Dr. Kathleen MacLellan:

I will respond to a few questions and we may have to come back to the committee on those questions we cannot answer. At the time of the introduction of the nursing homes support scheme and the Act, a decision was taken not to exclude those under the age of 65 to ensure there would not be discrimination in terms of access to the scheme. Different funding mechanisms are currently being utilised with respect to those who are under the age of 65 in nursing homes. Specifically the HSE has agreed in its mapping exercise to do an assessment of the different funding schemes being used. That will help us to create a concrete pathway to how we might manage the funding in the future. Regarding funding, more than €4 million is being provided for decongregation of 144 people from disability congregated settings. The Minister of State, Deputy Rabbitte, is passionate and clear in her direction on the importance of accelerating the moving of those who are aged under 65 in nursing homes. The Department and the HSE are taking that seriously with respect to the establishment of the steering committee and the action plan.

In terms of pathways, what we will learn from the demonstrator project regarding the newer rehab strategy is critically important to create a number of pathways for those individuals who are coming to access our disability services in other ways. I am referring to those who were not born with a disability or those who acquire a disability throughout their lifetime. It is important we build those pathways whether through the intensive home care packages, the newer rehab strategy, our home care services or our personal assistant, PA, supports. We are conscious of the need to build all those supports across the whole set of care. As we identified earlier, it is important this is person-centred care and individualised for those people in order that we can support their will and preference inasmuch as possible in the types of supports that will provide for those people having meaningful lives. We have found within the decongregation programme from disability settings it is important to take the necessary time and have a number of meetings with the individuals to give them the opportunity to talk through and outline their will and preference in that way and then the HSE can work through the types of support or package that would be helpful to them. I am not sure if I have missed any questions and I apologise if I have.