Willie Penrose (Westmeath, Labour)
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Question 238: To ask the Minister for Health and Children if people who have been in long stay mental health treatment units have been requested, to pay in a retrospective fashion charges, which have been imposed on them since July 2005; if she will take steps to only enforce same from a current date; and if she will make a statement on the matter. [8260/07]

Mary Harney (Dublin Mid West, Progressive Democrats)
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The Health (Amendment) Act 2005 and the Health (Charges for In-Patient Services) Regulations 2005 enabled the HSE to recommence the raising of charges for long stay in-patient services with effect from the 14th July 2005.

I understand from enquiries which have been made of the HSE that they established an Expert Group to develop a set of national guidelines to deal with the provisions of the legislation.

The Guidelines Expert Group's terms of reference were as follows:

Phase 1: to develop guidelines within a two week period, sufficient to meet the immediate requirements of the delivery system in implementing the regulations from the 14th of July 2005. These initial guidelines will support the establishment of a standardised approach across the delivery system in the assessment of charges to apply in each individual case.

Phase 2: to develop a more comprehensive set of guidelines in line with best practice, having considered legal opinion and its implications in relation to complex cases. Provision will also need to be made for appeals.

Phase 1 of the Group's work was completed on target by the 28th July 2005 and the guidelines issued to the system on the 2nd August 2005.

Phase 2 which was completed in June 2006, developed new National Guidelines which addressed the complex areas of community residences and related issues.

The guidelines which were developed, support a standardised approach to the implementation of Health (Charges for In-Patient) Regulations 2005 and take account of the persons residing in community residences. The system was instructed to implement the guidelines with effect from 1st August 2006 with retrospection back to 14th July 2005 where charges had not been raised while awaiting the guidelines. Clients in community residences were informed in July 2005 that they may be liable for charges under the new regulations.

In regard to retrospection, charges were to be raised with effect from the 1st August 2006 based on the financial assessment for each of the clients. Arrears of charges due from 14th July 2005 were to be calculated and advised to the client. The clients were to be given the following options:

1. Pay the arrears in full or in instalments

2. Deduct the arrears from any moneys due under the repayment scheme where applicable.

A Working Group on Rents and Charges in HSE Mental Health Services was established in December 2006. The purpose of this Working Group is to develop and recommend a process for the collection of rents and charges in accordance with the statutory provisions outlined in Section 43 (2) (a) of the Health Act 1970 was amended by the Health (Amendment) Act 2005, Health (Charges for In-Patient Services) Regulations 2005 S.I No 276 of 2005 specific to mental health services, that safeguards both the individual and the staff member and complies with financial probity and HSE governance requirements.

A specific recommendation has been made by the group:

Individuals who were in receipt of in-patient services (those persons with an intellectual, physical or mental disability, residing in community type residences where nursing or mental disability, residing in community type residence where nursing or medical care is provided) outlined in Section 2.1.1 and 2.1.2 above, from the commencement date of 14th July 2005 and any residents admitted after this date should immediately be assessed for charges (this is for instances where this has not already occurred due to lack of clarity on assessment procedures). This assessment should be backdated to 14th July 2005 as residents were made aware of their potential liability for charges at the time.

In cases where the residents do not have the ability to pay these charges in a lump sum, arrangements should be put in place whereby the amount due can be reclaimed by instalments at a nominal amount per week or deducted from monies claimed under the Repayment Scheme. Where payment is being made in instalments, the nominated officer should ensure that the additional amount agreed to on a weekly basis does not result in the resident being left a personal allowance of under €35/€55 per week.

To date the National Rents & Charges has met on four occasions and I understand a draft report with specific recommendations will be presented in the near future.