Mr. Patrick O'Sullivan:

The Senator made a number of points, the first of which related to people under 65 who are in nursing homes. The Ombudsman's Wasted Lives report was published and the Department of Health and the HSE are working to address the challenges in that area. They are complex. An integrated steering committee and a stakeholder reference group are in place. We sit on the stakeholder reference group and assist the Department and HSE in whatever way we can. Looking at our engagement with health, more than 1,200 individuals under 65 are resident in nursing homes. That is a significant challenge. It is because of their complex needs. For those who have to remain in nursing homes in the short to medium term, the nursing homes work on improving quality of life to the degree possible but the focus is on moving them to a step-down facility or to living in the community with a high level of support. The Department of Health will invest €5.5 million in the next two years to deliver, enhance and transition people under 65. Up to January or February 2023, 28 people had already transitioned. I think the target is for more than 63 people. In the context of the overall numbers, those targets could be higher.

The Senator highlighted the key challenge disabled people face is in the context of home supports and getting personal assistant support packages and the funding for that. In the context of the housing crisis, the HSE is challenged in the market in finding appropriate properties for step-down accommodation or for living as independently as possible in the community with the appropriate supports. The important thing is that structures and investment are in place. It will be an ongoing challenge. There is no doubt about it. We will assist as much as possible. It requires a strong whole-of-government focus. As the Senator mentioned, one in four is a high proportion of people who are homeless. They are challenged with mental health challenges which increases homelessness in the disability sector. We work directly with the Department of Health in the context of Sharing the Vision. Its strategy and ours both include the goal of delivering a better protocol under which the local authority co-ordinators and the HSE at local level are strongly engaged in ensuring they provide a clear pathway to housing for people who have mental health challenges. A national quality standards framework for homelessness services was developed by the Dublin Regional Homeless Executive. It is in operation for emergency accommodation. Revised guidelines were also developed by the Department in the context of new emergency accommodation. It is important to take into account the reality of being homeless with a disability. Under the guidelines, where existing configurations in buildings allow, measures must be considered for the needs of the homeless individual when they have to remain in emergency accommodation in the short term. The Senator made a point about disabled people being asked what needs package they have in place when they go to the local authority housing officer. It is critically important that the housing officer and the local authority are obliged to assess housing applications in the absence of any need. They will look at the application and assess whether disabled people are eligible for housing, so they can be placed on the housing list. Then it is looked at and the engagement happens with the HSE co-ordinators and the local authority who build the care and support packages for the eligible person around that. As I mentioned earlier and I think the Senator recognised, the allocations are demonstrating that people with disabilities are being allocated housing. They accounted for 15% of allocations last year which is a significant and fair share of the housing allocations.

As regards the crisis, yes we have a crisis. The terms "crisis" and "emergency" could be used in the same sentence. The important thing is that the whole-of-government approach that is in place, working with the HSE and the Department of Health and now the Department of Children, Equality, Disability, Integration and Youth and its disability unit. We are working closely together, not only from a housing perspective but also to provide complex and integrated supports. Ultimately, as the Senator is aware, the care package and the demands will increase and become more complex depending on the level of disability. The funding is certainly there for housing. In the context of Housing for All, more than €4 billion is invested annually so the crisis is not a question of funding. We have the right proportional-----