Richard Bruton (Dublin North Central, Fine Gael)
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Question 196: To ask the Tánaiste and Minister for Health and Children further to her reply to Parliamentary Question No. 198 of 4 April 2006, the way in which a refund can be obtained where a patient has been charged for extra services which are not permitted to be made under Article 16.1 of the Nursing Homes Subvention Regulations, by the nursing home management; if her Department or the Health Service Executive will take the necessary action for recovery of the costs involved on behalf of a patient who has been in receipt of nursing home subvention; and if she will make a statement on the matter. [20431/06]

Seán Power (Kildare South, Fianna Fail)
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Article 16.1 of the Nursing Homes (Subvention) Regulations 1993 provides that individuals resident in private nursing homes who are in receipt of a subvention from the Health Service Executive may not be charged extra for any service which is considered to be essential to their maintenance in the home and common practice in most nursing homes. Such services include bed and board, nursing care appropriate to the level of dependency of the person.

As the management and delivery of health and personal social services are the responsibility of the Health Service Executive under the Health Act 2004, the Department has requested the Parliamentary Affairs Division of the Executive to arrange to have this matter investigated and to have a reply issued directly to the Deputy.

Billy Timmins (Wicklow, Fine Gael)
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Question 197: To ask the Tánaiste and Minister for Health and Children the position in relation to the means assessment for the awarding of subvention for elderly people in nursing homes; if there has been a change in the assessment in relation to the patients homes under the value of €350,000; if the patient can still retain their house; if this will be assessed against them often resulting in the person having to sell the house in order to qualify for subvention; and if she will make a statement on the matter. [20447/06]

Seán Power (Kildare South, Fianna Fail)
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As the Deputy may be aware, the Health (Nursing Homes) Act 1990 and the Nursing Homes Regulations 1993 provide for the payment of subvention for private nursing home care for applicants who qualify on both medical and means grounds. General rules for the Assessment of Means in respect of an application for Nursing Home subvention are set out in the Second Schedule of the Nursing Homes Regulations 1993 and as amended by the 2005 Regulations.

Under the Regulations the Health Service Executive when considering an application for subvention carries out a means test which takes into account the means of the applicant and his or her spouse/cohabiting partner, where appropriate and the assets of the applicant. The means test is carried out by the Health Service Executive and involves looking at the applicant's income for the previous twelve months. Income from all sources is taken into account and is assessed net of PRSI, income tax and the health contribution and the income of a married or cohabiting person is taken to be half the total income of the couple. In assessing an applicant's assets the first €11,000 of such assets is disregarded. The HSE may refuse to pay a subvention if an applicant has assets exceeding €36,000, (excluding their principal residence).

In relation to the principal private residence of an applicant, the HSE, under the 1993 Nursing Home Regulations may impute an income of 5% of the estimated market value of the principal residence of an applicant for subvention, unless the residence is occupied by a spouse or son or daughter aged less than twenty one years or in full time education or in receipt of a social welfare pension/allowance as set out in the 2005 regulations and generally does so unless there are exceptional circumstances.

The HSE may refuse to pay a subvention if the value of the applicant's principal residence is in excess of €500,000 or more (where the residence is located in the Dublin area) or €300,000 or more (where the residence is located outside the Dublin area) and the residence is not occupied by a spouse, a son or daughter aged less than twenty one years or in full time education or a relative in receipt of a social welfare pension/allowance as set out in the 2005 regulations.

The recently published Health (Nursing Homes) (Amendment) Bill 2006 is designed to ensure that the existing subvention scheme for private nursing home care is grounded in primary legislation and to help the HSE to implement the scheme on a standardised basis across the country. It includes a provision to vary the 5% income imputation. I will be considering the issue of housing assets and long-term residential care following the enactment of this Bill and in the light of the report of the long-term care working group.