provide care and support to persons with dementia and related diseases, rehabilitation, counselling and outreach programmes, sport and recreation services as well as training for volunteer caregivers.
For the past eight years McKaiser has applied for just over R1 million per financial year, but have only ever been allocated roughly half.
Human rights violations
After months of non-payment, Walton filed a complaint with the SAHRC mid-September of this year.
The complaint claims that during the last five to six years the DSD has failed to pay NPO subsidies on time, reaching four to five months without payment.
“For too long, NPOs have been undermined and even threatened if they criticised the department’s inabilities,” states the complaint. “We are now appealing to the SAHRC and Public Protector to urgently investigate the financing of NPOs and maladministration within the Department of Social Development. The constitutional rights of vulnerable persons who benefit from social welfare NPOs have been compromised for too long. NPOs cannot function without the basic necessities.”
The provincial department responded to Walton’s complaint, stating that the reason for the delay in payments was due to “internal challenges”. The department did not dispute the complaint.
On 12 June, Eastern Cape Head of Department, Ntombi Baart, issued a letter to the Provincial NPO Forum apologising to NPOs for the delay in payments. The NPO Forum is an extension of the DSD as a means to better communicate with NPOs; however, this letter never made its way to NPOs directly.
The letter states: “The Department had enhanced the NPO Payment System which had to undergo rigorous audit to ensure its efficiency and effectiveness.”
Baart called the subsequent delays “highly regrettable”, and said the department was working “tirelessly” to ensure payments by 29 June. However, McKaiser only received their payment by the end of July.
In 2015 the SAHRC released an investigative report on the treatment of older persons. Submissions to the report included complaints of delayed payment of subsidies, as well as the inability for residential care facilities to meet the requirements set out in the Older Persons Act with respect to the allocated subsidies.
Recommendations in the report included that the DSD provide a circular ensuring uniformity in funding of services to older persons in all provinces within six months of the report. “This circular should prioritise issues of safety, staffing, nutrition, medicals,” the report stated.
Other recommendations pertained to the budget, calling for the Department to “ringfence” funding for residential facilities, “to ensure that they comply with health and safety standards in the Older Persons Act and National Building and Occupational Health and Safety Regulations”.
Another recommendation urged the DSD to give consideration to a 10 percent inflation increase in respect to key line budget items.
Phahlamohlaka told Grocott’s Mail that NPOs were funded from the provincial equitable share budget.
“The National Department is working jointly with provincial departments on an ongoing basis to address gaps identified by the [SAHRC]. The National Department meets on a quarterly basis with provinces through the Welfare Forum,” he said.
The National DSD did not respond as to how these recommendations had been implemented by the time of publication.